Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
1.
Metab Syndr Relat Disord ; 14(1): 33-9, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26569122

ABSTRACT

BACKGROUND: Our aim was to assess serum levels of the soluble receptor for advanced glycation end products (sRAGE) and to examine their association with anthropometric and metabolic parameters in patients with prediabetes and obese controls. METHODS: The two study groups were composed of 42 patients with prediabetes and diabetic neuropathy and 42 age-, gender-, body weight (BW)-, and body mass index (BMI)-matched obese adults as the control group. Prediabetes was diagnosed by the following criteria issued by the American Diabetes Association: impaired fasting glucose [fasting plasma glucose (FPG) level of 100-125 mg/dL], impaired glucose tolerance (2 hr plasma glucose level of 140-199 mg/dL after a 75 grams oral glucose challenge), or a glycated hemoglobin (HbA1C) level of 5.7%-6.4%. RESULTS: There were no differences between the groups in terms of age, gender distribution, BW, or BMI. Despite these similarities, patients with prediabetes had higher FPG, HbA1c, and 2-hr postchallenge glucose levels, higher systolic and diastolic blood pressure, and larger waist and hip circumferences compared with the obese controls. Lipid measurements, complete blood counts, kidney and liver function tests, high-sensitivity C-reactive protein, and sRAGE levels were similar between the two groups. We found significant negative correlations between sRAGE levels and BW, BMI, waist and hip circumferences, waist-to-hip ratios, and low-density lipoprotein (LDL) cholesterol levels. There were no significant correlations with other parameters, including demographic, metabolic, and blood pressure measurements. CONCLUSIONS: In contrast to glycemic parameters, serum levels of sRAGE were negatively correlated with body measurements indicative of obesity in the prediabetic state. In addition, the negative correlation with LDL cholesterol levels suggests that sRAGE has a more robust association with metabolic syndrome than with prediabetes.


Subject(s)
Anthropometry , Blood Glucose/metabolism , Diabetic Neuropathies/blood , Glycated Hemoglobin/analysis , Obesity/blood , Prediabetic State/blood , Receptor for Advanced Glycation End Products/blood , Biomarkers/blood , Body Mass Index , Body Weight , Case-Control Studies , Cholesterol, LDL/blood , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/physiopathology , Female , Glucose Tolerance Test , Humans , Male , Middle Aged , Obesity/diagnosis , Obesity/physiopathology , Prediabetic State/diagnosis , Prediabetic State/physiopathology , Predictive Value of Tests , Waist Circumference , Waist-Hip Ratio
2.
Prenat Diagn ; 31(10): 962-6, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21710589

ABSTRACT

OBJECTIVE: To define normal values of second trimester fetal nasal bone length (NBL) in a low-risk Turkish population. METHOD: Prenatal records of singleton fetuses who underwent second trimester ultrasonographic examination in the 16 to 23 weeks of pregnancy were retrospectively analyzed for NBL and biometric measurements (BPD, FL and HL). The relationship among NBL and gestational age (GA), biparietal diameter (BPD), femur length (FL) and humerus length (HL) was determined. Additionally, percentile values of NBL for each gestational week were provided. RESULTS: A total of 1467 fetuses were included in this study. There was a significant linear association among NBL and GA (R(2) = 0.709), BPD (R(2) = 0.752), FL (R(2) = 0.742) and HL (R(2) = 0.747). Fifth percentile values of fetal NBL were 3.11 mm for 16th, 3.50 mm for 17th, 3.70 mm for 18th, 4.10 mm for 19th, 4.50 mm for 20th, 4.62 mm for 21st, 5.24 mm for 22nd and 5.37 mm for 23rd gestational weeks. CONCLUSION: The study provides normal ranges of NBL between 16 and 23 weeks of pregnancy in a low-risk Turkish population. Future studies with larger sample sizes including pregnancies carrying high risk for aneuploidy are needed to define cut-off values for NBL.


