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Biomedical subjects

G Uncu

Publications and source records attributed to G Uncu.

14 recordsLinked to original sources

Free and phospholipid-bound choline concentrations in serum during pregnancy, after delivery and in newborns.

The aims of this study were to determine whether serum free choline and phospholipid-bound choline concentrations change during the pregnancy or after childbirth and to determine if the serum choline concentrations of the mother and newborn are correlated. Serum free and bound choline concentrations were 10.7 +/- 0.5 microM and 2780 +/- 95 microM in control, non-pregnant women, and rose significantly (p < 0.001) to 14.5 +/- 0.6 microM and 3370 +/- 50 microM or to 16.5 +/- 0.7 microM and 3520 +/- 150 microM after 16-20 weeks or 36-40 weeks of pregnancy, respectively. Serum free and phospholipid-bound choline fell by 14-22% (p < 0.05-01) after either vaginal delivery or caesarian section, and remained low (by 15-42%; p < 0.05-0.001) for 12 h and then rose toward the baseline within 24 h. In amniotic fluid, free choline and phospholipid-bound choline concentrations were 22.8 +/- 1.0 and 19.6 +/- 0.8 microM or 24.0 +/- 1.5 and 516 +/- 43 microM at 16-20 weeks of gestational age or at term, respectively. In newborns, serum free choline concentrations were higher (p < 0.001) and phospholipid-bound choline concentrations were lower (p < 0.001) than in their mothers. These results show that serum free choline and phospholipid-bound choline concentrations are elevated during the pregnancy, which may be required for an adequate maternal supply of choline to the fetus. These observations are clinically important to determine the ideal dietary intake of choline during the pregnancy.

Cesarean Section↗

The role of plasma renin activity in distinguishing patients with polycystic ovary syndrome (PCOS) from oligomenorrheic patients without PCOS.

All the components of the renin-angiotensin system have been identified in the human ovary. Renin plays a major role in folliculogenesis, and possibly in follicular atresia. Polycystic ovary syndrome (PCOS) is characterized by early follicular atresia. We studied whether assessment of plasma renin activity would be useful for diagnosing PCOS and distinguishing PCOS and non-PCOS in oligomenorrheic patients. Patients were divided into three groups: PCOS group (group 1, n = 40), non-PCOS oligomenorrheic group (group 2, n = 30) and ovulatory control group (group 3, n = 30). Plasma renin activity was determined in the early follicular phase of the menstrual cycle. Baseline serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, insulin, aldosterone and androgens (total testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and 17alpha hydroxyprogesterone) were determined in all groups. The mean LH level was lower (4.94 +/- 4.65 mIU/ml) in control patients than in PCOS patients (12.9 +/- 1.75 mIU/ml) and non-PCOS oligomenorrheic patients (10.8 +/- 1.65 mIU/ml). There was no statistically significant difference between the groups regarding FSH levels. The mean plasma renin activity was 3.47 +/- 0.29 ng/ml in the PCOS group. The mean plasma renin activity was 1.59 +/- 0.21 ng/ml the non-PCOS oligomenorrheic group (statistically significiant differrence). There was no statistically significant difference between the non-PCOS oligomenorrheic (1.59 +/- 0.21 ng/ml) and control groups (1.2 +/- 0.16 ng/ml). Use of plasma renin activity alone as a diagnostic marker in PCOS is not useful, because the clinical findings of PCOS are heterogeneous and the pathogenesis is unclear. However, it can be used together with other variables to diagnose women with PCOS and to distinguish non-PCOS oligomenorrheic women from those with PCOS.

17-alpha-Hydroxyprogesterone↗

Should asymptomatic bacteriuria be screened in pregnancy?

