Biomedical subjects

Yusuf Ustün

Publications and source records attributed to Yusuf Ustün.

13 recordsLinked to original sources

PubMed2006

Effect of postpartum counseling on postpartum contraceptive use.

OBJECTIVE: The aim of this study was to evaluate the effect of postpartum counseling on postpartum contraceptive use. METHODS: One hundred and forty-three women who delivered between 1 January 2004 and 31 September 2004 and counseled about postpartum contraception were included in the study. The participants were interviewed by telephone. Age, gravidity, parity, and mode of delivery of the participants were recorded. Their method of contraception before pregnancy, their decision on the contraceptive method after counseling and the method actually used were asked. RESULTS: Just after postpartum counseling, 47 women (32.9%) decided to use the intrauterine device (IUD), 23 (16.1%) condoms, 16 (11.2%) progestin injections, 7 (4.9%) oral contraceptives, and 7 (4.9%) coitus interruptus for contraception. Thirty-six women (25.2%) did not decide on any method of use. At the time of the telephone interview the actual method used was learned. Fifty-one women (35.7%) were using coitus interruptus, 45 women (31.5%) condoms, and 14 (9.8%) the IUD. Sixteen women (11.2%) were reported as not using any methods. CONCLUSION: In spite of postpartum counseling, a high majority of the women appeared to use traditional and less effective contraceptive methods.

Adolescent↗

PubMed2006

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

AIM: Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). METHODS: The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver-operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk. RESULTS: There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%. CONCLUSION: As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.

Adolescent↗

PubMed2006

Effects of intranasal 17beta-estradiol and raloxifene on lipid profile and fibrinogen in hypercholesterolemic postmenopausal women: a randomized, placebo-controlled clinical trial.

AIM: To compare the effects of 17beta-estradiol given intranasally (intranasal E2) and raloxifene on serum lipid profile and fibrinogen in hypercholesterolemic postmenopausal women. METHODS: The study population consisted of 46 women after menopause. The placebo group (n = 11) was given calcium, while the intervention groups were given intranasal E2 (Aerodiol; Servier, Chambray-les-Tours, France) (n = 16) or raloxifene (Evista; Lilly SA, Madrid, Spain) (n = 19). Blood lipids and fibrinogen were compared between groups at baseline and after 3 months of treatment. RESULTS: The group receiving intranasal E2 showed a significant decrease in triglyceride levels (p<0.05) and a marked increase in high-density lipoprotein cholesterol levels (p<0.05). No changes in lipid profile were observed in the raloxifene and placebo groups. Raloxifene caused a significant decrease in fibrinogen levels (p<0.05). CONCLUSION: Intranasal E2 exerts significant effects on lipid profile in hypercholesterolemic postmenopausal women. Raloxifene has a greater impact on fibrinogen than intranasal E2 application.

Administration, Intranasal↗

PubMed2006

A prospective randomized study comparing misoprostol and oxytocin for premature rupture of membranes at term.

OBJECTIVE: The aim of this randomized trial was to compare the efficacy and safety of vaginal misoprostol and oxytocin for cervical ripening and labor induction in patients with premature rupture of membrane (PROM) at term. METHODS: Ninety-seven women with PROM at term were assigned randomly to receive intravaginal misoprostol or oxytocin. The primary outcome measure was the induction-delivery interval. Secondary outcomes included the number of women who delivered vaginally within 12 hours of the start of the induction in the two groups, the cesarean, hyperstimulation, and failed induction rates, the mode of delivery, and the neonatal outcome. RESULTS: Forty-eight women were assigned to intravaginal misoprostol and 49 to oxytocin administration. The mean interval from induction to delivery was 10.61 +/- 2.45 hours in the misoprostol group and 11.57 +/- 1.91 hours in the oxytocin group (p = 0.063). The rates of vaginal delivery were 83.3% and 87.7% and cesarean delivery were 16.7% and 8.2% in the misoprostol and oxytocin groups, respectively. Neonatal outcomes were not significantly different. Of the cases, 8.3% in the misoprostol group and 8.2% in the oxytocin group revealed uterine contraction abnormalities. CONCLUSION: Our study demonstrates that, intravaginally, misoprostol results in a similar interval from induction of labor to delivery when compared to oxytocin.

Administration, Intravaginal↗

PubMed2006

Elevated nucleated red blood cell count: a population-based study.

OBJECTIVE: To assess the prevalence and causes of elevated nucleated red blood cell (NRBC) count. STUDY DESIGN: We conducted a 1-year, population-based surveillance study that included pregnant women and their infants from our medical center, which serves as a tertiary referral hospital. Outcome measures included NRBC count, gestational age, mode of delivery, birth weight, Apgar scores, cord blood gasses, rate of neonatal intensive care unit admission. Statistical analyses were performed with Mann-Whitney U-test, independent samples t test, chi2 test, Fisher's exact test and Spearman's correlation test, as appropriate. RESULTS: NRBC count obtained from 423 women had a median of 4 (0-163). A cutoff point of 13.5 for predicting fetal acidosis had the highest combined sensitivity (77.8%) and specificity (84%). Three hundred forty-nine neonates had a NRBC count < or = 13.5, whereas 73 had > 13.5. Logistic regression analysis revealed that preeclampsia (OR = 5.9, 95% CI = 2.8-12.3) remained the most prominent risk factor for elevated NRBC count. CONCLUSION: Elevated NRBC appears to be associated with preeclampsia.

