19 research outputs found
Incidence and outcome of prenatal brain abnormality in twin-to-twin transfusion syndrome: systematic review and meta-analysis
No full textOBJECTIVES: to ascertain the incidence of antenatally diagnosed brain injuries in twin pregnancies complicated by twin to twin transfusion syndrome (TTTS) and to quantify the perinatal mortality, morbidity and long-term neurodevelopmental outcomes of these fetuses. METHODS: Medline, Embase, Clinicaltrials.gov and Cochrane Library databases were searched. Inclusion criteria were studies reporting on brain abnormalities diagnosed antenatally in twin pregnancies complicated by TTTS. The primary outcome was the incidence of prenatal brain abnormalities. The secondary outcomes were intrauterine demise (IUD), neonatal death, termination of pregnancy (TOP) and long-term morbidity. All these outcomes were explored in the overall population of fetuses with antenatal diagnosis of brain abnormalities. Sub-group analysis according to: type of treatment, gestational age and Quintero stage at diagnosis and/or treatment, co-twin death was planned. Meta-analyses of proportions were used to combine data and reported pooled proportion and their 95% confidence intervals (CI). RESULTS: Thirteen studies including 1573 cases of TTTS and 88 fetuses with an antenatal diagnosis of brain abnormalities were included in the systematic review. The meta-analysis included only studies reporting on brain abnormalities in twin pregnancies complicated by TTTS cases and treated with laser. Overall, brain injuries occurred in 2.2% of fetuses (eight studies (52/2410 fetuses)). These brain abnormalities were reported in 1.03% and 0.82% of recipients or donors, respectively. These abnormalities were mainly ischemic lesions (30.4%, 95%CI 19.1-43), followed by destructive lesions (23.9%, 95%CI 13.7-35.9), ventriculomegaly (19.9%, 95% CI 10.6-31.3) and hemorrhagic (15.3%, 95%CI 7.1-25.8). Spontaneous IUD occurred in 13.4% (95%CI 5.1-24.8) of fetuses, while TOP was chosen by parents in 53.5% (95%CI 38.9-67.8) cases. Neonatal death was reported only by three studies with an incidence of 15.4% (95%CI 2.8-35.4). Finally, only two studies reported on composite morbidity with 20.4% of morbidity reported overall (95%CI 2.5-49.4) which occurred in 29.7% and 20.4% of the recipient and donor fetuses, respectively. Due to the small numbers, only composite morbidity was analyzed and no information on neonatal intensive care unit admission, respiratory distress syndrome or other long-term outcomes such as neurodevelopmental delay or cerebral palsy could be reliably retrieved. CONCLUSIONS: The overall incidence of antenatally diagnosed fetal brain abnormalities in fetuses from twin pregnancies complicated by TTTS treated with laser is around 2%, mainly ischemic (30.4%) in nature. TOP was chosen by parents in almost half of the cases (53.5%). No information could be retrieved on morbidity outcomes, highlighting the urgent need for long-term follow up studies of these children
Perinatal outcomes of twin pregnancies complicated by late twin‐twin transfusion syndrome: A systematic review and meta‐analysis
No full textIntroduction
Untreated twin‐to‐twin transfusion syndrome (TTTS) is associated with a high risk of perinatal mortality and morbidity. Laser surgery is recommended before 26 weeks of gestation. However, the optimal management in case of late TTTS (occurring after 26 weeks of gestation) is yet to be established.
Material and methods
We conducted a systematic review and meta‐analysis to evaluate the outcomes of monochorionic‐diamniotic twin pregnancies complicated by late TTTS according to different management options (expectant, laser therapy, amnioreduction, or delivery). The primary outcome was mortality, including single and double intrauterine, neonatal, and perinatal death. Secondary outcomes were composite morbidity, neuromorbidity, respiratory distress syndrome, admission to neonatal intensive care unit, intact survival (ie, free from neurological complications), and preterm birth before <32 weeks of gestation. Outcomes were reviewed according to the management and reported for the overall population of twins and disease status (ie, donor and recipient separately). Random‐effect meta‐analyses of proportions were used to analyze the data.
