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The Importance of Healthy Nutrition during Pregnancy

The Importance of Healthy Nutrition during Pregnancy

Pregnancy is the most likely and the most perfect thing that can ever happen to an adult woman. One of the most curious topics for many of the women, who recently find out that they are pregnant, is how nutrition should be. In order to be able to have a healthy and high quality pregnancy period, to reduce the complications that are specific to pregnancy and to bring a healthy baby with enough food deposits to the world, it is very important to have adequate and balanced nutrition in the pregnancy period, as it is in every period of life.

  • Meeting the physiological needs of the mother,
  • To keep the body’s nutrient storage depots in balance,
  • To provide normal growth and development of fetus (baby in mother’s womb)
  • Provide enough milk release during lactation period.

In cases where the mother cannot feed enough, the complications that can be observed in the mother and the baby may be as follows

July 23, 2023 BLOG-EN

Early Diagnosis Tests against Cancer

Is there cancer in your family?

Mutations from parents to children or variations in genes can greatly increase the risk of cancer. In fact, some hereditary syndromes almost 100% cause of some types of cancer.

Fortunately, if you or your family know if you are at risk or not, it will enable both you and your doctor to take the right step in acting against hereditary cancer and reduce the risk to a significant extent. If your family has a history of such illness, Myriad genetic tests can determine if you have some genetic variations that can cause hereditary cancers.

Learn Genetic Tests

We know from research that 10% of cancers pass through generations. These syndromes are known as hereditary cancers and there are some genetic tests that can determine the individual risks for such cancers. If you or an acquaintance has such a family history of cancer, is in risky ethnic population, or if there are other factors, it means that you may be at risk for cancer and that you have a reason to be suspicious. We recommend genetic testing for individuals to live a longer, healthier life and to take action in cancer prevention.

Regardless of the final result, there are many benefits to taking the test. If a family member is cancer (but distant), if there is an inherited gene mutation, then the chance not only increases for the present and future but also there is a risk to pass it onto a new generation. If you or someone you know is carrying a cancer gene mutation, it may be a signal for the risk of getting cancer before someone in the general population. The earlier the test is done, the easier it will be to manage the risk appropriately.

Do not forget that your doctor is the most valuable resource for information and advice on hereditary cancer screening.

Genetic Test Information:

  • Genetic tests can be done by taking an oral sample or drawing blood.
  • The insurance coverage usually covers 90% of the test cost.
  • Privacy laws are protecting you.
  • There are optional payment plans if necessary.

Many cancers are usually found out incidentally as result of environmental conditions and lifestyle preferences. In some families, we somehow see more cancer than expected. Since families with hereditary cancers are at a higher risk for cancer than the general population, it is important to identify families with cancers related to an inherited gene mutation. These subgroups or populations can be organized according to their family lineages, such as the presence of a single type of cancer, the simultaneous occurrence of the same or different types of cancer in an individual, or the pre-defined mutations of certain cancer genes.

  • Sporadic Cancer – Cancer occurs by chance. People with sporadic cancers usually do not have relatives who have the same type of cancer.
  • Familial Cancer – Cancer is probably the result of a combination of genetic and environmental risk factors. Familial cancer patients may have one or more relatives with the same type of cancer; however, heredity may not appear in a particular model (for example, the risk of cancer does not go directly from the parent to the child)
  • Hereditary Cancer – The cancer which occurs when there is a mutated gene is transferred from the parent to the child in the family. People with inherited cancers are likely to have relatives with the same type or related type of cancer. More than one cancer may develop in them, or the age that cancer is seen may be earlier than the average age

The following information can be used to identify and organize communities and persons at greater risk than the general population. Hereditary Cancer Testing should be seriously considered in these groups:

Hereditary Breast and Ovarian cancer:   

  • Ovarian cancer at any age
  • Two primary breast cancers *
  • Male breast cancer
  • Triple negative breast cancer
  • Cancer of the pancreas with a breast or ovarian cancer *
  • Ashkenazi Jewish Root with HBOC-associated cancer *
  • Breast cancer in two or more relatives under the age of 50
  • Breast cancer at three or more relatives at any age
  • Previously defined BRCA mutation in the family

Lynch syndrome:

If a person has a PERSONAL STORY* about any of the following:

  • Colorectal or endometrium cancers before the age of 50
  • Before age 60 High MSI Histology before the age of 60:
    • Musenöz
    • Signet ring (Stone Ring Cells-Krukenberg Tumor)
    • Tumor infiltrating lymphocytes
    • Crohn’s-like lymphatic reaction histology
    • Medullary growth pattern
  • Abnormal MSI / IHC tumor test result (Colorectal / Endometrial)
  • 2 or more Lynch syndrome cancers at any age **
  • Lynch syndrome cancer ** and one or more relatives with Lynch syndrome cancer **
  • Previously defined Lynch syndrome mutation in the family

If a person has a family story * related to any of the following:

  • Two or more relatives with Lynch syndrome cancer **, one before age 50
  • Two or more relatives with Lynch syndrome at any age
  • Previously defined Lynch syndrome mutation in the family

** Lynch associated cancers are colon, endometrium, stomach, over, ureter / renal pelvis, biliary tract, small intestine, pancreas, brain and fat adenomas.

