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    Course of obsessive-compulsive disorder during early postpartum period: a prospective analysis of 16 cases
    (W B SAUNDERS CO-ELSEVIER INC, 2007) Uğuz, Faruk; Gezginç, Kazım; Zeytinci, İsmet Esra; Karataylı, Savaş; Aşkın, Rüstem; Güler, Özkan; Şahin, Figen Kır
    Objective: The aim of the current study was to prospectively examine a course of obsessive-compulsive disorder (OCD) during the early postpartum period. Method: The study data were collected from 16 pregnant women. with a diagnosis of OCD according to the Structured Clinical Interview for DSM-IV (SCID-I). Obsessive-compulsive disorder symptoms were assessed by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) before and after childbirth. Psychopharmacologic or psychotherapeutic treatments were not administered over the study period. Results: Scores of the mean Y-BOCS-total and Y-BOCS-obsession were significantly reduced from the basal levels to 6 weeks postnatally. No significant difference was found in terms of Y-BOCS-compulsion between 2 interviews. During the study period, whereas the Y-BOCS-total scores were decreased by at least 25% in 8 (50.0%) of 16 patients, only 1 (6.2%) of 16 patients experienced at least a 25% increase in the same scores. Conclusion: The results from a small patient group suggest that some patients may experience a marked improvement in preexisting OCD symptoms after childbirth. (c) 2007 Elsevier Inc. All rights reserved.
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    Obsessive-compulsive disorder in pregnant women during the third trimester of pregnancy
    (W B SAUNDERS CO-ELSEVIER INC, 2007) Uğuz, Faruk; Gezginç, Kazım; Zeytinci, İsmet Esra; Karataylı, Savaş; Aşkın, Rüstem; Güler, Özkan; Şahin, Figen Kır
    Objective: The principal aims of this study were to examine the current prevalence rate, clinical characteristics, and related factors of obsessive -compulsive disorder (OCD) in pregnant women during the third trimester of pregnancy. Method: The study data were gathered from 434 consecutive women in the third trimester of pregnancy who presented to the obstetric outpatient clinics of 2 university research centers and from 58 consecutive nonpregnant women with diagnosed with OCD who presented to the psychiatric outpatient clinics of the same centers. Obsessive-compulsive disorder was diagnosed by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The Yale-Brown Obsessive-Compulsive Scale was used to determine the severity and types of obsessions and compulsions. Results: The prevalence rate of OCD was found to be 3.5% among the women in the third trimester of pregnancy. Two (0.5%) women reported that OCD developed during the second trimester (16th and 24th gestational weeks) of pregnancy. The most common obsessions were contamination (80.0%) and symmetry/exactness (60.0%), whereas the most common compulsions were cleaning/washing (86.7%) and checking (60.0%). Women with pregnancy-onset OCD and some women with previous diagnoses of OCD had obsessions and compulsions with themes focused on the fetus or newborn. Pregnant women with OCD had higher frequencies of family history of OCD compared with women without this disorder. Age, educational level, employment status, number of gestations and live births, history of abortion, frequency of primigravida, and the existence of gestational complications were unrelated to OCD in the pregnant women. Pregnant and nonpregnant 9 women with OCD had similar characteristics of obsessive-compulsive symptoms. Conclusion: Our study suggests that OCD is present relatively frequently among pregnant women during the third trimester of pregnancy, and it has similar clinical features during gestation and nongestation. (C) 2007 Elsevier Inc. All rights reserved.
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    Stepwise rising CO2 insufflation as an ischemic preconditioning method
    (MARY ANN LIEBERT, INC, 2007) Şahin, Dursun A.; Haliloğlu, Berna; Şahin, Figen Kır; Akbulut, Gökhan; Fidan, Hüseyin; Köken, Gülengül; Büyükbaş, Sadık
    Background: The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/ R) injury and oxidative stress. Various ischemic-preconditioning (IP) methods were used to reduce ischemic injury in intra-abdominal organs. In this experimental, randomized, controlled trial with a blind assessment of the outcome, we evaluated the effects of a new IP method, stepwise rising CO2 insufflation, on oxidative stress and inflammatory cytokine response. Methods: Twenty-one rats were divided into three groups. Rats in the control group were subjected to general anesthesia for only 60 minutes. The stepwise group was subjected to 5 mm Hg for 10 minutes, 10 mm Hg for 10 minutes, and 15 mm Hg of CO2 insufflation for 60 minutes without deflation. In the Pp15 group, the pressure of CO2 insufflation was fixed at 15 mm Hg for 60 minutes without deflation. Liver and blood samples were examined to determine malondialdehyde (MDA), the antioxidant, superoxide dismutase (SOD), and inflammatory cytokine (tumor necrosis factor-alpha [TNF-alpha], interleukin-6 [IL-6]) levels. Histopathologic scores of liver tissue were examined in all groups. Results: The highest plasma and liver MDA, TNF-alpha, and IL-6 values were in the Pp15 group, followed by the stepwise and control groups. However, plasma and liver SOD levels determined in the control group were significantly higher, compared to stepwise and Pp15 groups. The lowest plasma and liver levels of SOD were in the Pp15 group, followed by the stepwise and control groups. Significantly higher histopathologic scores were found in the Pp15 group, followed by the stepwise and control groups, as well as MDA and inflammatory cytokine (TNF-alpha, IL-6) levels. Conclusions: We concluded that the stepwise rising CO2 insufflation method may be an alternative IP method that may lead to a reduction in I/ R injury.