The relationship between complete hydatidiform mole and serum Vitamin D level: a prospective case-control study.

OBJECTIVE: This study aimed to determine whether or not there was a relationship between complete hydatidiform mole (CHM) and serum Vitamin D level by comparing CHM patients with two control groups and to determine whether or not Vitamin D deficiency is a risk factor for CHM. PATIENTS AND METHODS: This prospective study included 30 patients diagnosed with CHM (case group), 30 patients in the first trimester of a healthy pregnancy (control group), and 30 healthy non-pregnant subjects (control group). A record was made of serum 25-hydroxyvitamin D (25-OH D vitamin) levels, age, body mass index (BMI), gravida, parity, and the number of abortus. The serum 25-OH D vitamin levels were examined in each group and compared between groups. RESULTS: The 25-OH D vitamin level of all the patients in the study was determined as 11.16±8.64 ng/mL. No significant difference was determined between the groups in respect of 25 OH-D vitamin levels. When comparisons were made between the four subgroups according to the 25-OH-D level, no significant difference was determined between the CHM and control groups. When the patients were separated as obese and non-obese groups, no significant difference was determined between the groups. CONCLUSIONS: Severe deficiency, deficiency, or insufficient levels of serum Vitamin D are not thought to be risk factors for CHM patients.

Relationship between pterygomaxillary fissure morphology and maxillary/mandibular position : A cone beam computed tomography assessment.

PURPOSE: The aim of this study was to investigate the possible correlation between maxillary and mandibular positioning via cephalometric analysis with pterygomaxillary fissure (PMF) morphology using cone beam computed tomography (CBCT). METHODS: In this study, CBCT images from 825 individuals (448 female, 377 male; age range was 18-91 years with this cohort) were analyzed; PMF length and width were measured. Three-dimensional cephalometric analysis was also performed using cephalometric analysis software. The landmarks and measurements in relation to maxillary and mandibular positions were identified and performed for the cephalometric analysis. Analysis of variance (ANOVA) was used for comparison of the parameters, while the Bonferroni test was used for multiple comparisons. Pearson's test was also used to assess the correlations between the parameters. RESULTS: The results showed that males had significantly larger PMF length (p < 0.001) and width (p < 0.001) compared to females. The mean PMF length was 17.7 mm (standard deviation [SD] 3.2 mm) for right and 17.7 mm (SD 3.3 mm) for left but were not significantly different (p > 0.05). In terms of the cephalometric measurements, a significant correlation was found between upper central incisor (U1toAperp2D) and posterior facial height (PostFaceHtSGo2D) and PMF length, while correlations were found between PMF width and several cephalometric parameters such as lower lip (LwLiptoEPln2D and LwLiptoHLine2D) and occlusal plane (OPtoFHAng2D) (p < 0.05). CONCLUSION: A significant relationship was observed between PMF morphology and the position of the maxilla or mandible. PMF lengths and widths were larger in males than females. Posteroanterior maxillary and mandibular lengths and posterior facial height are associated with PMF length and width.

Evaluation of root canal morphology of human primary mandibular second molars by using cone beam computed tomography.

OBJECTIVES: The aim of the present study was to investigate the root canal configurations of primary mandibular second molars (PMSMs) using Vertucci classification. Materials and Methods: The root canal types of 228 PMSMs (228 mesial and 228 distal roots) were evaluated. In addition, the relationship between external root morphology and Vertucci classification was investigated. The Chi-square test or Fisher Exact Chi-square test was used for the evaluations, and P < 0.05 was considered statistically significant for all tests. Results: The most commonly observed root canal type, which was observed in 228 roots (50%), was Type 4 followed by Type 8 (15.79%), Type 5 (14.47%), Type 1 (9.21%), and Type 3 (6.57%). In 150 mesial roots, the root canal Type 4 was observed whereas the same type was observed in 78 distal roots, and the difference was significant (P < 0.001). In flat roots (82.9%), the most frequently observed root canal type was Type 4 (50.8%) (P < 0.001). CONCLUSION: Various root canal types were observed in both mesial and distal roots although Type 4 was the most commonly observed. Root canal types showed a consistent relationship with separated and conical root shapes whereas the flat roots showed different root canal types.

A comparison of maternal outcomes in complicated vaginal and cesarean deliveries.

