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Öğe Abnormal Cervical Cytology Risk Factors in the Western Black Sea Region and the Importance of Health Insurance(Federation Turkish Pathology Soc, 2014) Simavli, Serap; Kaygusuz, Ikbal; Cukur, Selma; Aksel, FerdaObjective: To evaluate the prevalence of abnormal cervical cytological findings in the Western Black Sea Region and investigate an association between socio-demographic risk factors and the presence of cytological abnormalities. Material and Method: The reports of 11,539 cervical smears diagnosed according to Bethesda System 2001 version in the Pathology Department between January 2011 and December 2012 were reviewed retrospectively from the hospital records and cytopathology reports. Repeated smear results, unsatisfactory smear results, patients with known gynecologic malignancy history, smear results of patients with hysterectomy and smear results of patients whose socio-demographic information could not be obtained were excluded from the evaluation. The results of 7,740 patients who met the criteria for the study were evaluated. Results: The prevalence of cervical cytological abnormalities was 1.8 % in general. The prevalence rates for atypical squamous cells with undetermined significance (ASC-US), atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and atypical glandular cells (AGC) were 1.16%, 0.11%, 0.29%, 0.15%, and 0.03% respectively. The prevalence of cytologically diagnosed cervical invasive neoplasia was 0.025%. Advanced age, low education level (primary school or less) and not having health insurance were found as to be risk factors for preinvasive and invasive lesions. Women who had a high school education and previously had a smear test had decreased risk for developing preinvasive and invasive lesions. Conclusion: This study shows prevalence of abnormal cervical cytology findings and associoted risk factors in the Western Black Sea Region of Turkey. The most important risk factor was identified as not having health insurance.Öğe Adipokine, adropin and endothelin-1 levels in intrauterine growth restricted neonates and their mothers(Walter De Gruyter Gmbh, 2016) Aydin, Halil Ibrahim; Eser, Ayla; Kaygusuz, Ikbal; Yildirim, Sevgi; Celik, Tugrul; Gunduz, Suzan; Kalman, SuleymanIntrauterine growth retardation/restriction (IUGR) is associated with fetal malnutrition. It has consequences for later life including increased incidence of obesity, diabetes mellitus, cardiovascular disease (CVD), and metabolic syndrome. Adipokines (adiponectin and leptin), adropin, and endothelin-1 are associated with obesity and metabolic syndrome regulation. Intrauterine changes in these mediators could affect programming of later adult obesity and metabolic syndrome. Our objectives were to compare the levels of these mediators in both cord and maternal blood between IUGR pregnancies and control, healthy pregnancies, and to study the correlation of adipokines with adropin and endothelin-1 in maternal and cord blood in IUGR pregnancies as well as in healthy control pregnancies. Maternal and cord blood samples were taken from 16 women with IUGR pregnancies and 16 women with healthy pregnancies. Serum levels of leptin, adiponectin, adropin, and endothelin-1 were measured by ELISA. Maternal blood adropin levels were significantly lower in the IUGR group than in the control group; the other mediators did not differ significantly. There was a positive correlation between maternal blood adropin and endothelin levels. (r = 0.731, P = 0.001) in the control but not the IUGR group. Cord blood adropin and adiponectin levels were significantly lower in the IUGR group compared with the control group, while leptin or endothelin-1 did not differ significantly. There was a negative correlation between adropin and leptin (r = -0.704, P = 0.001) in the IUGR but not the control group cord blood. There were also positive correlations between endothelin and adropin for both groups (r = 0.594, P = 0.006; r = 0.560, P = 0.010, respectively); to the best of our knowledge, this is the first report of such a correlation. Differences in fetal expression of adropin and adiponectin in IUGR could influence programming of obesity, metabolic syndrome, diabetes, and CVD in later life.