The serum level of soluble CXCL16 is increased in preeclampsia and associated with hepatic/renal damage.

OBJECTIVE: To compare the serum level of the chemokine, CXCL 16, in preeclamptic and healthy pregnant patients. METHODS: This prospective case control study was conducted between January and December 2018 in a tertiary level hospital. The study group was formed of 70 pregnant women diagnosed with preeclampsia, and the control group was formed of 70 healthy pregnant women matched to the study group in respect of age, gestational week and body mass index (BMI). The study group was separated into two subgroups of mild preeclampsia (n = 35) and severe preeclampsia (n = 35). The groups were compared in terms of demographic and clinical parameters and the levels of serum CXCL 16. RESULTS: No statistically significant difference was determined between the study and control groups in respect of maternal age, gravida, parity, BMI, and gestational age at sampling. Neonatal birth weight was significantly lower in the study group than in the control group. Mean serum alanine aminotransferase (ALT), aspartate amino transferase (AST) and creatinine levels of the study group were significantly higher than those of the control group (p < .05 for all). There was a statistically significant difference between the study and control groups regarding the mean platelet count. Compared to the control group, the severe and mild preeclampsia groups had a significantly higher serum level of CXCL 16. The serum level of CXCL 16 was significantly higher in patients with severe preeclampsia than in patients with mild preeclampsia (2.94 ± 3.89 pg mL-1 vs. 1.08 ± 1.87 pg mL-1, p = .14). Correlation analysis revealed a significant positive correlation of serum CXCL 16 level with serum ALT level (r = 0.320, p ≤ .001) and serum AST level (r = 0.373, p ≤ .001) and serum creatinine level (r = 0.279, p = .01) in both groups. High values indicated presence of preeclampsia, with a diagnostic cut-off point of 0.225, sensitivity of 75.7% and specificity of 72.9% for CXCL 16 (area under curve: 0.820, p < .001 CI: 0.753-0.888). CONCLUSIONS: This is the first study in literature to show a significantly higher level of CXCL 16 in patients with severe preeclampsia compared to those with mild preeclampsia. The study can also be considered of value in respect of showing that CXCL 16 could play a role in the etiopathogenesis of preeclampsia and the emergence of renal-hepatic damage. Blocking the CXCL 16/CXCR six axis in preeclampsia treatment could lay the ground for the development of new drugs which could be used in the treatment of preeclampsia.

Effects of Turkish Classical Music on Postpartum Pain and Anxiety in Cesarean Deliveries: A Randomized Controlled Trial.

CONTEXT: In recent years, delivery via cesarean section (C-section) has been one of the most frequent, major surgical interventions in the world. Reducing post-cesarean delivery-related pain and good pain management are important as is reducing mothers' anxiety. OBJECTIVE: The study intended to determine the effects of music therapy on levels of postpartum pain and anxiety in women who delivered via cesarean section. DESIGN: The randomized controlled trial was conducted with power analysis for a type-I error rate of α:0.05, type-II error rate of ß:0.20, representative power of 0.80, and effect size of 0.62. SETTING: The study took place at a tertiary hospital in a provincial center in Turkey. PARTICIPANTS: Participants were 126 women who were hospitalized at the hospital between February 2018 and October 2018 and who delivered via C-section. INTERVENTION: The participants were allocated to three groups with 42 women each. Intervention groups 1 and 2 listened to music once a day and twice a day, respectively, whereas the control group was given routine care for 2 consecutive days. OUTCOME MEASURES: A visual analog scale (VAS) on pain and the State-Trait Anxiety Inventory (STAI TX-1) were used to collect the data. RESULTS: The anxiety scores and pain levels were reduced in the intervention groups in comparison to the control group (P < .001). The anxiety scores weren't significantly different between the 2 intervention groups (P > .05), and the pain levels on the second day in intervention group 2 were lower than those of intervention group 1 (P < .05). While the pain levels were reduced in all groups (P < .001), the anxiety scores increased in the control group on the second day (P < .05) and decreased in the 2 intervention groups (P < .001). CONCLUSIONS: Music therapy can play an effective role in reducing pain and anxiety levels.

Density of crystalline lens and cornea in different trimesters of pregnancy.

PURPOSE: To evaluate topographic measurements of the anterior segment and densitometric measurements of the cornea and lens by Pentacam HR in different trimesters of pregnancy. METHODS: This prospective study included 150 healthy pregnant women in their first, second, or third trimester (Groups 1, 2 and 3, respectively) and 54 non-pregnant healthy women (Group 0). Topographic measurements, including central corneal thickness (CCT), corneal volume (CV), anterior chamber depth (ACD), corneal densitometry (CD) and lens densitometry (LD), were done with the Pentacam HR (Oculus, Wetzlar, Germany). The measurement results of the healthy pregnant women and non-pregnant healthy women were compared. RESULTS: CD values were found in Group 1 to be 13.19, in Group 2 to be 13.16, in Group 3 to be 13.17 and in Group 0 to be 13.22 (p = 0.811). The mean Group 1, Group 2, Group 3 and Group 0 LD-horizontal was 5.40 ± 0.5, 5.47 ± 0.38, 5.53 ± 0.44, 5.36 ± 0.43, respectively. The mean Group 1, Group 2, Group 3 and Group 0 LD-vertical was 5.6 ± 0.43, 5.66 ± 0.32, 5.71 ± 0.40 and 5.5 ± 0.44, respectively. Area LD values were higher in the advanced trimester period, and the only statistically significant difference was between Group 3 and Group 0 (p = 0.025). The difference between three-dimensional (3D) and peak LD values was not statistically significant between the groups (p = 0.89 and p = 0.91, respectively). DISCUSSION: The Pentacam HR seems to be an important option for the evaluation of LD, CD and topographic measurements of the anterior segment in pregnancy. In the present study, CD and LD, including LD-horizontal, LD-vertical, peak and 3D values, were not significantly different between pregnant women and non-pregnant women.

Prediction of intraoperative nausea and vomiting in caesarean delivery under regional anaesthesia.

Objectives This study aimed to predict patients who have caesarean operations under regional anaesthesia and are at risk for intraoperative nausea and vomiting (IONV), for ultimately prompting anaesthetists and surgeons to take preventive measures. Methods This was a retrospective study on 209 patients who had caesarean section under spinal-epidural combined regional anaesthesia. The relevant medical history, such as severe nausea and vomiting in the first trimester, smoking, a history of motion sickness, and premenstrual syndrome (PMS), were obtained from the patients' records and interviews. Results Patients who had a female neonate, a history of severe nausea and vomiting in the first trimester, and a history of PMS and motion sickness before pregnancy experienced a significantly higher rate of IONV. Smokers were less susceptible to IONV, but this was not significant. Conclusion This study shows that some factors in the medical history of a patient can help identify those who are more likely to suffer from IONV.