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Yayın Bone turnover and maternal 25(OH) vitamin D3 levels during pregnancy and the postpartum period: should routine vitamin D supplementation be increased in pregnant women?(ELSEVIER SCIENCE BV, 2011) Haliloglu, Berna; Ilter, Erdin; Aksungar, Fehime Benli; Celik, Aygen; Coksuer, Hakan; Gunduz, Tonguc; Yucel, Erdal; Ozekici, UmitObjective: To investigate the relationship between 25(OH) vitamin D3 levels and maternal bone turnover during pregnancy and lactation. Study design: Thirty pregnant women and 30 healthy non-pregnant controls were included the study. The pregnant women were examined in the 12th, 25th and 32nd gestational weeks and 6 weeks after delivery. The controls were examined once. Serum concentrations of 25(OH) vitamin D3, parathyroid hormone (PTH), cross-linked C-terminal telopeptide of type I collagen (CTX), calcium, and phosphate were measured. Results: In the 32nd week and the postpartum period, 25(OH) vitamin D3 deficiency rates were 13.3% and 333%, respectively. Serum 25(OH) vitamin 03 levels were below the detection limit in 10% and 33%, respectively, of the same subjects. In the control group, rates of 25(OH) vitamin D3 deficiency and "below detection limit" were 30% and 23%, respectively. While 25(OH) vitamin 03 and CTX levels were not correlated to each other in the first trimester, a negative correlation was found in the 2nd and 3rd trimesters and the postpartum period between 25(OH) vitamin 03 and CTX levels (r = -0.472, p = 0.048; r = -0.893, p < 0.0001, r = -0.881, p < 0.001, respectively). No correlation between 25(OH) vitamin D3 and CTX levels was found in controls. Conclusion: We consider that 25(OH) vitamin D3 supplementation of women could both decrease maternal bone resorption and lead to enhanced bone mass in offspring during later life. Since women are prone to 25(OH) vitamin D3 insufficiency, we suggest higher doses of 25(OH) vitamin D3 should be given to pregnant subjects. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Yayın Carbetocin Versus Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Section(Turkiye Klinikleri, 2021) Gürsoy, Ali; Ilter, Erdin; Çelik, Aygen; Peker, Berna Haliloğlu; Serifsoy, Talat Ercan; Atasayan, Kemal; Özekici, UmitObjective: We aimed to compare the haemodynamic effects of carbetocin and oxytocin in preventing postpartum hemorrhage during cesarean delivery. Material and Methods: This study was conducted retrospectively in a university hospital. Women in the carbetocin group (n=42) and women in the oxytocin group (n=78) were evaluated in terms of changes in hemoglobin level, hematocrit level, uterotonic need, urine output, blood transfusion requirement, hospital stay, postoperative fever and need for peripartum hysterectomy. Results: There was not statistically significant difference between their additional uterotonic need but preoperative and postoperative 24th hour hemoglobin reduction, calculated estimated blood loss and platelet count diminution percentage were significantly lower in the carbetocin group compared to oxytocin group (p=0.044; p=0.042; p=0.004, respectively). Besides that, the rate of blood loss of >= 500 mL was lower but not significantly different in patients receiving carbetocin compared to those using oxytocin (p=0.059) and the duration to reach 1,500 cc urine output of carbetocin group was significantly lower than the oxytocin group (p=0.001). Conclusion: Carbetocin appears to be more effective in the hemoglobin reduction, platelet reduction and calculated estimated blood loss. In addition, another advantage of carbetocin is that it has lower negative effects on urine output than oxytocin. It is noteworthy that carbetocin administration can prevent postpartum hemorrhage in appropriate cases.Yayın Comparison of conventional and liquid-based cytology: do the diagnostic benefits outweigh the financial aspect?