Browsing by Author "Colak, Eser"

Now showing 1 - 13 of 13

Analysis of the effectiveness of ultrasound and clinical examination methods in fetal weight estimation for term pregnancies
(2015) Zahran, Mehmet; Tohma, Yusuf Aytac; Erkaya, Salim; Evliyaoglu, Ozlem; Colak, Eser; Coskun, Bora; 28913073
Objective: To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies. Materials and Methods: Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight +/- 10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (>= 4000 g). Results: All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group. Conclusion: For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group.
Can complete blood count inflammatory parameters in epithelial ovarian cancer contribute to prognosis? - a survival analysis
(2019) Ceran, Mehmet Ufuk; Tasdemir, Umit; Colak, Eser; Gungor, Tayfun; 0000-0003-1923-2373; 0000-0002-8184-7531; 30744662
SubjectiveThe aim of the present study was to investigate the prognostic significance of preoperative complete blood count inflammatory markers in women operated for invasive Epithelial Ovarian Cancer (EOC).MethodTwo hundred forty four patients that underwent operation with the diagnosis of invasive EOC between 2006 and 2014 were included in the study. The date of operation, date of recurrence and final mortality evaluations were performed for survival analysis. The sensitivity, specificity, PPV and NPV were separately calculated with ROC analysis. Survival analysis was carried out with Kaplan Meier-Log Rank Method.ResultsFive-years overall survival rate was 56, 9% and 5-year disease-free survival (DFS) rate was 45,5%. Advanced disease stage, moderate-poor tumor differentiation, and the presence of recurrence were determined to have significant inverse relation at mean survival and 5-year survival rates. Neutrophil/lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) had prognostic effect on both DFS and overall survival based upon the cut-off values determined in the study (PLR=231, s36, NLR=3,83). Histopathological subtypes were not found to have any prognostic value. In correlation analysis, PLR and NLR had positive correlation with each other and negative correlation with overall survival.ConclusionsInflammatory markers such as NLR and PLR have independent prognostic value for women who undergo surgery for invasive EOC.
Comparison of Emergency and Elective Cesarean Sections in the Breech Presentation: A Case-Control Study
(2020) Coskun, Bugra; Pay, Ramazan Erda; Coskun, Bora; Simsir, Coskun; Dur, Riza; Colak, Eser; Karasahin, Kazim Emre
Objective: In this study, we aimed to compare the characteristics and outcomes between the patients who underwent emergency or elective cesarean section (CS) with the indication of breech presentation (BP). Method: All the patients who underwent cesarean delivery with the indication of BP between January 2016-December 2018 were included in this retrospective study. BP Patients with any other indication for CS were excluded from the study. Group I; consisting of patients with BP who underwent emergency CS due to progression of cervical dilation and/or effacement, pain or membrane rupture, presence of = 3 contractions at regular intervals over 25 mmHg within 10 minutes, and Group II; consisting of term pregnant patients without any additional problem who underwent elective CS following 38. gestational weeks between 08:00 AM to 05:00 PM were compared statistically. Also, subgroups were compared according to BP subtypes and cervical opening measurements. Results: APGAR scores at the 1st / 5th minutes and postoperative hemoglobin values were significantly lower in the emergency CS group than the elective CS group. Also we found that the decreases in hemoglobin values before and after the cesarean section, and APGAR scores at 1., and 5. min, were significantly higher, the operation time was significantly longer in the emergency CS group. Also, the median value of the week of emergency cesarean section was 37 gestational weeks, and we found that when the cervical dilation was 2 cm and above before operation, the drop in hemoglobin value, need for blood transfusion and neonatal intensive care increased significantly. No significant difference was found between BP subtypes. Conclusion: Postoperative parameters may tend to be unfavourable in patients with BP who underwent emergency CS due to pain or progression of cervical dilation. Therefore, clinicians who prefer cesarean delivery in patients with BP, should be very cautious against possible emergency operation until the time of the elective operation and also avoid iatrogenic preterm labor.