Results
Nine studies including 796 twin pregnancies affected by TTTS were included. No randomized controlled trials were available for inclusion. TTTS occurred at ≥26 weeks of gestation in 8.7% (95% CI 6.9%‐10.9%; 67/769) of cases reporting TTTS at all gestations. Intrauterine death occurred in 17.7% (95% CI 4.9%‐36.2%) of pregnancies managed expectantly, 5.3% (95% CI 0.9%‐12.9%) of pregnancies treated with laser, and 0% (95% CI 0%‐9%) after amnioreduction. Neonatal death occurred in 42.5% (95% CI 17.5%‐69.7%) of pregnancies managed expectantly, in 2.8% (95% CI 0.3%‐7.7%) of cases treated with laser, and in 20.2% (95% CI 6%‐40%) after amnioreduction. Only one study (10 cases) reported data on immediate delivery after diagnosis with no perinatal deaths. Perinatal death incidence was 55.7% (95% CI 31.4%‐78.6%) in twin pregnancies managed expectantly, 5.6% (95% CI 0.5%‐15.3%) in those treated with laser, and 20.2% (95% CI 6%‐40%) in those after amnioreduction. Intact survival was reported in 44.4%, 96.4%, and 78% of fetuses managed expectantly, with laser or amnioreduction, respectively.
Conclusions
Evidence regarding perinatal mortality and morbidity in twin pregnancies complicated by late TTTS according to the different managements was of very low quality. Therefore further high‐quality research in this field is needed to elucidate the optimal management of these pregnancies
Perinatal outcomes of twin pregnancies affected by early twin‐twin transfusion syndrome: A systematic review and meta‐analysis
No full textIntroduction
Twin‐to‐twin transfusion syndrome (TTTS) is associated with a high risk of perinatal mortality and morbidity if not treated. However, the optimal timing and management in case of early (occurring < 18 weeks) TTTS has not been established yet.
Material and methods
This is a systematic review and meta‐analysis aiming at evaluating the outcomes of monochorionic diamniotic twin pregnancies complicated by early (ie before 18 weeks) TTTS according to different management options (expectant, laser therapy, amnioreduction or cord occlusion). The primary outcome was mortality, including single and double intrauterine, neonatal and perinatal death. Secondary outcomes were: composite morbidity, neuromorbidity, respiratory distress syndrome, admission to neonatal intensive care unit, intact survival (defined as survival free from neurological complications) and preterm birth < 32 weeks of gestation. All outcomes were reviewed according to the different management options (expectant, laser therapy, amnioreduction or cord occlusion) and reported FOR the overall population of twins, and for the donor and recipient separately. Subgroup analysis for TTTS occurring before 16 weeks of gestation was performed. Random‐effect meta‐analyses of proportions were used to analyse the data.
Results
Thirteen studies were included. Early TTTS occurred in 14.3% (95% confidence interval [CI] 11.9‐17.0) of cases. The incidence of intrauterine death was 19.0% (95% CI 2.6‐45.5) in twins managed expectantly, 32.4% (95% CI 16.5‐50.7) in those who received laser treatment and 12.5% (95% CI 4.8‐23.0) in those treated with amnioreduction. The incidence of neonatal death was 22.6% (95% CI 4.2‐49.8) in twins managed expectantly, 24.7% (95% CI 0.5‐80.3) in those who received laser and 20.2 (95% CI 5.8‐43.4) in those who had amnioreduction; it was not possible to compute the incidence of these outcomes in twins undergoing cord occlusion because of insufficient sample and lack of reporting of most of the observed outcomes. Overall, the incidence of perinatal death was 43.9% (95% CI 5.9‐87.7) in twins managed expectantly, 47.3% (95% CI 21.4‐70.0) in those treated with laser and 28.5% in those who had amnioreduction.
