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Association Between Plasma Adrenomedullin Levels and Bone Mineral Density in Patients with Polycystic Ovary Syndrome
(Galenos Yayincilik, 2005) Uçar, Banu; Noyan, Volkan; Yücel, Aykan; Sağsöz, Nevin; Çağlayan, Osman
Objective: The aim of the study was to compare bone mineral density measurements between patients with polycystic ovary syndrome (PCOS) and age and body mass index matched healthy controls, and to examine whether plasma adrenomedullin concentration was associated with bone mineral density. Design: Prospective study. Setting: Department of Obstetrics and Gynecology, Kirikkale University School of Medicine. Patients: Twenty women with PCOS and 13 healthy control subjects were enrolled in the study. Interventions: Plasma adrenomedullin, serum androstenedione, free testosterone, testosterone, DHEAS, SHBG, FSH, LH, estradiol, fasting insulin and fasting glucose were measured in each subject. Bone mineral density (lumbar spine 2-4 (L2-4), femoral neck, ward's triangle, great trochanter) measurements were measured using dual energy X-ray absorptiometry. Insulin resistance was estimated by fasting insulin level, fasting glucose: insulin ratio and 75 g of glucose tolerance test for 2 hours. Main Outcome Measures: Bone mineral density and correlation between bone mineral density and plasma adrenomedullin. Result: Bone mineral density measurements did not differ between the groups. There were no correlations between plasma adrenomedullin and bone mineral density measurements. Conclusions: Further studies are needed to evaluate the relation between bone mineral density and plasma adrenomedullin.
Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs
(Galenos Yayincilik, 2009) Çil, Aylin Pelin; Leventoglu, Alev; Sönmezer, Murat; Soylukoç, Rabia; Oktay, Kutluk
Objective: There is limited data about fertility in multiple sclerosis (MS) patients using immunomodulating drugs and no data exists regarding the ovarian reserve of these patients. Therefore, we aimed to evaluate,the ovarian reserve and doppler characteristics of MS patients using irnmunomodulating drugs. Material and Methods: MS patients using immunomodulating drugs (interferon (1M) beta and glatiramer acetate) and age-matched healthy controls were included in the study. Subjects were examined in the early follicular phase of the menstrual cycle with transvaginal ultrasound to evaluate ovarian volume, antral follicle count (AFC) and ovarian stromal artery Doppler. On the same da blood was taken for determining serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels. A subgroup analysis was also carried out between MS patients using only IFN p and controls to compare the same parameters. Results: Mean ovarian volume and total AFC were lower in MS patients using immunomodulating drugs than in the controls. FSH and E2 levels did not show any differences between the groups, but LH levels were, significantly higher in MS patients. All the Doppler parameters of the ovarian stromal artery were higher in MS patients but not significantly. In the subgroup analysis, the same significant differences were found for ovarian volume, AFC and LH levels. In addition, MS patients showed significantly higher mean pulsatility index measurement than the controls. Conclusion: The findings of this study demonstrated diminished ovarian volume and follicular reserve in MS patients using immunomodulating drugs compared to age matched healthy controls. However, further studies are required to elucidate whether compromised ovarian reserve in MS patients is due to drugs or the disease itself.
