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1.
Minerva Pediatr ; 70(2): 165-174, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29446580

ABSTRACT

BACKGROUND: Acute gastroenteritis is responsible for dehydration in many children. The viruses like rotavirus, norovirus, and adenovirus are considered the main causative agents of gastroenteritis. The goal of this study is the evaluation of the symptoms, clinical findings and hospitalization requirements in pediatric patients with dehydration secondary to viral gastroenteritis. METHODS: The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of 156 viral acute gastroenteritis patients with moderate dehydration were evaluated retrospectively. Patients were between 3 months to 16 years of age (mean: 38.7 months). The patients were categorized into four groups according to etiological agents as rotavirus, norovirus, adenovirus, and mixed infections for the comparison of symptoms, clinical characteristics, laboratory results, seasonal distribution, treatment requirements, hospitalization unit, and hospitalization period. Age groups were categorized as 0-24 months, 25-72 months, and >72 months. Clinical characteristics of patients were analyzed for hospitalization period as <24 hours, and ≥24 hours. RESULTS: Moderate-degree dehydration was detected in 156 patients with acute gastroenteritis (156/278) caused by rotavirus (60.5%), norovirus (58%) and adenovirus (42%) respectively. The common symptoms of all patients were vomiting, diarrhea, abdominal pain and malaise, although fever was seen mostly in the patients of rotavirus. Aspartat aminotransferase (AST) was elevated in rotavirus gastroenteritis (11.5%) more than norovirus (5.4%) and adenovirus (0.8%) infections. Elevated blood urea nitrogen (BUN) levels (>20 mg/dL) were shown in 79.3%, of patients especially in rotavirus (43.8%). CONCLUSIONS: The main agents of acute gastroenteritis which caused dehydration were norovirus and rotavirus in our patients. Rotavirus was detected in most of the hospitalized patients with severe symptoms. AST was prominently elevated in rotavirus gastroenteritis. The clinical characteristics and some laboratory findings including hyperglycemia, leukocytosis, and elevated AST may be helpful in differentiating rotavirus from norovirus gastroenteritis. BUN level was insignificantly elevated in patients with rotavirus.


Subject(s)
Dehydration/virology , Gastroenteritis/complications , Rotavirus Infections/epidemiology , Abdominal Pain/epidemiology , Abdominal Pain/virology , Acute Disease , Adenoviridae Infections/complications , Adenoviridae Infections/epidemiology , Adolescent , Caliciviridae Infections/complications , Caliciviridae Infections/epidemiology , Child , Child, Preschool , Dehydration/epidemiology , Diarrhea/epidemiology , Diarrhea/virology , Gastroenteritis/virology , Hospitalization , Humans , Infant , Retrospective Studies , Rotavirus Infections/complications , Vomiting/epidemiology , Vomiting/virology
2.
Foot Ankle Surg ; 24(5): 448-452, 2018 Oct.
Article in English | MEDLINE | ID: mdl-29409200

ABSTRACT

BACKGROUND: Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented. METHODS AND PATIENTS: Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31-75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated. RESULTS: Mean follow-up period was 38 (range, 24-60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13±0,791 to 2,68±1,228 (p=0,0001) and from 58,25±6,15 to 78,25±8,13 (p=0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p=0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77±1,76 to 8,13±1,52° (p=0,0001) and from 35,28±5,86 to 20,10±5,55° (p=0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p=0,195). CONCLUSION: Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory.


Subject(s)
Hallux Valgus/surgery , Hallux/surgery , Metatarsal Bones/surgery , Metatarsophalangeal Joint/surgery , Osteotomy/methods , Patient Satisfaction , Adult , Aged , Female , Follow-Up Studies , Hallux/diagnostic imaging , Hallux Valgus/diagnosis , Humans , Male , Metatarsal Bones/diagnostic imaging , Metatarsophalangeal Joint/diagnostic imaging , Middle Aged , Radiography , Retrospective Studies , Severity of Illness Index , Treatment Outcome
3.
Gynecol Endocrinol ; 33(6): 467-471, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28277814

ABSTRACT

OBJECTIVE: The main purpose of our study is to categorize starting doses of recombinant follicle-stimulating hormone (recFSH) based on various cutoff values of anti-Mullerian hormone (AMH) and to determine the effectiveness of serum AMH levels in the prediction of poor ovarian response. MATERIAL AND METHODS: Prospective data analysis was conducted at IVF center. A total of 323 patients were included. All patients were divided into four groups according to the patients' serum AMH concentrations: Group 1 (AMH < 1 ng/ml; 450 IU/day n = 157); Group 2 (AMH 1-2 ng/ml; 375 IU/day, n = 55); Group 3 (AMH 2-3 ng/ml; 225 IU/day, n = 48); and Group 4 (AMH > 3 ng/ml; 150 IU/day, n = 63). Collected data included age, total gonadotropin dosage, duration of stimulations, the total number of oocytes retrieved, ovarian response, cancelation rate, and cPRs. RESULTS: As serum AMH levels increased, there were significant decreases in the starting recFSH dose and total gonadotropin dosage, and a significant increase in the total number of oocytes retrieved. There was a significant trend toward increasing cycle cancelation rates and decreasing cPRs with decreasing serum AMH levels. Although there were no significant differences with regard to the proportion of cycles with hypo-response between all groups. A result of ≤0.83 was considered the cutoff value of AMH to predict a hypo-response to ovarian stimulation. CONCLUSIONS: AMH is a useful marker in selecting the starting dose of recFSH and prediction of poor ovarian response. Our protocol may allow clinicians to modulate the starting dose of recFSH according to these cutoff values for serum AMH levels.


