Isolation, identification, and in vitro probiotic characterization of forty novel Bifidobacterium strains from neonatal feces in Erzurum province, Türkiye

BACKGROUND

Neonatal feces are one of the most important sources for probiotic isolation. The purpose of this study was the isolation and identification of Bifidobacterium spp. from neonatal feces and the evaluation of in vitro probiotic properties of strains including safety tests.

RESULTS

A total of 40 isolates were obtained from 14 healthy newborns' feces in Erzurum province, Türkiye. By their rep-PCR patterns and 16S rRNA gene sequences, isolates were identified as 26 Bifidobacterium breve and 14 Bifidobacterium longum. Fifteen of the isolates tolerated bile salts and showed high resistance to simulated gastric juice. Isolates exhibited varying rates of auto-aggregation and hydrophobicity. In addition, most of the isolates displayed antibacterial activity against Escherichia coli O157:H7, Staphylococcus aureus ATCC 29213, Salmonella Typhimurium RSHMB 95091, and Pseudomonas aeruginosa ATCC 9027. However, only one strain showed bile salt hydrolase activity and two strains showed the ability to produce H2O2. Bifidobacterium strains were generally sensitive to the tested antibiotics and lacked kanamycin, gentamicin, and streptomycin resistance genes, and hemolytic and DNAse activities. On the other hand, it was determined that five strains had various virulence genes including gelE, esp, efaAfs, hyl, and ace.

CONCLUSION

Results of the present study suggested that B. longum BH28, B. breve BH4 and B. breve BH5 strains have the potential as probiotic candidates for further studies. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Intra-gastric balloon with lifestyle modification: a promising therapeutic option for overweight and obese patients with metabolic dysfunction-associated steatotic liver disease

BACKGROUND

Data on effects of intra-gastric balloon (IGB) on metabolic dysfunction-associated steatotic liver disease (MASLD) are scarce, in part with contradictory results, and mainly obtained in tertiary care patients with diabetes and other comorbidities. We here explore effects of IGB in patients with MASLD referred to a first-line obesity clinic.

METHODS

In this prospective cohort study, patients with at least significant fibrosis (≥ F2) and/or severe steatosis (S3) according to screening transient elastography (FibroScan®) were offered a second FibroScan® after 6 months lifestyle modification with or without IGB (based on patient preference).

RESULTS

50 of 100 consecutively screened patients (generally non-diabetic) qualified for repeated evaluation and 29 (58%) of those had a second FibroScan®. At baseline, at least significant fibrosis was present in 28% and severe steatosis in 91%. IGB was placed in 19 patients (59%), whereas 10 patients (41%) preferred only lifestyle modification (no differences in baseline characteristics between both groups). After 6 months, liver stiffness decreased markedly in the IGB group (median: from 6.0 to 4.9 kPa, p = 0.005), but not in the lifestyle modification only group (median: from 5.5 to 6.9 kPa, p = 0.477). Steatosis improved in both groups, (controlled attenuation parameter values; IGB, mean ± SD: from 328 ± 34 to 272 ± 62 dB/m, p = 0.006: lifestyle modification only, mean ± SD: from 344 ± 33 to 305 ± 43 dB/m: p = 0.006).

CONCLUSION

Both steatosis and fibrosis improve markedly in overweight/obese patients with MASLD after 6 months IGB combined with lifestyle modification. Our results warrant further research into long-term effect of IGB in these patients.

Cortices of Fibula and Tibia Can Provide Landmarks for Accurate Syndesmosis Fixation Angle: Computed Tomography Validation of Angle Bisector Method

Anatomic syndesmosis reduction is necessary to restore ankle biomechanics and prevent poor clinical outcomes, but malreduction can be encountered frequently since the ideal fixation angle varies between patients and fixation levels. This study aimed to validate the angle bisector method to reveal whether it provides an accurate syndesmotic fixation angle that is patient- and level-specific. Lower extremity CT angiography of 50 consecutive patients (25 male, 25 female) without evident ankle pathology were evaluated. The average age was 52.8 (±18, range: 18-75). Lines tangent to anterior and posterior cortices of tibia and fibula were drawn in the axial plane at both 2 cm and 3.5 cm above the ankle joint line. Bisection of the angle formed between these lines was drawn and its relationship with the centroidal axis, which is proposed to be the ideal syndesmotic axis, was evaluated. The angle between the bisector line & the centroidal axis and the distance between their most lateral intersections with the fibula were calculated. The measurements were made by 3 blinded observers. Intra- and interobserver reliability analyses were conducted. The average centroidal axis-bisector angle was 2.1° ± 2.1° at 2 cm and 0.6° ± 1.3° at 3.5 cm level. The average distance to the actual syndesmosis entry point was 1.0 ± 0.9 mm at 2 cm and 0.4 ± 0.4 mm at 3.5 cm level. The values didn't show any significant difference according to gender. Intra- and interobserver reliability analysis showed excellent correlation in all parameters (interclass correlation coefficient > 0.90). Angle bisector method was found strongly reliable providing accurate direction for syndesmotic axis. It can provide a patient- and level-specific angle for the application of syndesmotic implants without increasing the fluoroscopy exposure. Its use can have a broad impact on functional outcomes of ankle injuries by decreasing the malreduction rates. Further cadaveric validation and safety studies should be conducted for possible clinical usage.

Does resveratrol reduce cisplatin-induced ovarian damage?

OBJECTIVE

The objective of this study was to investigate the protectiveness of resveratrol on cisplatin-induced damage to the ovary using experimental models.

METHODS

A total of 30 female Wistar-Albino rats constituted the research material. The rats were categorized into three groups: Group 1 was administered one milliliter of 0.9% NaCl solution, Group 2 was administered 7.5 mg/kg cisplatin, and Group 3 was administered 7.5 mg/kg cisplatin and 10 mg/kg resveratrol. Ovaries were extirpated in all groups and subjected to biochemical and histopathological tests. Cisplatin-induced damage to ovarian tissue was graded and scored as the total histopathological findings score. The ovarian function was assessed using immunohistochemical staining for c-kit expression. Rats' malondialdehyde, catalase, and superoxide dismutase levels were determined.

RESULTS

The histopathological finding score was significantly higher in Group 2 than in other groups (p<0.05). The superoxide dismutase and catalase levels were significantly higher in Group 3 than in Group 2 (p<0.001 for both cases). The malondialdehyde level was significantly higher in Group 2 than in Group 3 (p<0.001).

CONCLUSION

The study findings demonstrated that resveratrol reduced ovarian injury and enhanced biochemical parameters following cisplatin-induced ovary damage in experimental models.

First Dark Matter Search with Nuclear Recoils from the XENONnT Experiment

We report on the first search for nuclear recoils from dark matter in the form of weakly interacting massive particles (WIMPs) with the XENONnT experiment, which is based on a two-phase time projection chamber with a sensitive liquid xenon mass of 5.9 ton. During the (1.09±0.03)  ton yr exposure used for this search, the intrinsic ^{85}Kr and ^{222}Rn concentrations in the liquid target are reduced to unprecedentedly low levels, giving an electronic recoil background rate of (15.8±1.3)  events/ton yr keV in the region of interest. A blind analysis of nuclear recoil events with energies between 3.3 and 60.5 keV finds no significant excess. This leads to a minimum upper limit on the spin-independent WIMP-nucleon cross section of 2.58×10^{-47}  cm^{2} for a WIMP mass of 28  GeV/c^{2} at 90% confidence level. Limits for spin-dependent interactions are also provided. Both the limit and the sensitivity for the full range of WIMP masses analyzed here improve on previous results obtained with the XENON1T experiment for the same exposure.