What is the impact of intraperitoneal surfactant administration against postoperative intraabdominal adhesion formation? an experimental study
(Tubitak Scientific & Technological Research Council Turkey, 2023) Pala, Şehmus; Kuloğlu, Tuncay; Atılgan, Remzi; Özkan, Zehra Sema; Hançer, Serhat
Background/Aim: Surfactant is a surface-active substance that, in addition to its detergent effect, also has effects that reduce inflammation and fibrosis. Because of these effects, it was aimed herein to investigate the effect of intraperitoneal surfactant application on preventing postoperative peritoneal adhesion formation in a uterine horn adhesion model. Materials and methods: Twenty-one Wistar albino rats were randomly divided into 3 groups (G1-G3), as follows: G1 (n = 7): control group. The abdomen was opened and then closed; G2 (n = 7): adhesion group. The abdomen was opened. Then, a 2-cm linear incision was made over the right uterine horn, 2 mL of isotonic saline was administered intraperitoneally, and the abdomen was closed; and G3 (n = 7): treatment group. The abdomen was opened, a 2-cm linear incision was made over the right uterine horn, 2 mL (70 mg/kg) of surfactant was administered intraperitoneally, and the abdomen was closed. After 15 days, the rats were euthanized, the abdomens were reopened, and adhesion scoring was performed. After the right uterine horns were removed and fixed with 10% formalin, appropriate sections were taken from the traumatized tissue, stained with Masson's trichrome, and fibrosis and inflammation scoring were performed. Results: The adhesion area and intensity were significantly higher in G2 than in G1 and G3 (p = 0.001) and were similar in G1 and G3 (p = 0.165). While fibrosis and inflammation were significantly higher in G2 than in G1 and G3 (p = 0.001), there was no difference between G1 and G3 (p = 0.5). Conclusion: Intraperitoneal surfactant administration at a dose of 70 mg/kg was found to be effective in preventing intraabdominal adhesion formation in a rat uterine horn model.
Expression of laminin-1 and matrix metalloproteinase-9 in benign and malignant endometrium
(Tubitak Scientific & Technological Research Council Turkey, 2023) Küçükaydın, Zehra; Başaran, Mustafa; Ünlü, Yaşar; Başaran, Ahmet; Kurdoğlu, Mertihan
Background/aim: Laminin-1 and matrix metalloproteinase (MMP)-9 may play roles in the progression from benign to malignant endometrium, so we aimed to investigate their levels of expression in these tissues.Materials and methods: This case-control study was conducted at a tertiary care center between January 2014 and December 2016. Paraffin blocks of 50 specimens of benign endometrium with proliferative (n = 20), secretory (n = 11), and atrophic (n = 5) endometrium; simple endometrial hyperplasia without atypia (n = 12); and endometrial polyp (n = 2) histology and 49 specimens of malignant endometrium with endometrioid (n = 40), serous (n = 7), clear cell (n = 1), and undifferentiated (n = 1) types were immunostained with laminin-1 and MMP-9 antibodies and assessed for basement membrane continuity for laminin-1 and the percentage and intensity of MMP-9 expression in epithelial cytoplasm.Results: Laminin-1 continuity in the basement membrane was higher in benign (92%) compared to malignant (16.3%) endometrium (p < 0.0001) without any difference between the subgroups within each group (p > 0.05). All atrophic endometria and endometrial polyps and 23.5% of low grade endometrioid and none of the other endometrial cancers showed uninterrupted basement membrane staining with laminin-1. All cases in malignant endometrium expressed MMP-9 with either low or high immunoreactivity while none of the cases in benign endometrium showed a high staining with MMP-9 (p < 0.01). Proliferative and hyperplastic endometrium together with grade 1 endometrioid cancer expressed MMP-9 better than the atrophic endometrium (p < 0.05). The immunoreactivity with MMP-9 increased gradually from secretory to hyperplastic endometrium and serous carcinoma (p < 0.05). MMP-9 expression in all types of cancers except grade 1 endometrioid and clear cell compared to proliferative endometrium was significantly higher (p < 0.05) and increased from proliferative to grade 2 endometrioid, grade 3 endometrioid, serous and undifferentiated endometrial carcinoma.Conclusion: Gradual increments in MMP-9 expression and basement membrane laminin-1 discontinuity may indicate progression from normal to hyperplastic and to low-and high-grade cancerous endometrium.
