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    Acute respiratory İnsufficiency due to peripartum cardiomyopathy after caesarean section in a term pregnancy with twins
    (2010) Demiraran, Yavuz; İskender, Abdülkadir; Ersoy, Özlem; Albayrak, Mustafa; Kaynak, Gürsel
    İkiz gebeliği olan ve postoperatif dönemde kardiyomiyopatiye bağlı akut solunum yetmezliği gelişen bir olgu sunulmuştur. Bizim olgumuzda, 30 yaşında 32 haftalık ikiz gebeliği olan kadın hasta preterm membran rüptürü nedeniyle Kadın Hastalıkları ve Doğum kliniğine yatırıldı. Tokolizden 48 saat sonra genel anestezi altında hasta operasyona alındı. Uyandırma döneminde SpO2 %32 saptanan hastada taşikardi ve takipne gelişti. Oskültasyonda her iki akciğer alt zonda krepitan raller tespit edildi. Hasta pozitif basınçlı ventilasyona rağmen oksijen satürasyon yüzdesinin düşük seyretmesi ve siyanozunun devam etmesi nedeniyle, Yoğun Bakım Ünitesi’ne entübe halde alındı. Çekilen akciğer grafisinde, her iki akciğer alt loblarında pulmoner infiltratlar ve kalp gölgesinin genişlemiş olduğu tespit edildi. Ekokardiyografik incelemesinde ejeksiyon fraksiyonu %45, sol ventrikül sistolik disfonksiyonu, sol ventrikül boyutlarında artma, orta mitral kapak yetmezliği ve hafif triküspit kapak yetmezliği saptanan hastada, bu tabloyu açıklayacak anemi dışında bulgu saptanmadı. Peripartum kalp yetmezliği tanısı konan hastaya lisinopril ve furosemid başlandı. Postoperatif 4. günde hasta mekanik ventilatörden ayrıldı, postoperatif 7. günde taburcu edildi.
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    Alterations in placental pendrin expression in pre-eclampsia
    (Informa Healthcare, 2014) Karataş, Ahmet; Erdem, Havva; Albayrak, Mustafa; Oktay, Murat; Özlü, Tülay; Çakmak, Bülent; Dönmez, Melahat Emine
    Introduction: Pendrin is an integral membrane protein and plays a key role in extracellular fluid volume and blood pressure control. We aimed to investigate the relationship between pendrin immunostaining intensity in normal and pre-eclamptic placental tissue. Methods: Fifty-six placental tissues, of which 26 were in pre-eclamptic, and 30 were in control group were evaluated by immunohistochemical staining. Positive immunostaining was evaluated using a semiquantitative score: 0, negative; +, mild; ++, moderate; and +++, intense. Results: There was more positive immunstaining in the pre-eclamptic placenta compared to the controls (p<0.001). A significant positive correlation was observed between immunostaining level and diastolic blood pressure (r = 0.533, p = 0.005) in the pre-eclamptic group. However, no significant correlation was observed between any condition and immunostaining level in the control group. Conclusions: Placentas in the pre-eclamptic group were significantly more immunostained with pendrin than were those in the control group. In addition, a positive correlation between immunostaining intensity with pendrin and both systolic and diastolic blood pressure were observed. Pendrin may play a role in the mechanism of severe hypertension in women with pre-eclampsia.
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    Are insulin resistance and serum resistin levels increased in women with idiopathic hirsutism?
    (Verduci Publisher, 2014) Erkan, Müşerref; Albayrak, Mustafa; Karataş, Ahmet; Keskin, Fatih; Aydın, Yusuf; Ak, H.Y.; Bıyık, İsmail
    OBJECTIVE: To investigate the insulin resistance and serum resistin levels in women with idiopathic hirsutism compared to controls and women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: Three groups of women including 23 women with idiopathic hirsutism, 28 women with PCOS and 28 non-hirsute women serving as controls were included into the study. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), serum fasting insulin and resistin levels were compared between the groups. RESULTS: There were no statistically significant differences regarding the age, BMI and waist circumferences between the groups. Mean and median fasting blood glucose, fasting insulin, HOMA-IR, serum resistin levels were statistically similar between the groups (p = 0.966, p = 0.378, p = 0.409 and p = 0.784, respectively). There were no correlations between the resistin, HOMA-IR, fasting insulin levels and BMI in any of the three groups. CONCLUSIONS: Insulin resistance and serum resistin levels do not appear to be increased in women with idiopathic hirsutism compared to controls at similar BMI's and waist circumferences.