OBJECTIVE: The purpose of this study was to compare general characteristics, laboratory data, and maternal outcomes of patients who experienced complications in the first 24 hours after a normal vaginal delivery or cesarean section (C-section). This way, the authors intended to determine the results of complications in these patients. MATERIALS AND METHODS: Data of patients referred from the peripheral care centers to the present tertiary care center in the first 24 hours after a vaginal delivery or C-section due to the presence of various complications were screened retrospectively from 2009 to 2013. Clinical and demographic characteristics, laboratory parameters, indications for C-section, mortality rates, maternal morbidities, surgical and medical treatments administered in the clinic, as well as operations performed in other care centers were noted. RESULTS: A total of 330 patients were included in this study. Of these patients, 285 constituted the postoperative group (C-sections) whereas 45 constituted the postpartum (vaginal deliveries) group. There was no statistically significant difference between the two groups in demographic characteristics, results of laboratory parameters, maternal morbidity, and mortality rates. Requirement of hysterectomy and relaparotomy was significantly higher in the postoperative group. CONCLUSIONS: In the early follow-up, it was found that complicated C-sections and vaginal deliveries had similar results. However, it should also be mentioned that higher requirement of hysterectomy and relaparotomy emerged as an undesirable condition among the postoperative patients in this study. With this in mind, mode of delivery should be selected according to the overall health status of the patient and indications for C-section.

Clinical experience in pregnancies complicated by adnexal torsion.

OBJECTIVE: The purpose of this study was to present data on clinical and operational management and postoperative outcomes of pregnancies complicated by adnexal torsion (AT). MATERIALS AND METHODS: Twenty-four pregnant women who presented to the present clinic between January 2007 to December 2013 and were intraoperatively diagnosed with AT were included in this study. Demographic data such as age and data on obstetric history, gestational week, current trimester, previous gynecologic and non-gynecologic operations, type of surgery that was performed, average size, location and number of adnexal masses, surgical techniques that were employed, postoperative complications, and pathology results were investigated and noted. RESULTS: In this study, 132 patients were operated due to AT, and the rate of pregnant women with AT was 18.2% (24/132). The mean age of the patients was 29.25 ± 6.27 years, and the mean gestational week was 18.25 ± 7. Eight patients were in their first trimester (33.3%) whereas 13 were in their second trimester (54.2%), and three were in their third trimester (12.5%) when they presented to the hospital. The mean AT size was 95.3 ± 53.9 mm, as measured by ultrasonography. All the patients were operated by laparotomy. Regarding the types of abdominal incision, 13 patients (54.2%) had a Pfannenstiel incision, three patients (12.5%) had an infra-umbilical median incision, and eight patients (33.3%) had a pararectal incision. Duration of operation was significantly shorter in patients with pararectal incisions (p < 0.01) compared to those with Pfannenstiel and infra-umbilical median incisions. Regarding the types of treatment, ten patients (41.7%) underwent unilateral salpingo-oophorectomy (USO), eight patients (33.3%) underwent adnexal detorsion+cystectomy, and six patients (25%) underwent adnexal detorsion only. CONCLUSION: AT is a gynecologic emergency that requires early diagnosis and treatment, as it is capable of complicating the pregnancy. Determination of the current gestational week prior to the surgical intervention will assist and guide the surgeon in identifying the suitable type of surgery for a particular patient. Pararectal incision should be the incision of choice for a shorter duration of operation, which is crucial in pregnant women for reduced exposure to anesthesia.

Evaluation of articular eminence pneumatization using cone beam computed tomography.

AIM: Knowledge about the anatomy of the temporomandibular joint (TMJ) and its surrounding structures is mandatory for success in surgical interventions and for understanding the pathway of spread of infections in this region. This study aims to investigate the anatomy and morphology of pneumatized articular eminence (PAT) using cone beam computed tomography (CBCT) imaging in a group of patients. METHODS: A retrospective study on 825 patients (377 males, 448 females) aged between 18 and 91 years was performed using sagittal and coronal CBCT images. PAT was defined as non-expansile, nondestructive cyst-like radiolucency in the zygomatic process of the temporal bone, which appears similar to the mastoid air cells. It was classified in two groups as unilocular and multilocular. Statistical comparison of gender, age and localization was performed using chi-square test and correspondence analysis. P<0.05 was considered as significant. RESULTS: Twenty-eight pneumatized articular eminence were found in 21 patients, representing a prevalence of 2.54%. Patients with PAT had a mean age of 28.9 years with a range of 21-78 years. Ten cases (47.6%) occurred in females and 11 cases (52.4%) occurred in males. The results of statistical tests showed no significant differences among the groups with respect to gender, age, and localization (P>0.05). CONCLUSION: Pneumatization of the articular eminence is a challenging entity for TMJ surgery and spread of infections in this region. Practitioners who are dealing with TMJ surgery and pathology should have detailed information about this anatomical variation since it may cause serious complications.

