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Öğe Abdominal Sacrohysteropexy in Women with Uterovajinal Prolapse: Our 3 Years Clinical Experience(Derman Medical Publ, 2015) Karateke, Atilla; Kurt, Raziye Keskin; Dede, Mehmet; Ozkaya, Defne; Gul, AyhanAim: Weakening of uterine supporting ligaments, especially cardinal and uterosacral ligaments, causes uterovaginal prolapse. Although uterovaginal prolapse is not related to uterus, hysterectomy has been the most preferred surgery in these situations. However, in recent years, uterine preservation surgery has become popular because patients begin to prefer uterus preservation for psychological reasons and site specific surgery has been developed. One of the most important uterine preservation surgery is abdominal sacrohysteropexy(ASH). In this study, we aim to present our clinical result of ASH surgey in women with uterovaginal prolapsus. Material and Method: Of 27 patients who had ASH operation due to uterovaginal prolapsus between January 2010-March 2013 in our clinic were included in the study. All the patients had preoperative urogenital examination and transvaginal ultrasonography were performed before operation. Pelvic organ prolapsus degree were recorded according to the pelvic organ prolapsus quantification system(POP-Q). ASH operation was performed by laparatomy to all patients. Of 5 patients who had stress type incontinance had 'Burch' operation concomitantly. Results: The mean hospitalization day of patients who had ASH operation was 2.6 days(range 2-5days) and the mean age of patients were 52.8 +/- 7.5. None of the patients had bladder, ureter or intestine injury due to operation. While anatomical success rate were 92.6%, recurrence rate was 7.4 % at the end of first year. Ileus was not observed and only one patient who had burch operation had recurrent urinary incontinance symptoms at the end of the first year. Discussion: Our study results showed that ASH operation is a successfull operation in pelvic organ prolapse. This method also was found to be superior to others in terms of minimal complications.Öğe Can the ductus venosus doppler predict the hemoglobinopathies?(E-Century Publishing Corp, 2015) Karateke, Atilla; Silfeler, Dilek Benk; Gungoren, Arif; Kurt, Raziye Keskin; Okyay, Ayse Guler; Dokuyucu, Recep; Ulutas, TurkerObjective: The aim of our study was to investigate the ductus venosus doppler between 11-13+6 (weekday) in pregnant women with hemoglobinopaties and its relation with fetal outcomes. Material and methods: A total of 100 pregnant women with hemoglobinopathies and 100 healthy pregnant women were included in our study. Ultrasonography (USG) was performed to all pregnant women and the ductus venosus doppler (DVD) flows were evaluated. The results were statistically analyzed. Results: The mean hemoglobin level was significantly lower in hemoglobinopathy group (9.7 +/- 0.7) than control group (10.67 +/- 0.82) (P<0.001). There was a significant relationship between Vmax, Vmin, S/D and reverse 'a' wave in fetuses with hemoglobinopathies. Vmax, Vmin and S/D parameters were higher in the group of hemoglobinopathies (respectively mean value, 31.3 +/- 1.66, 8.90 +/- 0.81, 2.97 +/- 0.49). Reverse 'a' wave was detected especially in all fetuses with sickle cell anemia. There was no significantly relationship between the groups in terms of PI, RI and HR. In a logistic regression analyses, fetal hemoglobinopathy was independently associated with Vmin (beta = 1.07, P = 0.001), S/D (beta = 2.61, P = 0.001) and reverse 'a' wave (beta = 2.46, P = 0.004). Conclusion: Pregnant women with hemoglobinopathies had changed ductus venosus doppler values in compared to normal pregnant women. Maternal anemia may cause this doppler changes. Furthermore all fetuses with sickle cell anemia (n = 5) had abnormal ductus venosus doppler findings. Further studies are needed to investigate the relationship between abnormal ductus venosus doppler findings and fetuses diagnosed with sickle cell anemia.