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Öğe Analysis of Distress in Patients with Gynecological Cancers During the COVID-19 Pandemic: A Telephone Survey(Turkiye Klinikleri, 2022) Yavuz, Adem; Dolanbay, Mehmet; Akyuz Cim, Emine Fusun; Disli Gurler, Ayse; Cundubey, Cevat FiratObjective: To investigate distress levels in patients with gynaecological cancers during the coronavirus disease-2019 (COVID-19) pandemic and identify factors associated with distress. Material and Methods: A total of 193 patients who underwent cytoreductive surgery for gynaecological cancer were included in our research. The patients were contacted by phone and provided detailed information about our study and the questionnaire that was to be applied. We performed distress screening using The National Comprehensive Cancer Network Distress Thermometer and Problem List (PL), developed for cancer patients. Results: In the study group, 51% of patients were categorized in the high-stress group. As practical problems, childcare (p<0.001), insurance/financial (p<0.033), work/school (p<0.001), treatment decisions (p<0.001), have significant differences between 2 groups in the present study. As family problems dealing with children (p<0.001), family health issues (p<0.014) have significant differences between the low-stress group and the high-stress group. All the emotional parameters evaluated by PL questionnaire have significant difference between the groups. The emotional significance levels of the parameters are as follows: depression (p<0.001), fears (p<0.001), nervousness (p<0.002), sadness (p<0.001), worry (p<0.012), loss of interest (p<0.001). Conclusion: Our results send a message to the gynaecological cancer healthcare world about what conditions may plague the gynaecological cancer patient in COVID-19 pandemic. Identifying problem areas for patients in our study constitutes the first step in the intervention.Öğe Comparison of Adenosine Deaminase (ADA) and Cancer Antigen 125 (CA 125) Levels in Epithelial Ovarian Tumors(2019) Taş, Mustafa; Korun, Zeynep Ece Utkan; Koçak, Alper; Yavuz, Adem; Özçelik, Bülent; Güngör, Mete; Öner, GökalpIntroduction: In this study, we aimed to determine serum adenosine deaminase (ADA) and cancer antigen 125 (CA 125)levels in patients with epithelial ovarian tumors.Methods: A total of 75 patients with 47 malignant and 28 benign epithelial ovarian tumors were included in this case-controlstudy. On the morning of the operation, serum CA 125 and ADA levels were determined. Postoperative epithelial ovariantumor patients were divided into two subgroups as benign and malignant histopathologically. We evaluated whether therewas a correlation between tumor levels and serum CA-125 and ADA levels of subgroups and malignant patients.Results: Of 47 patients with malignant epithelial ovarian cancer, 20 of them had an early-stage (stage 1-2) and 27 of themhad advanced-stage (stage 3-4) tumors. Serum CA-125 (26.38 vs 44.93, p<0.001) and ADA levels (29.91 vs 42. 82, p?0.05)were significantly higher in malignant epithelial ovarian tumors than in benign epithelial ovarian tumors. There was no significantcorrelation between ADA levels.Discussion and Conclusion: This study showed that serum ADA levels in patients with epithelial ovarian cancer could beused as a biomarker in combination with other parameters for predicting malignancy in ovarian cancer. To validate theseclinical data, large-scale studies of epithelial ovarian tumors are needed.