Autistic traits in women with primary dysmenorrhea: a case-control study.

OBJECTIVES: Recent studies have shown that women with autism spectrum disorder have higher rates of menstrual problems, including irregular menstrual cycles, unusually painful periods (dysmenorrhea), and excessive menstrual bleeding. In this study, we investigated the autistic traits in female university students with primary dysmenorrhea (PD). METHODS: Seventy females with PD and 70 females without PD were enrolled in the study. The Autism Spectrum Quotient (AQ) was used to measure autistic traits and the Brief Symptom Inventory was used for evaluating anxiety and depression levels. The dysmenorrheal pain was assessed by visual analog scale (VAS), coded from 0 to 10. Weight and height were measured, and the body mass index was calculated. RESULTS: There were no statistical differences between the groups in terms of age, duration of education, and body mass index. Women with PD had higher AQ - Total, and AQ - Attention Switching subscale scores than subjects without PD. Spearman analysis revealed that AQ - Total and AQ - Attention Switching scores were correlated with VAS. According to the linear regression analysis, VAS was predicted only by AQ - Attention Switching subscale. CONCLUSION: Our findings showed an association between autistic traits and dysmenorrhea in typically developing females.

Attention deficit-hyperactivity disorder symptoms in women with polycystic ovary syndrome.

OBJECTIVES: Several studies suggest that androgens are involved in the etiology of attention deficit-hyperactivity disorder (ADHD). In this study, we investigated the ADHD symptoms in women with polycystic ovary syndrome (PCOS), a complex endocrine, hormonal, and metabolic condition associated with hyperandrogenism. METHODS: Forty women between the ages of 18 and 35 years with PCOS were recruited for the study group. For comparison, 40 healthy women who had regular menses were included. Current and childhood ADHD symptoms were assessed by using the Adult ADHD Self-Report Scale and Wender-Utah Rating Scale, respectively. RESULTS: Women with PCOS had higher total Adult ADHD Self-Report Scale and total Wender-Utah Rating Scale scores than controls. According to the Wender-Utah Rating Scale, the frequency of childhood ADHD was significantly higher in PCOS group than the control. Adult ADHD Self-Report Scale: Hyperactivity-Impulsivity and Wender-Utah Rating Scale: Behavioral Problems/Impulsivity scores were significantly higher in women with PCOS. However, there were no significant differences between groups in both current and childhood inattention scores. We found no correlations between ADHD symptoms and serum hormone levels including testosterone in women with PCOS. CONCLUSIONS: These results suggest that women with PCOS have higher ADHD symptoms. Further studies are needed to investigate the association between PCOS and ADHD.

Association of parity with osteoprotegerin levels and atherosclerosis.

PURPOSE: Association of serum osteoprotegerin (OPG) levels and cardiovascular disorders has been shown previously. The aim of this observational study was to investigate the relationship between parity, OPG and carotid intima-media thickness (CIMT) in premenopausal women. METHODS: A total of 128 women (mean age ± SD, 37.8 ± 4.7 years) were divided into three group according to parity [1-3 as group 1 (n = 41), 4-6 as group 2 (n = 55) and ≥7 as group 3 (n = 32)]. Serum OPG was measured and CIMT was evaluated. RESULTS: Both serum OPG levels and CIMT tended to increase with advancing parity; OPG level was significantly higher in group 3 than in group 1 (p = 0.013) and CIMT was significantly higher in group 2 and group 3 than in group 1 (p < 0.001 for both). In correlation analyses, there were significant correlations between all three parameters. CONCLUSIONS: Our results revealed that there was an increased risk of cardiovascular disease in women with multiparity. Significant association of OPG with CIMT suggested that OPG might play a role in the pathogenesis of parity-induced atherosclerosis.

Association of serum amyloid A with subclinical atherosclerosis in women with gestational diabetes.

The aim of our study was to evaluate serum amyloid A (SAA), an acute phase reactant, and carotid intima-media thickness (CIMT) as a valid predictor of atherosclerosis in women with gestational diabetes mellitus (GDM). Serum samples from 39 pregnant women with GDM and 25 healthy pregnant women were collected for the analysis of SAA. CIMT was measured in both groups to evaluate future atherosclerotic heart disease risk. The SAA level was measured with ELISA. The mean arterial blood pressure (MABP), CIMT and SAA levels were significantly higher in women with GDM compared with healthy pregnant controls (p = 0.033, p = 0.001 and p = 0.004, respectively). There were significant correlations between SAA and age, BMI, MABP, 50-g oral glucose tolerance test (OGTT), and A1c (p = 0.048, p = 0.037, p = 0.035, p = 0.042 and p = 0.048, respectively) and between CIMT and BMI, MABP, and 50-g OGTT, (p = 0.001, p = 0.004 and p < 0.001, respectively) in correlation analysis. Furthermore, there was a correlation between SAA and CIMT (p = 0.048). Increased SAA and CIMT values in GDM compared with healthy controls might indicate an increased risk of subclinical atherosclerosis and future atherosclerotic heart disease and the importance of inflammation in this process. These changes were associated with obesity, hypertension and glucose intolerance-related factors (BMI, MABP, and 50-g OGTT), which may be relevant to GDM pathophysiology.