Öğe The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case-control study(Springer Heidelberg, 2014) Kurt, Raziye Keskin; Okyay, Ayse Guler; Hakverdi, Ali Ulvi; Gungoren, Arif; Dolapcioglu, Kenan Serdar; Karateke, Atilla; Dogan, Mustafa OzcilPrevious studies have shown increased inflammatory activity in patients with polycystic ovary syndrome (PCOS); however, it remains uncertain whether this increased inflammatory activity is a consequence of the disorder itself or of the accompanying obesity. We therefore aimed to test the inflammatory marker levels in obese and lean patients with PCOS by using two separate control groups with matching body mass index (BMI). A total of 120 women in reproductive age with (n = 62) and without (n = 60) PCOS were recruited for the study. Patients with PCOS were divided into two groups as obese (n = 32) and lean (n = 30) PCOS groups according to BMI. Two BMI-matched control groups were created. Furthermore, high sensitive CRP protein (hsCRP), neutrophils, lymphocytes, white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) were evaluated with complete blood count. The hsCRP (5.5 +/- A 0.8 vs. 3.1 +/- A 0.7, p < 0.001), neutrophil count (3.8 +/- A 0.4 vs. 2.9 +/- A 0.7, p < 0.001), leukocyte count (7.2 +/- A 1.8 vs. 5.6 +/- A 1.6, p < 0.001), and NLR (2.6 +/- A 1.4 vs. 1.5 +/- A 0.4, p < 0.001) were higher in patients with PCOS compared to the control group while lymphocyte count was lower (1.71 +/- A 0.65 vs. 1.98 +/- A 0.39, p = 0.008). Similarly, both obese and lean patients with PCOS had higher levels of hsCRP, neutrophils, leukocytes and NLR ratios compared to BMI-matched controls. The correlation analysis revealed a moderate correlation between NLR and hsCRP (r 0.459, p < 0.001), and between HOMA-IR (r 0.476 p < 0.001) and BMI (r 0.310, p 0.001). Our study results demonstrated that both lean and obese patients with PCOS have increased inflammatory markers compared to BMI-matched control groups indicating that the inflammation seen in PCOS might be related with the presence of the disorder rather than with obesity.Öğe The effect of Ramadan fasting on fetal development(Professional Medical Publications, 2015) Karateke, Atilla; Kaplanoglu, Mustafa; Avci, Fazil; Kurt, Raziye Keskin; Baloglu, AliObjective: To evaluate the effects of Ramadan fasting on fetal development and outcomes of pregnancy. Methods: We performed this study in Antakya State Hospital of Obstetrics and Child Care, between 28 June 2014 and 27 July 2014 (during the month of Ramadan). A total of two hundred forty healthy pregnant women who were fasting during Ramadan, were included in the groups. The three groups were divided according to the trimesters. The each group was consisted of 40 healthy pregnant women with fasting and 40 healthy pregnant women without fasting. For evaluating the effects of Ramadan on fetus, ultrasonography was performed on all pregnant women in the beginning and the end of Ramadan. We used the essential parameters for the following measurements: increase of fetal biparietal diameter (BPD), increase of fetal femur length (FL), increase of estimated fetal body weight (EFBW), fetal biophysical profile (BPP), amniotic fluid index (AFI), and umbilical artery systole/diastole (S/D) ratio. Results: No