Öğe Association between maternal ghrelin levels and hyperemesis gravidarum(Tubitak Scientific & Technological Research Council Turkey, 2013) Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Yildirim, Melahat; Erdamar, Husamettin; Uysal, Aysel; Simavli, Serap Aynur; Ayyildiz, AbdullahAim: To investigate serum levels of ghrelin in pregnant women as a potential early marker for hyperemesis gravidarum (HG). Materials and methods: A cross-sectional study was carried out at Fatih University Hospital. Included in the study were 35 women with HG and 31 pregnant women without HG as a control group. The groups were compared in terms of age, gravidity, body mass index (BMI), and fasting serum thyroid-stimulating hormone (TSH) and ghrelin levels. Results: Ghrelin levels of the patients with HG were found to be significantly lower than those in the control group (P = 0.03). No intergroup differences could be found in serum TSH or BMI values. Conclusion: Ghrelin might serve as a reliable marker in the etiopathogenesis of HG.Öğe Autoimmune progesterone dermatitis(Elsevier Taiwan, 2014) Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Sarifakioglu, Evren; Eser, Ayla; Bozkurt, Bulent; Kafali, Hasan[Abstract Not Available]Öğe Combined procedure of cesarean delivery and preperitoneal mesh repair for inguinal hernia: An initial experience(Elsevier Singapore Pte Ltd, 2017) Surgit, Onder; Gumus, Ilknur Inegol; Kilic, Murat Ozgur; Kaygusuz, IkbalBackground: Combined surgery for cesarean delivery and preperitoneal mesh repair for inguinal hernia has not been previously reported. Objectives: Our aim was to describe the method and to present the results of this simultaneous surgery through a single incision. Methods: From 2012 to 2014, 15 patients underwent cesarean delivery combined with preperitoneal mesh repair for inguinal hernia. All patient characteristics and perioperative findings were recorded. Results: Among 15 patients, 13 had unilateral inguinal hernias and two had bilateral hernias. The mean times spent for unilateral and bilateral hernias were 35.8 minutes (range, 30-45 minutes) and 67.5 minutes (range, 65-70 minutes), respectively. Direct and indirect hernias were present in one and 15 patients, respectively. One patient had mixed hernia. No significant complication was observed perioperatively. Hospital stay ranged from 1 day to 3 days (mean, 1.87 days), and all patients were discharged without any problem. No recurrence was found during the follow-up periods. Conclusion: Single anesthesia, single incisional scar, and single hospitalization are the major advantages of this simultaneous approach of cesarean delivery and preperitoneal mesh repair for inguinal hernia. Our analysis suggests that this combined procedure can be performed safely in selected cases. (C) 2016 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.Öğe Effect of anti-vascular endothelial growth factor antibody during early fetal development in rats(Informa Healthcare, 2014) Kaygusuz, Ikbal; Eser, Ayla; Gumus, Ilknur Inegol; Kosus, Aydin; Yenidunya, Sibel; Namuslu, Mehmet; Kafali, HasanObjective: To examine the effect of anti-vascular endothelial growth factor (VEGF) antibody Bevacizumab during early fetal development in rats. Methods: Presumed-pregnant rats received single intraperitoneal injection of Bevacizumab (0-20 mg/kg) on gestational day (GD) 3, 7, and 14 (n = 2 rats/group). After Study 1 (dose range finding study), Study 2 performed with intraperitoneal 20 mg/kg bevacizumab or saline on GD 7 (n = 6 rats/group including the Study 1). Blood samples were collected 3 and 7 d after the injection. Uterus and ovarian tissues were obtained 7 d after the injection. Number of gestational sacs (GS), size of GS and fetus, serum rat beta chorionic gonadotropin (beta-CG), and platelet endothelial cell adhesion molecule (PECAM) for immunohistochemical assessment of angiogenesis were evaluated. Results: Number of GS, size of GS, and fetus were lower in the study group than the control group. Serum rat beta-CG levels were significantly increased in the control group and significantly decreased in the study group. Staining densities for PECAM in vascular structures in both corpus luteum and placenta were lower in the study group than the control group. Conclusion: Anti-VEGF antibody has an inhibitory effect on pregnancy development and caused litter death.