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Isaoglu U.,Nenehatun Obstetrics and Gynecology Hospital | Yilmaz M.,Nenehatun Obstetrics and Gynecology Hospital | Calik M.,Atatrk University | Polat B.,Atatrk University | And 4 more authors.
Gynecological Endocrinology | Year: 2012

It was biochemically and histopathologically investigated whether disulfiram has protective effects on ischemia-induced ovary damage. For this purpose, levels of tGSH, superoxide dismutase (SOD), malondialdehyde (MDA), and 8-OH Gua/Gua were investigated in ischemic rat ovary tissue. Results show that used doses of disulfiram (10, 25, and 50mg/kg) prevent MDA, a product of ischemia-induced lipid peroxidation, formation in female rat ovary tissue and prevent decrease of enzymatic and non-enzymatic (SOD, GSH) antioxidant parameters. Additionally, all doses of disulfiram significantly prevent DNA damage when compared to control group. Fewer histopathological findings were observed in tissues with higher antioxidant levels and lower oxidant and DNA damage levels. © 2012 Informa UK, Ltd.


Kabil Kucur S.,Dumlupinar University | Temizkan O.,Sisli Etfal Training and Research Hospital | Atis A.,Sisli Etfal Training and Research Hospital | Gozukara I.,Nenehatun Obstetrics and Gynecology Hospital | And 3 more authors.
Archives of Gynecology and Obstetrics | Year: 2013

Purpose: To assess the contribution of the terms and definitions recently described by international endometrial tumor analysis (IETA) group when evaluating endometrial lesions on power Doppler imaging. Methods: Patients requiring endometrial sampling were examined prospectively by transvaginal B-mode and power Doppler sonography (PDS) the day before scheduled diagnostic procedure. Sonographic features were classified using IETA group classification. These were compared with the final histopathological diagnosis. Results: Ninety-seven patients were included in the study. The histopathological diagnoses were as follows: endometrial polyp: 39 cases (40.2 %), endometrial hyperplasia: 9 cases (9.3 %), submucous myoma: 10 cases (10.3 %), endometrium cancer: 7 cases (7.2 %), non-specific findings: 32 cases (33 %). The sensitivity, specificity and positive and negative predictive values for single dominant or branching single dominant vessel pattern in diagnosing endometrial polyps were 66.67, 98.28, 96.3 and 81.43 %; for multiple vessels with focal origin pattern in diagnosing endometrial cancer, they were 42.86, 91.11, 27.27 and 95.35 %; for multifocal origin at the myometrial-endometrial junction in diagnosing other non-specific endometria, they were 81.25, 89.23, 78.79 and 90.62 %; for scattered vessel pattern in diagnosing endometrial hyperplasia, they were 88.89, 88.64, 44.4 and 98.73 % and for circular flow pattern in diagnosing submucosal fibroids, they were 80, 100, 100 and 97.75 %, respectively. The color score of the endometrium was not statistically different among different endometrial pathologies (P value >0.05). Conclusion: The nomenclature described by IETA group for power Doppler assessment of the endometrium is clinically valuable and reasonable. Using this terminology, it will be easier to compare results of different studies on endometrial Doppler sonography in the future. © 2013 Springer-Verlag Berlin Heidelberg.


Kucur S.K.,Dumlupinar University | Gozukara I.,Dumlupinar University | Aksoy A.,Nenehatun Obstetrics and Gynecology Hospital | Uludag E.U.,Nenehatun Obstetrics and Gynecology Hospital | And 3 more authors.
Blood Coagulation and Fibrinolysis | Year: 2015

Polycystic ovary syndrome (PCOS) is a prevalent disease with many potential long-term metabolic and cardiovascular risks if not managed appropriately. Mean platelet volume (MPV) is a marker associated with adverse cardiovascular events. In this study, we aimed to investigate MPV levels under ethinyl estradiol/cyproterone acetate or metformin therapy for the previous 6 months in PCOS. A total of 114 individuals [metformin treatment (n = 18), ethinyl estradiol/cyproterone acetate treatment (n = 29), newly diagnosed PCOS patient with no treatment (n = 35), and control group of eumenorrheic healthy individuals (n = 32)] were included in the current study. Hematologic parameters other than MPV were similar in all groups. The MPV value was significantly higher in the newly diagnosed PCOS patients compared with the other three groups independent of age, BMI, and C-reactive protein level in multiple regression analysis (P < 0.01). The MPV value of control group was comparable to the groups under ethinyl estradiol/cyproterone acetate or metformin therapy (P = 1.0). There was no statistically significant difference in the white blood cell count among the groups. The MPV values were positively correlated with the homeostatic model assessment-insulin resistance and Ferriman-Gallwey Score (P = 0.044, r = 0.261; P = 0.037, r = 0.229, respectively). Ethinyl estradiol/cyproterone acetate and metformin similarly appear to decrease MPV, a marker of cardiovascular risk. Therefore, a possible beneficial effect of ethinyl estradiol/cyproterone acetate and metformin on long-term cardiovascular morbidities in PCOS may be suggested. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


