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Öğe Association of Helicobacter pylori infection with systemic inflammation in preeclampsia(Taylor & Francis Ltd, 2010) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozkaplan, Esra; Otlu, Baris; Tekerekoglu, Mehmet SaitMethods. Forty patients with preeclampsia and 40 normotensive pregnant women of similar age and body mass index at the third trimester of gestation were selected for the study. Chlamydia pneumonia IgM and IgGs, Helicobacter pylori IgAs and concentrations of CRP and TNF-alpha were measured. Results. Concentrations of CRP and TNF-alpha were significantly higher in patients with preeclampsia than in control subjects. In the preeclamptic group, positivity rate for Helicobacter pylori IgA was significantly higher as compared to controls (p = 0.034). CRP and TNF-alpha levels were higher in Helicobacter pylori seropositive subjects. Conclusion. We demonstrated high levels of serum CRP and TNF-alpha in preeclamptic women who were seropositive to Helicobacter pylori in comparison with those in seronegative subjects.Öğe Effect of Intranasal Estrogen on Vocal Quality(Mosby-Elsevier, 2009) Firat, Yezdan; Engin-Ustun, Yaprak; Kizilay, Ahmet; Ustun, Yusuf; Akarcay, Mustafa; Selimoglu, Erol; Kafkasli, AyseThe objective of this study was to evaluate the effect of intranasal estrogen therapy on female vocal quality. Thirty-two women who had surgically induced menopause were included into the study group and examined through hall year for this study. Estrogen treatment was proposed to all of the patients. Twenty-three of them accepted the treatment protocols including oral (n = 12) (2 mg estradiol; Estrofem; Novo Nordisk, Denmark) and intranasal (n = 11) (300 mcg 17beta-estradiol; Aerodiol; Servier, Chambray-les-Tours, France) form of estrogen. The rest of patients refused estrogen treatment and those patients constituted the control group (n = 9). Vocal changes were evaluated with Voice Handicap Index (VHI) and acoustic analysis of voice variations (fundamental frequency [F0], SD F0, jitter, shimmer, normalized voice energy, and harmonics-to-noise ratio) at baseline and after 1-year follow-up. According to VHI, while voice improvement was not clear in oral estrogen group, it was significant at intranasal estrogen group. Voice quality in patients treated with hormone replacement therapy (HRT) was significantly higher than patients without HRT. But between two treatment groups, there were no any statistical discrepancy. According to acoustic analysis, vocal stability among the women who use HRT was significantly better than those who did not use. Intranasal estrogen exerted the most significant effects on vocal stability. The data of our study support that voice undergoes changes in lack of estrogen in surgically induced menopausal women. Taken together with the relevant studies, while oral estrogen replacement therapy shows a favorable influence on voice quality, it seems to be more pronounced with intranasal estrogen than oral form.Öğe Effect of metformin on serum visfatin levels in patients with polycystic ovary syndrome(Elsevier Science Inc, 2010) Ozkaya, Mesut; Cakal, Erman; Ustun, Yusuf; Engin-Ustun, YaprakObjective: To evaluate serum visfatin levels and to determine the effects of metformin treatment on visfatin levels in patients with polycystic ovary syndrome (PCOS). Design: Cross-sectional study. Setting: University hospital. Patient(s): Nineteen patients with PCOS and 21 controls. Intervention(s): Metformin was given to patients with PCOS, and serum visfatin levels were measured before and after treatment. Main Outcome Measure(S): Glucose, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, DHEAS, total T, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and visfatin levels were measured. Result(s): Serum visfatin levels were significantly higher in women with PCOS than in controls. Visfatin could differentiate between women with and without increased diabetogenic risk at a cut-off value of 19.24 ng/mL, with a sensitivity of 93.3% and a specificity of 84%. In bivariate analysis of subjects, T, insulin, and waist circumference were significantly and positively correlated with visfatin. Treatment resulted in a significant decrease in body mass index and a decrease in visfatin concentration. After therapy, statistically significant decreases in HOMA-IR, fasting insulin, free T, and DHEAS concentrations were observed for the PCOS group. Conclusion(s): Circulating visfatin levels were higher in patients with PCOS than healthy controls, and metformin treatment significantly reduced circulating visfatin concentrations after 3 months of therapy. (Fertil Steril (R) 2010:93:880-4. (C)2010 by American Society for Reproductive Medicine.)