Conclusions
Twin pregnancies affected by early TTTS are at substantial risk of perinatal mortality and morbidity; however, the data come from very small studies with a high risk of selection bias
Effects of soil amendments combined with solarization on the soil microbial community in strawberry cultivation using quantitative real-time PCR
No full textExperiments were conducted in commercial fields of strawberry-growing areas of the Aydin Province of Turkey during two cropping seasons: 2010-2011 and 2011-2012. Each year, eight separate treatments were used: (1) untreated control (C), (2) solarization alone (S), (3) solarization + broccoli (SBr), (4) solarization + fava bean (SFB), (5) solarization + dry olive-mill wastewater (SDOMW), (6) solarization + rice hulls (SRH), (7) solarization + sulfur powder (SSu), and (8) solarization + vermicast (SVe). DNA was extracted from bulk soil samples before and after solarization. The populations of the major taxonomic groups of bacteria and soil-borne fungal pathogens of strawberry were quantitatively calculated by quantitative real-time PCR (qPCR) with specific primer pairs using standard curves. The marketable fruit yield was recorded in the experimental plots. After the 6-week solarization period, there were significant reductions for total bacteria and for alpha-Proteobacteria in all of the experimental plots, except for SDOMW. However, the abundance of beta-Proteobacteria significantly increased in all of the experimental plots (except for C and SFB in 2011). Significant increases in Firmicutes and Actinobacteria were also recorded in all of the treated plots. The highest significant increase was noticed with SDOMW treatments for total bacteria, alpha-Proteobacteria, beta-Proteobacteria, Firmicutes and Actinobacteria in both years. The target level of Verticillium spp. Rhizoctonia solani and Fusarium oxysporum decreased significantly in all of the treated plots after solarization in both years. The reductions of M. phaseolina were significant in S, SVe, and SSu and were the highest in SDOMW in 2011; these reductions were significant in S, SSu and SDOMW in 2012. The abundance of Trichoderma spp. decreased insignificantly in all of the experimental plots. The highest significant yields were obtained from the combination of SDOMW, SRH and SSu compared to solarization alone in both seasons
Effects of soil solarization and some amendments to control verticillium wilt in established olive orchards
No full textThe effects of solarization treatments, alone or with organic amendments and urea against verticillium wilt on olives were studied. Trials were carried out during the 2005 - 2007 seasons in an olive orchard consisting of 700 4 - 6 year old trees (cv Gemlik) in Germencik region of Aydin. Five treatments were carried out: Solarization (S), solarization + chicken manure (SCM) (1 kg m-2), solarization + olive processing waste (SOPW) (2 kg m-2), solarization + urea (SU) (100 g m-2) and an untreated control (C). Maximum soil temperatures reached in solarized plots were 54.7 and 43.9°C and in the non-solarized plots were 44.4 and 37.4°C at 5 and 20 cm soil depth, respectively. At the end of two years, the disease incidence and severity index decreased to zero in the treatments that included S. In the SCM treatment and in the control, the highest severity index (8.0) was recorded while the disease incidence slightly decreased from 66.7 to 44.4%. In SOPW plots, the disease severity index decreased to 2.0 and the disease incidence remained the same. In SU plots, the disease severity index decreased from 5.6 to 4.5 and disease incidence slightly decreased to 44.4%. As a result, the trees treated with solarization alone and solarization with olive processing waste showed an increased recovery and symptom remission compared with the initial disease severity and incidence.Key words: Olea europaea, Verticillium dahliae, amendments
Effect of Different Musical Types on Patient\u27s Relaxation, Anxiety and Pain Perception During Shock Wave Lithotripsy: A Randomized Controlled Study
