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Öğe Cornea in PCOS patients as a possible target of IGF-1 action and insulin resistance(SPRINGER HEIDELBERG, 2014) Kebapcilar, Ayse Gul; Tatar, Mehmet Gurkan; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Korkmaz, Huseyin; Baldane, Suleyman; Celik, CetinPrevious studies suggest that serum IGF-1 is higher in women with polycystic ovary syndrome (PCOS). The ophthalmologic effects of IGF-1 excess have not yet been investigated in women with PCOS. The aim of the current study is to compare the corneal thickness of patients with PCOS and those of healthy subjects. Forty three patients with PCOS and 30 age-matched and gender-matched healthy individuals were enrolled in this cross-sectional study. Central corneal thickness (CCT) was measured in patients with PCOS and in healthy individuals with an ultrasound pachymeter. IGF-1 values were also determined in the study group. Women with PCOS had significantly higher levels of IGF-1 and homeostasis model assessment (HOMA-IR) levels than the control group. Right and left CCT measurements were higher in the PCOS group than in the control group. A positive correlation between IGF-1 and right and left CCT was identified in both groups. In multiple linear stepwise regression analyses, IGF-1 independently and positively associated with HOMA-IR in women with PCOS. A correlation between total testosterone and CCT was identified in the whole group. In multiple stepwise regression analyses, total testosterone independently and positively associated with left central corneal thickness in the whole group. These findings indicate that PCOS has target organ effects on the eye. Consequently, it can change central corneal thickness. Higher IGF-1 levels seem to be the main causes of increased corneal thickness. Insulin resistance in PCOS is one of the underlying causes and promotes increase in IGF-1. We suggest a careful and detailed corneal evaluation in PCOS patients to prevent the potential risk of increased CCT, in addition to the already-known complications.Öğe Depressive symptomatology and quality of life assessment among women using the levonorgestrel-releasing intrauterine system: an observational study(SPRINGER HEIDELBERG, 2014) Pekin, Aybike Tazegul; Kerimoglu, Ozlem Secilmis; Kebapcilar, Ayse Gul; Yilmaz, Setenay Arzu; Benzer, Nilgun; Celik, CetinThe aim of our study was to examine the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) treatment on depressive symptoms, changes in bleeding patterns, and quality of life (QoL) among premenopausal women in our clinic. We recruited 120 premenopausal women, aged 18-50 years, who had sought care in the previous year for menorrhagia. LNG-IUS was inserted into eligible patients after the relevant evaluations. Both questionnaires were administered at time of the initial screening before and 6 months after insertion of the LNG-IUS. All patients completed the 36-item Short-Form Health Survey (SF-36) for QoL and Beck's Depression Inventory for depressive symptoms. At the 6-month follow-up visit, the pictorial blood assessment chart score (PBAC) considerably decreased (p < 0.001). For SF-36 scores, physical functioning, physical role limitations, emotional role limitations, bodily pain, vitality, and mental health scores improved significantly after treatment (p < 0.001). Depression scores showed no significant difference from baseline to 6 months (p = 0.375). The LNG-IUS for the treatment of menorrhagia increases the QoL, and depression scores did not increase significantly in 6 months.Öğe Is adjuvant radiotherapy necessary for FIGO stage 1a grade 2 endometrial endometrioid adenocarcinoma?(TURGUT YAYINCILIK & TICARET AS, 2015) Inan, Abdurrahman Hamdi; Ersoy, Gulcin Sahin; Yildinm, Yusuf; Gurbuz, Tutku; Kebapcilar, Ayse Gul; Hanhan, MerihObjective: The impact of adjuvant radiotherapy on the rates of survival and local recurrence was analyzed in patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage 1a grade 2 endometrial endometrioid adenocarcinoma. Material and Methods: Medical records of 82 patients diagnosed and treated for FIGO stage 1a grade 2 endometrial endometrioid adenocarcinoma were reviewed retrospectively. A group of 59 patients who received postoperative radiotherapy was compared with a control group of 23 subjects treated without adjuvant radiotherapy; the duration of survival as well as the local recurrence and metastasis rates were evaluated in both groups. Results: The analysis of patient data has revealed the rate of local recurrence as 4.3% vs. 1.7% (p=0.485), the rate of distant metastasis as 4.3% vs. 6.9% (p=1.000), and the mean survival time as 83.6 +/- 38.7 vs. 81.5 +/- 37.5 months (p=0.828) in the adjuvant radiotherapy and control groups, respectively. Conclusion: In the presented study, adjuvant radiotherapy failed to improve the overall survival of the patients in the low-risk group (stage 1a grade 2). With the addition of the significant risk of radiation toxicity, it is highly probable that these patients will not benefit from postoperative radiotherapy. Close observation should be performed following the primary surgery in this patient group. Nevertheless, it should also be considered that adjuvant radiotherapy is a very effective treatment modality for the recovery of patients with vaginal relapse.Öğe Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study(PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2016) Kebapcilar, Levent; Kebapcilar, Ayse Gul; Ilhan, Tolgay Tuyan; Ipekci, Suleyman Hilmi; Baldane, Suleyman; Pekin, Aybike; Kulaksizoglu, MustafaIntroduction: Gestational diabetes is defined as various degrees of glucose intolerance diagnosed or detected for the first time during pregnancy and is the most common metabolic complication of pregnancy. Early diagnosis and adequate treatment are important to prevent complications. Preeclampsia, polyhydramnios, fetalmacrosomia, and operative delivery are some of the complications seen in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Aim: The present study was designed to determine whether there was an association between Mean Platelet Volume (MPV) in predicting poor fetal outcome, insulin resistance, neonatal Apgar scores and gestational age for women with GDM. Materials and Methods: In this retrospective study, we enrolled 101 pregnant women with