significant difference was found between the two groups for the fetal age, maternal weight gain (kilogram), estimated fetal weight gain (EFWG), fetal BPP, AFI, and umbilical artery S/D ratio. On the other hand, a statistically significant increase was observed in maternal weight in the second and third trimesters and a significant increase was observed in the amniotic fluid index in second trimester. Conclusion: In Ramadan there was no bad fetal outcome between pregnant women with fasting and pregnant women without fasting. Pregnant women who want to be with fast, should be examined by doctors, adequately get breakfast before starting to fast and after the fasting take essential calori and hydration. More comprehensive randomized studies are needed to explain the effects of fasting on the pregnancy and fetal outcomes.Öğe Erken 11 - 13+6 (hafta -gün) gebelik haftasında hemoglobinopatisi olan gebelerin fetuslarında duktus venosus doppler bulguları(Hatay Mustafa Kemal Üniversitesi, 2013) Karateke, Atilla; Şilfeler, Dilek BenkAmaç: Bulunduğumuz Akdeniz yöresinin en sık görülen hastalığı olan hemoglobinopatiler, hastada gebelik durumunda daha yakından takip edilmesi gereken bir hastalık grubudur. Çalışmamızda hemoglobinopatisi olan gebelerin, anemiden dolayı herhangi bir fetal etkilenme olup olmadığını araştırmak amacıyla 11 ? 13+6(hafta ?gün) gebe populasyonunda, duktus venosus doppler değerlendirilmesi ve gebelik sonuçlarına etkisini incelemek istedik. Yöntem: Hastanemiz obstetri polikliniğinde değerlendirilen, hemoglobinopatisi olan 100 gebe ve kontrol grubu olarak da herhangi bir hematojen hastalığı olmayan, eritrositleri normal olarak değerlendirilen sağlıklı olan 100 gebe olmak üzere toplamda 200 gebe çalışmaya alınmıştır. 200 gebenin tamamına ultrasonografi (USG) yapıldı ve duktus venosus doppler(DVD) akımları incelendi. Sonuçlar istatistiksel olarak değerlendirildi. Bulgular: Hemoglobinopatisi olan grupta hemoglobin(hb) ortalama 10.19 ± 0.90 olarak bulundu. İki grup arasında hb değerleri bakımından anlamlı fark bulundu. Doppler parametrelerinden Vmax, Vmin, S/D ve ters `a` dalgası ile hemoglobinopatili fetuslar arasında anlamlı ilişki saptandı. Vmax, Vmin, ve S/D parametreleri hemoglobinopatili grupta daha yüksek bulundu(sırasıyla ortalama değerler, 31,3 ± 1.66, 8,90 ± 0.81, 2,97 ± 0.49). Özellikle orak hücre anemili fetuslarda ters `a` dalgası, fetusların tamamında saptandı. PI, RI, HR açısından ise gruplar arasında anlamlı ilişki saptanamadı. Sonuçlar: Duktus venosus doppleri hemoglobinopatili fetusun tanısında ve prognozunda yardımcı olabilecek bir non-invaziv yöntemdir. İleriki yıllarda kullanımı artması beklenen doppler uygulamasının tanı koymanın ötesinde daha çok prognozu öngörmede kullanılması beklenmektedir. Anahtar sözcükler: Hemoglobinopati, Duktus Venosus Doppler, UltrasonografiÖğe Hatay yöresindeki gebelerde toksoplazma lgG seroprevalansı ve avidite testinin tanıya katkısı(2013) Okyay, Ayşe Güler; Karateke, Atilla; Yula, Erkan; İnci, Melek; Benk Şilfeler, Dilek; Köksaldı Motor, VicdanAmaç: Zorunlu hücre içi paraziti olan Toxoplazma gondii, dünyada sık görülen bir zoonoz olup, toksoplazmozis enfeksiyonuna neden olur. Enfeksiyon genellikle asemptomatik seyretmekle birlikte gebelik döneminde geçirildiğinde konjenital anomalili doğumlara, düşüklere, ölü doğum ve prematür doğuma neden olabilmektedir. Bu çalışmada, Hatay yöresindeki gebelerde Toxoplasma IgG ve IgM seroprevalansının saptanması amaçlanmıştır. Planlama: Çalışmaya 2007-2012 yılları arasında Hatay Mustafa Kemal Üniversitesi Kadın Hastalıkları ve Doğum polikliniğine başvuran 3340 gebe dahil edildi. Hastanemiz mikrobiyoloji