Radiographic assessment of incidental bone lesions of the proximal humerus: a prevalence study.

BACKGROUND: An increased prevalence of benign lesions has been associated with the increased use of radiological tools in orthopedic practice. PURPOSE: To investigate the inter-observer reliability of the radiographic detection of lesions on the proximal humerus between different observers. MATERIAL AND METHODS: X-ray radiological examinations of 17,243 patients were performed by an orthopedic surgeon to assess the presence of proximal humeral bone lesions. After this initial screening, 201 patients with lesions were identified and these 201 scans were assessed by three different physicians: an orthopedic oncologist, an orthopedic surgeon, and a musculoskeletal radiologist. Of the 201 patients with lesions, 80 had magnetic resonance imaging in addition to X-rays and were assessed. The diagnosis of the lesions was determined by each participant according to their radiological appearance to assess inter-observer reliability. RESULTS: The prevalence of proximal humeral lesions was determined by the orthopedic surgeon to be 1.165% (201 of 17,243 patients). In 201 patients with a lesion, the mean age was 48 ± 17 years (range = 18-91 years). According to the assessments of the orthopedic oncologist, orthopedic surgeon, and musculoskeletal radiologist, the most common bone lesion identified was enostosis, with prevalence percentages of 53.7%, 59.7%, and 64.7%, respectively. A noteworthy consensus exists in the collective diagnosis of bone lesions among the three investigators, demonstrated by a substantial agreement with Fleiss' κ at 0.74 (P < 0.001). CONCLUSION: There was remarkable agreement between the three investigators on the collective diagnosis of bone lesions. Enostosis was the most common bone lesion at the proximal humerus in our series.

Cortices of Fibula and Tibia Can Provide Landmarks for Accurate Syndesmosis Fixation Angle: Computed Tomography Validation of Angle Bisector Method.

Anatomic syndesmosis reduction is necessary to restore ankle biomechanics and prevent poor clinical outcomes, but malreduction can be encountered frequently since the ideal fixation angle varies between patients and fixation levels. This study aimed to validate the angle bisector method to reveal whether it provides an accurate syndesmotic fixation angle that is patient- and level-specific. Lower extremity CT angiography of 50 consecutive patients (25 male, 25 female) without evident ankle pathology were evaluated. The average age was 52.8 (±18, range: 18-75). Lines tangent to anterior and posterior cortices of tibia and fibula were drawn in the axial plane at both 2 cm and 3.5 cm above the ankle joint line. Bisection of the angle formed between these lines was drawn and its relationship with the centroidal axis, which is proposed to be the ideal syndesmotic axis, was evaluated. The angle between the bisector line & the centroidal axis and the distance between their most lateral intersections with the fibula were calculated. The measurements were made by 3 blinded observers. Intra- and interobserver reliability analyses were conducted. The average centroidal axis-bisector angle was 2.1° ± 2.1° at 2 cm and 0.6° ± 1.3° at 3.5 cm level. The average distance to the actual syndesmosis entry point was 1.0 ± 0.9 mm at 2 cm and 0.4 ± 0.4 mm at 3.5 cm level. The values didn't show any significant difference according to gender. Intra- and interobserver reliability analysis showed excellent correlation in all parameters (interclass correlation coefficient > 0.90). Angle bisector method was found strongly reliable providing accurate direction for syndesmotic axis. It can provide a patient- and level-specific angle for the application of syndesmotic implants without increasing the fluoroscopy exposure. Its use can have a broad impact on functional outcomes of ankle injuries by decreasing the malreduction rates. Further cadaveric validation and safety studies should be conducted for possible clinical usage.

Does resveratrol reduce cisplatin-induced ovarian damage?

SUMMARY OBJECTIVE: The objective of this study was to investigate the protectiveness of resveratrol on cisplatin-induced damage to the ovary using experimental models. METHODS: A total of 30 female Wistar-Albino rats constituted the research material. The rats were categorized into three groups: Group 1 was administered one milliliter of 0.9% NaCl solution, Group 2 was administered 7.5 mg/kg cisplatin, and Group 3 was administered 7.5 mg/kg cisplatin and 10 mg/kg resveratrol. Ovaries were extirpated in all groups and subjected to biochemical and histopathological tests. Cisplatin-induced damage to ovarian tissue was graded and scored as the total histopathological findings score. The ovarian function was assessed using immunohistochemical staining for c-kit expression. Rats' malondialdehyde, catalase, and superoxide dismutase levels were determined. RESULTS: The histopathological finding score was significantly higher in Group 2 than in other groups (p<0.05). The superoxide dismutase and catalase levels were significantly higher in Group 3 than in Group 2 (p<0.001 for both cases). The malondialdehyde level was significantly higher in Group 2 than in Group 3 (p<0.001). CONCLUSION: The study findings demonstrated that resveratrol reduced ovarian injury and enhanced biochemical parameters following cisplatin-induced ovary damage in experimental models.

