Stężenia adropiny i albuminy modyfikowanej niedokrwieniem w surowicy w zależności od występowania zespołu policystycznych jajników i wartości BMI

Introduction: The aim of this study was to evaluate the effects of polycystic ovary syndrome (PCOS) and body mass index (BMI) on serum adropin and ischemia modified albumin (IMA) levels. Materials and methods: This prospective cross-sectional study was performed with a total of 120 women [group1; non-PCOS = 60 (BMI < 25 = 30, BMI ≥25 = 30) and group 2; PCOS = 60 (BMI < 25 = 30, BMI ≥25 = 30)]. Blood samples were collected between the third and fifth days of the women’s menstrual cycles after a night of fasting. Results: There were no differences between the groups in relation to age, basal follicle stimulating hormone, estradiol, thyroid stimulating hormone, prolactin, high-density lipoprotein cholesterol, total testosterone, dehydroepiandrosterone sulfate levels, systolic and diastolic blood pressures. A significant difference was found in basal luteinizing hormone, fasting glucose, insulin, homeostatic model assessment of insulin resistance, total cholesterol, low-density lipoprotein cholesterol, triglycerides, free testosterone levels, waist-to-hip ratios and the Ferriman-Gallwey scores between the PCOS and non-PCOS patients in the lean and overweight groups (p < 0.05). The serum adropin levels in the lean PCOS group were lower than in the lean non-PCOS group (p < 0.05) and were lower in the overweight PCOS group than in the overweight non-PCOS group (p < 0.05). There was also a statistically significant difference in serum IMA levels in the PCOS group than in the non-PCOS group in both the lean and overweight groups (p < 0.05). Conclusions: Although serum adropin levels were significantly decreased in the PCOS group, IMA levels increased. Further studies are needed to determine the effects of adropin and IMA in women with PCOS and to use a new marker to monitorize treatment outcomes. Wstęp: Badanie przeprowadzono w celu oceny wpływu zespołu policystycznych jajników (polycystic ovary syndrome, PCOS) i wskaźnika masy ciała (body mass index, BMI) na surowicze stężenia adropiny i albumin modyfikowanej niedokrwieniem (ischemia modified albumin, IMA). Materiał i metody: To prospektywne badanie przekrojowe obejmowało 120 kobiet [grupa 1: osoby bez PCOS — n= 60 (BMI &lt; 25 — n= 30; BMI ≥ 25 — n = 30) oraz grupa 2: osoby z PCOS — n= 60 (BMI &lt; 25 — n= 30, BMI ≥ 25 —n = 30)]. Próbki krwi pobierano między trzecim a piątym dniem cyklu menstruacyjnego badanych kobiet, rano na czczo. Wyniki: Grupy nie różniły się pod względem wieku, podstawowego stężenia hormonu folikulotropowego, stężeń estradiolu, tyreotropiny, prolaktyny, cholesterol frakcji HDL, testosteronu całkowitego i siarczanu dehydroepiandrosteronu ani skurczowego i rozkurczowego ciśnienia tętniczego. Stwierdzono natomiast istotne różnice między grupą z PCOS i bez PCOS w podgrupach osób szczupłych i otyłych w zakresie podstawowego stężenia hormonu luteinizującego, glikemii na czczo, wskaźnika insulinooporności w modelu homeostazy, stężeń cholesterolu całkowitego, cholesterolu frakcji LDL, triglicerydów i wolnego testosteronu, a także wskaźnika talia-biodra oraz oceny w skali Ferrimana-Gallweya (P &lt; 0,05). Stężenia adropiny w osoczu były niższe w grupie szczupłych kobiet z PCOS niż u szczupłych osób niechorujących na PCOS (P &lt; 0,05) oraz były niższe u otyłych osób z PCOS niż u otyłych osób z grupy bez PCOS (P &lt; 0,05). Stwierdzono również statystycznie istotną różnice w stężeniach IMA w surowicy między kobietami z PCOS i bez PCOS, zarówno w podgrupie osób szczupłych, jak i otyłych (P &lt; 0,05). Wnioski: Mimo że surowicze stężenia adropiny były istotnie niższe w grupie z PCOS, stężenia IMA były podwyższone w tej grupie badanych. Konieczne są dalsze badania w celu określenia wpływu adropiny i IMA u kobiet z PCOS i stosowanie nowych wskaźników do monitorowania efektów leczenia

Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Objectives: The aim of the present study is to determine the predictive value of Computed Tomography (CT), alone or in combination with serum CA-125 levels, for preoperative staging, detection of the extent of the disease, and surgical complications in patients with ovarian carcinoma. Material and methods: One hundred and fourteen patients diagnosed with ovarian carcinoma following an exploratory laparotomy with a preoperative CT scan, performed between January 2007 and June 2013, were enrolled in the study. Preoperative CT and intraoperative surgical findings were compared using 14 parameters and predictions of CT for gas­trointestinal, genitourinary, and cardiovascular complications. All radiological features and clinical characteristics were analyzed statistically. Results: CT and surgical findings correlated (sensitivity/ specificity) as follows: uterine and tubal spread (66%/89%), cervical involvement (100%/80%), peritoneal nodulesincreased density-carcinomatosis (57%/93%), omental involvement (68%/95%), retroperitoneal involvement (25%/84%), ascites (85%/87%), perirectal and perivesical fat plan obliteration (43%/94%), liver metastasis (50%/91%), small and large bowel involvement (47%/95%), adnexal mass (94%/70%), and other metastases (47%/86%). Also, CT findings were found to be statistically insignificant for prediction of mesenteric involvement, bladder metastasis, and diaphragmatic involvement. The overall CT sensitivity and specificity at detecting intraoperative findings was 91% and 71%, respectively. We found a statistically significant correlation between intestinal involvement on CT and the necessity of additional surgical procedures. Conclusions: CT is a widely used imaging method in the preoperative evaluation of ovarian cancer. However, its predictive value, sensitivity and specificity differ, depending on the anatomical region

Therapeutic efficacy of dilatation and curettage in endometrial polyps: is it a valuable method?

Rezumat. Efi cacitatea terapeutică a dilatării și chiuretajului în polipii endometriali. Studiul a fost efectuat în perioada iunie 2008 – martie 2011, la Spitalul de Educaţie și Cercetare Ataturk din Izmir, Turcia. 36 de femei cu sângerare uterină anormală, care au suferit o dilatare și chiuretaj și la care evaluarea histopatologica a diagnosticat polip endometrial, au fost incluse în studiu. Toate pacientele au suportat histeroscopie imediat după menstruaţie. Au fost evaluate rezultatele şi ratele. Nouă (25%) dintre paciente au fost vindecate prin dilatare și chiuretaj și 27 (75%) au fost tratate cu succes prin histeroscopie. Diagnosticul a fost dovedit, polipii fiind eliminaţi prin histeroscopie de birou. În caz de hemoragii uterine anormale, cum ar fi polipul endometrial, histeroscopia de birou este o metodă mult mai utilă decât dilatarea și chiuretajul, pentru că este o metodă simplă prin care pacientul poate fi tratat la momentul diagnosticării.Резюме. Терапевтическая эффективность расширения и кюретажа в эндометрических полипах: действительно ли это ценный метод? Исследование проводилось с июня 2008 до марта 2011 года в Измир Ататюрк учебной и научной больнице, отделение гинекологии и акушерской помощи, Измир, Турция. Тридцать шесть женщин с аномальными маточными кровотечениями, которые прошли диагностическое выскабливание и у которых был поставлен диагноз полип эндометрия, были включены в исследование. Всем пациенткам проводилась амбулаторно-офисная гистероскопия сразу же после их очередной менструации. Результаты диагностического выскабливания и гистероскопии были оценены. Девять (25%) пациенток могут быть полностью вылечены при помощи диагностического выскабливания и 27 (75%) пациенток были успешно пролечены офисной гистероскопией. Диагноз был гистологически доказан, а полипы были удалены посредством офисной гистероскопии. В случаях патологии матки, которые вызывают аномальные кровотечения, как полип эндометрия, офисная гистероскопия является более полезной, чем метод диагностического выскабливания, потому, что это простой метод, который позволяет лечить пациента на момент постановки диагноза

