Browsing by Author "Adali, Ertan"

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Brucellosis in Pregnancy: a 6-Year Clinical Analysis
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Adali, Ertan; Kurdoglu, Zehra; Karahocagil, Mustafa Kasim; Kolusari, Ali; Yildizhan, Recep; Akdeniz, Hayrettin
To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P < 0.05). Hospitalization did not affect pregnancy outcomes significantly (P > 0.05). Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with habitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.
Does Residual Amniotic Fluid After Preterm Premature Rupture of Membranes Have an Effect on Perinatal Outcomes? 12 Years Experience of a Tertiary Care Center
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Kolusari, Ali; Adali, Ertan; Yildizhan, Recep; Kurdoglu, Zehra; Kucukaydin, Zehra; Kamaci, Mansur
To review our experience with preterm premature rupture of membranes at a tertiary-care hospital in Turkey to determine whether the amount of residual amniotic fluid after rupture has prognostic value for adverse maternal and fetal outcomes. We reviewed the medical records of 191 pregnant women with gestational ages between 24 and 34 weeks at the time of rupture of the amniotic membrane and of their babies delivered in our hospital between January 1996 and September 2008. On the basis of amniotic fluid index (AFI) values recorded at the time of admission, patients were categorized into two groups: those with an AFI < 50 mm (n = 119) and those with an AFI > 50 mm (n = 72). The patients with high gravidity (4-8) were more prevalent in the group with an AFI < 50 mm (37 vs. 23.6%), while nulliparous women were more common in the group with an AFI > 50 mm (44.4 vs. 30.2%) (P < 0.05). Seventy-two percent of the cesarean sections performed due to nonreassuring fetal status were in the group with an AFI < 50 mm (P < 0.01). In 71.4% of the cases with a 5 min Apgar score a parts per thousand currency sign 7, AFI was less than 50 mm (P < 0.01). AFI < 50 mm was present in 65, 70.8, 76.7, and 73.1% of the pregnancies complicated by chorioamnionitis, respiratory distress syndrome, composite neonatal morbidity, and neonatal death, respectively (P < 0.05). A residual AFI < 50 mm after preterm PROM between 24 and 34 weeks of gestation, which is mostly seen in grand multiparous women in Eastern Turkey, may be a valuable prognostic variable for anticipating adverse maternal and neonatal outcomes.
Domestic Violence Against Infertile Women in a Turkish Setting
(Elsevier Ireland Ltd, 2009) Yildizhan, Recep; Adali, Ertan; Kolusari, Ali; Kurdoglu, Mertihan; Yildizhan, Begum; Sahin, Guler
Objective: To investigate the prevalence of domestic violence against infertile women in a Turkish setting. Methods: A total of 122 women with primary infertility attending an obstetrics and gynecology outpatient clinic were interviewed using the Abuse Assessment Screen questionnaire to investigate their experiences of domestic violence. Results: In total, 41 (33.6%) women had experienced domestic violence because of their infertility. Of these women, 32 (78%) had experienced domestic violence for the first time in the relationship with the current partner following diagnosis of female factor infertility. The percentage of nonabused and abused infertile women who were mostly satisfied with their sexual lives was 56.87% and 29.2%, respectively (P<0.05). Conclusion: Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Doppler Analysis of Uterine Perfusion and Ovarian Stromal Blood Flow in Polycystic Ovary Syndrome
(Wiley, 2009) Adali, Ertan; Kolusari, Ali; Adali, Fulya; Yildizhan, Recep; Kurdoglu, Mertihan; Sahin, Hanim Guler
Objective: To investigate blood flow velocity in the ovarian stromal artery and uterine artery in women with polycystic ovary syndrome (PCOS) and to correlate these velocities with clinical and biochemical parameters. Methods: A prospective study was carried out in 55 patients with PCOS and 42 age-matched women who did not have PCOS. Clinical, biochemical, and hormonal characteristics, and utero-ovarian Doppler ultrasound blood flow parameters were determined, and correlations between the parameters were evaluated. Results: Ovarian stromal blood flow was higher (P<0.01) and uterine perfusion was lower (P<0.01) in women with PCOS compared with women who did not have PCOS. Ovarian stromal artery pulsatility index (PI) was inversely correlated with levels of dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor-1, and with the luteinizing hormone/follicle-stimulating hormone ratio. There was a positive correlation between uterine artery PI and DHEAS level. Conclusion: Doppler analysis of the uterine and intraovarian arteries may provide additional information about the etiopathogenesis of PCOS and partly explain the clinical implications of the condition. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Effects of Two Combined Oral Contraceptives Containing Ethinyl Estradiol 30 Μg Combined With Either Gestodene or Drospirenone on Hemostatic Parameters, Lipid Profiles and Blood Pressure
