The association of interleukin-6, interleukin-27, and body roundness index with gestational diabetes mellitus.

We aimed to investigate the relationship between GDM and IL-27, IL-6, and body roundness index (BRI), a new anthropometric measurement more sensitive than BMI in identifying obesity and predicting cardiometabolic outcomes. We enrolled 80 patients, 40 pregnant women with GDM and 40 healthy pregnant women at midgestation. The women's anthropometric measurements were recorded and serum markers and IL-6, IL-27 were analysed. At the time of delivery maternal, neonatal results were recorded. Women with GDM had significantly higher pregestational, midgestational and prepartum BMI and midgestational BRI; HOMA-IR; HbA1c; and IL-6 values and lower HDL values (p < .05). There was no statistically significant difference in IL-27 values between the groups (p = .939). In multivariate logistic regression analysis, HbA1c, IL-6 (>4.886 pg/mL), and BRI (>6.708) were found as independent risk factors associated with GDM (p < .05). Mean BRI was significantly associated with obesity (p < .001) and BRI higher than 6.708 was found to have 67.5% sensitivity and 80% specificity in the prediction of GDM. Women with GDM had elevated IL-6 levels, but no relationship was detected between IL-27 and GDM. BRI is a new anthropometric index that strongly correlated with BMI and seems to be a reliable alternative to BMI for the evaluation of obesity in GDM patients.IMPACT STATEMENTWhat's already known on this subject? Gestational diabetes mellitus (GDM) is the most common systemic disease in pregnancy. The risk of GDM was 3 times higher in obese pregnant women compared to normal weighted patients. IL-6 is an adipose-derived cytokine that was found to be associated with GDM. The body roundness index (BRI) is a new sensitive anthropometric index for detecting obesity and its secondary cardiometabolic results.What do the results of this study add? Our results showed that BRI was strongly correlated with obesity in GDM patients. HbA1c, IL-6 and BRI were found as independent risk factors associated with GDM. IL 27, a cytokine associated with inflammatory diseases, was not associated with GDM.What are the implications of these findings for clinical practice and/or further research? BRI could be a reliable alternative to BMI for the evaluation of obesity in pregnant women and predicting cardiometabolic outcomes.

YouTube as a source of information on gonadotropin self-injections.

OBJECTIVE: To investigate the comprehensiveness, quality, and reliability of YouTube videos that target teaching patients gonadotropin self-injections. STUDY DESIGN: Videos demonstrating gonadotropin self-injections were searched using the keywords "Gonal-f injection," "Puregon injection," "Menapur injection," "Merional injection," "Fostimon injection," and "Menagon injection," on December 20th, 2020. The videos were divided into two categories as including "useful information" and "misleading information" by two physicians. A 5-point global quality scale (GQS) and 5-point modified DISCERN scale were used for the assessments of quality and reliability, respectively. RESULTS: Among 110 videos, 90 (81.8%) were found to include useful information and 20 (18.2%) were found to give misleading information. The kappa statistic for inter-observer agreement was 0.817 (p < 0.001). Useful videos were the most comprehensive and had the highest reliability and quality scores. We found that all videos uploaded by universities or professional organizations included useful information. However, there was no significant difference between useful and misleading videos regarding audience interaction analysis parameters (p > 0.05). On the other hand, mean reliability, GQS, and comprehensiveness scores were higher in the useful information group than in the other group. As the subgroup analysis was performed by source, patient opinion videos had lower reliability, comprehensiveness, and GQS scores than videos created by other sources (p < 0.001). CONCLUSION: Our analysis revealed that there were a significant number of English-language YouTube videos, with high quality, rich content, and reliability that could be sources of information on the accurate technique of gonadotropin self-injections. However, some misleading information videos may lead to negative outcomes. Therefore, physicians should ensure that online sources are comprehensive and reliable for the use of their patients with infertility. Also, YouTube health videos should be checked for both reliability and ethical standards.

Uterine dimensions and intrauterine device malposition: can ultrasound predict displacement or expulsion before it happens?

OBJECTIVE: Intrauterine devices (IUDs) are the most commonly used method of long-acting reversible contraception. IUD malpositions are described as expulsion, embedding, displacement, and perforation, which may cause contraception failure, organ injury, hemorrhage, and infection. The aim of the study was to evaluate the relationship between displacement and IUD positioning in the uterus, and uterine dimensions as measured using transvaginal ultrasonography. MATERIALS AND METHODS: Three-hundred and eighty-four patients who had TCu380A devices inserted at a tertiary hospital were evaluated at insertion and at 1 month, 3 months, and 6 months after insertion. At the insertion visit, demographic characteristics, history of menorrhagia, dysmenorrhea, previous IUD displacement, and obstetric history were recorded. Transvaginal ultrasonographic measurement of the uterine cavity, uterine length, uterine width, cervix length, cervix width, transverse diameter of the uterine cavity, the distance between the tip of the IUD and the fundus, and endometrium were measured to evaluate IUD displacement. RESULTS: Sixteen of 384 patients had displacement. There were significant differences in times between last pregnancy outcomes and IUD insertion and dysmenorrhea history (p = 0.004 and p = 0.028, respectively). Among TCu380A users, women with 7.5 mm IUD endometrium distances had a higher risk for displacement with a sensitivity of 81% and specificity of 37.5% (AUC: 0.607, 95% CI 0.51-0.70). Women with uterus width less than 41.5 mm were more likely to have displacement with a sensitivity of 53.8% and a specificity of 75% (AUC: 0.673, 95% CI 0.60-0.75). CONCLUSION: IUD endometrium distance and uterus width are important parameters for displacement for TCu380A.

