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1.
J Obstet Gynaecol ; 42(7): 2931-2934, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35998260

RESUMO

This study aimed to determine cavum septum pellucidum (CSP) nomogram values between 15-28 weeks of gestation. Routine biometric measurements and CSP width were measured by transabdominal ultrasonography in 6042 structurally normal foetuses between 15-28 weeks of gestation. Distribution of CSP width by the week of pregnancy and percentile values were calculated. The mean week of gestation (GW) was 21 ± 1.7, and the mean biparietal diameter (BPD) was 50.2 ± 5.8 mm. The CSP width range was 1.6-7.7 mm at 15-28 weeks, and the mean CSP width was 4.1 ± 0.8 mm. CSP width was found to have a significant correlation between a gestational week (CSP = GW X 0.2705-1.6121; R = 0.62; p < .01) and BPD (CSP = BPD X 0.0859-0.273; R = 0.651; p 0.01). CSP width was found to differ significantly according to gestational weeks, and percentile distributions were calculated. Between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7-7 mm. Our study was determined that CSP width increased linearly between 15-28 weeks of gestation. For this reason, we think that it would be more appropriate to use CSP width percentile values in the examination of the foetus. Impact statementWhat is already known on this subject? The cavum septum pellucidum can be easily identified and evaluated by ultrasonography after 18 weeks of pregnancy. CSP can be associated with severe brain anomalies if it is not visualised or deformed. Moreover; large CSP may be associated with chromosomal abnormalities.What do the results of this study add? Our study showed that CSP width increased linearly between 15-28 weeks of gestation. CSP width was found to differ significantly according to gestational weeks, and between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7-7 mm.What are the implications of these findings for clinical practice and/or further research? We reported that it would be more appropriate to use CSP percentile values according to the gestational week in the definition of abnormal CSP.


Assuntos
Malformações do Sistema Nervoso , Septo Pelúcido , Gravidez , Feminino , Humanos , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Septo Pelúcido/diagnóstico por imagem , Septo Pelúcido/anormalidades , Nomogramas , Ultrassonografia Pré-Natal/métodos , Valores de Referência
2.
J Perinat Med ; 48(9): 857-866, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-32692708

RESUMO

These guidelines follow the mission of the World Association of Perinatal Medicine, which brings together groups and individuals throughout the world with the goal of improving outcomes of maternal, fetal and neonatal (perinatal) patients. Guidelines for auditing, evaluation, and clinical care in perinatal medicine enable physicians diagnose, treat and follow-up of COVID-19-exposed pregnant women. These guidelines are based on quality evidence in the peer review literature as well as the experience of perinatal expert throughout the world. Physicians are advised to apply these guidelines to the local realities which they face. We plan to update these guidelines as new evidence become available.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Assistência Perinatal/métodos , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/virologia , Antivirais/uso terapêutico , Aleitamento Materno , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Parto Obstétrico/métodos , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Pandemias , Morte Perinatal , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/terapia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2 , Natimorto/epidemiologia
3.
J Perinat Med ; 43(3): 319-23, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-24810552

RESUMO

AIMS: In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women. METHODS: This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July-7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan. RESULTS: At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P<0.05). When fasting and non-fasting groups were compared separately, an increase in amniotic fluid index was statistically significant in the non-fasting group (P<0.05). CONCLUSION: We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.


Assuntos
Jejum/efeitos adversos , Desenvolvimento Fetal , Islamismo , Gravidez/fisiologia , Adulto , Estudos de Casos e Controles , Jejum/fisiologia , Feminino , Humanos , Estudos Prospectivos , Estações do Ano , Ultrassonografia Pré-Natal , Adulto Jovem
4.
Arch Gynecol Obstet ; 291(3): 513-8, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25135380

RESUMO

PURPOSE: To establish a reference range for the intracranial translucency (IT). METHODS: In this prospective study, we examined 596 singleton fetuses at 11-14 weeks of gestation using transabdominal ultrasonography. The distribution curves of the anterior-posterior diameter of the IT were established according to the gestational weeks, and the percentiles for 11-14 weeks of gestation were calculated. Regression analysis was performed to estimate the relationship between the anterior-posterior diameter of the IT and other fetal biometric parameters. RESULTS: The mean anterior-posterior diameter of the IT was 1.8 ± 0.4 mm. From 11 to 14 weeks of gestation, the IT diameter increased linearly with advancing gestation. The linear regression equation for the IT × crown-rump length (CRL) was IT = CRL × 0.0184 + 0.575 (R = 0.385, p < 0.001). The linear regression equation for the IT × biparietal diameter (BPD) was IT = BPD × 0.0532 + 0.632 (R = 0.346, p < 0.001). The linear regression equation for IT × gestational age (days) (GA) was ICT = GA × 0.024 - 0.339 (R = 0.25, p < 0.001). The linear regression analysis revealed significant correlations of the IT with CRL, BPD, and GA. CONCLUSION: The IT increases linearly with increasing CRL, BPD, gestational age in weeks, and gestational age in days.