Comparison of placental alpha microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation
(2021) Esin, Sertac; Tohma, Yusuf Aytac; Alay, Ismail; Guden, Mahmut; Colak, Eser; Demirel, Nihal; Bas, Ahmet Yagmur; Serdar Yalvac, Ethem; Kandemir, Omer; 0000-0001-9577-4946; 32835549; AAI-8810-2021
In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (p = .21).Impact statement What is already known on this subject?Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis. However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously. What do the results of this study add?Although statistically insignificant, cases diagnosed by PAMG-1 assay had lower risk of chorioamnionitis during latency period. What are the implications of these findings for clinical practice and/or further research?Whether cases diagnosed by PAMG-1 assay represent a milder form of rupture of membranes than cases diagnosed by classical speculum examination group warrants further research.
Evaluation of the tear parameters of ovulation induction patients in a short time period with anterior segment optical coherence tomography
(2020) Colak, Eser; Ulusoy, Mahmut Oguz; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kal, Ali; Ozcimen, Emel Ebru; 33470279
Purpose: The effects of sex steroid hormones on tearparameters are known. Theaim of this studywas to examine the effects on tear parameters during exposure to high-dose sex steroids in a short period of time. Methods: Forty patients who were admitted to the infertility clinic of our hospital and planned to undergo ovulation induction with exogenous gonadotropins were included in our study. Prior tothe initiation of ovulation induction, the basal levels of estradiol were measured on day 3 of the menstrual cycle and ophthalmologic examinations were performed by the ophthalmology department of our hospital. The estradiol levels were-measured on the day ofovulation induction usinghuman chorionic gonadotropin and compared with basal estradiol; eye examinations were also repeated. Result: Forty women with reproductive period and average age of 33.3 +/- 4.2 years were included in this study. Basal levels of estradiol were significantly (p<0.001) higher after ovulation induction than before induction. The scores in the break-up timeand after induction were 6.2 +/- 2.8 sn and 8.4 +/- 1.4 sn, respectively. The values of Schirmer's test were 14.3 +/- 7.1 mm and 20.6 +/- 6.2 mm before and after induction, respectively. Both values were significantly higher after ovulation induction (p<0.001; p=0.001, respectively). Conclusion: We observed improvemet in tear function tests following the use of estradiol even for a limited time .The use of estradiol during menopause may improve dry eye symptoms in patients.
Fetal rhabdomyoma with maternal tuberous sclerosis that almost completely filled the left ventricle at an early gestational week
(2021) Colak, Eser; Ozcimen, Emel Ebru; Gokmen, Zeynel; Gokdemir, Mahmut; 0000-0002-2746-0547; 0000-0002-5676-2747; 34013241; AAJ-8069-2021; N-4174-2014
Incidence of unexpected leiomyosarcoma in a Turkish province: a retrospective multi-centre study in a low income setting
(2022) Tasdemir, Umit; Ceran, Mehmet Ufuk; Dirican, Aylin Onder; Akar, Serra; Celik, Cetin; Energin, Hasan; Gorkemli, Huseyin; Mammadova, Narmin; Colak, Eser; Ayhan, Ali; 0000-0003-1923-2373; 0000-0002-8184-7531; 35253591
The aim of the current study was to estimate the incidence of unexpected leiomyosarcoma (LMS) in patients who underwent surgery due to leiomyomas in Konya province, and to contribute to the literature discussing comparisons with similar studies. The digital archives of eight high-volume hospitals were studied for surgeries performed due to leiomyomas between January 2012 and January 2019, and leiomyosarcoma incidence was calculated based on the data obtained. Twenty-one patients in 3703 cases were found to have unexpected leiomyosarcoma, which means we can expect one leiomyosarcoma in 176 (0.56%) surgeries. Six more malignant tumours were detected among the remaining cases. Thus, our study estimated the incidence of unexpected leiomyosarcoma as 1/176 (0.56%), which is higher than most of the studies in the literature justifying the debate started by the FDA in 2014. As the tumour biology is not yet clear, and the incidence of unexpected leiomyosarcoma tends to be so high, the key focus must be to try to detect uterine leiomyosarcomas preoperatively for robust patient care.IMPACT STATEMENT What is already known on this subject? The incidence of unexpected leiomyosarcoma varies widely from 1/498 to 1/8300 depending on the study method and the type of procedure, and there is still controversy, even after the FDA statement that led to a major restriction in laparoscopic surgeries due to concerns about inadvertent morcellation of leiomyosarcomas. What do the results of this study add? To the best of our knowledge, the current study found the highest incidence of unexpected leiomyosarcoma, and consequently a serious evaluation of all patients undergoing surgery due to leiomyomas preoperatively considering a leiomyosarcoma candidate is recommended. What are the implications of these findings for clinical practice and/or further research? Studies on tumour biology and novel markers must be supported for accurate preoperative diagnosis of leiomyosarcoma.