The relationship between KRAS LCS6 polymorphism and endometrium cancer.

The aim of this study was to investigate the relationship between KRAS LCS6 mutation and endometrial cancer (EC). The study included 105 patients who had hysterectomy for benign reasons and 99 EC patients. The patients with Type 1 EC were classified according to histological properties, cancer stage, grade, tumour dimension, myometrial invasion (MMI), lymphovascular invasion (LVI), cytology, and number of positive lymph nodes. KRAS LCS6 mutation was examined in blood samples taken from all patients in both groups. No statistically significant difference was determined between the EC patients and the control group in demographic features. Weight and the Body Mass Index (BMI) values were higher in EC group (p < .001). While the incidence of this polymorphism is 5.8% throughout the world, the polymorphism rate was found to be 16.2% in the EC group and 12.4% in the control group, with no statistically significant difference determined (p > .05). Despite the higher rate of LCS6 polymorphism incidence in EC patients in this study conducted on a relatively large sample, there was not found to be a statistically significant difference in comparison with the control group. In addition, the presence of LCS6 polymorphism was not determined to have an effect on EC histopathological characteristics.Impact statementWhat is already known on this subject? Endometrial cancer (EC) is a genital system cancer which is one of the most widespread gynecological cancers seen in the USA and other developed countries, In EC, the most frequently seen gene mutations are PTEN tumour suppressor gene, KRAS, ß1 catenin, BCL-2, CTNNB and P53 mutations. KRAS LCS6(let-7 miRNA binding region polymorphism) polymorphism has a worldwide incidence of 5.8% (Chin et al. 2008).There are studies shown that KRAS LCS6 polymorphism has an effect on developing EC (Lee et al. 2014), ovarian cancer(Ratner et al. 2010)and endometriosis in women (Grechukhina et al. 2012).What do the results of this study add? In our study, LCS6 located on KRAS 3'-UTR was found at the rate of 16.2% in Type 1 EC patients. This increase is noticeable when it is considered that the incidence of this polymorphism is 5.8% in the general population. The results of the current study supports the preliminary findings of Lee et al.What are the implications of these findings for clinical practice and/or further research? These new genetic markers could help to develop gene-targeted therapies, identify genetic basis of the disease and the factors that could affect the EC prognosis.

Subclinical inflammation markers in hyperemesis gravidarum and ketonuria: A case-control study.

INTRODUCTION: Subclinical inflammation markers play a significant role in hyperemesis gravidarum (HEG). Simple hematological markers such as mean platelet volume (MPV), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), and platelet-to-lymphocyte ratio (PLR) have been shown to reflect inflammatory burden and disease activity in several disorders. Ketonuria is a parameter used in the diagnosis of severe HEG, but its correlation with disease severity remains controversial. The relationship of subclinical inflammation markers with degree of ketonuria has not been examined previously. In this study, we aimed to determine the diagnostic value of these subclinical inflammation markers and the relationship between these markers and grade of ketonuria in patients with HEG. MATERIALS AND METHODS: A total of 94 pregnant women with a diagnosis of HEG and 100 gestational age-matched healthy pregnant women were enrolled in this retrospective study. MPV, PDW, NLR, PLR, PCT, and ketonuria were calculated and analyzed from complete blood cell counts and total urine analyses. RESULTS: Lymphocyte count was significantly higher in the control group (P < 0,001); NLR and PLR values were significantly higher in the HEG group (P < 0,001). Among inflammation markers, RDW increased significantly (P = 0,008) with an increase in ketonuria in patients with HEG. A statistically significant correlation was found between white blood cell (WBC) and NLR, PLR, PCT. A moderate uphill relationship was observed between NLR and WBC and a weak uphill linear relationship was observed between WBC and PLR and between WBC and PCT. CONCLUSIONS: PLR and NLR can be considered effective markers to aid in the diagnosis of HEG. No marker was found to correlate with ketonuria grade except RDW, although the relationship of the severity of ketonuria with severity of disease is controversial. RDW increases as the degree of ketonuria increases.