The aim of this study was to investigate whether overactive bladder (OAB) influences hip fractures in climacteric women by comparing the frequency of OAB and nocturia symptoms in patients with hip fractures and their age-matched controls in pre-fracture period. A total of 30 climacteric patients with a history of hip fracture were compared to a control group of 51 women in terms of OAB, nocturia and nocturia-QoL. A questionnaire composed of structured questions and Turkish validated versions of the specific questionnaires for OAB, OAB-Quality of Life (OAB-q) and nocturia-QoL was directed to the two groups. We did not detect statistically relevant differences between the groups for the presence or severity of OAB and OAB-q (p>.05). However, Nocturia-QoL was worse in the group with hip fracture (p=.022). Overactive bladder has no contribution to the overall risk of hip fracture, whereas, the severity of nocturia seems to play a role as a risk factor in the formation of hip fracture.Impact statementWhat is already known on this subject: Hip fracture is associated with high morbidity, mortality and the cost. Prevention of hip fracture is a high priority for the patients, physicians and the public health. Several studies and consensus opinions have investigated the risk factors for the hip fractures.What the results of this study add: Although urinary symptoms were not evaluated in previous studies as a risk factor, desire of urination makes people stand up and move to their toilet, and may put them in a hurry if it is sudden and uncontrollable one. Therefore, we hypothesised that overactive bladder (OAB) and nocturia may be a risk factor in the formation of hip fractures. Our study showed that Nocturia Quality of Life is worse in patients with the hip fracture. Therefore, overactive bladder may not have a role on the overall risk of hip fracture, but the severity of nocturia seems as a risk factor in the fracture process.What the implications are of these findings for clinical practice and/or further research: The getting up from the bed would probably be harder than getting up from a chair in elderly, and life style modifications such as illumination bedroom and organisation of living place may be helpful to minimise the risks.

Emotional and mind‐body FertiQoL scores were higher among male partners in couples experiencing infertility, and among male partners who were employment compared with those not.

Purpose: To evaluate lenticular oxidative stress in rat menopausal models. Methods: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3), and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4). Total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurements of the crystalline lenses were analyzed. Results: The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p >0.05). The mean TOS values were similar between the groups (p >0.05), whereas the mean TAC of group 1 was significantly higher than that of the other groups (p <0.001). Conclusions: Our results indicate that menopause may not promote cataract formation.

The aim of this study was to determine the frequency of haemostatic abnormalities in women with menorrhagia and to evaluate their effect on quality of life (QoL). The study population was composed of patients with menorrhagia seen in the outpatient clinic, having a score of >185 with a pictorial blood assessment chart. Structured questionnaires were used in the assessment of demographic characteristics and QoL, and patients were tested for bleeding disorders. Ninety women were recruited for the study. Bleeding disorders were detected in 40% of them: 11.1% had von Willebrand disease, 2.2% had low von Willebrand factor and 26.7% had platelet function disorders (PFD). In 22 (91.6%) cases with PFD the, defect was non-specific and impaired aggregation response to ristocetine (37.5%) was the most commonly detected problem. Bleeding disorders were not associated with any significant reduction in QoL (p>.05). Hereditary bleeding disorders may be the cause of unexplained menorrhagia even in the middle-aged women, but they had no prominent effect on QoL.

OBJECTIVE: To investigate the healing effects of erythropoietin (EPO) and stem cells (SCs) in traumatic brain injury (TBI).METHODS: Twenty-nine Wistar albino rats were used and separated into the following groups: control (C), EPO, SC, and SC+EPO. Group C received a TBI only, with no treatment. In the EPO group, 1000 U/kg EPO was given intraperitoneally at 30 minutes after TBI. In SC group, immediately after formation of TBI, 3 x 10,000 CD34(+) stem cells were injected into the affected area. In the SC+EPO group, half an hour after TBI and the injection of stemcells, 1000 U/kg EPO was injected. Before and after injury, trauma coordination performance was measured by the rotarod and inclined plane tests.RESULTS: Seven weeks after trauma, rat brains were examined by radiology and histology. Rotarod performance test did not change remarkably, even after the injury. Compared with group C, the SC+EPO group was found to have significant differences in the inclined plane test results.CONCLUSIONS: Separately given, SCs and EPO have a positive effect on TBI, and our findings suggest that their coadministration is even more powerful.

