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Öğe Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women?(WILEY, 2014) Annagur, Bilge Burcak; Kerimoglu, Ozlem Secilmis; Gunduz, Sule; Tazegul, AybikeAimWe 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. MethodsThe study sample included 48 women with HG, and the control group had 44 pregnant women. The patients were selected from women with HG hospitalized in the obstetric inpatient clinic. All of the participants were in the first trimester of pregnancy. The participants' sociodemographic and clinical characteristics were recorded in the obstetric clinic. All of the participants completed a Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Eating Attitudes Test (EAT) and Body Image Scale (BIS). ResultsWomen with HG were more likely to have had a history of HG during their previous pregnancy (P<0.05). There was no significant difference between the study and control groups regarding obstetric history. Women with HG were more influenced by food that induced nausea. There was no significant difference between the study and control groups for pre-pregnancy nausea, food craving and the initial BMI (P>0.05). Depression and anxiety scores were significantly higher in women with HG (P<0.05). However, there was no significant difference between the study and control groups for body image score and eating attitude test scores (P>0.05). ConclusionWe suggest that HG appears to be associated with depression and anxiety symptoms rather than deterioration of eating attitudes and body image. However, these results should be confirmed by prospective and clinical studies.Öğe Association of FSH receptor gene polymorphism with menarche age(TAYLOR & FRANCIS LTD, 2016) Kerimoglu, Ozlem Secilmis; Pekin, Aybike; Yilmaz, Setenay; Incesu, Feyza; Nergiz, Suleyman; Dogan, Nasuh; Acar, Hasan[Abstract not Available]Öğe Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome(PERGAMON-ELSEVIER SCIENCE LTD, 2013) Annagur, Bilge Burcak; Tazegul, Aybike; Uguz, Faruk; Kerimoglu, Ozlem Secilmis; Tekinarslan, Emine; Celik, CetinObjective: 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. (C) 2013 Elsevier Inc. All rights reserved.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 Does lymphadenectomy have influence on postoperative body fluid distribution?(ELSEVIER SCIENCE BV, 2017) Ilhan, Tolgay Tuyan; Ucar, Mustafa Gazi; Pekin, Aybike Tazegul; Yilmaz, Setenay Arzu; Kerimoglu, Ozlem Secilmis; Celik, CetinObjective: We compared the fluid volume parameters in women undergoing gynaecological surgery for benign and malignant conditions before and after surgery using bioelectrical impedance vectors. Study design: A total of 181 patients were enrolled. In all, 89 patients had surgery for benign conditions and 92 patients underwent oncological procedures, including lymph node dissection, for malignant diseases. Bioelectrical impedance analysis (BIA) parameters were measured on the day of hospitalisation before any treatment and at 24h and 1 month after the surgical intervention. The BIA parameters measured included extracellular water (ECW), intracellular water (ICW), and total body water (TBW). Results: TBW increased significantly 1 month after surgery in all cases (p < 0,05 in both group). ECW was significantly higher (p < 0.05) and ICW was significantly lower (p < 0,05) in the malignant group than the benign group. Conclusion: Radical gynaecological surgeries, including lymph node dissection, have a greater effect on body water distribution than surgeries performed for benign conditions. (C) 2017 Elsevier B.V. All rights reserved.