Searching for Heavy Dark Matter near the Planck Mass with XENON1T

Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10^{12} and 2×10^{17}  GeV/c^{2}. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale.

Utilizing linkage-specific ethyl-esterification approach to perform in-depth analysis of sialylated N-glycans present on milk whey glycoproteins

Glycosylation of milk whey proteins, specifically the presence of sialic acid-containing glycan residues, causes functional changes in these proteins. This study aimed to analyze the N-glycome of milk whey glycoproteins from various milk sources using a linkage-specific ethyl esterification approach with MALDI-MS (matrix-assisted laser desorption/ionization-mass spectrometry). The results showed that the N-glycan profiles of bovine and buffalo whey mostly overlapped. Acetylated N-glycans were only detected in donkey milk whey at a rate of 16.06%. a2,6-linked N-Acetylneuraminic acid (a2,6-linked NeuAc, E) was found to be the predominant sialylation type in human milk whey (65.16%). The amount of a2,6-linked NeuAc in bovine, buffalo, goat, and donkey whey glycoproteomes was 42.33%, 44.16%, 39.00%, and 34.86%, respectively. The relative abundances of a2,6-linked N-Glycolylneuraminic acid (a2,6-linked NeuGc, Ge) in bovine, buffalo, goat, and donkey whey were 7.52%, 5.41%, 28.24%, and 17.31%, respectively. Goat whey exhibited the highest amount of a2,3-linked N-Glycolylneuraminic acid (a2,3-linked NeuGc, Gl, 8.62%), while bovine and donkey whey contained only 2.14% and 1.11%, respectively.

Placental and Umbilical Cord Blood Oxidative Stress Level and Telomere Homeostasis in Early Onset Severe Preeclampsia

OBJECTIVE

Although the etiopathogenesis of preeclampsia (PE) is unknown, evidence suggests that it may be associated with increased oxidative stress. Studies have shown that oxidative stress can affect DNA fragments called telomeres. However, the interactions of PE, oxidative stress, and telomere length are not clearly known. This study aims to evaluate the oxidative/anti-oxidative stress balance in the placenta and umbilical cord and examine the effect of oxidative stress on telomeres.

MATERIALS-METHOD

Cord blood and placental samples were collected from 27 pregnant women with severe PE (28^0/7-33^6/7 gestational weeks) and 53 healthy pregnant women. Telomere length (TL) was measured by real-time PCR in the cord blood and placenta tissue. Total antioxidant status (TAS) and total oxidant status (TOS) levels were measured in the cord blood and placenta tissue using a colorimetric method.

RESULTS

No significant differences were found between groups regarding age, BMI, gravida, parity, and newborn gender (p>0.05). Cord blood and placental TL of PE patients were significantly shorter than the control group, while cord blood and placental TAS and TOS levels were higher (p<0.05). The results of a multivariate logistic regression analysis showed that the level of placental TOS in PE patients (OR=1.212, 95% CI=1.068-1.375) was an independent risk factor affecting PE.

CONCLUSION

This study found that oxidative stress is an independent risk factor in the development of PE and shortens TL in both placental and umbilical cord blood. Future research on telomere homeostasis may offer a new perspective for the treatment of PE.

Determining attitudes toward e-learning: what are the attitudes of health professional students?

Aim

The research was carried out to determine the attitudes of nursing undergraduate students toward e-learning implemented during the COVID-19 pandemic.

Subject and methods

The study sample consisted of 320 undergraduate students studying at the Faculty of Health Sciences, Nursing Department of a state university. Personal Information Form and the Test of e-Learning Related Attitudes were administered to the research participants.

Results

Of the students, 68.8% were female and 51.6% were between the ages of 21-24. The attitude of 55.3% (177) toward e-learning is negative. Attitude scores of students aged 25-29 were significantly higher compared to those aged 17-20 and 21-24 years old (p = 0.002). The attitude scores of the students who have a computer are significantly higher than those who do not (p = 0.001). Most students did not agree with the statement "E-learning will provide me with better learning opportunities than conventional learning methods." (disagree n = 121; 37.8%, strongly disagree n = 110; 34.4%).

Conclusion

It is noticed that e-learning is not sufficient in subjects such as conducting clinical and laboratory practices in health sciences fields with practical training like nursing, and students' attitudes are generally negative. For undergraduate health sciences education, face-to-face and online education for support purposes can be used together in theoretical courses. In addition, it is recommended to use effective online communication techniques in online courses.

Evaluation of the Effects of Different Natural Dietary Feed Additives on Performance and Intestinal Histomorphology in Quails

The aim of the present study was to investigate the influence of a commercial probiotic and a commercial essential oil blend and their mixture, as a natural feed additive, on growth parameters live weight (LW), live weight gain (LWG), feed intake (FI), feed conversion ratio (FCR), carcass yield (CY) and small intestinal histomorphology of quails. A total of 200 1-day-old Japanese (Coturnix coturnix japonica) quails, including both males and females, were divided into four groups containing 50 quails and treated as follows: (1) a control treatment without medication (2) 18 g ton-1 probiotic;  (3) 300 g ton-1  essential oil blend  and (4) 18 g ton-1  probiotic plus 300 g ton-1 essential oil blend. The results of the research show that the additives added to quail diets do not have a significant effect (P > 0.05) on the performance parameters of LW, LWG, FI and FCR. However, significant differences (P < 0.05) were found in the CY, which is one of the performance parameters. A probiotic addition of 18 g ton -1 (treatment 1) to the quail diet resulted in a significant increase (P < 0.05) in carcass yield. Moreover, the addition of natural feed additives such as probiotics, essential oil blends and mixture to quail diets caused significant (P < 0.001) increases in villus heights and crypt depth in the duodenum and ileum segments. In addition, significant (P < 0.05) enlargements were found in the villus surface area in the experimental groups compared to the control group. In conclusion, in this study, it was determined that the addition of feed additives, which are developed as an alternative to antibiotics to the quail diet did not have a negative effect on performance and caused significant differences in the effective parameters in the evaluation of intestinal health.

Search for New Physics in Electronic Recoil Data from XENONnT

We report on a blinded analysis of low-energy electronic recoil data from the first science run of the XENONnT dark matter experiment. Novel subsystems and the increased 5.9 ton liquid xenon target reduced the background in the (1, 30) keV search region to (15.8±1.3)  events/(ton×year×keV), the lowest ever achieved in a dark matter detector and ∼5 times lower than in XENON1T. With an exposure of 1.16 ton-years, we observe no excess above background and set stringent new limits on solar axions, an enhanced neutrino magnetic moment, and bosonic dark matter.

AB0212 COMPARISON OF THE EFFECTS OF POLYPHARMACY IN THE TREATMENT OF RHEUMATOID ARTHRITIS PATIENTS AND PSORIATIC ARTHRITIS PATIENTS WITH PERIPHERAL JOINT INVOLVEMENT

Background

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are chronic, progressive inflammatory diseases that can be accompanied by other diseases. These patients use several medications, especially due to their comorbidities and widespread pain. In recent years, with the increase in the lifespan of individuals, the concept of polypharmacy has become more prominent. Accordingly, in our study, we aimed to present the prevalence of polypharmacy and its effects on these diseases.