Adolescent↗

PubMed2006

Relationship between meconium staining, umbilical cord plasma motilin level and infantile colic.

OBJECTIVE: To assess the effects of meconium-stained amniotic fluid and umbilical cord plasma motilin levels on the development of infantile colic. STUDY DESIGN: One hundred forty pregnant women referred to our department for labor care were enrolled in the study. All subjects were laboring women with singleton, vertex-presenting fetuses, with a gestational age of > or = 36 weeks. After each infant with meconium-stained amniotic fluid was born, the following 2 infants without meconium were selected as controls. Umbilical cord plasma motilin levels were measured in 47 infants with meconium-stained amniotic fluid and 93 infants with no meconium. At the end of the third month of the infants' lives, the development of infantile colic was evaluated. Umbilical cord serum specimens were collected from 45 infants with colic and 95 infants without colic. Statistics included Student's t, chi2 and Mann-Whitney U tests, as appropriate. Multivariate analysis was performed. RESULTS: There was no correlation between the presence of meconium-stained amniotic fluid and the development of infantile colic. No association was found between umbilical cord plasma motilin levels and the development of infantile colic. Neonatal intensive care unit admission was found to be a significant risk factor for the development of infantile colic. CONCLUSION: Meconium-stained amniotic fluid and umbilical cord plasma motilin levels do not affect the development of infantile colic.

Amniotic Fluid↗

PubMed2005

Pelvic organ prolapse complicating third trimester pregnancy. A case report.

The concomitant phenomenon of a third trimester pregnancy with a significant degree of pelvic organ prolapse is extremely rare. We report on a patient with pelvic organ prolapse complicating third trimester pregnancy treated by concomitant cesarean hysterectomy and abdominal sacrocolpopexy. A 30-year-old woman, gravida 6, parity 5, was admitted to the hospital with uterine contractions in week 35 of gestation. Pelvic examination in the dorsal lithotomy position revealed a stage 3 pelvic organ prolapse. A cesarean hysterectomy was performed. After hysterectomy, the vaginal cuff was suspended to the periosteum overlying the sacral promontory. Cesarean hysterectomy might be a therapeutic option for women who have completed their families and are suffering from severe pelvic organ prolapse complicating third trimester pregnancy, particularly in developing countries where access to health care is limited.

Adult↗

PubMed2005

Association of fibrinogen and C-reactive protein with severity of preeclampsia.

OBJECTIVE: The aim of this study was to determine the levels of plasma fibrinogen and C-reactive protein (CRP) in preeclampsia and their association with the severity of the disease. STUDY DESIGN: CRP and plasma levels of fibrinogen were investigated in 26 cases of normal pregnant women, 26 cases with mild preeclampsia and 26 cases with severe preeclampsia in the third trimester of pregnancy. Mean arterial pressure (MAP) was used as an indicator of the severity of the disease. Analysis of variance with the Kruskal-Wallis test was used when three groups were compared. For correlations, Spearman's rank correlation tests were used. A receiver operating characteristic curve was constructed to evaluate the sensitivity and specificity of CRP. RESULTS: Plasma CRP and fibrinogen levels in mild and severe preeclampsia patients were markedly higher than that of normal third trimester pregnant women. There were significant correlations between MAP and CRP (r = 0.515, p = 0.0001) and MAP and fibrinogen parameters (r = 0.383, p = 0.005) in pregnancies complicated with preeclampsia. CONCLUSION: We found higher levels of fibrinogen and CRP and presence of good correlation between CRP and MAP in preeclampsia.

Adolescent↗

PubMed2005

Raynaud's phenomenon in a healthy Turkish population.

Raynaud's phenomenon (RP) is a vasospastic disease and is characterized by ischemia of the digits, nose, and ears. The vasospasm can be triggered by cold weather, cold water, or emotional stress and is followed by triphasic color changes. First white color (ischemia), then blue color (congestion and cyanosis), and finally red color change (reactive hyperemia) can be observed. The prevalence is reported to be between 0.5 and 20% in different studies and is dependent on genetic, occupational, and environmental factors. The purpose of our study was to determine the prevalence of RP in an eastern part of Turkey among healthy subjects. A total of 768 people were included in the study. This cross-sectional study was conducted between April 2003 and October 2003 at the University Hospital and at the State Hospital in Van, Turkey. The participants were interviewed and examined to diagnose RP and a questionnaire and color charts were used. Of these 768 patients, 25 women and 20 men were diagnosed to have RP. A female predominance (25/20) was observed. Their mean age was 24.78 +/- 5.71 years. The prevalence of RP was 5.9% in our study population.