No full textPURPOSE: The aim of this study was to investigate the effects of listening to different music types during extracorporeal shock wave lithotripsy (SWL) on the patients\u27 pain control, anxiety level, and satisfaction. MATERIALS AND METHODS: This study was a prospective single-blinded, paral-lel-group randomized clinical trial with balanced ran-domization [1:1]. A total of 150 patients who underwent first-session SWL were included in the study. The patients were randomly divided in to five groups (30 participants in each group) as follows: headphones were not put on and no music was played in Group 1 (control group); headphones were put on but no music was played in Group 2; Turkish art music was listened to with headphones in Group 3; Western classical music was listened to with headphones in Group 4; thetype of music the patient liked was listened to with headphones in Group 5. Demographic data related to patients and procedure, State-Trait Anxiety Inventory-State Anxiety (STAI-SA), Visual Analog Scale (VAS) scores, willingness to repeat procedure (0: never 4: happily), and patient satisfaction rates (0: poor 4: excellent) were recorded immediately after the procedure. RESULTS: There was a statistically significant difference between groups in terms of median VAS scores (7, 6, 4.5, 5, and 4, respectively, P\u3c .001), whereas the VAS scores in Groups 3, 4, and 5 were significantly lower than those in Group 1 and 2 (P\u3c .001). The median STAI-SA scores between the groups were significantly different (45, 45, 42, 45, and 40, respectively, P\u3c .001), while the anxiety levels in Groups 3, 4, and 5 were significantly lower than those in Group 1 (P=.008, P=.018, and P\u3c .001, respectively). Moreover, there were statistically significant differences between the groups in terms of willingness to repeat the procedure and patient satisfaction rates (P\u3c .001). CONCLUSIONS: Music therapy during SWL reduced the patients\u27 pain and anxiety scores, moreover listening to the patient\u27s preferred music type provided greater satisfaction. Listening to the patient\u27s preferred music type could be standardized and routinely used during SWL
Development of a double monoclonal antibody sandwich ELISA test for Verticillium dahliae Kleb.
No full textVerticillium dahliae causes wilt diseases in a wide range of horticultural and field crops in many parts of Turkey. In the Aegean region it has been a serious problem in cotton and vegetables for many years. More recently, it has become a major problem for olive growers in relatively newly established orchards. The fact that the only possible control methods of Verticillium wilt disease is the use of healthy and pathogen free propagating material has directed us to produce monoclonal antibodies against V. dahliae in order to apply rapid, sensitive and reliable serological detection methods. Verticillium spp. isolates were obtained from olive plantations, as well as from cotton and tomato fields in the Aegean and Marmara Regions. All suspected isolates were obtained as V. dahliae after determining microscopic morphological characteristics and pathogenicity tests on cotton seedlings. Immunizing antigens were prepared by three different methods including surface washing system, czapek dox agar and gel filtration methods. BALB/c mice were immunized with each antigenic form. Lymph node, spleen and bone marrow cells were used as sources of B-lymphocytes and 8D2 (IgM) and 7D6 (IgG1) were obtained from the spleen and lymph node fusion. The monoclonal antibodies were purified and immunoglobulin types were identified. 8D2 monoclonal antibody gave positive reaction with the V. dahliae isolates from olive, cotton, tomato and watermelon; however, it didn't give any cross reactivity with other epiphytic fungi. 7D6 antibody displayed cross-reactions with a few fungi. The monoclonal antibody ( 8D2) was conjugated with horseradish peroxidase (HRP). These monoclonal antibodies were characterized for use in the development of diagnostic kits based on double-monoclonal antibody sandwich ELISA test system for detecting V. dahliae in Turkish isolates. In this test, the first antibody was used as capture antibody and the second one was used for detection of antigens
Relationship between mean platelet volume, platelet distribution width, plateletcrit and varicocele