Evaluation of the future atherosclerotic heart disease with oxidative stress and carotid artery intima media thickness in gestational diabetes mellitus.

BACKGROUND AND OBJECTIVE: In this study our aim was to evaluate paraoxonase (PON1) activity and free sulfhydryl groups (-SH) as antioxidative parameters and lipid hydroperoxide (LOOH) as oxidative parameter in the serum of women with gestational diabetes mellitus (GDM) and determine their relation with the degree of subclinical atherosclerosis. MATERIAL AND METHODS: Serum samples from 39 pregnant women complicated with GDM and 40 healthy pregnant women were collected for the analysis of oxidative markers. Common carotid artery intima media thickness (CIMT) was measured for both groups to assess future atherosclerotic heart disease risk. PON1 activity and -SH were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with a xylenol orange assay. RESULTS: CIMT and LOOH levels were significantly higher (p = 0.01, p < 0.001, respectively) in GDM group compared to controls, whereas PON1 and -SH levels were significantly lower (p < 0.001 for both). CIMT values were significantly correlated with body mass index (BMI), 50 g oral glucose tolerance test (OGTT), and mean arterial blood pressure (MABP) (p = 0.003, p = 0.02, and p = 0.03, respectively). However, there was no correlation between CIMT and oxidative markers. CONCLUSIONS: Increased levels of LOOH and decreased levels of PON1 and -SH showed disturbance of antioxidative mechanisms in GDM. These changes were associated with increased BMI and MABP which may be relevant to GDM pathophysiology. Furthermore, increased CIMT values in GDM compared to healthy controls designate increased risk of future atherosclerotic heart disease.

Paraoxonase-1 is not affected in polycystic ovary syndrome without metabolic syndrome and insulin resistance, but oxidative stress is altered.

Paraoxonase-1 (PON1) activity is decreased in polycystic ovary syndrome (PCOS) having metabolic syndrome (MetS) or insulin resistance (IR). We aimed to assess PON1 activity and oxidative stress in PCOS without MetS or IR. Metabolic and hormonal parameters, high-sensitive C-reactive protein (hs-CRP), oxidative stress parameters (total antioxidant status (TAS), total oxidative stress (TOS), oxidative stress index (OSI), lipid hydroperoxide (LOOH), total free sulfhydryl (--SH) groups), PON and arylesterase were analyzed in 30 normal weighed patients with PCOS without MetS or IR and 20 normal controls. Hs-CRP, PON, arylesterase, and TAS levels of PCOS and control groups were similar. LOOH, TOS, and OSI of PCOS group were higher than in the controls (p < 0.05; p < 0.001, and p < 0.001, respectively). - SH group levels showed a positive correlation with free testosterone (fT). TOS positively correlated with free androgen index (FAI), body mass index (BMI), waist-to-hip ratio (WHR), LOOH, and OSI. This study showed that oxidative stress is increased in PCOS even in the absence of MetS or IR. PON1 activity appears not to be affected in PCOS without MetS and IR. Several metabolic and antropometric risk factors may aggravate this altered oxidative state in PCOS.

Comparison of prolidase enzyme activities of maternal serum and placental tissue in patients with early pregnancy failure.

PURPOSE: To compare the maternal serum and placental tissue levels of prolidase enzyme activity in women with early pregnancy loss (EPL) with those of women who underwent elective dilatation and curettage (D&C). METHODS: Serum and placental tissue samples from 52 women with early pregnancy loss (study group) and 49 women who underwent elective D&C (control group) were collected. Criteria for inclusion in the study group were based on evidence of vaginal bleeding, transvaginal ultrasonography results, and clinical findings. Prolidase enzyme activity was determined using a photometric method. RESULTS: Serum levels of prolidase activity were lower in the early pregnancy loss group than in the control group (p < 0.001). However, placental tissue activity levels were significantly higher among women with an EPL than among women without an EPL (p < 0.001). CONCLUSION: Results from this study demonstrate an inverse relationship of serum and placental levels of prolidase activity. Placental utilization of the prolidase enzyme may explain the low serum levels. As prolidase is a marker of collagen turnover, we conclude that collagen turnover is increased in patients with early pregnancy loss and may be an etiopathological factor of this disease.