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    Atypical preeclampsia and eclampsia: Report of four cases and review of the literature
    (2010) Albayrak, Mustafa; Özdemir, İsmail; Demiraran, Yavuz; Dikici, Süber
    Klinik olarak preeklampsi (hipertansiyon ve proteinüri) geliştiren çoğu kadında bulgular 20 gebelik haftasından postpartum 48 saate kadar ortaya çıkar ve bu özellikle diğer yönlerden sağlıklı nullipar gebelerde böyledir. Son bazı çalışmalarda preeklampsi ve hatta eklampsinin hipertansiyon ve proteinüri olmadan gelişebileceği gösterilmiştir. Burda biz dört atipik vaka takdim ettik: proteinüri ve hipertansiyon olmadan eklampsi (olgu 1), hipertansiyon olmaksızın proteinüriyi takip eden parsiyel eklampsi nöbeti (olgu 2), fetal distresle gelen ancak hipertansiyon olmayan bir vaka (olgu 3) ve hızlı gelişen tedaviye yanıt vermeyen masif proteinüri vakası (olgu 4). Atipik eklampsideki problem tahmin edilemeyen ortaya çıkışıdır, o nedenle zamanında tanı ve müdahale komplikasyonları engellemek için elzemdir. Bu yazının amacı gebelikteki atipik hipertansif durumlar hakkındaki bilinci arttırmaktır.
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    Atypical preeclampsia and eclampsia: Report of four cases and review of the literature
    (2010) Albayrak, Mustafa; Özdemir, İsmail; Demiraran, Yavuz; Dikici, Süber
    Classically,most women who develop preeclampsia (hypertension and proteinuria) present some time after 20 weeks of gestation up to 48 h postpartum;and this is especially true in otherwise healthy,nulliparous pregnancies.Recent data suggest that in some women,preeclampsia and even eclampsia may develop in the absence of hypertension or proteinuria.Here,we report four atypical cases:Eclampsia in the absence of hypertension and proteinuria(case1),a partial seizure following eclampsia with antecedent proteinuria, but no hypertension(case2),a case presenting with fetal distress,but no hypertension(case3),and a case with unusually rapid progression and massive proteinuria that was unresponsive to therapy(case4).Problems with atypical forms of eclampsia lie in its unpredictable onset;Timely diagnosis and management are critical in avoiding complications.The purpose of this review is to increase he awareness of atypical forms of hypertensive disorders during pregnancy.
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    Bilateral Tubal Faktör Nedenli Yardımla Üreme Tedavisi Uygulanan İki Kadında Endometriyum Tüberkülozu Tanısı: Olgu Sunumu
    (2012) Şahin, Levent; Albayrak, Mustafa; Çelik, Ebru; Özkan, Zehra Sema; Artaş, Gökhan; Aygün, Banu Kumbak
    Genital tüberküloz (tbc) kadın infertilitesinin önemli bir nedeni olup son yıllarda primer ve sekonder infertilite bulunan olgularda daha sık tanınmaya başlamıştır. Bu yazıda tubal faktör infertilitesi olan ve daha önce birçok kez yardımla üreme tedavisi uygulanan iki hastada saptanan endometriyal tbc olgusu bildirilmiştir. Tubal faktör infertilitesi nedeniyle yardımcı üreme tedavileri uygulanmasına rağmen gebelik elde edilemeyen iki olgu implantasyon başarısızlığınının araştırılması için laparoskopi ve histeroskopi ile değerlendirilmiştir. Yardımla üreme tedavilerinde tekrarlayan başarısızlık görülen iki hastaya ofis histeroskopi uygulanmış ve işlem esnasında alınan endometrial örneklerin histopatolojik incelemesi granulomatöz endometrit olarak sonuçlanmıştır. Olguların birinde endometrial doku kültüründe Mycobacterium tuberculosis üremesi gözlenmiştir. Her iki olguya da tüberküloza yönelik tedavi başlanmıştır. :Bilateral tubal faktörü olan olgularda genital tbc ayırıcı tanıda düşünülebilir. Böylesi olgularda endometrial kavite değerlendirilmeli ve histopatolojik inceleme için endometrial örnek alınmalıdır.
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    Can anti-adhesive efficacy of sodium hyaluronate and carboxymethylcellulose membrane be improved further by colchicine and collagenase?