Objectives

Demonstrating the prevalence of polypharmacy in RA and PsA, which are among the most frequently encountered inflammatory arthritides, and the effects of polypharmacy on disease activity.

Methods

This study included PsA patients with only peripheral joint involvement and no distal interphalangeal joint involvement and RA patients. The numbers of medications used by the patients at the onset of their treatment and in the sixth month of their treatment were recorded. Non-prescribed (over the counter), topical and herbal/homeopathic medications were excluded. Polypharmacy was accepted as the simultaneous use of at least five medications by the person. Disease activity score in 28 joints C-reactive protein (DAS-28 CRP) was used for disease activity for both diseases. In addition to these, the scores of the patients who attended their follow-ups in the 12th month were calculated and analyzed. The Charlson Comorbidity Index (CCI) scores of the patient were calculated based on their chronic diseases.

Results

The sample of the study included 232 RA and 73 PsA patients. Demographic and some clinical characteristics are shown in Table 1. The mean numbers of medication used by the patients at the onset of their treatment were respectively 5.09±2.89 and 4.03±2.7 for the RA and PsA patients, whereas these mean numbers were found consecutively as 8.67±3.58 and 7.71±3.3 in the sixth month of their treatment. Polypharmacy was present in the sixth month of the treatment in 217 (93.5%) RA and 61 (83.6%) PsA patients.

Table 1.

Demographic and some clinical features

RA (n=232)PSA (n=73)Age (mean±SD)55.2±13.6648.4±13.43Age Group<65 years171(73.7)65(89)≥65 years61(26.3)8(11)SexFemale, n (%)172(74.1)50(68.5)Male, n (%)60(25.9)23(31.5)Current smoker, n (%)82(35.3)33(45.2)The numbers of medication used8.67±3.587.71±3.3Polypharmacy at the Beginning of Treatment115(49.6)28(38.4)Polypharmacy in the sixth month of treatment217(93.5)61(83.6)CCI (n=232/72) (mean±SD)1.25±0.881.31±0.710th month DAS-28 CRP (mean±SD)4.91±1.284.68±1.036th month DAS-28 CRP (mean±SD)3.14±1.062.86±0.9912th month DAS-28 CRP (n=83/29) (mean±SD)2.73±1.182.8±1.12

While the mean ages of the RA and PsA patients who had polypharmacy treatment at the beginning were respectively 59.21±12.65 and 53.5±13.81, their ages were significantly higher than the ages of those who did not receive polypharmacy treatment (respectively, 51.26±13.53 and 45.22±12.3).

In RA ve PsA patients, the status of polypharmacy is higher in the groups in the groups aged 65 and over than those under 65 years of age, and it is statistically significant (p=0.001 and p=0.048, respectively). The risk of polypharmacy in people over 65 years of age in RA patients was 8.2 times, and the risk of polypharmacy in people over 65 years old in PSA patients was increased 6.3 times (p=0.015).

In both the RA and PSA groups, patients with baseline polypharmacy had statistically significantly higher DAS-28 CRP scores at 6 months of treatment than those without baseline polypharmacy. (p<0.001). While the higher DAS-28 CRP score was maintained at 12 months in the RA group with polypharmacy at baseline (p=0.006), this was not significant in the PSA group (p=0.07).

Conclusion

Polypharmacy was present both at the time of diagnosis and in the treatment process in the RA and PsA patients, and the presence of polypharmacy at the beginning of the treatment was among the factors that affected the treatment of these patients by significantly affecting their 6th-month DAS-28 CRP values.

Disclosure of Interests

None declared

Characteristics and research trends of 50 most-cited hallux rigidus papers

BACKGROUND

The bibliometric studies in the field of orthopaedics have gained popularity since they can determine the characteristics and research trends of most influential papers in specific subjects. This study aimed to evaluate the 50 most-cited articles related to hallux rigidus, and analyze possible factors associated with increased citation counts.

METHODS

The available literature about hallux rigidus on Web of Science database until January 2021 were analyzed and the 50 most-cited articles were determined. The characteristics of the papers were documented and analyzed for any relationship or correlation with total citation or citation per year (citation density) values.

RESULTS

The average citation number and citation density were 52.8 (range: 26-243) and 3 (range: 0.8-12.8), respectively. The average author number was 3.4, while the average institution number was 1.9. The USA had the highest number of articles with 29. Twenty-six papers were case-series, only 3 studies had level 1 and only 2 had level 2 evidence. The highest number of articles were published in Foot and Ankle International with 22 papers. Forty papers were clinical studies while 10 were reviews. Five studies were multicentric.

CONCLUSION

This study provided the general characteristic and research trends of 50 most influential hallux rigidus papers. The number of institutions and references were positively correlated with citation density, indicating a higher chance of getting cited for papers with collaborations from different institutions and papers using more references from other works. Publication year was also positively correlated with citation density, indicating the better performance of more recent articles.

LEVEL OF CLINICAL EVIDENCE

Level 3.

Evaluation of occurrence, fate and removal of priority phthalate esters (PAEs) in wastewater and sewage sludge by advanced biological treatment, waste stabilization pond and constructed wetland

Phthalate Esters (PAEs), detected in high concentrations generally in treated wastewater discharged from wastewater treatment plants (WWTPs), are important pollutants that restrict the reuse of wastewater. Investigating the fate of these endocrine-disrupting chemicals in WWTPs is crucial in order to protect both receiving environments and ecosystems. For this purpose, di(2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP) and benzyl butyl phthalate (BBP) in the group of PAEs were monitored in simultaneously both in wastewater and sludge lines of selected two nature-based WWTPs and one advanced biological WWTP. Although it was frequently stated that phthalates were significantly removed in WWTPs in many studies found in literature, negative removal efficiencies of selected phthalates in investigated WWTPs during the sampling period were observed generally in this study. One of the reasons for this concentration increase could be releasing of phthalates from microplastics in wastewater during the treatment process or the desorption of PAEs from treatment sludge. DNOP was the compound with the highest concentration increase at almost each treatment unit of the three WWTPs. On the other hand, total PAEs load was 1997 g d^-1 in advanced biological WWTP and adsorption onto sludge of PAEs were determined as 90%. The side-stream total load returned from the decanter supernatant was 0.02% of the total PAEs load coming to advanced biological WWTP from the sewer system. As a result of detailed statistical analysis, the correlation between raw wastewater and primary clarifier (PC) effluent was determined as an increasing linear relation for DEHP and DNOP. On the other hand, moderate and strong correlations were observed both between septic tank and constructed wetland (CW) processes with raw wastewater. In the waste stabilization pond (WSP), while a significant correlation was not found between the sludge line data, homogeneous variance, strong and moderate correlations were obtained in the wastewater line data. However, while mean differences for all investigated PAEs were not significant (p > 0.05) in the wastewater line, mean differences of DEHP (p < 0.05) were significant in the sludge line according to ANOVA analysis.

Brucellosis in pregnancy and its response to the changing immunoglobulin A: A prospective controlled study

Objective:

This study aimed to define the rare Brucella infection in pregnancy and its effects on immunoglobulins (Ig).