Öğe ERKEN EVRE UTERİN SERVİKS KANSERLİ HASTALARDA PELVİK VE PARAAORTİK LENF NODU METASTAZLARININ SAPTANMASINDA 18F-FDG PET / BT'NİN TANISAL DEĞERİNİN BELİRLENMESİ(2019) Tas, Mustafa; Yavuz, Adem; Kaya, Eser; Özçelik, BülentAmaç: Bu çalışmanın amacı, erken evre uterin serviks kanserli hastalarda pelvik ve paraaortik lenf nodumetastazlarının saptanmasında 18F-florodeoksiglukoz Pozitron Emisyon tomografisi / Bilgisayarlı Tomografi(PET/BT) 'nin tanısal değerini belirlemekti.Gereç ve Yöntem: Radikal histerektomi ve sistemik pelvik ve paraaortik lenf nodu diseksiyonu öncesi PET/BT görüntülemesi yapılan erken evre uterin serviks kanserli 18 hasta çalışmaya dahil edildi. Lenf nodlarınınhistopatolojik değerlendirmesi tanısal standart olarak kabul edildi ve PET/BT bulguları histopatolojik bulgularlakarşılaştırıldı.Bulgular: 18 hastadan toplam 807 (577 pelvik - 230 paraaortik) lenf nodu örneklendi ve histopatolojikincelemede 5 (% 28) hastada 10 (%1,2) nod (8 pelvik - 2 paraaortik) pozitif bulundu. Genel nod bazlı PET/BT'nin duyarlılık, özgüllük, pozitif prediktif değer (PPV), negatif prediktif değer (NPV) ve doğruluğu sırasıyla %10 (1/10), % 100 (797/797), %100 (1/1) % 99 (797/806) ve % 99 (798/807) idi.Genel hasta bazlı PET/BT'nin duyarlılık, özgüllük, PPV, NPV ve doğruluğu sırasıyla %20 (1/5), %100 (13/13), %100 (1/1), % 76 (13/17), %78 (14/18) idi.Sonuç: Erken evre uterin serviks kanserli hastaların yönetiminde, mikrometastatik lenf nodu olan hastalarınPET / BT'de yanlış negatif olarak rapor edilebileceği akılda tutulmalıdır.Öğe Evaluation of protective effects of GnRH agonist or antagonist on ovarian reserve with anti-M?llerian hormone and histological analysis in a rat model using cisplatin(Termedia Publishing House Ltd, 2023) Tas, Mustafa; Oner, Gokalp; Ulug, Pasa; Yavuz, Adem; Ozcelik, BulentIntroduction: The aim of this prospective trial was to evaluate the ovarian reserve with anti-Mullerian hormone (AMH), which is the best predictor of ovarian reserve, and perform histological analysis after exposure to cisplatin with a GnRH agonist or antagonist.Material and methods: Twenty-four Wistar albino rats were randomly divided into three groups, each consisting of eight rats. In the GnRH agonist group (group 1), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg triptorelin. In the GnRH antagonist group (group 2), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg cetrorelix. In the control group (group 3), rats received 50 mg/m2 cisplatin. Ovarian reserve was assessed by AMH and histology.Results: Primary follicle counts were higher in group 2 (4.50 +/- 1.47 vs. 3.50 +/- 1.70 vs. 3.00 +/- 3.54) and secondary follicle counts were higher in group 1 (2.96 +/- 1.11 vs. 1.74 +/- 1.03 vs. 1.37 +/- 3.11). Numbers of tertiary follicles were higher both in groups 1 and 2 than the control group (1.36 +/- 0.83 vs. 0.84 +/- 0.99 vs. 0.50 +/- 0.75). The total follicle count of the study groups were signifi-cantly higher compared with the control group (14.32 +/- 5.96 vs. 12.48 +/- 4.12 vs. 10.63 +/- 6.80). AMH was significantly higher in groups 1 and 2 compared with the control group (18.56 +/- 25.33 vs. 16.48 +/- 24.66 vs. 9.37 +/- 26.54).Conclusions: This is the first prospective randomized controlled study show-ing the protective effects of GnRH agonist and antagonist on ovarian reserve after cisplatin exposure in an animal model.Öğe Exposure of Pregnant Women to Intimate Partner Violence during the Pandemic in Turkey and Influencing Factors(Routledge Journals, Taylor & Francis Ltd, 2023) Atilla, Rabia; Yavuz, Adem; Kocaoz, SemraPurpose: This research was conducted to determine the exposure of pregnant women to intimate partner violence (IPV) during the Covid-19 pandemic and its influencing factors. Design: Cross-sectional study. Methods: This study included 456 pregnant women. The Pregnant Information Form and Intimate Partner Violence During Pregnancy Questionnaire were used to collect data. Findings: Exposure frequency to IPV during the pandemic and curfews were 44.1% and 43.9%, respectively. A significant relationship was found between exposure to IPV and the partner having wage-earning employment, marital relationship during Covid-19, the effect of the pandemic on spousal relationships, and gravida. Conclusions: The prevalence of IPV in pregnant women during and after the pandemic did not change significantly from IPV in pregnant women before the pandemic. Clinical Evidence: To prevent and reduce partner violence during pregnancy, there is a need to evaluate IPV among women who apply for routine pregnancy examinations.