Increased serum myonectin and irisin levels with myonectin and FNDC5 expressions in polycystic ovary syndrome: a case control study.

The aim of this study is to assess the FNDC5 and myonectin expressions and serum levels of myonectin and irisin in women with PCOS. 90 participants were included in this case-control study. 45 of these participants were with PCOS, and 45 of them were healthy volunteers matched for age and body mass index (BMI). Serum irisin and myonectin levels were measured with commercially available enzyme-linked immune sorbent assay (ELISA) kits. Expression of the myonectin and FNDC5 genes were determined by RT-PCR analysis. It was found out that FSI, HOMA-IR, LH, LH/FSH, TT, serum irisin and serum myonectin levels, myonectin mRNA expression, and FNDC5 mRNA expression were higher in the PCOS group, whereas HDL-C level was lower in the PCOS group (p < .05). When the groups were compared, it was detected that IR and HA were significantly higher in the PCOS group (p < .05). Serum irisin and myonectin levels, and myonectin and FNDC5 mRNA expressions were increased in women with PCOS. These molecules can be target molecules in PCOS pathophysiology and treatment.IMPACT STATEMENTWhat is already known on this subject? Although the aetiology of PCOS is not fully understood, it is thought that insulin resistance may play a critical role. In recent studies, the relationship of cytokines secreted from skeletal muscle with insulin resistance has been shown. The effects of irisin and myonectin, which are members of the myokine family, on lipid and glucose metabolism are known.What do the results of this study add? Although there are many studies in the literature regarding serum irisin levels in women with PCOS, their results are confusing. There is a study in the literature investigating the relationship between myonectin and PCOS. In our study, we evaluated myonectin and FNDC mRNA expressions in addition to serum irisin and myonectin levels. As a result, we found that markers and their mRNA expressions were lower in patients with PCOS compared to controls.What are the implications of these findings for clinical practice and/or further research? We think that the results of our study will shed light on future studies. Due to their effects on adipose tissue, these markers may play a role in the aetiology of long-term complications of PCOS. Moreover, they can become pharmacological targets in preventing these complications.

Dual energy CT in necrotizing enterocolitis; a novel diagnostic approach.

BACKGROUND: Necrotizing enterocolitis (NEC) is one of the most important causes of morbidity and mortality in premature infants. Although there are no specific diagnostic tools, the main factors affecting prognosis are clinical and laboratory findings, and early diagnosis and treatment. In this study, we demonstrate the importance of dual-energy computed tomography (DECT) in confirming intestinal ischemia in neonates with NEC. METHODS: Patients diagnosed with NEC in a neonatal intensive care unit were staged according to modified Bell's classification, and DECT was performed on patients with NEC stages 2-A, 2-B and 3-A. According to their DECT reports, these patients were then separated into two groups: those with intestinal ischemia and those without intestinal ischemia. The patients with intestinal ischemia were evaluated using surgical reports, and the other patients were evaluated using clinical findings. RESULTS: DECT was performed in 21 patients with NEC stages 2-A, 2-B and 3-A. Twelve patients (57.1%) without ischemia were followed up without surgery. Nine patients (42.9%) with ischemia on DECT were operated on, and resection and anastomosis or ileostomy and colostomy were performed. DISCUSSION: In patients with NEC, DECT significantly increases overall diagnostic confidence in assessing intestinal necrosis when compared with traditional diagnostic methods.

The protective effect of JZL184 on ovarian ischemia reperfusion injury and ovarian reserve in rats.