(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2012) Ilter, Erdin; Midi, Ahmet; Haliloglu, Berna; Celik, Alrgen; Yener, Arzu Nee; Ulu, Ipek; Bozkurt, Hayriye Serpil; Ozekici, UmitAim: We aimed to compare the efficiency of conventional cytology (CC) and new liquid-based cytology (LBC) techniques in the assessment and the accuracy of Pap smears reported as abnormal by histological examinations. Materials and methods: A total of 3488 women who were undergoing routine cervical screening (1308 CC and 2180 LBC) were included in the initial screening. The results were assessed as either satisfactory or unsatisfactory. Satisfactory results were subdivided as negative, atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells for which high-grade lesions could not be excluded (ASC-H), low-grade squamous intraepithelial lesion (LGSIL), high-grade squamous intraepithelial lesion (HGSIL), and cancer. Results: These data show that the rate of unsatisfactory results for the LBC technique (0.05%) was lower than for the CC group (0.5%). Except for ASCUS and cancer cytology, all other atypical cytology results were diagnosed more frequently with CC than with LBC. The rates of detected ASC-H and HGSIL were higher with CC than LBC, and the difference was statistically significant (P <0.05). Conclusion: LBC has higher satisfaction rates than CC. LBC also detected more true-abnormal cases when compared with CC. The residual specimens from the LBC technique can be used to detect human papillomavirus DNA through immunocytochemistry, if needed. However, the benefits of LBC do not seem to justify the cost. It seems that CC should be the first choice for developing countries with lower incomes.Yayın Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device(ELSEVIER SCIENCE INC, 2011) Haliloglu, Berna; Celik, Aygen; Ilter, Erdin; Bozkurt, Serpil; Ozekici, UmitBackground: As a contraceptive method, we investigated whether the levonorgestrel-releasing intrauterine system (LNG-IUS) has any effect on uterine artery blood flow when compared with copper intrauterine device (IUD). Study Design: Sixty women with copper IUD and 60 women with LNG-IUS were included in the study. The age, gravidity, parity, body mass index (HMI) and menstrual flow pattern using a pictorial chart were recorded. All women were assessed by ultrasonography at the preinsertion period and 1 year after insertion. The pulsatility and resistance indices (PI and RI, respectively) of the uterine artery and endometrial thickness were evaluated in the preinsertion and postinsertion periods. Results: In copper IUD users, preinsertion and postinsertion ultrasonographic assessments were not significantly different. However, postinsertion RI was significantly higher compared with preinsertion RI in LNG-IUS users (p=.001). The PI was also increased 1 year after insertion, but it did not reach statistically significant levels (p=.08). Endometrial thickness was also significantly decreased in the postinsertion period in women with LNG-IUS (p=.04). Conclusion: The significant increase in uterine artery RI in LNG-IUS users 1 year after insertion might be due to its local progestational effects. It might also indicate the mechanism of the LNG-IUS in reducing menstrual blood flow. (C) 2011 Elsevier Inc. All rights reserved.Yayın Evaluation of cervical cytological abnormalities in Turkish population(MEDKNOW PUBLICATIONS, 2012) Atilgan, Remzi; Celik, Aygen; Boztosun, Abdullah; Ilter, Erdin; Yalta, Tulin; Ozercan, ResatIntroduction: Cervical cancer is one of the most common female malignancy with high mortality rates in developing countries. Our purpose was to determine the prevalence of cervical cytologic abnormalities in population (strict Islamic religious area) and the detection rate of epithelial abnormalities by cervical cytology (CC). Materials and Methods: A total of 32,026 conventional pap smear tests collected between January 2006 and January 2010 from three hospitals are retrospectively analyzed. Results: Total of 900 (2.8%) cases had epithelial abnormalities. The numbers and rates of epithelial abnormalities were as the followings: Atypical squamous cell of undetermined significance (ASCUS; n=615 [1.9%]); atypical squamous cell suspicious for high-grade squamous intraepithelial lesion (ASC-H; n=27 [0.1%]); atypical glandular cell of undetermined significance (AGUS; n=73 [0.2%]); low-grade squamous intraepitelial lesion (LSIL; n=147 [0.5%]); high-grade squamous intraepithelial lesion (HSIL; n=35 [0.1%]); and squamous cell carinoma (SCC; n=3 [0.0%]). Conclusion: The prevalence of cervical cytological abnormality in our study was 2.8%. Recently, some conflicting results from the same population were published. More prospective studies with larger numbers are needed.Yayın Fluid intake and voiding parameters in asymptomatic Turkish women(SPRINGER LONDON LTD, 2012) Haliloglu, Berna; Peker, Hakan; Ilter, Erdin; Celik, Aygen; Kucukasci, Meryem; Bozkurt, SerpilFor an accurate evaluation of bladder diaries, we aim to investigate normal urinary habits and determining factors on functional bladder capacity, frequency, and 24-h volume in the bladder diaries of asymptomatic women. One-hundred and fifteen asymptomatic women who recorded a 24-h bladder diary were included