Öğe Dosimetric comparison of 3-dimensional conformal and field-in-field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer(ELSEVIER SCI LTD, 2013) Yavas, Guler; Yavas, Cagdas; Acar, Hilal; Buyukyoruk, Ahmet; Cobanoglu, Gokcen; Kerimoglu, Ozlem Secilmis; Yavas, OzlemBackground: The purpose of this study is to compare field-in-field radiotherapy (FIF) with conformal radiotherapy (CRT) in terms of dosimetric benefits for early stage endometrial cancer patients. Materials and methods: Ten consecutive early stage endometrial cancer patients who underwent adjuvant external beam radiotherapy were included in the study. For each patient, two different treatment plans were created. FIF and CRT plans were compared for doses in the planning target volume (PTV), the organ at risk (OAR) volumes including rectum, bladder, bowel, bilateral femurs and bone marrow, the dose homogeneity index, and the monitor unit counts required for the treatment. Results: The FIF technique significantly reduced the maximum dose of the PTV, rectum, bladder, bowel, left femur, right femur and bone marrow (p values were: <0.001, 0.031, 0.003, <0.001, 0.001, 0.001 and <0.001 respectively). When the OAR volumes irradiated with >30 and >45 Gy were compared, the results were in favor of the FIF technique. The volumes of rectum, bladder, bowel, left femur, right femur and bone marrow receiving more than the prescription dose of 45 Gy were significantly reduced with FIF technique (p values were 0.016, 0.039, 0.01, 0.04, 0.037 and 0.01 respectively). The dose homogeneity index (DHI) was significantly improved with FIF technique (p < 0.001). Conclusions: FIF allowed more homogeneous dose distribution in the PTV and reduced the doses received by OAR. Considering the lower maximum doses in the OAR and PTV, FIF technique seems to be more advantageous than CRT during adjuvant radiotherapy for early stage endometrial cancer patients. (C) 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.Öğe Effect of a low dose of gonadotropin releasing hormone antagonist on in vitro fertilization outcomes(SPRINGER HEIDELBERG, 2013) Kerimoglu, Ozlem Secilmis; Ercan, Cihangir Mutlu; Keskin, Ugur; Korkmaz, Cem; Duru, Namik Kemal; Ergun, AliThis study aims to determine whether a low dose of the gonadotropin releasing hormone antagonist, cetrorelix, prevents a premature luteinizing hormone (LH) surge and affects in vitro fertilization (IVF) outcomes compared to the standard dose of 0.25 mg/day. In this study, 45 IVF/intracytoplasmic sperm injection patients were stimulated with recombinant follicle stimulation hormone from day 2 of the cycle. Cetrorelix was injected daily from day 6 of gonadotropin administration. Twenty-two patients received cetrorelix at a dose of 0.25 mg/day, whereas 23 participants received half dose. The mean consumption of gonadotropins was significantly higher in patients receiving 0.25 mg/day of cetrorelix (2,213 vs. 1,350 U; p = 0.046). The clinical pregnancy rates were similar in both groups (31.8 vs. 47.8 %; p = 0.273). Premature LH surge was detected in 9.1 % of the patients receiving cetrorelix 0.25 mg/day and in 13 % of the patients receiving cetrorelix 0.125 mg/day (p > 0.05). The difference between two groups was not statistically significant (p > 0.05). Our results suggest that there is no difference between a cetrorelix dose of 0.125 or 0.25 mg/day in preventing premature LH rise during ovarian stimulation for IVF.Öğe Effect of the percentage of body fat on surgical, clinical and pathological outcomes in women with endometrial cancer(WILEY, 2015) Kerimoglu, Ozlem Secilmis; Pekin, Aybike; Yilmaz, Setenay Arzu; Yavas, Guler; Beyhekim, Fatma; Demirtas, Ayse Ayda; Dogan, Nasuh UtkuAimThis 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. MethodsBetween 2011 and 2013, bioelectrical impedance analysis and body size measurements of 94 patients whose endometrial biopsy revealed endometrial cancer were obtained. Patients were divided into two groups according to body mass index (BMI) (normal, <30kg/m(2); elevated, 30kg/m(2)), and also classified by %BF (normal, <32%; elevated, 32%). ResultsThe patients' mean age was 55.010.9 years. Mean %BF and BMI were 40.8%+/- 9.8% and 32.9 +/- 7.5, respectively. Eighty-three (88%) patients were obese according to %BF; 54 (57%) were obese according to BMI. Patients with elevated %BF were more likely to have less than 50% myometrial invasion (P=0.004). Significantly more para-aortic lymph nodes were retrieved in patients with normal %BF or BMI (P<0.001, P<0.001). Patients with elevated %BF had longer operating times (P=0.043) and were more likely to have stage I disease than patients with normal %BF (P<0.001). ConclusionEndometrial cancer patients with an elevated %BF are more likely to have stage I disease and less than 50% myometrial invasion than patients with normal %BF. Defining obesity by BF may provide better estimation of obesity prevalence in patients with endometrial cancer and further understanding the relationship between BF with endometrial cancer may give more information about the effects of obesity on endometrial cancer.