Healty Women Research Articles

Нейро-ортопедические критерии дорсопатии беременных

Study Objective: To improve the diagnostic and therapeutic efficiency of dorsopathy in pregnant women by introducing a neuro-orthopedic examination algorithm. Study Design: prospective cohort study. Materials and Methods. The study enrolled 171 pregnant women: 87 dorsopathy patients (study group) and 84 healty women (controls). Inclusion criteria in both groups were progressive single uterine pregnancy, while the inclusion criterion for the study group was lower back pain (LBP) or pelvic ring pain (PRP). Neuro-orthopedic examination complied with the Russian clinical recommendations. Study Results. Neuro-orthopedic criteria to differentiate between pregnant women with or without dorsopathy were lower craniosacral rhythm (7.37 ± 1.53 vs. 8.14 ± 1.46 cycle/min, р = 0.002); sacral counternutation (odds ratio (OR) = 2.66); somatic dysfunctions (SD) in the lower and/or middle third of the right shank, right knee, Th11 NSRL, right clavicle, atlantooccipital joint, cuniform bone (left torsion), dura mater. SD in the right hip and pubic symphysis was included into gestation-associated changes which were unrelated to dorsopathy (LBP and PRP). A probability of LBP and PRP during pregnancy is higher in right sacroiliac joint SD (OR = 13.28; 95% CI: 1.69-104.59). Conclusion. It is reasonable to use osteopathic methods in dorsopathy (LBP and PRP) during pregnancy. Neuro-orthopedic differential diagnosis of lower back and pelvic ring pain reduces the risk of unjustified therapy to prolong pregnancy. Keywords: dorsalgia, somatic dysfunction, pregnancy, neuro-orthopedic examination.

Comparison of Different Bupivacaine and Fentanyl Combinations When Used with A Single Shut Spinal Block for Labor Analgesia

Background: Single-shot spinal analgesia with bupivacaine plus a short-acting opioid is an effective technique for pain control in labor, and it is particularly useful in the active phase. We compared the effects of adding two different doses of fentanyl (15 μg or 25 μg) to intrathecal bupivacaine, and to evaluate the impacts on duration of labor analgesia, newborn, and side effects. Method: One hundred and five multiparous healty women in advanced labor (cervical dilatation ≥ 7 cm, and pain score >5), requesting labor analgesia were included in the study. They were randomly allocated into three groups. Group I received 2.5 mg bupivacaine; Group II received 2.5 mg bupivacaine plus 15 μg fentanyl; Group III received 2.5 bupivacaine plus 25 μg fentanyl intrathecally. The patients' demo figure characteristics, hemodynamic parameters, pain scores (by using visual analogue scale - VAS), analgesic requirements, duration of analgesia (the time from intrathecal injection to the return of pain >4), fetal Apgar scores (at 1st and 5th min), and maternal and neonatal side effects were recorded. We used analysis of variance (ANOVA), post hoc test with Bonferroni adjustment, and chi-square test for statistical analysis; the analyses were performed using the SPSS-16 software. Given a significant level of 0.05, overall and pair-wise comparisons were made. Results: The mean VAS scores were significantly lower in Group II than in the other two groups at 5, 15, 30 min, and 1 h (P<0.001). There was no difference among Group I and Group III. The VAS scores were significantly higher in the Group III than in the other two groups at 2 (P=0.005) and 3 h (P<0.001). The incidence of adverse events was similar in all three groups. There was no difference in Apgar scores at 1 min, but Apgar score at 5 min was higher in Group 2 (P=0.02). Conclusion: In this study, we found that 2.5 mg of bupivacaine plus 15 μg fentanyl is more preferable option for SSA.

