Tevfik Yoldemir

Vitamin D receptor gene polymorphisms in a group of postmenopausal Turkish women: association wıth bone mineral density.

Objective To determine the frequency of the vitamin D receptor (VDR) gene polymorphisms BsmI, ApaI, TaqI and FokI and their associations with bone mineral density (BMD) in postmenopausal Turkish women. Design One hundred and thirty healthy postmenopausal women and 130 premenopausal healthy women acting as controls were included in the study. The BsmI, FokI, ApaI and TaqI polymorphisms in the VDR gene were studied by polymerase chain reaction–restriction fragment length polymorphism method. The BMD of the lumbar vertebrae and femur neck were measured by dual-energy X-ray absorptiometry. Comparisons between the groups were performed using the paired t-test and ANOVA. χ2 or contingency tables were used to analyze qualitative results. Results Genotypes BB, Bb and bb occurred in premenopausal women with frequencies of 16.92%, 50% and 33.08% and in postmenopausal women with frequencies of 16.92%, 56.15% and 26.92%, respectively. Genotypes FF, Ff, ff occurred in premenopausal women with frequencies of 47.69%, 42.31% and 10% and in postmenopausal women with frequencies of 50.77%, 42.31% and 6.92%, respectively. Genotypes AA, Aa, aa occurred in premenopausal women with frequencies of 23.85%, 56.15% and 20% and in postmenopausal women with frequencies of 26.15%, 46.15% and 27.70%, respectively. Genotypes TT, Tt and tt occurred in premenopausal women with frequencies of 37.69%, 45.38% and 16.92% and in postmenopausal women with frequencies of 39.23%, 45% and 15.38%, respectively. There was no difference in the frequencies of VDR gene polymorphisms between premenopausal and postmenopausal women. BMD measurements were not different between genotypes in premenopausal and postmenopausal women. Conclusions The VDR gene BsmI, FokI, ApaI and TaqI polymorphisms have no major influence on bone mineral density in our group of postmenopausal women.

Prevalence of HPV infection by cytologic diagnosis and HPV DNA extraction and prevalence of the HPV genotypes detected in urban Turkish women

To evaluate the prevalence of the different human papillomavirus (HPV) genotypes in women seen at 2 Marmara University Hospital gynecologic outpatient clinics in Istanbul, Turkey.

Assessment of bone mineral density should be considered earlier in perimenopausal women with vasomotor symptoms

To investigate the relationship between vasomotor symptoms (hot flashes) and osteopenia or osteoporosis in perimenopausal women.

The effect of retrieved oocyte count on pregnancy outcomes in an assisted reproduction program.

ObjectiveTo determine if women with less than five eggs retrieved do as well as women with more eggs retrieved in terms of pregnancy outcomes in our assisted reproduction program.MethodTwo hundred one women undergoing in vitro fertilization treatment at Fertility Unit in Royal Prince Alfred Hospital, University of Sydney, Australia were selected for retrospective evaluation. The women were grouped according to the number of oocytes retrieved at ovum pick-up. Group A consisted of women with less than 5 oocytes, group B with 5 to 10 oocytes and group C with 11 to 15 oocytes collected. Clinical and ongoing pregnancy rates were compared.ResultsThere was no difference between the groups in terms of clinical and ongoing pregnancy rates.ConclusionWith good IVF lab conditions, if a patient reaches embryo transfer, the number of eggs retrieved should not affect the likelihood of pregnancy outcome in an assisted reproductive technology treatment.