No full textIncreases in platelet count and platelet indices such as mean platelet volume (MPV), platelet distribution width (RDW) and plateletcrit (PCT) have been reported in a wide range of pathological settings. The aetiology of varicocele, a vascular disease, is poorly defined. In this study, we aimed to examine the relationship between varicocele, platelet count and a series of platelet indices. A total of 69 patients with varicocele and 56 patients without varicocele were enrolled in the study. Patient sperm parameters, platelet, MPV, PDW and PCT values were analysed. There were semen abnormalities in 37 (53.6%) patients in the varicocele group and 19 (33.9%) patients in nonvaricocele group (P < 0.05). There was no significant difference in platelet count or platelet indices (MPV, PDW and PCT) between the patients with and without varicocele (P < 0.05). There was no statistically significant difference in platelet count or MPV, PDW and PCT between patients with varicocele and the control subjects
First Report of Bacterial Blight Caused by <i>Pseudomonas syringae</i> pv. <i>pisi</i> on Pea in Turkey
No full text In April of 2009, leaf blight symptoms were observed on field peas (Pisum sativum L.) grown in Söke, Torbali, and Ödemis counties in the Aegean Region of Turkey. Field inspections revealed disease incidence as high as 45% and the disease was found in 13 commercial fields. Initial symptoms consisted of small, dark green, water-soaked lesions on leaves, stipules, and stems near ground level. Lesions often enlarged and coalesced and turned chocolate brown with a water-soaked margin. Stem infections usually coalesced and girdled the stem spreading upward to stipules and leaflets forming a fan-like lesion on the stipule. A fluorescent, gram-negative bacterium was consistently isolated from diseased tissues onto King's B medium. Twelve strains (five from cv. Early Sweet, three from cv. Geneva, two from cv. Bolero, and two from cv. Carina) from thirteen pea fields were obtained. All strains metabolized glucose oxidatively, and their reactions in LOPAT tests were +, —, —, —, +, and thus classified as belonging to Pseudomonas syringae LOPAT group Ia (1). The 12 strains utilized homoserine, inositol, sorbitol, sucrose, mannitol, and mannose but did not utilize erythritol, trehalose, and L-tartarate. All showed ice nucleation activity but variable results were obtained for gelatin liquefaction and esculin hydrolysis. Identification of P. syringae pv. pisi was confirmed by sequencing the 16S rDNA with primers Univ-1390R (3) and 27F (2). Sequences of the three local strains (Bz2, Bz4, and Bz8) were 100% identical to a type culture strain. The nucleotide sequence of strain Bz4 was submitted to GenBank (Accession No. GU332546). Pathogenicity tests were performed on greenhouse-grown 2-week-old pea plants cv. Geneva as three replicates in 12-cm pots containing a steamed sand/peat/soil mixture. Plants were stab inoculated by puncturing the main stem at its junction with the stipules at the second node from the apical end with a 26-gauge needle through a 5-μl drop of 108 CFU/ml bacterial suspensions. Control plants were inoculated with sterile water. After 10 days of incubation in a growth chamber at 24 ± 1°C with a 14-h photoperiod, stems inoculated with pea isolates resulted in water-soaked tissue spreading from the site of inoculation along the veins on stipules and leaflets that were identical to symptoms seen in the field. Control plants remained symptomless. Isolates recovered from the symptomatic stems showed the same morphological and biochemical features of the original isolates. All physiological and biochemical tests as well as the pathogenicity assay were performed at least twice and the type strain of P. syringae pv. pisi (NCPPB 2585) was used as reference. On the basis of the physiological, biochemical, genetic, and pathological characteristics, all strains were identified as P. syringae pv. pisi. To our knowledge, this is the first report of P. syringae pv. pisi causing bacterial blight on pea in Turkey. Turkey currently produces approximately 93.000 t of peas annually and three-quarters of that is produced in Western Anatolia. The new disease may represent a limiting factor for future production. References: (1) R. A. Lelliott et al. J. Appl. Bacteriol. 29:470, 1966. (2) W. G. Weisburg et al. J. Bacteriol. 173:697, 1991. (3) D. Zeng et al. Appl. Environ. Microbiol. 62:4504, 1996. </jats:p
OC28.03: Home blood pressure monitoring in pregnant women during antenatal and postpartum period: a systematic review and meta‐analysis
No full text