Materials and Methods:

This prospective study has conducted Brucella screening using the Rose Bengal test on pregnant and non-pregnant outpatients who did not show any specific Brucella symptoms. The immunoglobulin levels were measured using the enzyme-linked immunosorbent assay. The study group consisted of pregnant women who were at 20 weeks or below gestation and applied to our hospital outpatient clinic for routine check-ups. The control group consisted of healthy patients who applied for routine controls.

Results:

This study included a total of 584 participants, 293 of whom were controls and 291 were the study (pregnant) participants. The study revealed a 1.5% incidence of Brucella during pregnancy. In acute and chronic Brucella infection, lower levels of IgA response were observed in pregnant cases compared to the control group.

Conclusion:

Brucella infection is a disease that can cause fetal problems, especially in endemic areas. The role of the altered IgA response in pathologies that are associated with Brucella infection stands out as a new target for disease pathophysiology.

Future anxiety and coping methods of nursing students during COVID-19 pandemic: A cross-sectional study

The aim of this research is to examine the methods of nursing students to deal with future anxiety and stress.It is a cross-sectional survey conducted in Turkey with 291 students in Çukurova University of Faculty of Health Sciences, Kahramanmaraş Sütçü İmam University Health College and Batman University Health College Nursing Department in June 2020. Personal Data Form, Stress Coping Scale, State and Trait Anxiety Scale were sent online to students' smartphones and/or e-mails as data collection tools and it was collected this way.The mean age of the participants was 21.09 ± 2.02 (years). 78% of respondents were women. 48.4% of the participants were students of Çukurova University. It was determined that 201 (69.1%) of the participants isolated themselves during the pandemic. It was found that 171 students (58.8%) spent 23 to 24 hours at home, whereas 284 students (97.6%) spent time with their parents/siblings. 47.4% of respondents stated that they had spent the pandemic watching a series/film. 47.1% of respondents had good family relationships. 50.2% of respondents had good relationships with college friends. 74.9% of respondents said they were happy. Women's trait anxiety scale scores were higher than men's (P < .05). Men have higher problem-Oriented coping scores than women (P < .05). Significant differences were found in the Status Anxiety Scale scores and trait anxiety scale scores according to self-isolation status (P < .05). A significant difference was found in terms of state anxiety scale and trait anxiety scale according to happiness status (P < .05). The problem-based coping scores of those who were happy with the Stress Coping Scale were higher than those who were not happy (P < .05). The state anxiety scale of the students was 42.54, and the trait anxiety scale was 45.16.Nursing students' status and sustained Anxiety Scale scores were moderate. It is important for individuals to have good family and friends and to be happy in the process of the Corona Virus Disease pandemic.

Examining the Knowledge Level of the Nurses and Midwives Had Neonatal Resuscitation Program (NRP) Practitioner Training Course

Background and Purpose

Methods

Results

Implications for Practice

Implications for Research

Cervicovaginal coronavirus disease 2019 (COVID-19) positivity: A pilot study

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can potentially infect female reproductive organs. In this study, we investigated the presence of SARS-CoV-2 in cervicovaginal fluid. This study included 31 female patients aged 18–65 years. The presence of SARS-CoV-2 RNA was investigated by RT‒PCR in two separate cervicovaginal swab samples collected from patients 14 days apart. Viral RNA was extracted using Bio-Speedy ®vNAT® Viral Nucleic Acid Buffer (vNAT) solution, and SARS-CoV-2 RNA was analyzed using Bio-Speedy SARS-CoV-2 RT‒qPCR kits in a Bio-Rad CFX96 TouchTM device. First and second cervical swab samples were collected 14 days apart. The SARS-CoV-2 RNA result was negative in all 53 cervicovaginal swab samples collected. Negative SARS-CoV-2 RNA results in cervicovaginal swab samples indicate that coronavirus disease 2019 (COVID-19) is not sexually transmitted. However, the number of studies on this subject and the sample size examined are still insufficient for reaching this conclusion.

Congenital afibrinogenemia in a newborn

Introduction: Congenital afibrinogenemia is a rare coagulation disorder characterized by a deficiency in the fibrinogen molecule. Fibrinogen is a hexameric glycoprotein consisting of a polypeptide chain encoded by FGB, FGA, and FGG and is required for normal hemostasis. Changes in FGA, FGB, and FGG may affect fibrinogen at different levels. As a result of these changes, fibrinogen cannot be detected in the blood. Clinical manifestations of such changes range from asymptomatic to life-threatening bleeding or thromboembolic events. Since it is an autosomal recessive disease, the risk is higher in children whose parents are related. Therefore, the disease is more common in regions where consanguineous marriage rates are high. Diagnosis is made by laboratory tests that show the absence of fibrinogen. These patients need to be treated with fibrinogen replacement therapy. Case presentation: This study reports the case of a newborn with congenital afibrinogenemia. The baby born from a first-degree consanguineous marriage was referred to our hospital due to bleeding and ecchymosis, and afibrinogenemia was diagnosed after coagulation tests were performed. Blood samples of the patient and his parents were sent to the Genetic Diseases Diagnosis Center for a genetic diagnosis of afibrinogenemia. A new homozygous mutation of FGB exon 7: c.1220c > t (p.t407 m) (p.thr407 met) was identified in the patient. The patients' parents were heterozygous for the same mutation. Prophylaxis was not recommended for our patient who was asymptomatic in the follow-up. Conclusions: We present the case of a hemorrhagic neonatal patient diagnosed with congenital afibrinogenemia and emphasize that fibrinogen testing should be included in the evaluation of such patients. Furthermore, congenital fibrinogen disorders may be more severe when caused due to unknown specific mutation genes. Therefore, a more center-involved genetic analysis is required to identify undiagnosed fibrinogen and fibrinogen mutations.

Increased serum myonectin and irisin levels with myonectin and FNDC5 expressions in polycystic ovary syndrome: a case control study

The aim of this study is to assess the FNDC5 and myonectin expressions and serum levels of myonectin and irisin in women with PCOS. 90 participants were included in this case-control study. 45 of these participants were with PCOS, and 45 of them were healthy volunteers matched for age and body mass index (BMI). Serum irisin and myonectin levels were measured with commercially available enzyme-linked immune sorbent assay (ELISA) kits. Expression of the myonectin and FNDC5 genes were determined by RT-PCR analysis. It was found out that FSI, HOMA-IR, LH, LH/FSH, TT, serum irisin and serum myonectin levels, myonectin mRNA expression, and FNDC5 mRNA expression were higher in the PCOS group, whereas HDL-C level was lower in the PCOS group (p < .05). When the groups were compared, it was detected that IR and HA were significantly higher in the PCOS group (p < .05). Serum irisin and myonectin levels, and myonectin and FNDC5 mRNA expressions were increased in women with PCOS. These molecules can be target molecules in PCOS pathophysiology and treatment.IMPACT STATEMENTWhat is already known on this subject? Although the aetiology of PCOS is not fully understood, it is thought that insulin resistance may play a critical role. In recent studies, the relationship of cytokines secreted from skeletal muscle with insulin resistance has been shown. The effects of irisin and myonectin, which are members of the myokine family, on lipid and glucose metabolism are known.What do the results of this study add? Although there are many studies in the literature regarding serum irisin levels in women with PCOS, their results are confusing. There is a study in the literature investigating the relationship between myonectin and PCOS. In our study, we evaluated myonectin and FNDC mRNA expressions in addition to serum irisin and myonectin levels. As a result, we found that markers and their mRNA expressions were lower in patients with PCOS compared to controls.What are the implications of these findings for clinical practice and/or further research? We think that the results of our study will shed light on future studies. Due to their effects on adipose tissue, these markers may play a role in the aetiology of long-term complications of PCOS. Moreover, they can become pharmacological targets in preventing these complications.