GDM together with a group of 138 healthy controls. MPV, insulin and homeostatic model assessment (HOMA-IR) values were measured at 24-28 weeks of the pregnancy. An independent samples t-test was used to compare MPV values. Multivariate linear regression models were used to establish relations between MPV values, HOMAIR, insulin levels and Apgar score. Results: There was a significant positive correlation between MPV values, HOMA-IR and Insulin levels and a negative correlation with Apgar score at 1 min and 5 min in the GDM group (r=0.227, p=0.02; r=0.206, p=0.03; r=-0.485, p<0.001; and r=-0.399, p<0.001, respectively). In the multivariate logistic regression analysis, a high MPV value was most consistently associated with a low Apgar 1 min score (beta=-0.387, p=0.003) in the GDM group. An MPV of >8.0 fL had a sensitivity of 82% and a specificity of 75% for the prediction of GDM. Conclusion: We investigated the potential of MPV values in predicting low Apgar scores and insulin resistance in women with GDM.Öğe Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper?(LIPPINCOTT WILLIAMS & WILKINS, 2013) Kebapcilar, Ayse Gul; Kulaksizoglu, Mustafa; Kebapcilar, Levent; Gonen, Mustafa Sait; Unlu, Ali; Topcu, Ali; Demirci, FatihObjective: The risk of primary ovarian insufficiency (POI) increases in association with autoimmune conditions. Adequate intake of vitamin D (vit D) and trace elements is required for the immune system to function efficiently. The aim of this study was to evaluate vit D, zinc, and copper blood levels in women with POI who had given birth to at least one child and in women with normal menstrual cycles. Methods: This was a cross-sectional, case-control study involving 63 participants divided into two groups: the study group, which is composed of 35 women with POI, and the control group, which is composed of 28 women with normal menstrual cycles. Serum concentrations of zinc, vit D, and copper were determined for each participant. Results: Women with POI had significantly higher serum copper levels and copper-to-zinc ratio but significantly lower serum vit D and zinc levels when compared with the healthy control group. Serum follicle-stimulating hormone levels were inversely correlated with zinc and vit D levels and positively correlated with the copper-to-zinc ratio and copper levels. Vit D levels were inversely correlated with follicle-stimulating hormone levels, copper-to-zinc ratio, and copper levels and positively correlated with zinc levels. Conclusions: Most women with POI are deficient in vit D. Zinc, copper, and vit D seem to correlate with hormonal status in the participants. The present study may generate hypotheses for future studies that will investigate the possible mechanisms behind alterations in trace elements and vit D deficiency in women with POI and whether these changes could be used to screen for the risk of developing POI.Öğe Successful preoperative treatment by plasmapheresis of hyperthyroidism with hydatidiform mole(AVES, 2018) Kirac, Cem Onur; Baldane, Suleyman; Kebapcilar, Ayse Gul; Ipekci, Suleyman Hilmi; Ucar, Mustafa Gazi; Celik, Cetin; Kebapcilar, LeventWe recently encountered the case of an 18-year-old female complaining of abdominal pain, fatigue, nausea, vomiting, tremor of the hands, and vaginal bleeding. Her blood test revealed highly elevated human chorionic gonadotropin (hCG) levels, suppressed thyroid-stimulating hormone (TSH) levels, and increased free thyroid hormone levels. Molar pregnancy and hyperthyroidism were suspected based on highly elevated hCG levels and suppressed TSH levels with the co-existence of ultrasono-graphic findings of the uterus and thyroid Doppler images. Her symptoms and thyroid hormone levels responded well to plasmapheresis. Subsequently, the patient underwent dilatation and curettage for hydatidiform mole. Histopathology of the products verified the diagnosis of complete hydatidiform mole with no invasion. The patient is currently stable, and her hCG and thyroid hormone levels are within normal reference ranges.Öğe What is the fate of scientific abstracts? The publication rates of abstracts presented at the 7th National Congress of Gynecology and Obstetrics(GALENOS YAYINCILIK, 2015) Ersoy, Gulcin Sahin; Oztekin, Deniz; Kebapcilar, Ayse Gul; Gurbuz, TutkuObjective: Oral and poster presentations held at national and international congresses are recognized as valuable tools for sharing current scientific data and experience among physicians. However, a large proportion of these works fail to be published in scientific journals. We have designed a study to identify the publication rate of presentations held at the 7th National Congress of Obstetrics and Gynecology in 2009. Materials and Methods: A systematic search of databases was performed using author names and key words from the abstract title to locate publications in peer-reviewed journals corresponding to the presentations held at the 7th National Congress of Obstetrics and Gynecology. Information regarding mode of presentation, topic, type of affiliation, name and impact factor of the scientific journal, change in author names and time elapsed between presentation and publication were recorded and analyzed statistically. Results: Of 243 abstracts that were presented at the congress, 45 papers (18.5%) were published in international peer-reviewed journals, whereas 39 (16%) were published in national journals. The mean time to publication was 17 +/- 2 months for international and 11 +/- 4 months for national journals (p=0.102). The international publication rate of oral presentations was significantly higher than that of poster presentations (50% vs. 16.2%; p<0.03). The manuscripts were published in a total of 21 journals, with four journals accounting for 49% of the publications. The comparison of the publication rates of the universities with other institutions has yielded no significant difference. Conclusion: Alltough a significant proportion of the abstracts presented in the 7th National Gynecology and Obstetrics Congress have been succesfully converted to publication overall, only a limited percentage of all abstracts have been published in international peer-reviewed journals. The relatively higher conversion to international publication rate of the oral presentations show that they are of higher interest and clinical relevance.
