Can an apparent diffusion coefficient of uterine fibroid before uterine artery embolization predict potential fibroid response?

OBJECTIVES: ACOG guidance confirms the use of uterine artery embolisation (UAE) as an alternative to hysterectomy or myomectomy. The main objective of this article is to evaluate the ability of preoperative magnetic resonance imaging (MRI) to study the relationship between uterine fibroid reduction and diffusion coefficient (ADC) value after UAE. This is a relevant topic with the growing interest in using ADC as a noninvasive imaging biomarker for monitoring tissue changes and predicting uterine fibroid response to UAE over the past years. MATERIAL AND METHODS: In this prospective controlled non-randomized trial; uterine fibroid volume, fibroid diameter, uterine volume, fibroid ADC and normal myometrium ADC were recorded before and after UAE. Wilcoxon test was used in the analysis of the dependent quantitative data. Pearson correlation coefficients were calculated between post-UAE uterine volume, fibroid volume, and average fibroid diameter reduction and the patient's age, parity, gravidity, fibroid ADC and myometrial ADC before UAE. RESULTS: The mean fibroid volume reduction was 36.0% (range between 17.3-77.7%). Mean fibroid diameter, fibroid volume, uterine volume, and myometrium ADC values after UAE were significantly lower than before the procedure (p = 0.002, < 0.001, 0.001, 0.006 respectively), but the decrease in fibroid ADC is not significant. As a result decrease in fibroid volume was greater as pre-UAE fibroid ADC values increased, and that finding may contribute to the selection of the patients for the procedure. CONCLUSIONS: The ADC value before UAE was positively correlated with fibroid volume reduction.

Is it possible to predict Surgical Site Infection?

Introduction: Surgical site infection (SSI) is a widely seen postoperative complication that causes a decrease in life quality and an economic burden. In this study, we aim to find the predictive values of preoperative and postoperative neutrophile lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) values for SSI. Methods: In this retrospective study, 698 patients who had total abdominal hysterectomy operations with benign indications and confirmed histopathological results were accessed. In this study, the correlation of preoperative NLR, preoperative PLR, postoperative NLR, and postoperative PLR, with the occurrence of postoperative surgical site infection complications were examined. Results: The overall SSI rate was 9.46% (n = 66) with 30 days follow-up postoperatively. Preoperative NLR and PLR values of the patients who had SSIs were significantly lower than the control group (p < 0.05). Postoperative NLR and PLR values of the patients who had SSIs were significantly higher than control group (p < 0.05). In the patients who had postoperative SSIs, the increase of the values of postoperative NLR and PLR were significantly higher than the control group (p < 0.05). Conclusions: In our study, hematological markers of NLR and PLR were found to be independent and significant predictive markers for SSI.

The apoptotic effects of bisphenol A exposure on the rat ovary: an experimental study.

Bisphenol A (BPA) is a key endocrine-disrupting chemical (EDC) in the manufacturing industry. It is found in the structure of compounds such as polycarbonate and epoxy in combination with other chemicals. Our objective was to investigate the effect of BPA on rat ovaries. A total of 32 female rats were divided into four equal groups: In group 1 (control), vehicle was administered; in group 2, BPA 50 µg/day was administered intraperitoneally; in group 3, BPA 100 mg/kg/day was administered intraperitoneally; and in group 4, BPA 100 mg/kg/day and vitamin C (50 mg/kg) were administered intraperitoneally, while vitamin E (50 mg/kg) was administered intramuscularly. Thirty days after the treatment, the effects of BPA on the ovaries were evaluated by terminal deoxynucleotidyltransferase [TdT]-mediated dUTP-biotin nick end labeling (TUNEL) assay. There was no difference in the number of apoptotic cells between group 2 and group 4. In addition, there was no significant difference between control group and group 2, 4. However, the number of apoptotic cells per unit area was significantly increased in group 3 compared with all groups (p < 0.01, p < 0.05). In conclusion, this study showed that high doses of BPA (100 mg/kg/day) have a toxic effect on the ovaries. The fact that the number of apoptotic cells in the group administered with high dose of BPA + 50 mg/kg/day vitamin C + 50 mg/kg/day vitamin E was lower than that of the high-dose BPA-administered group shows that these vitamins may have a protective effect.

Comparison of the acute alterations in serum bone turnover markers and bone mineral density among women with surgical menopause.

OBJECTIVE: To determine the effect of a sudden decrease in estrogen levels via bilateral oophorectomy on serum turnover markers and to examine their correlation with bone mineral density (BMD). STUDY DESIGN: This study included 51 women who had regular menses preoperatively and underwent bilateral oophorectomy for benign reasons. These women did not have any systemic disease or drug use that would influence bone metabolism. For each woman, spine and femur BMD were measured preoperatively and sixth months after surgery. Serum C-terminal telopeptide (CTX) and bone alkaline phosphatase (BAP) were measured preoperatively and at the first and sixth months after surgery. Correlations between bone turnover markers and BMD were pre- and post-operatively analyzed. RESULTS: The mean serum CTX and BAP concentrations at the first and sixth postoperative months were significantly higher compared to the preoperative measurements (p=0.001). Spine BMD values at the sixth postoperative month was significantly lower compared to preoperative period (p=0.0001). There was a significant negative correlation between spine BMD values and BAP levels both in the preoperative period and at the sixth postoperative month (r=-0.407, p=0.001), whereas a significant positive correlation between serum CTX and BAP was noted at this time periods (r=0.615, p<0.001). CONCLUSIONS: The results of this study showed that serum BAP and CTX levels rapidly increase in women after bilateral oophorectomy. Therefore, these markers (especially BAP) could be useful in the evaluation of osteoporosis risk in the early period of surgical menopause.