Effect of daily hormone therapy and alendronate use on bone mineral density in postmenopausal women

OBJECTIVE To evaluate the effect of daily oral and transdermal hormone therapy alone or in combination with alendronate on bone mineral density in postmenopausal women. DESIGN Comparative prospective clinical study. SETTING Outpatient clinic of a training and research hospital. PATIENT(S) One hundred seventy-three consecutive postmenopausal women with no previous hormone therapy and a bone mineral density T score <-1 SD were randomly enrolled. INTERVENTION(S) Oral conjugated estrogen, alone or with alendronate, or transdermal estrogen, alone or with alendronate, given for 1 year. All patients also received medroxyprogesterone acetate and calcium. MAIN OUTCOME MEASURE(S) Bone density measurement at L2 to 4 region by dual-energy X-ray absorptiometry. RESULTS At the end of 1 year, significant increase in bone density measurements were seen in all groups. Oral conjugated estrogen and transdermal estrogen have the same effect on bone mineral density loss. Hormone therapy alone stabilized the bone mineral density loss. Hormone therapy together with alendronate resulted in better values in all groups. CONCLUSION Hormone therapy is adequate in osteopenic women. However, hormone therapy plus alendronate is advantageous in women with considerable bone mineral density loss.

Iodine status of pregnant women in a metropolitan city which proved to be an iodine-sufficient area. Is mandatory salt iodisation enough for pregnant women?

Abstract The objective of this study was to assess the iodine status of pregnant women in a metropolitan city which was stated as iodine sufficient area after salt iodination program. This multicenter, cross-sectional study was carried out on 3543 pregnant women. Age, gestational weeks, smoking, consumption of iodized salt, dietary salt restriction, history of stillbirth, abortus and congenital malformations were questioned. Spot urine samples were analyzed for urine iodine concentration (UIC). The outcomes were: (a) median UIC in three trimesters of pregnancy and (b) frequency of ID among pregnant women. The median UIC was 73 µg/L. The median UIC was 77 µg/L (1–324), 73 µg/L (1–600) and 70 µg/L (1–1650) in three trimesters of pregnancy, respectively (p: 0.14). UIC <50 µg/L was observed in 36.6% (n: 1295) and UIC<150 µg/L was observed in 90.7% (n: 3214) of pregnant women. Only 1% (n: 34) of the pregnant women had UIC levels higher than 500 µg/L. This study showed that more than 90% of the pregnant women in this iodine-sufficient city are facing some degree of iodine deficiency during their pregnancy. A salt iodization program might be satisfactory for the non-pregnant population, but it seems to be insufficient for the pregnant population.

Susceptibility-weighted magnetic resonance imaging for the evaluation of deep infiltrating endometriosis: preliminary results

Background Knowledge of the precise sites of deep infiltrating endometriosis (DIE) lesions is essential for preoperative workup and treatment. Susceptibility-weighted imaging (SWI) has high sensitivity for blood products and have recently been applied in abdominal imaging. Purpose To determine the value of SWI in the diagnosis of DIE. Material and Methods Forty-three clinically suspected DIE patients with sonographically diagnosed ovarian endometriomas who had tenderness or palpable nodule(s) on rectovaginal examination were referred to pelvic magnetic resonance imaging (MRI) including SWI. Two patients were excluded from the study because of low quality of SWI series. Twenty-eight patients who were offered laparoscopic endometriosis surgery (LES) preferred medical treatment over surgical approach. Thirteen out of 41 participants had LES. Lesions were evaluated for their locations, signal intensities on T1-weighted (T1W) and T2-weighted (T2W) images, and presence of signal voids on SWI using 3T MRI and correlated with LES findings. Results A total of 18 endometriosis foci were laparoscopically removed from 13 patients. DIE lesions removed at laparoscopy were located at the uterosacral ligament (9/18), rectovaginal region (4/18), retrocervical region (2/18), and fallopian tubes (3/18). Eleven out of 18 (61%) DIE foci were detected by their high-signal intensities on T1W images whereas 16 out of 18 (89%) DIE foci were detected by signal voids on SWI. Conclusion SWI imaging with its high sensitivity to blood products, contributes to the diagnosis of DIE by depicting different phases of hemorrhage not seen by conventional MRI sequences.