Subject(s)
Anti-Mullerian Hormone/blood , Follicle Stimulating Hormone/administration & dosage , Ovulation Induction/methods , Adult , Female , Fertilization in Vitro , Humans , Ovarian Reserve , Precision Medicine , Pregnancy , Pregnancy Rate
4.
Urology ; 99: 288.e1-288.e7, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27725234

ABSTRACT

OBJECTIVE: To examine the diagnostic value of pudendal somatosensory evoked potentials (SEPs) in pudendal nerve entrapment (PNE) neuropathy by stimulating the 2 sides separately after provocation by a standard sitting position. Routine pudendal SEPs performed in the supine position with bilateral simultaneous stimulation may fail to show the abnormality because the complaints of PNE appear or worsen in the sitting position. METHODS: Forty-nine patients with PNE and 16 controls were included. SEP recordings were performed by stimulating the dorsal nerve of penis or clitoris on either side. The recordings were performed at the initial supine position, at the beginning and end of the provocation by sitting position, and at the second supine position. RESULTS: Amplitude loss in the SEP responses after prolonged sitting was significantly more pronounced on the symptomatic sides of the patients. Approximately 45% decrease in the SEP amplitude or an amplitude value less than 1.5 µV at the end of sitting are the parameters to be used with high selectivity. CONCLUSION: The dynamic pudendal SEP study described herein seems to be more helpful in PNE diagnosis than in conventional SEPs.


Subject(s)
Clitoris/innervation , Electrodiagnosis/methods , Evoked Potentials, Somatosensory/physiology , Patient Positioning , Penis/innervation , Pudendal Neuralgia/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pudendal Neuralgia/physiopathology
5.
Daru ; 24(1): 24, 2016 Oct 06.
Article in English | MEDLINE | ID: mdl-27716437

ABSTRACT

BACKGROUND: Evaluations of silver in both nanoparticle (Ag-NPs) and ionic forms indicate some adverse effects on living organisms, but little is known about their potential for developmental toxicity. In this study, developmental toxicity of Ag-NPs (from 0.2 to 20 mg/kg/day) and ionic Ag (AgNO3, 20 mg Ag/kg/day) were investigated in rats. METHODS: Animals were dosed by gavage from gestation day 7 - 20. The day after parturition, dams and pups were sacrificed and Ag level assessed in several maternal and pup organs. In addition, hepatotoxicity and oxidative stress parameters and histopathology were evaluated. RESULTS: No treatment related effects were found for gestational parameters including pregnancy length, maternal weight gain, implantations, birth weight and litter size at any dose level of Ag-NPs. Maternal weight gain was lower in dams receiving AgNO3 compared to the other groups, suggesting that the ionic form may exert a higher degree of toxicity compared to the NP form. Tissue contents of Ag were higher in all treated groups compared to control dams and pups, indicating transfer of Ag across the placenta. The findings furthermore suggest that Ag may induce oxidative stress in dams and their offspring, although significant induction was only observed after dosing with AgNO3. Histopathological examination of brain tissue revealed a high incidence of hippocampal sclerosis in dams treated with nanoparticle as well as ionic Ag. CONCLUSION: The difference in offspring deposition patterns between ionic and NP Ag and the observations in dam brain tissue, requires scrutiny, and, if corroborated, indicate that ionic and NP forms maybe need separate risk assessments and that the hazard ratings of silver in both ionic and nanoparticle forms should be increased, respectively. TRIAL REGISTRATION: Not applicable. Developmental Toxicity of Ag-NPs.


