Sexual problems of women with spinal cord injury in Turkey.

OBJECTIVES: Spinal cord injury (SCI) is a traumatic event that affects many facets of the injured people's lives. One aspect is sexual functioning. The purpose of this study is to identify the sexual problems of women with SCI and determine their level of knowledge about sexuality. METHODS: Twenty-six women with SCI for longer than 6 months were evaluated. Demographic information, sexual experiences were surveyed. Patients were also asked if and how they received sexual health consultation after SCI. Female Sexual Function Index (FSFI) and Beck Depression Inventory were evaluated. RESULTS: In this study, average age of the women with SCI was 32.96±8.23 years (22-50 years). Eight patients had regular sexual intercourse while one married woman did not have any sexual relationship after SCI. Twenty-four of the patients in the study received no information about pregnancy or sexual health after SCI. All women were willing to receive information about sexuality after SCI. These patients expected the doctors to start the conversation about sexuality rather than asking about it. FSFI survey revealed that all the patients had sexual dysfunction. CONCLUSION: Sexual rehabilitation should thus be fully addressed in all spinal units and rehabilitation centers, along with other aspects of rehabilitation.

Anterior meningocele misdiagnosed as an ovarian cyst.

OBJECTIVE: An undiagnosed anterior meningocele may mimic an ovarian cyst. Careful evaluation and consultation must be the mainstay of surgery for adnexal masses. RESULTS: A patient initially diagnosed as having an adnexal mass was discovered to have an anterior meningocele at surgery. In vitro fertilization plans were delayed to prevent complications during procedures.

Knowledge and interest of Turkish women about cervical cancer and HPV vaccine.

OBJECTIVE: We aimed to evaluate the knowledge and interest level of Turkish women about HPV, HPV vaccines and cervical cancer using a questionaire. METHOD: A 25-item questionnaire was distributed to women in three different cities located in separate sociocultural locations. RESULTS: At the closure of the study 143 women responded and returned the survey. Of the participants 62.2% (89) had a university degree, 36.4% (52) a high school education, and 1.4% (2) had lower school degrees; 98.5% of the women would consent to have their daughter vaccinated for HPV and 94.7% would consent to have their son vaccinated if vaccine provided prevention against cancer and related diseases. However in both cases women gave importance to the "cost" - unless vaccine could be free. On logistic regression analyses none of the variables (i.e., questions) in the survey predicted women's willingness to accept the vaccine for themselves or their children. CONCLUSIONS: Women in Turkey would be willing to have themselves and their children receive HPV vaccine against cervical cancer and related diseases.

Well differentiated mesothelioma complicating endometrial carcinoma; a case report.

Peritoneal mesothelioma is a rare cancer of the abdominal cavity which has low malignant potential. Peritoneal mesothelioma can mimic other types of gynecologic malignancies. Careful clinical and pathologic evaluation is essential for an accurate diagnosis and treatment.

Maternal zinc and cord blood zinc, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 levels in small-for-gestational-age newborns.

PURPOSE: To determine the relationship between maternal serum zinc (Zn) levels and birth weight of the offspring and their correlation with cord blood Zn, insulin-like growth factor (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels. METHOD: 22 term small-for-gestational-age (SGA) and 34 term appropriate-for-gestational-age (AGA) infants and their mothers were included. Maternal and cord blood Zn levels and cord blood IGF-1 and IGFBP-3 levels were measured. RESULTS: Eighteen percent of mothers had Zn deficiency (< 75 mcg/dl). No significant difference between IGF-1 and IGFBP-3 levels and birth weight of infants of the mothers with and without Zn deficiency was found. Maternal and neonatal Zn levels correlated (r = 0.38, p < 0.01). Mean IGF-1 and IGFBP-3 levels were significantly lower in the SGA group compared to the AGA group (42.3 +/- 16.8 ng/ml, 1.2 +/- 0.2 mcg/ml, and 62.4 +/- 22.7 ng/ml, 1.5 +/- 0.4 mcg/ml, p < 0.001). A correlation was found between birth weight, IGF-1 and IGFBP-3 levels, and weight gain of the mother during pregnancy (p < 0.01). CONCLUSIONS: Zn deficiency was not observed to be a risk factor for low birth weight. The significant difference between the SGA and AGA babies' IGF-1 and IGFBP-3 levels emphasizes function of the IGF system in intrauterine growth.

The significance of amniotic fluid interleukin-6 levels in preterm labour.