AIM: Ovarian torsion is a gynecopathology that requires emergency surgery in women. However, ischemia reperfusion injury (IRI) occurs after treatment with detorsion. This study aimed to evaluate the effects of monoacylglycerol lipase inhibitor JZL184 on ovarian IRI and ovarian reserve. METHODS: Forty-eight female Wistar albino rats were divided into six groups. Group 1: Sham, Group 2: Ischemia, Group 3: ischemia/reperfusion (IR), Group 4: IR + JZL184 4 mg/kg, Group 5: IR + JZL184 16 mg/kg, Group 6: IR + vehicle (dimethyl sulfoxide). Three hours of ischemia followed by 3 h of reperfusion. Two different doses of JZL184 (4 and 16 mg/kg) were administered intraperitoneally in Group 4 and 5, 30 min before reperfusion. Ovarian IRI and ovarian reserve were evaluated in serum and tissue by using histopathological and biochemical parameters. RESULTS: Treatment with JZL184 was associated with a significant increase in ovarian 2-arachidonoylglycerol and improved serum anti-Mullerian hormone, Inhibin B, primordial follicle count, and ovarian histopathological damage score (p < 0.05). JZL184 treatment significantly decreased the level of malondialdehyde, and increased superoxide dismutase enzyme activity and glutathione (GSH) levels (p < 0.05). The increased phosphorile nuclear factor-κB (Phospho-NF-κB-p65), tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1ß), transforming growth factor beta 1 (TGF-ß1), and TUNEL assay immunopositivity scores in ovarian I/R injury were decreased after treatment with JZL184 (p < 0.05). CONCLUSIONS: JZL184 showed significant ameliorative effects on ovarian IRI and ovarian reserve caused by IR through acting as an antioxidant, anti-inflammatory, and antiapoptotic agent. Thus, JZL184 may be a novel therapeutic agent for ovarian IRI.

The Effect of Maternal Pulmonary Function Test Parameters on Umbilical Cord Blood Gas and the Duration of Labor.

OBJECTIVE: To evaluate the relationship between the maternal pulmonary function test (PFT) and the Apgar score of the newborn, umbilical cord blood (UCB) gas values and the duration of delivery. MATERIAL AND METHODS: The present study included 41 volunteer nulliparous pregnant women who presented to our obstetrics clinic and PFTs were performed by using spirometry. RESULTS: A significant positive correlation was observed between 5th-minute Apgar scores and maternal FEV1 (forced expiratory volume in the first second) (lt), FEV1%, FVC (lt), FVC% (r=0.509, p=0.003; r=0.47, p=0.007; r=0.434, p=0.013; r=0.417, p=0.017; respectively). A significant positive correlation was observed between UCB pH value and maternal FEV1 (lt), FVC (lt) (r=0.515, p=0.003; r=0.351, p=0.049; respectively). CONCLUSION: Our results showed that FEV1 and FVC values, which indicate maternal respiratory functions, may affect Apgar scores of the newborn and UCB gas values.

Sexual function and depression in polycystic ovary syndrome: Is it associated with inflammation and neuromodulators?

Numerous studies have been carried out on depression and sexual dysfunction concomitant with polycystic ovary syndrome (PCOS). Increasing evidence has revealed the importance of inflammation in the etiology of PCOS. In addition, it has been known that some neuromodulators affect depression and sexual function. However, their effects on PCOS are not known. This study aimed to evaluate the relationship of depression and sexual function with cytokines and neuromodulators in PCOS patients. The present study included 20 fertile and 30 infertile patients diagnosed with PCOS and 30 healthy volunteers. Metabolic and endocrine parameters, interleukin (IL)-1ß, IL-6, TNFα, γ-aminobutyric acid (GABA), Glutamate, Brain-derived neurotrophic factor (BDNF) serum levels, Beck Depression Index (BDI) and Female Sexual Function Index (FSFI) scores of the patients were compared between the groups. TNFα, IL-1ß, IL-6, glutamate, GABA, and BDI scores were found to be significantly higher (p < 0.05) in the PCOS group (p < 0.05). Glutamate, TNFα, IL-1ß, and IL-6 values were higher whereas GABA and BDNF values were lower in pateints with moderate and severe depression (p < 0.05). There were no statistically significant relationships between these parameters and the FSFI scores (p > 0.05). Multivariate logistic regression analysis was conducted with potential factors that may affect sexual dysfunction. The results indicated that high waist-to-hip ratio (WHR) (> 0.80) with an odds ratio of 1.81 in PCOS patients, and body mass index (BMI) with an odds ratio of 2.3 and high WHR (> 0.80) with an odds ratio of 1.97 in all patients were found to be independent risk factors affecting sexual dysfunction. The results of the present study suggested that chronic low-dose inflammation seen in PCOS may interact with some neuromodulators, leading to the development of depression. However, no relationship was found between these parameters and sexual function.

Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?

This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities.

Awareness of women about cervical smear, human papilloma virus and human papilloma virus vaccine.

OBJECTIVE: The aim of this study was to assess the awareness level of women about cervical smears, human papilloma virus (HPV), and HPV vaccine in a rural city in the central part of Anatolia. MATERIALS AND METHODS: A total of 553 patients were included in the study. A 16 item questionnaire developed by our group was completed by all participants. The first part of the questionnaire collected the demographic and socioeconomic information of the participants. In the second part, it was questioned whether this information had a relationship with HPV, HPV vaccine awareness, and cervical screening tests. In the third part, the participants were asked questions related to the acceptance of an HPV vaccine for themselves and their willingness to give consent to have their children vaccinated. RESULTS: In our study, it was found that HPV awareness significantly increased with the level of education, occupational status and total monthly family income (p<0.001). There was a significant increase in HPV vaccine awareness as the parity (p=0.016), level of education (p=0.025), and occupational status (p=0.001) increased. Having a Pap smear significantly increased with age, income, and number of parity (p<0.001). CONCLUSION: Our study revealed that only 9.8% of the women had knowledge about HPV, the majority of the women reported that they would accept vaccination for themselves and for their children. These results indicate that physicians should pay attention to increasing the awareness about HPV.

Evaluation of Endometrial Receptivity by Measuring HOXA-10, HOXA-11, and Leukemia Inhibitory Factor Expression in Patients with Polycystic Ovary Syndrome.

CONTEXT: Polycystic ovary syndrome (PCOS) is an important cause of infertility. In women with PCOS have increased rate of spontaneous abortion and reduced rate of conception. HOXA-10 and HOXA-11 are proteinous products of homeobox gene group and play an important role during implantation. AIMS: The aim of this study was to evaluate endometrial receptivity by measuring HOXA-10, HOXA-11, and leukemia inhibitory factor (LIF) gene expressions in women with PCOS. SETTINGS AND DESIGN: A tertiary referral center. MATERIALS AND METHODS: This study was conducted on reproductive age women with abnormal uterine bleeding without sonographically proven anatomical reason. Endometrial sampling procedures were done in proliferative phase using low-pressure endometrial suction device to exclude endometrial pathology. HOXA-10, HOXA-11, and LIF gene expressions were measured from endometrial sampling material. Blood sample was taken to measure serum estradiol level on the day of endometrial sampling. STATISTICAL ANALYSIS USED: Statistical analysis was performed using SPSS software version 17 (SPSS Inc., Chicago, IL, USA). Mann-Whitney U-test was used to compare the variables. RESULTS: A total of 53 patients were included in this study. Study group consisted of 33 patients with PCOS. Gene expressions of HOXA-10, HOXA-11, and LIF were significantly lower in patients with PCOS (P < 0.05). CONCLUSIONS: This study results showed that in patients with PCOS have decreased gene expression of HOXA-10, HOXA-11, and LIF which might contribute PCOS-related infertility.

ULTRASONOGRAPHIC EVALUATION OF FEMORAL CARTILAGE THICKNESS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME.

The aim of the study was to investigate knee cartilage thickness in polycystic ovary syndrome (PCOS) patients using ultrasonography and to assess the effects of sex steroids on osteoarthritis development. A total of 90 female patients were enrolled in the study, including 47 patients diagnosed with PCOS as study group and 43 patients admitted to our hospital for any other complaints as control group. Ultrasonographic evaluation of both knees was performed in all patients. The knee cartilage thickness was measured at lateral condyle, intercondylar area and medial condyle. The measurements were averaged for each region. The mean femoral cartilage thickness was greater in the study group compared with control group in all regions, with a statistically significant difference (p<0.005). In conclusion, we found PCOS patients to have greater mean cartilage thickness, supporting the possible effects of sex steroids on osteoarthritis development.

Rupture of cerebral aneurysm during pregnancy: a case report.

The most common cause of subarachnoid hemorrhage at the period of pregnancy and during puerperium is rupture of an intracranial aneurysm. It is five times more common in pregnant women than in non-pregnant women. This pathology is more common in primiparous women and in the third trimester of pregnancy. A 37-year-old woman who was admitted to the emergency department with sudden-onset headache and loss of consciousness was diagnosed with intracranial hemorrhage due to middle cerebral artery aneurysm rupture. The patient, who gave birth with emergency cesarean delivery, underwent surgery for subarachnoid hemorrhage. The case is presented here because of its rarity.