Öğe Evaluation of Toll-Like Receptor Expression with Clinicopathologic Variables in Endometrium Cancer(YERKURE TANITIM YAYINCILIK HIZMETLERI AS, 2018) Bakbak, Berat Berrin Gencoglu; Ilhan, Tolgay Tuyan; Pekin, Aybike; Kerimoglu, Ozlem Secilmis; Yilmaz, Setenay Arzu; Kebapcilar, Aysegul; Dogan, Nasuh UtkuObjectives: Clinical evidence supports the association of toll-like receptor (TLR) with abnormal cell proliferation and cancer. In this study, we investigated the expression of TLRs 2, 4, 5, and 6 in healthy endometrium and endometrium cancer to study the relationship of these receptors' expression with carcinogenesis. Methods: Patients who had undergone a hysterectomy owing to endometrium cancer (group 1, 66 patients), endometrial hyperplasia (group 2, 14 patients), and other reasons besides endometrium cancer (group 3, 20 patients as controls) were included. The cases in the first group were classified by histological type of the cancer, stage, grade, and size of the tumor. In all the cases, expressions of TLRs 2, 4, 5, and 6 were assessed, and the relationship of these receptors with clinicopathologic signs was analyzed. For immunohistochemical staining, nuclear and cytoplasmic stainings were considered positive. A Chi-squared test was used to assess the correlation of the groups. A p<0.05 was considered significant. Results: The mean ages of patients in groups 1, 2, and 3 were 59.8 (range 33-83), 48.3 (range 40-59), and 53.4 (range 38-84) years, respectively. All types of TLRs were highly expressed in both types of endometrium cancer (groups 1 and 2). TLR expression was observed with a ratio of 87.9% in group 1, 100% in group 2, and 35% in group 3. There was a statistically significant association of TLR 2 among the three groups (p=0.000). TLR 6 expression in both group 1 and group 2 was significantly higher than that in the control group (p=0.000, p=0.000, respectively). In addition, TLR 6 was higher in cases with late-stage cancer (p=0.033). Regarding tumor grade and the size of the tumor, no association was found between TLR 2 and TLR 6. Conclusion: TLR 2 and TLR 6 were significantly more expressed in cases with endometrium cancer and endometrial hyperplasia. In addition, the presence of TLR 6 may indicate the presence of late-stage endometrial cancer.Öğe Follicle-stimulating hormone receptor gene polymorphisms in women with endometriosis(SPRINGER HEIDELBERG, 2015) Kerimoglu, Ozlem Secilmis; Yilmaz, Setenay Arzu; Pekin, Aybike; Nergiz, Suleyman; Incesu, Feyzanur; Dogan, Nasuh Utku; Acar, HasanThe purpose of this study was to evaluate the influence of the follicle-stimulating hormone (FSH) receptor poymorphisms Asn680Ser and Thr307Ala on endometriosis in Turkish women. Polymorphic analysis of the FSH receptor gene was performed in 100 patients with endometriosis and 100 controls. Genomic DNA was obtained from peripheral blood leukocytes and polymorphisms were investigated using restriction fragment length polymorphism analysis. There were no significant differences in genotype frequencies of FSH receptor gene between endometriosis patients and controls. When the patients were divided into two groups according to disease severity, we found that the patients with the SS (680 Ser/Ser) or AA (307 Ala/Ala) genotype were less likely to develop stage 3-4 endometriosis compared to the stage 1-2 endometriosis group (P = 0.004; OR: 0.177, 95 % CI 0.055-0.568 and P = 0.040; OR: 0.240, 95 % CI 0.061-0.938; respectively). The distributions of FSHR polymorphisms may not have an effect on endometriosis development but they are associated with the severity of the disease. The polymorphisms encoding SS at the position 680 and AA at the position 307 and the patients with the genotype that included alanine or serine were less likely to develop stage 3-4 endometriosis compared to the stage 1-2 endometriosis group.