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Öğe Are serum Netrin-4 levels predictive of preeclampsia?(Via Medica, 2020) İçen, Mehmet Sait; Agaçayak, Elif; Fındık, Fatih Mehmet; Tunç, Senem Yaman; Kaplan, İbrahim; Tan, İlhan; Evsen, Mehmet Sıddık; Gül, TalipObjective: To investigate the levels of anti-angiogenic factors, namely sFlt-1 and Netrin-4, in patients with preeclampsia (PE). Material and methods: Cord-blood (UC) sFlt-1 and Netrin-4 concentrations were measured in 30 patients with severe PE, 30 patients with PE and 30 control infants and their mothers (MS). Results: Maternal sFlt-1 levels were significantly higher in the severe PE and PE groups than in the control group. There were no statistical differences among the three groups in maternal and fetal Netrin-4 levels. But Netrin-4 levels were found to be the lowest in the control group and higher in the PE and severe PE groups. The correlation analysis revealed a positive correlation between maternal sFlt-1 levels and maternal Netrin-4 levels (p = 0.012, and r = 0.263), maternal sFlt-1 levels and fetal sFlt-1 levels (p = 0.012, and r = 0.263). Conclusions: There was a positive correlation found between maternal sFlt-1 levels and maternal Netrin-4 levels. We are of the opinion that elevation in levels of Netrin-4 might be secondary to placental hypoxia occurring in PE. The present study led to the consideration of anti-angiogenic biomarkers (sFlt-1 and Netrin-4) on automated platforms for clinical use as an aid in establishing the diagnosis and prognosis of PE.Öğe Clinical comparison of anterior or posterior placental location with placenta previa and history of previous cesarean section delivery(International Scientific Information, Inc., 2023) Fındık, Fatih Mehmet; İçen, Mehmet SaitPlacenta previa is defined as a placenta that grows from the anterior or posterior wall of the uterus and covers the cervix. The incidence of placenta previa has been increasing in recent years. It is thought that bleeding is more common during surgery in cases with anterior placenta that is closing the cervix. This study investigated the importance of placental location in pregnant women with placenta previa who had a previous cesarean section. Material/Methods: This study covered the period from July 2017 to June 2020. The 116 patients included in the study were divided into 2 groups according to placental location: anterior (group 1) and posterior (group 2). All patients had previously delivered via cesarean section. Operation time, presence of invasion, estimated blood loss during surgery, and transfused erythrocyte volume were evaluated. Medical records were used to access the relevant data. Results: The patients in group 1 and group 2 had an average of 2.71 and 2.01 previous cesarean sections, respectively (P=0.002). The placental invasion (percreta) rate was significantly higher in group 1 than in group 2 (65.4 vs 5.3%, P<0.001), as was the estimated blood loss during surgery (790 vs 527 mL, P=0.014). The total erythrocyte suspension was considerably higher in group 1 than in group 2 patients (0.8 vs 0.2, P=0.014), both during and after surgery. Conclusions: In patients with placenta previa, the location of the placenta should always be examined with ultrasonography to allow better preoperative planning.Öğe Comparison of IMA, YKL-40, EN-RAGE, and AIM levels in maternal blood and cord blood in patients with preeclampsia(2023) Fındık, Fatih Mehmet; İçen, Mehmet Sait; Tunç, Senem Yaman; Gündüz, Reyhan; Ağaçayak, Elif; Evsen, Mehmet Sıddık; Satıcı, ÖmerAim: Preeclampsia and severe preeclampsia are among the most significant causes of maternal mortality. Preeclampsia’s pathogenesis is not fully understood, and it is a disease with early diagnosis and treatment possibilities. In this study, we aimed to investigate the levels of IMA, YKL-40, EN-RAGE, and AIM in maternal and cord blood. The results will ideally shed light on preeclampsia’s pathogenesis and early diagnosis. Methods: The study was conducted with the following three groups: a severe preeclampsia group (group 1), a preeclampsia group (group 2), and a control group (group 3). IMA, YKL-40, EN-RAGE, and AIM levels were measured in all patients across the groups using blood taken from the mothers before delivery and from the cords during delivery. Statistically descriptive analyses were performed. Specifically, a