May myo-inositol andd-chiro-inositol (40:1) treatment be a good option on normal-weighted polycystic ovary syndrome patients without insulin resistance?
(2020) Colak, Eser; Ozcimen, Emel Ebru; Tohma, Yusuf Aytac; Ceran, Mehmet Ufuk; 0000-0002-8184-7531; 32989863
Aim To investigate the effectiveness of myo-inositol andd-chiro-inositol (MI:DCI) (40:1) treatment in normal-weight polycystic ovary syndrome (PCOS) patients without insulin resistance. Methods This retrospective case-control study included PCOS patients without insulin resistance who were diagnosed in the gynecology and obstetrics clinic of Baskent University Konya Practice and Research Hospital between January 2016 and October 2019 and received at least 6 months of MI:DCI (40:1) treatment. The patients were divided into two groups according to body mass index (BMI). Twenty-nine anovulatory patients without insulin resistance with a BMI of 18-25 were included in group 1 (normal-weight group), whereas 17 patients without insulin resistance with BMI > 25 were included in group 2 (obese/overweight group). Ovulation status of both groups was compared after MI:DCI treatment. Results Ovulation was detected in 23 of 29 patients in the normal-weight group, whereas it was detected only in 5 of 17 patients in the obese/overweight group; this difference was statistically significant (P < 0.001) (Table 2, Figure 1). Post-treatment progesterone levels of both groups were compared and in the normal-weight PCOS group was significantly higher than the obese/overweight group (P < 0.001) (Table 2, Figure 2). In addition, spontaneous pregnancy following treatment was observed in six of the seven (85.7%) patients in the normal-weight group who wanted to conceive, whereas it was observed in only two of the six (33.3%) patients in the obese/overweight group who wanted to conceive. Conclusion Our results showed that MI:DCI (40:1) treatment may be a first-line treatment in normal-weight PCOS patients without insulin resistance.
Phosphodiesterase 4 inhibitor plus metformin is superior to metformin alone for the treatment of polycystic ovary syndrome: A rat model study
(2019) Tohma, Yusuf Aytac; Onalan, Gogsen; Tepeoglu, Merih; Bayraktar, Nilufer; Colak, Eser; Ozcimen, Emel Ebru; Zeyneloglu, Hulusi Bulent; 30988783
The role of metformin in the management of polycystic ovary syndrome (PCOS) and PCOS-related obesity remains controversial. Recent research on the treatment of PCOS-related obesity investigated novel therapeutic agents with the potential to work synergistically with metformin. The aim of the present study was to determine the synergistic effect of a phosphodiesterase 4 inhibitor (PDE4i) and metformin on weight and hormonal changes in a rat model of PCOS. A total of 40 female Sprague-Dawley rats were randomly divided into 4 groups (n=10/group): Sham; PCOS control (no medication after PCOS induction with dehydroepiandrosterone); metformin (300 mg/kg/day p.o. after PCOS induction); and metformin + PDE4i (300 mg/kg/day p.o. metformin + 0.5 mg/kg/day p.o. PDE4i after PCOS induction). The body weight was measured every 7 days, from day 1 to day 49. Vaginal smears were performed and examined daily via light microscopy for determination of the stage of each rat's estrous cycle. At the end of 21st day and at the end of the study, blood samples were collected from rats and the testosterone and insulin levels were measured. Immunohistochemical staining was performed to quantify phosphorylated cyclic AMP response element-binding protein expression in all groups. At the end of the study, the median body weight differed significantly among the groups ((2)=30.581, P<0.001), being the highest in the PCOS control group and the lowest in the metformin + PDE4i group. At the end of the study, the median testosterone level differed significantly among the groups ((2)=27.057, P<0.001), being the highest in the PCOS control group and the lowest in the metformin + PDE4i group. The cycle was restored to normal at the end of the study in all the rats in the metformin and metformin + PDE4i groups, whereas an irregular cycle persisted in all the rats in the PCOS control group. In conclusion, PDE4i + metformin was superior to metformin alone in reducing weight gain and decreasing the testosterone levels in a rat model of PCOS.
Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester
(2020) Colak, Eser; Ozcimen, Emel Ebru; Ceran, Mehmet Ufuk; Tohma, Yusuf Aytac; Kulaksizoglu, Sevsen; 0000-0001-9418-4733; 0000-0002-7613-2240; 0000-0003-1923-2373; 0000-0002-8184-7531; 30947572; AAE-6482-2021; AAI-8932-2021
Objectives:Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected for the first time in pregnancy or identified during pregnancy. Mean platelet volume (MPV) is a marker of activation and function of platelet. Several studies investigated the relation between MPV and GDM. The purpose of the present study is to predict GDM in the first trimester by using MPV value. Materials and methods:Two hundred pregnant women with GDM and 200 normal pregnant women were enrolled in the study. The first trimester MPV values of GDM and control groups were compared to predict GDM in the first trimester. Results:Women with GDM had higher MPV value compared with the control group (p < .001). The area under the receiver-operator curve was 0.70 for MPV. The cutoff value of MPV was 7.38 fl with 70% sensitivity and 60% specificity. According to the ages, MPV value was higher in GDM group in the individuals who were above 28-year-old (p < .001). Conclusion:MPV can be used to predict GDM in the first trimester.
Serum and placental periostin levels in women with early pregnancy loss
(2020) Eroglu, Semra; Colak, Eser; Erinanc, Ozgur Hilal; Ozdemir, Duygu; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kulaksizoglu, Sevsen; Ozcimen, Emel Ebru; 0000-0003-1401-6356; 0000-0002-7613-2240; 0000-0002-9959-9433; 32460058; AAL-1268-2021; AAI-8932-2021
Objectives: Periostin is secreted from the placenta in the embryonic period and it is emphasized that it may be involved in endometrial implantation. In this study, we aimed to investigate periostin serum levels and placental tissue expression in first trimester pregnancy losses. Study design: In this prospective case-control study, 30 patients who underwent dilatation and curettage with first trimester spontaneous abortion (< 10 weeks of gestation) were included in the study group and 30 patients who had voluntary pregnancy termination (< 10 gestational weeks) were included in the control group. Serum samples collected from the study and control groups were analyzed usingenzyme-linkedimmunosorbent assay (ELISA), and trophoblastic and decidual tissues were examined using immunohistochemical staining with streptavidin-biotin-peroxidase techniques. Results: There were no significant differences between the groups in terms of age, gravida status, parity number, gestational week, and number of previous abortions. In the spontaneous abortion group, the serum level of periostin was significantly lower than in the voluntary termination group (6.56 +/- 4.16 pg/mLvs. 9.51 +/- 4.52 pg/mL, p = 0.03). There was no significant difference between the two groups in terms of periostin expression in decidual and trophoblastic tissue (p = 0.617, p = 0.274, p = 0.497). Conclusion: Periostin serum levels were significantly reduced in patients with spontaneous pregnancy loss. Periostin can be used as a predictive marker for the success of endometrial implantation.