The incidence of asymptomatic bacteriuria is reported as 2-14% during pregnancy. Fetal and maternal complications like acute pyelonephritis, hypertension, anemia, preterm labor, low-birth-weight infants and intrauterine growth retardation can be expected. The purpose of this study was to determine the incidence of asymptomatic bacteriuria during pregnancy and its relation to pregnancy complications. The study involved 270 pregnant women up to 32 gestational weeks during a 9-month period. At the initial visit, they were screened with urine culture in order to detect asymptomatic bacteriuria. A control group was formed in a retrospective manner from the first day of the study with 186 pregnant women who delivered in our clinic and who were not screened for asymptomatic bacteriuria. The incidence of asymptomatic bacteriuria was 9.31%. Escherichia coli accounted for 79%, which was the most frequent of the isolates. We observed recurrence and had to apply treatment again to 21.7% of the women. The sensitivity, specificity, positive predictive and negative predictive values of leucocyturia as a screening test for asymptomatic bacteriuria were 91.3%, 83.6%, 45.6% and 98.5%, respectively. We diagnosed preterm labor in six of 23 (26%) with asymptomatic bacteriuria and 16 in 163 (9.3%) women in the urine culture negative group. The ratio acute pyelonephritis in the group which was routinely screened and treated for asymtomatic bacteriuria was 0.5% while the prevalence was 2.1% in the nonscreened group. Considering the relatively high incidence of asymptomatic bacteriuria during pregnancy and the relevant complications, we propose to screen and treat asymptomatic bacteriuria routinely in all pregnant women.

Adult↗

Misoprostol in labor induction.

The efficacy of a new dosing regimen of misoprostol, a recently introduced labor-inducing agent, was studied. Fifty-eight patients received 50 microg of misoprostol intravaginally and the dose was repeated every 3 hours until uterine contractions begin. Those who had an adequate contraction pattern, defined as three contractions in 10 minutes, were not given the repeat dose. Oxytocin augmentation, but not further misoprostol doses, was used in patients with an inadequate contraction pattern. The maximum total daily dose was 200 microg. The patients had the mean age of 28.9 +/- 5.4, the mean gestational age of 211.8 +/- 46.6 days, the mean gravidity of 2.5 +/- 1.2, the mean parity of 0.9 +/- 0.9 and the mean initial Bishop score of 1.6 +/- 1.8. The mean required dose of misoprostol was 120.5 +/- 54.7 microg and 10 of 58 patients required oxytocin augmentation. The mean induction of labor to delivery time was 701.5 +/- 404.0 minutes. When 3 cases who gave birth with caesarean section were excluded, the interval was 708.4 +/- 407.2 minutes. The mean 5th minute Apgar score of the newborns was 8.2 +/- 2.5. Two patients developed tachysystole after the second dose of misoprostol and were managed with vaginal irrigation and O2 supplementation successfully. Slight nausea and vomiting in 2 patients were the other adverse reactions. Our findings revealed that, 50 microg intravaginal misoprostol, combined with oxytocin augmentation when necessary, appears to be an effective and safe method of labor induction.

Administration, Intravaginal↗

Plasma interleukin-1alpha, interleukin-1beta and interleukin-1 receptor antagonist levels in pre-eclampsia.

The values of plasma interleukin-1alpha (IL-1alpha), interleukin-1beta (IL-1beta) and interleukin-1 receptor antagonist (IL-1ra) levels were evaluated as the markers of pre-eclampsia in 35 serial plasma samples from ten pregnant women who subsequently developed pre-eclampsia and in 74 plasma samples from 20 uncomplicated pregnancies, retrospectively. No correlation was found between plasma IL-1alpha, IL-1beta and IL-1ra levels, liver and renal function tests, thrombocyte and white blood cell counts, proteinuria, systolic and diastolic blood pressures and gestational weeks. Almost equal levels of IL-1alpha and IL-1beta were measured in all corresponding groups, but these were too few in number to statistically analyze. IL-1ra values were higher in the pre-eclampsia group than in the uncomplicated pregnancy group, at 20-25 and 31-35 gestational weeks significantly and 26-30 gestational weeks insignificantly and showed an increase during labor in both groups. It was found to have 58% positive predictivity, 100% negative predictivity, 50% specificity and 100% sensitivity at gestational weeks 20-25. According to these results, IL-1ra seems to be considered for its high negative predictivity in the exclusion of the probability of pre-eclampsia development during antenatal visits, but its plasma level is not correlated with the severity of the disease.