Internal iliac artery ligation for severe postpartum hemorrhage and severe hemorrhage after postpartum hysterectomy.

AIM: The aim of this study was to evaluate the effect of internal iliac artery (IIA) ligation performed for severe postpartum hemorrhage (PPH). METHODS: Thirty-three women who underwent IIA ligation to control PPH in a tertiary referral center between June 2007 and May 2009 were included in this retrospective analysis. IIA ligation was performed as the primary surgical intervention or to control bleeding following hysterectomy. RESULTS: The 33 women underwent IIA ligation due to uterine atony (n = 22), placenta previa accreta/increta/percreta (n = 5), uterine rupture (n = 4), and placental abruption (n = 2). Twenty-four women underwent IIA ligation as the primary surgical intervention. IIA ligation resulted in control of bleeding in 18/24 women (75%), and only 6/24 women (25%) showed unsuccessful management of bleeding with IIA ligation. In the six women for whom the bleeding was not controlled with IIA ligation, hysterectomy was urgently performed before closure of the abdomen. After obtaining adequate hemostasis with IIA ligation, no women required relaparotomy in the postoperative period. Nine women with persistent bleeding following hysterectomy were also treated with IIA ligation. In our study, there were no intraoperative or postoperative complications related to the procedure. CONCLUSION: IIA ligation may be an effective and safe treatment option to arrest severe PPH. This procedure may also be useful to arrest persistent hemorrhage after hysterectomy. Increased understanding of the retroperitoneal anatomy is needed to reduce the risk of intraoperative and postoperative serious complications.

Amniotic fluid prolidase activity and oxidative status in neural tube defects.

OBJECTIVE: To evaluate oxidative stress markers and prolidase activity in the amniotic fluid of fetuses with a neural tube defect (NTD) compared to the amniotic fluid of normal fetuses. METHODS: Amniotic fluid samples from 36 pregnancies of fetuses with NTD were compared with the amniotic fluid from 36 pregnancies of genetically normal fetuses for analysis of oxidative status and prolidase activity. The control group consisted of fetuses from pregnancies that were diagnosed as high-risk according to a 1st or 2nd trimester aneuploidy screening, but which were later confirmed to have normal results. An automated method was used to measure oxidative status. Prolidase enzyme activity was determined using a photometric method. RESULTS: Prolidase activity, total oxidant status and oxidative stress index of amniotic fluid from fetuses with NTD were significantly higher compared to controls (p < 0.001, p = 0.003 and p = 0.002, respectively), whereas total antioxidant capacity was significantly lower (p < 0.001). CONCLUSION: Levels of prolidase activity and oxidative stress are increased in the amniotic fluid of fetuses with NTD. These indicators may serve as diagnostic markers in this disease.

Decreased serum prolidase activity and increased oxidative stress in early pregnancy loss.

AIMS: To compare the levels of serum prolidase activity and oxidative stress markers including total oxidative status (TOS), total antioxidant capacity (TAC), lipid hydroperoxide (LOOH) and total free sulfhydryl (-SH) in healthy pregnant women without early pregnancy loss (EPL) and women with EPL. METHODS: Serum samples were obtained from 45 healthy first-trimester pregnancies and 45 pregnancies complicated with EPL. We have measured serum prolidase activity, TAC, TOS, -SH and LOOH levels spectrophotometrically. RESULTS: Serum prolidase, TAC and -SH levels were significantly lower in the women with EPL than in the women without EPL (p <0.001, p = 0.001, p < 0.001, respectively), whereas TOS and LOOH levels were significantly higher (p < 0.001, p = 0.004, respectively). Prolidase activity was negatively correlated with TOS and LOOH levels (r = -0.299, p = 0.004; r = -0.323, p = 0.002, respectively), while positively correlated with TAC and -SH levels (r = 0.232, p = 0.028, and r = 0.418, p <0.001, respectively) CONCLUSION: Findings of this study have shown that serum prolidase activity and oxidative stress are significantly associated with the presence of EPL, and the correlation between serum prolidase activity and the markers of oxidative stress was reflected in increased serum TOS and LOOH levels and decreased serum TAC and -SH levels.

Prenatal diagnosis of dicephalic parapagus conjoined twins.