(Springer Heidelberg, 2009) Yildizhan, Recep; Yildizhan, Begum; Adali, Ertan; Yoruk, Pinar; Birol, Fatih; Suer, Necdet
The aim of this study is to compare the effect of ethinyl estradiol 0.03 mg/gestodene 0.075 mg (EE/GSD) with ethinylestradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) administered according to conventional 21/7 regimen on body mass index (BMI), blood pressure (BP), lipid metabolism and hemostatic parameters. In this study, 160 healthy women were randomized to EE/GSD mg or EE/DRSP for 12 months. Mean differences in BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) levels and BP compared to baseline were assessed. One hundred and forty-five (89%) of the women completed all 12 treatment cycles. The subjects randomly assigned into two treatment groups. Group EE/GSD (n = 71) and group EE/DRSP (n = 72). In group B, BMI values were significantly lower than baseline at the sixth cycle. DRSP/EE had more favorable effects on BP than GSD/EE with the mean systolic and diastolic BPs remaining lower in the DRSP/EE group. The difference between the two preparations was not statistically significant at the end of the study. TC levels remained similar in both groups throughout the study period. In both groups LDL-C levels decreased, triglyceride and HDL-C levels significantly increased from baseline levels. These changes result in increasing HDL-C/LDL-C ratio, demonstrating anti-atherogenic effect. Menstrual cycle patterns and the incidence of adverse events were similar between groups. The duration of withdrawal bleeding decreased during the study for both groups and was similar. The EE/DRSP regimen provides good cycle control with reliable contraceptive efficacy and low incidence of adverse events. Compared with the EE/GSD preparation, the EE/DRSP preparation demonstrated a more favorable effect on BMI and BP with the mean BMI and mean BP remaining lower than baseline mean. The new formulation may be especially beneficial for women susceptible to body weight gain and rise in BP.
Expression of Laminin Receptor 1 in Gestational Trophoblastic Diseases and Normal Placenta and Its Relationship With the Development of Postmolar Tumors
(Academic Press inc Elsevier Science, 2009) Kurdoglu, Mertihan; Bayram, Irfan; Kolusari, Ali; Erten, Remzi; Adali, Ertan; Bulut, Gulay; Sahin, H. Guler
Objectives. To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in gestational trophoblastic diseases and normal first-trimester placenta, since it may play a role in controlling trophoblast invasion in normal and molar pregnancies. Methods. Paraffin sections from 24 gestational age controlled normal first-trimester placentas, 47 partial moles, 56 complete moles, 3 invasive moles, 4 gestational choriocarcinomas, and 1 placental-site trophoblastic tumor were studied immunohistochemically for expression of LR1. Results. In complete and partial moles, decidual cells showed significantly stronger LR1 protein staining compared to the normal placenta (p<0.01). When compared to the partial moles, weak staining in less than 33% of decidual cells was also more prominent in the normal placenta (p<0.05). Complete and partial moles, invasive moles, choriocarcinomas, and placental-site tumors did not differ from each other with respect to staining intensity. Strong immunostaining for LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of partial and complete moles was not significantly correlated with the development of persistent postmolar gestational trophoblastic tumors. Conclusions. LR1 may be important in the pathogenesis of gestational trophoblastic diseases. The increased expression of LR1 in decidual cells of partial and complete moles may not influence the development of persistent gestational trophoblastic tumor. Since they are seen rarely, multicentric studies should be planned to study LR1 expression in invasive moles and gestational trophoblastic neoplasms. (C) 2009 Elsevier Inc. All rights reserved.