Subject(s)
Metal Nanoparticles/toxicity , Silver Nitrate/toxicity , Silver/toxicity , Animals , Brain/drug effects , Brain/pathology , Female , Male , Maternal-Fetal Exchange , Milk/chemistry , Oxidative Stress/drug effects , Pregnancy , Rats, Sprague-Dawley , Silver/pharmacokinetics , Silver Nitrate/pharmacokinetics , Tissue Distribution , Weight Gain/drug effects
6.
Infez Med ; 24(3): 194-200, 2016 Sep 01.
Article in English | MEDLINE | ID: mdl-27668899

ABSTRACT

The purpose of this study was to evaluate the clinical and laboratory data of children with acute gastroenteritis caused by non-typhoid Salmonella spp. infections. Clinical (demographic data, symptoms and findings) and laboratory data (stool microscopy, rapid antigen tests, culture, multiplex polymerase chain reaction and blood test results) of children with acute gastroenteritis caused by non-typhoid Salmonella spp. between January 2010 and October 2012 were evaluated. Differences between the groups for categorical variables were estimated with a chi-square or Fisher exact test; for continuous variables with two independent samples a t test was used. P values < 0.05 were considered statistically significant. Sixty-seven children, 39 (58.2%) males and 28 (41.8%) females aged between 1 - 16 years (mean ± SD: 4.64 ± 2.91), were diagnosed with acute bacterial gastroenteritis caused by non-typhoid Salmonella spp. The main serotypes are Salmonella enteritidis (85%) and Salmonella typhimurium (7.5%). The presenting symptoms were diarrhoea (95.5%), fever (61.1%), vomiting (34.3%), abdominal pain (32.8%), loss of appetite (7.4%) and malaise (7.4%). Fever and dehydration (moderate and/or severe) were detected in 11 (16.4%) patients. The mean leukocyte count was 10.930/µL [95% confidence interval (CI), SD: ± 5.710/µL], neutrophil count was 7.880/µL (95% CI, SD: ± 4.960/µL), CRP was 64.16 mg/L (95% CI, SD: ± 76.24 mg/L), and erythrocyte sedimentation rate was 34.72 mm/hour (95% CI, SD: ± 13.64 mm/h). Stool microscopy was positive for leukocytes in 18 patients (26.8%). The definitive diagnosis was made with positive stool culture (n = 65) and/or PCR test (n = 4). Viral antigen positivity was detected in 10 patients (14.9%), evaluated as viral co-infection and false positive results. Antibiotic therapy and hospitalization were required in 26 (38.8%) and 23 (34.3%) patients, respectively. Salmonella carriage was detected in one patient (1.5%). Bloody diarrhoea, leukocytes in stool with an increased erythrocyte sedimentation rate and a CRP level without overt leukocytosis may indicate Salmonella infection. Viral antigens may cause false positive results in fast antigen tests in cases where clinical and laboratory findings indicate bacterial aetiology. Stool culture is a reference method in diagnosis whereas some agents may be detected via molecular techniques (polymerase chain reaction) in spite of negative culture. Multiplex polymerase chain reaction may be used to detect Salmonella spp. and may reveal false positivity for viruses as well as the detection of other bacteria.


Subject(s)
Gastroenteritis/epidemiology , Salmonella Infections/epidemiology , Acute Disease , Adolescent , Child , Child, Preschool , Coinfection , Endemic Diseases , False Positive Reactions , Feces/microbiology , Female , Gastroenteritis/diagnosis , Gastroenteritis/microbiology , Humans , Infant , Male , Polymerase Chain Reaction , Retrospective Studies , Salmonella Food Poisoning/epidemiology , Salmonella Food Poisoning/microbiology , Salmonella Infections/diagnosis , Salmonella Infections/microbiology , Salmonella enteritidis/isolation & purification , Salmonella typhimurium/isolation & purification , Seasons , Symptom Assessment , Turkey/epidemiology , Virus Diseases/complications , Water Pollution/adverse effects
7.
Infez Med ; 24(1): 32-7, 2016.
Article in English | MEDLINE | ID: mdl-27031894

ABSTRACT

We investigated the rates of increase in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels of patients with rotavirus, norovirus and enteric adenovirus gastroenteritis. Two hundred children with viral gastroenteritis were evaluated for hypertransaminasaemia retrospectively. The patients were between 0 - 17 years (mean ± SD: 5.10 ± 3.01) of age. ALT was elevated up to 67 IU/L in 7 (8.5%) patients in the rotavirus group (n=82), whereas it was elevated in 3 (4.0%) and 1 (2.3%) patients in the norovirus (n=74) and adenovirus (n=44) groups, respectively. AST was elevated up to 89 IU/L in 20 (24.4%) patients in the rotavirus group, whereas it was elevated in 6 (8.1%) and 1 (2.3%) patients in the norovirus and adenovirus groups, respectively. Both transaminases were elevated in 7.3%, 1.4%, and 2.3% of patients in the rotavirus, norovirus, and adenovirus groups, respectively. The increases in ALT and AST levels were found to be significantly higher in the rotavirus group (n=27) than in the norovirus (n=9), and adenovirus group (n=2) (p<0.05). Mean serum ALT and AST levels in the rotavirus group were significantly higher than those in the norovirus and adenovirus group (p<0.05). Our study investigated the correlation between viral gastroenteritis and hypertransaminasaemia. When evaluating a patient with hypertransaminasaemia physicians should remember to consider acute gastroenteritis due to some viruses as a cause of elevated AST and ALT.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Gastroenteritis/diagnosis , Gastroenteritis/virology , Rotavirus Infections/complications , Rotavirus Infections/diagnosis , Rotavirus/isolation & purification , Adenoviridae/isolation & purification , Adenoviridae Infections/complications , Adolescent , Biomarkers/blood , Caliciviridae Infections/complications , Child , Child, Preschool , Feces/virology , Female , Gastroenteritis/blood , Humans , Infant , Infant, Newborn , Male , Norovirus/isolation & purification , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity
8.
J Matern Fetal Neonatal Med ; 29(8): 1358-62, 2016.
Article in English | MEDLINE | ID: mdl-26115232