Comparison of the efficacy between bilateral proximal tubal occlusion and total salpingectomy on ovarian reserve and the cholinergic system: an experimental study
(2020) Atılgan, Remzi; Pala, Şehmus; Kuloğlu, Tuncay; Şanlı, Cengiz; Yavuzkır, Şeyda; Özkan, Zehra
Background and aim: To compare the effects of bilateral proximal tubal occlusion and bilateral total salpingectomy on ovarian reserve and the cholinergic system via rat experiment. Materials and methods: Twenty-one adult female rats were randomly divided into the following three groups: G1 (n = 7), sham group; G2 (n = 7), bilateral total salpingectomy group; and G3 (n = 7), bilateral proximal tubal occlusion group. Four weeks later, the abdomen of the rats was opened. The right ovarian tissues were stored in 10% formaldehyde, whereas the left ovarian tissues were stored at –80 °C in aluminum foil. Serum samples were evaluated for antimullerian hormone. The right ovary was used for histological and immunoreactive examination, and the left ovary was used for tissue MDA analysis. Tissue samples were analyzed for MDA levels with spectrophotometric measurement, apoptosis with TUNEL staining, fibrosis score with Mason trichrome staining, ovarian reserve with HE staining, and cholinergic receptor muscarinic 1 (CHRM1) level with immunoreactivity method. Results: Compared to G1 and G3, the number of corpus luteum with secondary follicles was significantly lower in G2, whereas the number of ovarian cysts and fibrosis and apoptosis scores increased significantly. The CHRM1 immunoreactivity was significantly lower in G2 than in G1 and G3. Conclusions: Compared to the bilateral proximal tubal occlusion performed by using bipolar cautery, bilateral total salpingectomy in rats leads to a significant damage in ovarian histopathology and the cholinergic system.
Doğum Eyleminde Perineal-İnguinal Herpes Zoster Enfeksiyonu: Nadir bir olgu sunumu
(2017) Bulanık, Murat; Sağsöz, Nevin; Kurtay, Sabri; Işık, Yüksel
Amaç: Herpes Zoster (zona) enfeksiyonu yaşam boyu görülme sıklığı % 0,3-0,8 olan, varisella zoster virusunun (VZV) primer olarak nöral dokuyu tuttuğu fakat komplikasyonları dermatolojik, nörolojik, oftalmolojik ya da visseral olabilen viral enfeksiyondur Gebelikte varisella zoster enfeksiyonu 1-5/10.000 gibi düşük insidansa sahipken olgulardaki VZV seropozitifliği oldukça yüksektir (> % 95). Gebelikte bulaş in-utero, perinatal, postnatal olabilir. Mortalitesi yüksek olan neonatal suçiçeği enfeksiyonu ise doğum sırasındaki bulaş sonucu ortaya çıkar. Bu yazıda gebeliğinde travay takibinde zona enfeksiyonu geçiren ve bunun üzerine sezeryan ile doğumu gerçekleştirilen bir olgu sunularak konu literatur bilgileri eşliğinde tartışıldı.
Gebelikte Uyku Kalitesinin Değerlendirilmesi
(2019) Yeral, İlkin
AMAÇ: Gebelikte trimesterler arası uyku kalitesinin ve uykululuk düzeyinin karşılaştırılması amaçlandı. GEREÇ-YÖNTEM: Kliniğimize 1 ay içerisinde başvuran ilk trimester gebeler 1. grup, ikinci trimester gebeler 2. grup ve son trimester gebeler 3. grup olacak şekilde gruplandırıldı. Hastalara Pittsburgh Uyku Kalite İndeksi ve Epworth Uykululuk Skalası uygulandı. BULGULAR: Çalışmaya katılan tüm gebelerin (n=240) %74,2’sinde (n=178) uyku kalitesinin kötü olduğu (toplam Pittsburgh skoru>5) tespit edildi. PUKİ bileşenleri incelendiğinde; sadece uyku ilacına başvurmada tüm gruplar arasında istatistiksel olarak anlamlı bir fark saptanmadı (p=0,084). Diğer bileşenler ve toplam PUKİ skorları incelendiğinde ise; uyku kalitesinin 3. grupta en kötü, 2. grupta ise en iyi olduğu görüldü (p<0,005). EUS’ye göre; sadece 2. ve 3. grup arasında istatistiksel olarak anlamlı bir fark saptandı ve uykululuk 3. grupta daha fazlaydı (p<0,005). SONUÇ: Uyku kalitesinin genel olarak gebelikte bozulduğu ve bu bozukluğun son trimesterde en çok olduğu, ikinci trimesterde ise en az olduğunu saptandı.