Öğe Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Discriminating Precancerous Pathologies from Cervical Cancer(Hindawi Ltd, 2019) Tas, Mustafa; Yavuz, Adem; Ak, Mehmet; Ozcelik, BulentPurpose. We aimed to determine the predictive value of several hematological markers of inflammation on the presence/absence of cervical cancer and also to determine their ability in discriminating precancerous cervical pathologies from cervical cancer. Materials and Methods. In this study, patients who presented to Acibadem Kayseri Hospital between May 2010 and June 2018 were evaluated. Forty patients with low-grade squamous intraepithelial lesions (LSIL), 40 patients with high-grade squamous intraepithelial lesions (HSIL), and 30 patients with cervical cancer (CC) were retrospectively included in this study. A control group of 70 healthy volunteers with normal cervical cytology was also included in the study. Results. The neutrophil-to-lymphocyte ratio (NLR) was significantly higher in patients with CC than in controls. The platelet-to-lymphocyte ratio (PLR) was significantly higher in patients with CC compared to those with LSIL and HSIL diagnoses and also controls (p<0.001). Logistic regression analysis revealed that age (OR: 1.075, 95% CI: 1.020-1.132, p=0.007), NLR (OR: 1.643, 95% CI: 1.009-3.142, p=0.047), and PLR (OR: 1.032, 95% CI: 1.003-1.062, p=0.029) were predictors for the presence of CC. ROC curve analysis revealed that both NLR and PLR were predictive of CC with a cutoff value of 2.02 for NLR (71% sensitivity and 60% specificity, AUC: 0.682, p=0.004) and 126.7 for PLR (83% sensitivity and 69% specificity, AUC: 0.752, p<0.001). Conclusion. In addition to patients' age, determination of NLR and PLR values, which are simple, inexpensive, and readily available markers of systemic inflammation, may help in decision making precancerous pathologies of the cervix.Öğe Serum and salivary obestatin concentrations in thediagnosis of polycystic ovary syndrome(2021) Yavuz, Adem; Aydin, Suleyman; Gurates, BilginAim: : To measure obestatin levels in the blood and saliva samples of normal-weight patients with polycystic ovary syndrome(PCOS) in comparison with normal-weight healthy controls, and to determine whether there were relationships between blood and/or salivary obestatin levels and other measured parameters.Materials and Methods: Fifteen healthy women and 15 patients with PCOS, all of which had normal weight, were included in thestudy. Participants’ age, height, weight, menstrual characteristics, hormone levels, body mass index, waist/hip ratio, and modified Ferriman-Gallwey (FG) scores were recorded. Obestatin levels were measured in both fasting blood and saliva samples. Homeostasis Model Assessment (HOMA-IR) was used to predict insulin resistance.Results: In the PCOS group, menstrual cycle duration and FG scores were significantly higher (P-value, <0.001, <0.001, respectively).The levels of luteinizing hormone, total testosterone and androstenedione were significantly higher in the PCOS group than in the control group (P-value, 0.001, 0.009, 0.004, respectively). In the PCOS group, blood obestatin level was 1265.2 ± 221.9 pg/ml, salivary obestatin level was 3095.33 ± 310.2 pg/ml; whereas the control group demonstrated lower levels of 939.66 ± 72.3 pg/ml and 2611.20 ± 217.1 pg/mL, respectively. However, no statistically significant difference was found between the PCOS and control groups when comparing obestatin levels in blood or saliva (P-value, 0.218, 0.369, respectively). No correlation was found between blood and salivary obestatin levels in either group. Finally, obestatin levels were not associated with any of the other measured parameters.Conclusion: Our results suggest that increased levels of obestatin, albeit in a small amount that would not be statistically significantin normal weight patients with PCOS, may have significant effects on weight control in these patients. In addition, our findings show that saliva sample can be used as an alternative to blood sample in the measurement of obestatin level in patients with PCOS.