Adenomatous Polyposis Syndromes:

  • Individuals who are clinically affected by FAP (100 or more colorectal adenomas)
  • Individuals with multiple colorectal adenomas (generally 10 or more cumulative adenomas)
  • Relatives carrying APC or MYH mutation

Hereditary Melanoma:

  • Two or more melanomas in the person or in the family
  • Melanoma and pancreas cancer in the person or in the family
  • P16 mutation carrier relatives

Hereditary Pancreatic Cancer:

  • Pancreatic cancer patient with at least one close relative# with pancreatic cancer163-168
  • People with two or more close relatives# with pancreatic cancer
  • First degree relatives# with pancreatic cancer or Ashkenazi Jewish people with pancreatic cancer histology169-171
  • Previously defined PALB2 or BRCA2 mutations172-178 in the family

You can answer the Hereditary Cancer Questions to find out if you are a candidate for testing. This quiz can help them get the information they need to discuss with their risk of cancer with their healthcare provider and ask for further evaluation. If someone matches any of the red flags above or takes the quiz and finds red flags in their own history or their family history, they may benefit from hereditary cancer testing.

Benefits of Genetic Testing

There are many different types of genetic tests. The tests at Myriad include hereditary cancer tests, prognostic tests and personal tests. The purposes of our tests are:

  • To provide valuable information to you and your doctor when you organize your medical treatment plans.
  • To inform you and your doctor whether there is a genetic mutation known to raise the risk for some hereditary cancers.
  • To make it easier for your doctor to better anticipate the progress of your illness, and it can make your treatment conscious.
  • To help your doctor make important decisions about your medical treatment.

If cancer is common in your family, taking a genetic test can be an important step for you. If your test result is higher than average:

  • More frequent follow-up can help detect cancer at an earlier and more manageable stage.
  • Preventive strategies that can reduce the risk of developing cancer can be evaluated.
  • You and your doctor can make more informed decisions about treatment options.

Being informed about a hereditary mutation enables you to identify cancer at an earlier and more manageable stage or to reduce the risk of developing some cancers, and gives you the power to take the necessary steps.

July 23, 2023 Genel

Stem Cell for Beauty

In general terms, stem cells are the main cells found in the human body and capable of being transformed into body cells of various kinds. They have infinite proliferation and differentiation capacity. Wherever there is a bruising or a need for repair, they go there to become the required cell type and repair the damage.

The ratio of stem cells and the ability to transform into different structures is the highest in embryonic, fetal tissues and later in infants, but decreases as age progresses. It is for this reason that, wound healing in adults and elderly becomes increasingly difficult, and organ-tissue failure related diseases begin to appear. Because the lower the ratio of stem cells per total cell, the slower the tissue-organ recovery.

Similarly, depending on the aging of the skin, dryness, wrinkles, subcutaneous tissue thinning and smearing begin to be seen. Skin texture begins to loosen and sag. So how can stem cells help us on this issue?

If the person does not have any stocked source such as stored cord blood-texture, which is from infancy, which has a longer life span (long telomere) and a higher reproductive capacity; it is clear that we need to make use of the available resources more efficiently.

The most common stem cell sources used for cosmetic purposes in the world today are skin and fat tissue. In some ecoles, such as German and Swiss, tissue extracts from lamb fetuses are used, but this is not widespread worldwide.

In order to obtain stem cells from the skin, a small biopsy from the back of the ear is taken and put into nutrient fluid. The reason why this region is preferred is that it is naturally preserved from the sun and therefore the biological age is smaller than the face. The stem cells are separated by putting the tissue through enzymatic-physical processes in a laboratory with GMP standards. It is planted in plastic containers containing medium, waiting for it to multiply. The proliferating cells are collected and divided into new containers, again expected to multiply. This process is repeated four or five times to multiply the cells. The process lasts for one to one-and-a-half months.

Almost all of these cells will turn into fibroblast structure, either during production or after application to the skin. Fibroblasts are the basic cells responsible for the synthesis of collagen in the skin. In addition to collagen, elastic fibers and hyaluronic acid are produced by fibroblasts. The fibroblast cells in the skin play a leading role in wound healing and tissue repair. Decrease in these cells with age progression is the main cause of treatment. Following the replication process, cells are subcutaneously administered with the help of fine-tipped needles to increase the number of fibroblasts per millimeter, thereby activating the skin.

