Premenstrual syndrome and fibromyalgia: the frequency of the coexistence and their effects on quality of life.

OBJECTIVE: We aimed to investigate the association between Premenstrual syndrome (PMS) and fibromyalgia syndrome (FMS), to assess common symptoms and quality of life (QOL) of them. METHODS: Patients with PMS formed the PMS group and age-matched healthy normal controls were included in the control group. The diagnosis of the FMS and PMS were based on new American College of Rheumatology FMS criteria and DSM-IV PMS criteria. FMS-related symptoms assessed by visual analog scale and number of tender points (TePs) were analyzed. QOL, PMS severity and FMS severity were assessed with SF-36, fibromyalgia impact questionnaire (FIQ) and premenstrual assessment form (PAF), respectively. Patients with PMS were divided into two subgroups according to coexistence of FMS or not. RESULTS: The frequency of FMS in PMS and control group were 20 and 0%, respectively (p = 0.002). FMS-related symptoms, number of TePs in the PMS group were higher than those in the control group. The mean mental component summary (MCS) score of SF-36 was low in the PMS group. The mean PAF score in PMS with FMS subgroup was higher than those in without FMS subgroup. The mean physical component summary of SF-36 was low in the PMS patient with FMS. There was correlation between PAF score and FIQ score (r = 0.476, p < 0.001). CONCLUSION: FMS was common among the patients with PMS and frequently seen in the PMS patients having severe premenstrual complaints. Mental QOL was distressed in the patients with PMS but while FMS accompanied to PMS, the physical QOL was decreased.

Conventional 22- and 20-gauge needle for second trimester amniocentesis: A comparison of short term outcomes.

OBJECTIVE: To compare the short-term outcomes of two different-sized needles for genetic amniocentesis. MATERIALS AND METHODS: A total of 271 amniocentesis were retrospectively evaluated in 2 groups concerning the size of the needles used during the procedure: Conventional 20-gauge (G) (n=164) and 22G (n=107). Periprocedural complications and cost-effectiveness were compared across the groups. RESULTS: There were no differences between groups concerning complications within 15 days after the procedure (fetal loss, 0.6% versus 0.9%, and amniotic fluid leak 1.2% versus 1.8%, p=0.99 for each). The 22G needle was significantly more cost efficient (p<0.0001). CONCLUSION: The 22 G spinal needle is convenient for second trimester amniocentesis with similar complication rate and has a favorable cost profile.

Do follicular fluid gelatinase levels affect fertilization rates and oocyte quality?

BACKGROUND: Matrix metalloproteinase-2 and -9, known as gelatinases, are considered to be essential for tissue remodelling during the reproductive process. However, their role in reproduction is unclear. AIMS: In the present study, we aimed to investigate the relationship between follicular fluid gelatinase levels and oocyte quality and fertilization, and to compare the activities of gelatinase levels with different drug stimulation protocols. METHODS: We evaluated 60 women with unexplained infertility who underwent in vitro fertilization (IVF) treatment. Thirty patients underwent a gonadotropin-releasing hormone (GnRH) agonist protocol and 30 underwent a GnRH antagonist protocol. Follicular fluid was obtained during oocyte retrieval. Oocyte quality was determined using light microscopy, and oocytes were considered to be fertilized when two pronuclei were present. Gelatinase activities were measured using commercial enzyme-linked immunosorbent assay kits. The study was partially supported by the Scientific Research Unit of Suleyman Demirel University (Protocol Number: 3620-TU1-13), and all procedures were conducted with the approval of the Suleyman Demirel University Local Ethics Board. Statistical analyses of the data were performed using the independent t test, Fisher exact test, Mann-Whitney U test, one-way ANOVA, and posthoc least significant difference. RESULTS: Follicular fluid gelatinase levels were significantly higher for agonist drug administration (p = 0.001), and a positive correlation was observed between matrix metalloproteinase-9 levels and oocyte grade (p = 0.01). Moreover, a positive relationship between matrix metalloproteinase-9 levels and fertilization was observed (p = 0.02). CONCLUSION: Follicular fluid gelatinase activities, particularly MMP-9 activity, might be a predictor of oocyte quality and IVF success.