Öğe Ischemia-modified albumin as an oxidative stress marker in preeclampsia(Taylor & Francis Ltd, 2011) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozturk, Ozlem; Alanbay, Ibrahim; Yaman, HalilMethods. aEuro integral Serum ischaemia-modified albumin levels were measured in 18 normotensive and 36 preeclamptic pregnant women by enzyme linked immuno-sorbent assay. Patients were subdivided as having either mild (n == 18) or severe preeclampsia (n == 18). Receiver operating characteristic curve was constructed, and sensitivity and specificity were calculated based on the best cut-off. Results. aEuro integral IMA levels were significantly higher in the mild and severe preeclamptic groups than in the control group. IMA with a cut-off point of 0.31 identified women with preeclampsia with sensitivity 80%% and specificity 77.8%%. Conclusion. aEuro integral Our study demonstrates that serum levels of IMA correlate with severity of preeclampsia.Öğe Meydanli Compression Suture: New surgical procedure for postpartum hemorrhage due to uterine atony associated with abnormal placental adherence(Wiley, 2008) Meydanli, Mehmet Mutlu; Turkcuoglu, Ilgin; Engin-Ustun, Yaprak; Ustun, Yusuf; Kafkasli, AyseAim: To inform about the clinical results of a new uterine compression suture technique used in the surgical management of postpartum hemorrhage due to uterine atony associated with abnormal placental adherence. Methods: Postpartum hemorrhage due to uterine atony associated with abnormal placental adherence was diagnosed in seven out of 1819 (0.38%) cesarean sections performed between January 2004 and February 2007, and a new uterine compression suture technique was used for surgical management. Age, parity, gestational age and cesarean section indications, amount of transfusion performed, length of hospital stay, postoperative complications, and number of patients in whom the uterus was preserved were evaluated. Results: The mean age of the cases was 30.5 +/- 3.7 (24-35) years. Cesarean indications were previous cesarean section plus placenta previa totalis in three cases (43%), previous cesarean section in two cases (29%), a twin pregnancy as a result of in vitro fertilization-embryo transfer in one case (14%) and preterm premature rupture of membranes in one case (14%). Six out of seven cases (85%) were successfully treated with the Meydanli compression suture and the uterus was preserved. Conclusion: The Meydanli compression suture seems to be a simple, quickly applicable and safe uterine compression suture technique, which decreases maternal mortality and peripartum hysterectomy rates.Öğe The relation of infectious and inflammatory markers with placental atherosclerosis in preeclampsia(2021) Ozkaplan, Sukran Esra; Topdagi, Yunus Emre; Ustun, YusufAim: The aim of this study was to compare CRP, TNF-α, CMV, Chlamydia pneumonia IgG and IgM levels between preeclamptic and uneventful pregnant womens, to explain the effects of infectious trigger on the placental pathology of preeclampsia. Materials and Methods: All cases of preeclamptic pregnants detected at or referred to Inonu Univrsty Faculty of Medicine Gynaecology and Obstetric Department between July 2006 and July 2007 were prospectively collected. The study group was a group of 40 women who are preeclamptic. The study also included 40 control subjects who were matched for age, gestational age and body mass index. Results: In the preeclamptic group the level of CRP was significantly higher [28 (1.9– 196); vs. 6.2 (1.2–23) (mg/L) (p0.999 and p=0.385). Plasma H.pylori IgA levels were higher in the study group with the value of [ 14 (35%) vs. 5 (12.5%) (p=0.035)].Conclusion: In the present study, serum CRP, TNF-α and H.pylori IgA levels were significantly higher than normal pregnant women.