Investigation of copeptin levels in foetal congenital central nervous system anomalies.

Copeptin has been shown to be associated with central nervous system pathologies. The aim of this study was to investigate the relationship between serum CCP levels and central nervous system (CNS) anomalies. In this case-control study, those at 9-14 weeks of gestation serum levels of copeptin, were assessed in pregnant women whose foetuses subsequently developed CNS anomalies (group 1: n = 60) and compared with gestational age-matched pregnant women who exhibited normal pregnancy outcomes (group 2: n = 48). The mean copeptin levels were 1.58 ± 0.40 ng/mL and 1.11 ± 0.36 ng/mL in the CNS anomalies and control groups, respectively (p < .0001). An increased level of copeptin independently predicts development of CNS anomalies, suggesting that copeptin can be used for prediction and discrimination of CNS anomalies in normal pregnancies at 9-14 weeks of gestation.Impact statementWhat is already known on this subject? There is no test or method to diagnose CNS anomalies in the first trimester of pregnancy. This study presents the first and new information on the relationship between serum copeptin levels and central nervous system anomalies in pregnant women whose foetuses subsequently developed CNS anomalies.What do the results of this study add? I have strongly demonstrated differences in maternal CPP levels between CNS anomalous pregnancies and healthy controls.What are the implications of these findings for clinical practice and/or further research? It has been thought that copeptin appears to be an ideal marker for central nervous system anomaly prediction at 9-14 weeks of gestational age and if confirmed in larger prospective studies. Finally, these results could not be used as parameters for prenatal CNS screening. Advanced studies, well-structured and conducted on larger populations are needed to investigate the issue further.

Predictors of Initiating Hormone Replacement Therapy in Postmenopausal Women: A Cross-Sectional Study.

OBJECTIVES: Some of the social factors were related to hormone replacement therapy. The purpose of this study is to determine hormone replacement therapy (HRT) rates and to illustrate social factors affecting hormone replacement therapy in postmenopausal women. MATERIAL AND METHODS: This study comprised a total of 1052 postmenopausal women, 926 of whom were reported menopausal symptoms and sought for the treatment. 432 of these 926 participants had treated their symptoms by receiving HRT. The data was collected with a data collection form prepared by the researcher by using face-to-face interview technique. In these analyses, chi-square and Backward Logistic regression analyses were used. RESULTS: The multivariate analyses indicated that the decision to seek treatment was influenced by a multitude of factors. These factors included location of hormone replacement therapy (OR: 12.32 [3.21-44.46] in university hospital and OR: 5.42 [2.43-13.26] in private hospital), information received about HRT (OR: 7.25 [2.14,-30.80]), physicians' counselling and involvement (OR: 5.24 [2.82-9.86]), knowledge of complications associated with HRT (OR: 6.21 [3.28-16.62]), and employment status (OR: 3.42 [1.86-5.58]). The current study identifies these factors affecting the HRT process in postmenopausal women. CONCLUSION: This study suggests that although the results do not demonstrate an exhaustive list of factors affecting the HRT process, they nonetheless provide evidence that the location participants applied for, physicians' counselling and involvement, participant employment status, and knowledge surrounding HRT may affect a woman's intent to receive HRT. Therefore, these results indicate that health professional influence and HRT awareness are important for HRT use. Suggestions for health care include informing women of the advantages and disadvantages of HRT to encourage popularity.

Can adnexal torsion be predicted by measuring plasma heat shock protein 70 level? An experimental study.

OBJECTIVE: To investigate the effect of adnexal torsion on the plasma heat shock protein 70 level and to determine whether plasma heat shock protein 70 can be used in the adnexal torsion diagnosis. MATERIALS AND METHODS: Twenty-one nulligravid 3-month-old female Wistar albino rats were randomly and equally allocated into three groups: study group (ovarian torsion) (n = 7), laparotomy group (sham operation) (n = 7) and control group (received no special treatment) (n = 7). Ovarian torsion model was created by twisting the right adnexa two times around its pedicle and fixing over the lateral pelvis with 6.0 polyglactin absorbable surgical suture. Blood was sampled before and 12 h after operation to assess plasma heat shock protein 70 level. RESULTS: In the study group, the mean plasma heat shock protein 70 level was significantly higher than that in the laparotomy and control groups (1.75 ± 0.25), (1.16 ± 0.99), (1.19 ± 0.11) ng/ml, respectively, P = 0.001), following 12 h of ovarian torsion. CONCLUSION: A significant increase in plasma heat shock protein 70 level in the study group indicates that plasma heat shock protein 70 level could be used as a serum marker in the early detection of adnexal torsion. However, further clinical and experimental studies of a larger size are required.