Assuntos
Quarto Ventrículo/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Medição da Translucência Nucal/métodos , Disrafismo Espinal/diagnóstico por imagem , Adulto , Biometria , Estudos Transversais , Estatura Cabeça-Cóccix , Feminino , Idade Gestacional , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Valores de Referência , Análise de Regressão , Ultrassonografia Pré-Natal
5.
Biol Trace Elem Res ; 202(4): 1816-1828, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37558909

RESUMO

Toxic elements that pose a potential threat to human health are found as impurities in various cosmetic products. In this study, the inorganic profile of 19 elements (Li, B, Mg, Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sb, Ba, Hg, and Pb) in 90 cosmetic products (lipsticks, lip glosses, lip pencils and eye shadows) were detected by inductively coupled plasma-mass spectrometry after microwave acid digestion method and hazard indices (HI) of 9 toxic elements (Pb, Cd, Cr, Ni, Co, As, Hg, Sb, and Al) were calculated for the assessment of theoretical health risk. Satisfactory method performance parameters were found for each analyte. The results were compared with the maximum permissible limits set by regulatory agencies; 38 of 41 lip products (92.68%) and all eye shadows (n = 49) exceeded the established limits. The HI was found to be ≥ 1 in 82.76% of lip products for oral exposure, whereas HI was ≤ 1 for dermal exposure in all lip products (n = 41) and only one eye shadow sample was ≥ 1 (2.04%). Remarkable results were also detected for 19 elements in this study, which conducted a comprehensive inorganic profiling for the first time. Wide-range concentrations of Mg, Al, Ba, Mn, Cu, Zn, and Sr elements were remarkable. HI values were firstly brought out in this study, although Al, as a well-known toxic element, has not been listed in regulations yet. In conclusion, it is obviously seen that continuous monitoring of cosmetics is crucial not only for toxic elements but also for other essential or non-toxic elements to prevent consumers from long-term exposure.


Assuntos
Cosméticos , Mercúrio , Oligoelementos , Humanos , Cádmio/análise , Chumbo/análise , Mercúrio/análise , Cosméticos/análise , Medição de Risco/métodos , Oligoelementos/análise , Monitoramento Ambiental
6.
Forensic Sci Int ; 364: 112222, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39276628

RESUMO

Detection of ignitable liquid residues in a fire scene is essential for determining the origin. Although studies are focused on the detection of residues of accelerants depending on time or matrices, the time-dependent effect of the water extinguishing method in a fire has not yet been investigated. Experimental studies are needed to determine how long ignitable liquid residues can be detected in water-extinguished evidence compared to the smothering method. In this study, the effects of both extinguishing methods on gasoline residues were investigated after burning of carpet, sofa fabric, tablecloth, and towel by Solid Phase Micro Extraction- Gas Chromatography/Mass Spectrometry (SPME-GC/MS) technique. Four mandatory and 14 additional compounds were considered to prove the gasoline residue after the monitoring of possible interferences. Results showed that gasoline residues on the burned carpet and sofa fabric samples were successfully detected in both extinguishing methods up to 60 and 30 days after fire exposure, respectively due to multi-layered structures of related substrates. Additionally, the prolonged detection time of the water-extinguishing method made it particularly beneficial for single-layered products like tablecloths, where gasoline residues were found after an hour in this substrate. This is the first study investigating the effects of the extinguishing methods depending on time for textile products, which are the most used materials in houses. In addition, the fact that acrylamide-containing sofa fabric was investigated for the first time and that gasoline residues in carpet samples can be detected up to 60 days makes this study stand out.