Serum endocan levels in fresh IVF/ICSI cycles in women with endometriosis: a comparative prospective study
(2022) Ceran, Mehmet Ufuk; Yilmaz, Nafiye; Colak, Eser; Bayraktar, Nilufer; Tohma, Yusuf Aytac; Zeyneloglu, Hulusi Bulent
Background: The current study tested the level of endocan, which is thought to have an effective role in both endothelial dysfunction and inflammation, in infertile women with endometriosis treated with in vitro fertilizationlintracytoplasmic sperm injection (IVF/ICSI). It is based on the hypothesis of chronic inflammation in the pathophysiology of endometriosis. Methods: This prospective case control study included a total of 64 women who were in the IVF/ICSI program. The women were divided into two groups: endometriosis (n = 32) and non-endometriosis (n = 32). Their baseline characteristics, stimulation parameters, and IVF/ICSI outcomes (clinical pregnancy and live birth rates) were recorded. Blood samples collected at the beginning of the IVE cycle for endocan levels were analyzed with a sandwich enzyme immunoassay and the results were documented. Results: The endocan levels in the endometriosis group were significantly higher than those in the non-endometriosis group, i.e., 5010 pg/mL and 2738 pg/mL, respectively (p < 0.05). A significant weakly positive correlation was found between endocan levels and the presence of endometriosis (p < 0.05, r: 0.284). The cut-off value for endometriosis was determined as 4693 pg/mL with a sensitivity of 53.13% and a specificity of 78.12%. Clinical pregnancy was insignificantly higher in the non-endometriosis group (p = 0.079). However, live birth rates were significantly higher in the non-endometriosis group (p < 0.05). No correlation was found between clinical pregnancy and live birth rate and endocan levels (p > 0.05). Conclusion: High endocan levels were detected in women who underwent IVF/ICSI treatment for endometriosis and infertility and there was a positive correlation between them. However, there was no relationship between endocan levels and IVF/ICSI outcomes.
Vitamin D receptor gene TaqI single nucleotide polymorphism is not associated with lead levels in maternal and umbilical cord blood
(2019) Tohma, Yusuf Aytac; Akad, Selin; Colak, Eser; Kulaksizoglu, Sevsen; Akyol, Mesut; Terzi, Yunus Kasim; Ozcimen, Emel Ebru; Esin, Sertac; Sahin, Feride Iffet; 0000-0001-5612-9696; 0000-0001-7308-9673; 0000-0002-3808-7004; 0000-0001-9418-4733; 0000-0002-8184-7531; 29463156; AAC-8356-2020; B-4372-2018; AAC-7232-2020
Purpose: We aimed to investigate the association of vitamin D receptor (VDR) gene TaqI single nucleotide polymorphism (SNPs) with serum lead (Pb) levels in maternal and umbilical cord blood. Materials and methods: Eighty-one patients who lived in Konya, Turkey for the last 3 years and had delivery at Baskent University Konya Hospital in 2016 were included in this study. Venous blood samples were drawn from each volunteer immediately before giving birth to determine the maternal Pb levels and VDR SNPs. Additionally, umbilical cord blood samples were collected from the umbilical vein into tube with EDTA as an anticoagulant immediately after birth to determine Pb levels of the fetus. Results: The median level of Pb in the maternal blood was 29.00 (Interquartile Range (IQR) = 16.35) mu g/L and the median Pb level in the cord blood was 22.50 (IQR = 9.75) mu g/L. Blood Pb level of women living in the urban area was significantly higher than in those living in the rural area (Z = 2.118; p = .034). There was a very strong positive correlation between the Pb levels in the maternal blood and in the umbilical cord blood (rho = 0.825, p < .001, respectively). Regarding VDR SNPs, "TT", "TC", and "CC" VDR TaqI genotypes were observed in 28 (34.6%), 45 (55.5%), and eight samples (9.9%), respectively. Pb levels in maternal and cord blood were higher in women with the "CC" VDR TaqI genotype; however, there was no statistically significant difference (p > .05). Conclusions: Although women with the "CC" VDR TaqI genotype had higher maternal and cord blood Pb levels, this was statistically insignificant and therefore, VDR TaqI SNPs did not significantly affect maternal and umbilical cord blood Pb levels.