An Intervention Study to Increase the Medication Compliance of 60 Years and Older Individuals

Background

In older age, taking medication at the desired level contributes to the health and well-being, and therefore, constitutes an essential part of the effectiveness of treatment and ultimately desired public health impact and reduced healthcare budgets. However, it is known that medication compliance among older persons is frequently not at a desired level. Therefore, in this study, it was aimed to increase medication compliance through an educational intervention for patients aged 60 and over, who applied to two healthcare facilities in Ankara, Turkey.

Methods

This intervention study was implemented in two public health hospitals between March and June 2019. 315 people aged 60 and over participated in the study. The intervention tool was the “teach-back” method. SPSS program was used for data entry and analysis. P value less than 0.05 was indicated for statistical significance.

Results

Mean age of the participants was found to be 70.16±7.9 for the control group and 70.27±7.4 for the intervention group. In the intervention group, a statistically significant increase was found in the capacity of learning the long-term benefits of drugs, their side effects and storage conditions, and knowing when the drugs shouldn't be taken, and repeating information about the drugs used (p = 0.000).

Conclusions

This study has revealed that medication compliance among older individuals can be increased with an appropriate communication and training method in healthcare settings. Time allocated by health workers in this regard has a potential to respond to the compliance-related needs. With the “Teach-back” method utilized in the interactions between older patients and health workers, it is possible to attain meaningful, large-scale and cost-effective public health outcomes that contribute to the clinical benefits of treatments and the effectiveness of health systems.

Key messages

Older people are open to receive information on the actual health needs. A well-structured interaction between healthcare workers and patients involving “teach-back” method contributes to medication compliance among the elderly.

The prevalence of non-vascular pulmonary manifestations in Takayasu's Arteritis patients: A Retrospective multi-centred Turkish cohort study

Objectives Takayasu's arteritis (TAK) is a rare vasculitis characterized by inflammation of intermediate- to large-size arteries. Although pulmonary artery involvement (PAI) is an expected finding in some TAK patients, data on non-vascular pulmonary involvement (NVPI) are limited. We aimed to investigate the frequency of NVPI, including parenchymal infiltration, nodules/cavities, pleural effusion, and haemorrhage, in TAK.Method We assembled a retrospective cohort of TAK patients from nine tertiary centres in Turkey. The demographics and clinical characteristics of patients were extracted from medical records and the imaging findings were evaluated for pulmonary manifestations.Results As of January 2021, 319 TAK patients (female/male 276/43; mean age 42.4 ± 13.5 years) were recruited. Eighty-two patients had cough and/or dyspnoea and four had haemoptysis as pulmonary symptoms. On computed tomography assessment, the overall frequency of NVPI was 7.2%; parenchymal infiltrations were present in 10 (3.1%), pleural effusion in eight (2.5%), nodules/cavities in six (1.9%), and pulmonary haemorrhage in four patients (1.3%). In the whole cohort, 10.3% of patients had pulmonary artery hypertension (PAH) and 5.6% had PAI. Among patients with PAH or PAI, the overall frequency of NVPI was significantly higher than in the rest of the group.Conclusions In this TAK cohort from Turkey, we observed NVPI in 7.2% of patients, with parenchymal infiltrations being the most common, followed by pleural effusion. Notably, NVPI was more frequent in patients with PAH or PAI. Although not as common as PAI, NVPI should be kept in mind, especially in TAK patients with PAH or PAI.

The effect of placental angiogenic and anti-angiogenic factors on pregnancy outcome in patients with early onset preeclampsia

Objective:

The aim was to evaluate the possible effects of anti-angiogenic factors including soluble endoglin (sEng), placental growth factor (Pgf), and soluble fms-like tyrosine kinase 1 (sFlt-1) in both normotensive pregnant patients and preeclampsia (PE) patients.

Material and Methods:

The study was carried out at the Departments of Gynecology and Obstetrics and Biochemistry of Yozgat Bozok University Training and Research Hospital. Eighteen women with PE who were pregnant for at least 20 weeks comprised the study group. The control group consisted of 33 pregnant women with no complications and with similar demographic features. In the study, laboratory parameters, demographic characteristics, sEng, sFlt-1, and Pgf levels, delivery type, APGAR scores of the infants, and birthweight were determined and a comparison was made between the groups.

Results:

It was found that the sEng level was significantly lower in the PE group compared to the control group (p<0.05). In addition, the Pgf, birthweight, and 1^st and 5^th-minute APGAR scores were significantly lower in the PE group compared to the control group (p<0.05).

Conclusion:

The decrease in Pgf may have an effect on the pathogenesis of PE and can be utilized for the determination of PE.

Behaviors and Attitudes of Obstetricians in Turkey Related to Cord Clamping, Cord Milking, and Skin-To-Skin Contact

Objective This study was planned to evaluate obstetricians' practices of umbilical cord clamping, milking, and skin-to-skin contact applications and to determine the related variables. Material and methods A total of 522 obstetricians participated in the study. Participants were reached via the internet and a 15-item questionnaire was applied about umbilical cord clamping, cord milking, and skin-to-skin contact. Mann-Whitney U test and Student's t-test were used for continuous data and Chi-square test or Fisher's exact test for categorical data in determining the difference between groups. For the multivariate analysis, the possible factors identified with univariate analyses were entered into the logistic regression analysis to determine further independent predictors of delayed clamping. Statistical analysis was performed using the SPSS software (version 20, IBM Corp, Armonk, USA). Results It was determined that 234 (44.8%) of the participants clamped the umbilical cord early whereas 288 (55.2%) clamped it late. It was found that the delayed clamping rates of physicians working in public hospitals were significantly lower than those working in private (p<0.001). It was observed that 132 of the participants (25.3%) did not milk the cord and 180 (34.5%) of them applied it continuously, and no significant difference was found between physicians working in the public and private sectors (p=0.130). It was observed that 384 (73.6%) physicians applied skin-to-skin contact. In the multivariate regression analysis, it was determined that working status in a private hospital with a 3.6 odds ratio (OR) (95% CI = 2.0-6.3) and a low number of patients examined daily with a 1.2 OR (95%CI= 1.0-1.4) were the most important independent factors affecting the choice of delayed clamping. Conclusion It is seen that the most important parameter affecting the birth practices of physicians in our country is the employment status in public or private institutions. The age and professional experience of the physicians who clamp the umbilical cord late were found to be higher. Obstetricians are at the key point in obstetrics practice, and the experience of physicians and the type of institution they work with affect these practices.

Levels of glucagon-like peptide 1 in hyperemesis gravidarum

Objective

Glucagon-like peptide 1 (GLP-1), a gut-derived peptide has been reported to have insulin-like effects. Our aim is to examine GLP1 levels in hyperemesis gravidarum (HEG).

Materials-methods

The study population consisted of 2 groups: Group 1 (control subjects) consisted of 22 women with uncomplicated singleton pregnancies in the first trimester. Group 2 consisted of 22 singleton pregnancies complicated by HEG. Glucose and GLP1 levels were determined. Enzyme-linked Immunosorbent Assay Kit for Glucagon like Peptide 1 (GLP1) was used (Uscn, Life Science Inc.).