Subject(s)
Fetal Development/physiology , Nasal Bone/embryology , Ultrasonography, Prenatal/methods , Adolescent , Adult , Female , Femur/diagnostic imaging , Femur/embryology , Gestational Age , Humans , Humerus/diagnostic imaging , Humerus/embryology , Nasal Bone/diagnostic imaging , Pregnancy , Pregnancy Trimester, Second , Reference Values , Turkey , Young Adult
3.
Gynecol Endocrinol ; 23(7): 404-9, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17701772

ABSTRACT

OBJECTIVE: To determine menopause-related symptoms and quality of life in women aged 40-80 years living in a rural area of Turkey. METHODS: A total of 338 women were evaluated in this cross-sectional study. As data sources we used a questionnaire that elicited information on the descriptive, fertility and menopausal characteristics of the women, the Menopause Rating Scale (MRS) and the Short Form-36 (SF-36). RESULTS: The mean age at menopause was 46.5 +/- 0.4 years. The complaint stated most often as 'severe or very severe' was 'hot flushes and sweating' (50.7%). The physical functioning, physical role, bodily pain, general health, social functioning, emotional role and mental health scores of postmenopausal women were statistically higher (p < 0.05) than those of premenopausal women. Scores on physical function, physical role, general health and social function decreased significantly with age in postmenopausal women (p < 0.05), while none of the quality-of-life domain scores differed significantly with age in premenopausal women. CONCLUSIONS: Quality of life is worse in postmenopausal women than premenopausal women, and in older than younger women in the postmenopausal period. Thus rural populations are primarily in need of public health care in the postmenopausal period.


Subject(s)
Postmenopause/psychology , Quality of Life , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Surveys , Humans , Middle Aged , Postmenopause/ethnology , Postmenopause/physiology , Rural Population , Severity of Illness Index , Turkey
4.
Adv Ther ; 24(2): 448-61, 2007.
Article in English | MEDLINE | ID: mdl-17565936

ABSTRACT

The objective of this study was to evaluate the efficacy of fluoxetine and black cohosh in the treatment of women with postmenopausal symptoms. A total of 120 healthy women with menopausal symptoms were recruited to this prospective study with a follow-up period of 6 mo. They were randomly assigned to 1 of 2 groups and were treated with fluoxetine or black cohosh. After entry into the study, patients were examined at the first, second, third, and sixth months of the treatment period. The women kept diaries in which they reported the daily number and intensity of hot flushes and night sweats. In addition, at the beginning and end of the third month, they completed questionnaires consisting of a modified Kupperman Index, Beck's Depression Scale, and a RAND-36 Quality-of-Life Questionnaire. Statistically significant differences were noted in the Kupperman Index and Beck's Depression Scale at the end of the third month in both groups compared with baseline values. In the black cohosh group, the Kupperman Index decreased significantly compared with that in the fluoxetine group by the end of the third month. On the other hand, in the fluoxetine group, Beck's Depression Scale decreased significantly compared with that in the black cohosh group. Monthly scores for hot flushes and night sweats decreased significantly in both groups; however, black cohosh reduced monthly scores for hot flushes and night sweats to a greater extent than did fluoxetine. At the end of the sixth month of treatment, black cohosh reduced the hot flush score by 85%, compared with a 62% result for fluoxetine. By the sixth month of the study, 40 women had discontinued the study--20 (33%) in the fluoxetine group and 20 (33%) in the black cohosh group. Compared with fluoxetine, black cohosh is more effective for treating hot flushes and night sweats. On the other hand, fluoxetine is more effective in improvements shown on Beck's Depression Scale.


Subject(s)
Cimicifuga , Fluoxetine/therapeutic use , Menopause/drug effects , Selective Serotonin Reuptake Inhibitors/therapeutic use , Depression/drug therapy , Female , Hot Flashes/drug therapy , Humans , Middle Aged , Plant Extracts/therapeutic use , Prospective Studies , Quality of Life
5.
Gynecol Obstet Invest ; 64(2): 109-16, 2007.
Article in English | MEDLINE | ID: mdl-17339775

ABSTRACT

BACKGROUND/AIMS: To determine predictive values of fetal fibronectin and phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) in cervicovaginal secretions and ultrasonographic measurement of cervical length for delivery <35 weeks in patients with uterine contractions. METHODS: Our study included 51 women between 24 and 35 weeks' gestation with uterine contractions and 90 controls. Cervicovaginal samples were analyzed for presence of fetal fibronectin and phIGFBP-1. Cervical length was measured by transvaginal sonography. RESULTS: Preterm birth rate was 19.6% (10/51) in the study group. Negative predictive values of fetal fibronectin, phIGFBP-1 and ultrasonographic cervical length <20 mm, and <25 mm for delivery <35 weeks were 91.9, 92.3, 91.1, and 90.5%, respectively. Positive predictive values were 50, 58.3, 100 and 66.7%, respectively. When results of fetal fibronectin/phIGFBP-1 test and ultrasonographic cervical length <25 mm were combined, specificity and positive predictive values of each test for delivery within 7 days increased. CONCLUSION: Fetal fibronectin and phIGFBP-1 tests have approximately equivalent ability to predict delivery <35 weeks' gestation. An ultrasonographic cervical length measurement >20 mm or a negative fetal fibronectin/phIGFBP-1 test obtained from patients with uterine contractions at 24-35 weeks' gestation may avoid overdiagnosis.