7.
Environ Sci Pollut Res Int ; 31(23): 33975-33992, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38696006

RESUMO

Inorganic elements are added to toys as impurities to give desired stability, brightness, flexibility, and color; however, these elements may cause numerous health issues after acute or chronic exposure. In this study, the inorganic profile of 14 elements (Al, As, Ba, Cd, Co, Cr, Cu, Hg, Mn, Ni, Se, Sb, Pb, and Zn) in 63 toy makeup products was identified by inductively coupled plasma-mass spectrometry after microwave acid digestion method. Additionally, organic allergen fragrance was investigated by gas chromatography-mass spectrometry. The systemic exposure dosage (SED), margin of safety (MoS), lifetime cancer risk (LCR), hazard quotient (HQ), and hazard indices were used to assess the safety evaluation. Then, 57 out of 63 samples (90.48%) exceeded the limits at least for one toxic element with descending order Ni > Cr > Co > Pb > Sb > Cd > As > Hg. The SED values were compared with tolerable daily intake values and remarkably differences were found for Al and Pb. The MoS values for 57.15% of samples exceeded the limit value for Al, As, Cd, Co, Hg, Mn, Sb, and Zn elements. The LCR values were observed at 100% (n = 63), 79.37% (n = 50), 85.71% (n = 54), 77.78% (n = 49), and 18.87% (n = 10) for Cr, Ni, As, Pb, and Cd, respectively. Also, the skin sensitization risks were obtained for Cr and Ni at 26.980% (n = 17) and 9.52% (n = 6), respectively. The HQ values for 80% of samples were found to be ≥ 1 at least for one parameter. The investigation of fragrance allergens in samples did not show any significant ingredients. As a result, toy makeup products marketed in local stores were found to be predominantly unsafe. Children should be protected from harmful chemicals by regular monitoring and strict measures.


Assuntos
Jogos e Brinquedos , Humanos , Criança , Saúde da Criança , Medição de Risco
8.
Drug Test Anal ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840461

RESUMO

Olanzapine (OLZ), a second-generation antipsychotic drug, is effective in the treatment of acute psychosis, schizophrenia, agitation, bipolar mania, and other psychiatric problems. Antipsychotics are prescribed drugs, which lead the drug abuser to illegal methods of access. This behavior also demonstrates the association of OLZ with criminal involvement, commonly observed at forensic crime scenes. The acute toxicity and even death resulting from OLZ exposure have been highlighted in numerous studies. Therefore, developing analytical techniques to detect OLZ is essential for forensic toxicology. This study aimed to develop a specific and reliable LC-MS/MS method for OLZ detection and quantification in hair samples. The method was validated in terms of selectivity, linearity, limit of detection (LOD), limit of quantification (LOQ), trueness, precision, and uncertainty. The range of linearity was between 0.1-100 ng/mg, with LOD and LOQ values established at 0.036 ng/mg and 0.1 ng/mg, respectively. All validation results are within acceptable parameters. The validated method has been applied to authentic hair samples. The variation of OLZ concentrations in 12 hair segments (2 from Case 1 and 10 from Case 2) from two drug-positive patients, ranging from 0.131 to 0.460 ng/mg, is presented in this study. Although several studies have been conducted to determine OLZ in hair samples using segmental analysis via hair solubilization, this study is the first to determine OLZ in hair samples after "digestion" with comparative parameters prior to chromatographic analysis.

9.
J Pharm Biomed Anal ; 235: 115670, 2023 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-37647794

RESUMO

Pethidine (PET) is an opioid pain-relief medicine with high addiction potential, especially among health professionals. Pethidine is commonly prescribed in Turkey as a pain-relieving medication for operative purposes. Due to its accessibility, low cost, user-friendliness, and effectiveness, PET is often misused by both healthcare professionals and patients. For this reason, analytical determination methods for PET abuse are essential in terms of forensic toxicology. In this study, a fast, reliable, and accurate gas chromatography-mass spectrometry method was developed for the first time in Turkey for the simultaneous detection of PET and its main urinary metabolite norpethidine (NPET). The method was validated in terms of selectivity, linearity, the limit of detection (LOD), the limit of quantification (LOQ), trueness, and precision according to the Scientific Working Group for Forensic Toxicology guidelines. The linear range was between 0.125-25.00 µg/mL for PET and 1.00-20.00 µg/mL for NPET. The LOD values for PET and NPET were 0.05 µg/mL and 0.49 µg/mL, while the LOQ values were 0.125 µg/mL and 1.00 µg/mL, respectively. Extraction efficiencies were calculated as 113% for PET and 104% for NPET. The intra-assay and inter-assay precision results were within acceptable limits. In the presented study, the validated method was applied to the urine of 18 patients collected at the 1st and 3rd hours after receiving PET. All samples in the study were collected under patients' consent and in line with ethical guidelines.