Results

No significant differences in maternal age, gestational age and gravida were observed between hypermetric and control groups. Maternal serum GLP1 levels were significantly higher in HEG compared with control group (P = 0.004).

Conclusion

The results of our study revealed that the presence of increased GLP1 levels in women with HEG could contribute to the pathogenesis of the disease. Our results indicated that increased GLP1 levels may be associated with hyperemesis gravidarum. The limitation of our study was the restricted number of patients. Large prospective and randomized studies are required to evaluate the effect of GLP1 levels on hyperemesis gravidarum.

Factors That Affect Placental Retinol Transfer In Preterm Infants And Mothers With Retinol Deficiency

BACKGROUND

The retinol level and retinol delivery to the placenta may vary depending on various factors involving the mother and baby. The present study evaluates the factors affecting retinol levels in babies and the transplacental retinol passage in preterm babies.

MATERIALS AND METHODS

In this prospective cohort study, the retinol and retinol binding protein (RBP) in the umbilical cord blood of 44 preterm infants with a gestation age of <30 weeks were studied. Serum retinol and RBP levels were determined using an enzyme-linked immunosorbent assay, and the rate of transplacental retinol passage was calculated. The demographic data of mothers and babies, the use of vitamins by the mother, the application of antenatal corticosteroids and any diseases diagnosed during pregnancy were recorded. An evaluation was made of the retinol, RBP and other factors of the mother and baby affecting transplacental retinol passage.

RESULTS

A retinol deficiency was identified in 68.2% of the study population. Retinol and RBP levels in umbilical cord blood (273.7±150.03 ng/ml, 7.88±5.6 ng/ml, respectively) were significantly higher than the corresponding levels in the mother (206.4±86.26 ng/ml, 1.04±0.97 ng/ml, respectively).Umbilical cord blood retinol deficiency was more common in the male participants, while the transplacental retinol passage rate was higher in females. The umbilical cord blood RBP was found to be lower in those administered antenatal corticosteroids than in those who did not receive antenatal corticosteroids, and median maternal RBP levels were lower in patients with anemia and pregnancy-induced hypertension than in those with no disease.

CONCLUSION

Placental adaptation and contributing factors may vary in populations with severe retinol deficiency. The finding of significantly increased cord retinol levels when compared to maternal retinol levels in the present study suggests that some compensatory mechanisms, such as increased placental RBP levels, support the presentation of retinol to the fetus, even if the mother has a retinol deficiency.

Comparison of glucose degradation product and receptor levels in diabetic and normal pregnancy

Objective:

The aim of this study was to assess the diagnostic values of new biochemical markers that may be an alternative to the oral glucose tolerance test (OGTT) and determine the differences in these markers among three groups of women with varying degrees of glucose homeostasis dysregulation.

Material and Methods:

This was a prospective study. All women were screened with 50 gram (g) oral glucose and a 100 g OGTT for gestational diabetes mellitus (GDM). The patients were divided into three groups depending on the result of the tests: no evidence of glucose metabolism abnormality (controls); impaired glucose tolerance (IGT); and GDM. All three groups were evaluated for serum human advanced glycation end-products (AGEs) concentrations, carboxymethyl lysine (CML) concentration and receptor for advanced glycation end-product concentrations (RAGE/AGER), body mass index (BMI), age, fasting glucose levels, obstetrical parameters and gestational age.

Results:

The study included 180 women divided into 59 (32.8%) GDM, 50 (27.8%) IGT and 71 (39.4%) controls. Age was similar among the three groups. Whereas fasting glucose levels and BMI in the three groups was significantly different, AGEs, CML, RAGE/AGER levels were found as significantly different between the groups (p<0.001).

Conclusion:

In this study the use of AGEs, CML, and RAGE/AGER concentrations for the diagnosis and screening of gestational diabetes was investigated. It was found that advanced glycation products were significantly elevated in pregnancies with both IGT and GDM. These biochemical markers of glucose homeostasis dysregulation may have potential for GDM screening in the future.

Relationship Between the of Type of Accessory Navicular Bone and Radiological Parameters of the Foot

BACKGROUND

In this study, we evaluated to the relationship between the type of accessory navicular bone (ANB) and radiological parameters of foot in patients with bilateral ANB of different types.

METHODS

Patients with bilateral ANB of different types participated in this study, from May 2019 to April 2020. Patient data, including age, sex, body mass index (BMI), and presence of symptoms were obtained. We aimed to compare the radiological parameters of both the feet for evaluate the differences from one another in patients with bilateral ANB of different types (one side type 1 and contralateral side type 2) because the foot angles may differ in each person. Seven radiographic parameters were measured, including calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, anteroposterior talo-first metatarsal angle, and the lateral talo-first metatarsal angle, which evaluated hindfoot, midfoot, and forefoot alignment.

RESULTS

Twenty patients (13 women and 7 men) with a mean age (and standard deviation) of 38.5 {plus minus} 12.3 years were included in the study. The patients had a mean height of 168.1 {plus minus} 7.1 cm, a mean weight of 77.2 {plus minus} 10.5 kg, and a mean BMI of 27.4 {plus minus} 4.3 kg/m2. There was no significant difference between type 1 and type 2 in all radiological parameters. There was no significant correlation between radiological parameters and age, BMI, or the presence of symptoms.

CONCLUSIONS

We found that the type of ANB had no effect on the radiological measurements of the foot in which we evaluate the parameters patients with bilateral ANB of different types. Additionally, age, BMI, and the presence of symptoms, also demonstrated no correlation with the radiological parameters of the foot.

The protective effect of JZL184 on ovarian ischemia reperfusion injury and ovarian reserve in rats

AIM

Ovarian torsion is a gynecopathology that requires emergency surgery in women. However, ischemia reperfusion injury (IRI) occurs after treatment with detorsion. This study aimed to evaluate the effects of monoacylglycerol lipase inhibitor JZL184 on ovarian IRI and ovarian reserve.

METHODS

Forty-eight female Wistar albino rats were divided into six groups. Group 1: Sham, Group 2: Ischemia, Group 3: ischemia/reperfusion (IR), Group 4: IR + JZL184 4 mg/kg, Group 5: IR + JZL184 16 mg/kg, Group 6: IR + vehicle (dimethyl sulfoxide). Three hours of ischemia followed by 3 h of reperfusion. Two different doses of JZL184 (4 and 16 mg/kg) were administered intraperitoneally in Group 4 and 5, 30 min before reperfusion. Ovarian IRI and ovarian reserve were evaluated in serum and tissue by using histopathological and biochemical parameters.

RESULTS

Treatment with JZL184 was associated with a significant increase in ovarian 2-arachidonoylglycerol and improved serum anti-Mullerian hormone, İnhibin B, primordial follicle count, and ovarian histopathological damage score (p < 0.05). JZL184 treatment significantly decreased the level of malondialdehyde, and increased superoxide dismutase enzyme activity and glutathione (GSH) levels (p < 0.05). The increased phosphorile nuclear factor-κB (Phospho-NF-κB-p65), tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β), transforming growth factor beta 1 (TGF-β1), and TUNEL assay immunopositivity scores in ovarian I/R injury were decreased after treatment with JZL184 (p < 0.05).

