Özlem Seçilmiş Kerimoğlu

Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome

OBJECTIVE 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.

Psychiatric comorbidity in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that women experience during their reproductive years and is associated with many psychiatric disorders. This study sought to determine the existence of psychiatric disorders in women with untreated PCOS. Another objective of the study was to examine whether an association exists between psychiatric disorders, insulin resistance, and body mass index.

Relations of Serum Visfatin and Resistin Levels with Endometrial Cancer and Factors Associated with its Prognosis

BACKGROUND The aims of this study were compare the serum visfatin and resistin levels between endometrial cancer (EC) patients and controls and evaluate their power to predict prognosis. MATERIALS AND METHODS This prospective study was conducted between March 2013 to June 2014 on the Gynecologic Oncology Department of the University of Selcuk, Konya, Turkey. A total of 42 EC patients and 42 controls were included and assessed for differences in serum visfatin and resistin levels, along with prognostic factors. RESULTS Endometrial cancer patients had significantly higher visfatin levels than control s (p: 0.011), associated with deep myometrial invasion (p: 0.019). In contrast the serum level of resistin did not significantly differ between EC patients and controls (p: 0.362). However, high resistin level in EC patients was associated with increase lymph node metastasis (p: 0.009). On logistic regression analysis, we found that serum visfatin elevation was associated with risk of myometrial invasion (OR: 1,091; 95%CI: 1.021- 1.166; p: 0.010) and serum resistin with risk of lymph node metastasis (OR: 1.018; 95%CI: 1.000- 1.035; p: 0.046). For myometrial invasion prediction, a serum visfatin level greater than 26.8 ng/mL demonstrated a sensitivity and specificity of 66.6 % and 96.4%, respectively. For lymph node metastasis prediction, the best cut-off for serum resistin level was 599ng/mL. A serum resistin level greater than this demonstrated a sensitivity and specificity of 87.5% and 77.1%, respectively. CONCLUSIONS Our data suggest that serum visfatin is elevated in patients with EC and serum visfatin and resistin levels could be used to predict the risk of advance stage lesions.

Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women

We aimed to determine the relationship between eating attitudes and psychiatric symptoms in women with hyperemesis gravidarum (HG) and to compare these women with healthy control subjects.

Metastin levels in relation with hormonal and metabolic profile in patients with polycystic ovary syndrome

OBJECTIVE The aim of the present study was to evaluate serum concentrations of metastin in relation with hormonal and metabolic profile in patients with and without polycystic ovary syndrome (PCOS). STUDY DESIGN The study was a clinical study. Eighty-three women with PCOS and 66 body mass index (BMI) matched controls were divided into two groups, based on BMI: overweight and obese (BMI≥25 kg/m(2)) and normal weight. (BMI<25 kg/m(2)) Hirsutism scores, hormonal and metabolic profile as well as metastin levels were evaluated in each subject. Blood samples were collected in the early follicular phase (between day 2 and day 5 of the menstrual cycle) at 9:00 AM, after an overnight fast. Circulating levels of LH, FSH, PRL, TSH, T, fT, DHEAS, 17-OH-P, sex hormone-binding globulin (SHBG), insulin, glucose, lipid profile and metastin were measured. RESULTS Metastin levels were significantly higher in the PCOS group compared to controls (2.02 ng/ml versus 1.16 ng/ml, p<0.001). Metastin levels correlated significantly positively with luteinizing hormone (LH), total testosterone (T), dehydroepiandrosteronesulphate (DHEA-SO4) levels, modified Ferriman-Gallwey (mFG) scores and free androgen index (FAI); however, correlated negatively with sex hormone binding globulin (SHBG) levels (p<0.05). When overweight or obese (BMI≥25 kg/m(2)) and normal weight (BMI<25 kg/m(2)) women with PCOS were compared to body mass index (BMI) matched controls, higher metastin levels were also found in PCOS groups (1.94 ng/ml versus 1.18 ng/ml, and 2.06 ng/ml versus 1.08 ng/ml, p<0.05, respectively). CONCLUSIONS These findings suggest that metastin levels were higher in women with PCOS as compared to controls regardless of BMI. Furthermore, metastin levels can be used as a specific marker for androgenic profile and this marker might play a role in the pathogenesis of PCOS.

Effect of the percentage of body fat on surgical, clinical and pathological outcomes in women with endometrial cancer

This study used the measure of percentage of body fat (%BF) to define obesity and evaluated the effect of percentage of %BF on clinical, surgical and pathological features in women with endometrial cancer.

