Role of lymphadenectomy in disease-free and overall survival on low risk endometrium cancer patients

Objectives: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on the low risk corpus cancer. Material and methods: Between 1994 and 2012, a total of 257 patients with endometrioid type, grade 1 or 2, myometrial invasion < 1/2, no intraoperative evidence of macroscopic extrauterine spread was treated surgically. Pelvic lymphadenec­tomy was performed in 184 cases, and not performed in 73 cases. Results: There was no difference between two groups about tumor sizes. Also lymphovascular space invasion and histo­logic grade of two groups were similar. Omission of LA did not worsen DFS and OS in early stage low risk corpus cancer. Conclusions: Patients who have low risk corpus cancer, can be treated optimally with hysterectomy only

Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss?

Objectives: An investigation of the importance of hematological inflammatory markers on the prognosis of first trimesterpregnancies and their role in predicting threatened abortion and early pregnancy loss.Material and methods: This study was carried out in the Obstetrics and Gynecology Department of the Faculty of Medicine inour University between January 2018 and May 2019. Three-hundred individuals, 100 of them diagnosed with early pregnancyloss (EPL), 100 diagnosed with threatened abortion (TA) and 100 healthy control patients (HC), participated in the study.Results: There were no statistically significant differences in terms of hemoglobin, platelet, neutrophil count and NLRbetween the three groups. The RBC counts were significantly lower in EPL and TA compared to HC. Similarly, it was determinedthat the MPV value was significantly lower in EPL compared to HC. On the other hand, there was no difference inMPV between TA and HC. The PLR was higher in EPL and TA.Conclusions: MPV, RBCs and PLR values were strongly associated with first-trimester miscarriage. These economical andeasily measurable platelet indices can be used to predict fetal losses

Assessment of clinicopathological features, evaluation of treatment, and prognosis of clear cell and serous papillary endometrial carcinoma

Objectives: We aimed to evaluate and compare the clinical and pathological features, diagnosis, treatment, and prognosis of uterine papillary serous carcinoma (UPSC) and clear-cell carcinoma (CC). Material and methods: Thirty-four patients who were operated on for UPSC and CC carcinoma at the İzmir Tepecik Research and Teaching Hospital, between January 1983 and December 2014, were included. Patients were evaluated for the following factors: age, gravidity, parity, preoperative CA-125, tumor size, myometrial and lymphovascular invasion, lymph node tumor metastasis, presence of atypical cells in peritoneal cytology, pathology results, operation types, whether or not they received postoperative adjuvant therapy, prognosis, and death rate. Results: The stage of the disease was the main factor affecting disease-free and the overall survival. Cisplatin-based chemotherapy was partially effective in patients with postoperative recurrence, while postoperative adjuvant radiotherapy proved to be more effective in preventing relapse. Conclusion: The studied parameters generally were concordant with the literature but, due to the relatively small sample size, more comprehensive and multicenter studies are needed to generate valid results

Serum levels of soluble interleukin-2 receptor in association with oxidative stress index in patients with different types of HPV

Objectives: The aim of this paper is to determine the oxidative–antioxidative status and levels of soluble interleukin-2 recep­tor (sIL-2R) in serum of patients with different types of HPV infections and to compare it with patients who are negative for HPV. Material and methods: A total of 80 women were divided into three groups as follows: Group 1 consisted of 25 women who were positive for HPV types 16 or 18; Group 2 consisted of 25 women who were positive for other types of HPV includ­ing type 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 or 68; Group 3 consisted of 30 patients who were negative for HPV as a control group. Serum sIL-2R and plasma oxidative stress index (OSI) were analyzed. Results: Serum sIL-2R levels were significantly higher in group 1 compared to group 2 and 3. OSI was found significantly increased in groups 1 and 2 compared to group 3. Also, we found a weak positive correlation between IL-2R and OSI. Conclusion: sIL-2R and oxidative stress may have a role in HPV infection, especially in case of high-risk types

Outcomes of the patients diagnosed incidentally appendicitis during cesarean section

Objectives: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester. Material and methods: The study population consisted of 23 pregnant women who were diagnosed incidentally with appendicitis during cesarean at Erzincan University Hospital between 2015 and 2016. Results: Appendectomy was performed on 23 patients during a caesarean section performed for any reason. The mean dia-meter of appendix was 7.82 ± 1.85 mm. The mean operation time was 67.39 ± 18.94 SD and antibiotic therapy was given to all patients. Postoperative complications were noted in 4 (17.4%) patients. Wound infection was seen in 4 (17.4%) patients, the other 19 patients revealed no postoperative complications. The mean of APGAR score of newborns in the postoperative period was 8.26 ± 0.86 SD and no complications were observed in both mothers and newborns. Histopathology of the specimen confirmed acute appendicitis in 23 (100%) cases. Conclusions: Acute appendicitis is a challenging diagnosis in the pregnant patient; however, early surgical intervention should be performed with any suspicion. The type of surgery depends on the surgeon’s preference and experience