Sub-clinic atherosclerosis in patients with postprandial reactive hypoglycemia
(2019) Çiftçi, Faika Ceylan; Tuğcu, A Ulaş; Çiftçi, Özgür
Aim: Hypoglycemia is associated with excessive cardiovascular mortality because of the pro-inflammatory and pro-atherothrombotic pathway stimulation. Hypoglycemia is known to affect the development of sub-clinic atherosclerosis. This study aims to determine the development of sub-clinic atherosclerosis in patients with postprandial reactive hypoglycemia by investigating thickness of carotid intima media and epicardial fat, and high-sensitivity C-reactive protein values and their relationships with each other. Material and Methods: 51 patients in total were included in the project, including 28 patients (37.50±10.82 years) who had hypoglycemia symptoms and who had hypoglycemia during prolonged oral glucose tolerance test and 23 healthy adult volunteers (35.01±10.92 years) as a control group. Subjects underwent echocardiographic examination including EFT and IMT measurement using transthoracic echocardiography. Results: Postprandial Reactive Hypoglycemia group were marked with higher high-sensitivity C-reactive protein levels (1.67±0.67 vs. 1.20±0.52; p= 0.007), carotid intima media thickness (0.65±0.10 vs. 0.50±0.10; p<0.001) and epicardial fat thickness (0.57±0.07 vs. 0.48±0.08; p= 0.001) values as compared to the control group. Conclusion: Patients with postprandial reactive hypoglycemia had impaired epicardial fat thickness and increased thickness of carotid intima media, and carotid intima media thickness linked with significantly with high-sensitivity C-reactive protein. These observations support the importance of chronic inflammation mechanism for the development of sub-clinic atherosclerotic disease in postprandial reactive hypoglycemia.
Oxytocin-Induced Bilateral Serous Retinal Detachment
(2019) Örnek, Nurgül; Örnek, Kemal; Timur, İnci Elif Erbahçeci; Tulmaç, Özlem Banu
A 27-year-old multigravid patient was admitted with bilateral blurring of vision after caesarean delivery. She had history of oxytocin infusion for labor stimulation. Visual acuities were 1/10 in both eyes. Fundus examination showed bilateral serous retinal detachments affecting predominantly the posterior pole and the peripapillary area. Optical coherence tomography revealed bilateral serous retinal detachment of the macular area. Spontaneous resorption of the subretinal fl uid started promptly the following day after the delivery. Large volumes of hypotonic solution with oxytocin may induce water retension during labor. This should be considered in the differential diagnosis of bilateral serous RD in pregnancy.
Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey
(2020) Bayram, Merih; Biri, Aydan Asyalı; Büyükbayrak, Esra Esim; Dağlar, Halil Korkut; Ercan, Fedi; Erzincan, Selen Gürsoy; Esmer, Aytül Çorbacıoğlu
ABS TRACT Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.
What is the protective effect of krill oil on rat ovary against ischemia–reperfusion injury?
(Blackwell Publishing, 2019) Yeral I.; Sayan C.D.; Karaca G.; Simsek Y.; Sagsoz N.; Ozkan Z.S.; Atasoy P.