Abstract P4-04-23: Clinical importance of S100A9 and S100A2 in breast cancer

Abstract Background: The most frequent cause of cancer deaths throughout the world is breast cancer (BC). Therefore, preventing, diagnosing and treating BC has gained importance. Calcium-binding S100 group proteins are coded in the chromosome 1q21 and have many members. It is claimed that S100A12 and S100A9 play an important role in the development of cancer. S100A12 is normally expressed in neutrophil granulocytes, and from lymphocytes and monocytes in small amounts. S100A12 is closely related to inflammation and vascular invasion by tumor cells, and causes excessive inflammation and vascular invasion causes tumor recurrence and metastasis. S100A9 protein is found in human epithelial cells and cytosols in phagocytes and regulates the motility of phagocytes and activity of target proteins through interaction with danger signal molecules. Furthermore, it has also been stated that it is possible that it regulates the cellular growth through interaction with p53 like other S100 proteins and can modulate metastasis of malignant tumors. In this study, we aimed at diagnostic and clinic-pathological importance of serum levels of S100A9 and S100A12 with known cytokin-like pro-inflammatory effects in BC. Material: A total number of 45 patients with breast cancer were first admitted in the study. Sixteen age-matched healty women were enrolled in to this study. All the samples were analyzed with enzyme-linked immunosorbent assay for serum S100A9 and S100A12 levels before starting the systemic chemotherapy. The characteristics of the breast cancer patients with respect to age, weight, height, menopausal status, histopathological type, tumor size, tumor lymph node metastasis, tumor grade, and estrogen receptor (ER) and progesterone receptor (PR) and HER2, lymphovascular invasion (LVI), perineural invasion (PNI) status and stage were collected for data analyses. Clinicopathologic characteristics of BC and other blood parameters were compared in relation with serum S100A9 and S100A12 levels. Results: While the serum S100A9 levels were found significantly higher as compared to healthy individuals (190.85±32.29 and 92.72±54, respectively) (p=0.001), it was observed that there were no differences in S100A12 (120.50±15.78 and 112.21±10.46, respectively) (p=0.056) levels. As regards the subgroup analysis in BC patients, no statistically significant results were found in body mass index, smoking, menopause status, histopathologic type, grade, biological subtype of BC, tumor size, presence of lymph node metastases, LVI, PNI and stage. As regards the blood parameters and serum S100 A9, while only statistically significant results were found with anemia (209.05±33.12 and 181.75±28.21, respectively) (p=0.005), no statistically significant results were found with leukocytosis, thrombocytosis and tumor markers. Conclusion: In this study, while we found the level of S100A9, which has a potential cytokine-like function in inflammation, significantly higher, we could not find any increase in S100A12 level. Therefore, it is possible that S100A9 can play a key role in inflammation-related BC. We therefore suggest that serum S100A9 can be the target marker in breast cancer both as a diagnostic tool and to suppress inflammation in treatment. Citation Format: Gunaldi M, Okuturlar Y, Üstüngüler A, Akarsu C, Kural A. Clinical importance of S100A9 and S100A2 in breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-04-23.

Acute effect of created muscle fatigue in cervical region on temporomandibular joint in healthy women

The aim of study was to investigate acute effects of neck muscles fatigue, on masticator muscle pain threshold, endurance and maximum pain-free mouth opening. 14 healty women aged between 20-25 years (Mean±SD: 21.7±1.18) were included in the study. Initially, lack of teeth and bruxism status and demographic information of cases were recorded. Before fatigue protocole, masticator muscle pain threshold, maximum pain-free mouth opening and fatigue level of masticator muscles by 5 minutes chewing gum test were evaluated. After that, participants performed fatigue protocole consisting of head flexion and extension at prone position until take 10 points from Modify Borg Scale. And all the tests were re-performed after fatigue protocole. After fatigue protocol, pain threshold of masseter muscles, right temporomandibular joint and left temporalis muscle, maximum pain-free mouth opening and chewing endurance were reduced (p 0.05). In our study, we identified that neck fatigue negatively affects some parameteres of masticator muscle immediately. Fatigue of the neck muscles are thought to predispose temporomandibular joint dysfunction.

Increased Lipid Levels Improves after Treatment with Cabergolin in Patients with Prolactinoma

It has been suggested that hyperprolactinemia may be associated with obesity and dyslipidemia. However it is not fully understood that dyslipidemia is occurs independently or due to obesity. The study was aimed to investigate lipid abnormalities and androgen hormone levels before and after cabergolin (CAB) treatment in non- obese premenauposal patients with prolactinoma. This study was a single-centre, prospective, case–control study, consisted of 53 patients with symptomatic prolactinoma (group 1) and 57 healty women (group 3). All subjects underwent a physical examination, anthropometric measurement and a 12 hour fasting blood sample for fasting blood glucose and lipid levels. 49 patients with prolactinoma were reevaluated for metabolic parameters after one year of cabergolin treatment (group 2). The median age was 34 (24-38) in group 1, and 33 (27-41) in group 3 (p=0.522). The initially higher body mass index (BMI) in patients with prolactinoma became similar after one year of treatment those with control group (p=0.475). While LDL-C was significanly higher in group 1 than in controls, HDL was significanly lower in group 1. Also post- treatment values of LDL-C (p=0.440) and HDL-C (p=0.612) were not different from the control group. No correlation was found between baseline prolactin levels and FSH, LH, LDL-C, HDL-C (p=0.129, p=0.658, p=0.817, p=0.760 respectively). In conclusion, beneficial metabolic changes were seen in patients with prolactinoma after treatment with cabergoline. Thus considering the metabolic profile and an appropriate treatment goal is important in the clinical management of patients with prolactinoma.