PubMed | Nenehatun Obstetrics and Gynecology Hospital, Erzurum District Training and Research Hospital, Dr Sami Ulus Children Research And Training Hospital, Atatürk University and Denzili Public Healt Hospital
Type: Journal Article | Journal: Indian journal of clinical biochemistry : IJCB | Year: 2016

Hemodynamically significant ductus arteriosus (hsPDA) may alter organ perfusion by interfering blood flow to the tissues. Therefore, in infants with hsPDA, hypoxia occurs in many tissues. In this study, we aimed to investigate the diagnostic significance of serum (ischemia-modified albumin) IMA levels as a screening tool for hsPDA, and its relation to the severity of the disease in the preterm neonates. For this purpose, seventy-two premature infants with gestation age <34weeks were included in the study. Thirty premature infants with hsPDA were assigned as the study group and 42 premature infants without PDA were determined as the control group. Blood samples were collected before the treatment and 24h after the treatment, and analyzed for IMA levels. IMA levels in the study group (1.260.36 ABSU) were found to be significantly higher than control group (0.650.12 ABSU) (p<0.05). In infants with hsPDA, a positive correlation was found between IMA and PDA diameter (=0.876, p=0.022), and LA/Ao ratio (=0.863, p=0.014). The cut-off value of IMA for hsPDA was measured as 0.78 ABSU with 88.89% sensitivity, and 90.24% specificity, 85.71% positive predictive, 92.5% negative predictive value [area under the curve (AUC)=0.96; p<0.001]. The mean IMA value of the infants with hsPDA before treatment was 1.260.36 ABSU, and the mean IMA value of infants after medical treatment was 0.670.27 ABSU (p=0.03). We concluded that IMA can be used as a marker for the diagnosis and monitoring of a successful treatment of hsPDA.


Yilmaz O.,District Training and Research Hospital | Kahveci H.,Nenehatun Obstetrics and Gynecology Hospital | Zeybek C.,District Training and Research Hospital | Ciftel M.,District Training and Research Hospital | Kilic O.,District Training and Research Hospital
American Journal of Perinatology | Year: 2014

Objective Many vasodilator drugs, including inhaled iloprost, are used to treat insufficient pulmonary vasodilatation, which is the main issue in pulmonary hypertension in newborns. Study Design The safety and efficacy of inhaled iloprost for the treatment of pulmonary hypertension were evaluated retrospectively in 15 preterm infants diagnosed with respiratory distress syndrome and pulmonary hypertension. Results The infants were unresponsive to surfactant and conventional mechanical ventilation and thus were treated with inhaled iloprost. Oxygenation parameters and hypoxemia improved rapidly after treatment. There was no decline in systemic blood pressure, no need for increased doses of vasopressor, and no side effects during treatment. One patient died of sepsis during treatment. Conclusion In the treatment of severely sick premature babies with pulmonary hypertension, inhaled iloprost has high tolerability and a low incidence of systemic side effects. Based on the benefits of inhaled iloprost in preterm infants with pulmonary hypertension in this case series, further studies are required to evaluate its efficacy and safety in the preterm population. Copyright © 2014 by Thieme Medical Publishers, Inc.


Yilmaz O.,Erzurum District Training and Research Hospital | Olgun H.,Atatürk University | Ciftel M.,Erzurum District Training and Research Hospital | Kilic O.,Erzurum District Training and Research Hospital | And 4 more authors.
Cardiology in the Young | Year: 2015

Introduction: Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia. Materials and Methods: Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D3 blood level was measured. Results: We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged. Conclusions: Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well. © Cambridge University Press 2013.


Kahveci H.,Erzurum District Training and Research Hospital | Yilmaz O.,Erzurum District Training and Research Hospital | Avsar U.Z.,Atatürk University | Ciftel M.,Erzurum District Training and Research Hospital | And 3 more authors.
Pediatric Pulmonology | Year: 2014