CONCLUSIONS

JZL184 showed significant ameliorative effects on ovarian IRI and ovarian reserve caused by IR through acting as an antioxidant, anti-inflammatory, and antiapoptotic agent. Thus, JZL184 may be a novel therapeutic agent for ovarian IRI.

Activation of cannabinoid 2 receptors by JWH-133 protects against ovarian ischemia-reperfusion injury in rats

We investigated the efficacy of activated cannabinoid 2 receptors for alleviating ovarian ischemia-reperfusion injury in rats. Female Wistar albino rats were divided randomly into six groups: ischemia-reperfusion (IRG); ischemia-reperfusion + 0.2 mg/kg JWH-133 (JIRG1), ischemia-reperfusion + 1 mg/kg JWH-133 (JIRG2); ischemia-reperfusion + 5 mg/kg JWH-133 (JIRG3); solvent control, and sham control. Ovarian ischemia was established for 3 h followed by reperfusion for 3 h. Ovarian tissue was investigated using histology, immunohistochemistry and biochemistry. Administration of JWH-133 synthetic cannabinoid reduced nuclear factor kappa-B immunoreactivity as well as TUNEL positivity scores and malondialdehyde levels. These reductions were significant in all cases except for the malondialdehyde levels in the 1 mg/kg JWH-133 group. Activation of cannabinoid 2 receptors by JWH-133 reduced ovarian ischemia-reperfusion injury due to its antioxidant and anti-inflammatory effects.

Effect of Unilateral Accessory Navicular Bone on Radiologic Parameters of Foot

BACKGROUND

This study aimed to compare the radiologic parameters of both feet in patients with unilateral accessory navicular bone (ANB) and evaluate the differences from one another.

METHODS

Forty-one patients with unilateral ANB volunteered to participate in this study from August 2019 to January 2020. Patient data, including age, sex, body mass index (BMI), type of ANB, and presence of symptoms were obtained. Group 1 comprised 23 patients with asymptomatic unilateral ANB, and group 2 comprised 18 patients with symptomatic unilateral ANB. Seven radiologic parameters were evaluated assessing hindfoot, midfoot, and forefoot alignment-calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap (NCO), talonavicular coverage angle (TNCA), anteroposterior talo-first metatarsal angle, and lateral talo-first metatarsal angle.

RESULTS

The mean age of patients was 40.1 years in group 1 and 42.6 years in group 2. Mean BMI was 25.2 in group 1 and 26.6 in group 2. No significant differences were noted in the radiologic parameters between the ANB and contralateral sides in all patients. The radiologic parameters of both feet in symptomatic and asymptomatic patients were not significantly different. No significant differences were noted between the affected sides of type 1 and 2 ANB and contralateral sides in terms of the radiologic parameters. BMI was significantly correlated with NCO and TNCA.

CONCLUSION

This study demonstrated that the presence of an accessory navicular bone did not affect radiologic parameters of the foot. Radiologic parameters of both feet in symptomatic patients were not significantly different.

LEVEL OF EVIDENCE

Level III, diagnostic, comparative study.

The Relationship Between Heavy Metal Exposure, Trace Element Level, and Monocyte to HDL Cholesterol Ratio with Gestational Diabetes Mellitus

The objective of this study is to assess the levels of heavy metals (cadmium, lead, antimony, mercury, and arsenic), which are also called endocrine-disrupting chemicals, and trace elements (chromium-III, chromium-VI, zinc, copper, and selenium) vs. monocyte to HDL ratio among pregnant women with gestational diabetes mellitus (GDM). A total of 112 pregnant women (60 with GDM and 52 healthy women) were included in this case-control study. Analysis of heavy metals and trace elements were performed in inductively coupled plasma mass spectrometer. Heavy metals (cadmium, lead, antimony, mercury, and arsenic), trace elements (chromium-III, chromium-VI, zinc, copper, and selenium), and metabolic parameters were assessed in both groups. It was determined that the levels of cadmium, lead, antimony, and copper were higher (p < 0.05) and levels of chromium-III, zinc, and selenium were lower (p < 0.05) among the GDM group compared to the control group, whereas there was a statistically insignificant difference between the two groups, regarding the levels of copper, mercury, and arsenic (p > 0.05). Moreover, the monocyte to HDL ratio was higher in the GDM group (p < 0.05), and the insulin resistance was significantly higher as well (p < 0.05). The results of our study demonstrated that environmental factors could be effective in the etiology of GDM. Toxic heavy metals, through inducing Cu, OS, and chronic inflammation, and other trace elements, either directly by impacting insulin secretion or through weakening the body's antioxidant defense system, could play a role in the occurrence of GDM.

Letter to the Editor: Adjusting Anterior Thigh Muscle Measurements Using Ultrasound in Sarcopenia

We have read with great interest the recently published article by Tsukasaki et al (1). We congratulate the authors for drawing attention to regional muscle mass measurements for evaluating sarcopenia. As they highlighted, age-related muscle loss occurs initially in the anterior thigh muscles that predominantly contain fast-twitch (type II) fibers (2). Therefore, regional muscle mass and functional assessments are important for the early diagnosis and follow-up of sarcopenia (2). In this regard, computed tomography (CT), magnetic resonance imaging, ultrasound (US) and dual-energy X-ray absorptiometry (DXA) techniques give opportunity for regional muscle mass measurements. Likewise, the authors compared the relationships among regional/total muscle mass measurements, muscle power, strength and performance tests. Although we agree with them in general, we would like to add further.

The effect of a natural molecule in ovary ischemia reperfusion damage: does lycopene protect ovary?

Ovarian ischemia is a gynecological emergency case that occurs as a result of ovarian torsion. Oxidative stress plays a central role in the development of ischemia/reperfusion (IR) injuries. Lycopene (LYC) is a lipophilic, natural carotenoid well known for its antioxidant properties. This study provides information on the potential applications of lycopene. The Wistar Albino rats were distributed into six groups: Sham group (only a laparotomy was performed), Control group [laparotomy and intraperitoneal dissolvent (olive oil)], IR group, IR+olive oil group, IR+LYC 2.5 mg/kg/dose, intraperitoneal group, IR+LYC 5 mg/kg/dose intraperitoneal group. Evaluated in terms of histopathological changes, tissue malondialdehyde levels (MDA), ovarian expressions of phosphorylated nuclear factor-kappa B (p-NF-κB) and the TUNEL method was utilized to show apoptosis of ovarian tissue. There was a significant decrease in MDA, p-NF-κB values and the proportion of apoptotic cells assessed by TUNEL compared to the group that did not receive intraperitoneal LYC in rat injury with IR damage (P<0.05). In histopathological damage scoring, it was observed that the cell damage was significantly reduced in LYC-administered groups. LYC showed significant ameliorative effects on ovary injury caused by IR through acting as an antioxidant, antiinflammatory, and antiapoptotic agent.

Telomere Length in Idiopathic Recurrent Pregnancy Loss

OBJECTIVE

Telomere length is used as an indicator of biological aging. It is well known that one of the most remarkable risk factors of recurrent pregnancy losses is advanced maternal age. The objective of this study was to investigate the correlation between idiopathic recurrent pregnancy loss and telomere length.

METHOD

The study group included 40 women, while the control group consisted of 41 healthy women whose age and body mass index were matched. A venous blood sample was taken from all participants into EDTA tubes in the early follicular phase, and telomere length was measured through the qPCR technique.

