Cytohistological discrepancies of cervico-vaginal smears and HPV status

Objectives: Discrepancies between abnormal cervical cytology or high-risk human papillomavirus (HR-HPV) status (cytolo-gy negative/HPV positive) and subsequent histological findings are a common occurrence. After using co-testing, the dis­crepancies between the HR-HPV status and cervical cytology have become an issue. In this study, we aimed to determine the characteristics of women with a discrepancy between histology and cytology/HR-HPV status, in terms of diagnosis, review and identification. Material and methods: A total of 52 women, patients of the University Hospital between 2013–2015, with cytohistologi­cal or HR-HPV status discrepancy were recruited for the study and retrospectively analyzed. The cytological samples were liquid-based Pap smears, classified according to the 2001 Bethesda system. The HR-HPV status was identified using the Hybrid Capture 2 HR-HPV DNA assay. The histological samples were obtained by cervical biopsy as well as large loop exci­sion of the transformation zone (LLETZ). Results: A cytohistological discrepancy was demonstrated in patients with (-)cytology/HR-HPV(+), ASCUS, LSIL, ASC-H, HSIL, AGC-NOS: 17.3%, 23.07%, 26.9%, 9.5%, 17.3% and 5.7%, respectively. When the degree of atypia in cytology increases, the concurrency of cervical cytology with biopsy also increases. A positive HR-HPV co-test result (19/24, 79.1%) was observed in nearly all CIN2 ≥ (+) cases. Our study emphasizes the significance of HR-HPV testing to determine CIN2 ≥ (+) cases, even in the presence of a normal cytological result. Conclusions: In case of cytohistological or HR-HPV discrepancies, a careful review of the HR-HPV status and the degree of cytological atypia should be performed before further intervention

Intragastric Migration of Gastric Band Diagnosed During Surgery: A Case Report and Literature

Intragastric band migration (IGBM) is one of the major complications of gastric banding. In this report, we aimed to present a case of IGBM, which was diagnosed intraoperatively, and to review the relevant literature. A 59-year-old male patient was admitted to our outpatient clinic due to epigastric pain persisting for the past three months. The patient had a history of gastric banding surgery owing to obesity with open surgery nine years ago. Postoperative follow-up was not done properly and the patient had started to gain weight in the third postoperative year. Incisional hernia was found in physical examination and operation for gastric band removal and hernia repair was planned. During surgery, the band could not be found around the stomach, therefore, gastroscopy was performed and it was found that the majority of the band was placed in the stomach. The patient was intraoperatively diagnosed with IGBM and the band was removed through gastrotomy, and hernia repair was performed. The patient was discharged at postoperative 6th day without any complication. Although IGBM is rarely seen, it should be considered as a long-term complication in cases with dysfunctional gastric band and in patients who started to gain weight after operation. Treatment is the removal of the band review

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

The Status of Telomerase Enzyme Activity in Benign and Malignant Gynaecologic Pathologies

Background: Telomeres are essential for the function and stability of eukaryotic chromosomes. Telomerase consists of three subunits: human telomerase reverse transcriptase (hTERT), human telomerase RNA (hTR), and telomerase protein 1 (TP1). The hTERT subunit determines the activity of telomerase as an enzyme and is detected in most human tumors and regenerative cells. Telomerase activity is a useful cancer-cell detecting marker in some types of cancers. Aims: The aim of this study was to assess of telomerase hTERT mRNA in gynaecological tumors for diagnosis of malignancy. Study Design: Cross-sectional study. Methods: A total of 55 gynaecologic tumor samples (35 ovarian, 13 endometrial, 6 cervical and 1 placental site trophoblastic tumor tissue) were obtained at the time of surgery. Quantification of hTERT mRNA was performed in a real-time reverse transcriptase polymerase chain reaction (RT-PCR) using the LightCycler TeloTAGGG hTERT Quantification Kit. Results: It was histopathologically detected that 18 of the tissue samples were malignant and 37 of the samples were benign. 16 of the malignant tissue samples (88.9%) and 3 (8.1%) (endometrial tissue in proliferative phase, mucinous cyst adenoma and endometriosis) of the benign tissue samples were found to be hTERT positive. With the presence of these data, sensitivity and specificity of hTERT for the diagnosis of malignancy were calculated to be 88.9% and 91.9%, respectively. Conclusion: It was suggested that the measurement of telomerase activity in gynaecologic tumors, except for endometrial tissue in the reproductive phase, is a valuable method for pathological investigation

Investigation the Perceived Social Support Levels of Pregnants with Hyperemesis Gravidarum

AMAÇ: Sosyal destek kişinin fiziksel ve psikolojik sağlığının sürdürülmesinde önemlidir. Bu nedenle, bu araştırma hiperemezis gravidarum tanısı alan gebelerde sosyal destek düzeyini belirlemek amacıyla yapıldı. YÖNTEM: Araştırmanın evrenini, bir devlet ve bir üniversite hastanesinde kadın doğum kliniğinde yatan, hiperemezis gravidarum tanısı alan gebeler, örneklem grubunu ise rastgele örnekleme yöntemi ile seçilen 119 gebe oluşturdu. Veriler; Kişisel Bilgi Formu ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği kullanılarak toplandı. Elde edilen veriler SPSS programında analiz edildi. BULGULAR: Çalışmada gebelerin %71,4’ünün 20-29 yaş grubunda olduğu, %65,6’sının ilköğretim mezunu olduğu bulunmuştur. Gebelerin çok boyutlu algılanan sosyal destek puan ortalamasının 60,87±13,04 olduğu bulunmuştur. Gebelerin çok boyutlu algılanan sosyal destek ölçeğinin özel insan alt boyutu toplam puan ortalaması, aile ve arkadaş alt boyutları toplam puan ortalamasından yüksek bulunmuştur. SONUÇ: Çalışmaya alınan gebelerin sosyal destek düzeyinin iyi olduğu belirlenmiştir

Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy

Study Objective: This study was conducted to determine the changes in ovarian reserve markers after laparoscopic ovarian cystectomy (LOC)

The effects of different therapeutic modalities on cardiovascular risk factors in women with polycystıc ovary syndrome: A randomızed controlled study

Objective: This study was designed to evaluate the effects of 3 mg drospirenone/30 μg ethinyl estradiol (OC) alone or combined with 1700 mg metformin on metabolic risk factors. Materials and methods: In this randomized, prospective, controlled study, 87 non-obese (18–30 BMI) women of reproductive age (18–39) with polycystic ovary syndrome (PCOS) were assigned to control (n = 17), OC (n = 21), combination (n = 20) and metformin (n = 29) therapy groups. Results: Adiponectin levels changed −28.27%, −20.37% and 35.78% after OC, combination and metformin therapies, respectively. High sensitive C-reactive protein levels (hsCRP) changed with OC, combination and metformin therapies by 102.32%, 3.2% and −7.14%, respectively. Plasminogen activator inhibitor-1 levels decreased 41.34% in the metformin group. Apolipoprotein-B levels changed in a manner similar to changes in hsCRP levels. The homeostatic model insulin resistance index changed significantly between the groups following treatment (p = 0.001). Conclusion: Six cycles of treatments with OC alone may cause metabolic variables to deteriorate in non-obese women with PCOS. The addition of metformin to OC may ameliorate some aspects of this effect

Vacuum assisted-birth: why do we abstain from?

AMAÇ: Vakum ekstraksiyon ile gerçekleşen müdahaleli doğumun kısa dönem klinik sonuçları açısından, sezaryen doğum ile karşılaştırılması. GEREÇ VE YÖNTEM: Çalışma 2015-2016 yılları arasında Gülhane Askeri Tıp Akademisi Kadın Hastalıkları ve Doğum Anabilim Dalında retrospektif kohort olarak yürütülmüştür. Çalışmaya primipar gebeler dahil edilmiştir. Doğumun ikinci evresinin uzaması endikasyonu ile vakum ekstraksiyon yapılarak vajinal doğum gerçekleştirilen gebeler ile baş pelvis uyumsuzluğu nedeniyle sezaryen doğum yapılan gebeler kısa dönem sonuçları (fetal pH, postpartum kan kaybı, maliyet) açısından karşılaştırılmıştır. BULGULAR: Vakum ekstraksiyon yapılan grupta (n:22), sezaryen yapılan gruba (n:30) göre aktif eylem süresi, doğum sonu kan kaybı ve buna bağlı olarak kan transfüzyonu oranları daha fazla iken, tedavi maliyeti daha azdır (p<0,05). SONUÇ: Her ne kadar vakum ekstraksiyon grubunda doğum sonu kanama komplikasyonu daha fazla olsa da, bu konudaki deneyim arttırılmalı ve hekimler vakum ekstraksiyon uygulaması açısından cesaretlendirilmelidir.OBJECTIVE: The aim of the present study was to compare the vacuum assisted- vaginal delivery and cesarean section in terms of short term clinical outcomes. MATERIAL AND METHODS: The study was executed as a retrospective cohort study at Gülhane Military Medical Academy Department of Obstetrics and Gynecology between 2015 and 2016. Primiparous pregnant women were included in the study. The short term clinical outcomes (feotal pH, blood loss, cost) of the deliveries performed by vacuum extraction due to the diagnosis of prolonged second stage of labor were compared with the deliveries performed by cesarean section due to the diagnosis of cefalo-pelvic disproportion at early stages of labor. RESULTS: The duration of active phase, the amount of blood loss and the transfusion rate were all detected to be higher in the vacuum extraction group (n=22) respect to the cesarean delivery group (n=30). (p<0,05) CONCLUSIONS: Although the results of this showed that the amount of blood loss was higher in the deliveries performed by vacuum extraction, we believe in that this complication can be managed exclusively well by the effect of increased experience. So we are in favor of encouraging obstetricians to apply vacuum extraction in the necessary circumstances to obtain increased clinical experience

Association of oxidative stress marker ischemia modified albumin and polycystic ovary syndrome in adolescent and young girls

Objective: The pathophysiologic features of polycystic ovary syndrome (PCOS) seem to be a combination of genetic predisposition and environmental factors. However, data regarding the exact effect of oxidative stress on PCOS is conflicting. This cross sectional and case-control study was designed to compare the serum ischemia modified albumin (IMA) levels in adolescent and young girls with and without PCOS