in the study. Linear regression analyses were used to explore associations between diary values and patient characteristics. Total number of voids was related to age, body mass index, total voided volume, total fluid intake, total diuresis rate, and maximum fluid intake in one go. Maximum, average, and minimum volumes per void were found to be related to body mass index, total voided volume, total fluid intake, total diuresis rate, and maximum fluid intake. When we used multiple regression analysis, only maximum fluid intake was found to be related to the total number of voids, maximum, average, and minimum volumes per void. Maximum fluid intake rather than total voided volume seems to be an important determinant factor for total number of voids and functional bladder capacity.Yayın Laparoscopic Sacrohysteropexy in aWoman at 12 Weeks' Gestation(ELSEVIER SCIENCE INC, 2018) Peker, Berna Haliloglu; Ilter, Erdin; Peker, Hakan; Celik, Aygen; Gursoy, Ali; Gunaldi, Onur…Yayın Negative correlation between D-dimer and homocysteine levels during pregnancy and the postpartum period a prospective study(ELSEVIER SCIENCE BV, 2010) Haliloglu, Berna; Aksungar, Fehime Benli; Celik, Aygen; Ilter, Erdin; Coksuer, Hakan; Ozekici, UmitObjective There have been conflicting data about the role of increased levels of homocysteine (Hcy) on haemostatic system We aim to investigate prospectively the relation between serum Hcy levels and changes in haemostatic system in pregnancy and postpartum period Study design Sixty-eight healthy pregnant women were included in the study Blood samples were obtained in the 11th gestational week 25th gestational week 32nd gestational week and postpartum 4th week The haemoglobin levels white blood cell count (WBC) platelet count activated partial thromboplastin time (aPTI-) prothrombin time (PT) fibrinogen D-dimer Hcy vitamin B12 and folate levels were measured Results Serum Hcy levels were negatively correlated with D-dimer levels (r = -0 57 p < 0 0001) The highest levels of D-dimer (1046 62 +/- 322 01 ng/ml) were achieved in the third trimester and the lowest levels of serum Hcy (4 45 +/- 123 mmol/1) were detected in the same trimester In postpartum fourth week D dimer levels were decreased to normal levels (238 27 +/- 198 59 ng/ml) while the serum Hcy levels were reached to the highest levels (7 99 +/- 1 36 mmol/1) Conclusion The negative correlation between Hcy and D-dimer levels may be a compensatory mechanism to maintain the normal haemostatic balance in pregnancy Hence possible advantage of low Hcy levels in pregnancy may be to prevent undesired thrombosis (C) 2010 Elsevier Ireland Ltd All rights reservedYayın Primary omental pregnancy: case report(2011) Haliloglu, Berna; Çelik, Aygen; Ilter, Erdin; Küçükaşçı, Meryem; Yener, Neşe; Manukyan, Manuk Norayık; Bozkurt, Serpil; Özekici, ÜmitPrimary omental pregnancy is an extremely rare type of ectopic pregnancy. It can be primary or secondary to a tubal pregnancy that aborts out of the fimbria and reimplants in the peritoneal cavity. We present a case in which a 27-year-old woman admitted to emergency department with severe abdominal pain. There was no gestational sac in the endometrium, however, marked free fluid and normal ovaries were demonstrated in transvaginal ultrasound. She was diagnosed as ruptured ectopic pregnancy and laparotomy was carried out. In exploration, bilateral tubes and ovaries were intact. An omental pregnancy was detected and partial omentectomy was performed. Histopathologic evidence of neovascularization confirmed the diagnosis of "primary omental pregnancy". The primary omental pregnancy should be considered in the cases with diffuse hemorrhage and normal appearance of bilateral tubes and ovaries in exploration. Copyright © 2011 by Türkiye Klinikleri.Yayın Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women(SPRINGER HEIDELBERG, 2010) Haliloglu, Berna; Aksungar, Fehime Benli; Ilter, Erdin; Peker, Hakan; Akin, Figen Temelli; Ozekici, UmitWe aimed to investigate whether levels of homocysteine (Hcy), folate, and vitamin B12 are related to bone turnover markers and bone mineral density (BMD) in postmenopausal women. One hundred and twenty postmenopausal women were divided into three groups: osteoporotic, osteopenic and normal, according to the BMD measurements. The age, weight, body mass index (BMI), years since menopause (YSM), gravidity, parity, bone turnover markers [type I collagen C-telopeptides (CTx) and bone-specific alkaline phosphatase (BAP)], serum Hcy, parathyroid hormone (PTH), vitamin B12, folate, calcium and magnesium levels