Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes.

PURPOSE: To study the effect of maternal lipid profile changes in pregnancy in relation to fetal growth and development, prognosis, and complications of pregnancy. METHODS: One thousand pregnant women between 17 and 48 years of age were included in this prospective longitudinal and uni-center study. Lipid profile tests [triglyceride (TG), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL)] were first requested as part of the routine pregnancy follow-up in first antenatal visit (<14 weeks) then repeated in the last trimester (>28 weeks). The analysis included the medical, social-demographic, and nutritional status of the women as well. Primer outcome measures were defined as the association of the pregnancy-related lipid profile change to neonatal weight, the weight of the infant in third month and pregnancy complications (preeclampsia, gestational diabetes mellitus, IUGR, and preterm birth). RESULTS: The levels of TG, total cholesterol, HDL, LDL increased significantly as pregnancy progressed. The percentage of the change in the TG levels were higher in patients with well nutritional parameters (p = 0.033). As the percentage of change in the TG levels increased, the neonatal weight increased (p = 0.033) but no effect on the placental weight and the third month weight of the infant was seen. As the percent change in TG levels decreased, the risk of the preterm birth significantly increased. In women who were positive in 50 g screening test, but were uncomplicated with gestational diabetes mellitus, the percent change in cholesterol was lower (p = 0.010), the percent change in LDL was lower (p = 0.015), and the percent change in TG was higher (p = 0.032). CONCLUSION: In pregnancy, complex alterations occur in lipid metabolism. Percent change in TG is affected positively by the nutrition level. The neonatal weight also increases as well but postnatal weight is unaffected. Conversely TG levels significantly decrease in preterm birth. No association between preeclampsia and gestational diabetes mellitus with lipid profile changes were noted except in patients with glucose intolerance (>140 mg/dl in 50 g screening test) in which change in cholesterol, LDL was low and TG was high.

[Early diagnosis of colorectal anastomotic leakages by detection of bacterial genome]. / Mikrobiyal DNA tayini ile kolorektal anastomoz kaçaklarinin erken tanisi.

BACKGROUND: Microbial infections and translocation of intestinal bacteria are thought to contribute to multiple system organ failure, but bacterial cultures are often negative in patients with this complication. The purpose of this study was to determine the sensitivity of PCR for detecting microbial DNA in the blood of animals after conducting an experimental model of anastomotic leakage. METHODS: Fourty rats were divided into three groups as follows: Control Group; simple laparotomy group, Anastomosis Group; colon resection and anastomosis group, and Leakage Group; group with colon resection and an anastomosis leaving a 5 mm opening. Blood was drawn form rats before the procedure, and postoperative 3rd and 6th days. DNAs were extracted from these samples and PCR techniques were used to amplify genes of Escherichia coli. Statistical analysis for the percentage of rats with microbial DNA in the blood for all groups was done by Fisher's exact chi- square test. The difference among groups was considered significant if the P value was less than 0.05. RESULTS: Most of the detected Escherichia coli genes were from the Leakage Group, and the detection rate was significant compared to other groups. CONCLUSION: We suggest that PCR could be a useful adjunct tool for immediate diagnosis of anastomotic leakages.