    (Duzce University Medical School, 2011) Sarohan, Aziz Rodan; Albayrak, Mustafa; Somunkıran, Aslı; Özdemir, İsmail; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Demiraran, Yavuz
    Aim: The aim of this study was to determine the impact of collagenase and colchicine in the prevention of postsurgical adhesion formation in a rat uterine horn model. Materials and Methods: Forty female Wistar albino rats were divided into four equal groups including controls, seprafilm, colchicine-seprafilm and collagenase-seprafilm groups. After laparotomy, a standard 0.5-cm injury was made to the antimesosalpingeal side of the right proximal uterine horn by unipolar cautery. After hemostasis, 0.5 cm seprafilm or colchicine 2 mg-0.5 cm seprafilm or collagenase 1?g - 0.5 cm seprafilm was applied to the site of injury. The abdominal incision was then sutured en bloc and the rats were observed for 20 days. Then, all rats were sacrified and second look laparotomy was performed. Macroscopic adhesion score of each rat was noted and histopathologic scoring was made according to Kanbour-Shakir criteria. Results: All of the five scores of the histologic parameters were lowest in the colchicineseprafilm group. The total histologic score of colchicine-seprafilm group was significantly lower than controls, seprafilm and collagenase-seprafilm groups (p<0.05). Conclusions: The results of this rat model suggested that local use of colchicines in the abdominal operations prevents formation of postsurgical adhesions based on both visual assessment and histological analyses. The promising result obtained from this experimental study needs further investigation. © 2011 Düzce Medical Journal.
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    Can anti–adhesive efficacy of sodium hyaluronate and carboxymethylcellulose membrane be improved further by colchicine and collagenase?
    (2011) Sarohan, Aziz Rodan; Albayrak, Mustafa; Somunkıran, Aslı; Özdemir, İsmail; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Demiraran, Yavuz
    Amaç: Cerrahi sonrası intraperitoneal adezyonların oluşumunu önlemede kollajenaz ve kolşisinin etkinliklerini deneysel hayvan modelinde histopatolojik değerlendirme ile araştırmaktır. Gereç ve Yöntem: Çalışmada 40 adet dişi Wistar Albino cinsi rat kullanıldı. Ratlar, kontrol, seprafilm, kolşisin-seprafilm, kollajenaz-seprafilm olmak üzere dört gruba ayrıldı. Laparotomi ile sağ proksimal uterin horn antimezosalpingeal yüzde bisturi aracılığı ile 0.5 cm’lik bir kesi oluşturuldu. Takiben kesi üstüne deneklerin grubuna uygun olarak 0.5 cm’lik Seprafilm; 2 mg Kolşisin emdirilmiş 0.5 cm’lik Seprafilm; 1?g kollajenaz emdirilmiş 0.5 cm’lik Seprafilm yerleştirilerek batın kapatıldı. Kontrol grubuna herhangi bir ajan uygulanmadı. Ratlar 20 gün sonra sakrifiye edilerek makroskopik ve histopatolojik değerlendirmeleri yapıldı. Histopatolojik inceleme Kanbour-Shakir kriterlerine göre yapıldı. Bulgular: Histopatolojik olarak değerlendirilen beş parametrenin toplamı ile elde edilen histolojik toplam skorun kolşisin-seprafilm grubunda en düşük olduğu görüldü. Kolşisinseprafilm grubunun total histolojik skoru ile kontrol, seprafilm ve kollajenaz-seprafilm gruplarının ortalama histolojik skorları arasında istatistiksel olarak anlamlı ölçüde farklılık bulundu (p0.05). Sonuç: Batın içi operasyonlarda kolşisinin uzun süre lokal olarak etki etmesini sağlayacak bir metod ile kullanımı, cerrahi sonrası adezyon oluşumunu hem makroskopik hem de histolojik olarak azaltmaktadır. Bu deneysel çalışmadan elde edilen umut verici sonuçların araştırılacağı daha geniş kapsamlı çalışmalara ihtiyaç vardır.
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    Can maternal height predict shorter cervical length in asymptomatic low-risk pregnant women?
