41 research outputs found
Cleft Palate and Lip with Fetal Ehlers-Danlos Syndrome Type 4
No full textSB-24Cleft Palate and Lip with Fetal Ehlers-Danlos Syndrome Type 4Umutcan KAYIKCI, Erdem Fadiloglu, Özgür DerenHacettepe Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Perinatoloji Biilim Dalı, AnkaraFetal cleft lip and palate (CLP) is a congenital anomaly that can present as part of various genetic syndromes,including Ehlers-Danlos Syndrome (EDS) Type 4, also known as the vascular type. EDS Type 4 is characterized bydefects in type III collagen synthesis, leading to tissue fragility, which can manifest in multiple systems,including the craniofacial region. The association of CLP with EDS Type 4 is less frequently documented butunderscores the importance of thorough prenatal diagnosis when EDS is suspected.In this case, the patient was diagnosed as Ehlers-Danlos Syndrome Type 4, Autosomal Dominant (Vascular typeEDS) with a diagnosis of bilateral cleft lip and palate and bilateral pes equinovarus in the 2nd trimester prenatalultrasonography and heterozygous mutation in COL3A1 gene as a result of whole exon sequencing performedby cordocentesis and her pregnancy was terminated at 32 weeks with the family request and perinatologycouncil recommendation.Prenatal ultrasonography, genetic examination and perinatology consultation are very important in theapproach to anomalies with expected severe morbidity.Anahtar Kelimeler: ehlers danlos syndrome, prenatal ultrasonography, genetic</p
Relationship between copper IUD complications and ultrasonographic findings
No full textObjective: Intrauterine device (IUD) is a widely used long-acting contraceptive method; however, the side-effects related to IUD may lead to method discontinuation. The aim of this study is to evaluate the relation between the most common side-effects of IUD use; mainly dysmenorrhea, menorrhaghia, pelvic cramping and the relation of these complications with the position of the IUD device within the cavity and uterine dimensions evaluated by transvaginal ultrasonography. Material and method: Two hundred and eighty-four patients who had Cu-T380A IUD insertion at the Family Planning Clinic of a tertiary health center were evaluated at insertion and 6 and 12 weeks after the insertion. Demographic characteristics, medical history, symptoms and findings of the gynecological examination were recorded. Transvaginal ultrasonographic measurement of the uterine dimensions, the distance between the tip of the Cu-IUD and the fundus, myometrium and endometrium were measured to evaluate the displacement of the IUD. The relationship between the symptoms and IUD displacement diagnosed by ultrasonographic examination were investigated. Results: Two hundred and sixty-seven patients were followed-up for 12 weeks as the remaining 16 had partial or complete IUD expulsion. A statistically significantly shorter uterine length was measured in patients who complained of menorrhagia in comparison to the ones without this complaint (54.27 ± 6.11 vs 60.25 ± 10.52 mm, p = 0.02) while uterine length was similar in patients with or without dysmenorrhea at 12 weeks (59.60 ± 10.25 vs 60.33 ± 10.68 mm, p = 0.71). The distances between the tip of the IUD and the endometrium, myometrium and the uterine fundus, were statistically and significantly longer in patients who experienced pelvic cramping at 3rd month, showing a downward movement of the IUD. (Endometrium; 0.29 ± 0.72 vs 0.45 ± 0.35 mm, p = 0.02, Myometrium; 1.25 ± 1.39 vs 2.38 ± 2.26 mm p < 0.05, Fundus; 1.68 ± 2.39 vs 2.92 ± 1.78 mm, p < 0.05). Conclusion: A shorter uterine cavity length seems to be a predictor of menorrhagia in patients with Cu-T 380A IUD. Patients experiencing pelvic cramping with IUD are more susceptible for IUD expulsion as the downward movement of IUD is more prominent in these patients
Isolated tubal torsion: Successful preoperative diagnosis of five cases using ultrasound and management with laparoscopy
No full textOur aim was to evaluate the presentation and diagnostic evaluation of patients with isolated tubal torsion and to evaluate the surgical approach to these patients. We also aimed to define the ultrasonographic diagnostic criteria. Five patients with isolated tubal torsion who were admitted to our gynecology department between January 2014 and January 2017 were evaluated and included in this study. All cases were diagnosed through ultrasonographic imaging alone. The preoperative findings of the patients were similar to those described in the literature. No further imaging modality was used for diagnosis and all patients were managed with laparoscopy. The clinical findings and ultrasonographic findings were consistent with literature. It may be difficult to preoperatively diagnose isolated tubal torsion, which is a rare clinical entity. Evaluation of these patients by an experienced sonographer and knowledge of the ultrasonographic findings of isolated tubal torsion may have vital preventive measures