Öğe Role of psychiatric disorders and irritable bowel syndrome in asthma patients(Hospital Clinicas, Univ Sao Paulo, 2011) Yilmaz, Ayse; Cumurcu, Birgul Elbozan; Tasliyurt, Turker; Sahan, Abdulkadir Geylani; Ustun, Yusuf; Etikan, IlkerOBJECTIVES: The goals of the study were the following: 1) to determine the frequency of psychiatric disorders and irritable bowel syndrome in patients with asthma and 2) to compare the frequency of these disorders in patients with asthma to their frequency in healthy controls. INTRODUCTION: Patients with asthma have a higher frequency of irritable bowel syndrome and psychiatric disorders. METHODS: We evaluated 101 patients with bronchial asthma and 67 healthy subjects. All subjects completed the brief version of the Bowel Symptoms Questionnaire and a structured clinical interview for DSM-IV axis disorders (SCID-I/CV). RESULTS: There were 37 cases of irritable bowel syndrome in the group of 101 stable asthma patients (36.6%) and 12 cases in the group of 67 healthy subjects (17.9%) (p = 0.009). Irritable bowel syndrome comorbidity was not related to the severity of asthma (p = 0.15). Regardless of the presence of irritable bowel syndrome, psychiatric disorders in asthma patients (52/97; 53.6%) were more common than in the control group (22/63, 34.9%) (p = 0.02). Although psychiatric disorders were more common in asthma patients with irritable bowel syndrome (21/35, 60%) than in those without irritable bowel syndrome (31/62, 50%), the difference was not significant (p = 0.34). In asthma patients with irritable bowel syndrome and psychiatric disorders, the percentage of forced expiratory volume in 1 s (FEV1) was lower than it was in those with no comorbidities (p = 0.02). CONCLUSIONS: Both irritable bowel syndrome and psychiatric disorders were more common in asthma patients than in healthy controls. Psychiatric disorders were more common in asthma patients with irritable bowel syndrome than in those without irritable bowel syndrome, although the differences failed to reach statistical significance. In asthma patients with IBS and psychiatric disorders, FEV(1)s were significantly lower than in other asthma patients. It is important for clinicians to accurately recognize that these comorbid conditions are associated with additive functional impairment.Öğe Umbilical Artery Erythropoietin Levels in Preeclamptic Pregnancies(Galenos Yayincilik, 2006) Sahin, H. Guler; Surucu, Ramazan; Zeteroglu, Fiahin; Ustun, Y. Engin; Ustun, Yusuf; Kamaci, Mansur; Kolusari, AliObjective: The aim of this study was to determine the levels of umbilical artery erythropoietin (EPO) levels and to evaluate its relation with clinical findings. Material and Methods: In this prospective study, 26 normal (Group I), 25 mild preeclamptic (Group II) and 17 severe preeclamptic (Group III) pregnant women whose gestational ages were between 37-42 weeks were enrolled. After the delivery, blood samples were taken from the umbilical artery of double clamped umbilical cord and umbilical artery EPO levels and blood gas parameters were analyzed. Sociodemographic findings, labor properties and physical examination of neonates were recorded. The blood gas parameters, EPO levels, their relationships with clinical findings of the groups were evaluated. Statistical analyses were performed by SPSS 9.05 statistical package program. Results: There were no statistical differences between gravidity, parity and gestational ages of the groups (p> 0.05). Maternal ages were significantly higher in the second group when compared with the others (p< 0.05). Systolic and diastolic blood pressures were statistically different in the groups (p< 0.05), and the highest levels were found in the third group. Birth weights were; 3480.76 +/- 431.75, 3373.20 +/- 846.83 and 2497.05 +/- 859.83 grams in group I, group II and group III, respectively (p< 0.05). First minute Apgar scores were 8 (ranges between 7-10) in the first group, 8 (ranges between 3-9) in the second group and 6 (ranges between 3-9) in the third group (p< 0.05). Umbilical cord pH levels were 7.35 +/- 0.06, 7.25 +/- 0.11 and 7.19 +/- 0.09; base excess (BE) levels were -4,71 +/- 2,02, -6.53 +/- 3.98 and -9.29 +/- 3.82 mmol/L; EPO levels were 30.0 (9.2-122), 62.5 (11.0-549) and 167.4 (10.1-908) mU/ml, respectively, and the differences between the groups were statistically significant (p< 0.05). In the Spearman bivariate correlation analysis, there was no significant relation between maternal age and EPO levels. There was significant positive correlation between EPO levels and systolic, diastolic blood pressures, pCO2 levels, and, significant negative correlation between first, fifth minute Apgar scores, birth weight, umbilical cord blood pH and BE levels. Conclusions: After delivery umbilical artery EPO levels showed significant correlation with severity of preeclampsia and, clinical and biochemical determinants of perinatal hypoxia. Our results support that erythropoietin can be used as a biochemical determinant of chronic fetal hypoxia that is caused by preeclampsia.