Acute-Phase Reaction↗

Laparoscopic treatment of benign adnexial cysts.

The results of laparoscopic adnexial cyst excision operations performed within the last 2.5 years in our clinic are reported. Thirty-three adnexial masses thought to be benign after gynaecological examination and ultrasonographic findings were treated. Laparoscopy was done in 32 cases but laparotomy had to be performed in one case of stage IV endometriosis. The mean duration of the operations was 72.78 +/- 34.09 minutes and no major complication occurred. Pathologic examinations of the specimens were reported as benign in all cases. According to these results, laparoscopy should be the preferred method in the treatment of benign adnexial cysts.

Adnexal Diseases↗

Anticardiolipin antibodies in pregnancy induced hypertension.

It was suggested that anticardiolipin antibodies (ACA) were found positive in some obstetrical problems such as recurrent foetal losses, intrauterine growth retardation, etc. The aim of this study was to determine ACA levels in pregnancy induced hypertension (PIH) cases. ACA IgG and IgM levels were measured by the ELISA method in 65 PIH cases and 23 control pregnancies. We could not find any difference between the PIH and the control groups. There was not any statistically significant difference between the subtypes of PIH. According to these results, we say that ACA IgG and IgM levels have no diagnostic and prognostic value in PIH.

Adult↗

Hemodynamic profiles in severe preeclamptic and superimposed preeclamptic pregnancies.

In this study, we investigated the hemodynamic profiles of pregnancy-induced hypertension cases. Hemodynamic measurements were performed in five severe preeclamptic and three superimposed preeclamptic cases. We applied Swan-Ganz catheters and measured hemodynamic parameters. According to the results, we suggest that pulmonary edema occurs more easily in severe preeclampsia than in superimposed preeclampsia.

Adult↗

Gestational herpes: 3 cases.

Three histologically proven gestational herpes cases were presented. All were complaining of itching and vesiculobullous skin lesions. The diagnosis was confirmed by skin biopsies and they all gave a complete response to 1 mg/kg-day oral prednisolone therapy. No neonatal morbidity was observed.

Adult↗

Antenatal ambroxol usage in the prevention of infant respiratory distress syndrome. Beneficial and adverse effects.

A bromhexine metabolite ambroxol, is a relatively new promoter of fetal lung maturation. The data on its efficacy and side effects in humans are not yet as many as those of corticosteroids. We found that in 24 premature labor patients ambroxol reduced the incidence of respiratory distress syndrome when compared with the control group, consisting of 58 patients. There was no concomitant disorder in any patient that would have contributed to the fetal lung maturation. We also observed septic morbidity to be less frequent in the ambroxol group. Thyroid hormone levels were within normal range both in maternal and fetal circulation. There were no side effects attributable to the drug. Maternal liver and renal function test results did not differ significantly throughout the treatment.

Ambroxol↗

The comparison of 50 grams glucose challenge test, HbA1c and fructosamine levels in diagnosis of gestational diabetes mellitus.

We evaluated the sensitivity, specificity, positive and negative predictive values of 50 grams glucose challenge test, serum fructosamine and HbA1c levels as screening tests for gestational diabetes mellitus. Forty-two pregnant patients between the 24th and 28th week of their pregnancies were included in the study. Blood fructosamine and HbA1c levels did not differ significantly from the 50 grams glucose challenge test and were concluded to be alternatives to this test. Any combination of these 3 tests gives better results than a single test, but no one of the combinations is superior to the others.

Blood Glucose↗