NURSING STUDENTS' APPROACHES TOWARD EUTHANASIA
No full textBackground: In Turkey, which is a secular, democratic nation with a majority Muslim population, euthanasia is illegal and regarded as murder. Nurses and students can be faced with ethical dilemmas and a lack of a legal basis, with a conflict of religious beliefs and social and cultural values concerning euthanasia. The aim of this study was to investigate undergraduate nursing students' attitudes towards euthanasia. Method: The study, which had a descriptive design, was conducted with 600 students. The 1st, 2nd, 3rd, and 4th year nursing students at a school of nursing were contacted in May 2009, and 383 students (63.8% of the study population of a total of 600 students) gave informed consent. Two tools were used in accordance with questionnaire preparation rules. Results: The majority of students were female and single (96.9%), and their mean age was 21.3 +/- 1.5 years. A majority (78.9%) stated they had received no training course/education on the concept of euthanasia. Nearly one-third (32.4%) of the students were against euthanasia; 14.3% of the students in the study agreed that if their relatives had an irreversible, lethal condition, passive euthanasia could be performed. In addition, 24.8% of the students agreed that if they themselves had an irreversible, lethal condition, passive euthanasia could be performed. Less than half (42.5%) of the students thought that discussions about euthanasia could be useful. There was a significant relation between the study year and being against euthanasia (p < 0.05), the idea that euthanasia could be abused (p < 0.05), and the idea that euthanasia was unethical (p < 0.05). Conclusion: It was concluded that the lack of legal regulations, ethical considerations, religious beliefs, and work experience with dying patients affect nursing students' attitudes towards euthanasia
NURSING STUDENTS' APPROACHES TOWARD EUTHANASIA
No full textBackground: In Turkey, which is a secular, democratic nation with a majority Muslim population, euthanasia is illegal and regarded as murder. Nurses and students can be faced with ethical dilemmas and a lack of a legal basis, with a conflict of religious beliefs and social and cultural values concerning euthanasia. The aim of this study was to investigate undergraduate nursing students' attitudes towards euthanasia. Method: The study, which had a descriptive design, was conducted with 600 students. The 1st, 2nd, 3rd, and 4th year nursing students at a school of nursing were contacted in May 2009, and 383 students (63.8% of the study population of a total of 600 students) gave informed consent. Two tools were used in accordance with questionnaire preparation rules. Results: The majority of students were female and single (96.9%), and their mean age was 21.3 +/- 1.5 years. A majority (78.9%) stated they had received no training course/education on the concept of euthanasia. Nearly one-third (32.4%) of the students were against euthanasia; 14.3% of the students in the study agreed that if their relatives had an irreversible, lethal condition, passive euthanasia could be performed. In addition, 24.8% of the students agreed that if they themselves had an irreversible, lethal condition, passive euthanasia could be performed. Less than half (42.5%) of the students thought that discussions about euthanasia could be useful. There was a significant relation between the study year and being against euthanasia (p < 0.05), the idea that euthanasia could be abused (p < 0.05), and the idea that euthanasia was unethical (p < 0.05). Conclusion: It was concluded that the lack of legal regulations, ethical considerations, religious beliefs, and work experience with dying patients affect nursing students' attitudes towards euthanasia
Impact of Increased Activated Protein-C Resistance, Decreased Antithrombin III Activity and Hypocomplementemia on the Gestational Outcomes of Pregnancies with MTHFR Polymorphisms.