Öğe The Impact of Body Mass Index on Radiotherapy Technique in Patients With Early-Stage Endometrial Cancer A Single-Center Dosimetric Study(LIPPINCOTT WILLIAMS & WILKINS, 2014) Yavas, Guler; Yavas, Cagdas; Kerimoglu, Ozlem Secilmis; Celik, CetinObjective: 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, 18.5Y24.9 kg/m(2); overweight, 25-29.9 kg/m(2); obese, 30-39.9 kg/m(2)). 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.Öğe Predictive value of second and third trimester fetal renal artery Doppler indices in idiopathic oligohydramnios and polyhydramnios in low-risk pregnancies: A longitudinal study(WILEY, 2015) Benzer, Nilgun; Pekin, Aybike Tazegul; Yilmaz, Setenay Arzu; Kerimoglu, Ozlem Secilmis; Dogan, Nasuh Utku; Celik, CetinAimIntermittent assessment of renal artery flow velocity waveforms during the early stages of pregnancy may help in predicting changes in amniotic fluid dynamics. The current study sought to determine the relation of renal artery and umbilical artery flow velocity waveforms with normal pregnancies and pregnancies complicated by either polyhydramnios or oligohydramnios. Material and MethodsRenal and umbilical artery Doppler values were evaluated at 22, 28 and 34 weeks' gestation in 300 low-risk pregnant women with singleton pregnancies. Pulsatility index (PI) and resistance index (RI) were recorded and the amniotic fluid volume was evaluated. Three groups were formed according to the amniotic fluid volume at birth. Group I consisted of 264 pregnant women with normal amniotic fluid, group II included 30 pregnant women with oligohydramnios and group III included six pregnant women with polyhydramnios. Doppler parameters were compared between the groups and within each group according to gestational age. ResultsRenal artery PI values were higher in group II than group I at 22 weeks, 28 weeks and 34 weeks. The PI value at 28 weeks' gestation was statistically significant (P=0.011). At 28 weeks' gestation, group II also had higher umbilical artery PI and RI values than group I. ConclusionAn increase in renal artery PI develops in early pregnancy before the development of oligohydramnios. In pregnancies developing polyhydramnios, renal artery PI was lower; however, our study included a small number of women with polyhydramnios.Öğe Pregnancy outcomes in a university hospital after legal requirement for single-embryo transfer(ELSEVIER SCIENCE BV, 2014) Ercan, Cihangir Mutlu; Kerimoglu, Ozlem Secilmis; Sakinci, Mehmet; Korkmaz, Cem; Duru, Namik Kemal; Ergun, AliObjective: 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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Öğe Psychiatric comorbidity in women with polycystic ovary syndrome(WILEY, 2015) Annagur, Bilge Burcak; Kerimoglu, Ozlem Secilmis; Tazegul, Aybike; Gunduz, Sule; Gencoglu, Berat BerrinAim: 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. Material and Methods: Women who met the Rotterdam criteria for PCOS (n=88) were included. Structured Clinical Interviews for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edn were conducted. After the psychiatric evaluations, blood samples were obtained from the participants. Results: Prevalence for all comorbid psychiatric disorders was 50% (n=44). The most common psychiatric disorder was major depression (33%), followed by generalized anxiety disorder (13.6%) and binge-eating disorder (6.8%). No significant difference in body mass index and insulin resistance index scores was found between women with and without psychiatric disorders (P > 0.05 for both comparisons). Conclusion: A considerable number of women with PCOS experience a psychiatric disorder during their lifetime. Clinicians should be aware that women with PCOS are at a high risk for major depression, generalized anxiety disorder, and binge-eating disorder.Öğe Response to: Comment on 'Effect of a low dose of gonadotropin releasing hormone antagonist on in vitro fertilization outcomes' by Kerimoglu et al.: Cetrorelix in COH cycles: time to re-evaluate the daily administered dose?(SPRINGER HEIDELBERG, 2014) Kerimoglu, Ozlem Secilmis; Ercan, Cihangir Mutlu[Abstract not Available]
