Obstetric outcomes of adolescent pregnancies in Turkey

Pregnancy in adolescence has been and continues to be a problem in public health. The purpose of this study was to investigate obstetric outcomes of adolescent pregnancies in Samsun, Turkey. A cross-sectional study was conducted between January 1 and December 31, 2004, at 3 hospitals in Samsun, Turkey. Of the 10,100 women who gave birth during this period, 357 (3.5%) were 18 years of age or younger; these patients were included in the study. Participants with a history of any chronic disease were excluded. Data were provided as median values (minmax) and percentages. In this study, the rate of birth for females 18 years or younger was found to be 35 per 1000. The median age of participants was 18 (14–18) years. The prevalence of cesarean section was calculated at 55.7%. Prevalences of lowbirthweight infants, preterm delivery, and eclampsia/preeclampsia were recorded as 44 (12.3%), 34 (9.5%), and 30 (8.4%) cases, respectively. Although the stillbirth rate was determined to be 1.7%, no congenital deformity was noted in infants, and none of the mothers died. The cephalopelvic disproportion rate was 5.9%, and only 2 adolescents experienced abruptio placentae. To reduce the occurrence of adolescent childbearing, pregnancy intentions must be assessed in multiple ways. Information/education may provide benefit to those female adolescents with inconsistent pregnancy intentions.     

Low Density Granulocytes and Dysregulated Neutrophils Driving Autoinflammatory Manifestations in NEMO Deficiency

Journal of Clinical Immunology - NF-κB essential modulator (NEMO, IKK-γ) deficiency is a rare combined immunodeficiency caused by mutations in the IKBKG gene. Conventionally, patients are...     

Hyperthyroidism in molar pregnancy: rapid preoperative preparation by plasmapheresis and complete improvement after evacuation.

Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely elevated levels of human chorionic gonadotropin in patients with molar pregnancy or other trophoblastic diseases can lead to hyperthyroidism. We describe a patient with molar pregnancy who had secondary hyperthyroidism prepared rapidly by plasmapheresis for surgery. The clinical picture improved dramatically after the first plasmapheresis. Three subsequent plasmapheresis provided a 75.1% decrease in serum free T3 concentrations and 63.9% free T4 concentrations and recovery after evacuation. This is the first use of plasmapheresis in rapid preparation of a patient who had secondary hyperthyroidism due to molar pregnancy.     

Hemi-meningitis with hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) is a rare lymphoproliferative disorder. HLH may occur as a complication of Epstein-Barr virus (EBV), particularly in patients with immunodeficiencies. Herein, we describe a 16-year-old girl with neurological complications associated EBV-induced HLH. Her cerebral magnetic resonance imaging (MRI) showed contrast-enhanced axial T1-weighted images with enhancement of meningeal surface in the right hemisphere that was consistent with right hemi-meningitis. Hydrocephalus, dilated subdural spaces, delayed myelination, edema, diffuse parenchymal atrophy, calcifications, diffuse/patchy white matter abnormalities have all been previously described with HLH. To the best of our knowledge, this is the first case of hemi-meningitis associated with HLH. We suggest that clinicians should consider HLH with vascular disorders when they determine unilateral meningitis on a brain MRI.     

Long-Term Experience of Subcutaneous Immunoglobulin Therapy in Pediatric Primary Immunodeficient Patients with Low and Normal Body Weight

Journal of Clinical Immunology - The aim was to review the compliance, side effects and effectiveness of subcutaneous immunoglobulin (SCIG) supplementation in patients with primary...     

Macular and peripapillary vessel density alterations in a large series of patients with systemic lupus erythematosus without ocular involvement

Graefe's Archive for Clinical and Experimental Ophthalmology - The aim of this study was to investigate changes in both macular and peripapillary retinal microcirculation in the subclinical...     

Left ventricular aneurysm in the scope of gated perfusion SPECT: accuracy of detection and ejection fraction calculation

PURPOSE: The objective of this trial was to investigate the capacity of gated perfusion SPECT (GPS) to detect left ventricular aneurysm (ANV) by comparing QGS and 4D-MSPECT (4DM) algorithms with radionuclide ventriculography (RVG). Secondarily, the comparison of GPS ejection fraction (EF) measurements with those of contrast left ventriculography (LVG) and RVG was aimed. METHODS: Twenty-five patients with ANV confirmed by LVG were studied. The patients underwent RVG and rest Tc-99m-tetrofosmin GPS 1 week after LVG. A 9-segment model was used both in RVG and GPS evaluation. Aneurysm was defined by scoring the wall motion (WM) and phase analysis in RVG; perfusion, wall thickening and WM in GPS. RESULTS: The detection rate of ANV was 96%, 84% and 52% for RVG, QGS and 4DM, respectively. The LVG mean EF (43.52% +/- 16.93%) was significantly higher (P < 0.01) than those of RVG (29.40% +/- 10.90), QGS (30.04% +/- 13.25%) and 4DM (34.92% +/- 13.01%). Moderate to high EF correlation values were obtained between LVG and GPS (r = 0.71-0.79) and GPS-RVG (r = 0.69). There was no significant EF difference between the radionuclide methods except between 4DM-EF and RVG-EF (5.52%, P < 0.05). Wide Bland-Altman limits were observed between the radionuclide methods in EF comparisons (range: 30.5-38.5%). CONCLUSION: GPS seems to have a role in the non-invasive investigation of ANV. QGS-GPS proved to be more reliable (84%) than 4DM-GPS (52%) in the ANV detection. The localization and the extent of the aneurysm itself as well as perfusion and function of adjacent segments may affect aneurysm diagnosis by means of GPS. RVG, QGS-GPS and 4DM-GPS seem not to be interchangeable for routine EF calculation in ANV patients.