Adult↗

PubMed2005

Serotonergic activity and the Beck Depression Inventory in the premenstrual syndrome.

OBJECTIVE: To investigate the relationship between platelet [3H]-imipramine binding and Beck Depression Inventory scores in the premenstrual syndrome (PMS). STUDY DESIGN: Thirty-one patients with PMS and 26 healthy female volunteers participated in the study. Imipramine binding was measured by saturation binding of [3H]-imipramine. The Beck Depression Inventory form was completed. RESULTS: The number of [3H]-imipramine binding sites (Bmax) was significantly lower in the study group (p = 0.003). Beck Depression Scores were significantly higher in the study group as compared with the control group (p = 0.001). No correlation was found between platelet [3H]-imipramine binding and Beck Depression Inventory scores (r = 0.100, p = 0.591). CONCLUSION: A significantly lower number of Bmax wasfound in patients with PMS as compared to controls, but no correlation between platelet [3H]-imipramine binding and Beck Depression Inventory scores was found.

Adolescent↗

PubMed2004

Randomized comparison of Burch urethropexy procedures concomitant with gynecologic operations.

OBJECTIVE: We compared the success of laparoscopic Burch colposuspension with the laparotomic Burch colposuspension for the treatment of genuine stress incontinence (GSI) concomitant with gynecologic operations. MATERIALS AND METHODS: Fifty-two women with symptoms of GSI, also requiring additional gynecologic operations, were randomly assigned to undergo laparoscopic (n = 26) or laparotomic (n = 26) Burch colposuspension. For all patients complete histories were taken and physical examination, urinalysis, urine culture, multi-channel urodynamics with cystometry, uroflowmetry, and measurement of Valsalva leak-point pressure were performed. Variables analyzed included: age, surgical time, length of catheterization, number of days in hospital, and complications. RESULTS: Both groups were similar in age, parity and menopausal status. Valsalva leak-point pressure significantly increased in the laparoscopy group after the operation. There were no statistical differences in other urodynamics in both groups. The mean operating time in the laparoscopy group was longer than in the laparotomy group. The laparoscopy group required a significantly shorter hospitalization and catheterization than the laparotomy group. The success and complication rates did not differ significantly for both groups. CONCLUSION: The laparoscopic approach for the treatment of GSI in patients requiring additional gynecologic procedures is associated with a shorter duration of hospital stay compared with the abdominal approach.

Adult↗

PubMed2004

Trace element status in plasma and erythrocytes in hyperemesis gravidarum.

OBJECTIVE: To determine trace element status in plasma and erythrocytes hyperemetic women at presentation and after treatment. STUDY DESIGN: Studies were carried out on 32 women with hyperemesis gravidarum. Thirteen non-vomiting, healthy, pregnant women served as controls. Copper, zinc and magnesium concentrations in both plasma and erythrocytes were estimated before and after treatment. Independent sample t test, paired sample t test, Wilcoxon signed rank test, Mann-Whitney U test, chi2 test, Kruskall-Wallis one-way analysis of variance and Spearman's correlation study were used for statistical analysis. RESULTS: There were no significant differences between the 2 groups in erythrocyte zinc, copper and magnesium concentration. Plasma zinc levels were significantly higher (P = .006), while plasma copper levels were significantly lower (P = .001) in the study group as compared to the controls, but plasma magnesium levels were not significantly altered. Treatment brought a significant decrease in plasma zinc levels (P = .001), increase in plasma copper concentration (P = .001) but no change in erythrocyte zinc, copper or magnesium concentration. When trace element levels were grouped according to the degree of ketonuria, no significant differences were found in the 2 groups. CONCLUSION: Hyperemetic women had normal tissue zinc, copper and magnesium concentrations, and rehydration normalized the plasma zinc and copper levels. Otherwise, no significant effects on trace elements were noted.

Adult↗

PubMed2003

Tension-free vaginal tape compared with laparoscopic Burch urethropexy.

STUDY OBJECTIVE: To compare laparoscopic Burch colposuspension and tension-free vaginal tape (TVT) procedure in women with genuine stress incontinence. DESIGN: Randomized clinical study (Canadian Task Force classification I). SETTING: Tertiary care university hospital. PATIENTS: Forty-six consecutive women. INTERVENTION: Laparoscopic Burch colposuspension (23) and TVT procedure (23). MEASUREMENTS AND MAIN RESULTS: Valsalva leak-point pressure increased after surgery in both groups, but TVT substantially decreased maximum urinary flow rate. Other urodynamic studies showed no statistical differences. The groups did not differ significantly with respect to intraoperative complications or objective and subjective cure rates. Operating time was significantly longer for laparoscopic Burch (p = 0.001), and three patients in that group required conversion to laparotomy. Length of hospital stay (p = 0.003) and duration of catheterization (p = 0.003) were shorter in the TVT group. CONCLUSION: TVT holds promise in women with genuine stress incontinence, with several advantages over laparoscopic Burch.

Female↗