A Five-Year Audit of Cases With Ectopic Pregnancy in Our Clinic
(Galenos Yayincilik, 2010) Adali, Ertan; Kurdoglu, Mertihan; Kolusari, Ali; Yildizhan, Recep; Cim, Numan; Sahin, Hanim Guler; Kamaci, Mansur
Objective: The aim of this study was to review the ectopic pregnancy cases that were administered to our clinic in the last five years. Materials and methods: According to the dermographic features, risk factors, clinical signs and treatment approaches, ninetyone cases with ectopic pregnancies were evaluated retrospectively between 2004-2009. For statistical analysis, SPSS was used. Results: The average age of the patients were 28,38 +/- 6,47 years and ectopic pregnancies were mostly seen between the ages of 26-35. The mean gravida and parity were 3,86 +/- 2,55 and 2,34 +/- 2,16, respectively. The mean serum beta-hCG level of the patients on admission to our clinic was 3085,41 +/- 6346,84 mIU/L. The risk factors in the order of frequencies were previous abdomino-pelvic surgery (16 %), the use of intrauterine device (12 %), previous ectopic pregnancies (7 %) and previous pelvic inflammatory disease (2 %). The most common complaint on admission were abdominal pain (40 %) and following that in the order of frequencies were vaginal bleeding with pain (38 %) and only vaginal bleeding (15 %). As a treatment option, surgery, methotrexate and expectant management were applied to 66 %, 20% and 10% of the patients respectively. Conclusion: Ectopic pregnancies are important health problems since they may interfere with fertility capability of the patient in her future life and may even cause maternal mortality. Especially, women who had abdomino-pelvic surgery before are at risk. Early diagnosis enables conservative management approaches.
Increased Plasma Thrombin-Activatable Fibrinolysis Inhibitor Levels in Young Obese Women With Polycystic Ovary Syndrome
(Elsevier Science inc, 2010) Adali, Ertan; Yildizhan, Recep; Kurdoglu, Mertihan; Bugdayci, Guler; Kolusari, Ali; Sahin, H. Guler
Objective: To evaluate carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor levels in young women with polycystic ovary syndrome (PCOS) and age-matched healthy controls, and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. Design: Clinical study. Setting: University hospital. Patient(s): Fifty young women with PCOS (overweight or obese [n = 24] and nonobese [n = 26]) and 25 age-matched healthy controls. Intervention(s): History and physical examination, peripheral venous blood sampling, carotid ultrasonography. Main Outcome Measure(s): Plasma thrombin-activatable fibrinolysis inhibitor, serum FSH, LH, DHEAS, total T, E-2, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin resistance defined by the homeostasis model assessment insulin resistance index, and carotid intima-media thickness. Result(s): Plasma thrombin-activatable fibrinolysis inhibitor levels in the overweight or obese PCOS group were significantly higher than those in the nonobese PCOS and control groups. Carotid intima-media thickness did not significantly differ between the groups. Obesity and insulin resistance were associated positively with plasma thrombin-activatable fibrinolysis inhibitor levels, but there was no association between carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor. Conclusion(s): Young overweight or obese women with PCOS have increased plasma thrombin-activatable fibrinolysis inhibitor levels. Impaired fibrinolysis may be responsible for the increased risk of cardiovascular diseases in women with PCOS. (Fertil Steril (R) 2010;94:666-72. (C) 2010 by American Society for Reproductive Medicine.)
Increased Visfatin and Leptin in Pregnancies Complicated by Pre-Eclampsia
(Taylor & Francis Ltd, 2009) Adali, Ertan; Yildizhan, Recep; Kolusari, Ali; Kurdoglu, Mertihan; Bugdayci, Guler; Sahin, Hanim Guler; Kamaci, Mansur
Objective. To evaluate the role of the adipokines, visfatin and leptin in the pathophysiology of pre-eclampsia and how their concentrations correlate with the severity of the disease and abnormal Doppler velocimetry. Methods. A cross-sectional study was carried out in 72 pregnant women (30 patients with mild pre-eclampsia, 20 patients with severe pre-eclampsia and 22 healthy normotensive pregnant women) during the third trimester of pregnancy. The maternal levels of plasma visfatin and serum leptin were determined in all cases by enzyme immunoassay and enzyme-linked immunosorbent assay, respectively. The uterine artery and umbilical artery RI were determined by Doppler analysis in all cases. Results. Plasma visfatin levels and serum leptin levels were higher in patients with pre-eclampsia than in the normotensive pregnant women. Six patients with mild pre-eclampsia and five patients with severe pre-eclampsia had abnormal Doppler velocimetry. Visfatin and leptin levels of pre-eclamptic patients with abnormal Doppler velocimetry were significantly higher than they were in those with normal Doppler velocimetry. Serum leptin levels were positively correlated with plasma visfatin level in cases of pre-eclampsia. Conclusions. These findings suggest that increased maternal levels of leptin and visfatin may be involved in the pathogenesis of pre-eclampsia, and measurement of these adipokines may be useful in assessment of the severity of disease.