Aim: In this study, we aimed to investigate the protective effect of krill oil (KO) against ischemia–reperfusion (I/R) injury on rat ovary. Methods: This study was conducted with 32 Wistar Albino rats. Rats were divided into four groups, with eight rats in each group-as follows: Sham group, I/R group, I/R + low dose KO group (50 mg) and I/R + high dose KO group (500 mg). The histopathological and follicle counts were performed on the right ovary. The total antioxidant status, total oxidant status and oxidative stress index were evaluated on the left ovary. And also serum N-thiol level, serum T-thiol level, serum disulfide (SDS) level, serum disulfide/N-thiol and serum disulfide/T-thiol ratios were evaluated too. Results: A statistically significant difference was determined between the I/R group and all the other groups for all parameters. There was significant difference between KO groups and the Sham group for the parameters of serum N-thiol, serum T-thiol, SDS, serum disulfide/N-thiol and serum disulfide/T-thiol. SDS, total oxidant status and oxidative stress index were determined to be the highest in the I/R group and the lowest in the low dose KO group. The total antioxidant status values were found to be the highest in the high dose KO group and the lowest in the I/R group. Follicle counts and histological injury scores showed no significant difference between Sham and KO groups. Conclusion: This study demonstrated that KO has beneficial effects on decreasing the injury after I/R on rat ovary. © 2018 Japan Society of Obstetrics and Gynecology
What is the effect of the early follicular phase FSH/LH ratio on the number of mature oocytes and embryo development?
(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2020) Arat, Ozgur; Deveci, Derya; Ozkan, Zehra Sema; Tuncer Can, Sevim
Background/aim: Basal level of follicle stimulating hormone (FSH), luteinizing le (LH), estradiol (E2), and antral follicle count are used as predictors of ovarian reserve before starting ovulation induction. e aimed to investigate the predictor potential of early fbllictilar phase FSH/LH ratio on controlled ovarian hyperstimulation-intrac Aasmic sperm injection (COH-ICSI) cycle outcomes. Materials and methods: This retrospective cohort study was conducted with 648 COH-ICSI cycles pertbrmed between 2012 and 2014. Cycles were classified according to their basal FSH/LH ratio, group 1(01) = FSH/LH ratio < 2, N = 473 and group 2(G2) = FSH/LH ratio 2, N = 175. Demographic characteristics and stimulation parameters were evaluated. Retrieved total oocyte count (TO C), mature oocyte count (MOO, transferred embryo number, and pregnancy results were obtained and transferred to computer by SPSS 21.0 programme. Results: TOC and \1O( of G1 were signilieantly higher than those of '2 "l he total gonadotrophin doses of 02 were significantly higher than 0l. "I here was no significant difference between groups for transferred embryo number. Pregnancy and live birth rates were similar in both groups. Conclusion. In our population, increased FSH/LH ratio did not affect he rates of pregnancy and live birth negatively.
Effect of delivery mode and anaesthesia methods on cardiac troponin T
(ELSEVIER MASSON, CORP OFF, 2020) Bakirci, Sukru; Tulmac, Murat; Dag, Zeynep Ozcan; Sayan, Cemile Dayangan; Isik, Yuksel; Gencay, Isin; Boyunaga, Hakan
[Özet Yok]
Evaluation of the vestibular system with video head impulse test in pregnant women with hyperemesis gravidarum
(WILEY, 2020) Tulmac, Ozlem B.; Kilic, Rahmi; Yaman, Selen; Aktulum, Fatma; Simsek, Gokce; Erdinc, Seval
Aim We aimed to evaluate the semicircular canal functions of the vestibular system in pregnant women with hyperemesis gravidarum. Methods This is a prospective case-control study. Among pregnant women in their first trimester (<14. gestational weeks) who presented to our outpatient clinic, 36 patients diagnosed with hyperemesis gravidarum defined as persistent nausea and vomiting requiring intravenous hydration or loss of at least 5% of prepregnancy weight and 34 healthy pregnant without nausea and vomiting were included. Otorhinolaryngologic examination and video head impulse test (vHIT) was performed to all patients. Vestibular-ocular reflex (VOR) gain and gain asymmetry were assessed between groups. Results The VOR gains in each semicircular canal did not differ between hyperemesis and control groups. Using a VOR gain cut-off value of 0.8, the groups were compared in terms of the frequency of low values. In the hyperemesis group, abnormally low gain values of left anterior canal were more frequently observed than in the control group (32 [88.9%], 22 [64.7%], respectively,P= 0.01). In left anterior-right posterior (LARP) plane VOR gain asymmetry was higher in hyperemesis group (13.5 [1.0-71.0], 6.0 [0.0-35.0],P= 0.001). No significant gain asymmetry was detected between the groups in the other planes. Conclusion Semicircular canal functions were not abnormal globally in women with hyperemesis gravidarum. However, higher LARP plane asymmetry and low LA gain in women with hyperemesis suggests need for further research to clarify functional role of vestibular system on hyperemesis gravidarum.