No full textManagement and the pregnancy outcomes of patients positive for anti-parietal cell antibody
No full textBACKGROUND: Autoimmunity is related to poor obstetric outcomes in previous studies. OBJECTIVE: To evaluate the management and the pregnancy outcomes of patients positive for anti-parietal cell antibody (APCA). METHODS: We retrospectively evaluated obstetric, neonatal outcomes and Beksac Obstetrics Index (BOI) of pregnancies with APCA positivity. Coexisting Methylentetrahydrofolate reductase (MTHFR) polymorphisms, other autoimmune antibody positivities, or thrombophilias were also evaluated in terms of obstetric outcomes. RESULTS: Of 39 pregnancies, three resulted in abortions (7.6%). The median gestational week and birthweight was 37 weeks and 2795 g. The median APGAR scores were 8, 9, and 9 for first, fifth, and tenth minute, respectively. Analysis involving additional risk factors showed no significant difference between the groups, evaluating APCA titers, MTHFR polymorphisms, or thrombophilia status. Significant difference was only observed for the fifth minute APGAR scores between the groups with other autoantibody positivities (p= 0.036). Despite lack of significant differences, patients with positivity for more than one autoimmune antibody had lower APGAR scores for the first and tenth minute, respectively (p= 0.727; p= 0.083). BOI analysis showed a statistically significant difference between the groups, demonstrating that more than one "antibody positivity" indicated a worse obstetric history. CONCLUSIONS: Patients with more than one autoantibody positivity, including APCA, must be considered as high-risk patients
The importance of proteinuria in preeclampsia and its predictive role in maternal and neonatal outcomes
No full textObjective: To evaluate impact of 24-h proteinuria level in preeclampsia on maternal/perinatal outcomes. Methods: Singleton pregnancies with preeclampsia delivered after 24 weeks of gestation were included. Patients were divided into mild (0.3 to <2 g) (n=72), severe (2 to <5 g) (n=30), and massive (≥5 g) (n=24) proteinuria groups, and cut-off values of 24-h proteinuria for composite adverse maternal and neonatal outcomes were calculated. Results: Twenty-four hour proteinuria level cut-offs for composite adverse outcomes were 3275 mg (72.2% sensitivity, 85.6% specificity) and 2395 mg (72.7% sensitivity, 78% specificity) respectively. Conclusion: Severe and massive proteinuria were related to poor maternal, perinatal, and neonatal outcomes
Effect of anti-epileptic drugs on first trimester screening test results
No full textObjective: To evaluate first trimester screening test parameters in epileptic patients using anti-epileptic drugs. Materials and methods: We retrospectively evaluated first trimester screening test results of 23 epileptic pregnant women using anti-epileptic drugs with a control group consisting of 92 healthy pregnancies. The anti-epileptic drugs used in this study were carbamazepine, levatiracetam, valproic acid and lamotrigine. Single drug or multi-drug regimens were used according to the clinical conditions. Patients with any known chronic or acute disease and drug usage were excluded from the study. Comparisons were performed via Mann–Whitney U test. Results: First trimester screening test biochemical markers were compared and maternal serum PAPP-A MoM values were found to be similar in study and control groups while β-hCG MoM values were significantly higher in pregnancies using epileptic drugs (p: 0,737 and p < 0.001, respectively). Conclusion: Biochemical first trimester screening test results may be affected by anti-epileptic drug usage, which may lead to misinterpretation of the risk level. Thus, validation of MoM values should be necessary in order to obtain optimal results
The Effect of Small Size Uterine Fibroids on Pregnancy Outcomes in High-risk Pregnancies
No full textObjective To evaluate the obstetric outcomes of singleton high-risk pregnancies with a small size uterine fibroid