    (Elsevier Science Bv, 2011) Albayrak, Mustafa; Özdemir, İsmail; Koç, Önder; Coşkun, Esra
    Objective: To evaluate the association between maternal height and cervical length in the first and second trimesters in low-risk asymptomatic pregnant women. Study design: Maternal height and cervical length of 146 asymptomatic women with singleton pregnancies at low risk for preterm birth were measured during the first and second trimesters. Preterm birth was defined as birth before <37 gestational weeks. Correlations between maternal height and cervical length measurements were determined using Pearson correlation analysis. The women were also divided into three groups based on height percentiles: <25% (Group I), 25-75% (Group II) and >75% (Group III). Cervical lengths were compared among groups. Correlations between cervical length and maternal height and statistically significant differences in cervical length among height percentile groups were the main outcomes. Results: Maternal height was positively but weakly correlated with first and second trimester cervical lengths (p = 0.047, r = 0.167 and p = 0.039, r = 0.197 respectively). The mean first trimester cervical lengths were significantly different between the groups (p = 0.04). There were no significant differences, however, in the mean second trimester cervical lengths among the three groups although the difference was close to significance (p = 0.06). Conclusion: Although our results indicate a relationship between maternal height and cervical length in our population, maternal height seems to have only limited value in identifying women to be screened for shorter cervical length in a low risk asymptomatic population. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Comparison of Ectopic Pregnancy Treatment Modalities: Experience from a Tertiary Center
    (Kuwait Medical Assoc, 2013) Albayrak, Mustafa; Karataş, Ahmet; Bıyık, İsmail; Keskin, Fatih
    Objectives: To review and analyze the outcomes of various treatment modalities in women with ectopic pregnancy (EP) in a tertiary center between January 2006 and February 2011 Design: Retrospective study Setting: Duzce University Hospital, Turkey Subjects and Methods: The medical records of 116 women diagnosed with EP were reviewed retrospectively. Women were grouped based on the treatment modality: Expectant (Group I), Medical treatment with methotrexate (Group II) and Surgical (salpingostomy and salpingectomy) (Group III). Demographic characteristics were analyzed and the success rates between the groups were compared. Intervention: None Main Outcome Measures: Success rates between groups based on treatment modality Results: Success rates for expectant, medical management with single dose of methotrexate, salpingostomy and salpingectomy were 66.7%, 79%, 92.7% and 100%, respectively. There was no difference between the success rates of laparoscopic salpingostomy and single dose methotrexate (p = 0.246). Salpingectomy was more successful compared to expectant and medical managements (p = 0.003 and p = 0.040, respectively). Conclusion: The highest success rate in EP was achieved by surgical treatment. However, expectant and medical treatment may eliminate the need for surgery in selected cases with low and / or decreasing initial beta-hCG levels.
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    Comparison of maternal serum and umbilical cord concentrations of nitric oxide and asymmetric-dimethyl-arginine in pre-eclamptic and uncomplicated pregnancies
    (2013) Albayrak, Mustafa; Öncül, Mahmut; Uludağ, Seyfettin; Uzun, Hafize; Benian, Ali; Güralp, Onur; Madazlı, Rıza
    The aim of this study was to compare maternal serum and umbilical cord levels of asymmetric-dimethyl-arginine (ADMA) and nitric oxide (NO) in pre-eclamptic and non-pre-eclamptic women and the possible effects of ADMA and NO on fetal outcome. Mean umbilical cord and maternal serum NO and ADMA levels of 29 women with preeclampsia (PE) and 24 randomly selected healthy pregnant women were compared. Maternal venous blood samples were collected before delivery and umbilical cord venous blood samples were obtained after delivery. Birth weight, apgar score, cord blood pH, duration of stay in the neonatal intensive care unit (NICU), and maternal and neonatal complications were recorded. Umbilical cord ADMA and maternal NO levels were significantly higher in women with pre-eclampsia compared to women without pre-eclampsia. There were no significant differences between means of maternal serum ADMA levels and cord blood NO levels in women with and without pre-eclampsia. Maternal and cord serum NO and ADMA levels in the pre-eclampsia group did not show a significant correlation with cord blood pH, umbilical artery pulsatility index (PI). In conclusion, umbilical cord ADMA and maternal NO levels were significantly higher in women with pre-eclampsia compared to women without pre-eclampsia. © 2013 OMU.
