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1.
Minerva Endocrinol (Torino) ; 48(3): 282-287, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36285745

RESUMO

BACKGROUND: The aim of this study was to determine whether sirtuin-1 (SIRT1), which has a regulatory role in glucose and lipid metabolism with its deacetylase activity, has a decisive role in predicting gestational diabetes (GDM). METHODS: This study was performed at the antenatal outpatient clinic of Ankara City Hospital between January 2021 and May 2021. A total of 525 women with low-risk pregnancy underwent the 75 g oral glucose tolerance test (OGTT) between 24th-28th weeks of pregnancy during the study period. Fasting serum SIRT1 levels of patients diagnosed with GDM according to OGTT results were compared some of those without GDM. RESULTS: Of the 525 pregnant women who underwent 75 g OGTT, 50 (9.6%) were diagnosed with GDM. The data of pregnant women with GDM were compared with age and Body Mass Index matched 122 controls. While serum SIRT1 levels were 22.0 (19.9-24.3) ng/mL in the GDM group, it was 34.7 (28.8-54.6) ng/mL in the control group (P<0.001). ROC curve analysis showed that a threshold level for serum SIRT1 equal to or greater than 27.3 ng/mL may predict GDM with a sensitivity of 86% and specificity of 80%. CONCLUSIONS: Second-trimester low serum SIRT1 levels are associated with GDM. It may be a diagnostic marker for GDM.


Assuntos
Diabetes Gestacional , Feminino , Humanos , Gravidez , Glicemia/análise , Diabetes Gestacional/diagnóstico , Teste de Tolerância a Glucose , Segundo Trimestre da Gravidez , Sirtuína 1
2.
J Perinat Med ; 50(1): 46-55, 2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-34411469

RESUMO

OBJECTIVES: We aimed to evaluate the cardiotocograph (CTG) traces of 224 women infected with novel coronavirus 2019 (COVID-19) and analyze whether changes in the CTG traces are related to the severity of COVID-19. METHODS: We designed a prospective cohort study. Two-hundred and twenty-four women who had a single pregnancy of 32 weeks or more, and tested positive for SARS-CoV-2 were included. Clinical diagnosis and classifications were made according to the Chinese management guideline for COVID-19 (version 6.0). Patients were classified into categories as mild, moderate, severe and the CTG traces were observed comparing the hospital admission with the third day of positivity. RESULTS: There was no statistically significant relationship between COVID-19 severity and CTG category, variability, tachycardia, bradycardia, acceleration, deceleration, and uterine contractility, Apgar 1st and 5th min. CONCLUSIONS: Maternal COVID-19 infection can cause changes that can be observed in CTG. Regardless of the severity of the disease, COVID-19 infection is associated with changes in CTG. The increase in the baseline is the most obvious change.


Assuntos
COVID-19/fisiopatologia , Coração Fetal/fisiopatologia , Complicações Infecciosas na Gravidez/fisiopatologia , Adolescente , Adulto , Cardiotocografia , Feminino , Frequência Cardíaca Fetal , Humanos , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Adulto Jovem
3.
J Matern Fetal Neonatal Med ; 34(1): 105-111, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32907417

RESUMO

OBJECTIVE: We aimed to evaluate the changes in cardiac functions by echocardiography and oxidative stress markers in pregnant women with iron deficiency anemia. METHOD: A total of 100 patients (pregnant women with IDA n = 34, healthy pregnant women n = 33, non-pregnant control group n = 33) were enrolled. Demographic data, serum thiol-disulfide and ischemia modified albumin levels, and echocardiographic parameters were compared. RESULTS: Native thiol (NT) (p < .001) and Total Thiol (TT) (p < .001) levels as antioxidant markers; left ventricular ejection fraction (LVEF) (p < .001), tricuspid annular plane systolic excursion (TAPSE) (p < .001) were significantly decreased in the IDA group compared to healthy pregnant women and non-pregnant controls. Adjusted IMA ratios were significantly increased in the IDA group (p =.001). A significant negative correlation was determined between adjusted IMA and LVEF (r = -0,4226; p =.016), a significant positive correlation was determined between thiol levels and TAPSE (r = 0.361; p =.041) in IDA group, no correlation was observed in healthy pregnant women and healthy non-pregnant control group. CONCLUSION: Anemia in pregnanc may trigger oxidative stress and increased OS may be related to changes in cardiac functions. The possible cardiovascular impact should be considered in pregnant women with anemia and clinicians should not neglect to refer these patients to cardiology in clinical practise.


Assuntos
Anemia Ferropriva , Função Ventricular Esquerda , Biomarcadores/metabolismo , Feminino , Humanos , Estresse Oxidativo , Gravidez , Albumina Sérica , Volume Sistólico
4.
J Matern Fetal Neonatal Med ; 32(23): 3998-4004, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29890882