ABSTRACT

OBJECTIVE: To evaluate the effects of lower back pain (LBP) on postural equilibrium and fall risk during the third trimester pregnancy period by comparing postural stability between pregnant with LBP and pregnant without LBP control women. METHODS: The study population comprised 68 women of 24-35 years in the third trimester of pregnancy. They were divided into Groups 1 (n = 30) and 2 (n = 38) according to the presence or absence of LBP, respectively. Postural stability were evaluated between groups using Tetrax Interactive Balance System posturography (Tetrax, Sunlight Medical Ltd, Tel Aviv, Israel) with eight sensory conditions. RESULTS: For eight different positions, pregnant patients with LBP showed significantly higher values of general stability index, Fourier transformation index (F1, F2-F4, F5-F6 and F7-F8) and fall index than controls. CONCLUSION: LBP has a negative effect on postural stability. Postural equilibrium decreases and fall risk increases in pregnant patients with LBP.


Subject(s)
Low Back Pain/physiopathology , Postural Balance/physiology , Pregnancy Trimester, Third/physiology , Accidental Falls , Adult , Case-Control Studies , Female , Humans , Pregnancy , Regression Analysis , Risk Assessment , Young Adult
9.
Ann Transplant ; 20: 418-23, 2015 Jul 23.
Article in English | MEDLINE | ID: mdl-26204418

ABSTRACT

BACKGROUND: The most common treatment modality for postoperative pain relief following laparoscopic surgery is multimodal, using nonsteroidal antiinflammatory drugs (NSAID), opioids, and infiltration of local anesthetics. Because NSAIDs are nephrotoxic, local infiltration does not relieve deep tissue pain, and opioids have an adverse effects profile including pruritus, nausea, vomiting, oversedation, apnea, and decreased gastrointestinal motility. Therefore, the use of a regional analgesic technique can lead to an improved quality of recovery. The aim of this prospective, randomized, placebo-controlled study was to evaluate the effect of TAP block on postoperative verbal analog scale (VAS) scores and total morphine requirements in the first 24 hours after laparoscopic live donor nephrectomy. MATERIAL AND METHODS: After obtaining approval from the hospital ethics committee and written informed consent from the patients, 49 ASA I-II patients undergoing laparoscopic donor nephrectomy, aged 18 years or over, were included in this prospective, randomized, controlled study. In this clinical trial patients were divided into 2 groups: TAP block group (group T) and placebo group (group P). The demographic variables, pain scores, morphine consumption, level of sedation, presence of postoperative nausea, vomiting, pruritus, and average length of postoperative stay were reviewed. RESULTS: The pain scores were significantly lower after TAP block with bupivacaine at most but not all time points. Patients receiving the TAP block with bupivacaine required less morphine up to 24 hours after surgery compared with the saline group. CONCLUSIONS: USG-guided TAP block as part of a balanced analgesia regimen is of benefit in reducing postoperative pain and morphine consumption after laparoscopic donor nephrectomy.


Subject(s)
Anesthetics, Local/therapeutic use , Bupivacaine/therapeutic use , Kidney Transplantation/adverse effects , Living Donors , Nephrectomy/adverse effects , Pain Management/methods , Pain, Postoperative/drug therapy , Adult , Double-Blind Method , Female , Humans , Kidney Transplantation/methods , Laparoscopy/adverse effects , Male , Middle Aged , Morphine/therapeutic use , Narcotics/therapeutic use , Nephrectomy/methods , Pain Measurement , Prospective Studies , Treatment Outcome
10.
Caries Res ; 49(1): 70-7, 2015.
Article in English | MEDLINE | ID: mdl-25531160

ABSTRACT

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of an imbalance of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred and fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in 10 genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC, whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene interactions can act as protective or risk factors for ECC. These factors together contribute to the presence and severity of the disease.