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    Comparison of the diagnostic efficacy of the two rapid bedside immunoassays and combined clinical conventional diagnosis in prelabour rupture of membranes
    (Elsevier Science Bv, 2011) Albayrak, Mustafa; Özdemir, İsmail; Koç, Önder; Ankaralı, Handan; Özen, Orhan
    Objective: Diagnosis of prelabour rupture of membranes (PROM) may be challenging. Conventional diagnostic methods such as speculum examination, ferning pattern, and pH detection are not satisfactorily accurate. Two relatively new, commercially available rapid bedside immunoassay strip tests, for placental alpha microglobulin-1 (PAMG-1) and insulin-like growth factor binding protein-1 (ILGFBP-1), are alleged to be more accurate. We compared the diagnostic efficacy of PAMG-1 and ILGFBP-1 immunoassay tests and combined conventional clinical diagnostic methods in PROM. Study design: 167 pregnant women with signs and/or symptoms of PROM were prospectively evaluated with a combination of conventional clinical tests including speculum examination, nitrazine, ferning pattern, and pooling, in addition to PAMG-1 and ILGFBP-1 immunoassays. Differences in sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the diagnostic methods were compared. Results: Although the PAMG-1 assay was more accurate, the PAMG-1 immunoassay, ILGFBP-1 immunoassay, and combined conventional clinical diagnosis were, in fact, all highly accurate with no significant difference in sensitivity, specificity, PPV, NPV, or accuracy. Conclusion: Both rapid bedside strip tests may be used in clinical practice with similar efficacy in diagnosing PROM, particularly as a backup when diagnosis is still in doubt following a combination of conventional diagnostic methods. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Deliberate Posterior Low Transverse Incision at Cesarean Section of a Gravid Uterus in 180 degrees of Torsion A Case Report
    (Sci Printers & Publ Inc, 2011) Albayrak, Mustafa; Benian, Ali; Özdemir, İsmail; Demiraran, Yavuz; Güralp, Onur
    BACKGROUND: Torsion of the term gravid uterus is a rare, potentially serious, unexpected obstetric pathology and is almost always diagnosed at cesarean section. We report a case of deliberate posterior low transverse segment hysterotomy in irreducible uterine torsion at 41 weeks' gestation. CASE: A 29-year-old nullipara with a 15-cm uterine fibroid was admitted at 41 weeks' gestation with regular uterine contractions. Cesarean delivery was carried out for obstructed labor. Intraoperatively, 180 degrees levotorsion of the uterus was diagnosed. Following unsuccessful attempts at detorsioning the uterus, a posterior low transverse hysterotomy was performed for delivery. CONCLUSION: Delivery by a posterior low transverse hysterotomy may be feasible in uterine torsion after unsuccessful attempts at detorsioning the uterus during cesarean section at term. (J Reprod Med 2011;56:181-183)
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    Effect of anesthesiological strategies on neonatal bilirubin levels during cesarean section: a prospective and randomized trial
    (Springer Heidelberg, 2011) Demiraran, Yavuz; Albayrak, Mustafa; Şeker, İlknur Suidiye; Kaynak, Gürsel; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Özdemir, İsmail
    Purpose Neonatal jaundice, a frequent problem in neonatology, can be influenced by many factors. Here, we sought to clarify the role of anesthesia and to compare the effects of various anesthesiological strategies on neonatal bilirubin levels during cesarean section. Methods We prospectively enrolled 167 ASA I-II status uncomplicated pregnant women who delivered by cesarean section as the study group. The patients were randomized based on anesthesiological strategy: inhalation (IA), spinal (SA), total intravenous (TIVA), and epidural anesthesia (EA) groups. Neonatal total (TB) and direct bilirubin (DB) levels at the 24th hour and 5th day of life and the need for phototherapy were compared between the groups. Results Direct bilirubin levels at 24th hour of SA group and EA group were higher compared to IA group (p = 0.008). When DB levels at fifth day were compared, levels in group TIVA were significantly higher than group SA (p = 0.019). TB levels at fifth day in group TIVA were higher than SA and EA groups (p = 0.05). The percentage of newborns needing phototherapy did not differ significantly among groups, but was highest in the TIVA group (25%), followed by the IA (15%), EA (10%) and SA (7%) groups (p = 0.08). Conclusions EA and SA at cesarean section seem to be better among the four anesthesia techniques considering neonatal hyperbilirubinemia. Our findings are consistent with the idea that anesthesia may be a risk factor for hyperbilirubinemia. Although anesthesia may not significantly increase the need for interventions such as phototherapy, it may increase the burden of time, labor and cost.