Introduction and Hypothesis Steroid soaking may decrease mesh-triggered inflammatory reaction in tissue. We aimed to investigate the tissue reaction to a steroid-soaked mesh material and an unsoaked mesh material in the rat model. Methods Neutral and steroid-soaked type I macroporous polypropylene (PP) monofilament and polyvinylidene fluoride (PVF) mesh materials were implanted on the rectus abdominis muscle of 20 mature Wistar albino rats. Animals were divided into four groups: PP mesh with steroid (PP-S), PP mesh without steroid, PVF mesh with steroid (PVF-S), and PVF mesh without steroid. The rats were killed after 12 weeks, and histologic, immunohistochemical and electron microscopic examinations were performed. For immunohistochemical analysis, polyclonal rabbit anti-mouse CD3, rabbit anti-mouse CD68, rabbit anti-mouse CD15, and rabbit anti-mouse CD34 antibodies were used for the detection of lymphocytes, macrophages, polymorphonuclear leukocyte foreign body giant cells, and fibromyocyte stem cells, respectively. Samples were stained with hematoxylin and eosin for the histologic evaluation of inflammation and with Masson’s trichrome stain for the evaluation of collagen deposition. Pore size and mesh ultrastructure were evaluated by electron microscopy. Results Expression of CD3 was lower in the PVF, PVF-S and PP-S groups, and expression of CD34 was higher in the PVF-S and PP-S groups than in the PP groups ( p < 0.05). Collagen deposition was lower in the PVF, PVF-S and PP-S groups ( p < 0.05). Histologically, the intensity of inflammation was lower in the PVF-S and PP-S groups than in the PP mesh group ( p < 0.05). There were no significant differences among the groups in terms of pore size and mesh ultrastructure on electron microscopic examination ( p > 0.05). Conclusions PVF mesh induces less inflammation than PP mesh, and in both mesh types steroid soaking further decreases inflammation without changing the pore size.

Myomas are commonly seen benign tumors of the uterus; they may cause a great variety of symptoms depending on the location. Herein, we presented an unusual case of giant cervical myoma with associated actinomycosis resulting in bilateral hydronephrosis and uremia. A 42-year-old woman was admitted to emergency service with anuria and confusion. She had an intra-abdominal mass extending 4-5 cm above the level of umbilicus. The hemoglobin level was 5.1 g/dl and creatinine level was 5.2 mg/dl. Magnetic resonance imaging revealed enlarged uterus with intrauterine device which was displaced up above the level of umbilicus due to a large cervical mass measuring 16.5x11.5x12 cm, tortuous hydroureters on both sites and left tuba ovarian abscess. A huge cervical lobulated mass which was pressing both ureters and filling the lower abdomen, and left tuba ovarian abscess with dense adhesions which was created by actinomycotic infection were detected on explorative laparotomy. Uremia was normalized gradually following hysterectomy, and the patient was discharged with penicillin treatment. Although myomas are the benign tumors, they may mimic the genital malignancy, and may cause life-threatening complications such as renal failure and uremia.