one-way analysis of variance was performed on group variables, and a Tukey test was used to determine the differences between the groups. Results: The mean age was similar across all groups. The gestational week at delivery was low for the severe preeclampsia group (p=0.001). The IMA and YKL-40 levels in the maternal and cord blood were the same between the groups. The EN-RAGE levels in the maternal blood were found to be significantly higher in the control group (p=0.000). While the AIM levels in the maternal blood were high in the control group (p=0.001), they were significantly lower in the cord blood in the control group (p=0.029). Conclusion: EN-RAGE and AIM levels are parameters that can be used in the early diagnosis of preeclampsia and severe preeclampsia.Öğe Comparison of ultrasound-guided drainage with other available treatment modalities for, treatment of tubo-ovarian abscess(Türkiye Klinikleri Yayınevi, 2018) Aydın, Edip; Peker, Nurullah; Bademkıran, M. Hanifi; İçen, Mehmet Sait; Gül, TalipObjective: The present study aimed at the retrospective evaluation of the medicalrecords of patients treated for tubo-ovarian abscess (TOA) at our clinic and investigation of the efficacyof USG-guided drainage compared with that of other available treatment modalities. Materialand Methods: Medical records of 100 patients with TOA, who were treated and followed up atthe Department of Gynecology and Obstetrics, School of Medicine, Dicle University between January2009 and April 2015, were reviewed retrospectively. Details such as demographic data, risk factors,clinical and laboratory findings, treatment modalities used, and complications observed wererecorded for each patient. Results: The mean age of the patients was 36.46±11.6 years. Of the 100patients, 10 were menopausal women. Pelvic pain was the most common complaint in all patients(100%). The history of intrauterine or intra-abdominal intervention within six months was themost common risk factor (60.5% patients) for the development of TOA. Of the patients, 25% reportedfever (≥38 °C), 55% had leukocytosis, 85% had high sedimentation rate, and 92% had highCRP levels. The development of leukocytosis was not observed to be associated with the treatmentmodality used (p > 0.05). Of the patients, 38% underwent only medical treatment, 47% underwentmedical treatment followed by surgery, and 15% underwent medical treatment followed by USGguideddrainage. All 34 (72.3%) patients who had undergone surgical treatment required fertilitypreservingsurgery. Intraoperative bowel injury (6.3% patients) and wound site infection (8.5%patients) were among the common complications reported in patients undergoing surgical treatment.The mean duration of hospital stay was 7.9±6 days. The longest mean duration of hospital stay(10.5±3.9 days) was observed in the patients who had undergone USG-guided drainage. Conclusion:Broad-spectrum antibiotic therapy, the first step of treatment in patients with TOA, increasesthe size of abscess. In addition, a significant number of patients with bilateral abscesses require additionalintervention (surgery). Our findings suggest that USG-guided drainage should be consideredonly in patients not responding to medical treatment and not consenting to undergo surgicaltreatment.Öğe The evaluation of diagnostic and clinical findings in grand multiparous patients with endometrial cancer(Dicle Üniversitesi Tıp Fakültesi, 2013) Özler, Ali; Turgut, Abdulkadir; Ağaçayak, Elif; İçen, Mehmet Sait; Alabalık, Ulaş; Başaranoğlu, Serdar; Peker, Nurullah; Gül, TalipAmaç: Bu çalışmanın amacı grand multipar, endometrium kanserli hastaların tanısal ve klinik özelliklerini diğer endometrial kanserli hastalar ile karşılaştırarak değerlendirmektir. Yöntemler: Kliniğimizde Ocak 2006-Ağustos 2012 tarihleri arasında endometrium kanseri nedeniyle opere edilen 34 hasta dahil edildi. Hastalar doğum sayısına göre üç gruba ayrıldı; Grup 1 (doğum yapmamış hastalar, n=8), Grup 2 (doğum sayıları 1’den 4’e kadar olan hastalar, n=14), Grup 3 (grand multipar hastalar, n=12). Grand multipar hastaların tanısal, klinik ve histopatolojik verileri diğer gruplardaki hastalar ile karşılaştırıldı. Bulgular: Grup 3 (grand multipar) hastaların yaş ortalaması diğer gruplara göre anlamlı yüksek bulundu. (p<0,05). Tüm gruplar tümörün myometrial invazyon derinliği açısından karşılaştırıldığında ise anlamlı bir farklılık tespit edilmedi (p>0,05). Grup 1, 2 ve 3’ deki Evre 1A tümörlü hastaların oranlarının sırasıyla %75, %64,2 ve %83,3 olduğu bulundu. Ayrıca, bütün grand multipar hastaların evre 1 tümöre sahip oldukları bulunmuştur. Sonuç: Sonuç olarak, grand multipar hastaların tanıları daha geç yaşlarda konmakta, fakat erken evrede ve endometrioid tip endometrial kanser tanılarını almışlardır. Son doğumdan itibaren geçen süre endometrial kanser riski üzerine etkili bir faktör olabilir.