Decreased expression of LIF mRNA in patients withmyoma uteri.

OBJECTIVE: The aim of this study was to evaluate endometrial receptivity by measuring HOXA-10, HOXA-11, and LIF gene expressions in women with polycystic ovary syndrome. METHODS: A total of 48 women were included in this clinical study. Thepatients were allocated to two groups: study group consisted of 28 patients with myoma uteri and control group consisted of 20 patients without myoma uteri. Endometrial sampling was performed during the proliferative phase. The biopsies obtained from the patients with myoma uteri were taken from the place where the fibroids were localized. HOXA-10, HOXA-11, and LIF expressions were measured in the endometrial sampling material. Demographic data of the patients such as age, obstetric and gynecologic history, medical conditions, medications, surgical history, last menstrual period were recorded. Also, the number, size, localization, and type of the myoma were registered. RESULTS: The mean age of the patients was 42.07 and 38.17, respectively. HOXA-11 levels in the study and control groups were 0.004 ± 0.001 and 0.010 ± 0.001, respectively ( P < 0.90). Paradoxically, HOXA-10 levels were found to be higher in the study group than the control group, but the difference was not statistically significant ( P < 0.25). LIF levels were significantly lower in the study group ( P < 0.05). CONCLUSION: Our results showed that myoma uteri might lead to a decrease in implantation rate by diminishing LIF gene expressions. However, there were no differences between the two groups in terms of HOXA-10 and HOXA-11 levels.

Can Red Blood Cell Distribution Width be a Potential Marker in the Decision to Perform Tonsillectomy?

OBJECTIVE: Tonsillectomy is one of the most common surgical procedures performed at ear, nose, and throat clinics. Chronic recurrent tonsillitis, obstructive tonsillitis, and halitosis are among the most common indications for surgery. Determining whether the infection is chronic and the patient's annual number of infections are important in estimating the necessity for surgery to be performed due to infectious causes. Red blood cell distribution width (RDW) is a numerical value present in normal complete blood count that provides information about erythrocytes and their dimensions. Studies in recent years have shown that RDW increases in chronic infections, hypoxia, and oxidative stress. This study investigated the changes in RDW in patients with chronic tonsillitis and the effect tonsillectomy has on this value by comparing RDW between patients scheduled for tonsillectomy and normal population and examining preoperative and postoperative changes in RDW. MATERIALS AND METHODS: Sixty-three patients scheduled for tonsillectomy due to recurrent tonsillitis aged 4-14 years were included in the study. The control group consisted of 60 subjects comparable in terms of age and sex. Hemoglobin level and RDW were recorded by collecting 2 mlof blood before surgery and at 4 months postoperatively from all patients. RESULTS: Preoperative RDW was significantly higher in the patient group than in the control group. Comparison of patients' preoperative and postoperative RDW revealed a significant decrease in RDW after surgery. CONCLUSION: As a biomarker showing chronic infection in patients with tonsillitis, RDW can provide support to the clinician in deciding on surgery. However, this has to be confirmed in further studies with greater participation.

Protective Effect of Nicotine on Sepsis-Induced Oxidative Multiorgan Damage: Role of Neutrophils.

INTRODUCTION: Despite its adverse health consequences, tobacco smoking is associated with lower incidence of several neurodegenerative and inflammatory diseases. The present study is aimed to show the effects of nicotine, major tobacco constituent, on five organs targeted by sepsis. METHODS: Male Wistar albino rats received tap water with (5mg/kg) or without nicotine for 14 days. Under ketamine anesthesia, sepsis (n = 50) was induced by ligation and puncture of the cecum, while sham group (n = 8) had only laparotomy. In other rats, nicotine drink was withdrawn for 5 days before sepsis induction, while in acute nicotine group, rats were injected with nicotine (30mg/kg, i.p.) before sepsis, but had no oral intake. Rats were decapitated 24 hours after surgery to obtain lung, liver, ileum, heart, and kidney tissues to determine malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) activities. Data were analyzed by one-way analysis of variance and Tukey multiple comparison tests or Student's t test. RESULTS: Chronic nicotine administration or its withdrawal reduced lipid peroxidation and MPO activity and prevented GSH depletion with some varying results in different target tissues. Nicotine injection prior to sepsis depressed MPO activity in all tissues and reduced MDA levels except for the lung, while GSH levels were elevated only in the hepatic and ileal tissues. Histologically observed injury was ameliorated by all nicotine treatments at varying degrees. CONCLUSIONS: The findings of the present study indicate that long-term nicotine administration reduces sepsis-induced oxidative damage in several tissues, which appears to involve inhibition of neutrophil activity in the inflamed tissues. IMPLICATIONS: Nicotine administration or its withdrawal reduced lipid peroxidation and neutrophil content and prevented GSH depletion with some varying results in different target tissues. A single injection prior to sepsis induction depressed MPO activity in all the tissues and reduced all tissue MDA levels except for the lung. When nicotine was withdrawn for 5 days, its inhibitory effect on MPO activity was still present in all the tissues except for the liver. Microscopically an improved inflammatory response was observed in all the tissues of rats that have received different nicotine pretreatment regimens.

