Gestational diabetes mellitus (GDM) is associated with an increased risk of postpartum type 2 diabetes mellitus and cardiovascular risk factors, such as obesity, hypertension, dyslipidaemia and systemic inflammation. We aimed to evaluate further lipid profile and inflammatory status assessed by high sensitive C-reactive protein (hsCRP) and TNF-α in GDM. Based on oral glucose tolerance testing, participants were stratified into three groups: normal 50 g glucose challenge test (GCT), normal 100 g glucose tolerance test (NOGTT) (control group) (n = 40); abnormal GCT NOGTT (glucose intolerance) (n = 37); and GDM (n = 39), defined by Carpenter and Coustan. The three groups did not demonstrate significantly different hsCRP levels (p = 0.4180) and lipid profile parameters, such as total cholesterol (p = 0.4210) and LDL-cholesterol (p = 0.4440) levels. Triglycerides (p = 0.0150) and atherogenic index of the plasma levels (p = 0.0280) were slightly higher in the GDM group. But, TNF-α levels increased significantly in the GDM (p < 0.0001) and in glucose intolerance (p = 0.0062) groups as compared with the control group. Among the metabolic syndrome components, insulin resistance was apparently associated with TNF-α, whereas dyslipidaemia was slightly associated with hsCRP because of the effects of maternal age on lipid markers. These findings suggest that TNF-α has a stronger correlation with pregnancy-associated insulin resistance than hsCRP at 24 to 28 weeks' gestation.
A series of 460 surgically treated cases of hydatid cyst of the lung is presented. Radiologic preoperative diagnosis was made in 90% of the patients. Cystotomy with subsequent capitonnage was performed in 395 cases, wedge resection in 27, lobectomy in 15 and segmental resection in 23 cases. After careful hemostasis, two drains were placed in the thorax and the thoracic cavity was closed. There were three postoperative deaths (0.6%) and two recurrences of cyst (0.4%) during follow-up investigation for periods up to 10 years.
IntroductionEndometrial thickness is measured by transvaginal sonography and thickening indicates an increased risk of malignancy or other pathology (hyperplasia or polyp) in the postmenopausal period. The main screening methods for the uterine cavity are dilatation and curettage, and hysteroscopy. We sought to correlate hysteroscopic and pathological findings in asymptomatic postmenopausal women with sonographically thickened endometrium (> 5 mm) in this study.Material and methodsThis retrospective cross-sectional study involved case records of 197 women who have thickened (> 5 mm) endometrium in the postmenopausal period. All these women underwent hysteroscopy with diagnostic dilatation and curettage between January 2012 and January 2013 at the Bursa Zübeyde Hanım Maternity Hospital. Sensitivity, specificity, positive, negative predictive values and p value of hysteroscopy were calculated. Dilatation and curettage was set as the gold standard.ResultsFor the evaluation of postmenopausal thickened endometrium, hysteroscopy revealed sensitivity, specificity, positive predictive value and negative predictive value as 76.4%, 76.9%, 73.1%, 79.8%, respectively.ConclusionsHysteroscopy is a fast and accurate technique in evaluation of the intrauterine space occupying lesions (polyp, fibroid) but only moderate for endometrial hyperplasia. Hysteroscopic view combined with direct biopsy could be a gold standard for endometrial assessment.
Non-puerperal uterine inversion is an extremely rare gynaecological event that is usually associated with uterine tumours such as submucous or cervical leiomyomas. In this report, we describe a case of uterine inversion due to a large submucous leiomyoma in a 42-year-old multiparous and obese Caucasian woman.
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