The impact of metabolic syndrome on bone mineral density in postmenopausal women

Aim: To determine the impact of metabolic syndrome (MS) on dual-energy X-ray absorptiometry (DEXA) derived mean T scores of lumbar vertebra of Turkish women during postmenopausal period. Methods: One hundred and eighty healthy postmenopausal women seen at the University Gynecology or Menopause Outpatient Clinics were enrolled for this cross sectional study. The women were allocated to one of two groups according to the presence or absence of MS. The groups were then compared for bone mineral density (BMD) of the lumbar vertebrae, as measured by DEXA. The Fischer exact test were used for continuous variables and chi-square test was used for categorical variables. Multivariable logistic regression modeling was used to compute the odds ratios of variables predictive of diminished T scores at lumbar area less than −1. Results: The mean T scores for the lumbar area for women with or without MS were comparable either according to National Cholesterol Education Program criteria. Moderate positive correlation was found between T score less than −1 and high density lipoprotein (HDL) cholesterol. Triglyceride/HDL cholesterol and fasting blood glucose showed weak negative correlation with T score less than −1. Conclusions: It appears that MS in postmenopausal women does not have an impact on BMD in our population.

Prevalence of dynamic magnetic resonance imaging-identified pelvic organ prolapse in pre- and postmenopausal women without clinically evident pelvic organ descent

Background Dynamic magnetic resonance imaging (dMRI) is an imaging tool that can be used to evaluate and stage pelvic organ prolapse (POP). Greater understanding of the incidental detection of POP in asymptomatic patients is needed. Purpose To evaluate the prevalence of dMRI-detected POP in pre-and postmenopausal women who were imaged for reasons unrelated to pelvic floor dysfunction. Material and Methods A total of 227 women who had diagnoses that did not include POP underwent abdominal/pelvic dMRI. Patients with a positive gynecological examination for or a clinical history of POP (n = 11), hysterectomy (n = 4), or gynecologic-oncology surgery (n = 2) were excluded, as well as patients who were unable to strain during MRI (n = 11). A total of 199 patients without visible prolapse were enrolled in the study. An H-line, M-line, pubococcygeal line (PCL), and mid-pubic line (MPL) were used to detect and grade prolapse. Results The prevalence of dMRI-identified POP was higher in postmenopausal subjects. The PCL led to a greater frequency of prolapse detection than the MPL. The frequency of middle compartment descent was similar regardless of whether the PCL or MPL was used as a reference line. There was a higher incidence of prolapse in the posterior compartment. Using an H-line and PCL as references, the anterior and posterior compartments were found to significantly differ between pre- and postmenopausal subjects. The MRI parameters that were used to define POP were not correlated with parity, vaginal birth, BMI, or fetal birth weight. With respect to the MPL, age was correlated with both the presence of an elongated H-line and with descent. Conclusion Dynamic MRI identified incidental pelvic organ prolapse in asymptomatic patients. The prevalence of dMRI-detected POP was higher in postmenopausal women without visible prolapse. These findings suggest the need for further studies to identify how to modify the currently used dMRI thresholds for postmenopausal women.

The prevalence of metabolic syndrome in pre- and post-menopausal women attending a tertiary clinic in Turkey

OBJECTIVE To determine the prevalence of metabolic syndrome among pre- and post-menopausal women attending a tertiary clinic in Turkey. STUDY DESIGN This is a cross-sectional study consisting of one hundred and eighty healthy postmenopausal women and fifty-three healthy premenopausal women evaluated for presence or absence of metabolic syndrome. The t test and Fischer exact test were used for continuous variables and chi-square test was used for categorical variables. RESULTS The prevalence of metabolic syndrome among pre-menopausal women was 15.09% according to NCEP criteria. The prevalence of metabolic syndrome among postmenopausal women was 19.44% according to NCEP criteria. There was no significant difference in the prevalence of metabolic syndrome between premenopausal and postmenopausal women in our study population. CONCLUSION There was no significant difference in the prevalence of metabolic syndrome between premenopausal and postmenopausal women attending a tertiary clinic in Turkey.