RESUMEN
OBJECTIVES: To evaluate the incidence of numerical chromosomal abnormalities in the patients with early pregnancy loss (EPL) following in vitro fertilization, and evaluate the role of different confounders of the risk of chromosomal abnormality-related pregnancy loss. MATERIAL AND METHODS: A retrospective chart review of all patients from our in vitro fertilization (IVF) center who conceived using assisted reproduction techniques between April 2017 and 2019, who experienced a subsequent early pregnancy loss, and whose abortus materials were successfully karyotyped were included. RESULTS: Of the 243 patients experienced an early loss, the overall rate of chromosomal abnormality was 46.75%. The overall rate of aneuploidy in our patient group was 88.8% (64/72), whereas 6.94% (5/72) of the abnormal karyotypes were polyploid. The most common type of trisomy was Trisomy 16 (20.0%; 11/55) followed by Trisomy 15 (14.5%; 8/55). Univariate and multivariate analyses showed that maternal age (< 35 years) and the total number of retrieved oocytes per cycle (≥ 5) were risk factors for a chromosomal abnormality (< 0.001; < 0.05, respectively). The adjusted OR of karyotypic abnormalities was 0.45 for the antagonist cycle type (p < 0.05), and 0.58 for frozen embryo transfer (p < 0.05). CONCLUSIONS: Karyotypic abnormality is one of the main reasons for pregnancy loss following an IVF procedure. Although the pregnancy rates increased as a result of novel technologies, the ratio of EPL is still high. The implementation of preimplantation genetic screening techniques might lower the incidence of EPL due to chromosomal abnormalities, thus decreasing the burden on the physicians and the patients.
Asunto(s)
Aborto Espontáneo , Inyecciones de Esperma Intracitoplasmáticas , Aborto Espontáneo/epidemiología , Femenino , Fertilización In Vitro/efectos adversos , Fertilización In Vitro/métodos , Humanos , Cariotipificación , Embarazo , Índice de Embarazo , Estudios Retrospectivos , Inyecciones de Esperma Intracitoplasmáticas/efectos adversosRESUMEN
Objective: This study aimed to determine the ratio of seasonal vitamin D deficiency and insufficiency in elementary school children aged between 6-9 years old, living in one of the largest metropols of Europe, Istanbul. Methods: Serum 25(OH)D levels of 640 children aged 6-9 years old were scanned retrospectively from the hospital information system records between September 2017-August 2018 period. Vitamin D deficiency was defined as a serum 25(OH)D level less than 12 ng/mL (30 nmol/L) and insufficiency as levels between 12 and 20 ng/mL (30-50 nmol/L). Results: Serum 25(OH)D levels ranged from 3.90 to 64.60 ng/mL, the median value was 25.95 ng/mL for all subjects. Of all the primary school children, 485 (75.78%) had adequate levels of 25(OH)D. Vitamin D deficiency was observed in 36 of children (5.62%), whereas insufficient levels of 25(OH)D were found in 119 children (18.60%). The ratio of vitamin D insufficiency and deficiency together was highest in spring (31.87%) and lowest in summer (13.12%). Conclusion: Vitamin D deficiency is a widely observed and preventable public health problem among children of different ages. It is necessary to increase the awareness among health professionals, and providing 25(OH)D supplements will yield generations with healthy bone structure and well growth.
Asunto(s)
Biomarcadores/sangre , Estaciones del Año , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Vitamina D/sangre , Vitaminas/sangre , Niño , Suplementos Dietéticos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Prevalencia , Pronóstico , Estudios Retrospectivos , Turquía/epidemiología , Deficiencia de Vitamina D/diagnósticoRESUMEN
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a multisystemic, chronic disease accompanied by microvascular complications involving various complicated mechanisms. Intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), and cluster of differentiation-146 (CD146) are mainly expressed by endothelial cells, and facilitate the adhesion and transmigration of immune cells, leading to inflammation. In the present study, we evaluated the levels of soluble adhesion molecules in patients with microvascular complications of T2DM. METHODS: Serum and whole blood samples were collected from 58 T2DM patients with microvascular complications and 20 age-matched healthy subjects. Levels of soluble ICAM-1 (sICAM-1) and soluble VCAM-1 (sVCAM-1) were assessed using enzyme-linked immunosorbent assay, while flow cytometry was used to determine CD146 levels. RESULTS: Serum sICAM-1 levels were lower in T2DM patients with microvascular complications than in healthy controls (P<0.05). No significant differences were found in sVCAM-1 and CD146 levels between the study and the control group. Although patients were subdivided into groups according to the type of microvascular complications that they experienced, cell adhesion molecule levels were not correlated with the complication type. CONCLUSION: In the study group, most of the patients were on insulin therapy (76%), and 95% of them were receiving angiotensin-converting enzyme (ACE)-inhibitor agents. Insulin and ACE-inhibitors have been shown to decrease soluble adhesion molecule levels via various mechanisms, so we suggest that the decreased or unchanged levels of soluble forms of cellular adhesion molecules in our study group may have resulted from insulin and ACE-inhibitor therapy, as well as tissue-localized inflammation in patients with T2DM.