Subject(s)
Amelogenesis/genetics , Dental Caries/genetics , Genes, MHC Class II/genetics , Genetic Variation/genetics , Adenine , Arachidonate 15-Lipoxygenase/genetics , Child, Preschool , Cross-Sectional Studies , Cytosine , Dental Enamel Proteins/genetics , Epistasis, Genetic/genetics , Extracellular Matrix Proteins/genetics , Feeding Behavior , Female , Gene-Environment Interaction , Genetic Markers/genetics , Guanine , Humans , Kallikreins/genetics , Lactoferrin/genetics , Male , Polymorphism, Genetic/genetics , Thymine
11.
Clin Biochem ; 47(13-14): 1231-4, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24882509

ABSTRACT

OBJECTIVES: Accelerated atherosclerosis is the major cause of mortality in patients on chronic maintenance hemodialysis (HD). Epicardial fat tissue (EFT) is a new risk factor in cardiovascular disease (CVD). The aim of this study was to evaluate the relation between plasma coenzyme Q10 levels (Co-Q10) which is a potent physiologic antioxidant and EFT thickness in HD patients. DESIGN AND METHODS: Seventy one chronic HD patients and 65 age and sex matched healthy individuals were included in the study. Plasma Co-Q10 levels were performed by high-performance liquid chromatography (HPLC) measurements. EFT was measured by transthoracic echocardiograpy (TTE) performed with a VIVID 7 instrument. RESULTS: Plasma Co-Q10 levels (1.36±0.43 vs 2.53±0.55, p<0.001) were significantly lower in HD patients compared to controls. EFT was significantly increased in HD patients compared to healthy controls (6.53±1.01 vs. 5.79±1.06 mm respectively, p<0.001). Correlation analysis showed that plasma Co-Q10 levels were inversely correlated with EFT (r=-0.263, p<0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. According to linear regression analysis, age, BMI, total cholesterol and Co-Q10 levels were found to be independent predictors of EFT (adjusted r(2)=0.38, p<0.001). CONCLUSION: This study demonstrated that EFT thickness was significantly higher among HD patients compared to healthy controls. In addition; this study was the first to demonstrate an inverse correlation between EFT thickness and Co-Q10 levels in this patient population.


Subject(s)
Adipose Tissue/physiopathology , Antioxidants/metabolism , Cardiovascular Diseases/blood , Cardiovascular Diseases/physiopathology , Ubiquinone/analogs & derivatives , Adipose Tissue/diagnostic imaging , Adult , Cardiovascular Diseases/diagnostic imaging , Carotid Arteries/diagnostic imaging , Carotid Arteries/physiopathology , Carotid Intima-Media Thickness , Case-Control Studies , Echocardiography/methods , Female , Humans , Male , Middle Aged , Pericardium/diagnostic imaging , Pericardium/physiopathology , Renal Dialysis/methods , Risk Factors , Ubiquinone/blood
12.
Gynecol Endocrinol ; 30(5): 372-6, 2014 May.
Article in English | MEDLINE | ID: mdl-24576292

ABSTRACT

The aim of our study is to demonstrate which cut-off value of serum anti-Müllerian hormone (AMH) level can predict poor ovarian reserve, poor ovarian response to stimulation and IVF outcomes. About 311 of 520 women enrolled IVF treatment cycle that meets inclusion criteria were recruited for this prospective data analysis. Data were collected for: age, duration of infertility, basal FSH and AMH level, total dosage of gonadotropins, maximum estradiol levels, duration of stimulations, total number of oocytes retrieved and clinical PR. Mean AMH was 1.76 ± 1.4 ng/ml and mean age was 33.25 ± 5.5 years. Clinical PR was 39.8% (n = 124). AMH was inversely correlated to total dosage of gonadotropins and age, AMH positively had a significant correlation with maximum estradiol levels, duration of stimulations and total number of oocytes retrieved. The patients in both categories of AMH levels, ≤0.5 and ≤1 ng/ml responded poorly to ovarian stimulation, had significantly higher total dosage of gonadotropins used and FSH levels on cycle day 3, lower maximum E2 levels and clinical PR. AMH could be an acceptable screening test in prediction of ovarian reserve, response to ovarian stimulation and PRs. AMH cut-off value ≤1 ng/ml may predict poor ovarian reserve, poor ovarian response to stimulation and IVF outcomes.


Subject(s)
Anti-Mullerian Hormone/blood , Follicle Stimulating Hormone/blood , Ovarian Reserve/physiology , Ovulation Induction/methods , Adult , Estradiol/blood , Estradiol/physiology , Female , Fertilization in Vitro/methods , Humans , Prospective Studies , Statistics, Nonparametric
13.
Gynecol Endocrinol ; 30(7): 485-9, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24592985