Selenium reduces oxidative stress and calcium entry through TRPV1 channels in the neutrophils of patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common inflammatory disease with an uncertain pathogenesis, although one consistent finding is increased neutrophil activity. It has been recently reported that the essential antioxidant element selenium has protective effects on oxidative stress and cytosolic Ca(2+) concentrations in human neutrophil. We aimed to investigate the effects of selenium on oxidative stress and Ca(2+) levels through TRPV1 channels in neutrophils from patients with PCOS. Blood samples were obtained for neutrophil isolation from ten female patients with PCOS and ten healthy female subjects. Neutrophils isolated from PCOS group were investigated in four settings: (1) PCOS, (2) after incubation with TRPV1 channel blocker capsazepine (CPZ), (3) after incubation with selenium (sodium selenite), and (4) with combination (CPZ + selenium) exposure. Intracellular free Ca(2+) concentrations were higher in the patients than those in the controls, although their levels were reduced after CPZ and selenium incubations. The cytosolic Ca(2+) concentrations in neutrophils obtained from PCOS group were further decreased after incubation with CPZ + selenium, as compared with those exposed to neither agent. Lipid peroxidation levels were higher in the PCOS group than those in the control although neutrophil glutathione peroxidase (GSH-Px) and reduced glutathione (GSH) values were decreased. The lipid peroxidation level was lower in the CPZ and selenium groups than that in the PCOS group although GSH and GSH-Px values were higher in the treatment with selenium and CPZ. In conclusion, we observed the importance of Ca(2+) influx into the neutrophils through TRPV1 channels in the pathogenesis of the patients with PCOS. The selenium appeared to provide a protective effect against oxidative stress and Ca(2+) entry through modulation of neutrophil TRPV1 calcium channels.

Effects of different anesthesia protocols on lactation in the postpartum period.

OBJECTIVE: Many factors can influence the secretion of breast milk. Cesarean section is a risk factor for late onset of breastfeeding. MATERIAL AND METHODS: In our study, we compared the lactation process by mothers who underwent elective cesarean section under general anesthesia, spinal anesthesia, epidural anesthesia, and normal birth; 84 patients between 18-40 years of age with a risk of ASA I-II were included. Randomly patients were divided into four groups: group G (general anesthesia, n:21), group S (spinal anesthesia, n:21), group E (epidural anesthesia, n:21), and group V (vaginal birth, without anesthesia, n:21). Oxytocin and prolactin values of all patients before and after operation or birth were recorded. In addition the initiation time of lactation after delivery or cesarean section were recorded. RESULTS: In all groups, there were no significant differences among hormone levels in the prepartum period (p=0.350). Prolactin levels in group G (p=0.011) and oxytocin levels in group V (p=0.012) in the postpartum period were significantly higher than in the other groups. The start of lactation was significantly delayed in group G (p=0.003). CONCLUSION: We consider that the onset time of lactation is delayed in patients undergoing cesarean section with general anesthesia when compared with patients who undergo cesarean section with spinal and epidural anesthesia and with patients who undergo normal vaginal birth. Because of the delay of awakening and recovery of cognitive functions in general anesthesia, communication between the mother and the newborn is delayed and so is the lactation.

Recent reports of Wi-Fi and mobile phone-induced radiation on oxidative stress and reproductive signaling pathways in females and males.

Environmental exposure to electromagnetic radiation (EMR) has been increasing with the increasing demand for communication devices. The aim of the study was to discuss the mechanisms and risk factors of EMR changes on reproductive functions and membrane oxidative biology in females and males. It was reported that even chronic exposure to EMR did not increase the risk of reproductive functions such as increased levels of neoantigens abort. However, the results of some studies indicate that EMR induced endometriosis and inflammation and decreased the number of follicles in the ovarium or uterus of rats. In studies with male rats, exposure caused degeneration in the seminiferous tubules, reduction in the number of Leydig cells and testosterone production as well as increases in luteinizing hormone levels and apoptotic cells. In some cases of male and female infertility, increased levels of oxidative stress and lipid peroxidation and decreased values of antioxidants such as melatonin, vitamin E and glutathione peroxidase were reported in animals exposed to EMR. In conclusion, the results of current studies indicate that oxidative stress from exposure to Wi-Fi and mobile phone-induced EMR is a significant mechanism affecting female and male reproductive systems. However, there is no evidence to this date to support an increased risk of female and male infertility related to EMR exposure.

Wi-Fi (2.45 GHz)- and mobile phone (900 and 1800 MHz)-induced risks on oxidative stress and elements in kidney and testis of rats during pregnancy and the development of offspring.