Isolated Impairment of Posterior Pituitary Function Secondary To Severe Postpartum Haemorrhage Due To Uterine Rupture
(informa Healthcare, 2011) Adali, Ertan; Kucukaydin, Zehra; Adali, Fulya; Yildizhan, Recep
Cranial diabetes insipidus (DI) due to postpartum haemorrhage is an extremely rare clinical event. We describe herein isolated posterior pituitary insufficiency in a 26-year-old woman who had undergone subtotal hysterectomy for severe postpartum haemorrhage because of uterine rupture. The patient experienced polyuria within 6 h postoperatively. DI was suggested by the elevated urine volumes and low urine specific gravity. The diagnosis of DI was confirmed by water deprivation test and vasopressin stimulation test. The anterior pituitary function was within normal limits. A high clinical suspicion is certainly required for the diagnosis of DI in the immediate postpartum period. To rapidly initiate appropriate therapy, the possibility of DI should always be kept in mind while evaluating patients who have polyuria and polydipsia after severe postpartum bleeding. Delay or failure to treat this condition might result in hypovolemic shock.
Jinekolojik Laparoskopi Esnasında Ana Damar Yaralanması: Olgu Sunumu
(2009) Kamacı, Mansur; Kurdoğlu, Mertihan; Yildizhan, Recep; Erdemoğlu, Evrim; Adali, Ertan
Jinekolojik laparoskopik cerrahilerde çok seyrek görülen ancak meydana geldiğinde de hasta hayatını tehlikeye sokabilen komplikasyonların başında ana damar yaralanmaları gelmektedir. Elektif jinekolojik girişimde bulunulan 15 yaşındaki bir olguda meydana gelen sol eksternal iliak arter yaralanması mevcut literatür eşliğinde; etyolojik faktörleri ve yönetim prensipleri de özetlenerek sunulmaktadır.
Kliniğimizdeki Ektopik Gebelik Olgularının Beş Yıllık Analizi
(2010) Kurdoğlu, Mertihan; Adali, Ertan; Yildizhan, Recep; Kolusarı, Ali; Şahin, Hanım Güler; Çim, Numan; Kamacı, Mansur
Amaç: Bu çalışmanın amacı, son beş yılda kliniğimizde tedavi edilen ektopik gebelik vakalarını değerlendirmektir. Gereç ve Yöntemler: 2004–2009 yılları arasında 91 ektopik gebelik olgusu, dermografik özellikleri, risk faktörleri, klinik bulguları ve tedavi yaklaşımları açısından geriye dönük olarak değerlendirildi. İstatistiksel analiz için SPSS kullanıldı. Bulgular: Hastalarımızın yaş ortalaması 28,38± 6,47 olup, ektopik gebeliğin en sık görüldüğü yaş aralığı 26-35’dir. Hastaların gravida ve parite ortalamaları sırasıyla 3,86± 2,55 ve 2,34± 2,16’ dır. Hastaların kliniğimize başvuru sırasındaki ortalama serum β-hCG düzeyi 3085,41± 6346,84 mIU/L idi. Risk faktörleri sıklık sırasına göre abdomino-pelvik cerrahi öyküsü (% 16), rahim içi araç öyküsü (% 12), geçirilmiş ektopik gebelik öyküsü (% 7), pelvik inflamatuar hastalık öyküsü (% 2) idi. Hastaların kliniğimize en sık başvuru şikâyeti karın ağrısı (% 40) olup bunu takiben sırası ile vajinal kanama ile birlikte ağrı (% 38) ve sadece vajinal kanama (% 15) idi. Olguların % 66’ sına cerrahi, % 20’ sine metotreksat, % 10’ una bekleme tedavisi yapılmıştır. Sonuç: Ektopik gebelikler, hastanın ilerideki hayatta fertilite yeteneğini bozması hatta maternal mortaliteye yol açabilmesi nedeniyle önemli bir sağlık sorunudur. Özellikle abdomino- pelvik cerrahi öyküsü olan kadınlar risk altındadır. Erken tanı, konservatif tedavi yaklaşımlarına olanak tanır.
Large Mesenteric Cyst Mimicking Tuberculous Ascites
(Hindawi Ltd, 2010) Dulger, Cumhur; Adali, Ertan; Avcu, Serhat; Kurdoglu, Zehra
Background. Intraabdominal lesions such as mesenteric cysts are uncommon disorders. Most are discovered incidentally during routine abdominal examinations. Methods. We report a patient with a mesenteric cyst masquerading as tuberculous peritonitis and ascites. Conclusion. Mesenteric cysts generally do not show typical clinical findings. They may also present with peritoneal tuberculosis findings such as low albumin gradient ascites with high ascitic adenosine deaminase levels. Surgery is used to remove a wide variety of mesenteric cysts. A correct diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical signs.