The utility of cervical elastosonography in prediction of cervical insufficiency: cervical elastosonography and cervical insufficiency

Objective: To evaluate the utility of cervical elastosonography (ES) in prediction of cervical insufficiency (CI).Methods: A total of 40 women, of which 20 who had previously received the diagnosis of CI and 20 healty women were included in the study. None of the women were pregnant. All subjects underwent sonographic evaluation including cervical length measurement and ES of uterine cervix. Adjacent muscular tissue was the reference point for elastosonography evaluation. Tissue strain ratio values were obtained from all the patients.Results: The area around the internal cervical os of the group with CI was found to be significantly softer as compared to the control group (higher SR rate, p < 0.05). Furthermore, the outer parts of the cervix (sites A and D) were also found harder in the group that had CI (lower SR rate, p < 0.05).Conclusions: According to our knowledge, this is preliminary study to evaluate the predictive value of cervical ES in CI and we concluded that ES can be used as reliable method to determine CI but it is necessary to be studied in different cohort groups.

Fasting and post-prandial glucagon like peptide 1 and oral contraception in polycystic ovary syndrome.

We aimed to investigate whether fasting and meal regulated glucagon like peptide 1 (GLP-1) secretion are altered in patients with polycystic ovary syndrome (PCOS) compared to healty women and whether oral contraceptive use influence GLP-1 secretion dynamics in the syndrome. Prospective observational study. Fourteen lean normal glucose tolerant patients with PCOS and 11 age- and body mass index (BMI)-matched healthy women. Glucagon like peptide 1, glucose and insulin levels were measured during a standardized meal tolerance test and area under the curves (AUCs) were calculated. Whereas healthy controls were assessed at baseline, all tests were repeated in women with PCOS after treatment with ethinyl estradiol 30μg/drospirenone 3mg (EE/DRSP) for 3months. Both fasting and post-meal levels of GLP-1 were significantly reduced in women with PCOS compared to controls (P=0·022 and P=0·028, respectively). AUC for GLP-1 was also lower in PCOS (P=0·012). Glucose and insulin measurements did not show a significant change between the groups. In the PCOS group, GLP-1, glucose and insulin levels did not show any change after 3months of EE/DRSP use. GLP-1 levels both at fasting and in response to a meal are blunted in lean women with PCOS compared to healthy women. Short term oral contraception do not alter GLP-1 secretion in PCOS. Disturbance in incretin secretion dynamics might contribute to the risk of impaired glucose tolerance and type 2 diabetes in PCOS.

Menarche age in schizophrenia

Object: Interest in the association between female sex hormones and mental diseases is not new. A possible association betweeen schizophrenia and estrogens is remarkable. Research on the subject suggested that, women with schizophrenia have chronic gonadal hypofunction and hypoestrogenism. With regard to the hypotesis claiming; insufficient functioning of the sexual glands and estrogen defficiency in women with schizophrenia, the onset of the puberty may be later. In this study,our aim is to examine whether there is difference between women with schizophrenia and mentally healty women considering the age at menarche. Methods: In this study, we included 289 patients who were diagnosed with schizophrenia and 339 mentally healty individuals from the internal medicine outpatient clinic as control group. SCID-I is used to confirm the disorder in schizophrenia group, and to exclude any mental ilness in the control group. Those with mental retardation or organic brain disorders were excluded from the study. Individuals personal information and age at menarche is determined with a sociodemografic form in consultation with the patient and a relative. Results: Compared to controls, the mean age at menarche was higher in women with schizophrenia, but this difference is not statistically significant. Discussion: This supports hypothesis that hypoestrogenism in women with schizophrenia may be caused by neuroleptic treatment. However the participation of the internal medicine patients instead of the healty controls is the limitation of our study. Internal diseases may have influence on the onset of puberty.