Obtaining of stem cells from fat tissue, is mainly applied to people who will have liposuction done. Stem cells are mostly separated from fat tissue taken from the abdomen or upper leg, with the help of a special machine. The feature of this method is that the cells can be taken and applied to the required region at the same time, while the patient is under the general anesthesia. If the area to be applied is large, these cells can also be reproduced. In this case, there will again be a period of time between obtaining and application.

For a successful treatment (e.g., in the face area), it is targeted to deliver about 200-300 million cells, even at intervals. Usually two sessions, two to three weeks apart are sufficient. Since the cells applied to the skin are the person’s own cells and continue to live, the obtained state of wellness lasts longer.

During the application, PRP (Platelet Rich Plasma) can be given together with the stem cells to provide support of various magnifier, enhancer secretions. For this purpose, 10cc of blood taken from the person is turned in the centrifuge, separating the plasma part and the part of the red blood cells. The part that contains thrombocytes, which provide blood coagulation, is taken and used. Likewise, using a filler such as hyaluronic acid for very deep and settled wrinkles will increase local success.

July 23, 2023 Genel

Microarray Blood Test

General Information:

Breast cancer is one of the leading causes of premature deaths in women. Epidemiological studies show that in 36% of women diagnosed with breast cancer, especially under 30 years of age, the cancer may be associated with a genetic disorder. This situation increases the chances of early diagnosis of breast cancer clinically and increases the likelihood of treatment.

In breast cancer, the major genes that are thought to be caused about 5-10% by inherited factors are BRCA1, BRCA2. It is known that mutations in these genes with tumor suppression features are responsible for about 40% of inherited breast cancers.

  • Life-long risk of developing breast cancer in women is 1/8; ovarian cancer development risk is 1/70.
  • 5-10% of breast and ovarian cancers are familial.
Who should have mutation screening in BRCA1 and BRCA2 gene?
  • Women who are diagnosed with breast or ovarian cancer (to provide genetic counseling to the family)
  • Women who are diagnosed with ovarian cancer, whose first or second degree relatives have history of breast or ovarian cancer,
  • Women who are diagnosed with breast cancer before 50 years of age,
  • Women who have a history of ovarian cancer in their first or second degree relatives, or who have a male relative diagnosed with breast cancer,
  • Women with mutation in the BRCA1 or BRCA2 gene in their first or second degree relatives should have this screening done.

Women carrying the BRCA mutation were found to be associated with a 2.7 to 6.4 times increased life-long risk of breast cancer, and an increased risk of over-cancer at 9.3 to 35.3 times, compared to women at average risk.

  • The tumor suppressor genes, BRCA1 is located in the 17q21 region and the BRCA2 gene is localized in the 13q12.3 region. There genes are also responsible for DNA repair. Mutations detected on both genes lead to inherited breast cancer
  • BRCA1 and BRCA2 genes are responsible for 84% of inherited breast cancer and 90% of inherited ovarian cancer.
  • The life-long risk of developing breast cancer in a woman carrying a mutation in the BRCA1 gene is 50-80%
  • The life-long risk of developing breast cancer in a woman carrying a mutation in the BRCA2 gene is 50%.
  • The BRCA1 mutation increases the lifetime risk of ovarian cancer in women by 20-50%.
  • The BRCA2 gene mutation increases the life-long risk of ovarian cancer in women by 10-20%.
  • Breast cancer occurs in 6% of men with BRCA2 gene mutation
  • Over 1600 mutations for the BRCA1 gene and over 1800 mutations for the BRCA2 gene have been reported.
  • In women with mutations in the BRCA1 and BRCA2 genes, the risk of breast cancer is reduced by 90% with bilateral prophylactic mastectomy, while the risk of ovarian cancer is reduced by 90% and breast cancer by 50% with prophylactic oophorectomy.
  • With sequence analysis done in cancer patients using the Affymetrix GeneChip BRCA1-BRCA2 Resequencing Arrays, reported mutations can be identified for these genes responsible for breast cancer.
  • Genes, other than BRCA1 and BRCA2 genes, that have been reported to have effect in breast cancer can also be analyzed within the Affymetrix GeneChip BRCA1-BRCA2 Resequencing Arrays. These are;
  • TP53 (tumor protein p53)
  • PALB2 (partner and localizer of BRCA2)
  • CHEK2 [CHK2 checkpoint homolog (S. pombe)]
  • ATM (ataxia telangiectasia mutated)
  • PTEN (phosphatase and tensin homolog) genes.
  • In addition to early diagnosis of familial breast cancer being quickly and reliably possible with these Arrays, the possibility of early treatment of breast cancer also increases; and with the detected mutations in familial breast and/or ovarian cancers, it is possible to scan these mutations faster in other family members.
  • At the same time, detected mutations may form a basis for preimplantation genetic diagnosis.
Warnings and Ethics
  • This test should only be performed on the above indications
  • • Each individual has the right to have genetic testing for breast cancer, but they must be informed about hereditary cancers and about their responsibilities in sharing genetic results with their relatives at risk.
  • The penetration of the gene / genes to be screened for breast cancers and environmental factors must be taken into consideration. For this reason, the patient should be given genetic counselling before and after the test.
July 23, 2023 Genel