This study was performed to determine the prevalence of subclinical intraamniotic infection in patients with preterm labour and intact membranes, and to evaluate the significance of interleukin-6 levels for diagnosis and prognosis of tocolysis failure, amniocentesis-delivery interval and neonatal mortality and morbidity. Transabdominal amniocentesis was performed on 74 randomly-selected patients with preterm labour and intact membranes. The prevalence of amniotic fluid infection in this group was found to be 33.7% (25 of 74). The most sensitive test to identify the intraamniotic infection was found to be the measurement of interleukin-6 level. However the most specific test was confirmed to be Gram staining. Interleukin-6 level measurement was the best test to correlate with positive amniotic fluid culture and histological chorioamnionitis. Also, interleukin-6 level measurement had the advantage of predicting preterm delivery risk and neonatal complications compared to the other tests.

The use of transvaginal ultrasonography in the evaluation of luteal phase endometrium.

OBJECTIVE: To investigate the use of transvaginal ultrasonography, a non invasive method, for the evaluation of endometrium, to diagnose luteal phase insufficiency. DESIGN: Prospective, randomized, clinical study. SETTING: Human volunteers in an infertility clinic. PATIENTS: Patients who applied to the infertility clinic undergoing diagnostic procedures for their complaints. INTERVENTIONS: Follicle maturation, ovulation and endometrial grades were studied with transvaginal ultrasonography. Endometrial sampling was performed during midluteal and late luteal phase. Progesterone and estradiol levels were measured in the blood drawn on the sampling day. MAIN OUTCOME MEASURES: Endometrial grade, histopathology, estradiol and progesterone levels. RESULTS: In both groups, as the endometrial grades increased, the rate of normal histopathological results increased significantly. There was no statistically significant correlation between endometrial thickness and progesterone and estradiol levels. CONCLUSIONS: Evaluation of stromal maturation with ultrasonography is successful, but cannot replace endometrial sampling in evaluating luteal phase endometrium.

A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats.

OBJECTIVE: The aim of this study was to investigate whether fluoxetine given to castrated and noncastrated rats caused hyperprolactinemia and its effects with respect to adenomyosis. DESIGN: Fluoxetine, a serotonin reuptake inhibitor, was given to Wistar Albino rats for 98 days to produce hyperprolactinemia. The drug was given to two groups consisting of castrated and noncastrated rats and compared to two groups of castrated and noncastrated controls. Prolactin levels were measured and the uteri of the rats were removed for histopathological analysis at the end of 98 days. SETTING: Marmara University School of Medicine, Department of Histology and Embryology, Zeynep Kamil Women and Children's Hospital. MAIN OUTCOME MEASURES: Serum prolactin levels, uterine histopathology. RESULTS: The prolactin levels of castrated and noncastrated groups treated with fluoxetine were statistically significantly higher when compared to their respective control groups. Histological studies revealed 11 cases of adenomyosis, all within the noncastrated group receiving fluoxetine. CONCLUSION: It was suggested that high serum prolactin levels cause degeneration of myometrial cells in the presence of ovarian steroids that results in a myometrial invasion by endometrial stroma. This invasion eventually progresses to adenomyosis.

Comparison of the intrapartum analysis of Doppler blood flow velocity waveform of the umbilical artery and fetal heart rate tracing for the prediction of perinatal outcome.

This study was performed to determine the value of umbilical artery Doppler flow velocity waveform (FVW) analysis and fetal heart rate (FHR) tracing in the course of labour for predicting poor perinatal outcome. The randomised, controlled and prospective study was carried out on 99 singleton term pregnant women in labour at the Zeynep Kamil Women and Children's Hospital, Istanbul. All patients were evaluated by both methods during the intrapartum period. Blood gases and pH of umbilical venous blood and 1 and 5 minute Apgar scores of the newborn infants were determined immediately after delivery. For the prediction of poor perinatal outcome, the sensitivity, specificity, negative predictive value and positive predictive value of FHR were 72.0%, 85.1%, 60.1% and 90.0%, respectively. FHR was pathological in all four cases with a neonatal death, whereas only two had pathological Doppler FVW. We conclude that FHR is a more sensitive method than umbilical artery Doppler FVW analysis (72.0% versus 36.0%) in the prediction of poor perinatal outcome during the intrapartum period. A combination of the two tests increases the specificity of the prediction of poor perinatal outcome from 89.2% and 85.1% to 94.9%. High negative predictive values of both tests should reassure the clinician when the test results are normal.