Pregnancy outcomes in a university hospital after legal requirement for single-embryo transfer

OBJECTIVE To present our in vitro fertilization outcomes after implementation of the Turkish government policy limiting the number of transferred embryos to one, in women under the age of 35, and two, in women over age 35; and to demonstrate the feasibility of this policy. STUDY DESIGN We retrospectively reviewed the records of 423 patients who underwent ovarian stimulation, oocyte pick-up, intracytoplasmic sperm injection and embryo transfer due to primary or secondary infertility over a 22-month time interval. Clinical pregnancy was defined as a fetal heartbeat in the seventh gestational week. Embryo transfers were carried out on day 3 or 5. Descriptive statistics are given as the number of subjects and percentages. RESULTS A total of 353 embryo transfers were performed: 261 (73.9%) were single-embryo transfer (244 (69.1%) elective and 17 (4.8%) non-elective) and 92 (26.1%) were double-embryo transfer. Of the 244 elective single-embryo transfers, 6.6% (n=16) were performed using frozen-thawed embryos. The average patient age was 29.6±4.5 years in the single-embryo group and 36.5±2.4 years in the double-embryo group. The cumulative pregnancy rates per oocyte pick-up were similar in both groups: 41% (n=107) in the single-embryo group and 43.4% (n=40) in the double-embryo group (p=0.678). The cumulative live birth rate of the single-embryo group (32.1%) was not statistically different from the double-embryo group (35.8%) (p=0.518). The twin pregnancy rate after single-embro transfer was significantly lower than with double-embryo transfer (2.8% (n=3) vs. 32.5% (n=13); p<0.001) and 62.5% of the twin pregnancies occurred in women 35 years or older who underwent double-embryo transfer. No significant difference in the spontaneous abortion rates was recorded between the single- and double-embryo transfer groups (16 (6.1%) vs. 6 (6.5%); p=0.894). CONCLUSION Single-embryo transfer results in a pregnancy rate comparable to double-embryo transfer, with a significantly reduced multiple pregnancy rate. Double-embryo transfer in patients over age 35 should be reconsidered because of the resulting high rate of multiple pregnancy.

Rectal Cancer in Pregnancy: a Case Report and Review of the Literature

Rectal cancer is extremely rare during pregnancy with an incidence of 1/13,000. Over 300 cases in pregnancy were reported so far. Lifetime risk for colorectal cancer is 1 in 17, but rectal cancer before age 40 is rare (1/2,000) [1, 2]. Here, we presented a pregnant woman with familial history of rectal cancer and incidental diagnosis of rectal carcinoma who was managed with folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) neoadjuvant chemotherapy.

Effect of drainage on postoperative pain after laparoscopic ovarian cystectomy

Abstract The aim of this prospective study was to investigate the effect of drainage on postoperative shoulder and abdominal pain after uncomplicated laparoscopic ovarian cystectomy (LOC). Allocation to drain or not to drain was non-randomised. There were 55 patients with drainage and 56 patients without drainage. Postoperative shoulder and abdominal pain was assessed using a 10-point visual analogue scale. Postoperative hospital stay in the drainage group was longer than the non-drainage group (p = 0.040). Postoperative shoulder pain scores at 6 h and 24 h were similar between the drainage and non-drainage groups (p = 0.376 and p = 0.847, respectively). Postoperative abdominal pain was higher in the drainage group at 6 h (p = 0.009), but was similar at 24 h (p = 0.097) between the groups. These data suggest that for LOC, drainage may not be useful to prevent postoperative shoulder pain and also increases postoperative abdominal pain and length of hospital stay.

The impact of body mass index on radiotherapy technique in patients with early-stage endometrial cancer: a single-center dosimetric study.

Objective We aimed to evaluate the impact of body mass index on radiotherapy (RT) technique in patients with early-stage endometrial cancer. Materials and Methods Twenty-seven consecutive patients were included in the study and divided into 3 groups with respect to their body mass index (normal weight, 18.5–24.9 kg/m2; overweight, 25–29.9 kg/m2; obese, 30–39.9 kg/m2). Treatment plans using field-in-field (FIF) and 3-dimesional conformal RT (3D-CRT) were compared for the doses in the planning target volume (PTV), organs-at-risk (OAR) volumes, dose homogeneity index, and monitor unit counts required for the treatment. Results The FIF technique was superior to 3D-CRT with respect to the maximum and mean doses received by OAR and dose homogeneity index values. The subgroup analyses revealed that the maximum dose received by the right femur and the mean doses received by the rectum and bladder were significantly reduced only in obese patients (Ps = 0.021, 0.008, and 0.008, respectively). The FIF technique significantly reduced the PTV volumes irradiated with greater than 105% of the prescribed dose (P < 0.001). The volumes of bowel and bone marrow receiving more than the prescribed dose of 30 Gy were significantly reduced only in obese patients (Ps = 0.025 and 0.043, respectively). The volumes of bladder, bowel, and bone marrow receiving more than the prescribed dose of 45 Gy were significantly reduced in only obese patients (Ps = 0.011, 0.011, and 0.008, respectively). Conclusions Considering the lower maximum doses in OAR and PTV, we demonstrate the FIF technique to be more advantageous than 3D-CRT during adjuvant RT for early-stage endometrial cancer patients. This advantage is more prominent in obese patients. Therefore, FIF technique represents an effective pelvic RT treatment option for obese patients in clinics that do not have access to or prefer an alternative to intensity-modulated RT.