Subject(s)
Cervix Uteri/diagnostic imaging , Fibronectins/metabolism , Insulin-Like Growth Factor Binding Protein 1/metabolism , Obstetric Labor, Premature/diagnosis , Adult , Biomarkers/analysis , Case-Control Studies , Cervix Uteri/anatomy & histology , Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Predictive Value of Tests , Pregnancy , Pregnancy Trimester, Third , Sensitivity and Specificity , Ultrasonography , Uterine Contraction/physiology
6.
Hum Reprod ; 22(5): 1474-80, 2007 May.
Article in English | MEDLINE | ID: mdl-17234677

ABSTRACT

BACKGROUND: This prospective randomized-controlled animal study was designed to determine the effects of atorvastatin on experimentally induced endometriosis in a rat model. METHODS: Thirty-seven Wistar-Albino rats in which endometriotic implants were induced were randomly divided into four groups. Group I (Low-dose atorvastatin group, eight rats) were given 0.5 mg kg(-1) day(-1) oral atorvastatin. Group II (High-dose atorvastatin group, 10 rats) were given 2.5 mg kg(-1) day(-1) oral atorvastatin. Group III were given a single dose of 1 mg kg(-1) s.c. leuprolide acetate (GnRH agonist group, nine rats). Group IV were given no medication and served as controls (10 rats). All rats received the treatment for 21 days and were then euthanized to assess the implants' size, vascular endothelial growth factor (VEGF) level in peritoneal fluid and histological score. RESULTS: At the end of the treatment, the mean areas of implants were smaller and VEGF levels in peritoneal fluid were lower in Groups II and III than those in Group I and the control group (all P < 0.05). The mean areas of implants decreased from 41.2 +/- 13.9 to 22.7 +/- 13.9 mm(2) after medication in Group II and decreased from 41.2 +/- 18.1 to 13.1 +/- 13.8 mm(2) in Group III (both P < 0.05), whereas in Group I, the mean area increased from 43.0 +/- 12.7 to 50.5 +/- 13.9 mm(2) (P < 0.05). CONCLUSIONS: High-dose atorvastatin caused a significant regression of endometriotic implants.


Subject(s)
Endometriosis/drug therapy , Heptanoic Acids/administration & dosage , Pyrroles/administration & dosage , Animals , Atorvastatin , Disease Models, Animal , Dose-Response Relationship, Drug , Endometriosis/pathology , Endometrium/transplantation , Female , Leuprolide/therapeutic use , Rats , Rats, Wistar , Vascular Endothelial Growth Factor A/analysis
7.
J Obstet Gynaecol Res ; 32(4): 408-15, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16882267

ABSTRACT

AIM: To determine metabolic disorders in patients with recent gestational diabetes mellitus (GDM) compared with controls. METHODS: Thirty-six patients with recent GDM and treated with a diabetic diet only, and 33 controls with normal pregnancies, were included in the study. An oral glucose tolerance test, with corresponding insulin and hormone levels, was performed; the homeostatic model assessment scores were calculated to estimate insulin resistance; prevalence of polycystic ovarian morphology on ultrasound scan was assessed; and results were recorded 10-15 months after delivery. RESULTS: Waist : hip ratio and fasting cholesterol and triglyceride levels were significantly higher in women with recent GDM; high-density lipoprotein cholesterol did not differ between groups. Fasting, 1-h and 2-h plasma glucose levels were significantly higher in the GDM group; no statistically significant difference was found between groups regarding fasting insulin levels, 1-h and 2-h insulin response, and homeostatic model assessment scores. Serum hormone levels did not differ between groups. The prevalence of polycystic ovarian morphology was greater in women with GDM. There was no difference in any metabolic parameter between women in the GDM group with polycystic ovaries and those with normal ovaries. CONCLUSIONS: We found a higher prevalence of polycystic ovarian morphology in women with GDM than in controls. Among women with recent GDM, higher waist : hip ratios and fasting plasma glucose and triglyceride levels may indicate metabolic syndrome. In women with recent GDM managed by diet only, insulin resistance may not be detected in the short term.