RESULTS

When the mean TL of the groups was compared, it was determined that TL was significantly shorter among the iRPL group (7763.89±924.58 base pair) compared to the control group (8398.84±1102.95 base pair) (p<0.006). Whereas FSH and E2 were higher in the iRPL group, TAFC was lower (p<0.001). When the correlation between telomere length and endocrine parameters was statistically tested in the iRPL group, a negative correlation was found between FSH and telomere length (r=-0.437; p<0.001).

CONCLUSION

Shortened telomere length might play a role in the etiology of iRPL. We are of the opinion that patients with RPL should be screened for the presence of cardiovascular diseases and other chronic diseases, as is the case for POF.

Sexual function and depression in polycystic ovary syndrome: Is it associated with inflammation and neuromodulators?

Numerous studies have been carried out on depression and sexual dysfunction concomitant with polycystic ovary syndrome (PCOS). Increasing evidence has revealed the importance of inflammation in the etiology of PCOS. In addition, it has been known that some neuromodulators affect depression and sexual function. However, their effects on PCOS are not known. This study aimed to evaluate the relationship of depression and sexual function with cytokines and neuromodulators in PCOS patients. The present study included 20 fertile and 30 infertile patients diagnosed with PCOS and 30 healthy volunteers. Metabolic and endocrine parameters, interleukin (IL)-1β, IL-6, TNFα, γ-aminobutyric acid (GABA), Glutamate, Brain-derived neurotrophic factor (BDNF) serum levels, Beck Depression Index (BDI) and Female Sexual Function Index (FSFI) scores of the patients were compared between the groups. TNFα, IL-1β, IL-6, glutamate, GABA, and BDI scores were found to be significantly higher (p < 0.05) in the PCOS group (p < 0.05). Glutamate, TNFα, IL-1β, and IL-6 values were higher whereas GABA and BDNF values were lower in pateints with moderate and severe depression (p < 0.05). There were no statistically significant relationships between these parameters and the FSFI scores (p > 0.05). Multivariate logistic regression analysis was conducted with potential factors that may affect sexual dysfunction. The results indicated that high waist-to-hip ratio (WHR) (> 0.80) with an odds ratio of 1.81 in PCOS patients, and body mass index (BMI) with an odds ratio of 2.3 and high WHR (> 0.80) with an odds ratio of 1.97 in all patients were found to be independent risk factors affecting sexual dysfunction. The results of the present study suggested that chronic low-dose inflammation seen in PCOS may interact with some neuromodulators, leading to the development of depression. However, no relationship was found between these parameters and sexual function.

Relation of shunt index with the patent ductus arteriosus among preterm infants under 30 weeks or 1500 g

Objective: Patent ductus arteriosus is an important problem in preterms. We aimed to investigate the relation of patent ductus arteriosus with shunt index.Methods: The preterm infants with a birth weight of ≤1500 g and/or gestational age of <30 weeks and an indication for umbilical artery and venous catheterization formed the study group. Between the postnatal 24-48 hours, the first arterial and venous blood samples were obtained and the patients were evaluated by echocardiography. In patients with hemodynamically significant patent ductus arteriosus (patient group), during the first 24 hours after the competition of the first course of medical treatment, the second blood samples were obtained and echocardiography repeated. In patients without patent ductus arteriosus (control group), second blood samples were taken after the postnatal 72 hours. Also, echocardiography was performed.Results: A total of 60 infants, (female = 29, male = 31), were included in the study. We did not find a statistically significant relation between shunt index and the presence of patent ductus arteriosus (p > .05). A statistically significant positive correlation between the fraction of inspired oxygen and shunt index was found. As the postnatal ages progressed, the shunt index values tended to decrease significantly.Conclusion: Our results suggest that shunt index cannot be used as an indicator of hemodynamically significant patent ductus arteriosus in preterm infants. The postnatal age and fraction of inspired oxygen have a significant effect on shunt index in these patients. It was thought that the other possible factors that affect the shunt index should be investigated in preterms between certain postnatal ages.

The Effect of Maternal Pulmonary Function Test Parameters on Umbilical Cord Blood Gas and the Duration of Labor

OBJECTIVE

To evaluate the relationship between the maternal pulmonary function test (PFT) and the Apgar score of the newborn, umbilical cord blood (UCB) gas values and the duration of delivery.

MATERIAL AND METHODS

The present study included 41 volunteer nulliparous pregnant women who presented to our obstetrics clinic and PFTs were performed by using spirometry.

RESULTS

A significant positive correlation was observed between 5^th-minute Apgar scores and maternal FEV1 (forced expiratory volume in the first second) (lt), FEV1%, FVC (lt), FVC% (r=0.509, p=0.003; r=0.47, p=0.007; r=0.434, p=0.013; r=0.417, p=0.017; respectively). A significant positive correlation was observed between UCB pH value and maternal FEV1 (lt), FVC (lt) (r=0.515, p=0.003; r=0.351, p=0.049; respectively).

CONCLUSION

Our results showed that FEV1 and FVC values, which indicate maternal respiratory functions, may affect Apgar scores of the newborn and UCB gas values.

Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?

This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities.

Maternal and fetal outcomes of COVID-19, SARS, and MERS: a narrative review on the current knowledge

OBJECTIVE

Coronavirus infections, including SARS, MERS and COVID-19 have significant impact on global health as well as on pregnancies. The aim of this review was to enlighten and summarize the cumulative knowledge regarding the relationship between Coronavirus outbreaks and pregnancy.

MATERIALS AND METHODS

Literature search was commenced in order to analyze the maternofetal effects of Coronavirus outbreaks.

RESULTS

Fever and cough are the most common presenting symptoms of COVID-19 which mostly affects pregnant women in their 3rd trimester with a maternal mortality rate of  0-77%  and fetal and neonatal mortality rates of 1.2%. Fetal demise is common in critically ill pregnant. Pregnancy seems as a worsening factor for SARS and MERS epidemics and both infections affect prominently 3rd trimester pregnancies, although abortion (57%) is a significant risk for cases of early pregnancy. Clinical course of COVID-19, SARS and MERS may be rapid and worse in pregnant women than non-pregnant individuals. Cesarean section is the choice of delivery in most reported women due to mostly obstetrical reasons, although vaginal delivery seems not a worsening factor for the disease.

CONCLUSIONS

COVID-19, SARS and MERS have significant detrimental effect on pregnancy. Rapid intervention, treatment, and intensive care support are essential for infected pregnant. Timely delivery is important in order to avoid intrauterine fetal death.

Environmental Exposures in the Etiology of Abortion: Placental Toxic and Trace Element Levels

PURPOSE

Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion.

METHODS

The patient group consisted of 30 women with missed abortion. The control group comprised 60 healthy term and singleton pregnant women who gave birth. Placental samples were obtained from the patients and the healthy controls, and the concentrations of placental elements were measured using inductively coupled plasma mass spectrometry.

RESULTS

In the abortion group, placental arsenic, cadmium, mercury, lead, antimony, tin, cobalt, manganese, and selenium levels were significantly higher than those of the control group (p<0.05). Antimony was determined as an independent predictor with an odds ratio of 6.1 in toxic elements (p=0.025), and selenium was determined as an independent predictor with an odds ratio of 2.3 in trace elements (p=0.015).

CONCLUSION

The changes in trace element and toxic element levels, especially an increase in antimony and selenium, in placental tissue due to environmental exposure may play an important role in second-trimester abortion.