The Relationship Between Skinfold Thickness and Leptin, Ghrelin, Adiponectin, and Resistin Levels in Infants of Diabetic Mothers.

This study aimed to investigate the relationship between skinfold thickness and serum leptin, ghrelin, adiponectin, and resistin levels in infants of diabetic mothers. Biochemical parameters were also similar for the two groups (infants of diabetic mothers and controls) (p > 0.05). We confirmed that there was a negative correlation between birth weight and serum ghrelin level (p < 0.05) in the two groups. When it was evaluated for control newborns, a positive correlation between abdominal circumference and serum resistin level was found in the controls (p < 0.05). Our results indicate that gestational diabetes by appropriate diet or insulin treatment may be effective in the protection of fetuses of diabetic mothers from the negative effects of gestational diabetes. Ghrelin alone was negatively correlated with birth weight. This negative correlation could be potentially advantageous to infants, because a reduction in appetite might prevent excessive food intake and postnatal weight gain.

Is there association between vitamin D levels, apelin 36, and visfatin in PCOS?

AIM: We aimed to evaluate vitamin D, apelin-36, and visfatin levels in patients with polycystic ovary syndrome (PCOS). MATERIAL AND METHOD: The study was completed in six months, including a total of 110 patients who were admitted to the obstetrics and gynecology polyclinic. Patients with a diagnosis of PCOS were divided into two subgroups according to their vitamin D levels. Thirty-four patients had <10 ng/ml of vitamin D deficiency and 21 patients had 10-30 ng/ml of vitamin D insufficiency, with each being defined as a subgroup. RESULTS: Average apelin-36 and visfatin levels in PCOS patients were 2.52 ± 0.68 nmol/L and 72.63 ± 22:31 ng/ml, in the control group they were 0.92 ± 0.33 nmol/L, 24.66 ± 6 ng/ml, respectively. The difference found in PCOS patients was statistically significant (p = 0.0001, p = 0.0001). CONCLUSION: In conclusion, the present study shows that in PCOS patients with low levels of vitamin D, insulin resistance is greater and apelin-36 serum levels were significantly higher. Although there are different opinions in the literature on this subject, we believe that when vitamin D levels are brought to an optimal level in PCOS patient, it can prevent the negative effects of adipokines in the pathogenesis of PCOS.

Effect of Familial Mediterranean Fever on Ivf Outcome: A Retrospective Case Series.

Although the in vitro fertilization-intra-cytoplasmic sperm injection (IVF-ICSI) has been utilized widely, the management in patients with an autoimmune disease is still a challenge. The aim of this study was to demonstrate IVF-ICSI outcomes in infertile women with familial Mediterranean fever (FMF). Patient data were collected from the cases registered from January 2006 until January 2014. A total of 6152 assisted reproductive technology (ART) cycles were analyzed retrospectively in the Ankara Zekai Tahir Burak Women's Health Education and Research Hospital. Ten infertile women with FMF were included in the study. Baseline clinical and laboratory characteristics were collected and perinatal outcomes evaluated. T e mean age (years), duration of infertility (years) and body mass index (kg/m2) were 29.9±5.3, 5.7±5.3 and 27.9±5.7, respectively. The mean baseline follicle-stimulating hormone (FSH; IU/L), estradiol (E2; pg/mL) and antral follicle count were 7.0±2.4, 48.1±15.8 and 7.9±2.9, respectively. The distribution of ovarian response was heterogeneous. Fourteen cycles in ten patients were evaluated. Embryo transfer could be achieved in only ten cycles. Three out of ten patients became pregnant. No adverse perinatal outcome was observed. Our findings indicate that FMF might have no impact on ART cycles.