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    Effect of combined oral contraceptive use on platelet volume in women at reproductive age
    (I R O G Canada, Inc, 2012) Bulur, Serkan; Albayrak, Mustafa; Bulur, S.; Keskin, Fatih; Köse, Seyit Ali; Aslantaş, Yusuf; Özhan, Hakan
    Investigation: Combined oral contraceptives use is associated with an increased risk of developing venous and arterial thromboembolic events. Platelet size, measured as mean platelet volume (MPV), is associated with platelet reactivity. Methods: Ninety-five women using oral contraceptives for contraception were investigated retrospectively. The patients' blood pressure, pulse and hematological values at application and at the sixth month were evaluated retrospectively. Results: There was no difference between the values of blood pressure (systolic and diastolic), pulse, hematological values (which contain leukocytes, platelets and mean platelet volume) at application and at the sixth month. Conclusion: We determined that using oral contraceptives for contraception did not change MPV values in young women.
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    Effects of Hormone Replacement Therapy on Plasma and Tissue Fibrinolytic Activity in a Rat Model of Surgically Induced Menopause
    (Canadian Soc Clinical Investigation, 2014) Topçuoğlu, Ata; Albayrak, Mustafa; Erman, Hayriye; Balcı, Huriye; Karakuş, Mesut; Çoban, İlker; Uzun, Hafize
    Purpose: The purpose of this study was to analyze the effects of estrogen deficiency and hormone replacement therapy (HRT) on fibrinolytic activity in a rat mode of surgically induced menopause. Methods: Twelve-week-old, sexually mature female Sprague-Dawley rats, each weighing 200-250 g, were randomly divided into four groups: (1) sham- operated group, (2) ovariectomy group, (3) ovariectomy group followed by oral administration of daily 17 beta-estradiol (0.02 mg/kg/day) (E2) + norethisterone acetate (0.01 mg/kg/day), and (4) ovariectomy group followed by oral administration of daily 17 beta-estradiol (0.01 mg/kg/day) + drospirenone (0.02 mg/kg/day). Tissue plasminogen activator (tPA) antigen, plasminogen activator inhibitor-1 (PAI- 1) antigen, and PAI-1/tPA levels were measured as markers of fibrinolysis in plasma and liver and brain tissue. Results: Compared with sham-operated rats, ovariectomized rats showed higher levels of fibrinolytic activity; however, the increased fibrinolytic activity in plasma and liver tissue was significantly reduced by HRT regimens. No change was observed in the levels of fi brinolytic activity in brain tissue. Conclusions: HRT showed beneficial effects by decreasing fibrinolytic activity related to surgically induced menopause. Short-term HRT treatment was associated with a shift in the procoagulant-anticoagulant balance toward a procoagulant state.
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    Effects of hormone replacement therapy on plasma and tissue fibrinolytic activity in a rat model of surgically induced menopause [conferenceObject]
    (Wiley-Blackwell, 2014) Topçuoğlu, Ata; Albayrak, Mustafa; Erman, Hayriye; Balcı, Huriye; Karakuş, Mesut; Çoban, İlker; Uzun, Hafize
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    Evaluation of chromosomal abnormalities and common trombophilic mutations in cases with recurrent miscarriage
    (Makerere Univ, Fac Med, 2014) Karataş, Ahmet; Eröz, Recep; Albayrak, Mustafa; Özlü, Tülay; Çakmak, Bülent; Keskin, Fatih
    Background: Recurrent miscarriage (RM) is a frequent obstetric problem. Its' pathophysiology is poorly understood. Infections, genetic, endocrine, anatomic and immunologic problems have been suggested as causes for RM. Objective: To evaluate the frequency of chromosomal abnormalities and 3 common thrombophilic mutations in couples with RM. Methods: A retrospective data collection was performed for the results of the cytogenetic analysis of the couples and Methylenetetrahydrofolate Reductase (MTHFR) C677T, Factor V Leiden (FVL) G1691A and Prothrombin (PTm) G20210A mutations of the mother in 142 couples suffering from RM. Results: Prevalence of FVL, MTHFR, and PTm gene mutations were similar between cases shaving 2 or >= 3 abortions (P=0.528; P=0.233; P=0.375). In patients with FVL, MTHFR and PTm gene mutations, the OR's of having >= 3 abortions when compared to having 2 abortions were 1.515 (95% CI: 0.414-5.552), 0.573 (95% CI: 0.228-1.441), and 2.848 (95% CI: 0.355-22.871). All cases with PTm mutation had >= 3 abortions and all abortions occurred between 6-8 gestational weeks. Conclusion: Chromosomal abnormalities and thrombophilic mutations (especially PTm) seem to have an important role in RM. Additional larger studies involving investigation of more genes that may have a role in pregnancy are needed to assess this association.