Retrospective evaluation of clinical and pathological features, as well as diagnostic and treatment protocols of primary vaginal malignancy

Objectives: Our study aimed to determine the epidemiological characteristics and diagnostic and treatment protocols of primary vaginal carcinoma. Also, we compared the clinical and pathological features of primary vaginal carcinoma which intersect with cervical and vulvar carcinomas. Material and methods: Sixteen patients with primary vaginal carcinoma, admitted to the Department of Gynecologic Oncology, Izmir Tepecik Training and Research Hospital between January 1983 and December 2012, were evaluated retrospectively. FIGO (International Federation of Gynecology and Obstetrics) Surgical staging was performed. The SPSS (Statistical Package for Social Sciences) program was used for statistical analyses. Results: The histological distribution of the 16 patients with primary vaginal carcinoma was as follows: 9 patients (56.3%) with squamous cell carcinoma (SCC), 5 (31.3%) with rhabdomyosarcoma, and 2 (12.5%) with adenocarcinoma. Conclusion: The stage of the disease was found the be the main factor affecting the survival

The Effects of Different Diet Models on Oocyte Quality, Oocyte Maturation and in Vitro Fertilization Outcomes in Mice

Nutritional quality affects fertility in both men and women. Nutrition should be considered in the prevention and treatment of infertility in men and women. In this study, we evaluated IVF rates, oocyte maturation and oocyte quality in a female animal model feding ketogenic, western and standard type diet. Female BALB / c mice were allocated to three groups: (a) control; (b) Western and (c) Ketogenic. After feeding female mice with these 3 feeding groups for 4 weeks, IVF was administered before sacrification of the mice. The number of collected oocytes and oocyte quality, fertilization rates and embryo quality were evaluated.The number of total oocytes was the highest in the ketogenic diet and the least in the western diet. MII stage oocytes in the ketogenic group were statistically significantly higher than the control group and western groups. Fertilized oocyte count was significantly lower in the western group compared to the other two groups. When the two-cell zygote stage was evaluated, it was found that the results were better in the ketogenic diet group and worse in the western diet group. The worst results in terms of the number of zygotes reaching the blastocyst stage were observed in the western type nutrition group, and the best results were observed in the group on the keteogenic diet. The results of our study show that western nutritional models negatively affect IVF results, while ketogenic diet has a positive effect. Keywords: Fertility, ketogenic diet, oocyte, ovulation, western diet DOI: 10.7176/JMPB/72-02 Publication date: January 31st 202

Urodynamic assessment of short-term effects of pelvic radiotherapy on bladder function in patients with gynecologic cancers

Objectives: To determine the short-term effects of adjuvant or primary curative radiotherapy (RT) on the urinary system in women with gynecologic cancer. Material and methods: This is a prospective, concurrent cohort study including 55 patients with gynecologic cancer who were divided into three groups. Group 1 included 10 patients who were administered adjuvant RT following a radical hysterectomy (RH); Group 2 included 36 patients who were administered adjuvant RT following a type 1 hysterectomy and Group 3 included 9 patients who were administered primary curative RT. Urogynecologic assessments were carried out on patients before and six months after the treatment. Results: Compared to pretreatment, no significant differences were observed in any of the three groups after treatment in terms of incontinence, first urge to urinate, normal urge to urinate, severe urge to urinate and changes in residual urine volumes. There was a significant decrease in maximal vesical pressure after treatment in Group 1 and Group 3. The maxi­mum detrusor pressure decreased significantly in Group 1. The post-treatment decline in bladder capacity in Group 1 and Group 2 was also significant. Conclusions: RH and pelvic RT cause lower urinary system dysfunction. Especially patients who receive primary curative RT and patients who are administered RT after RH, where more pelvic denervation occurs, are at higher risk due to high doses of RT

A Study of Inflammatory Markers in Gestational Diabetes Mellitus

Objective: Gestational diabetes mellitus is a common disorder of carbohydrate metabolism, with onset or first recognition during pregnancy, resulting in hyperglycemia of variable severity. Insulin resistance and chronic subclinical inflammation are the underlying mechanisms of the disease. Soluble interleukin-2 receptor, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio are the markers of inflammatory disease processes such as type 1 and 2 diabetes mellitus, hepatitis, and neoplasms. Study Design: In our study, we measured complete blood count, serum soluble interleukin-2 receptor, serum glucose in blood samples from 52 women with gestational diabetes mellitus and 50 pregnant women with normal glucose tolerance. Pregnant women which were tested for oral glucose tolerance test (75 gr load) between 24 and 28 weeks of pregnancy were selected for the study. Gestational diabetes mellitus was defined according to the criteria provided by the National Institute for Health and Care Excellence. Results: In terms of age, gestational diabetes mellitus patients (mean±SD; 31±6 years) were older than controls (mean±SD; 25±5.3 years). Mean platelet volume values were lower in gestational diabetes mellitus patients (mean±SD; 10.3±1.4 fL) as compared to normal glucose tolerance group (mean±SD; 10.8±1fL). No statistically significant differences in serum glucose concentration, white blood cell count, neutrophil count, lymphocyte count, hemoglobin concentration, platelet count, neutrophil-to-lymphocyte ratio value, platelet-to-lymphocyte ratio value, and serum soluble interleukin-2 receptor concentration were found. Conclusion: This study did not reveal an increase in the inflammatory markers, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and serum soluble interleukin-2 receptor, in gestational diabetes mellitus. The mean platelet volume values were observed to be lower in gestational diabetes mellitus patients

