Systemic immune-inflammation index to predict placenta accreta spectrum and its histological subtypes.

AIM: In this study, we aimed to investigate the role of systemic immune-inflammation index (SII) and other inflammatory parameters in the diagnosis of placenta accreta spectrum (PAS) and its histological subtypes. METHODS: This retrospective case-control study included patients who underwent surgery for placenta previa (PP). Case group (patients with PAS) included pregnant women diagnosed with histologically confirmed PAS, whereas control group (patients with PP) included pregnant women who underwent cesarean section with a PP diagnosis, required no additional intervention during the operation. Both groups were compared with respect to their demographic data, clinical characteristics, SII, and other laboratory parameters. Cut-off values that can predict PAS were calculated. The PAS group was separated into subgroups based on histology findings, and inflammatory parameters were compared between subgroups. RESULTS: In this study, data of 273 patients were analyzed. Of these, 68 (24.9%) were included in the PAS group and 205 (75.1%) patients were included in the PP group. Significant differences were observed in SII, platelet distribution width, mean platelet volume, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (p = 0.000, p = 0.006, p = 0.002, p = 0.000, and p = 0.000, respectively). The best SII cut-off value was 985.02109/L (57.4% sensitivity and 72.2% specificity). There was no significant association between the histologic subtypes of PAS and inflammatory parameters. CONCLUSION: SII can be used to predict PAS in pregnant women with PP. The relationship between the histologic subtypes of PAS and inflammatory parameters should be investigated in more comprehensive studies.

Outcomes of pregnancies diagnosed with circumvallate placenta, and use of uterine artery pulsatility index and maternal serum alpha-fetoprotein for prediction of adverse outcomes.

OBJECTIVES: To evaluate the outcomes, and predictive value of uterine artery pulsatility index (UtA-PI) and second-trimester maternal serum alpha-fetoprotein (MSAFP) for adverse obstetric outcomes in cases with morphologically confirmed circumvallate placenta by comparison with normal pregnancies. STUDY DESIGN: This prospective study was conducted in a tertiary referral hospital between January 2017 and December 2019. During the study period, 77 patients with a circumvallate placenta and 77 patients without any placental or feto-maternal diseases or abnormalities were evaluated. The final diagnosis was made based on macroscopic examination of the placenta soon after birth. Demographic characteristics, MSAFP, obstetric complications, haemoglobin after delivery, gestational week of birth, fetal sex, 1- and 5-min Apgar scores, postnatal complications and type of delivery were retrieved from hospital records. Bilateral mean transabdominal UtA-PI and MSAFP were evaluated for the prediction of adverse outcomes. SPSS Version 21.0 for Windows was used for statistical analysis, and receiver operating characteristic (ROC) curves were used for the prediction model of adverse outcomes. RESULTS: Smoking rate, MSAFP, preterm birth and intrauterine growth restriction (IUGR) were higher in the patients with a circumvallate placenta (p = 0.005, 0.00, 0.025 and 0.027, respectively). The cut-off value of MSAFP was 1.41 (0.60-3.32) and the cut-off value of UtA-PI was 1.2 using the ROC curves, and had sensitivity of 73.7 % and specificity of 71.9 %, and sensitivity of 73.7 % and specificity of 76.3 %, respectively (p < 0.05). CONCLUSIONS: Circumvallate placenta was associated with a higher rate of IUGR, preterm birth and bleeding at the time of delivery. In patients with a circumvallate placenta, UtA-PI and MSAFP may be valuable as predictors of IUGR.

Exposure to electromagnetic field, cell phone use behaviors, SAR values, and changes in health following exposure in adolescent university students / Exposição ao campo eletromagnético, comportamentos de uso de telefones celulares, valores SAR mudanças na saúde após exposição em estudantes universitários adolescentes

ABSTRACT Background: The use of technological devices is growing rapidly, and the use of cell phones increases in parallel. Dependence on technological devices is a particular factor in this increased exposure. Many studies have been performed on this electromagnetic field, but no definite conclusions have been drawn. Objective: The purpose of this research was to investigate exposure to electromagnetic field, cell phone use behaviors, the specific absorption rate (SAR) values, and changes in health occurring after exposure in university students. Methods: A questionnaire was administered to 1,019 volunteer students aged 18-24 years at the Niğde Ömer Halisdemir and Recep Tayip Erdoğan Universities in 2018-2019. The questions were based on a survey of the literature. Results: The students spent an average 4-8 hours per day on their cell phones, and findings such as headache (p=0.002), concentration deficit (p=0.001), tiredness on waking in the morning (p=0.001), hyperactivity (p=0.001), general feeling of fatigue (p=0.001), and lethargy (p=0.001) increased in a statistically significant manner with length of use. Conclusions: Participants exhibited high levels of cell phone use and experienced biological, behavioral, and sleep problems. They also had very little knowledge about specific SAR values, an important criterion concerning cell phones.

RESUMO Introdução: O uso de dispositivos tecnológicos está crescendo rapidamente e o uso de telefone celulares aumenta em paralelo. A dependência de dispositivos tecnológicos é um fator nesse aumento de exposição. Diversos estudos sobre o campo eletromagnético foram realizados, mas nenhuma conclusão definitiva foi alcançada. Objetivo: O objetivo desta pesquisa foi investigar a exposição ao campo eletromagnético, os comportamentos de uso do telefone celular, os valores de absorção específica (specific absorption rate — SAR) dos telefones celulares utilizados e as alterações na saúde ocorridas após a exposição em adolescentes universitários. Métodos: Um questionário foi aplicado a 1.019 alunos voluntários com idades entre 18-24 anos nas universidades Niğde Ömer Halisdemir e Recep Tayip Erdoğan em 2018-2019. As perguntas foram baseadas em um levantamento bibliográfico. Resultados: Os estudantes gastaram em média 4-8 horas por dia em seus celulares, e achados como cefaleia (p=0,002), dificuldade de concentração (p=0,001), cansaço ao acordar pela manhã (p=0,001), hiperatividade (p=0,001), sensação geral de fadiga (p=0,001) e letargia (p=0,001) aumentaram de forma estatisticamente significativa com o tempo de uso. Conclusões: Os participantes exibiram altos níveis de uso de telefone celular e problemas biológicos, comportamentais e de sono. Eles também tinham pouco conhecimento sobre valores específicos de SAR, um critério importante para telefones celulares.

The Rate of Influenza Vaccination after Face-to-Face Interview in Pregnancy.

PURPOSE: Most societies recommend routine influenza vaccine to all pregnant women. In Turkey, the Ministry of Health provides the influenza vaccine free of charge to pregnant women during the second and third trimesters. Pregnant women may not be willing to accept vaccination despite their knowledge and attitudes. We aimed to investigate the rate and determining factors of influenza vaccine acceptance after receipt of face-to-face information. METHODS: Pregnant women were informed about the benefits of the influenza vaccine and asked if they would get the vaccine. RESULTS: A total of 353 Turkish women were involved, and 191 (54.1%) accepted influenza vaccination. There was no statistically significant difference in terms of maternal age, body mass index, gravida, number of children, socioeconomic status, smoking and occupation between groups. Women in the third trimester had lower vaccination rates compared to first- and second-trimester pregnancies (35.7% vs. 67.7-64.2%). Women with at least a university degree also had lower vaccine uptake rates (58.1% vs. 59.5-36.8%). While 82.2% of women who accepted vaccination believed the benefit of the vaccine to the baby, the rate was 54.9% in the non-vaccinated group. The most common reason for refusal was the belief that influenza was not a serious disease. Vaccination uptake was higher especially for women who understood the benefits of the influenza vaccine for the baby (OR=3.79, 95%Cl=2.34-6.14). CONCLUSION: Women who had enough information, who had a lower education level, who had a previous history of influenza infection, and who had decided to have their babies vaccinated were more likely to accept influenza vaccine.

A case of xanthogranulomatous pyelonephritis mimicking Wilms tumor.

Xanthogranulomatous pyelonephritis (XGPN) is a very rare, unusual variant of pyelonephritis characterized by destruction of renal parenchyma. It usually occurs in adults with a history of recurrent urinary tract infections. The condition is rare in children and the disease can imitate renal tumors. Here, we describe a 12-year-old boy who presented with abdominal pain. He did not have any history of urinary tract infection. Computed tomography and magnetic resonance imaging showed a cystic lesion in the left upper kidney. The patient underwent radical nephrectomy with a provisional diagnosis of Wilms tumor however histopathological examination of specimen revealed XGPN. Xanthogranulomatous pyelonephritis should be kept in mind in the differential diagnosis of renal lesions in childhood, during surgery if any suspicion from the diagnosis, a frozen biopsy should have been taken.

CD147 expression in uterine smooth muscle tumors, and its potential role as a diagnostic and prognostic marker in patients with leiomyosarcoma.