laboratuvar kayıtları taranarak olguların Toxoplasma IgM ve IgG antikor test sonuçları retrospektif olarak incelendi. Toxoplazma IgM ve IgG testlerinin her ikisi birden pozitif olan 114 olguda ise IgG avidite testi yapıldı. Olgulara avidite testine göre tedavi, takip veya gebeliğin sonlandırılması önerildi. Değerlendirme parametreleri: Araştırmada % 3,6 (n:120 ) oranında IgM pozitişiği ve % 57 (n:1910 ) oranında ise IgG seropozitişiği saptandı. Avidite testi ile % 31 olguda yeni enfeksiyon tespit edildi. Yorum: Çalışmada Akdeniz bölgesinde özellikle Hatay ve yöresinde parazitin seropozitişiğinin dikkate değer düzeyde yüksek olduğu gözlenmiş olduğundan özellikle birinci trimesterdeki gebelerin ve gebelik planlayan kadınların rutin muayenelerinde Toxoplasma gondii antikor testi yapılması faydalı olabilir. Ayrıca, bölgemizde su ve hijyen açısından bilincin arttırılması için tedbirler alınmalıdır.Öğe Hipergonadotropik hipogonadizmin nadir bir nedeni olarak ullrich turner sendromu : olgu sunumu(2014) Şilfeler Benk, Dilek; Karateke, Atilla; Tertemiz, Selin; Dolapçıoğlu, Kenan Serdar; Güngören, Arif; Hakverdi, Ali Ulvi; Baloğlu, AliTurner sendromlu 45XO/46XY mozaikliği, nadir görülen kromozomal bir anomalidir. Yaklaşık 1/10.000‘de bir görülen bu mozaismin fenotip yansımaları normal bir erkekten, klasik Ullrich-Turner Sendromuna (UTS) kadar değişen çeşitliliktedir. Primer amenore şikayeti ile kliniğimize başvuran hastanın yapılan kromozom analiz sonucu 45XO/46XY olarak geldi.Öğe Increased Density of Demodex folliculorum Mites in Pregnancies with Gestational Diabetes(Karger, 2014) Kurt, Raziye Keskin; Kaya, Ozlem Aycan; Karateke, Atilla; Silfeler, Dilek Benk; Karapinar, Oya Soylu; Akkoca, Ayse Neslin; Hakverdi, Ali UlviObjective: To investigate the presence of Demodex in patients with gestational diabetes and the impact of glucose regulation on Demodex density in gestational diabetes. Subjects and Methods: The study population consisted of 33 patients with gestational diabetes and 30 pregnant women without gestational diabetes (control group). The age, parity, gestational age, and BMI of the study group were recorded and the patients were divided into 2 groups, i. e. those with regulated and unregulated glucose levels, according to their postprandial 1st-and 2nd-hour glucose values. A standardized skin surface biopsy method was used to determine if patients had Demodex folliculorum infestation (> 5 mites/cm 2 of skin). Results: Patients with gestational diabetes had a statistically significantly higher Demodex density compared to the control group (24.2 vs. 3.3%; p < 0.001). Furthermore, a significantly higher proportion of gestational diabetes patients with unregulated glucose levels had a higher Demodex density compared to those in the regulated subgroup (6/19 vs. 2/14; p = 0.001). Conclusion: Our study revealed that the Demodex density was increased in gestational diabetes patients. Further, poor glucose regulation could be the mechanism responsible for the increased Demodex density in gestational diabetes patients with unregulated glucose levels compared to those with regulated glucose levels. (C) 2014 S. Karger AG, BaselÖğe Investigation of Therapeutic Effects of Erdosteine on Polycystic Ovary Syndrome in a Rat Model(Karger, 2018) Karateke, Atilla; Dokuyucu, Recep; Dogan, Hatice; Ozgur, Tumay; Tas, Zeynel Abidin; Tutuk, Okan; Agturk, GokhanObjective: Polycystic ovary syndrome (PCOS) is a serious endocrine disorder. In the present study, we investigated the therapeutic effects of erdosteine in letrozole-induced PCOS in rats. Methods: Thirty-two Wistar albino female rats were grouped as control