Öğe The Effects of an Absorbable Hemostat Produced From Oxidized Regenerated Cellulose on Adhesion Formation in a Rat Mode(Galenos Yayincilik, 2021) Yavuz, Adem; Oner, Gokalp; Tas, Mustafa; Cinaroglu, SelimObjective: This study aimed to analyze the effect of an absorbable hemostat produced from oxidized regenerated cellulose (ORC) on pelvic adhesion formation in a rat model using an adhesion scoring system and immunohistochemical staining. Methods: This randomized, controlled experimental study included 20 female Wistar-Albino rats that were equally divided into the following groups: control and absorbable hemostat groups. The uterine horns of all the rats were exposed by laparotomy and using 10 W bipolar cautery. Five standard lesions were applied to the antimesenteric areas of each uterine horn. The experimental group received an absorbable hemostat to the traumatized uterine surfaces, whereas the control group did not. After a 28-day follow-up period, a relaparotomy was performed, and adhesions were evaluated based on an adhesion scoring system, and histological sections from areas with adhesion were obtained for immunohistochemical staining. Immunohistochemical staining included analysis of Ki-67 (proliferation index), CD-31 (neovascularization index), and Masson Trichrome [(MTC) fibrosis and collagen formation index]. Additionally, acute and chronic inflammation indices were determined via polymorphonuclear leukocytes (PMNL) and mononuclear leukocytes (MNL), respectively. Results: The intensity and scope of adhesion and overall adhesion ratings were substantially higher in the absorbable hemostat group than the control group (2.8 +/- 0.85 vs. 2.2 +/- 0.53, 0.92 +/- 0.26 vs. 0.61 +/- 0.25, and 3.72 +/- 0.96 vs. 2.81 +/- 0.75, respectively). Staining results for Ki-67, CD-31, MTC, PMNL, and MNL were also significantly higher in the absorbable hemostat group than in the control group (p<0.05 for all). Conclusion: The obtained results suggest that the use of ORC-based absorbable hemostats in pelvic surgery may increase adhesion formation on peritoneal surfaces by increasing inflammation, vascularity, and collagen formation.Öğe The effects of gestational diabetes on lower urinary tract symptoms of pregnant women: a case-control study(Taylor & Francis Inc, 2022) Yavuz, Adem; Kocaoz, Semra; Kara, Pinar; Destegul, EmreGestational diabetes mellitus (GDM) and lower urinary tract symptoms (LUTS) are common health problems in pregnant women. The aim of this case-control study was to evaluate the effects of GDM on LUTS in pregnant women. This study was conducted with 44 pregnant women diagnosed with GDM and 44 pregnant without GDM. Patients with GDM had significantly lower likelihood of experiencing urgency (7.069-fold lower likelihood); whereas they had significantly greater likelihoods for urinary incontinence (UI) during sexual intercourse (OR: 0.185; 5.4-fold higher), need for clothing change due to UI (OR: 0.268; 3.7-fold higher), and adverse effects on daily life due to UI (OR: 0.338; 2.9-fold higher) compared to women without GDM (p < .05 for all). Although pregnant women with GDM appear to have a lower likelihood of urgency, this may be associated with the adverse effects of GDM since the likelihoods for UI-related outcomes were increased and quality of life was reduced among pregnant women with GDM compared to those without GDM.Impact statementWhat is already known on this subject? Lower urinary tract symptoms (LUTS) are very common among pregnant women, and negatively affect social, sexual and working life. There are many risk factors that affect the development of LUTS in pregnant women. It is stated that gestational diabetes mellitus (GDM) may be a predisposing factor in the development of LUTS in women.What do the results of this study add? Women with GDM experienced storage symptoms at a lower frequency (especially urgency) compared to the control group. In addition, we determined worse quality of life among women with GDM who experienced a greater frequency of urinary incontinence.What are the implications of these findings for clinical practice and/or further research? It may be beneficial to provide training on the prevention and management of LUTS to all pregnant women, especially women with GDM, and to increase the sensitivity of health professionals on the subject.