Assessment of the effects of menopause on semicircular canal using the video head impulse test
(TAYLOR & FRANCIS INC, 2020) Tulmac, Ozlem Banu; Simsek, Gokce
This cross-sectional study included early menopausal and late menopausal women aged between 40 and 60 years to evaluate the effects of menopause on semicircular canal function. A video head impulse test (vHIT) was performed for all subjects. Vestibulo-ocular reflex (VOR) mean gains of each semicircular canal and gain asymmetry were compared between groups. Of the 87 subjects, 37(42.5%) were reproductive age 28(32.5%) were early menopausal and 22(25.3%) were late menopausal patients. VOR gain of semicircular canals or gain asymmetry values did not differ between groups. In postmenopausal women, presence of vasomotor symptoms was associated with higher gain asymmetry of the left anterior-right posterior (LARP) plane (p = .01), and presence of balance problems was associated with lower right anterior (RA) VOR gain (p = .01). In conclusion semicircular canal function in postmenopausal women was similar to that in women of reproductive age. IMPACT STATEMENT What is already known on this subject? During menopause, women face potential risks such as dizziness, balance problems, falls and fractures. Postmenopausal patients were tested with dynamic posturography to measure balance before and after oestrogen treatment, and it was shown that balance problems significantly improved with oestrogen treatment. Healthy vestibular system is one of the components for sustaining normal balance. What do the results of this study add? In postmenopausal women the function of the semicircular canals is normal and the balance deficit in postmenopausal women may not be caused by the vestibular system. In this study changes within normal limits were observed in vestibular system of postmenopausal women. What are the implications of these findings for clinical practice and/or further research? Reported balance deficits might have been due to central origin. Further research to differentiate origin of balance deficits are needed. Specific research on symptomatic postmenopausal patients would reveal more information.
Obituary: Remembering Professor Oktay Kadayifci (1942-2015)
(Aras Part Medical Int Press, 2019) Kurdoglu, Mertihan; Khaki, Arash
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Personality profile in menopausal women
(7847050 Canada Inc, 2019) Ogurturk, O.; Sagsoz, N.
Purpose of Investigation: Different menopausal conditions may exhibit different personality traits. The Minnesota Multiphasic Personality Inventory (MMPI) responses between naturally menopausal women and surgically menopausal women may be different. The authors compared the personality characteristics of naturally and surgically menopausal women by using MMPI. Materials and Methods: Twenty-five surgically menopausal women and 54 natural menopausal women were included in the present study. Psychometric evaluation was established with the Turkish version of the MMPI. The patients were divided into two separate groups as the surgically menopausal women and naturally menopausal women. Results: Surgically menopausal women compared to naturally menopausal women had higher absolute scores on hypochondriasis (66.4 +/- 9.2 vs. 57.1 +/- 8.0, p = 0.001, respectively). Surgically menopausal women compared to naturally menopausal women had a higher rate of clinical elevation on both depression (40.0 vs. 13.0%, p = 0.007, respectively) and hypochondriasis (60.0 vs. 14.8 %, p = 0.001, respectively). Hypochondriasis t score in patients with menopause was associated with the presence of surgically menopausal status after adjusting for possible confounding factors in multivariate model. Conclusion: Surgical menopause may take the foreground hypochondriac personality traits because of its unique characteristics. Surgically menopausal women are relatively more overworked with their bodies, so they complain of chronic fatigue, pain, and weakness, indicating hypochondriacal personality features.