ABSTRACT

PURPOSE: To compare the effects of microdose GnRH-a flare-up, GnRH antagonist/aromatase inhibitor letrozole and GnRH antagonist/clomiphene citrate protocols on IVF outcomes in poor responder patients. METHODS: Of 225 patients, 83 patients were in microdose flare-up group (Group 1), 70 patients were in GnRH antagonist/letrozole group (Group 2) and 72 patients were in GnRH antagonist/clomiphene citrate group (Group 3). Demographic and endocrine characteristics, the total number of oocytes retrieved, cancellation rate and clinical pregnancy rate were collected Results: Total dosage of gonadotropins (p=0.002) and serum E2 levels on the day of hCG administration (p=0.010) were significantly higher and duration of stimulations (p=0.03) was significantly longer in group 1. The number of oocytes retrieved was significantly greater in group 1 and 2 when compare to those of group 3 (p=0,000). There was a trend towards increasing cycle cancellation rates with GnRH antagonist/clomiphene citrate and GnRH antagonist/letrozole. CONCLUSION: Our finding suggest that the results of microdose flare-up protocol are better than other two used treatment protocols, in terms of maximum estradiol levels, number of mature oocytes retrieved, and cancellation rate and it still seems to be superior the ovarian stimulation regime for the poor responder patients.


Subject(s)
Clomiphene/administration & dosage , Infertility, Female/therapy , Nitriles/administration & dosage , Ovarian Follicle/drug effects , Ovulation Induction/methods , Sperm Injections, Intracytoplasmic/methods , Triazoles/administration & dosage , Adult , Aromatase Inhibitors/administration & dosage , Estradiol/blood , Female , Gonadotropin-Releasing Hormone/agonists , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Humans , Infertility, Female/blood , Infertility, Female/drug therapy , Letrozole , Oocyte Retrieval , Ovarian Follicle/diagnostic imaging , Pregnancy , Retrospective Studies , Statistics, Nonparametric , Ultrasonography
14.
Int J Neurosci ; 124(6): 443-9, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24094130

ABSTRACT

The purpose of this study was to investigate whether functional polymorphisms of apoptosis pathway genes FAS and FASL are associated with the development of primary brain tumors. The study constituted 83 patients with primary brain tumor and 108 healthy individuals. In the present case-control study, the primary brain tumors were divided into two groups: gliomas and meningiomas. Evaluation of FAS -1377 G/A and FASL -844 T/C gene polymorphisms were performed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). To confirm the genotyping, results were examined by DNA sequencing method. Our results were analyzed by SPSS. The frequency of the FAS -1377 AA genotype was significantly lower in meningioma and glioma patients compared to controls (p = 0.023; p = 0.001, respectively). Multivariate logistic regression analysis revealed that FAS -1377 AA genotype was associated with decreased risk of meningioma and glioma (OR = 0.092, 95% CI: 0.012-0.719, p = 0.023 for meningiomas; OR = 0.056, 95% CI: 0.007-0.428, p = 0.006 for gliomas). However, there was no significant differences in FASL -844 T/C genotype frequencies between patients with primary brain tumors and controls (p > 0.05). In this study, combined genotypes were evaluated for association with primary brain tumors. Combined genotype analysis showed that the frequencies of AATC and AACC were significantly lower in glioma patients in comparison with those of controls (p = 0.023; p = 0.022, respectively). This study provides the first evidence that FAS -1377 AA genotype may have a protective effect on the developing primary brain tumor in a Turkish population.


Subject(s)
Brain Neoplasms/genetics , Fas Ligand Protein/genetics , Glioma/genetics , Meningeal Neoplasms/genetics , Meningioma/genetics , fas Receptor/genetics , Adult , Case-Control Studies , Female , Humans , Male , Middle Aged , Polymorphism, Genetic , Turkey
15.
Eur J Obstet Gynecol Reprod Biol ; 172: 46-50, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24192665

ABSTRACT

OBJECTIVE: To evaluate the relationship between the pregnancy rate (PR) and the positioning of the intrauterine catheter at embryo transfer (ET) under transabdominal ultrasound (US) guidance in in vitro fertilization (IVF) cycles. STUDY DESIGN: Prospective data analysis of 281 consecutive US-guided fresh ETs performed by a single physician at Yeditepe University Hospital IVF Center, Istanbul, Turkey, after controlled ovarian hyperstimulation between April 2012 and March 2013. The length of the uterine cavity (A), the distance between the fundal endometrial surface and the tip of inner catheter (B), the distance between the fundal endometrial surface and the air bubbles (C), and the pregnancy rates (PRs) were recorded. RESULTS: The mean age of the patients was 33.25±5.5 years. Of all transfers, 115 (40.9%) resulted in a clinical pregnancy. With regard to distance (C), the clinical intrauterine pregnancy rates were 65.2%, 32.2% and 2.6% in the <10mm, 10-20mm, and 20mm distance groups, respectively. The PR was dramatically reduced in cases with >10mm between the fundal endometrial surface and the air bubbles, although this did not reach statistical significance. Between those patients who conceived and those who did not, there was no significant difference in terms of the distance between the fundal endometrial surface and the tip of inner catheter, the ratio of A/B or the ratio of B/C. CONCLUSIONS: The final position of the air bubble used as an identifier of the position of the embryo at ET can be determinative for PR, although it cannot be predicted. Clinical pregnancy rates appeared higher in cases with air bubbles closer to the fundus and the optimal position of the air bubble seems to be a distance of <10mm from the fundal endometrial surface. It could be advisable to monitor the final position of air bubble at ET for identifying PR. In addition, the depth of uterine cavity may be considered to indirectly be important factor as it affects ET depth. The optimal distance between the fundal endometrial surface and the tip of inner catheter is 1.5-2cm. Further well-designed randomized controlled trials are required to optimize ET technique in the future.