OBJECTIVE: To investigate the role of CD147 expression in uterine smooth muscle neoplasms, as a potential diagnostic and prognostic marker in patients with leiomyosarcoma (LMS). STUDY DESIGN: We investigated CD147 protein expression in uterine smooth muscle tumor samples from patients diagnosed with leiomyoma (n = 22), atypical leiomyoma (BLM) (n = 5), smooth muscle tumor of uncertain malignant potential (STUMP) (n = 14), and LMS (n = 22). The intensity and extensity of immunohistochemical staining were compared to determine its potential role in differential diagnosis. Spearman's rank correlation tests were performed to determine the relationship between CD147 expression and prognostic clinical and pathological criteria in the patients with LMS. RESULTS: CD147 was strongly expressed in 81.8% (n = 18) of the LMS tissue samples. In fact expression of CD147 in LMS tissues was significantly higher than that of the three other uterine smooth muscle tumor types (p = 0.000). However, high CD147 expression was found in only one BLM sample and one STUMP sample. Furthermore, CD147 percent expression positively correlated with Ki67 percent expression (r = 0.466, p<0.05) and mitotic index (r = 0.554, p<0.05), respectively. CONCLUSION: Our results suggest that immunohistochemistry may be a helpful tool in determining whether CD147 is a useful marker in the differential diagnosis of certain uterine smooth muscle tumors. CD147 may also have prognostic value for patients with LMS. Yet, in order to determine the extent of this potential marker's utility as a diagnostic and prognostic indicator, a larger randomized multicenter study must be performed.

A case of lymphoma simulating primary sternal tumour.

Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal lymphoma presented with a sternal mass. Partial sternectomy with replacement by methyl methacrylate prosthesis was performed.

Solitary plexiform neurofibroma of the buccal region unassociated with neurofibromatosis type 1.

Neurofibroma is a benign neural tumor. Plexiform type of this tumor is rarely seen in oral cavity in solitary form. In this article, we present an 18-year-old male case with an isolated plexiform neurofibroma localized at buccal region without any other manifestation or family history of neurofibromatosis type 1.

[A review on the impact of IUD in cervical cytology: Mardin Region Data]. / Mardin Bölgesinden Verilerle Servikal Sitolojide RIA Etkisine Bir Bakis

OBJECTIVE: The aim of the study was to provide an overview to infectious and reactive cytological effects of intrauterine devices, which are one of the most widely used methods of contraception, with the results we obtained in the Mardin region. MATERIAL AND METHOD: We evaluated together the pap smears of the 300 intrauterine device (+) and 300 intrauterine device (-) patients sent to the pathology department in the period of 2010-2011. Genital infection rates and frequency of reactive-dysplastic cellular changes were statistically compared between the groups together with the literature data. RESULTS: In the intrauterine device (+) group, 2 (+) and more severe inflammation was observed in 66.3% of cases. Bacterial vaginosis (26%), candida (12%) and trichomonas vaginalis (8%) were recorded as the most common infectious agents, followed by actinomyces (4%). Between the groups of intrauterine device (+) and (-), no significant difference was observed in terms of the incidence of squamous cell abnormalities, except ASC-US (p=0.02). In the intrauterine device (+) group, the presence of atypical glandular cells and reactive findings was significantly higher than the control group. After the removal of the intrauterine device, 61 cases that had control smears showed regression, with a rate of %75.4 (n=46). CONCLUSION: The local irritative and inflammatory effect of intrauterine devices basically causes reactive and regenerative changes mostly in glandular cells. Intrauterine devices disrupt the genital flora and significantly increase the frequency of genital infection by creating a foreign body reaction.

[The influence of cervicovaginitis agents on epithelial cell changes: comparison of Mardin city's data with the literature]. / Servikovajinit Ajanlarinin Epitelyal Hücre Degisiklikleri Üzerine Etkileri: Mardin Bölgesi Verilerinin Literatür Verileri ile Karsilastirilmasi

OBJECTIVE: The aim of this paper was to observe the reactive changes of epithelial cells exposed to the influence of cervicovaginitis agents that play an important role in the cytology practice and may cause an exaggerated appearance. MATERIAL AND METHOD: 378 cases with cervicovaginitis caused by a specific agent were compared with 100 control cases. It was recorded if the inflammation had concomitant cellular changes and atypia or not. After treatment, control smears were examined. The reactive and atypical situations of the cells were considered after the treatment. With the aid of the previous data, the answer to the following question was searched: Is epithelial atypia a real event or a reactive atypia that accompanies an existing cervicitis agent? RESULTS: In the first interpretation, Candida group had the most frequent reactive and ASC-US (Atypic Squamous cells of Undetermined Significance) changes (56,4% and 59,5% respectively). The bacterial vaginosis and Trichomonas vaginalis groups showed ASC-US rates of 25% and 9,5% respectively while in control group the rate was 6,0%. After treatment, the number of cases of ASC-US decreased from 50 to 11. Similarly, the number decreased from 21 to 10 in the bacterial vaginosis group. CONCLUSION: Cervicovaginitis agents need more attention because of their outcomes. Being aware of the cervicovaginitis agents during interpretation is essential for preventing a false positive diagnosis and unnecessary anxiety especially where cellular atypia is concerned.