Dicephalic parapagus is a rare anomaly of monochorionic twinning. We present prenatal diagnosis of this anomaly with ultrasonography and magnetic resonance imaging. She was at the 19th week of gestation. Even if earlier diagnosis is possible, this was her first examination unfortunately. Baby had two head and a common trunk. This is one of the rarest twinning. Termination of pregnancy is performed and baby is delivered by cesarean section. Imaging findings of the case are illustrated and discussed with the autopsy findings.

Serum prolidase activity and oxidative status in patients with stage I endometrial cancer.

INTRODUCTION: We aimed to investigate the serum prolidase activity, total oxidant status (TOS), total antioxidant capacity (TAC), and total free sulfhydryl (-SH) groups in patients with stage I endometrial cancer. METHODS: Serum prolidase activity, TOS, TAC, and -SH levels were measured in patients with endometrial cancer (n = 23) and controls (n = 25). RESULTS: Serum prolidase activity and TOS were significantly higher in patients with endometrial cancer than in controls (P = 0.02 and P = 0.02, respectively), whereas TAC and -SH group levels were significantly lower (P = 0.004 and P = 0.001, respectively). There were no differences between surgical stages IA and IB or between stages IB and IC (P = 0.189 and P = 0.161, respectively) with respect to prolidase levels, whereas there was a significant difference between stages IA and IC (P < 0.001). CONCLUSIONS: Increased serum prolidase activity and oxidative stress may be associated with endometrial cancer, and increased serum prolidase activity may be related to local invasion of endometrial cancer.

A rare cause of difficulty with sexual intercourse: large retroperitoneal leiomyoma.

INTRODUCTION: The prevalence of sexual dysfunction is high among women; however, sexual dysfunction secondary to anatomical deformity in women is rare. In addition, primary retroperitoneal leiomyomas are very rare clinical conditions. AIM: To present a case with sexual dysfunction secondary to anatomical deformity. METHODS: In this article, we report the case of a large retroperitoneal leiomyoma causing sexual dysfunction. RESULTS: After the surgical removal of the large retroperitoneal mass, previous intercourse difficulties had been resolved. CONCLUSIONS: Retroperitoneal tumors may obstruct the vagina by congesting the pelvic area and may be considered as a possible cause of female sexual dysfunction.

Decreased paraoxonase and arylesterase activities in the pathogenesis of future atherosclerotic heart disease in women with gestational diabetes mellitus.

OBJECTIVE: The aim of this study was to investigate serum paraoxonase, arlyesterase activities, and lipid hydroperoxide (LOOH) levels in patients with gestational diabetes mellitus (GDM). METHODS: Paraoxonase and arylesterase activities, and LOOH levels were assessed for GDM cases (n = 55) and controls (n = 59). Serum basal and salt-stimulated paraoxonase and arylesterase activities were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with a xylenol orange assay. RESULTS: Basal and salt-stimulated paraoxonase and arylesterase activities were significantly lower (p = 0.002, p = 0.004; and p = 0.013, respectively) in patients with GDM compared to controls, while LOOH levels were significantly higher (p < 0.001). Among gestational diabetes patients, serum paraoxonase and arylesterase activities were inversely correlated with LOOH levels (r = - 0.390, p = 0.003; and r = - 0.287, p = 0.034, respectively). CONCLUSIONS: Findings of the present study have shown that serum paraoxonase and arylesterase activities are significantly reduced in women with GDM. Decreased serum paraoxonase and arylesterase activities might play a role in the potential early pathogenesis for atherosclerotic heart disease in GDM beyond their antioxidant properties.

Assessment of preoperative serum prolidase activity in epithelial ovarian cancer.

OBJECTIVE: Prolidase is a cytosolic exopeptidase that cleaves iminodipeptides with C-terminal proline and hydroxyproline and plays a major role in collagen turnover. The aim of this study was to evaluate preoperative serum prolidase activity, total oxidant status (TOS), and total antioxidant capacity (TAC) in patients with newly diagnosed epithelial ovarian cancer (EOC). STUDY DESIGN: Serum prolidase activity, TOS, and TAC were measured spectrophotometrically in both EOC cases (n=28) and controls (n=28). RESULTS: Preoperative serum prolidase activity and TOS were significantly higher in patients with EOC compared to controls (p=0.009 and 0.008, respectively), whereas TAC was significantly lower in cases (p<0.001). A significant positive correlation was found between the stage, grade, and CA-125 level of EOC and serum prolidase activity (rho=0.466, p=0.012; rho=0.501, p=0.007; and rho=0.447, p=0.017, respectively) and TOS (rho=0.588, p=0.001; rho=0.412, p=0.029; and rho=0.568, p=0.002, respectively). In contrast, there was a negative correlation between TAC and the stage, grade, and CA-125 level of EOC (rho=-0.555, p=0.002; rho=-0.566, p=0.002; and rho=-0.581, p=0.001, respectively). CONCLUSION: Findings of the present study demonstrate that serum prolidase activity is significantly associated with the stage, tumor grade, and preoperative CA-125 level of EOC.