Coexistence of adenomyosis in women operated for benign gynecological diseases.

BACKGROUND: To compare demographic, clinical and histopathological characteristics of women diagnosed with adenomyosis (AG) after hysterectomy to those of women diagnosed with leiomyoma (LG) and to investigate the predisposing factors for AG. METHODS: This study was carried out on 204 patients who underwent gynecologic surgery for various indications except for gynecologic malignancy between January 2005 and December 2009 and whose histopathological analysis of hysterectomy/myomectomy specimen revealed either AG or LG. Women with AG and those with LG were compared with respect to age, parity, menstrual pattern, history of induced abortion, history of prior uterine surgery, smoking, dysmenorrhea, dyspareunia, chronic pelvic pain and coexisting endometrial and ovarian pathologies. RESULTS: The mean age of our patients was 51 ± 8 years (range 28-85), 40% of them were postmenopausal, and 64% had a history of uterine surgery. The mean age (p = 0.014), gravida (p = 0.018), parity (p = 0.017) and previous endometrial sampling (p < 0.01) were significantly higher in AG. Main symptoms were abnormal uterine bleeding (39%), dysmenorrhea (63%) and nonmenstrual pelvic pain (62%). Age (p = 0.01), menometrorrhagia (p = 0.02) and endometrial sampling (p < 0.01) were the significant covariants in binary logistic regression for AG. CONCLUSION: AG is an enigmatic disease frequently causing gynecologic complaints and endomyometrial junction deterioration during endometrial sampling may be a trigger point for developing AG.

Can a cyclooxygenase inhibitor be an option for treatment of ovarian hyperstimulation syndrome?

PURPOSE: This study aimed to investigate the role of a cyclooxygenase inhibitor in ovarian hyperstimulation syndrome (OHSS) treatment and compare it with cabergoline. MATERIALS AND METHODS: A total of 32 immature female Wistar albino rats were randomly divided into four groups, with each group consisting of eight rats. The first group received only saline for 6 consecutive days, and the remaining 24 rats were given 10 IU of recombinant follicle stimulating hormone subcutaneously on 5 consecutive days. On day 6, 30 IU of human chorionic gonadotropin was administered for OHSS induction. After the development of OHSS, while the second group had no further intervention, the third and fourth groups were given cabergoline and celecoxib daily for 6 days, respectively. Besides weight and hematocrit values, vascular endothelial growth factor (VEGF), IL-2, and endothelin-1 (ET-1) levels were evaluated. RESULTS: Initially, no significant differences were observed between the groups with respect to the evaluated parameters. Although there were no differences between the weight and hema-tocrit values at the end of treatment (P=0.158, P=0.674), the difference between group 1 and the other groups was statistically significant after OHSS was established (P=0.001, P=0.004). Comparison of the groups in terms of VEGF, ET-1, and IL-2 levels revealed that the difference between group 1 and the other groups was significant after OHSS was formed (P=0.012, P=0.018, P=0.015). After treatment, however, a significant difference was observed only between group 2 and the other groups (P=0.001, P=0.002, P=0.038). CONCLUSION: According to these results, celecoxib significantly decreased VEGF, IL-2, and ET-1 levels as much as cabergoline and could reduce the extent of OHSS development.

Investigation of apelin expression in endometriosis.

BACKGROUND: Apelin is a mitogenic peptide; it has functions in vessel formation and cell proliferation. In this study we aimed to evaluate the serum and tissue levels and local expression pattern of apelin in eutopic and ectopic endometrium from patients with and without endometriosis and to compare the proliferative and secretory phase differences. METHODS: Thirty women with endometriosis and 15 women without endometriosis undergoing surgery for benign indications as control group were included in the study. Serum and tissue concentrations and proliferative and secretory phase expression patterns of apelin were evaluated in the ectopic and eutopic endometrium using immunoassay and immunohistochemistry methods. The results were compared with Mann-Whitney U test. The p-values smaller than 0.05 were considered as statistically significant. RESULTS: Apelin expression was detected in eutopic and ectopic endometrium of women with endometriosis and endometrium of control group. Intense immunoreactivity of apelin was observed in glandular cells of eutopic and ectopic endometrial tissues of women with endometriosis and endometrium of control group during secretory phase (p<0.01). In both groups, tissue concentrations of apelin were higher than of the serum (p=0.03) but, there were no significant differences between the two groups for tissue and serum concentrations of apelin. CONCLUSION: Apelin expression showed cyclic changes in eutopic and ectopic endometrium. Its expression may be related to menstrual changes of angiogenesis in endometrium of women.