Major Vessel Injury During Gynecologic Laparoscopy: a Case Report
(Marmara Univ, Fac Medicine, 2009) Erdemoglu, Evrim; Yildizhan, Recep; Kurdoglu, Mertihan; Adali, Ertan; Kamaci, Mansur
Major vessel injuries rarely occur in gynecologic laparoscopic surgery. However, when they do occur, they present life-threatening complications. A left iliac artery injury occurring in a 15 year-old patient undergoing an elective laparoscopic surgery is presented together with summarized etiological factors and management principles in the light of the available current literature.
Metastin Levels in Pregnancies Complicated by Pre-Eclampsia and Their Relation With Disease Severity
(Taylor & Francis Ltd, 2012) Adali, Ertan; Kurdoglu, Zehra; Kurdoglu, Mertihan; Kamaci, Mansur; Kolusari, Ali; Yildizhan, Recep
Aims: To evaluate the role of metastin levels in the pathophysiology of pre-eclampsia and to determine whether there is a relationship between the severity of the disease and Doppler velocimetry measurements. Methods: This cross-sectional study included 89 pregnant women (50 healthy normotensive pregnant women, 15 patients with mild pre-eclampsia, and 24 patients with severe pre-eclampsia) at the third trimester of pregnancy. The maternal levels of plasma metastin were determined by enzyme-linked immunosorbent assay. The umbilical artery and uterine artery blood flow velocities were measured by transabdominal color and pulsed Doppler ultrasound. Results: Plasma metastin levels were lower in patients with pre-eclampsia than those in the normotensive pregnant women. Four patients with mild pre-eclampsia and seven patients with severe pre-eclampsia had abnormal Doppler velocimetry findings. Metastin levels of pre-eclamptic patients with abnormal Doppler velocimetry findings were significantly lower than those in patients with normal Doppler velocimetry findings. Plasma metastin levels negatively correlated with proteinuria in 24 hours and with mean arterial pressure in the cases of pre-eclampsia. Conclusions: The findings suggest that decreased maternal concentrations of plasma metastin may be involved in the pathogenesis of pre-eclampsia. Plasma metastin levels may be useful in the assessment of the severity of pre-eclampsia. However, further trials are needed to clarify the role of metastin in pre-eclampsia.
Mri of Omphalopagus Conjoined Twins With a Dandy-Walker Malformation: Prenatal True Fisp and Haste Sequences
(Aves, 2010) Uenal, Oezkan; Arslan, Halil; Adali, Ertan; Bora, Aydin; Yildizhan, Recep; Avcu, Serhat
Conjoined twins are an extremely rare congenital malformation without any known genetic predisposition. Omphalopagus twins are the second most common variety of conjoined twins and usually are joined at the umbilicus. We present omphalopagus conjoined twins demonstrated with true FISP (fast imaging with steady-state procession) and HASTE (half-Fourier acquisition single-shot turbo spin-echo) magnetic resonance imaging (MRI) sequences, which showed Dandy-Walker malformation in one of the pair. To our knowledge, this is the first case of conjoined twins with this malformation, which was diagnosed with ultrafast MRI.
An Overlooked Cause of Acute Urinary Retention in an Adolescent Girl: a Case Report
(Springer Heidelberg, 2009) Adali, Ertan; Kurdoglu, Mertihan; Yildizhan, Recep; Kolusari, Ali
Massive hematocolpos resulting from an imperforate hymen is quite a rare cause of acute urinary retention, in an adolescent girl admitted to the emergency department. A 12-year-old girl suffering from severe inguinal pain and dysuria together with difficulty in urination for about 1 month was admitted to the emergency department for acute urinary retention. On gynecological examination, imperforate hymen was observed to be the cause of the urinary difficulty. Pelvic magnetic resonance imaging revealed a dilated vagina exerting pressure on the bladder outlet suggestive of hematocolpos. Cruciate hymenotomy was performed. The postoperative period and three follow-up visits of the patient up to the 6th month were uneventful. The diagnosis of imperforate hymen can be missed if a genital examination is not performed in adolescent girls presenting to emergency departments with urinary difficulty. The purpose of this paper is to increase awareness among emergency physicians about the probability of imperforate hymen while examining adolescent girls with urinary retention and intermittent lower abdominal pain.