Öğe Effect of bupivacaine-soaked spongostan in cesarean section wound on postoperative maternal health(Springer Heidelberg, 2014) Simavli, Serap; Kaygusuz, Ikbal; Kafali, HasanTo investigate the efficacy of bupivacaine-soaked spongostan in cesarean section wound for postoperative anxiety level, satisfaction and early postpartum depression rate. A total of 121 women, American Society of Anesthesiologists physical status I-II, scheduled to undergo general anesthesia and elective cesarean section were recruited and randomized into a study group (n = 61) or a control group (n = 60). In the spongostan group, bupivacaine-soaked spongostan was placed in the cesarean section wound. The control group did not receive spongostan, but only general postoperative care. Maternal health was assessed using a visual analog scale for satisfaction, a visual analog scale for anxiety and the Edinburgh Postpartum Depression Scale for postpartum depression. Also, first breast-feeding time, first mobilization time and opioid consumption were recorded and compared. The anxiety level of the spongostan group was lower than that of the control group and the difference was statistically significant at all time intervals (1, 6, 12, 18, 24, 30, 36 and 48 h, p < 0.001, respectively). Postpartum depression rate again was significantly lower in the spongostan group both on postoperative day 2 and day 9 (p a parts per thousand currency sign 0.01). All satisfaction scores were significantly higher in the spongostan group than in the control group (p < 0.001). Additionally, first breast-feeding and first mobilization times were significantly shorter and opioid consumption was lower in the spongostan group (p < 0.001). Placement of bupivacaine-soaked spongostan into the cesarean section wound resulted in decreased postoperative anxiety level and postpartum depression rate and increased satisfaction.Öğe Effect of ethinyl estradiol-cyproterone acetate treatment on asymmetric dimethyl-arginine levels in women with polycystic ovary syndrome(Springer Heidelberg, 2014) Karakurt, Feridun; Carlioglu, Ayse; Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Uz, Burak; Akdeniz, DeryaOur study was undertaken to evaluate the levels of asymmetric dimethyl-arginine (ADMA) in a group of patients affected with polycystic ovary syndrome (PCOS)-under ethinyl estradiol-cyproterone acetate treatment or not-as compared with a group of healthy controls. Fifty-eight women with PCOS and 45 patients as control group were included in the study. The 58 women with PCOS were separated into two groups: Group A (n = 29) were treated with an oral contraceptive pill containing 0.035 mg of ethinyl estradiol (EE) and 2 mg of cyproterone acetate (CA) (Diane-35) for 6 months. Group B (n = 29) did not take any drug. Group C (n = 45) was healthy women as control group. Serum levels of ADMA, lipid and glucose metabolism parameters, hormone profile were measured on the sixth month of treatment. ADMA levels were similar in women with PCOS and controls, whereas ADMA levels significantly decreased after a period of 6 months treatment with EE + CA in women with PCOS. ADMA levels and insulin resistance were decreased with treatment. However, patients with PCOS had significantly higher total cholesterol and Low-density lipoprotein cholesterol (LDL-C) compared to controls, treatment with EE + CA did not provide any improvement on lipid parameters. Serum ADMA levels and insulin resistance were lower in PCOS group treated with EE + CA than control group.Öğe Effect of Music on Labor Pain Relief, Anxiety Level and Postpartum Analgesic Requirement: A Randomized Controlled Clinical Trial(Karger, 2014) Simavli, Serap; Gumus, Ilknur; Kaygusuz, Ikbal; Yildirim, Melahat; Usluogullari, Betul; Kafali, HasanBackground/Aims: The control of labor pain and the prevention of suffering are major concerns of clinicians and their patients. The aim of this study was to evaluate the effect of music on labor pain and anxiety, maternal hemodynamics, fetal-neonatal parameters and postpartum analgesic requirement in primiparous women. Methods: Overall, 156 primiparous women who expected vaginal delivery were recruited