Objective: To investigate the effect of a previous IVF failure on the quality of life and emotional distress, in couples undergoing IVF treatment. Experiencing IVF failure might cause differences on the anxiety depression and quality of life scores of the couples, compared to the ones who were undergoing IVF treatment for the first time.Study design: This study included 64 couples who had previously experienced at least one IVF failure (Group 1) and 56 couples without history of IVF failure (Group 2) in a private Assisted Reproductive Center, Istanbul, Turkey. A sociodemographic data form, the FertiQoL International and Hospital Anxiety (HAD-A) and Depression scale (HAD-D) for evaluating the status of distress, were administered for the study.Result(s): FertiQoL scores were compared between the groups, the environment scale of the quality of life in treatment section was found to be significantly higher in Group 1 compared with Group 2 (p = 0.009). The HAD-A and HAD-D scores did not differ significantly between the groups. Group-variables were investigated using multilevel analysis, the infertility duration and income level were found to have an effect on the subscales of quality of life (p = 0.009 and p = 0.001 respectively) in Group 2. Depression scores were higher in couples with infertility duration of below five years in Group 1 and Group 2 compared to couples with infertility duration of five years or above (MANOVA analysis). The level of education was found to affect the scores of HAD-D in Group 2, but not in Group 1 (p = 0.011). The score of HAD-D was significantly affected by the family type only in Group 2 (p = 0.009); the depression score of the couples living with a nuclear family was found to be higher compared with the couples living in a traditional family (p = 0.021).Conclusion(s): Fertility-specific quality of life scores reveals better results regarding the orientation to the treatment environment in the couples with a previous IVF failure, compared to first IVF cycle couples. Treatment failure does not elevate the level of anxiety, while the effect on depression scores changes according to duration of infertility. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Objective: We aim to evaluate and describe the tissue elasticity characteristics of various ovarian lesions with sonoelastography.Methods: 35 patients (age range 16-85 years; mean age 40.8 years) underwent sonoelastography and later MRI. Histopathological confirmation of all lesions was carried out, except eight of endometriomas and six of septated cysts which were confirmed on MRI and follow-up ultrasonography. Strain ratios and elastogram patterns were recorded. Lesions were classified into three groups (Group 1: cystic lesions, Group 2: benign tumours and Group 3: malignant lesions) and findings were compared between groups for both observers. Interobserver agreement was analyzed. Optimal cut-off values for strain ratios were achieved with receiver operating characteristic curve analysis.Results: Ovarian endometriomas and complex cystic lesions were observed hard on elastograms with high strain ratios, and malignant lesions were observed mostly soft with very small strain ratios. Benign tumours had average tissue stiffness, observed harder than the malignant lesions, and strain ratios ranged from 4 to 14. The differences in patterns and strain ratios between groups were statistically significant (p < 0.05 for both observers).Conclusion: Our study revealed that malignant ovarian lesions have softer tissue property than benign lesions and cystic lesions in terms of elastogram patterns and strain ratios.Advances in knowledge: Most ovarian lesions contain solid and cystic parts which make the malignant and benign lesions look similar on imaging modalities. Using real-time sonoelastography as an adjunct to other imaging modalities may improve the differentiation of malignant ovarian lesions from benign lesions.

OBJECTIVE:To investigate ways of coping with stress in infertile men and women.STUDY DESIGN:The study population was composed of 255 women and 238 men (total, 493) admitted to an infertility clinic between May 2012 and December 2012. A questionnaire was used to gather information and the Ways of Coping inventory was used for the evaluation of patients.RESULTS:The mean age of the study population was 28.33 ± 5.59 (mean ± SD) for females and 31.60 ± 5.64 for males. We found similar coping scores for men and women in all subscales (Self-confident, Desperate, Obedient, Optimistic, Social Support Seeking) (p > 0.05). The variables affected Coping with Stress Scores in a similar way for both women and men except for "age" and "the desire for psychological support." The Optimistic approach score was worse in men over age 35 and better in those desiring psychological support in both sexes (p < 0.05).CONCLUSION:Infertile men and women use similar coping strategies and have similar coping scores. They mainly use active strategies at a moderate level. Increasing age in the male group, and lack of desire for psychological support in both sexes, are the factors negatively affecting the Optimistic approach scores.