Evaluation Of Uterine Artery Doppler, Afp And ?-Hcg In Terms Of Perinatal Outcomes

AMAÇ: Uterin arter doppler bulguları ile alfa fetoprotein (AFP) / beta-human koryonik gonadotropin (?-hCG) de-ğerlerinin perinatal sonuçlarla ilişkisini araştırmak.GEREÇ VE YÖNTEM: Temmuz 2009’dan itibaren gebe polikliniğine başvuran, 18. gebelik haftasına girmemiş ilk elli gebe incelenmeye alındı. Çalışmaya 49 gebe dahil edildi ve prospektif olarak izlendi.Gebeliğin 16-18. haftaları arasında ölçülen AFP ve ?-hCG düzeyleri ile 22-24. gebelik haftaları arasında suprapubik olarak bakılan uterin arter doppler değerleri kaydedildi. Dışlanma kriterleri olarak, gebelikten önce hipertansiyon olması veya önceki gebelikte preeklampsi-eklampsi öy-küsü, tekrarlayan gebelik kayıpları, düşük doğum ağırlıklı yenidoğan hikayesi, kalp ya da renal hastalık hikayesi, di-abetes mellitus, antikoagulan veya aspirin tedavisi belir-lendi. Verilerin karşılaştırılmasında nonparametrik özel-liklerinden dolayı ki-kare testi uygulandı.BULGULAR: Gebelerin yaşları 19 ile 35 yaş arasınday-dı. Ortalama gebelik sayısı 2.1; ortalama parite 1.6 ola-rak saptandı. Uterin arter dopler, uterin arter çentiği ve ?-hCG değerleri ile perinatal sonuçlar arasında bir ilişki saptanamadı. AFP değeri yüksek olan hastaların tümün-de intrauterin gelişme geriliği tespit edildi. Ayrıca has-taların 4’ünde intrauterin gelişme geriliği, 9’unda erken doğum, 7’sinde gestasyonel diabet, 2’sinde preeklampsi, 2’sinde fetal distress ve 6’sında mekonyum saptandı. İnt-rauterin gelişme geriliği dışındaki perinatal sonuçlarla bir bağlantı tespit edilemedi.SONUÇ: Kötü obstetrik sonuçları öngörebilmek adına bir takım testler yapılmaktadır fakat faydaları sınırlıdır. Dola-yısıyla daha spesifik serum belirteçlerinin ve ultrasonog-rafik parametrelerin belirlenerek, gebeliğin seyri sırasın-da ne tür risklerle karşılaşılabileceğinin saptanması, hem koruyucu hekimlik hem de komplikasyonların tedavisi açısından çok faydalı olacaktır.OBJECTIVE: Evaluation of relationship between uterine artery doppler findings, alpha fetoprotein (AFP) and be-ta-human chorionic gonadotropin (?-hCG) levels for pe-rinatal outcomes.MATERIALS AND METHODS: First fifty pregnant with 18 weeks of gestation who were admitted to the clinic from July 2009 were to be examined. The study included forty nine of pregnants and they were followed prospe-ctively.Serum concentrations of AFP and ?-hCG measured between 16-18 weeks of pregnancy and suprapubic doppler ultrasonography for uterine artery performed between 22-24 weeks of pregnancy were noted. Hyper-tension before pregnancy or previous pregnancies with preeclampsia-eclampsia, history of recurrent pregnancy loss, history of low birth weight newborn, history of car-diac or renal disease, diabetes mellitus and anticoagula-tion or aspirin treatments were determined as exclusion criteria. Chi-square test was performed for comparision of datas because of non-parametric specialities.RESULTS: The ages of the pregnants were between 19 and 35. The mean gravidity and parity of the study cohort were 2.1 and 1.6 respectively. There were no correlations among uterine artery doppler findings, serum ?-hCG le-vels and perinatal outcomes. Serum AFP concentrations were significantly higher in all patients with intrauterine growth restriction (IUGR). Also 4 patients had IUGR, 9 pa-tients had preterm labor, 7 patients had gestational dia-betes, 2 patients had preeclampsia, 2 patients had fetal distress and 6 patients had fetal meconium. There were no correlations for perinatal outcomes except IUGR.CONCLUSION: A number of tests performed to predict adverse obstetric outcomes but the benefits are limited. Developing of more specific serum markers and ultraso-nography parameters in order to determination of risks during pregnancy, would be very useful for preventive medicine and treatment of complications