group (C), PCOS group (PCOS), PCOS-metformin group (PCOS+MET), and PCOS-erdosteine group (PCOS+Erd). PCOS was induced by administering letrozole; such rats presented with sex hormone disorder, abnormal estrous cycles determined by daily vaginal smear, large cystic follicles, and increasing fasting insulin levels. After induction of PCOS, metformin (500 mg/kg/day) and erdosteine (100 mg/kg/day) were given orally to the treatment groups for 30 days. Serum concentrations of glucose, total cholesterol, low-and high-density lipoprotein, triglyceride, as well as the total oxidant and antioxidant status, oxidative stress index, circulating estrone (E1), estradiol (E2), testosterone, and androstenedione were evaluated. The ovaries were graded histologically. Results: Weights of ovarian tissues (p < 0.05) and the number of atretic follicles (p < 0.001) and cystic follicles (p < 0.01) decreased in the PCOS+Erd group; the corpus luteum number was significantly higher in the PCOS+Erd group (p < 0.01) as compared with the PCOS group. Lipid parameters (total-C, LDL-C, and TG), E1 (estrone), E1/E2 ratio, testosterone, and androstenedione significantly decreased, while HDL-C and E2 (estradiol) significantly increased in the PCOS+Erd group as compared with the PCOS group. Moreover glucose, insulin, and HOMA-IR were reduced with treatment of erdosteine (p > 0.05, p < 0.001, and p < 0.001, respectively). Conclusion: It is suggested that erdosteine may be used in the treatment of PCOS as an alternative to metformin. It appears that our findings might be supported by clinical and molecular studies. (c) 2018 The Author(s) Published by S. Karger AG, BaselÖğe Menopausal cardiomyopathy: Does it really exist? A case-control deformation imaging study(Wiley, 2014) Kurt, Raziye Keskin; Nacar, Alper B.; Guler, Ayse; Silfeler, Dilek B.; Buyukkaya, Eyup; Karateke, Atilla; Kurt, MustafaAim We aimed to evaluate and compare the left ventricular (LV) functions of pre- and postmenopausal women at similar ages with none of the known cardiovascular risk factors, by both conventional and advanced echocardiographic methods such as 2-D strain imaging via speckle tracking echocardiography. Methods The study population consisted of 40 healthy postmenopausal women aged 45-50 years and 40 healthy premenopausal women of the same age group. None of the subjects had any cardiovascular risk factors and were on hormone replacement therapy. LV strain and strain rate parameters were measured by 2-D strain imaging. The main outcome measure was effect of menopause on LV function. Results There were no significant differences between the pre- and postmenopausal groups with regard to conventional echocardiographic parameters. LV longitudinal strain and LV early diastolic strain rate values were significantly lower in the postmenopausal group when compared to the premenopausal group. Also, there was a significant negative correlation between LV global strain and serum follicle-stimulating hormone (r=-0.349, P=0.002). Conclusion Our study results demonstrated that healthy postmenopausal women had lower LV longitudinal strain values when compared to the healthy premenopausal women of the same age group by speckle tracking echocardiography.