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    Geç Preterm Doğum Olgularında Erken Neonatal Sonuçlar
    (2013) Karataş, Ahmet; Albayrak, Mustafa; Keskin, Fatih; Bıyık, İsmail; Okur, Mesut; Güneş, Cemalettin; Köse, Seyit Ali
    Amaç: Preterm doğumlar son zamanlarda birçok ülkede artış göstermiştir. Fetal akciğerin gelişmiş olmasına rağmen, 34. gebelik haftasından sonra bile ciddi yenidoğan morbiditesi meydana gelebilir. Bu çalışmanın amacı, geç preterm doğum olgularında neonatal morbidite ve mortaliteyi araştırmaktır. Planlama: Retrospektif Ortam: Düzce Üniversitesi Tıp Fakültesi, Kadın Hastalıkları-Doğum ve Pediatri Kliniği Hastalar: 340/7-366/7 gebelik haftasında doğum yapan 291 gebe kadın ve yenidoğanlar incelendi. Girişim: Çalışmaya dahil edilen olgular PPROM varlığı ya da yokluğuna göre öncelikle iki gruba ayrıldı. Daha sonra gruplar, tekrar gebelik haftasına göre kendi içlerinde, 340/7-346/7 hafta olanlar(grup 1),350/7-356/7 hafta olanlar (grup 2), 360/7-366/7 hafta olanlar(grup 3) şeklinde üçe ayrıldı. Değerlendirme parametreleri: Gruplar prematürite ve erken membran rüptürü ile ilişkili yenidoğan komplikasyonları açısından karşılaştırıldı. Sonuç: Çalışmaya dahil edilen ikiyüz doksanbir olgunun 85'i PPROM nedeniyle erken doğum yapmıştı. 206'sı PPROM olmayan gruptaydı ve 76'sı 1. grup, 108'i 2. grup, 107'si de 3. grupta yer aldı. Sepsis oranı, birinci ve ikinci grupta üçüncü gruba göre daha yüksekti (p:0.016, p:0.029). Yenidoğan yoğunbakım ünitesinde (YDYB) kalış süresi 3. gruba oranla, 1. ve 2. grupta daha yüksekti (sırasıyla p:0.028, p:0.015). Birinci gruptaki yenidoğanlar, üçüncü gruptakilere göre anlamlı olarak daha uzun hastanede kalış süresine sahipti (p0.010), ve toplam hastanede kalış süresi sepsisli yenidoğanlarda anlamlı olarak daha yüksekti. Yorum: Özellikle daha erken gebelik haftalarında olan geç preterm yenidoğanlar, yenidoğan komplikasyonları için anlamlı olarak daha fazla risklidirler, aynı zamanda anlamlı olarak yenidoğan yoğun bakım ve hastanede daha uzun kalış süresine sahiptir.
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    Ghrelin, acylated ghrelin, leptin and PYY-3 levels in hyperemesis gravidarum
    (Taylor & Francis Ltd, 2013) Albayrak, Mustafa; Karataş, Ahmet; Demiraran, Yavuz; Erman, Hayriye; Topuz, Seren; Bıyık, İsmail; Erkan, Müşerref
    Objective: To assess the serum levels of gut and adipocyte-derived metabolic hormones that control appetite, adipocity, weight gain and energy hemostasis, namely total ghrelin (TG), acylated ghrelin (AG), leptin and PYY-3 in hyperemesis gravidarum (HG). Methods: Plasma samples of 86 women in their first trimester pregnancies with HG (n = 30), morning sickness of pregnancy (MSP) (n = 34) and control (n = 22) groups were obtained. Serum levels of TG, AG, leptin and PYY-3 were compared between the groups, and the correlations with severity of symptoms using modified PUQE (Pregnancy Unique Quantification of Emesis) scoring, BMI, E2, hCG and TSH were calculated. Results: Levels of TG, AG, PYY-3 and the TG/leptin ratio were significantly higher in HG group compared to MSP and the control groups (p <= 0.017). AG/TG ratio was significantly lower in the HG group compared to both MSP and control groups (p <= 0.017). There were either weak or no significant statistical correlations between the gut and adipose-related hormones and the modified PUQE scores, BMI, E2, hCG and TSH. Conclusion: Gut-derived metabolic hormones ghrelin, AG and PYY-3 may be involved in the HG pathophysiology.