and randomly assigned to a music group (n = 77) or a control group (n = 79). Women in the music group listened to music during labor. Pain intensity and anxiety level were measured using a visual analogue scale (0-10 cm). The two groups were compared in terms of pain severity, anxiety level, maternal hemodynamics, fetal-neonatal parameters and postpartum analgesic requirement. Results: Mothers in the music therapy group had a lower level of pain and anxiety compared with those in the control group at all stages of labor (p < 0.001). A significant difference was observed between the two groups in terms of maternal hemodynamics and fetal heart rate after intervention (p < 0.01). Postpartum analgesic requirement significantly decreased in the music therapy group (p < 0.01). Conclusion: Listening to music during labor has a positive impact on labor pain and anxiety, maternal-fetal parameters and analgesic requirement. (C) 2014 S. Karger AG, BaselÖğe Effect of music therapy during vaginal delivery on postpartum pain relief and mental health(Elsevier, 2014) Simavli, Serap; Kaygusuz, Ikbal; Gumus, Ilknur; Usluogullari, Betul; Yildirim, Melahat; Kafali, HasanBackground: Childbirth is an important experience in a woman's life, and unfavorable birth experiences have been shown to negatively impact postpartum maternal health. Aim of this study was to evaluate the effects of music therapy on postpartum pain, anxiety level, satisfaction and early pospartum depression rate. Methods: Totally 161 primiparous women were recruited and randomized either music group (n=80) or a control group (n=81). Women in the music group listened to self-selected music during labor. Postpartum pain intensify, anxiety level and satisfaction rate were measured using the visual analog scale (VAS), postpartum depression rate was assessed with Edinburg Postpartum Depression Scale (EPDS) at postpartum day one and day eight. Results: Mothers in the music therapy group had a lower level of postpartum pain and anxiety than the control group and it was statistically significant at all time intervals (1, 4, 8, 16 and 24 h, p < 0.001). A significant difference was observed between the two groups in terms of satisfaction rate (p < 0.001) and postpartum depression rate at postpartum day one and day eight (p <005). Limitations: We only measured the effect of music therapy on early postpartum depression rate. Effect of music on late postpartum depression rate should be investigated in future. Conclusions: Using music therapy during labor decreased postpartum anxiety and pain, increased the satisfaction with childbirth and reduced early postpartum depression rate. Music therapy can be clinically recommended as an alternative, safe, easy and enjoyable nonpharmacological method for postpartum well-being. Published by Elsevier B.V.Öğe Effects of cesarean section on mean platelet volume(Taylor & Francis Inc, 2015) Usluogullari, Betul; Kaygusuz, Ikbal; Simavli, Serap; Eser, Ayla; Gumus, Iknur InegolMean platelet volume (MPV) is a risk factor for cardiovascular complications, cerebrovascular disorders, and low-grade inflammatory conditions prone to arterial and venous thromboses. Cesarean delivery is the most important risk factor for pulmonary embolism, stroke, and intracranial venous thrombosis. The hypothesis is that increase in the prevalence of cesarean section and high MPV may be associated with cardiovascular complications such as stroke along with intracranial complications in addition to known systemic and surgical complications. In this study, platelet counts and MPV for postpartum women who delivered by cesarean section and normal vaginal parturition are compared. The subjects were divided in two groups, one was study group consisting of 118 patients giving birth by cesarean section and the other was the control group consisting 94 patients giving birth by normal vaginal parturition. Peripheral venous blood samples in EDTA tubes were collected from all the subjects 1 week before and after the delivery for their prenatal and postpartum periods, respectively. The values were compared between the groups and also before and after the delivery. In the cesarean group, while the MPV level was 8.60 (1.64) fl in the prenatal period, it increased to 9.10 (2.00) fl in the postnatal period (p<0.001). Group effect, time effect (independent from group effect), and group*time interaction effect were statistically significant for MPV variable (p = 0.032, p<0.001, and p = 0.012, respectively). This study concluded that MPV, along with several other factors, may be used as a prognostic, independent, and therapeutic marker in patients who are inclined to thrombotic events after cesarean section.