Ovarian stimulation modalities in poor responders
(Tubitak Scientific & Technical Research Council Turkey, 2019) Ozkan, Zehra Sema
In a group of IVF/ICSI cycles, despite the appropriate ovarian stimulation, the number of oocytes collected is below the expected value. This condition is defined as poor ovarian response (POR) to stimulation. POR brings the risk of cycle cancellation with an estimated rate of 20%. Infertility experts are trying to improve cycle outcomes of POR cases with multiple modifications. This review article will present the latest modifications on the management of POR. The studies performed for improving cycle outcome in POR cases were evaluated and their notable results were presented. The first intervention among infertility specialists is to make a standard definition for POR. The BOLOGNA criteria and the subsequent POSEIDON group definitions are the latest updates in POR management. GnRH antagonists, estradiol priming, double stimulation, letrozole administration, DHEA, and herbal therapy supplementations are the recent modifications done to improve oocyte retrieval and subsequent embryo transfer for POR cases. This review article presents the encouraging methods applied for POR cases to improve cycle outcome.
Ruptured cystic teratoma associated with mucinous cystadenoma in a pregnant woman
(Wolters Kluwer Medknow Publications, 2019) Aydin, O.; Pehlivanli, F.; Karaca, G.; Aydin, G.; Sayan, C. D.; Atasoy, P.; Daphan, C. E.
Mature cystic teratoma is the most common ovarian neoplasm. However, mucinous cystadenoma with teratoma has been very rarely reported in literature. This case report, which is very rare, describes a clinical entity not previously reported in literature. A 34-year-old pregnant woman presented in the 23rd gestational week with severe right lower quadrant pain. She was diagnosed with acute abdomen and was then treated surgically. During the surgical intervention, a spontaneously ruptured mass was detected in the right ovary. This was reported histopathologically as a mature cystic teratoma in collision with mucinous cystadenoma. To the best of our knowledge, this case report is the first to have identified a ruptured mature cystic teratoma in collision with mucinous cystadenoma in a pregnant woman.
Evaluation of the optic nerve using strain and shear-wave elastography in pre-eclampsia
(W B Saunders Co Ltd, 2019) Asal, N.; Sayan, C. D.; Gokcinar, N. B.; Sahan, M. H.; Dogan, A.; Inal, M.
AIM: To investigate the utility of strain elastography and shear-wave elastography for assessing optic nerve involvement in pre-eclampsia. MATERIAL AND METHODS: A total of 120 eyes were evaluated in 60 cases consisting of 30 participants in the pre-eclamptic and 30 participants in the non-pre-eclamptic pregnant patient group. The findings of strain and shear-wave elastography, grey-scale sonography, and optical coherence tomography were compared between the groups. RESULTS: There was a statistically significant difference for the average shear-wave elastography values between groups (17.6 +/- 4.1 and 9.4 +/- 2 kPa, p<0.01). The analysis of the strain elastography types also revealed a statistically significant difference between the groups (p<0.01). A statistically significant difference was found for the average values of the optic nerve sheath diameter between the two groups (p<0.05). A statistically significant difference was found in the average value of the superior quadrant of the retina nerve fibre layer between the groups in optical coherence tomography analysis (p=0.04). The peripapillary choroidal thickness values of pre-eclamptic pregnant women were higher than that of non-preeclamptic pregnant women, but the difference was not significant (p>0.05). CONCLUSION: Stiffness of the optic nerve was greater in patients with pre-eclampsia in the study. Elasticity changes in the optic nerve may be generally attributed to microvascular and biomechanical changes secondary to increased hypertension in pre-eclamptic patients. Elastography could be used as assistive diagnostic techniques to evaluate the optic nerve structure changes in pre-eclampsia. (C) 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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