A postpartum arteriovenous malformation case diagnosed with late postpartum bleeding.

Postpartum hemorrhage is the most important and also preventable cause of maternal morbidity and mortality worldwide. Arteriovenous malformation (AVM) is a rare cause of postpartum hemorrhage. We present a case of arteriovenous malformation, which may be one of the rare but potentially fatal causes of postpartum hemorrhage (PPH). In the case report, on the postpartum 52nd day, the patient presented to the emergency department with a complaint of vaginal bleeding. Doppler ultrasonography revealed a lesion compatible with the vascular structure, the largest diameter of 28 * 28 mm, in the uterus. The patient was found not eligible for embolization, and a hysterectomy was then indicated. After the hysterectomy, the pathology diagnosis supported the initial clinical and radiological suspicions of AVM. Hysterectomy is the definitive treatment method of AVM and should be considered in patients who are not eligible for embolization. This case is presented to draw the attention of physicians to AVM as a possible cause of secondary PPH.

Thiol/disulfide homeostasis in postmenopausal osteoporosis.

AIM: To evaluate the impact of postmenopausal osteoporosis on thiol/disulfide homeostasis. MATERIALS AND METHODS: A total of 75 participants were divided into two groups: Group 1 (n = 40) was composed of healthy postmenopausal women, and group 2 (n = 35) was composed of women with postmenopausal osteoporosis. Clinical findings and thiol/disulfide homeostasis were compared between the two groups. RESULTS: The disulfide/native thiol ratio was 8.6% ± 3.6 in group 1 and 12.7% ± 8.4 in group 2 (p = 0.04). The disulfide/native thiol percent ratio was significantly higher in group 2 after adjustment for the years since menopause and age (p < 0.05). The native thiol/total thiol percent ratio was 85.6% ± 4.8 in group 1 and 73.8% ± 24.9 in group 2 (p = 0.01). The native thiol/total thiol percent ratio was significantly lower in group 2 after adjustment for the years since menopause and age (p < 0.05). CONCLUSION: Thiol/disulfide homeostasis shifted to the disulfide side independent of age and years since menopause in postmenopausal osteoporosis.

Investigation of cardiovascular disease risk in women with uterine leiomyomas.

OBJECTIVE: The aim of this study was to investigate the cardiovascular disease risk of patients with uterine leiomyoma using carotid intima-media thickness (CIMT), insulin resistance and lipid profile. METHODS: A total of 84 reproductive-aged women (20-45 years) were divided into two groups as the study group (n = 42) of women with leiomyoma and the control group (n = 42) of healthy women without leiomyoma. The risk factors for cardiovascular disease such as age, body mass index (BMI), low-density lipoprotein (LDL), triglycerides (Tg), high-density lipoprotein (HDL), total cholesterol and lipoprotein a levels, systemic disorders, cigarette smoking and CIMT were all recorded and compared between groups. RESULTS: The mean age, gravida, parity, BMI, total cholesterol level and CIMT were significantly different between the groups (p < 0.05). CIMT after adjusted for the age and age, BMI was significantly lower in study groups (<0.001). Insulin resistance, serum LDL, Tg, HDL, lipoprotein a, and endometrial thickness were comparable between groups (p > 0.05). The number of leiomyoma was significantly correlated with Tg (r = 0. 322, p = 0.037) and LDL (r = 0. 431, p = 0.006). The size of leiomyoma was significantly correlated with HOMA-IR values (r = -0.370, p = 0.016). CONCLUSION: Uterine leiomyoma was associated with lipid profile, insulin resistance and CIMT in reproductive-aged women.

Utility of superior mesenteric artery Doppler and maternal pancreatic size for predicting gestational diabetes mellitus.

AIM: The aim of this study was to assess the relationship between the maternal superior mesenteric artery Doppler, pancreatic size and gestational diabetes mellitus (GDM). METHODS: Two hundred and fifty-eight consecutive, pregnant women between 20 and 22 weeks of gestation underwent routine fetal anomaly screening. All subjects underwent maternal superior mesenteric artery Doppler and pancreatic size measurement of head, corpus and tail during screening. Screening was done with 50 g glucose challenge test (GCT) at gestational age 24-28 weeks. The patients who were having an abnormal GCT were subjected to 100 g GCT. Subjects were divided into two groups such as pregnancies with gestational diabetes and normal pregnancies. Relationship between Doppler and pancreatic measurements with GDM was analyzed. RESULTS: Out of 258 screened pregnancies, 28 (10.9 %) were diagnosed as GDM. There were significant differences between GDM positive and negative cases in terms of pancreatic body size (17.5 vs. 14.4 mm, p = 0.05), superior mesenteric artery Doppler systolic/diastolic ratio (S/D) (4.2 vs. 3.4) and resistance index (RI) (0.72 vs. 0.68) values. Superior mesenteric artery Doppler S/D (AUC = 0.761, p < 0.001) and RI (AUC = 0.762, p < 0.001) indices were significant predictors for GDM. CONCLUSION: Superior mesenteric artery Doppler and pancreatic size evaluation may be utilized to detect abnormal glucose metabolism during pregnancy care.

Micro-organic pollutants and biological response of mussels in marinas and ship building/breaking yards in Turkey.

Concentrations of PAHs, PCBs and OCPs in sediments and mussels (caged and/or native) were determined at 16 stations in six major sites of coastal Turkey. The biological effects of pollution were evaluated using sediment toxicity tests and enzyme activity assays. EROD, PROD, GST, AChE, CaE, and GR activities were evaluated using the digestive glands of mussels. The total PAH concentrations in the sediments varied between nd and 79,674 ng g(-1) dw, while the total OCP concentrations were in the range of nd to 53.7 ng g(-1) dw. The total PAH concentrations in mussels varied between 22.3 and 37.4 ng g(-1) ww. The average concentrations of total PCBs in mussels were 2795 pg g(-1) ww in the shipyard, 797 pg g(-1) ww in Marina 2 and 53 pg g(-1) ww in Marina 1 stations. The results of whole-sediment toxicity tests showed a strong correlation between toxicity test results and pollutant concentrations. Selected cytosolic enzyme activities in digestive glands differed significantly depending on localities. These differences in enzyme activities were mainly related to the different pollutant levels of the sampling sites. The micro-organic contaminant profile patterns, toxicity tests and biomarker studies showed that shipyards and shipbreaking yards are the major potential sources of organic pollution in coastal areas.