GW24-e1277 Increased risk of nonalcoholic fatty liver disease in women with polycystic ovary syndrome related to insulin resistance

ObjectivesThe aim of this study was to investigate the presence of nonalcoholic fatty liver disease (NAFLD) in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR).MethodsThirty-six women with PCOS...

Comparative Study of Serum levels of Granzyme H & Estrogen In Patients Suffering From Breast Cancer

GranymeH is a functional cytotoxic serine protease of NK cell granules,which expands the cell death-inducing repertoire of innate immune system.The purpose of this study was to determine GranymeH(GZMH)level in breast cancer(BC) and healty women.This study was performed on 30 patients with BC and 30 healty woman.GZMH and Estrogen levels were measured in cancer patients and healty women subsequently using ELISA and Radioimmunoassay(RIA) methods. Mean GZMH value was lower in BC than healty women(p<0.0001) and mean Estrogen level was higher in BC patients in comparison to healty women (p<0.003).Our finding indicates probability of existance of suppressor or a problem in production of GZMH in cancer patients

Vajinusmuslu Kadınlarda Cinsel İşlev Ve Doyum / Sexual Function And Satisfaction of Women With Vaginismus

Sexual function and satisfaction of women with vaginismus Objective: Vaginismus is one of the sexual dysfunctions that affects couples’ sexual life. There is a common opinion that women with vaginismus have a satisfied sexual life even there is no vaginal entry. But contrary to this opinion, several studies reported that sexual function and satisfaction of women with vaginismus were impaired. In our study, our purpose was to evaluate sexual function and satisfaction in women with vaginismus and to compare the findings with that of healty women’s. Method: Forty women with vaginismus who referred to Sexual Dysfunction Therapy Outpatient Unit and fifty healthy voluntary women who had no sexual complaint participated in the study. Questionnaire regarding demographic characteristics, Symptom Check List (SCL-90 R), Cloninger’s Temperament and Character Inventory (TCI), Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were evaluated. Results: It was found that women with vaginismus avoided sexual intercourse, were more emotional and needed approval more frequently. Also, vaginismus history was more frequent in their family and among close relatives. They found inadequate their and their partners’ level of sexual knowledge. They had typical fears and they had problems in all other domains of sexual function as well as the vaginal entry. There were statistically significant differences in GRISS vaginismus, avoidance, satisfaction, frequency, lack of orgasm subscales and total GRISS score between vaginismus and control groups. Conclusions: Unlike general opinion, women with vaginismus have problems in many domains of sexual function. We think that it would be inadequate if vaginismus is considered only a problem of vaginal entry, that all domains of sexual function, avoidance and enviromental factors should be evaluated together.

Serological responses to human papillomavirus type 6 and 16 virus-like particles in patients with cervical neoplastic lesions.

Serum samples from 36 cervical carcinoma patients, 33 patients with high-grade squamous intraepithelial lesions, and 31 cytologically normal women were tested by enzyme-linked immunosorbent assay (ELISA) using human papilloma virus type 6 (HPV 6) and HPV 16 virus-like particles as antigens. Forty serum specimens from 1-year-old children were used to assign cutoff points. When serum samples from the subjects infected with HPV 16 were tested in an HPV 16 ELISA detecting immunoglobulin A (IgA), IgG, and IgM binding, 61% showed IgA, 44% showed IgG, and 39% showed IgM reactivity. Of HPV 6- or 11- or HPV 18-infected subjects. fewer than 17% showed IgA or IgG responses and 33% showed IgM reactivity. In contrast, 13% showed IgA, 10% showed IgG, and 16% showed IgM reactivity in the HPV DNA-negative controls. The results suggest that the IgA and IgG responses are HPV 16 specific and the IgM response is cross-reactive to different HPV types. On the other hand, the serological responses to HPV 6 did not differ in the patient and control groups. The percentages of patients positive for both IgA and IgG antibodies were significantly higher in the groups with high-grade squamous intraepithelial lesions (12% [4 of 33]; P = 0.04) and cancer (17% [6 of 36]; P = 0.02) than in the healty women (0% [0 of 31]), and the percentages for either IgA or IgG were higher for the cancer group (47% [17 of 36]; P = 0.01) than in the normal group (19% [6 of 31]). Most sera positive for IgA and IgG in the patient groups showed higher titers than those in the normal group. All these results suggest that high IgA and IgG responses are good indicators for estimating HPV 16 infection.