Öğe Nadir bir sendrom, cantrell pentalojisi : olgu sunumu(2016) Karateke, Atilla; Keskin Kurt, Raziye; Çelik, ÇetinCantrell pentalojisi, omfalosel ve torako-abdominal ön duvar defektiyle birlikte ektopia kordisin beraber görüldüğü nadir bir sendromdur. Etyopatogenezi net olarak bilinmeyen bu sendromlu fetusların prognozu kötüdür. Gebeliğin 25.haftasında kliniğe başvuran olgunun yapılan ultrasonografik muayenesinde Cantrell pentalojisinin tüm özellikleri saptanmıştır. Bu yazıda Cantrell pentalojisi güncel literatür eşliğinde tartışılmıştırÖğe Orak hücre anemisi olan gebelerde perinatal ve maternal sonuçlar(2014) Keskin Kurt, Raziye; Güngören, Arif; Hakverdi, Ali Ulvi; Dolapçıoğlu, Kenan Serdar; Silfeler Benk, Dilek; Karapınar Soylu, Oya; Karateke, AtillaAmaç: Maternal orak hücreli anemi hastalığı (SCA) olan gebeliklerin çoğu canlı doğum ile sonuçlanmasına karşın, bu gebeliklerde fetal ve maternal komplikasyonlar için artmış risk söz konusudur. Çalışmanın amacı Hatay ilinde orak hücreli anemisi ve SCA taşıyıcı olan gebelerde maternal ve fetal komplikasyonları araştırmaktır. Gereç ve Yöntem: Çalışmaya kadın doğum polikliniğine başvuran 150 gebe dahil edildi (50 SCA gebe, 50 SCA taşıyıcısı olan gebe ve 50 kronik hastalığı olmayan gebe). Hastaların hemogram değerleri, gebeliğinde yapılan transfüzyon sayısı, maternal ve fetal komplikasyonlar, doğum haftası, doğum şekli, doğum ağırlığı, 1. ve 5. dakika APGAR skoru kaydedildi. Bulgular: Gebelikte transfüzyon yapılan gebe sayısı SCA ve SCA taşıyıcı grupta daha fazlaydı (p<0.01). SCA grubunda 2 maternal mortalite olgusu görüldü. Diğer gruplarda ise maternal mortalite izlenmedi (p<0.01). SCA grubunda 4 hastada pyelonefrit izlenirken, diğer gebelerde pyelonefrit izlenmedi (p<0.01). Gruplar arasında benzer fetal komplikasyonlar izlendi (p>0.05). Sonuç: Çalışmamız sonucunda orak hücre gebeliklerinin, SCA taşıyıcısı ve kronik hastalığı olmayan gebeliklerle kıyaslandığında fetal sonuçların benzer olduğu fakat pyelonefrit ve maternal ölüm de dahil artmış maternal komplikasyon ile ilişkili olduğu bulunmuştur. Maternal ölüm oranı % 4 olup, pulmoner emboliye bağlanmıştır. SCA gebelikleri yüksek riskli gebeliklerdir ve multidisipliner, deneyimli merkezlerde takip edilmelidir.Öğe Primer abdominal gebelik : Olgu sunumu(2011) Benk Şilfeler, Dilek; Güngören, Arif; Dolapçıoğlu, Kenan; Karateke, Atilla; Güney, Çağatay; Akın, Mehmet Mustafa; Hakverdi, Ali Ulvi; Baloğlu, AliPrimer abdominal gebelik tüm ektopik gebeliklerin yalnızca %1’ini oluşturur. Abdominal gebeliklerde gestasyonel kese genellikle pelvise veya karaciğer ve mezenter gibi yüksek vasküler bölgelere implante olur. Maternal morbidite ve mortalitenin önemli nedenlerindendir. Erken tanı ve tedavi ile potansiyel mortalite ciddi bir şekilde azaltılabilir. Tanı, Studdiford abdominal kriterleri ile konur. Gebelik haftasının erken olduğu uygun olgu grubunda laparoskopik cerrahi tedavide yüz güldürücüdür. Cerrahinin yeterli olmadığı durumlarda sistemik veya lokal metotreksat tedavisi oldukça başarılı sonuçlar verir.Öğe Protective Effects of Colchicine in an Experimental Rat Endometriosis Model: Histopathological Evaluation and Assessment of TNF-? Levels(Sage Publications Inc, 2015) Kurt, Raziye Keskin; Pinar, Neslihan; Karateke, Atilla; Okyay, Ayse Guler; Silfeler, Dilek Benk; Albayrak, Aynur; Ozdemir, SeydaObjective: Endometriosis is an estrogen-dependent chronic inflammatory disease observed in reproductive period. The aim of the present study is to assess the efficacy of colchicine, widely used to treat many inflammatory diseases, in an experimental rat endometriosis model. Study Design: Experimental endometriosis was constituted with implantation of autogenous endometrial tissue. Rats were divided randomly into 2 groups as colchicine group (n = 8) and control group (n =8). Although oral 0.1 mg/kg colchicine was administered 4 weeks to the colchicine group, the same amount of saline solution was administered to the control group. Before and after 30 days of treatment period, peritoneal and tissue tumor necrosis factor (TNF-), the volumes and histopathological properties of the implants were evaluated. Results: Although the implant volume decreased significantly in the colchicine group (89.2 13.4 mm(3) to 35.2 +/- 4.5 mm(3), P < .05), the implant volume increased in the control group (85.1 +/- 14.2 mm3 to 110.3 +/- 10.5 mm(3), P < .05). When compared to the control group, the colchicine group had significantly lower histopathologic sores (1.4 +/- 0.2 vs 2.6 +/- 0.4, P < .001). Although peritoneal fluid TNF- levels were significantly decreased in the colchicine group (45.2 +/- 5.3 pg/mL vs 12.1 +/- 5.2 pg/mL, P < .001), the peritoneal fluid TNF- levels were significantly increased in the control group after the treatment (44.2 +/- 3.5 pg/mL vs 61.3 +/- 12.2 pg/mL; P < .001). Tissue TNF- levels were significantly lower in the colchicine group when compared to the control group (45.4 +/- 8.6 pg/mL vs 71.3 +/- 11.2 pg/mL; P < .001). Conclusion: Colchicine resulted in regression of endometrial implant volumes in experimental rat endometriosis model and decreased peritoneal and tissue TNF- levels.Öğe Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum(Via Medica, 2014) Kurt, Raziye Keskin; Guler, Ayse; Silfeler, Dilek Benk; Ozcil, Mustafa Dogan; Karateke, Atilla; Hakverdi, Ali UlviObjectives: The aim of our study is to determine the newly introduced systemic inflammation marker, neutrophil lymphocyte ratio (NLR) in hyperemesis gravidarum (HG) patients and to investigate the association between severity of the disease and NLR. Method: The study population consisted of 55 pregnant patients with HG and 50 pregnant women without complaints matched for gestational age as a control group. The HG patients were grouped as mild (n=16), moderate (n=19) and severe (n=20) according to Modified Pregnancy-Unique Quantification of Emesis and Nausea Scoring Index Questionnaire. Furthermore, hsCRP, neutrophils, lymphocytes, and NLR were evaluated with complete blood count. Results: The HG group had significantly higher NLR values compared to the control group (2.69 +/- 1.81 vs 1.97 +/- 1.34, p=0.004). HsCRP levels were significantly higher among HG patients compared to the control group (1.95 +/- 2.2 vs 0.56 +/- 0.30, p<0.001). The subgroup analysis revealed statistically significant increases in NLR and hsCRP values with increased HG severity (p<0.001, p=0.002). The correlation analysis demonstrated a strong correlation between NLR and hsCRP levels (r: 0.703, p<0.001). Conclusion: Our study results showed that NLR and hsCRP levels are increased in HG disease compared to gestational age matched control group subjects. Furthermore, NLR and hsCRP values are correlated with severity of disease. NLR could be used as a marker for both presence and severity of hyperemesis gravidarum.Öğe Romatoid artrit ve gebelik : 15 olgu sunumu(2014) Karateke, Atilla; Kurt Keskin, Raziye; Paksoy, Hacer; Erman, Abdullah YağızAmaç: Romatoid artrit (RA), yetişkin populasyonun yaklaşık %1-2’sinde görülmekte olup, kadınlarda görülme sıklığı, erkeklerden fazladır. RA’lı kadınların önemli bir kısmı da reprodüktif çağdadır. RA’nın aktivitesi gebelikte genellikle azalırken, bir kısmında ise semptomlar daha da kötüleşir. RA tedavisinde kullanılan ilaçların, gebelik üzerine etkisi tam bilinmediğinden dolayı, gebelik sürecinde hastalığın tedavisi tartışmalıdır. Bu yazıda amacımız, kliniğimiz de gebelik ve RA tanıları ile takip edilen olguların antenatal ve postnatal dönemdeki klinik özelliklerinin irdelenmesidir. Gereç ve Yöntemler: Bu çalışmaya RA tanısıyla takip edilen 15 hasta dahil edilmiştir. Gebelik öncesi kullanılan tedavi kesilmiş ve hastalar sadece