Subject(s)
Diabetes, Gestational/metabolism , Insulin Resistance/physiology , Adult , Diabetes, Gestational/diet therapy , Female , Glucose Tolerance Test , Humans , Polycystic Ovary Syndrome/diagnostic imaging , Polycystic Ovary Syndrome/metabolism , Pregnancy , Prospective Studies , Ultrasonography
8.
J Obstet Gynaecol Res ; 32(1): 90-3, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16445532

ABSTRACT

This report describes a case of prenatally diagnosed bilateral diaphragmatic hernia. At 22 weeks' gestation, ultrasound revealed a cystic structure behind the fetus's heart on the axial image at the level of the cardiac four-chamber view. This suggested a left-sided congenital diaphragmatic hernia with herniation of the stomach into the left hemithorax. However, the left-to-right midline shift of the heart was minimal, which is not typical of left-sided congenital diaphragmatic hernia. Throughout the 30th week of gestation, the right and left branches of the pulmonary artery were hypoplastic compared with the values in normal fetuses of the same gestational age. The presumptive diagnosis was bilateral congenital diaphragmatic hernia. A female newborn weighing 2900 g was delivered at 37 weeks' gestation, and she died at 7 h of age. An autopsy revealed large defects on both sides of the diaphragm. In conclusion, prenatal diagnosis of bilateral diaphragmatic hernia is possible with fetal sonography.


Subject(s)
Diaphragm/abnormalities , Hernia, Diaphragmatic/diagnosis , Lung/abnormalities , Ultrasonography, Prenatal , Adult , Female , Hernia, Diaphragmatic/diagnostic imaging , Humans , Pregnancy
9.
Fetal Diagn Ther ; 20(4): 254-7, 2005.
Article in English | MEDLINE | ID: mdl-15980635

ABSTRACT

There is an increased risk of fetal goiter in patients who have a history of Grave's disease and undergo propylthiouracil (PTU) treatment during pregnancy. In this report, we describe a case of a fetal goiter detected by antenatal ultrasound at the 26th week of gestation in a mother treated with PTU for Grave's disease. A 32 x 38 x 20 mm fetal goiter was detected, each lobe measured 30 x 18 x 18 mm and estimated volume was 10 cm3. Subsequently, fetal thyroid function was assessed by umbilical fetal blood sampling. Cord blood showed elevated serum TSH (40.2 mU/l) and normal concentrations of free T4 (9.5 pmol/l) and free T3 (2.6 pmol/l). There were no other ultrasonographic signs of fetal hypothyroidism. Based on the above findings, the mother's PTU dosage was reduced to 50 mg daily from a total of 150 mg and weekly ultrasonographic examinations were performed. Six weeks after the initial ultrasound, a complete regression of the fetal goiter was noted. At the 34th week of gestation, the patient was delivered due to intrauterine growth restriction and oligohydramnios and gave birth to a male, weighing 1,920 g. The newborn thyroid was not palpable and thyroid ultrasonography was normal. Cord blood TSH was normal (8.4 mU/l) and free T4 was within lower normal limit (9.03 pmol/l). Ten days later, newborn thyroid function was normal and the baby did well afterwards. In conclusion, after the evaluation of fetal thyroid status, selected cases with fetal goiter can be initially managed without intrauterine treatment.


Subject(s)
Antithyroid Agents/adverse effects , Fetal Diseases/chemically induced , Goiter/chemically induced , Graves Disease/drug therapy , Propylthiouracil/adverse effects , Adult , Antithyroid Agents/administration & dosage , Female , Fetal Diseases/diagnostic imaging , Fetal Diseases/therapy , Goiter/diagnostic imaging , Goiter/therapy , Humans , Pregnancy , Propylthiouracil/administration & dosage , Remission Induction , Ultrasonography, Prenatal
10.
Fetal Diagn Ther ; 20(2): 132-5, 2005.
Article in English | MEDLINE | ID: mdl-15692208

ABSTRACT

OBJECTIVE: A 27-year-old woman was referred to our laboratory for genetic counseling at 26 weeks of gestation due to abnormal ultrasound findings including intrauterine growth retardation, Dandy-Walker malformation and lower extremity anomalies. METHODS: Chromosome analysis was performed on fetal blood sample obtained by cardiocentesis. RESULT: We observed an abnormal karyotype with a structural abnormality of the long arm of chromosome 7. Both parents' chromosomes were normal; thus, the fetal karyotype designation was 46,XX, del(7)(pter-->q11::q31-->qter) de novo. Skin biopsy sample was taken to confirm the karyotype after therapeutic abortion was performed. The result was identical. Postmortem examination and autopsy showed facial dysmorphism, malformations of the lower extremities and central nervous system anomalies. CONCLUSION: 7q interstitial deletions cause a wide spectrum of congenital abnormalities and syndromes linked to the deleted segments. Our case had a rather wide chromosome region deleted and it is important, because prenatal diagnosis was performed. Thus, the family had the chance to evaluate the situation and decided to terminate the pregnancy after genetic counseling.