Assuntos
Líquidos Corporais , Humanos , Meperidina , Dor , Analgésicos Opioides , Bioensaio
10.
J Anal Toxicol ; 46(9): e239-e242, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36355788

RESUMO

Forensic veterinary toxicology has become a popular branch of toxicology, dealing with animal cruelty (e.g., malicious poisoning), regulatory issues (e.g., contamination of the feed supply chain), insurance litigation or wildlife poisoning. The current study highlights the importance of the toxicological aspects of animal health-related disagreements in a pet custody case following a divorce. In this study, the custody case of three dogs and a cat was concluded with the aid of toxicological test results that were obtained from the pets' blood samples for the first time in Turkey. The results confirmed the presence of benzoylecgonine in one of the blood samples, as alleged by one of the owners. The study also aims to raise the veterinarians', as well as the judicial system members', awareness of drug abuse in pets.


Assuntos
Bem-Estar do Animal , Médicos Veterinários , Animais , Cães , Humanos , Toxicologia Forense , Inquéritos e Questionários
11.
Eur J Obstet Gynecol Reprod Biol ; 268: 18-21, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34794070

RESUMO

OBJECTIVE: The management of multiple pregnancies is still a challenge. The aim of this study was to compare the outcome of triplet pregnancies managed expectantly or by multifetal pregnancy reduction to twins. STUDY DESIGN: For this retrospective, comparative and monocentric study, the medical files of all women with triplets who admitted to our institution over a 13-year period were examined. Women requesting multifetal pregnancy reduction to have twins formed the study group, and women with triplets who wished to continue their pregnancies formed the control group. Main outcome measures were durations of pregnancies presented as number of weeks gestation, abortion rates, term and preterm birth rates, fetal loss and live birth rates. RESULTS: During the study period, 171 women with triplets admitted to our institution. One hundred fifty one patients are included in this study. Forty-five women carrying triplets wished to continue their pregnancies and 106 women requested multifetal pregnancy reduction to have twins. Fetal reduction of triplets to twins was associated with a significantly lower incidence of birth before 34th gestational week and higher incidence of late preterm and term birth rates without changing live birth rates. CONCLUSION: Multifetal pregnancy reduction of triplet pregnancies to twins resulted in a later gestational age at birth compared with the triplet gestations managed expectantly.


Assuntos
Gravidez de Trigêmeos , Nascimento Prematuro , Coeficiente de Natalidade , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Redução de Gravidez Multifetal , Gravidez Múltipla , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Conduta Expectante
12.
Biol Trace Elem Res ; 200(1): 49-58, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33609234

RESUMO

Nickel (Ni) is a frequently used metal in the production of many products, and Ni exposure occurs in humans through food, inhalation, and skin. Studies reported Ni as the most common allergen diagnosed in the serial patch test. The main purpose of our study was to determine the concentration of Ni and other elements in the urine samples of individuals with Ni-sensitivity and to determine the effect of lifestyle habits on these variables. This study was conducted with 388 participants; additionally, both Ni patch test and inorganic analysis (for 24 elements) method in urine with inductively coupled plasma-mass spectrometry (ICP-MS) were applied to all participants. Ninety-two (23.7%) of the participants were found to have nickel sensitivity with a mean urine concentration of 4.475 µg/g creatinine (median=4.260; SD=2.527). The urine nickel concentration was significantly different between female and male participants (p =0.001). We found a significant correlation between Ni and other metals alongside various element pairs. The mean urine Ni concentration of the individuals with a positive Ni sensitivity test result was not different from that of the participants without Ni sensitivity (4.475 vs 4.256 µg/g creatinine, respectively; p = 0.068). The high accuracy, recovery, and repeatability data obtained from the analyses indicate that this study is efficient and appropriate for the quantitative determination of nickel and other elements in urine samples. Ni-containing objects and Ni-rich foods should be of concern for individuals with hypersensitivity reactions to the element.