Öğe Evaluation of factors affecting perinatal mortality in patients with HELLP syndrome(Mebas Medikal Basın Yayın, 2021) Gündüz, Reyhan; Tunç, Senem Yaman; İçen, Mehmet Sait; Gül, Talip; Ertuğrul, SabahattinOBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p<0.05). With respect to methods of delivery, we determined that vaginal delivery was linked to a significantly higher rate of perinatal mortality (p<0.001). Gestational age at delivery, birth weight, 1- and 5-minute APGAR scores were negatively correlated with perinatal mortality. Logistic regression revealed the APGAR score at 5 minutes as the most reliable independent predictive finding for perinatal mortality. CONCLUSION: We think that to decrease perinatal mortality rates, maternal and fetal well-being in patients with HELLP syndrome should be closely monitored and delivery and follow-up should take place at tertiary health institutions after maternal and neonatal intensive care arrangements are made. Particularly, neonates with low 5-minute APGAR scores in the postpartum evaluation of neonatal condition are recommended to be followed-up at the neonatal intensive care unit.Öğe Expression of sirtuin 2 and 7 in placenta accreta spectrum(NLM (Medline), 2023) Taşkın, Irmak İçen; Gürbüz, Sevim; İçen, Mehmet Sait; Derin, Dilek Cam; Fındık, Fatih MehmetOBJECTIVE: This study aimed to investigate the expression levels of sirtuin 2 and sirtuin 7 in the placenta accreta spectrum to reveal their role in its pathogenesis. METHODS: A total of 30 placenta accreta spectrum, 20 placenta previa, and 30 controls were experienced. The sirtuin 2 and sirtuin 7 expression levels in the placentas of these groups were determined by Western blot. sirtuin 2 and sirtuin 7 serum levels in the maternal and fetal cord blood were examined by enzyme-linked immunosorbent assay. RESULTS: It was found that sirtuin 7 in placenta accreta spectrum was significantly lower in the placenta compared to the control and placenta previa groups (p[removed]0.05). CONCLUSION: Sirtuin 7 may play an important role in the formation of placenta accreta spectrum. The effect of decreased expression of sirtuin 7 might be tissue-dependent in the placenta accreta spectrum and needs to be investigated further.Öğe Gebeliğe Bağlı İntrahepatik Kolestaz: 48 Vakanın Fetal ve Maternal Sonuçlarının Değerlendirilmesi(İstanbul Aydın Üniversitesi, 2021) Öcal, Aydın; Fındık, Fatih Mehmet; İçen, Mehmet SaitAmaç: Kliniğimizde takip edilen gebeliğe bağlı intrahepatik kolestaz tanılı hastaların fetal - maternal sonuçlarının değerlendirilmesi ve bu hastaların gebelik yönetiminin tartışılması. Gereç ve Yöntem: Çalışmamızda Dicle Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı Obstetri kliniğine Ocak 2011 -Aralık 2015 tarihleri arasında başvuran ve gebeliğe bağlı intrahepatik kolestaz (GBİHK) tanısı alan 48 hasta incelendi. Başvuru esnasındaki bilgiler hastane arşivi ve hasta dosyaları incelenerek toplandı. Bulgular: Gebeliğe bağlı intrahepatik kolestaz tanılı hastaların ortalama yaşları 27.6±6.5 idi.. Gebelerin ortalama doğum haftaları 36.1±3.1 idi. Hastaların %48’i (n=23) otuz yedinci gebelik haftasından önce doğum yaptı. 5. dk ortalama APGAR 8.19±1.73 idi. Sezaryen ile doğum oranı %56.25 (n=27) idi. Yeni doğan yoğun bakıma kabul oranı %10.6 idi. Yenidoğan bebeklerin %76.5’i (n=39) erkek %23.5 ‘i (n=12) kız idi. Perinatal mortalite oranı %3.92 idi. Maternal mortalite izlenmedi. Sonuç: Gebeliğe bağlı intrahepatik kolestaz tanısı klinik bulgu ve laboratuvar sonuçlar ile konur. Hastalığın ayırıcı tanısı dikkatli bir şekilde yapılmalı, ayırıcı tanı üzerinde dikkatle durulmalıdır. Antenatal dönemde fetal ve maternal takip dikkatli bir şekilde yapılmalı, tedavi ve doğum süreci hastaya göre planlanmalıdır. Yüksek prematüre doğum riski nedeniyle yenidoğan yoğun bakım ihtiyacı göz önünde bulundurulmalıdır.