Subject(s)
Chromosomes, Human, Pair 7 , Foot Deformities, Congenital/genetics , Monosomy/diagnosis , Prenatal Diagnosis , Adult , Central Nervous System/abnormalities , Facial Bones/abnormalities , Female , Gene Deletion , Humans , Pregnancy , Ultrasonography, Prenatal
11.
Acta Obstet Gynecol Scand ; 81(8): 706-12, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12174153

ABSTRACT

BACKGROUND: Phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) is secreted by decidual cells and leaks into cervical secretions when fetal membranes detach from decidua. Our aim was to assess whether detection of phIGFBP-1 in cervical secretions by a rapid bed-side test could be used to predict preterm delivery in patients with regular uterine contractions. STUDY DESIGN: In our prospective study, 36 women between 20 and 36 weeks of gestation with regular, persistent contractions (> 10/h) and 18 women between 20 and 36 weeks gestation without symptoms of preterm labor were assessed for the presence of cervical phIGFBP-1. Dacron swabs were applied to the cervix and assayed in 5 min by using immunochromotography, a new rapid bed-side test (actim partus test, Medix Biochemica, Kauniainen, Finland). Data analysis included one-way variance analysis (ANOVA), Student's t-test, chi-square and Fisher's exact test. RESULTS: Of the 36 patients with regular uterine contractions, 18 had a positive actim partus test and 18 had a negative test. Among the 18 patients with a positive test, only one delivered term and the other 17 patients delivered preterm (< 37 weeks). Among the 18 women with a negative test, only two delivered preterm (p < 0.05). Mean gestational age at delivery for patients with a positive and a negative test was 34.4 +/- 3.0 and 37.9 +/- 2.3 weeks, respectively (p < 0.05). Sensitivity, specificity, positive and negative predictive values of the rapid phIGFBP-1 test for preterm delivery was 89.5, 94.1, 94.4 and 88.9%, respectively. For delivery < 37 weeks, positive likelihood ratio was 15.2 (+/- 95% CI; range 2.6-102.5). When cervical phIGBP-1 assay was used to predict delivery within 7 days, sensitivity, specificity, positive and negative predictive values were 93.8, 85%, 83.3 and 94.1%, respectively. Positive likelihood ratio with +/- 95% CI was 6.25 (range 2.2-17.8). When patients were categorized according to cervical dilatation, the positive likelihood ratio of the test when the cervix was closed at 2 cm were 8.3 (1.3-55.3), 13.6 (2-91.4), 15.8 (2.3-106.3) and 1.5 (0.2-11.5), respectively, CONCLUSION: The presence of cervical phIGFBP-1 is predictive of preterm delivery < 37 weeks of gestation. Our study shows that cervical detection of phIGFBP-1 by immunochromotography is a rapid and easily applicable test that highly anticipates preterm delivery in patients at risk.


Subject(s)
Cervix Uteri/metabolism , Insulin-Like Growth Factor Binding Protein 1/metabolism , Obstetric Labor, Premature/diagnosis , Obstetric Labor, Premature/enzymology , Adult , Bodily Secretions/metabolism , Case-Control Studies , Cervix Uteri/enzymology , Female , Gestational Age , Humans , Point-of-Care Systems/standards , Predictive Value of Tests , Pregnancy , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Prospective Studies , Sensitivity and Specificity
12.
Fetal Diagn Ther ; 17(4): 240-2, 2002.
Article in English | MEDLINE | ID: mdl-12065953

ABSTRACT

Pregnancy in women having chronic renal insufficiency and undergoing hemodialysis is a rare event with a poor outcome. This is the 1st case in whom pre- and posthemodialysis fetal renal artery Doppler flow velocimetry was used in conjunction with fetal blood sampling which was performed to assess fetal karyotype and blood chemistry. Uteroplacental Doppler measurements were also performed, and a close correlation between maternal-fetal blood creatinine and urea nitrogen levels and fetal renal, umbilical, and uterine artery resistance indexes was observed.


Subject(s)
Kidney Failure, Chronic/therapy , Laser-Doppler Flowmetry , Pregnancy Complications/diagnostic imaging , Renal Dialysis , Ultrasonography, Prenatal , Adult , Blood Urea Nitrogen , Creatinine/blood , Female , Fetus/blood supply , Humans , Pregnancy , Renal Artery/physiology , Umbilical Arteries/physiology , Uterus/blood supply , Vascular Resistance
SELECTION OF CITATIONS
SEARCH DETAIL
...