Serum paraoxonase and arylesterase activities in patients with epithelial ovarian cancer.

OBJECTIVE: The HDL-associated paraoxonase and arylesterase activities play a role in decreasing oxidative stress, which is known to contribute to cancer development. The aim of this study was to evaluate serum paraoxonase and arylesterase activities and lipid hydroperoxide (LOOH) levels in patients with newly-diagnosed epithelial ovarian cancer. MATERIALS: Serum paraoxonase and arylesterase activities, total free sulfhydryl (-SH) levels and LOOH levels were measured in patients with epithelial ovarian cancer (n=24) and controls (n=29). RESULTS: Serum paraoxonase activity and arylesterase activity, as well as -SH levels were significantly lower (p=0.003, p<0.001 and p<0.001, respectively) in patients with epithelial ovarian cancer compared to controls, while LOOH levels were significantly higher (p<0.001). A significant inverse correlation was found between the stage, grade and CA-125 level of ovarian cancer and paraoxonase activity (rho=-0.630, p=0.001 and rho=-0.601, p=0.002 and rho=-0.436, p=0.033, respectively), arylesterase activity (rho=-0.601, p=0.002 and rho=-0.713, p<0.001 and rho=-0.580, p=0.003, respectively), and -SH levels (rho=-0.642, p=0.001 and rho=-0.637, p=0.001 and rho=-0.530, p=0.008, respectively). In contrast, there was a positive correlation between LOOH and the stage, grade and CA-125 level of ovarian cancer (rho=0.565, p=0.004 and rho=0.479, p=0.018 and rho=0.642, p=0.001). CONCLUSION: Our results suggest that diminished paraoxonase and arylesterase activity, -SH levels and increased LOOH levels are associated with particular stage, grade and CA-125 level of ovarian cancer.

Uterine prolapse in a 19 year old pregnant woman: a case report.

It is well-known that multiparity and advanced age are major risk factors for pelvic organ prolapse which can rarely complicate pregnancy. We present the youngest case of uterine prolapse during pregnancy. She admitted with ruptured membranes at the 36th week of gestation and irreducible prolapse. As the edematous and thick, trapped and ulcerated cervix was not reducible, labor was obstructed due to cervical dystocia and a cesarean delivery was decided. A live male infant weighing 3100 gram was delivered. The prolapsed uterus recovered spontaneously following the cesarean operation. Uterine prolapse during pregnancy should be managed conservatively. It seems to be essential to perform elective cesarean section because of the risk of possible obstructed labor. We observed a rapid recovery of the anatomy, probably due to the young age.

Serum prolidase activity and oxidative stress markers in pregnancies with intrauterine growth restricted infants.

AIM: To compare the levels of serum prolidase activity and oxidative stress markers, including total oxidative status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and total free sulfhydryl (-SH) in healthy pregnant women and pregnant women with intrauterine growth restricted infants. METHODS: Serum samples were obtained from 18 healthy third trimester pregnancies and 14 pregnancies complicated by fetal growth restriction (FGR). The criteria for FGR were clinical evidence of suboptimal growth, ultrasonographic demonstration of deviation from normal percentiles of growth, and birthweight under the 10th percentile. We spectrophotometrically measured serum prolidase activity, TAC, TOS, and -SH levels. Oxidative stress was determined from total antioxidant capacity and total oxidant status measurement and calculation of the oxidative stress index. RESULTS: Serum TAC and -SH levels were significantly lower in the FGR group than in the healthy control group (P = 0.001, P < 0.001, respectively), whereas TOS level, OSI value, and prolidase activity were significantly higher (P = 0.003, P < 0.001, P < 0.001, respectively). Prolidase activity was positively correlated with TOS and OSI values (rho = 0.552, P = 0.041 and rho = 0.635, P = 0.015, respectively) and negatively correlated with TAC and -SH levels (rho = -0.578, P = 0.030 and rho = -0.622, P = 0.018, respectively). CONCLUSION: The present study shows that serum prolidase activity and oxidative stress are significantly associated with the presence of FGR and that the correlation between serum prolidase activity and markers of oxidative stress are represented as increased serum TOS level and decreased serum TAC and -SH levels, suggesting an association of collagen turnover and oxidative stress in vascular dysfunction.