Disease severity and therapy as predictors of cardiovascular risk in psoriasis: a population-based cohort study.

BACKGROUND: Previous studies suggest an increased risk of cardiovascular disease in psoriasis, but the relative contributions of traditional risk factors and markers of disease severity are unclear. We examined the effect of psoriasis disease characteristics on cardiovascular risk after adjusting for traditional cardiovascular risk factors. METHODS: Study populations included (a) case-cohort sample of 771 patients nested within a population-based psoriasis incidence cohort, and (b) cohort of 1905 patients with incident and prevalent psoriasis patients. Both cohorts were followed-up to ascertain disease and treatment characteristics, traditional cardiovascular risk factors and cardiovascular outcomes. Cox proportional hazards regression models were used to identify predictors of cardiovascular outcomes. RESULTS: After adjusting for traditional risk factors, increasing number of psoriasis-affected body sites at disease onset (HR: 1.53 per additional site, 95% CI: 1.20, 1.95) was significantly associated with an increased risk of cardiovascular outcomes. Phototherapy (HR: 3.76, 95% CI: 2.45, 5.77) and systemic therapy (HR: 2.17, 95% CI: 1.50, 3.13) were associated with a higher risk of cardiovascular outcomes in univariate analyses, but these relatively strong associations disappeared after adjusting for cardiovascular risk factors. CONCLUSIONS: Increasing number of psoriasis-affected body sites may be a severity indicator in psoriasis and is associated with an increased cardiovascular risk. Due to low number of patients exposed to systemic therapy, this study had limited power to examine the effect of treatment on cardiovascular risk. Strong associations with phototherapy and systemic therapy suggest that the cardiovascular risk in psoriasis is confined to patients with severe disease.

Anemia or low hemoglobin levels preceding Parkinson disease: a case-control study.

OBJECTIVE: It has been suggested that anemia may be a risk factor for dementia, for restless legs syndrome, and for Parkinson disease (PD). Thus, we investigated the association of anemia with the subsequent risk of PD using a case-control study design. METHODS: We used the medical records-linkage system of the Rochester Epidemiology Project to identify 196 subjects who developed PD in Olmsted County, Minnesota, from 1976 through 1995. Each incident case was matched by age (+/-1 year) and sex to a general population control. We reviewed the complete medical records of cases and controls in the system to detect anemia defined using the World Health Organization criteria. RESULTS: Anemia was more common in the history of cases than of controls (odds ratio 2.00, 95% confidence interval 1.31-3.06, p = 0.001). The association remained significant after adjustment for cigarette smoking, exposure to pesticides, or hysterectomy (in women). The association was not significantly different between men and women, or between PD patients with or without rest tremor. Analyses stratified by time of onset of anemia showed a greater association for anemia that started 20 to 29 years before the onset of PD. Hemoglobin levels were slightly but consistently lower in cases than in controls across all ages. CONCLUSIONS: Our results support an association between anemia experienced early in life and the later development of Parkinson disease. The interpretation of this association remains uncertain.

Bilateral nipple necrosis in a breastfeeding woman with Behçet's disease.

Behçet's disease is a chronic, multisystem disorder. A 23-year-old female patient diagnosed with Behçet's disease 3 years earlier was admitted with deep ulcers on both areolae caused by detachment of the nipples following breastfeeding since spontaneous delivery of her baby. Physical examination revealed a necrotic ulcer crater 2 cm in diameter on each breast, with the lactiferous ducts draining into these. Incisional biopsy sample from the areola ulcer border on the left breast showed leukocytoclastic vasculitis. Breastfeeding was stopped, and local wound care and systemic corticosteroid therapy were started. After 4 weeks, epithelialization tissue filled the ulcers, leveling the crater base with the areola. Bilateral nipple necrosis in a breastfeeding woman is a rare entity. It is thought that in the present case minor trauma caused by breastfeeding accompanied by neutrophilic infiltration resulting from amplified inflammatory response and leukocytoclastic vasculitis attributable to Behçet's disease was responsible for the necrosis.