Pelvic-Peritoneal Tuberculosis Simulating Peritoneal Carcinomatosis: High Clinical Suspicion and a Minimally Invasive Procedure
(Springer Heidelberg, 2009) Adali, Ertan; Dulger, Cumhur; Kolusari, Ali; Kurdoglu, Mertihan; Yildizhan, Recep
Peritoneal tuberculosis (TB) is still a major health problem in developing countries. We describe a 26-year-old woman with peritoneal TB presenting with lower abdominal pain and distention, weight loss, and night sweats. There are no pathognomonic clinical, laboratory, or radiologic findings for peritoneal TB. Therefore, it can be easily confused with peritoneal carcinomatosis and advanced ovarian carcinoma. Adenosine deaminase activity in ascitic fluid combined with a high clinic suspicion is an effective and minimally invasive procedure for the differential diagnosis of pelvic-peritoneal TB simulating peritoneal carcinomatosis, and may obviate the need for unnecessary extensive surgery and rapidly initiate appropriate therapy.
Plasma Lipocalin-2 Levels in Pregnant Women With Pre-Eclampsia, and Their Relation With Severity of Disease
(informa Healthcare, 2011) Arikan, Deniz Cemgil; Ozkaya, Mesut; Adali, Ertan; Kilinc, Metin; Coskun, Ayhan; Ozer, Au; Bilge, Fidan
Objective. To compare lipocalin-2 (LCN2) levels in pre-eclamptic women with those in healthy pregnant women, and to determine whether there is a correlation between LCN2 levels and the severity of the disease. Methods. The study included 66 pregnant women: 22 healthy pregnant women (Group 1), 23 women with mild pre-eclampsia (Group 2), and 21 women with severe pre-eclampsia (Group 3). Pre-eclamptic women and normal controls were carefully matched for maternal age, gestational age, and body mass index (BMI). The maternal levels of plasma LCN2 were determined by enzyme-linked immunosorbent assay. Results. Plasma LCN2 levels in the pre-eclamptic group were significantly lower than those in the healthy control group (p < 0.05). Although plasma LCN2 level was lower in the severe compared to the mild pre-eclamptic group, the difference was not statistically significant (p > 0.05). There was no significant correlation between LCN2 levels and the homeostasis model assessment of insulin resistance (HOMA-IR), BMI, triglyceride, gestational week at delivery, birth weight, and systolic and diastolic blood pressure in pre-eclamptic and healthy pregnant women (p > 0.05). Conclusions. Our results show that there are decreased concentrations of plasma LCN2 in pre-eclamptic subjects and this may indicate that LCN2 plays a role in the pathogenesis of pre-eclampsia. However, further experiments are needed to clarify this role.
The Relationship Between Brachial Artery Flow-Mediated Dilatation, High Sensitivity C-Reactive Protein, and Uterine Artery Doppler Velocimetry in Women With Pre-Eclampsia
(Wiley, 2011) Adali, Ertan; Kurdoglu, Mertihan; Adali, Fulya; Cim, Numan; Yildizhan, Recep; Kolusari, Ali
Purpose: To investigate serum high sensitivity C-reactive protein (hs-CRP) levels and endothelial function in pregnancies complicated by pre-eclampsia. and to clarify their relationship with uterine artery Doppler velocimetry. Methods: A cross-sectional study was carried out in 70 pregnant women (35 patients with pre-eclampsia and 35 age-matched normotensive healthy pregnant women) during the third trimester of pregnancy. The maternal levels of serum hs-CRP were determined in all cases by immunonephelometry. Uterine artery Doppler velocimetry was performed. Flow-mediated dilatation was measured by sonography of the brachial artery for the assessment of endothelial function. Results: Serum hs-CRP levels were higher in the pre-eclamptic group than in the normotensive group. hs-CRP levels were positively correlated with mean arterial pressure. Eleven patients with pre-eclampsia had abnormal uterine artery Doppler velocimetry. hs-CRP levels were significantly higher in pre-eclamptic patients with than without abnormal uterine artery Doppler velocimetry. Endothelial function was inversely correlated with hs-CRP levels and mean arterial pressure. Conclusions: These findings suggest that maternal serum hs-CRP levels increase with the severity of pre-eclampsia, reflecting endothelial dysfunction and constituting a potential marker of pathological utero-placental perfusion,. with a high risk for fetal growth restriction. (C) 2010 Wiley Periodicals, Inc. J Clin Ultrasound 39:191-197, 2011; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/jcu.20781