RESUMO

Objective: The aim of this study was to determine the epidemiological characteristics of maternal mortality due to postpartum hemorrhage, and to investigate whether national preventative measures of the Maternal Mortality Program have been successful in Turkey. Design: A population-based cohort study. Setting: Turkish National Maternal Mortality Data collected by the Turkish Ministry of Health. Participants: Women who died due to hemorrhage during pregnancy or after delivery within the initial 42 days, from 2012 to 2015, throughout Turkey (N = 812/146). Main outcome measures: The preventability and problems in each maternal death due to hemorrhage. Results: A total of 779 maternal deaths were identified during the study period. Our estimate of the Maternal Mortality Ratio (MMR) in the 3-year period was 19.7 per 100,000 live births. Of the 779 deaths, the report listed 411 as direct and 285 as indirect deaths. Direct obstetric complications were the leading causes of maternal deaths, the most common of which was maternal cardiovascular diseases (21%) and obstetric hemorrhage (20.6%). Conclusion: Improving data surveillance and implementing national guidelines for the prevention and management of major complications of pregnancy, childbirth, and puerperium is necessary to reduce MMR. The healthcare authorities of Turkey should continue to set a sustainable development goal of ≤70 maternal deaths per 100,000 live births by 2030. We believe our results may provide useful information for other developing countries that are aiming to reduce maternal mortality, as well as mobilize global efforts to improve women's health.


Assuntos
Mortalidade Materna , Hemorragia Pós-Parto/mortalidade , Complicações na Gravidez/mortalidade , Adulto , Causas de Morte , Estudos de Coortes , Parto Obstétrico/efeitos adversos , Parto Obstétrico/métodos , Parto Obstétrico/mortalidade , Feminino , História do Século XXI , Humanos , Mortalidade Materna/tendências , Hemorragia Pós-Parto/etiologia , Gravidez , Complicações na Gravidez/etiologia , Turquia/epidemiologia , Adulto Jovem
5.
J Turk Ger Gynecol Assoc ; 15(3): 164-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25317045

RESUMO

OBJECTIVE: To identify surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastasis from endometrial cancer. MATERIAL AND METHODS: Patients with endometrial cancer operated on between 1993-2012 in our hospital and who had omental metastases were included. Patients with either uterine sarcoma or synchronous tumors were excluded. RESULTS: Omentectomy was performed in 811 patients with endometrial cancer, and omental metastasis was found in 48 (5.9%) patients. Tumor type was endometrioid cancer in 26 patients. Omental metastasis was macroscopic and microscopic in 60% and 40% of the patients, respectively. Total omentectomy increased the chance of detection of the microscopic metastases. Among the patients with omental metastasis, 68.8% had positive peritoneal cytology, 66.7% had adnexal involvement, 60.5% had metastases in the lymph nodes, 47.9% had cervical involvement, and 29.2% had serosal involvement; 43.8% of these patients had intra-abdominal spread beyond the omentum, adnexa, and peritoneal cytology. Two-year disease-free survival (DFS) was 28.2%, and 2-y overall survival (OS) was 40%. The depth of myometrial invasion, grade, cytology, and status of pelvic lymph nodes affected 2-y DFS, while cervical invasion and cytology affected 2-y OS. CONCLUSION: Omental metastasis in endometrial cancer means poor prognosis, and two-thirds of these patients are lost at the end of the second year. Although total omentectomy increases the chance of the detection of micrometastases, its effect on survival is controversial. New treatment modalities are necessary in this patient group.

6.
Turk Patoloji Derg ; 29(3): 210-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24022311

RESUMO

OBJECTIVE: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. MATERIAL AND METHOD: Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared. RESULTS: The mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. There was significant difference with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively The most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). CONCLUSION: In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women.


Assuntos
Carcinoma de Células Escamosas/virologia , Infecções por Papillomavirus/virologia , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/virologia , Adulto , Idoso , Carcinoma de Células Escamosas/epidemiologia , DNA Viral/análise , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Prevalência , Estudos Retrospectivos , Turquia/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem , Displasia do Colo do Útero/epidemiologia
7.
J Urol ; 188(1): 194-9, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22591959

RESUMO

PURPOSE: We present the 5-year results of a randomized controlled trial comparing the efficacy of a transobturator tape operation with an adjustable mini-sling (tissue fixation system) for the treatment of stress urinary incontinence. MATERIALS AND METHODS: This prospective randomized controlled trial comprised 80 female patients with only urodynamically proven stress urinary incontinence. The participants were randomly allocated to the transobturator tape group or the tissue fixation system group according to a computer program at a maternity research hospital. The patients were reassessed 5 years after surgery. Primary outcome measures were objective and subjective cure rates as well as total failure rate. RESULTS: Total followup was 64 months (range 58 to 70). The objective cure, subjective cure and failure rates in the tissue fixation system group were 83% (30 cases), 6% (2) and 11% (4), respectively. The objective cure, subjective cure and failure rates in the transobturator tape group were 75% (27 cases), 3% (1) and 22% (8), respectively. The difference in objective cure rates was statistically significant in favor of the tissue fixation system (p = 0.029). The difference in decreased cure rates between 5 and 3 years was 7% (90% to 83%) for the tissue fixation system vs 9% (84% to 75%) for the transobturator tape. The relative decrease in cure rates between the 2 groups was not statistically significant (p = 0.16). CONCLUSIONS: Contrary to reports in the literature of poor results with mini-slings, the tissue fixation system mini-sling demonstrated a higher cure rate and lower complication rate than the transobturator tape.


Assuntos
Slings Suburetrais , Técnicas de Sutura , Incontinência Urinária por Estresse/cirurgia , Micção , Procedimentos Cirúrgicos Urológicos/métodos , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária por Estresse/fisiopatologia
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