Öğe The impact of indomethacin on the number of oocytes retrieved and IVF outcomes in patients with poor ovarian response(Elsevier, 2021) Yavuz, Adem; Oner, Gokalp; Tas, Mustafa; Sonmezer, MuratObjective: The aim of this retrospective case-control study was to analyze the effect of administering indomethacin after triggering final oocyte maturation in patients with poor ovarian response (POR) on the cycle cancellation rate due to premature ovulation (PO), the number of oocytes retrieved and the clinical outcomes of IVF cycles. Study Design: A total of 214 patients with POR, diagnosed according to the Bologna criteria, who underwent fresh IVF cycle via flexible gonadotrophin-releasing hormone antagonist (GnRH-ant) protocol were enrolled in the study. The control group consisted of 100 patients, whereas the indomethacin group included 114 patients who received 100 mg rectal indomethacin administered twice within the same day (twelve hours apart)-starting at twelve hours after triggering. Cycle cancelation rates (CCR), number of oocytes retrieved (nOR), implantation rates (IR), biochemical pregnancy (BP) and clinical pregnancy loss rates (CPL), ongoing pregnancy rates (OPR) and live birth rates (LBR) were compared between the indomethacin and control groups. Results: The CCR rate was significantly lower in the indomethacin group (1.8%) compared to the control group (1.8% vs %12%, p = 0.01). In the control group, those with cycle cancellation were older than those without cycle cancellation (mean age 42.2 +/- 2.3 years vs. 39.36 +/- 4.3 years, p = 0.001) and had lower anti-Mullerian hormone levels and lower antral follicle count (0.59 +/- 0.2 ng/mL vs 0.79 +/- 0.2 ng/mL, p = 0.001 and 4 +/- 0.6 vs 5.7 +/- 1.7, p = 0.001, respectively). In multivariable analysis, when the dependent variable in the logistic regression model was coded as the absence of cycle cancellation, it was observed that only indomethacin had a statistically significant effect on cycle cancellation (beta = -1.931, standard error = 0.832, Exp(B) = 0.145, p = 0.020). nOR was higher in the indomethacin group than control group but the difference did not reach significance (p = 0.07). Moreover, the IR, OPR and LBR, BP and CPL values were similar in the indomethacin and control groups (p > 0.05). Conclusions: Based on data from this study, it can be concluded that indomethacin reduces cycle cancelation due to PO in patients with POR -without compromising implantation and pregnancy rates. However, further randomized controlled trials with larger sample sizes are required to clarify the definitive effect of indomethacin in the treatment of patients with POR. (C) 2021 Elsevier B.V. All rights reserved.Öğe Unilateral Ectopic Kidney During Paraaortic Lymphadenectomy: A Case Report(2021) Yavuz, Adem; Cündübey, Cevat Rıfat; Dolanbay, MehmetThe incidence of ectopic kidney is approximately 1:1,000 in newborns. Ectopic kidney has a place outside of renal fossa and been found in the pelvis, abdomen, and thorax. We reported a case of a 51-year-old female who was referred to our hospital with the complaint of abnormal vaginal bleeding and pelvic pain. Adenocarcinoma of cervix was reported after biopsy, radical hysterectomy and bilateral salphingo-oopherectomy with pelvic and para-aortic lymph node dissection were performed. Unilateral, right renal ectopic kidney with vessels was observed during paraaortic lymphadenectomy in cervical cancer surgery. During gynecological oncologic surgery especially at the retroperitoneal stage congenital organ abnormalities must be kept in mind and surgery must be planned according to the abnormalities.