Subject(s)
Embryo Transfer/methods , Pregnancy Rate , Ultrasonography, Interventional/methods , Uterus/diagnostic imaging , Adult , Catheterization/methods , Cohort Studies , Embryo Transfer/instrumentation , Female , Fertilization in Vitro , Humans , Pregnancy , Prospective Studies , Uterus/anatomy & histology
16.
Indian J Pediatr ; 81(2): 138-42, 2014 Feb.
Article in English | MEDLINE | ID: mdl-23749414

ABSTRACT

OBJECTIVE: To evaluate the utility of rapid antigen detection testing (RADT) for the diagnosis of group A beta-hemolytic streptococcal tonsillopharyngitis in children, and to detect the sensitivity and specificity of rapid antigen detection of group A beta-hemolytic streptococci from throat specimen compared with throat culture. METHODS: Rapid antigen detection and throat culture results for group A beta-hemolytic streptococci from outpatients attending university hospital between 1st January 2011 and 31st of December 2011 were evaluated retrospectively. The antigen test negative-throat culture positive patients were investigated for streptococcal carriage. For this purpose, the throat culture results taken from these patients were reviewed after treatment. RESULTS: Eight hundred and ninetytwo children were included in the studywith a mean age of 5.34 y. There were 639 and 253 children in two groups with age of 0-6 and 7-17 y, RADT sensitivity and specificity were found to be 59.5 % and 97.2 %, respectively. The positive predictive value was 87.1 %, whereas negative predictive value was 88.4 %. After treatment of 74 patients with throat culture positive and antigen test negative. Group A beta-hemolytic streptococci were isolated in 12 of them (16.2 %) and accepted as a carrier. CONCLUSIONS: The low sensitivity of the RADT may be related to streptococcal carriage in some patients. The throat culture should be repeated after treatment to detect streptococcal carriage.


Subject(s)
Antigens, Bacterial/immunology , Pharyngitis/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes , Tonsillitis/microbiology , Adolescent , Child, Preschool , Female , Humans , Immunoassay , Infant , Male , Pharynx/microbiology , Sensitivity and Specificity
17.
Hemodial Int ; 18(1): 62-9, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24034564

ABSTRACT

Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross-sectional study including 71 chronic HD patients and 65 age- and sex-matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53 ± 1.01 mm vs. 5.79 ± 1.06 mm, respectively, P < 0.001). On transthoracic Doppler echocardiography, CFR values were significantly lower in HD patients when compared to healthy controls (1.73 ± 0.11 vs. 2.32 ± 0.28, P < 0.001). Correlation analysis showed CFR values to be inversely correlated with EFT (r = -0.287, P < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. Artery flow reserve, age, body mass index and total cholesterol levels were independently correlated with EFT thickness. This study demonstrated that EFT was significantly higher among HD patients compared to healthy controls. In addition, this study was the first to demonstrate an inverse correlation between EFT and CFR in this patient population.


Subject(s)
Adipose Tissue , Cardiovascular Diseases , Coronary Circulation , Echocardiography, Doppler , Pericardium , Adipose Tissue/diagnostic imaging , Adipose Tissue/physiopathology , Adult , Aged , Blood Flow Velocity , Cardiovascular Diseases/diagnostic imaging , Cardiovascular Diseases/physiopathology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pericardium/diagnostic imaging , Pericardium/physiopathology , Risk Factors
18.
Biol Trace Elem Res ; 155(3): 333-8, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24178732

ABSTRACT

Cardiovascular diseases are the main reason of high mortality among hemodialysis patients. Decreased serum selenium levels may have a role in accelerated atherosclerosis in this patient group. The hypothesis of this study was to show a correlation between decreased serum selenium levels and coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in HD patients. Seventy-one chronic hemodialysis patients and age 65 and sex-matched healthy controls were included in the study. Plasma selenium levels were measured by spectrophotometry, and coronary flow reserve was assessed by transthoracic Doppler echocardiography. Serum selenium levels (34.16 ± 6.15 ng/ml vs. 52.4 ± 5.51 ng/ml, P < 0.001) and coronary flow reserve values (1.73 ± 0.11 vs. 2.32 ± 0.28, P < 0.001) were significantly lower in hemodialysis patients compared with controls, respectively. There was a significant positive correlation between coronary flow reserve and serum levels of selenium (r = 0.676, P < 0.001). A linear regression analysis showed that serum levels of selenium were independently and positively correlated with coronary flow reserve (regression coefficient = 0.650, P < 0.05). This study was the first to show a positive and independent correlation between decreased selenium levels and diminished coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in hemodialysis patients. Our data suggest that decreased serum selenium levels may facilitate the development of endothelial dysfunction and disruption of coronary flow reserve which occur before the development of overt atherosclerosis.