Lymph Node Involvement in Endometrial Cancer

Objectives: The aim of this study was to evaluate the outcome of pelvic and/or para-aortic lymph node dissection in patients with endometrial cancer with regard to lymph node positivity.Materials and Methods: Retrospective chart review of 125 women with pathologically proven endometrial carcinoma who underwent a systematic surgical staging including lymphadenectomy between January 2006 and January 2011 was performed. Patients’ characteristics, histological findings, lymph node localization and involvement were analyzed. Detailed description of the extirpated and affected lymph nodes divided by area in the 125 patients with endometrial cancer were done.Results: The medical records for 125 patients were eligible for analysis. The mean number of all lymph nodes removed in operation was 38.9±14.194 (range 9 to 81 nodes). The mean number of pelvic lymph nodes (PLN) removed was 32±11.747 (range 9 to 75 nodes) and the mean number of para-aortic lymph nodes (PALN) removed was 7±5.123 (range 0 to 20 nodes). In the 24 patients with nodal metastasis, the mean number of all lymph nodes removed was 37.88±17.501 (range 9 to 81 nodes). The mean number of PLNs removed was 30.71±14.79 (range 9 to 66 nodes) and the mean number of PALNs removed was 7.17±4.198 (range 0 to 16 nodes).Nodal metastasis was shown in 24 (19.2%) patients. Isolated pelvic lymph node metastasis was shown in nine (37%) patients; isolated para-aortic lymph node metastasis was shown in one (4%) patient; both pelvic and para-aortic lymph node metastasis was shown in 14 (59%) patients. The most affected lymph node area was left external iliac artery with a ratio of 14%.Conclusions: In the field of gynecologic cancer surgery, for the determination of adequate number of lymph nodes to be retrieved, lymph node mapping plays a crucial role, and this issue should be investigated in studies performed with larger number of cases in order to standardize procedure of lymphadenectomy

Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study

WOS: 000327923400010PubMed ID: 24016409Objective. The objectives of this study were to examine demographic and clinicopathologic characteristics and to determine the effects of primary surgery, surgical staging and the extensiveness of staging. Methods. In a retrospective Turkish multicenter study, 539 patients, from 14 institutions, with borderline ovarian tumors were investigated. Some of the demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging on survival rates were calculated by using Kaplan-Meier method. Results. The median age at diagnosis was 40 years (range 15-84) and 71.1% of patients were premenopausal. The most common histologic types were serous and mucinous. Majority of the staged cases were in Stage IA (735%). 242 patients underwent conservative surgery. Recurrence rates were significantly higher in conservative surgery group (8.3% vs. 3%). Of all patients in this study, 294 (545%) have undergone surgical staging procedures. Of the patients who underwent surgical staging, 228 (77.6%) had comprehensive staging including lymphadenectomy. Appendectomy was performed on 204 (37.8%) of the patients. The median follow-up time was 36 months (range 1-120 months). Five-year survival rate was 100% and median survival time was 120 months. Surgical staging, lymph node sampling or dissection and appendectomy didn't cause any difference on survival. Conclusion. Comprehensive surgical staging, lymph node sampling or dissection and appendectomy are not beneficial in borderline ovarian tumors surgical management. (C) 2013 Elsevier Inc. All rights reserved

Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey

WOS: 000338633500049PubMed ID: 24870768Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN