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Öğe Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome(Pergamon-Elsevier Science Ltd, 2013) Annagur, Bilge Burcak; Tazegul, Aybike; Uguz, Faruk; Kerimoglu, Ozlem Secilmis; Tekinarslan, Emine; Celik, CetinObjective: We aimed to compare the levels of serum androgens in women with polycystic ovary syndrome (PCOS) who had a diagnosis of only major depressive disorder (MDD), only generalized anxiety disorder (GAD) or who had no psychiatric disorder, as determined by a structured clinical interview. Another objective of the study was to examine whether an association exists between these psychiatric diagnoses and insulin resistance or body mass index via a comparison among the study groups in terms of these parameters. Method: This study was performed between March 2011 and February 2012. A total of 73 patients were included in the study. The study sample consisted of three groups: PCOS patients with only major depressive disorder (n = 23), PCOS patients with only generalized anxiety disorder (n = 20), and PCOS patients without any diagnosed psychiatric disorders (not diagnosed - ND group, n = 30). Results: Significant difference was found among the three groups with regard to the serum levels of 17-OHP and DHEAS. When multiple comparisons were performed among the groups, 17-OHP levels were significantly higher in the MDD group than in the ND group. DHEAS levels were significantly higher in the MDD group and the GAD group than in the ND group. Conclusion: The present study suggests that MDD and GAD appear to be associated with higher DHEAS levels. (C) 2013 Elsevier Inc. All rights reserved.Öğe Early surgical abortion: Safe and effective(Informa Healthcare, 2013) Kara, Fatih; Dogan, Nasuh Utku; Bati, Serap; Demir, Senay; Durduran, Yasemin; Celik, CetinObjectives To evaluate patients' characteristics and complications of surgical abortion performed at an early gestation, compared to later gestations. Methods A total of 4310 women with unintended pregnancies attending the family planning unit of a government maternity hospital in Konya, Turkey, were included retrospectively. Abortions were carried out from 6 weeks' up to 10 weeks gestation. Results The gestational age in 62% of the cases was between 6 weeks and 6 weeks + 6 days. Only 8.5% of the 4310 women had used a modern contraceptive method, and 16% had had a surgical abortion for an unplanned pregnancy previously. These women were younger, had more siblings, and a shorter time had elapsed since their last pregnancy when compared to women who never had an abortion. There were four failures (0.09%). The rate of retained products of conception (RPCs) was 1.9% in women aborted between six and six(+6) weeks' gestation, and 6.2% (p < 0.001) in those aborted later. Women who had had a surgical abortion previously more often had RPCs than those who never had (16% vs. 1%, respectively, p < 0.001). Of the 151 women with RPCs, 65 (43%) had been using an intrauterine device prior to surgical abortion. Conclusion Early surgical abortion (at six-six(+6) weeks' gestation) generates few complications. Delaying surgical abortion until a somewhat later gestation causes complication rates (particularly RPCs) to increase.Öğe Incidence of unexpected leiomyosarcoma in a Turkish province: a retrospective multi-centre study in a low income setting(Taylor & Francis Inc, 2022) Tasdemir, Umit; Ceran, Mehmet Ufuk; Dirican, Aylin Onder; Akar, Serra; Celik, Cetin; Energin, Hasan; Gorkemli, HuseyinThe aim of the current study was to estimate the incidence of unexpected leiomyosarcoma (LMS) in patients who underwent surgery due to leiomyomas in Konya province, and to contribute to the literature discussing comparisons with similar studies. The digital archives of eight high-volume hospitals were studied for surgeries performed due to leiomyomas between January 2012 and January 2019, and leiomyosarcoma incidence was calculated based on the data obtained. Twenty-one patients in 3703 cases were found to have unexpected leiomyosarcoma, which means we can expect one leiomyosarcoma in 176 (0.56%) surgeries. Six more malignant tumours were detected among the remaining cases. Thus, our study estimated the incidence of unexpected leiomyosarcoma as 1/176 (0.56%), which is higher than most of the studies in the literature justifying the debate started by the FDA in 2014. As the tumour biology is not yet clear, and the incidence of unexpected leiomyosarcoma tends to be so high, the key focus must be to try to detect uterine leiomyosarcomas preoperatively for robust patient care.IMPACT STATEMENT What is already known on this subject? The incidence of unexpected leiomyosarcoma varies widely from 1/498 to 1/8300 depending on the study method and the type of procedure, and there is still controversy, even after the FDA statement that led to a major restriction in laparoscopic surgeries due to concerns about inadvertent morcellation of leiomyosarcomas. What do the results of this study add? To the best of our knowledge, the current study found the highest incidence of unexpected leiomyosarcoma, and consequently a serious evaluation of all patients undergoing surgery due to leiomyomas preoperatively considering a leiomyosarcoma candidate is recommended. What are the implications of these findings for clinical practice and/or further research? Studies on tumour biology and novel markers must be supported for accurate preoperative diagnosis of leiomyosarcoma.Öğe Nicotinamide N-methyltransferase expression in squamous cell carcinoma of the vulva(Taylor & Francis Inc, 2022) Celik, Zeliha Esin; Akar, Serra; Findik, Siddika; Aytekin, Emine; Celik, CetinThe molecular pathways involved in the development of vulvar squamous cell carcinoma (SCC) cancer are not completely known. Nicotinamide N-methyltransferase (NNMT) is a cytosolic enzyme associated with tumorigenesis and metastasis in a variety of cancers. Its role in vulvar cancer has not been studied, previously. Vulvar SCC, high and low grade squamous intraepithelial lesions (SILs) and benign squamous hyperplasia were analysed immunohistochemically. The mean staining score for vulvar SCC was significantly higher than the score for vulvar squamous hyperplasia (p<.001). The mean relapse-free survival for patients with low and high NNMT expression was 41.4 months (95% CI: 25.6-57.2) and 19.8 months (95% CI: 3.0-36.6), respectively (p=.035). The mean disease-specific survival for patients with low and high NNMT expression was 75.8 months (95% CI: 57.5-94.2) and 27.8 months (95% CI 12.2-43.4), respectively (p=.015). Although quite preliminary, this study showed that NNMT expression was elevated in vulvar SCC compared to benign and premalignant lesions. Additionally, elevated NNMT expression was associated with poor survival. Impact Statement What is already known on this subject? Nicotinamide N-methyltransferase (NNMT) is a methyltransferase, associated with tumour progression, spread and poor prognosis in a variety of cancers. Its upregulation can lead to DNA hypomethylation, which can in turn result in the activation of proto-oncogenes and deactivation of tumour suppressor genes. What do the results of this study add? Although quite preliminary, this study showed that NNMT expression was elevated in vulvar SCC compared to benign and premalignant lesions. Additionally, elevated NNMT expression was associated with poor survival. What are the implications of these findings for clinical practice and/or further research? NNMT has been regarded as a potential target of cancer therapy and its role in vulvar cancer has not been studied, previously. This is the first study to investigate the expression of NNMT in vulvar cancer and associate NNMT elevation with poor survival. NNMT can further be investigated as a possible target of vulvar cancer therapy.Öğe P-wave parameters and cardiac repolarization indices: Does menopausal status matter?(Elsevier Ireland Ltd, 2012) Dogan, Umuttan; Dogan, Nasuh Utku; Basarir, Ahmet Ozgur; Yildirim, Serkan; Celik, Cetin; Incesu, Feyzanur; Ozdemir, KurtulusBackground and purpose: Data regarding electrocardiographic characteristics of postmenopausal women are lacking. In this prospective, cross-sectional study, electrocardiographic P-wave parameters and cardiac repolarization indices of age-matched pre- and postmenopausal healthy women were compared. We hypothesized that menopausal status would have a significant effect on cardiac electrical activity and hence electrocardiography (ECG) recordings. Materials and methods: Twelve-lead ECG recordings were obtained from 125 consecutively recruited postmenopausal healthy women aged between 44 and 54 years. The control group consisted of 125 age-matched premenopausal women. P-wave parameters and cardiac repolarization indices were measured and compared with respect to menopausal status. Results: Demographic features of premenopausal and postmenopausal women were comparable. There were no significant differences between two groups regarding mean values of heart rate, maximum and minimum P-wave duration, P-wave dispersion, maximum and minimum QT interval, and QT dispersion. Mean values of QT interval obtained from lead V5 were also similar. Corrected values which were calculated according to Bazett and Fridericia formulas also did not differ between the groups. Mean values of Tpeak to Tend (TpTe) (p < 0.001) and corrected TpTe (p = 0.001) intervals obtained from lead V5 were significantly shorter in postmenopausal women when compared to those without menopause. Conclusion: Tpeak to Tend interval decreased significantly while QT intervals and P-wave parameters did not change in postmenopausal women when compared to premenopausal women. Association of these findings with changes in levels of sex steroids and their prognostic implications need to be elucidated with further studies. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe Prognostic significance of solid growth in endometrioid endometrial adenocarcinoma(Springer Japan Kk, 2020) Akar, Serra; Celik, Zeliha Esin; Findik, Siddika; Ilhan, Tolgay Tuyan; Ercan, Fedi; Celik, CetinBackground Endometrioid endometrial cancer is the most common histological subtype of endometrial adenocarcinoma. In the FIGO grading scheme, both architectural and nuclear grade are taken into consideration. However, the specific impact of solid growth alone on endometrioid endometrial adenocarcinoma outcome is not well documented. We sought to assess the degree of impact of solid growth on lymphovascular space invasion (LVSI), myometrial invasion, tumor size, FIGO stage, lymph node metastasis (LNM), relapse-free survival (RFS) and disease-specific survival (DSS). Methods Paraffin blocks of 269 patients treated for endometrioid endometrial cancer were retrospectively analyzed with morphometry for solid growth percentages. Results A statistically significant cut-off value of 1% solid growth was found for predicting LNM and advanced stage (III or IV), myometrial invasion and LVSI (p < 0.001) and a cut-off value of 8% was found for predicting adverse survival outcome (p < 0.001). The mean DSS was significantly higher in patients with < 6% solid growth compared to patients with 6-50%, 51-75% and > 75% solid growth (p < 0.001). Although, the mean RFS and DSS were lowest in patients with 51-75% solid growth, this did not reach statistical significance in comparison to 6-50% and > 75% (p > 0.05). Conclusion Although > 75% solid growth was most significantly associated with many of the adverse prognostic factors, this subset did not provide prognostic superiority in predicting adverse survival when compared to subsets within 6-75% solid growth. In conclusion, although no statistically significant difference in survival was found among subdivisions of architectural grades 2 and 3, solid growth, especially >= 8%, appeared to be an independent prognostic factor for survival in patients with early-stage endometrioid endometrial cancer.Öğe The Reasons of Induced Abortion and Contraceptive Preference in 15-49 Years Women(Istanbul Univ, Fac Nursing, 2010) Yilmaz, Sema Dereli; Ege, Emel; Akin, Belgin; Celik, CetinAim: The aim of this study is to describe the reasons of induced abortion and contraception preference of the 15-49 years old women. Method: This study has descriptive design. The study setting is Dr. Faruk Sukan Women and Children Hospital in Konya. 103 women (15-49 yrs) who came for induced abortion to the MR (Menstrual Regulation) Polyclinic from 11 November 2005 to 31 January 2006 and who accepted to join the study. It has been used a questionnaire consisted of 27 questions on variables such as demographic features, the reasons of voluntary abortion and contraception preference of women. One investigator collected the data with face to face interviews. Percentages were calculated and Chi-squared tests carried out. Results: The mean age of the 103 women in the study was 32.7 (SD: 5.91, median: 32.0, mode: 30, min. 18, max. 45). From the 103 women studied 85.4% of them were literate or primary school graduates, women with 3 or more pregnancy used abortion/MR with high frequency (94.2%). The most frequent reason for abortion was the number of children (47.6%) and 59.4% of women had been used to coitus interruption for contraceptive method just before the abortion. Conclusions: Induced abortion is still used as method of family planning. Focused contraception counseling, especially in their post partum setting, is important to help ensure the well-being of women and children.