Öğe Effects of oral hormone replacement therapy on mean platelet volume in postmenopausal women(Tubitak Scientific & Technological Research Council Turkey, 2014) Kaygusuz, Ikbal; Simavli, Serap Aynur; Eser, Ayla; Inegol Gumus, Ilknur; Yuksel, Selcen; Iltemir Duvan, Zehra Candan; Kafali, HasanBackground/aim: To examine the effects of hormone replacement therapy (HRT) on mean platelet volume (MPV), lipid profile, and C-reactive protein (CRP) levels in postmenopausal women who have a high risk and incidence of cardiovascular disease. Materials and methods: This study was performed retrospectively. Twenty-seven healthy postmenopausal women received 1 mg estradiol and 2 mg drospirenone orally for 6 months. Twenty-eight healthy postmenopausal women not taking any HRT were admitted to the study as the control population. Results: Time effect (independent from group effect) was statistically significant for the MPV variable (P = 0.025), but there was no significant change in MPV levels and other cardiovascular disease risk markers in women receiving HRT compared to women in the control group. Conclusion: Younger postmenopausal women taking HRT and women who initiated hormone therapy close to menopause are not at increased risk of cardiovascular disease.Öğe Investigation of Demodex folliculorum frequency in patients with polycystic ovary syndrome(Soc Brasileira Dermatologia, 2017) Eser, Ayla; Erpolat, Seval; Kaygusuz, Ikbal; Balci, Hatice; Kosus, AydinBackground: Background: Demodex mites are acari that reside in the pilosebaceous unit of the skin and have been associated with skin disorders. Objective: The objective of this study was to investigate the prevalence of Demodex folliculorum (D. folliculorum) mites in polycystic ovary syndrome patients as well as to examine the relationship between Demodex infestation and the presence of acne and oily or dry skin types in polycystic ovary syndrome patients. Methods: 41 polycystic ovary syndrome patients and 47 non-polycystic ovary syndrome control subjects were enrolled in the study. polycystic ovary syndrome was diagnosed according to the revised 2003 ESHRE/ASRM polycystic ovary syndrome Consensus Workshop Group diagnostic criteria. Microscopic examination of D. folliculorum mites was carried out by standardized skin surface biopsy. The result was considered positive when there were more than 5 mites per cm(2). Results: D. folliculorum was positive in 53.7% of the polycystic ovary syndrome patients and 31.9% of the non-polycystic ovary syndrome group (p=0.052). Demodex positivity was significantly associated with acne (p=0.003) and oily skin (p=0.005) in the polycystic ovary syndrome patients but not in the controls. Study limitation: Our study is limited by the relatively small number of subjects and the observational nature of the study design. Conclusion: Demodex mites might have a role in acne pathogenesis in patients with polycystic ovary syndrome. Anti-Demodex treatment may increase the response to treatment of acne. Further studies are indicated.Öğe Is Hepcidin a New Cardiovascular Risk Marker in Polycystic Ovary Syndrome?(Karger, 2013) Gozdemir, Elif; Kaygusuz, Ikbal; Kafali, HasanBackground/Aims: Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic abnormalities and carries a number of cardiovascular risk factors. Low-grade chronic inflammation has been thought to play a role in the pathogenesis of atherosclerosis and PCOS patients have an increased rate of subclinical inflammation. In the present study, considering the major role that hepcidin plays in the regulation of iron metabolism and as an inflammatory marker, we investigated hepcidin in PCOS patients and its role in predicting cardiovascular disease (CVD) development. Methods: Forty patients with PCOS and 40 age- and body mass index-matched healthy controls were included in the study. Iron metabolites, insulin resistance (IR), inflammatory markers and hepcidin levels were analyzed. Results:IR parameters, inflammatory markers, iron parameters and hepcidin levels were similar between the PCOS and control groups. While the inflammatory markers were significantly high in the overweight and obese PCOS subgroup, the hepcidin levels were also high but this elevation was not statistically significant. Conclusion:Obesity is the principle mechanism of chronic inflammation and IR in PCOS patients. C-reactive protein and interleukin-6 should be used to predict and follow the risk of CVD development in PCOS cases. Hepcidin may be used as an additional marker in the follow-up of PCOS patients in the future. Copyright (C) 2013 S. Karger AG, BaselÖğe Is Pentraxin 3 a New Cardiovascular Risk Marker in Polycystic Ovary Syndrome?(Karger, 2014) Sari, Umut; Kaygusuz, Ikbal; Kafali, HasanBackground/Aims: Polycystic ovary syndrome (PCOS) patients have an increased rate of subclinical inflammation, which plays a role in the pathogenesis of atherosclerosis. Pentraxin 3 (PTX3) is an inflammatory mediator which belongs to the same family as the well-established cardiovascular biomarker C-reactive protein (CRP). The present study was performed to investigate plasma PTX3 levels in patients with PCOS and to determine the relationship between PTX3 and other known cardiovascular risk factors. Methods: 40 patients with PCOS and 40 age- and BMI-matched healthy controls were included in the study. The groups were divided into subgroups according to BMI. Insulin resistance indexes, lipid profile, CRP and PTX3 levels were analyzed. Results: There was no difference for insulin resistance indexes and lipid profile between the PCOS and control groups. CRP levels were significantly higher in obese PCOS and control subjects than in lean subjects, whereas no difference in PTX3 concentrations was observed between subgroups. Conclusion: PTX3 and CRP levels were similar in the PCOS group compared with the non-PCOS control group. (C) 2014 S. Karger AG, BaselÖğe Is polycystic ovarian syndrome a risk factor for urolithiasis?(Springer, 2013) Kaygusuz, Ikbal; Karatas, Omer Faruk; Kafali, Hasan; Cimentepe, Ersin; Unal, DoganUrinary stone disease is a complex multifactorial disorder influenced by both intrinsic and environmental factors. It is generally known that age and sex are risk factors for urinary stone disease. Also men have higher mean urinary oxalate concentrations than women. In addition, in animal and human studies, testosterone has been shown to increase the formation of urinary stones. This suggests that sex hormones are considered to be involved in the pathogenesis of stone disease. Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine disorders of women in the reproductive age, affecting 5-10 % of women in this life span. It is characterized with chronic anovulation\oligo-ovulation, clinical or biochemical evidence of hyperandrogenism and polycystic ovaries on ultrasound examination. Hyperandrogenism, the main feature of PCOS, may trigger the urinary stone formation besides hirsutism, alopecia and acne. Therefore, we hypothesize that PCOS accompanied by hyperandrogenism may be a risk factor in the formation of urinary stone disease.Öğe Is There Any Relationship between Plasma Pentraxin 3 Levels and Gestational Diabetes Mellitus?(Karger, 2015) Yildirim, Melahat; Simavli, Serap Aynur; Derbent, Aysel Uysal; Kaygusuz, Ikbal; Uysal, SemaBackground: Pentraxin 3 (PTX3) is a novel vascular inflammatory marker which increases in vascular events such as diabetes mellitus. The aim of this study was to investigate the relationship between serum PTX3 levels and gestational diabetes mellitus (GDM). Methods: This prospective observational study was comprised of 88 pregnant women with singleton pregnancies. The subjects were classified into 3 groups according to their response to a 50-gram glucose challenge test (GCT) and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance group (n = 30), and GDM group (n = 30). Serum PTX3 levels were measured to examine the relationship between GDM and GCT values. Results: Significant differences in PTX3 levels were observed among the 3 groups in the sample (F = 7.598; p = 0.001). The mean PTX3 