Objective: This study was performed to examine the effectiveness and safety of oral sildenafil and inhaled iloprost in term newborns with persistent pulmonary hypertension of the newborn (PPHN).Results: Iloprost appeared to be more effective than sildenafil in the treatment of PPHN with regard to time to adequate clinical response, ventilatory parameters, duration of drug administration, duration of mechanical ventilation, duration of return to normal values of respiratory failure indices, use of MgSO4 as a second vasodilator and requirement for support with inotropic agents. We observed no side effects on blood pressure or homeostasis in any of the patients in the iloprost group. Systemic hypotension was significantly elevated in the sildenafil group. Four and three infants died of PPHN in the sildenafil and iloprost groups, respectively. Pulmonary systolic arterial pressure decreased to normal levels in the remaining 40 patients, and they were discharged from hospital.Patients and Methods: Oral sildenafil and inhaled iloprost were administered to 27 and 20 neonates, respectively, for treatment of persistent pulmonary hypertension. All patients were term infants at 37 gestational weeks or older. In the sildenafil group, 14 patients had meconium aspiration syndrome, 8 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, 1 had transient tachypnea, and 1 had idiopathic PPHN. In the iloprost group, 9 patients had meconium aspiration syndrome, 7 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, and 1 had transient tachypnea. Sildenafil citrate was administered via an oral feeding tube. Iloprost was administered endotracheally to patients on mechanical ventilation using a jet nebulizer.Conclusion: We suggested that inhaled iloprost may be a safe and effective treatment choice in newborn infants with persistent pulmonary hypertension. In cases where treatment with inhaled iloprost, ECMO or INO is not possible, oral sildenafil can be an alternative therapy option in the treatment of PPHN. © 2014 Wiley Periodicals, Inc.


PubMed | Erzurum District Training and Research Hospital, Atatürk University and Nenehatun Obstetrics and Gynecology Hospital
Type: Case Reports | Journal: Cardiology in the young | Year: 2015

Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia.Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D3 blood level was measured.We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged.Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well.


Yilmaz M.,Nenehatun Obstetrics and Gynecology Hospital | Isaoglu U.,Nenehatun Obstetrics and Gynecology Hospital | Delibas I.B.,Atatürk University | Kadanali S.,Atatürk University
Journal of Obstetrics and Gynaecology Research | Year: 2011

Aim: To compare all phenotypes of polycystic ovary syndrome (PCOS) for anthropometrical, hormonal, and metabolic differences according to Rotterdam criteria. Material & Methods: Women with PCOS (Rotterdam definition; n = 127) and women without PCOS used as controls (n = 44). There were four phenotypes of PCOS: 56/127 (44.09%) of the patients were polycystic ovaries on ultrasound (PCO) + oligo or anovulation (O) + biochemical and/or clinical hyperandrogenism (HA), 29/127 (22.84%) were HA+O, 24/127 (18.90%) were PCO+O and 18/127 (14.17%) were HA+PCO. And 42/127 (33.07%) patients represented the new phenotypes (PCO+O and HA+PCO). Phenotypical, hormonal and metabolic parameters were compared between the groups. Results: Waist-to-hip ratio, luteinizing hormone-to-follicle stimulating hormone ratio, testosterone, androstenedione, dehydroepiandrostenedione were lower in women with PCO+O and controls than the other three phenotypes. The highest score regarding hirsutismus was found in the HA+O phenotype and the lowest score in the PCO+O phenotype. Prevalence of metabolic syndrome and degree of insulin resistance in PCO+O phenotype was closer to control subjects than the other three phenotypes. Conclusions: Anthropometrical, hormonal, and metabolic differences suggest that PCO+O phenotype is closer to control group than the other PCOS phenotypes. © 2011 The Authors.


Ozkan A.,Regional Research and Education Hospital | Kumtepe Y.,Atatürk University | Delibas I.B.,Nenehatun Obstetrics and Gynecology Hospital
Research Journal of Medical Sciences | Year: 2012

The objective of this study was to evaluate the 1 year success of the Mini Sling System in the treatment of Stress Urinary Incontinence (SUI). The subjects were 22 patients who had been treated with the Mini Sling system between July 2009 to January 2010 in the clinic. After diagnosis of genuine SUI by history, physical examination, cough stress pad test and urodynamics. The patients were evaluated at postoperative 1st, 3rd, 6th and 12th months, in terms of urinary incontinence, dyspareunia and lower urinary tract infection and symptoms. The mean operation time was 7 min. There were no intraoperative complications. At the 1st week of surgery, the Mini Sling System was totally removed from a patient due to confirmation of treatment failure. One patient had tissue reaction manifested by a palpable right inguinal nodularity at the postoperative 6th month and treated with partial mesh excision following antibiotherapy. The patient remained continent throughout the follow-up period. There were no other procedure-related complications detected within 1 year of follow-up. Objective cure and failure rates at 1 year follow-up were 95% (21/22) and 5% (1/22), respectively. In conclusion, the Mini Sling System is easy to use and effective minimally invasive method in the treatment of genuine stress incontinence. © Medwell Journals, 2012.

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