Mullerian adenosarkom daha cok postmenapozal donemdeki kadinlari etkileyen nadir bir tumordur. Patolojik olarak dusuk gradeli endometrial stromal sarkom ve cogunlukla benign, ama bazen de atipik glanduler epitelden olusur. Hastalar cogunlukla karin agrisi, huzursuzluk ve uterin kanama sikayetiyle basvururlar. Bu yazida abse formasyonuyla komplike olan ve postoperatif donemde sepsis gelisen bir Mullerian adenosarkom olgusunu sunmayi amacladik. Mullerian adenosarkomlar rolatif olarak iyi prognoza sahip nadir gorulen tumorler olmakla birlikte klinik tablo nekroza sekonder gelisen enfeksiyon, abse gelisimi ve postoperatif sepsisle komplike olabilmektedir.

Faktör VII (F VII) eksikliği, otozomal resesif kalıtım gösteren ve nadir görülen bir koagülasyon bozukluğudur. Literatürde, F VII eksikliği geniş bir klinik yelpaze göstermektedir ve ileri yaşlarda tanı alabilmektedir. Hastalar F VII düzeylerine bağlı olarak farklı kanama problemleri ile başvurabilmekte veya cerrahi sonrası kanama ile karşımıza çıkabilmektedir. Ancak literatürde F VII düzeyleri ile kanama komplikasyonları arasındaki ilişki net olmamasına rağmen, majör cerrahi öncesi riskli hastalarda rekombinan F VII derivesi verilmesi önerilmektedir. Çalışmamızda, herhangi bir kanama komplikasyonunun tariflenmediği geçirilmiş sezaryen hikâyesi olan ve sezaryen öncesi tetkiklerinde yüksek 'Internationel Normalize Ratio (INR) değeri saptanıp F VII eksikliği tanısı alan 27 yaşında bir olguyu sunmayı amaçladık. Factor VII (F VII) deficiency is a rare coagulation disorder inherited autosomal recessively. According to our literature search, it shows a wide clinical spectrum and can be diagnosed in advanced ages. Depending on the F VII levels, patients can admit with different kind of bleeding disorders or face to bleeding in postoperative period. Although the association between F VII levels and severity bleeding problems is not clear cut, recombinant F VII product infusion was advised before major surgery. In this paper, we aimed to present a late diagnosed F VII deficiency during preoperative investigation for elevated International Normalize Ratio (INR) levels in a 27 years old woman with an uncomplicated cesarean section history.

BACKGROUND/AIM:Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an essential role in the healthy development of a fetus. We aimed to investigate hemoglobin, ferritin, folate, and vitamin B12 levels in preconceptional women in an area where a plant-based diet referred to as Mediterranean cuisine is commonly used.MATERIALS AND METHODS:The study population included 466 women between the ages of 18 and 45 years admitted for thalassemia screening. Sociodemographic variables and history of menometrorrhagia, pica, and dietary habits were collected. Serum vitamin B12, folate, ferritin, and hemoglobin levels were measured. Ferritin of <12µg/L, vitamin B12 of <200 pg/mL, and folate of <4 ng/mL were accepted as deficiencies. Hemoglobin level of <12 g/dL was classified as anemia.RESULTS:Polymenorrhea was present in 11.7% and hypermenorrhea in 24.8% of women. Anemia was detected in 24.9% and thalassemia trait in 3.0% of women. Low ferritin levels were observed in 46.1%, vitamin B12 in 21.6%, and folate in 3.4% of women. In the group with low vitamin B12, decreased meat consumption was more prevalent (27.5% vs. 16.9%; P = 0.019).CONCLUSION:Vitamin B12 and iron are the main micronutrients depleted in our community. This necessitates implementing a public health program for women consuming a Mediterranean diet.

ÖzetMüllerian adenosarkom daha çok postmenapozal dönemdeki kadınları etkileyen nadir bir tümördür.Patolojik olarak düşük gradeli endometrial stromal sarkom ve çoğunlukla benign, ama bazen de atipik glandüler epitelden oluşur.Hastalar çoğunlukla karın ağrısı, huzursuzluk ve uterin kanama şikayetiyle başvururlar.Bu yazıda abse formasyonuyla komplike olan ve postoperatif dönemde sepsis gelişen bir Müllerian adenosarkom olgusunu sunmayı amaçladık.Müllerian adenosarkomlar