Assuntos
Metais , Níquel , Feminino , Hábitos , Humanos , Estilo de Vida , Masculino , Testes do Emplastro
13.
Sci Total Environ ; 797: 149156, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34346379

RESUMO

A national wastewater-based epidemiology (WBE) monitoring campaign has been initiated to determine the trends in drug consumption in Turkey since 2019. This study aimed to present the wastewater monitoring results for four periods in 2019 for six major cities with 17 wastewater treatment plants. The study investigated heroin (HER), amphetamine (AMP), methamphetamine (METH), cocaine (COC), 3,4-methylenedioxymethamphetamine (MDMA), cannabis, alcohol, and tobacco to understand the temporal and geographical drug consumption trends. The results indicated a trend of regular cannabis use in all the cities. Considering geographical variations, the drug usage trends were not homogeneous within the country for any of the investigated drugs, except cannabis. HER consumption was predominant in Denizli (1042.48 mg/1000 inh/day), while Izmir and Antalya (154.10 and 79.56 mg/1000 inh/day, respectively) topped for COC consumption. Aydin had the highest consumption levels of AMP (90.03 mg/1000 inh/day) and METH (358.13 mg/1000 inh/day), while MDMA consumption was the highest in Samsun (157.64 mg/1000 inh/day). Tobacco consumption was high in Aydin (8791.69 mg/1000 inh/day) and Antalya (5375.17 mg/1000 inh/day), whereas alcohol consumption was higher in Bursa than in the other cities (53434.61 mL/1000 inh/day). There were no statistically significant differences in the weekend consumption levels of the investigated drugs among these six cities. Although this study included the results of 1 year of consumption monitoring, the data confirms internationally published information on the drug trafficking routes of conventional drugs in this region, especially the Heroin-Balkan route. Results from further sampling will enable accurate evaluation of global drug consumption and trafficking, in addition to alcohol and tobacco use.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Poluentes Químicos da Água , Cidades , Humanos , Detecção do Abuso de Substâncias , Uso de Tabaco , Turquia/epidemiologia , Águas Residuárias/análise , Poluentes Químicos da Água/análise
14.
Fetal Pediatr Pathol ; 29(3): 121-6, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20450264

RESUMO

The prenatal diagnosis of Bartter syndrome can be based on the high chloride level in the amniotic fluid. Microscopic examination of the placenta in untreated cases showed extensive mineralization in the chorionic villi in previous studies. Two cases were presented at 26-29 weeks of gestation with severe polyhydramnios. The mothers were treated with Indomethacin, KCl, and serial amniocentesis in order to reduce the amniotic fluid volume and prevent fetal hypokalemia. The microscopic examination of the placenta revealed focal calcification and acute atherosis in placental vessels. The treatment with Indomethacin in the antenatal period can prevent severe nephrocalcinosis.


Assuntos
Síndrome de Bartter/patologia , Vilosidades Coriônicas/patologia , Doenças Fetais/patologia , Doenças Placentárias/patologia , Poli-Hidrâmnios/patologia , Adulto , Amniocentese , Líquido Amniótico/química , Anti-Inflamatórios não Esteroides/uso terapêutico , Arteriosclerose/complicações , Arteriosclerose/patologia , Síndrome de Bartter/complicações , Síndrome de Bartter/terapia , Cloretos/análise , Vilosidades Coriônicas/irrigação sanguínea , Feminino , Doenças Fetais/terapia , Idade Gestacional , Humanos , Indometacina/uso terapêutico , Recém-Nascido , Masculino , Nefrocalcinose/patologia , Nefrocalcinose/prevenção & controle , Doenças Placentárias/terapia , Poli-Hidrâmnios/etiologia , Poli-Hidrâmnios/terapia , Cloreto de Potássio/uso terapêutico , Gravidez , Resultado do Tratamento
15.
Infect Dis Obstet Gynecol ; 2009: 91708, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-17485823

RESUMO

OBJECTIVE: Our aim is to investigate sonographically detectable vault hematomas after vaginal hysterectomy and its relation to postoperative morbidity. METHODS: We studied a group of 103 women who had undergone vaginal hysterectomy for benign causes apart from uterovaginal prolapse. Transabdominal ultrasound examinations were carried out 24 to 72 hours after surgery to assess the presence of vault hematomas. Ultrasound findings were correlated with clinical data and postoperative morbidity. RESULTS: The incidence of vault hematoma was found 19.4% in present study. In these patients, 40% (8/20) had fever while only 2.4% (2/83) of cases without vault hematoma suffered from fever. Out of all women having vault hematoma, 70% (14/20) had small-sized hematoma and 30% (6/20) had large-sized hematoma. Fifty percent of patients (3/6) with large-sized hematoma, as compared to only 35% (5/14) with small-sized hematoma, suffered from febrile morbidity. Large-sized hematomas drained by vaginally, while all small-sized pelvic hematomas managed by watchful expectancy successfully. The significant difference was found mean hemoglobin drop and postoperative stay in the hematoma group or without hematoma group. CONCLUSION: Sonographic detection of vaginal vault fluid collection is common after hysterectomy, but such a finding rarely indicates additional treatment. Though febrile morbidity was more in cases with vault hematoma, the number of such patients was too small to be significant. Vaginal ultrasound examination should not be performed routinely after hysterectomy.