Subject(s)
Coronary Circulation/physiology , Renal Dialysis , Selenium/blood , Adult , Female , Humans , Male , Middle Aged , Parathyroid Hormone/blood
19.
Ital J Pediatr ; 39: 22, 2013 Mar 27.
Article in English | MEDLINE | ID: mdl-23536956

ABSTRACT

BACKGROUND: The purpose of this study was to determine the incidence and seasonal distribution of viral etiological agents and to compare their clinical manifestations and disease severity, including single and co infections. METHODS: Multiplex reverse-transcription PCR was performed for the detection of viruses in nasopharyngeal aspirat. Disease severity was grouped using a categorization index as very mild/mild, and moderate/severe. Clinical and laboratory characteristics of hospitalized children with viral respiratory tract infection were analyzed. RESULTS: Viral pathogens were detected in 103/155 (66.5%) of patients. In order of frequency, identified pathogens were respiratory syncytial virus (32.0%), adenovirus (26.2%), parainfluenza viruses type 1-4 (19.4%), rhinovirus (18.4%), influenza A and B (12.6%), human metapneumovirus (12.6%), coronavirus (2.9%), and bocavirus (0.9%). Coinfections were present in 21 samples. Most of the children had very mild (38.8%) and mild disease (37.9%). Severity of illness was not worse with coinfections. The most common discharge diagnoses were "URTI" with or without LRTI/asthma (n=58). Most viruses exhibited strong seasonal patterns. Leukocytosis (22.2%) and neutrophilia (36.6%) were most commonly detected in patients with adenovirus and rhinovirus (p<0.05). Monocytosis was the most remarkable finding in the patients (n=48, 53.3%), especially in patients with adenovirus (p<0.05). CONCLUSIONS: RSV and RhV were associated with higher severity of illness in hospitalized children. RSV found to account for half of LRTI hospitalizations. In AdV and FluA and B infections, fever lasted longer than in other viruses. Coinfections were detected in 21 of the patients. The presence of coinfections was not associated with increased disease severity.


Subject(s)
Child, Hospitalized/statistics & numerical data , Respiratory Tract Infections/virology , Child , Child, Preschool , Cohort Studies , Female , Hospitals, University , Humans , Incidence , Infant , Male , Multiplex Polymerase Chain Reaction , Prevalence , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , Retrospective Studies , Seasons , Severity of Illness Index , Turkey/epidemiology
20.
J Tissue Eng Regen Med ; 7(2): 149-60, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22081628

ABSTRACT

The effects of double release of insulin-like growth factor I (IGF-I) and growth factor ß1 (TGF-ß1) from nanoparticles on the growth of bone marrow mesenchymal stem cells and their differentiation into cartilage cells were studied on PLGA scaffolds. The release was achieved by using nanoparticles of poly(lactic acid-co-glycolic acid) (PLGA) and poly(N-isopropylacrylamide) (PNIPAM) carrying IGF-I and TGF-ß1, respectively. On tissue culture polystyrene (TCPS), TGF-ß1 released from PNIPAM nanoparticles was found to have a significant effect on proliferation, while IGF-I encouraged differentiation, as shown by collagen type II deposition. The study was then conducted on macroporous (pore size 200-400 µm) PLGA scaffolds. It was observed that the combination of IGF-I and TGF-ß1 yielded better results in terms of collagen type II and aggrecan expression than GF-free and single GF-containing applications. It thus appears that gradual release of a combination of growth factors from nanoparticles could make a significant contribution to the quality of the engineered cartilage tissue.


Subject(s)
Cartilage/drug effects , Insulin-Like Growth Factor I/pharmacology , Tissue Engineering/methods , Transforming Growth Factor beta1/pharmacology , Acrylamides/pharmacology , Acrylic Resins , Aggrecans/metabolism , Animals , Cattle , Cell Proliferation/drug effects , Collagen/metabolism , Collagen Type II/metabolism , Extracellular Matrix/drug effects , Extracellular Matrix/metabolism , Glycosaminoglycans/metabolism , Lactic Acid/pharmacology , Male , Microscopy, Confocal , Nanoparticles/ultrastructure , Particle Size , Polyglycolic Acid/pharmacology , Polylactic Acid-Polyglycolic Acid Copolymer , Polymers/pharmacology , Rats , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Serum Albumin, Bovine/metabolism , Tissue Scaffolds/chemistry
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