In comparison to non-refugee control patients, refugee women in our study had poor antenatal care but no adverse perinatal outcomes were observed. Further larger multicenter studies may provide more convincing data about obstetric outcomes in the Syrian refugee population as well as adolescent pregnancies in this population.

Piscirickettsia salmonis is the causative agent of piscirickettsiosis, a transmissible disease of salmonid fish. Diagnosis of piscirickettsiosis has traditionally been based upon identification of typical pathological changes by histological investigation, with confirmation by immunohistochemistry on formalin-fixed, paraffin-embedded tissues. However, implementation of more rapid confirmatory techniques, preferably with higher levels of sensitivity and possibilities for quantification, is desirable. A real-time polymerase chain reaction (PCR) assay was designed for specific detection of P. salmonis and tested on samples extracted from formalin-fixed paraffin-embedded material. Construction of a PCR-target mimic allowed determination of detection limits, linearity of the real-time PCR and quantitative detection of P. salmonis. The present study demonstrates the capability of the described real time PCR assay for detection of P. salmonis from paraffin-embedded material with a high degree of sensitivity and specificity. Implementation of this assay constitutes an important development for a rapid and secure diagnosis of piscirickettsiosis.

Parasitic myoma is a term used to describe a myoma of extrauterine nourishing. Although uterine myomas are the most common female tumors, parasitic myomas are rare pathologic structures of uncertain etiology. One theory suggests that pedunculated subserosal myomas become separated from the uterus and receive blood supply from other adjacent organs, such as the bowel, peritoneum, omentum, or mesentery (1). Peritoneal metaplasia is another theory that describes the pathogenesis of myomas in unexpected fields of abdomen. The development of multiple nodules on peritoneal surfaces is referred to as leiomyomatosis peritonealis disseminata (LPD), which was first described in 1952 by Wilson et al. (2). Different pathological mechanisms related to hormonal factors, genetic basis, pregnancy, oral contraceptive pills, and prior surgery have been described in the literature. Estrogen exposure can stimulate metaplasia and differentiation of subperitoneal mesenchymal stem cells to smooth muscle cells (3). LPD is usually considered as a premenopausal benign condition; however, malignant transformation and postmenopausal status have also been observed in exceptional cases (4, 5). A recent report showed that currently, there are approximately 200 cases of LPD (6). In the last decade, there have been increasing reports of parasitic myomas after laparoscopic surgery, which have been newly classified as iatrogenic parasitic myomas (7). These myomas are related to the small fibroid fragments left after morcellation that could have detached from the uterus and developed blood supply from adjacent organs. In this paper, we aimed to summarize and discuss the various reports of parasitic myomas after laparoscopic uterine surgery.This systematic review was conducted in accordance with the PRISMA guidelines. Literature search was performed using the PubMed database for the period of January 1997 to December 2014. We used following keywords: "laparoscopic hysterectomy," "laparoscopic myomectomy," "morcellation," "parasitic fibroids," "parasitic myomas," and "leiomyomatosis." Specifically, reports written in English language and in which patients with parasitic myoma underwent laparoscopic uterine surgery were considered eligible for our review. Articles including patients who underwent laparotomy or vaginal surgery or who were operated on account of retained myoma in the initial surgery were excluded. Reports with malignant pathology results were also excluded from our review. The flow chart for the study selection process is shown in Figure 1. From the selected articles, the number, size, receptor status, location of parasitic myomas, usage of morcellator in previous surgery, and type of previous laparoscopic uterine surgery were determined. After the initial literature search, 36 articles were identified for review. However, after screening the language, 2 reports were excluded because they were not written in English. Of the remaining 34 reports, 5 did not meet the inclusion criteria and were thus excluded (4 reports involved previous l...

BackgroundHypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women.MethodsIn this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups.ResultsLumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=−0.382; P=0.001), lumbar vertebral z-scores (r=−0.290; P=0.001), and proximal femoral T-scores (r=−0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=−0.318; P=0.001), lumbar vertebral z-scores (r=−0.340; P=0.001), and proximal femoral T-scores (r=−0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46–3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254–3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007–1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters.ConclusionThe present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women.