Assuntos
Hematoma/diagnóstico por imagem , Histerectomia Vaginal/efeitos adversos , Doenças Vaginais/diagnóstico por imagem , Adulto , Feminino , Hematoma/etiologia , Humanos , Pessoa de Meia-Idade , Morbidade , Ultrassonografia/métodos , Doenças Vaginais/etiologia
16.
Arch Gynecol Obstet ; 280(4): 647-51, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19221775

RESUMO

INTRODUCTION: Holoprosencephaly (HPE) is commonly associated with facial malformations. We present a case of semilobar HPE associated with distal limb defect which was detected at 12 weeks of gestation. CASE: The fetus had a crown-rump length of 60 mm (12 weeks-4 days), had nuchal translucency thickness of 1.5 mm. Initial two-dimensional (2D) ultrasound revealed the absence of nasal bone, decreased BPD and abnormal profile. Transvaginal 2D ultrasound was effective in the detection of HPE (partially absence of the interhemispheric fissure, fused thalami, the choroid plexuses were not visualized bilateraly: absent 'butterfly' sign), cylopia, absence of the nose and unilateral radial aplasia. Three dimensional (3D) ultrasound provided a better visualization of the associated anomalies. The necropsy result confirmed the sonographic findings: the diagnosis was semilobar HPE, cyclopia, absence of the nose, and the absence of the radius and the thumb in the left arm. DISCUSSION: Transvaginal 2D sonographic examination is effective in detection of the cases with HPE at first trimester. Fetal morphological study through 3D ultrasound may facilitate the diagnosis of associated anomalies.


Assuntos
Anoftalmia/diagnóstico por imagem , Holoprosencefalia/diagnóstico por imagem , Rádio (Anatomia)/anormalidades , Adulto , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Rádio (Anatomia)/diagnóstico por imagem , Ultrassonografia Pré-Natal
17.
Fetal Diagn Ther ; 26(4): 189-94, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19923789

RESUMO

OBJECTIVE: To determine whether maternal plasma fibronectin and advanced oxidative protein products (AOPP) can be used for the prediction of preeclampsia in high-risk women. STUDY DESIGN: One hundred pregnant women at high risk of preeclampsia were enrolled in this prospective cohort study. Maternal plasma total fibronectin and AOPP levels were measured at 19-25 weeks of gestation. AOPP levels were also measured in 23 normal non-pregnant women. After delivery, the pregnant cohort was assigned to either the normotensive or preeclamptic group depending on their clinical course. RESULTS: Among the 78 pregnant women who completed the study, 19 (24.3%) developed preeclampsia between 36 and 39 (36.8 +/- 1.0) weeks of gestation. AOPP levels, which are significantly higher in normotensive pregnant women compared to nonpregnant controls (42.55 +/- 15.94 vs. 27.95 +/- 10.5; p = 0.0001) were not significantly different between normotensive and preeclamptic women (42.55 +/- 15.94 vs. 47.45 +/- 14.19 microM; p = 0.23). Plasma fibronectin levels were significantly higher in women who continued to develop preeclampsia rather than remain normotensive (383.68 +/- 19.07 vs. 227.65 +/- 97.39; p < 0.0001). ROC curve analysis shows that total fibronectin >or=360 mg/l is predictive for the development of preeclampsia. The sensitivity, specificity, positive and negative predictive values are 57, 92, 73 and 85%, respectively, with a likelihood ratio of 7.38. CONCLUSION: Second trimester plasma concentrations of AOPP are not altered in women that develop pre-eclampsia later in pregnancy. However, total fibronectin levels are significantly increased and may be used to predict the onset of clinical symptoms of preeclampsia.


