Assessment of the predictive value of serum progesterone levels on early pregnancy prognosis in spontaneous twin gestations: a prospective study

OBJECTIVES: The aim of this study was to assess the predictive value of serum progesterone levels in early pregnancy prognosis in spontaneous dichorionic-diamniotic twin gestations. STUDY DESIGN: This study was carried out among 38 spontaneous dichorionic-diamniotic twin gestations between January 2003 and June 2005 in the Department of Obstetrics and Gynaecology at the Gulhane Military Medical Academy. Serum progesterone levels were measured at 7 and 10 weeks' gestation and pregnancies were followed until 14 gestational weeks by ultrasound examination. RESULTS: We found that a progesterone level of 58 nmol/l in the 7th gestational week and of 51 ng/ml at 10 gestational weeks has a predictive value for viable intrauterine twin pregnancies with 83% sensitivity and 69% specificity and 83% sensitivity and 84% specificity, respectively. CONCLUSION: Progesterone levels in the early gestational weeks may be a biochemical marker for the prediction of a twin pregnancy outcome and may reduce the number of ultrasound examinations.     

Isolated torsion of fallopian tube in a premenarcheal 12-year-old girl

Isolated torsion of fallopian tubes should be considered even at premenarcheal ages in cases of acute pelvic pain, and prompt surgery can preserve the tube and thus fertility. It is an uncommon emergency event and a difficult condition to evaluate clinically. This report focuses on a 12-year-old premenarcheal girl who presented with acute pelvic pain of 2 days. Pelvic ultrasound showed an adnexal mass on the left side. Laparoscopy was performed and an isolated tubal torsion was discovered. The tube was necrotic and salpingectomy was performed. The appendix appeared to be hyperemic and erectile. Appendectomy was also performed to rule out appendicitis. It's our recommendation that in the differential diagnosis of acute lower abdominal pain of girls, isolated torsion of the fallopian tubes should be considered. Also, preservation of the tube and fertility should be possible with prompt surgical intervention.     

The development of registries for surveillance of adult lead exposure, 1981 to 1992.

OBJECTIVES. Since 1981, 15 states have established registries for surveillance of adult lead absorption, primarily based on reports of elevated blood lead levels from clinical laboratories. I review the status of the registries and recommend steps for further development. METHODS. Companies reported to the New York registry are compared with those cited by the Occupational Safety and Health Administration (OSHA). I present data on US workers and plants with potential lead exposures and blood tests, as well as review registries' reporting requirements. RESULTS. Registries identify many companies not cited by the Occupational Safety and Health Administration, but underreporting occurs because (1) reporting is usually not required from laboratories outside the state, (2) most registries use a blood lead reporting level of 1.21 mumol/L, which excludes many exposed workers, and (3) many companies with potential exposures do not have routine monitoring programs. CONCLUSIONS. Registries' reporting requirements and procedures should be standardized, including a blood lead reporting level of 0.72 mumol/L. Elevated blood lead levels should be a reportable condition nationwide, and a comprehensive national surveillance system should be established: clinical laboratories should be required to report cases to those states with lead registries or directly to the national adult lead registry.     

Elevated serum IgE, eosinophilia, and lung function in rubber workers

We previously reported an outbreak of acute respiratory illness associated with eosinophilia in a group of rubber workers who performed a thermoinjection process in which synthetic rubber was heated and then injected onto metal molds. This study was conducted to determine if persistent respiratory health effects were associated with this work area and to explore the possible allergic etiology of this syndrome. A survey was performed 1 mo after a major improvement in area ventilation and consisted of baseline, cross-shift, and cross-week spirometry; diffusing capacity; serum immunoglobulin E (IgE), total eosinophil count; and skin patch testing. Baseline lung function, cross-shift, and cross-week spirometry were not significantly worse in the exposed group as compared to the control group. However, either eosinophilia (greater than 450/mm3) or elevated serum IgE (greater than 470 ng/ml) were present in 44% of exposed workers vs. 11% of the control group (p = .003). Nine months later, neither eosinophilia nor elevated IgE were associated with employment in this work area. We conclude that employment in the thermoinjection process was associated with eosinophilia and elevated IgE, which suggests sensitization to one of the components of the rubber, although no effect on pulmonary function could be demonstrated.     

Anticipated and perceived pain from midtrimester amniocentesis

OBJECTIVE: To evaluate the anticipated and perceived pain and determine the factors contributing to pain perception in women undergoing midtrimester amniocentesis. METHODS: A visual analog scale was used to quantify pain in this prospective study of 64 women undergoing amniocentesis in the same clinical setting. The analysis was done using the paired-samples t test, analysis of variance, the Kruskal-Wallis test, the Mann-Whitney U test, and Pearson correlation analysis. RESULTS: The postprocedural pain scores were significantly less than the preprocedural pain scores (P<0.01). Parity, a previous amniocentesis, the indication for amniocentesis, and the previous loss of a child were factors contributing to pain scores. No correlations were found between pain score and maternal age, week of pregnancy at the time of the procedure, parity, or having lost a child. CONCLUSION: The perceived pain was less than the anticipated pain, and the factors contributing to pain should be kept in mind when counseling patients undergoing midtrimester amniocentesis.     

Antimicrobial compounds from Pimpinella species growing in Turkey

A new, 4-(2-propenyl)-phenyl angelate ( 1) and four known phenylpropanoids ( 2 - 5), were isolated from Pimpinella isaurica, a species endemic in Turkey. One new sesquiterpene, 1-methyl-4-(5-methyl-1-methylenehex-4-enyl)-7-oxabicyclo[4.1.0]heptane ( 6) was obtained from P. aurea and two known phenylpropanoids were isolated ( 7, 8), from P. corymbosa. The structure elucidation of the new compounds 1 and 6 was achieved by a combination of one- ( (1)H, and (13)C) and two-dimensional NMR techniques (G-DQF-COSY, G-HMQC, and G-HMBC) and LC-ESI-FTMS. Compounds 1, 2, 4, 6, 7, 8 have been evaluated for their antimalarial and antimicrobial activities. Compound 1, 2, 4, 6, 8 had antimicrobial activity against Mycobacterium intracellulare with IC (50) values of 7.0, 15.0, 2.5, 10.0 and 1.5 microg/mL, respectively.     

Association between root taper and root proximity of single-rooted teeth with periodontitis: a cone-beam computed tomography based study

Odontology - This study aimed to determine the association between the root taper and proximity of single-rooted teeth with periodontitis using cone-beam computed tomography (CBCT). CBCT images of...