Öğe A Rare Gestational Trophoblastic Disease: Placental Site Trophoblastic Tumor(2016) Avcı, Yahya; Evsen, Mehmet Sıddık; Tunç, Senem Yaman; Gül, Talip; Ağaçayak, Elif; Urakçı, Zuhat; İçen, Mehmet SaitPlacental site trophoblastic tumor (PSTT) is a highly rare form of gestational trophoblastic diseases thatarise from intermediate trophoblastic cells. By presenting this case, we aimed to review the treatmentand diagnosis, approach to PSTT.A 31-year-old (G2P1A1L1) patient had abnormal vaginal bleeding. Serum ß-HCG was 5.82 mIU/ml andthe transvaginal USG detected a polypoid mass in uterine cavity. Probe curettage was performed.Histopathologic specimens were confirmed as PSTT. No metastasis was detected. A total abdominalhysterectomy was performed.PSTT is a rare tumor. In contrast to other trophoblastic tumors, PSTT produces a small amount of ßHCG and it is relatively insensitive to chemotherapy. Adjuvant chemotherapy is suggested to follow surgical treatment in the cases with metastasis.Öğe The relationship between primary ovarian insufficiency and gene variations: a prospective case-control study(Routledge Journals, Taylor & Francis Ltd, 2024) Gündüz, Reyhan; Tekeş, Selahaddin; Özpak, Lütfiye; Ağaçayak, Elif; Tunç, Senem Yaman; İçen, Mehmet Sait; Evsen, Mehmet SiddikAround 70 percent of cases of Primary Ovarian Insufficiency (POI) etiology remain unexplained. The aim of our study is to contribute to the etiology and genetic background of POI. A total of 37 POI patients and 30 women in the reproductive period were included in this prospective, case-control study between August 2020 and December 2021. The women were examined for 36 genes with next-generation sequencing (NGS) panel. Gene variations were detected in 59.5 percent of the patients in the case group. FSHR p.S680N (rs6166, c.2039 G>A) and FSHR p.A307T (rs6165, c.919 G>A) gene variants, which are most frequently located in exon 10 of the FSHR gene, were detected in both groups. Although it was not found that these gene variants were significantly different between the groups, it was also found that they were significantly different in POI patients under 30 years of age and in those with a family history of POI. Variations were detected in 12 genes in POI patients. Two gene variants (FGFR1 [c.386A>C, rs765615419] and KISS1 [c.58 G>A, rs12998]) were detected in both groups, and the remaining gene variants were detected only in POI patients. No differences were detected between the groups in terms of gene variations. However, the gene variations detected only in POI patients may play a role in the etiology of POI.Öğe Should we add unilateral sacrospinous ligament fixation to vaginal hysterectomy in management of stage 3 and stage 4 pelvic organ prolapse(Galenos Yayınevi, 2015) Ağaçayak, Elif; Tunç, Senem Yaman; İçen, Mehmet Sait; Başaranoğlu, Serdar; Fındık, Fatih Mehmet; Sak, Sibel; Ceter, Yasemin; Akın, Gamze; Gül, TalipObjective: To compare ‘‘vaginal hysterectomy alone’’ with ‘‘vaginal hysterectomy with prophylactic unilateral sacrospinous ligament fixation’’ in terms of intraoperative complications and 1-year anatomic outcomes and symptoms in patients aged over 50 years who presented with stage 3 or 4 pelvic organ prolapse (POP). Materials and Methods: Thirty-five patients underwent vaginal hysterectomy alone and 32 patients underwent vaginal hysterectomy with unilateral sacrospinous ligament fixation because of benign pathology between January 2012, and June 2014, were retrospectively analyzed in this study. The patients’ demographic data and preoperative and intraoperative findings were obtained from the hospital records and noted. The patients were invited by phone to a follow-up visit to assess their 1-year anatomic outcomes and symptoms. Results: There was no significant demographic difference between the patients who underwent vaginal hysterectomy alone and those who had a vaginal hysterectomy with sacrospinous ligament fixation. Both length of operation and hospital stay were significantly longer in the patients who underwent vaginal hysterectomy with sacrospinous ligament fixation (p<0.001); intraoperative complications requiring blood transfusion were also significantly more frequent in these patients compared with the patients who underwent vaginal hysterectomy only (p=0.048). Recurrence of vaginal vault prolapse was significantly more frequent in the patients with vaginal hysterectomy alone compared with those who had both vaginal hysterectomy and sacrospinous ligament fixation (p=0.035). Conclusion: Unilateral sacrospinous ligament fixation might be added to vaginal hysterectomy in patients with stage 3 or 4 POP who are predicted to have long survival times. However, further studies with a larger sample size are needed in this area of research.