Assuntos
Fibronectinas/sangue , Pré-Eclâmpsia/diagnóstico , Adulto , Proteínas Sanguíneas/metabolismo , Feminino , Humanos , Estresse Oxidativo , Gravidez , Sensibilidade e Especificidade
18.
Fetal Diagn Ther ; 22(4): 282-4, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17356285

RESUMO

INTRODUCTION: Hemoglobin Brockton is indicated by the hemolytic anemia, which is rare qualitative variant of aspect of the hemoglobinopathies. Hemoglobin disorders in pregnancy are associated intrauterine growth retardation, premature birth, and low birth weight. One of the unstable hemoglobinopathies, Hb Brockton associated with pregnancy has not been previously mentioned in the literature. In this case presentation and things to be done in case of a pregnant patient with rare hemoglobinopathy have been reviewed in reference to the literature. CASE REPORT: Twin pregnancy of a 26-year-old patient with Hb Brockton disorder which was diagnosed at the age of 11, and has led to minor hemolytic anemia crisis over the years, was observed. Due to decrease in hemoglobin level, 8 units of transfusion were made. A twin pregnancy continued without any problems until the 38th week when a caesarean section was performed due to breech-breech presentations. The hemoglobin pattern of the newborn was studied at birth and after 1 year; the variant in the mother was not found. DISCUSSION: During pregnancies with unstable hemoglobinopathy, observation of hemoglobin levels every 3 weeks and carrying out blood transfusions when below 8 g/dl can stabilize the pregnancy in terms of the development of the baby and the mother. Patients with hemoglobinopathy carry an increased risk for complications and should therefore seek medical care early in pregnancy and be managed by a multidisciplinary team of specialists.


Assuntos
Hemoglobinopatias/terapia , Hemoglobinas Anormais , Complicações Hematológicas na Gravidez/terapia , Gravidez Múltipla , Cuidado Pré-Natal/métodos , Adulto , Transfusão de Sangue , Apresentação Pélvica , Cesárea , Feminino , Hemoglobinopatias/sangue , Humanos , Nascido Vivo , Gravidez , Complicações Hematológicas na Gravidez/sangue , Gêmeos
19.
Fetal Diagn Ther ; 22(6): 416-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17652927

RESUMO

Jarcho-Levin syndrome (JLS) causes severe vertebral and thoracic deformity and has an autosomal-recessive mode of inheritance. Prenatal diagnosis may be difficult in some cases without the history of an affected baby. We present 4 cases of JLS with neural tube defects as the prominent finding. In 2 of them the deformity of the thorax was minimal and was not detected by ultrasonography. Rib anomalies were revealed with radiological and pathological examinations after the termination. The location of the vertebral defect may be the determinant factor for the severity of the thoracic deformity. The real recurrence risk could only be found out after postnatal examinations in cases with neural tube defects.


Assuntos
Doenças Fetais/diagnóstico , Anormalidades Musculoesqueléticas/diagnóstico , Defeitos do Tubo Neural/diagnóstico , Diagnóstico Pré-Natal/métodos , Diagnóstico Diferencial , Feminino , Doenças Fetais/diagnóstico por imagem , Humanos , Anormalidades Musculoesqueléticas/diagnóstico por imagem , Defeitos do Tubo Neural/diagnóstico por imagem , Gravidez , Radiografia , Síndrome
20.
Food Chem ; 215: 92-100, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-27542454

RESUMO

The concentration of twenty-seven elements (Li, Be, B, Mg, Al, P, K, Ca, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sn, Sb, Ba, Hg, Pb, Bi, Th, and U) in green coffee samples and their infusions were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). Prior to analysis, green coffee samples were prepared by microwave digestion, while infusions were analyzed without any pre-treatment. The accuracy and precision of the proposed methods were verified by recovery experiments. Considering samples; K, Cu, and Al had the highest mean concentrations with 6714.5µgg(-1), 12.1µgg(-1), and 25.9µgg(-1) among major, trace and toxic elements, respectively. The impact of brewing type on leachability of elements was also studied and the results outlined that mean leachability of elements to Turkish coffee were greater than to mud coffee. Furthermore, dietary element intakes through green coffee consumption were also estimated. This is the first study presenting wide range of elements in green coffee brews and calculating dietary intakes.


Assuntos
Coffea/química , Sementes/química , Oligoelementos/química , Culinária , Ingestão de Alimentos , Humanos , Espectrometria de Massas , Turquia
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