prednol ve parasetamol almıştır. Bu sürede gebelerin takibi aynı klinisyen tarafından yapılmıştır. Ultrasonografi ile seri fetal ölçümler ve 3. trimestırda non-reaktif stres (NST) testi yapıldı. Gebelik boyunca her ay RA açısından klinik muayene yapıldı. Ayrıca her ay laboratuvar testlerinden tam kan sayımı, biokimya ile eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) çalışıldı. İstatiksel analiz SPPS 17.0 programı ile yapıldı. Bulgular: Hastaların yaş ortalaması 26.7 ± 1.2 (20-32) idi. Onbeş, hastanın ondördünde gebelik öncesinde RA mevcut iken, sadece bir tanesi hamilelik döneminde yeni tanı almıştır. Oniki RA’lı gebede semptomlar düzelirken, ikisinde şiddetlendiği gözlenmiştir. Gebelikte yeni tanı alan RA hastasına perinatal dönemde prednol ve sadece ağrı kesici olarak parasetamol verilirken, postpartum dönemde sulfasalazin başlanmıştır. Postpartum dönemde onbir hastada semptomlar yeniden şiddetlendi ve bunlara sulfasalazin başlandı. RA semptomları gebelikte azalan olgularda laboratuvar bulgularının gebelik haftası ilerledikçe azaldığı görülürken, klinik bulguların da aynı şekilde gerilediği izlenmiştir. ESH ve CRP ile hassas eklem sayısı ve şiş eklem sayısı arasında pozitif korelasyon olduğu tespit edilmiştir (r= 0.678, p: 0.02). Sonuç: RA’sı olan hastalara gebelik öncesinde kullandıkları ilaçların gebelikte zararlı olabileceği ve gebelik döneminde semptomların değişebileceği hakkında danış- manlık verilmelidir. RA’sı olan gebeler, gebelik döneminde yakından takip edilerek semptomlara yönelik tedavi uygulanmalıdır. Postpartum dönemde semptomların yeniden şiddetlenebileceği akılda tutulmalı ve hastalar bu konuda uyarılmalıdır. Ayrıca gebelik öncesi metotreksat kullanan hastalara emzirme döneminde de bu ilacın kontrendike olduğu anlatılmalıdır ve bunun yerine diğer ilaçlar düşünülmelidir.Öğe SEROPREVALANCE OF TOXOPLASMA IgG AMONG PREGNANT WOMEN IN THE PROVINCE OF HATAY AND CONTRIBUTION OF AVIDITY TEST TO THE DIAGNOSE(Galenos Yayincilik, 2013) Okyay, Ayfle Guler; Karateke, Atilla; Yula, Erkan; Inci, Melek; Silfeler, Dilek Benk; Motor, Vicdan KoksaldiObjective: Toxoplasma gondii, an obligate intracellular parasite, is a common zoonosis in the world and causes toxoplasmosis. The infection is usually asymptomatic and if it occurs during pregnancy it may cause congenital anomalies, miscarriage, stillbirth and premature delivery. In this study, determination of seroprevalance of Toxoplasma IgG and IgM among pregnant women in the province of Hatay was aimed. In addition, IgG avidity test was performed in subjects who had positive test results for both of the two antibodies. Design: In this study, 3340 pregnant women who admitted to the outpatient clinic of Gynecology and Obstetrics Department of Mustafa Kemal University between the years of 2007 and 2012 were included. Toxoplasma IgM and IgG antibody test results of the subjects were examined retrospectively by screening the records of microbiology laboratory of the hospital. Additionally, IgG avidity test was performed in 114 cases whose test results for both Toxoplasma IgM and IgG were positive. Main outcome measures: IgM and IgG seropositivity rates were found as 3.6% (n : 120) and 57% (n: 1910), respectively. The rate of new infection was detected with avidity test as 31%. Conclusions: Since remarkably high seropositivity rate was observed in the Mediterranean region especially in the province of Hatay, antibody testing for Toxoplasma gondii may be useful during routine examinations of women who are in this region. In addition, measures should be taken to raise awareness of hygiene in our region in terms of water and sanitation.