Öğe Should we add unilateral sacrospinous ligament fixation to vaginal hysterectomy in management of stage 3 and stage 4 pelvic organ prolapse?(2015) Ceter, Yasemin; Gül, Talip; Ağaçayak, Elif; İçen, Mehmet Sait; Akın, Gamze; Sak, Sibel; Yaman, Senem TunçObjective: To comparevaginal hysterectomy alone withvaginal hysterectomy with prophylactic unilateral sacrospinous ligament fixation in terms of intraoperative complications and 1-year anatomic outcomes and symptoms in patients aged over 50 years who presented with stage 3 or 4 pelvic organ prolapse (POP). Materials and Methods: Thirty-five patients underwent vaginal hysterectomy alone and 32 patients underwent vaginal hysterectomy with unilateral sacrospinous ligament fixation because of benign pathology between January 2012, and June 2014, were retrospectively analyzed in this study. The patients demographic data and preoperative and intraoperative findings were obtained from the hospital records and noted. The patients were invited by phone to a follow-up visit to assess their 1-year anatomic outcomes and symptoms. Results: There was no significant demographic difference between the patients who underwent vaginal hysterectomy alone and those who had a vaginal hysterectomy with sacrospinous ligament fixation. Both length of operation and hospital stay were significantly longer in the patients who underwent vaginal hysterectomy with sacrospinous ligament fixation (p<0.001); intraoperative complications requiring blood transfusion were also significantly more frequent in these patients compared with the patients who underwent vaginal hysterectomy only (p=0.048). Recurrence of vaginal vault prolapse was significantly more frequent in the patients with vaginal hysterectomy alone compared with those who had both vaginal hysterectomy and sacrospinous ligament fixation (p=0.035). Conclusion: Unilateral sacrospinous ligament fixation might be added to vaginal hysterectomy in patients with stage 3 or 4 POP who are predicted to have long survival times. However, further studies with a larger sample size are needed in this area of research. Keywords: Pelvic organ prolapse, vaginal hysterectomy, sacrospinous ligament fixationÖğe Should women between the ages of 25 and 30 get tested for HPV?(Gaziantep Üniversitesi Tıp Fakültesi, 2022) Gündüz, Reyhan; Ağaçayak, Elif; Bozbay, Özlem Polat; İçen, Mehmet Sait; Gül, Talip; Alabalık, UlaşObjectives: The aim of this study is to discuss whether performing the human papillomavirus test on women aged 25-30 in Turkey has any effect on preventing cervical cancer. It is aimed to reevaluate the screening program. Methods: A total of 400 patients between the ages of 25-30 who had the Papanicolaou smear and the human papillomavirus test were included in our study. Pap smear and the human papillomavirus test were performed again on the patients with a positive human papillomavirus test for high-risk types in accordance with the screening program. Demographical and clinical characteristics of the patients were recorded. The incidence of human papillomavirus test positivity with a high risk among patients aged 25-30, regression, and persistence ratios were calculated. Results: The incidence of human papillomavirus test positivity with a high risk among patients aged 25 to 30 was found to be 7%. Human papillomavirus persistence ratio was 17.6% and the regression ratio was 82.4%. Among patients with a positive high-risk human papillomavirus test between the ages of 25 and 30, human papillomavirus 16 was found in 47.1% of the patients. For one of our patients with a persistent human papillomavirus 16 positivity, conization was performed after the cervical biopsy. Conclusion: We believe that human papillomavirus, which plays an important role in the etiology of cervical cancer, should be screened from the age of 25. This way, we can catch and treat precursor lesions of cervical cancer at earlier ages and lower the incidence and mortality of cervical cancer.