NIFT Blood Test

Dear Mother Prospects,

The pregnancy process is at the top of your life’s most special periods, among the ones requiring the most responsibility. It will be a great advantage for you to go through this process easily and comprehensibly with your gynecologist and obstetrician. In this way, according to the information you will receive from your physician, you can evaluate what your baby’s Trisomy risk is and how it can be detected.

The Non-Invasive Fetal Trisomy (NIFTY) test, a non-interventional fetal trisomy test, allows you to detect whether your baby has Trisomy 21, Trisomy 18, Trisomy 13 or not, more clearly than by current methods. Information about what Trisomy is and how it can be detected will be provided. Do not hesitate to share with your doctor any questions you may have about your personal situation or about this test.

What is Trisomy and How Does it Develop?

Trisomy is the information of the chromosome, which normally comes one from the mother and one from the father, taking place in the cells a third time. This extra chromosome, sc. DNA information, causes several genes at the cellular level to find expression not two times but 3 times; thus causing anomalies in the production of various substances. When this anomalies at the cellular level are reflected in the body of the baby, a group of symptoms called syndrome emerges.

Trisomy 21 (Down syndrome)

Trisomy 21 is the most common chromosomal anomaly. It occurs in about 1/800 of live births. It is usually a chromosome illness that is not hereditary but occurs spontaneously during pregnancy, and is characterized by the fact that there are three of the 21st chromosome in the baby. With the increasing of the mother’s age, the frequency of the disease increases.

Trisomy 18 (Edwards Syndrome)

It is seen in about 1/5000 of live births. For this disease too, there is an increased risk with the advanced age of the mother. These babies have very serious congenital structure disorders. They are usually lost during pregnancy or in the first weeks of life.

Trisomy 13 (Patau Syndrome)

It is a chromosomal abnormality seen in about 1/10000 of live births. The increase in the age of the mother increases the frequency of Trisomy 13. Anomalies at the skull and face area, as well as at the heart, kidney, stomach and/or other physical anomalies are seen in newborns.

How can such diseases be detected during pregnancy??

There are both invasive and non-invasive screening test possibilities during pregnancy. Ultrasonographic examinations performed between 11th and 14th weeks of gestation are the primary non-invasive methods. In this way, the thickness of the baby’s nape can be measured. Double, triple scanning tests with maternal blood are other non-invasive techniques. However, although these techniques detect the risk to a certain extent, they do not provide a definitive diagnosis.

What is NIFTY Blood Test and How to Apply?

With the possibilities of the new generation technologies, identification of trisomy without intervention is enabled. The blood of the baby during pregnancy being mixed with the mother’s blood constitutes the basis of carrying out this test.

In invasive methods that require intervention to the candidate mother’s body, techniques such as amniocentesis, chorionic villus biopsy and cordocentesis are applied. Such methods are aimed at collecting cells from the baby in the mother’s womb. Even if these interventional tests are currently considered to have the highest percentage of safety worldwide, there is a risk of 0.2% to 1% of miscarriage after intervention. After a certain period of pregnancy, the blood from the mother’s arm and the DNA fragments from the baby can be separated. This way, it can be concluded if the baby has Trisomy 21, 18 or 13.

What is the Right Time to Apply the Test?

Although it is technically possible to perform the NIFTY test from the 8th week onwards, but the best time is after the 10th gestational week. You can have this test if your doctor, as a result of ultrasound and blood test, has determined that your baby is suspicious of carrying Trisomy, or if you are worried because you are in a risk group.

How is NIFTY Test Done?

After the information and genetic counseling you have received from your doctor, you can sign the required “NIFTY Test Approval Form” and perform the blood giving process. Blood drawn from you will be sent to BGI laboratories in special tubes. The analysis takes approximately 10 to 14 days. The results of the analysis are explained to you through your doctor.

Is the NIFTY Test Covered by Health Insurance?

No. Unfortunately, it needs to be covered by the patient…

What is it Mean for the Result to be Negative or Positive?

The negative test result shows that approximately 99.9% your baby does not have Trisomy; in the case of a positive test result, it implies that the baby has Trisomy with approximately 99.9% possibility.

July 23, 2023 Genel