value was found to be significantly higher in the GDM group (3.17 +/- 1.16 ng/ml) than in the control group (2.20 +/- 0.83 ng/ml; p = 0.001). A significant positive correlation between PTX3 and GCT values was detected (r = 0.289; p = 0.008). Conclusion: Maternal serum PTX3 levels were found to be significantly related to high blood glucose levels. This may be an indicator of vascular pathology in GDM around the time of an oral glucose tolerance test. (C) 2015 S. Karger AG, BaselÖğe Levels of thrombin-activatable fibrinolysis inhibitor and platelet-activating factor in recurrent pregnancy loss patients(Elsevier Taiwan, 2016) Eser, Ayla; Gumus, Ilknur Inegol; Erdamar, Husamettin; Kaygusuz, Ikbal; Yildirim, Melahat; Usluogullari, Betul; Erdolu, Muzeyyen DuranObjective: The aim of this study was to investigate factors associated with thrombosis that may contribute to recurrent pregnancy loss (habitual abortion), specifically differences in serum levels of platelet-activating factor and thrombin-activatable fibrinolysis inhibitor (carboxypeptidase B2) between women with a history of recurrent miscarriage and those with no recurrent miscarriage history. Materials and methods: A case-controlled, prospective study design was adopted to compare women with a history of two or more first-trimester miscarriages (n = 42) with those with no history of recurrent miscarriage (n = 36). Participants were recruited from the Department of Obstetrics and Gynecology of Turgut Ozal University Hospital. Platelet-activating factor and thrombin-activatable fibrinolysis inhibitor levels in serum samples were measured by an enzyme-linked immunosorbent assay. Results: Platelet-activating factor levels were significantly (p = 0.018) higher in the recurrent miscarriage group. There was no difference in levels of thrombin-activatable fibrinolysis inhibitor expression between the groups. Conclusion: Platelet-activating factor is significantly higher in serum of patients with a history of recurrent miscarriage than in those without such a history, with potential implications for placental function and fetal growth, which could be relevant to miscarriage recurrence. Larger studies are indicated to further examine these findings. Copyright (C) 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC.Öğe Nail alterations during pregnancy: a clinical study(Wiley-Blackwell, 2016) Erpolat, Seval; Eser, Ayla; Kaygusuz, Ikbal; Balci, Hatice; Kosus, Aydin; Kosus, NerminDuring pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of < 0.05 was considered to indicate statistical significance. No nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.Öğe Serum Levels of Visfatin and Possible Interaction with Iron Parameters in Gestational Diabetes Mellitus(Karger, 2013) Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Yilmaz, Saynur; Simavli, Serap; Uysal, Sema; Derbent, Aysel Uysal; Gozdemir, ElifBackground/Aims: Visfatin is a novel adipokine with insulinomimetic properties that increases in diabetes. However, for gestational diabetes mellitus (GDM) there are conflicting reports. Recent studies have reported a positive association of serum ferritin concentrations with insulin resistance. Thus, we assessed serum levels of visfatin in pregnant women with varying degrees of glucose tolerance and investigated the possible interaction of visfatin with parameters of iron metabolism. Methods: Visfatin levels were measured at 24-28 weeks of gestation in 88 women who were divided into three groups according to their response to a 50-gram glucose challenge test and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance (IGT) group (n = 30) and GDM group (n = 30). Results: Visfatin levels were significantly higher in the GDM and IGT group than in control (p < 0.001 for GDM vs. control, and p = 0.004 for IGT vs. control). Serum visfatin was significantly associated with serum ferritin, insulin, age, gravidity, and body mass index. In a linear regression model, the covariates explained only 17% of variability of serum visfatin concentration. Body mass index (p < 0.001) contributed independently to visfatin variance. Conclusion: Serum visfatin concentration is significantly higher in GDM and is correlated with ferritin levels. Copyright (C) 2013 S. Karger AG, Basel