The present study was designed to determine the effects of both Wi-Fi (2.45 GHz)- and mobile phone (900 and 1800 MHz)-induced electromagnetic radiation (EMR) on oxidative stress and trace element levels in the kidney and testis of growing rats from pregnancy to 6 weeks of age. Thirty-two rats and their 96 newborn offspring were equally divided into four different groups, namely, control, 2.45 GHz, 900 MHz, and 1800 MHz groups. The 2.45 GHz, 900 MHz, and 1,800 MHz groups were exposed to EMR for 60 min/day during pregnancy and growth. During the fourth, fifth, and sixth weeks of the experiment, kidney and testis samples were taken from decapitated rats. Results from the fourth week showed that the level of lipid peroxidation in the kidney and testis and the copper, zinc, reduced glutathione (GSH), glutathione peroxidase (GSH-Px), and total antioxidant status (TAS) values in the kidney decreased in the EMR groups, while iron concentrations in the kidney as well as vitamin A and vitamin E concentrations in the testis increased in the EMR groups. Results for fifth-week samples showed that iron, vitamin A, and ß-carotene concentrations in the kidney increased in the EMR groups, while the GSH and TAS levels decreased. The sixth week results showed that iron concentrations in the kidney and the extent of lipid peroxidation in the kidney and testis increased in the EMR groups, while copper, TAS, and GSH concentrations decreased. There were no statistically significant differences in kidney chromium, magnesium, and manganese concentrations among the four groups. In conclusion, Wi-Fi- and mobile phone-induced EMR caused oxidative damage by increasing the extent of lipid peroxidation and the iron level, while decreasing total antioxidant status, copper, and GSH values. Wi-Fi- and mobile phone-induced EMR may cause precocious puberty and oxidative kidney and testis injury in growing rats.

Branch retinal vein occlusion associated with tamoxifen use.

Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of hormone-responsive breast cancer. Tamoxifen-induced ocular complications are very rare. A post-menopausal woman with carcinoma of the left breast had presented with sudden loss of vision. The patient had been on tamoxifen therapy 20 mg daily for the last three years. Fundus examination showed left branch retinal vein occlusion. Fluorescein angiography and optical coherence tomography confirmed the diagnosis. Tamoxifen therapy was discontinued. Although branch retinal vein occlusion is rare, careful evaluation of patients on tamoxifen therapy with visual symptoms is required.

Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.

OBJECTIVE: The relationship between menstruation disorders and antidepressant drugs usage in women remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related menstruation disorders and to examine whether or not antidepressant use is associated with menstrual disorders in women. METHODS: The study sample was gathered from three centers and four hospitals. A total of 1432 women who met the criteria of inclusion were included in the study. The sample was divided into two groups: the antidepressant group (n=793) and the control group (n=639). The menstruation disorders were established with reports from the study participants on the basis of related gynecological descriptions. RESULTS: The prevalence of menstrual disorders was significantly higher in the antidepressant group (24.6%) than the control group (12.2%). The incidence of antidepressant-induced menstruation disorder was 14.5%. The antidepressants most associated with menstrual disorders were paroxetine, venlafaxine, sertraline and their combination with mirtazapine. Overall, the incidence rate was similar in women receiving selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors. CONCLUSIONS: The results of the present study suggest that menstruation disorders are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some women.

Mayer-Rokitansky-Küster-Hauser syndrome associated with unilateral gonadal agenesis. A case report.

BACKGROUND: Mayer-Rokitansky-Küster-Hauser syndrome is the second most frequent cause of primary amenorrhea, with a reported incidence of 0.002%. Patients have a normal karyo-type and usually normal ovaries. Associated ovarian abnormalities are rarely reported. CASE: A 17-year-old woman with primary amenorrhea was evaluated by diagnostic laparoscopy, which showed complete müllerian agenesis. On the left side, the uterine tube and round ligament were hypoplastic, and the ovary was absent. The karyotype was 46, XX. Intravenous urography revealed a right kidney below the normal site with malrotation abnormality. CONCLUSION: Müllerian duct agenesis coexisting with unilateral ovarian agenesis and a contralateral renal abnormality has not been widely described before. Unilaterality might play a role in the etiologic factor of Mayer-Rokitansky-Küster-Hauser syndrome.