were compared with each other. Twenty-five women had osteoporotic, 42 women had osteopenic, and 53 had normal BMD values. After adjusting for confounding factors, serum Hcy levels were significantly higher in osteoporotic women [adj OR = 38.95 (1.474-1029.88) p = 0.02]. The age, YSM, PTH, CTx and BAP levels were related to serum Hcy in all women (beta = 0.523, p = 0.0001; beta = 0.446, p = 0.001; beta = 0.295, p = 0.005; beta = 0.239, p = 0.026; beta = 0.451, p = 0.001, respectively). Our data showed that vitamin B12, folate and Hcy levels were not related with BMD in postmenopausal women. We think that one of the underlying mechanisms of increased Hcy levels and osteoporosis may be a mechanistic link which cannot detected by BMD or biochemical markers.Yayın Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women (vol 281, pg 663, 2010)(Springer Heidelberg, 2010) Haliloglu, Berna; Aksungar, Fehime Benli; Ilter, Erdin; Peker, Hakan; Akin, Figen Temelli; Mutlu, Nilgün; Özekici, Umit[Abstract Not Available]Yayın Serotonin dilemma in postmenopausal women: Is it low or high?(ELSEVIER IRELAND LTD, 2008) Haliloglu, Berna; Aksungar, Fehime Berth; Ilter, Erdin; Akin, Figen Temelli; Mutlu, Nilgun; Peker, Hakan; Ozden, SelcukObjective: In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and surgically induced menopausal (SM) women in order to investigate the differences in serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), follicle stimulating hormone (FSH) and estradiol (E2) levels on serum serotonin levels. Methods: Forty premenopausal (36.7 +/- 3.5 years), 40 naturally menopausal (54.2 +/- 8.4 years) and 38 surgically induced menopausal (55.4 +/- 11.2 years) women were included in the study. None of the subjects were using antidepressants or hormone replacement therapy. In NM and SM, years since menopause (YSM) were 3.16 +/- 1.58 and 3.36 +/- 1.89, respectively. Cortisol, DHEA-S, FSH and E2 levels were determined by immunochemiluminisence while serotonin levels were determined by HPLC. Results: Serum serotonin levels in NM women were higher than the other two groups [144.23 +/- 45.29 mu g/L vs 61.35 +/- 37.72 mu g/L in SM women and 98.74 +/- 50.29 mu g/L in PM women]. E2 and DHEA-S were positively correlated, while FSH and cortisol were negatively correlated with serotonin in NM and SM. There was no significant correlation between serotonin and age or YSM. In the PM group, there was no significant correlation between serotonin and the hormones. Conclusion: In conclusion, increased serotonin levels in naturally menopausal women may be a compensatory mechanism to decreased E2 levels as it is postulated that there is strong interaction between E2 and the serotoninergic system. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Yayın Utility of Cartilage Grafts Wrapped With Amniotic Membrane in Dorsal Nasal Augmentation(LIPPINCOTT WILLIAMS & WILKINS, 2016) Atespare, Altay; Kara, Hakan; Ilter, Erdin; Boyaci, Zerrin; Celik, Oner; Midi, AhmetObjectives: The success of rhinoplasty may be compromised with postoperative problems like rough and rigid nasal dorsum. Biological grafts or alloplastic materials are required to hurdle and correct nasal dorsal deformities and also irregularities. The purpose of this experimental study was to compare pure cartilage graft, cartilage graft wrapped in amniotic membrane, and diced cartilage grafts wrapped in amniotic membrane for soft tissue augmentation. Methods: All grafts were transplanted through a subcutaneous tunnel created in the nasal dorsum of 18 rats, 6 in each group. After 3 months follow-up, the histopathological changes in all groups were evaluated by light microscopy and volumetric measurements. Results: With regard to cartilage viability, cartilage wrapped in amniotic membrane had a higher success rate than pure cartilage graft. Also, a further increased success rate was found in the diced group. Conclusions: In the soft tissue augmentation after rhinoplasty surgery, especially diced cartilage wrapped in amniotic membrane keeps the graft viable and adjoined.Yayın Women's Knowledge of Pap Smear Test and Human Papillomavirus Acceptance of HPV Vaccination to Themselves and Their Daughters in an Islamic Society(LIPPINCOTT WILLIAMS & WILKINS, 2010) Ilter, Erdin; Celik, Aygen; Haliloglu, Berna; Unlugedik, Elif; Midi, Ahmet; Gunduz, Tonguc; Ozekici, UmitObjective: Cancer of cervix uteri is the second most common cancer among women, and it has been shown to be caused by human papillomavirus (HPV) infection in more than 99% of cases. We surveyed Muslim Turkish women, who mostly accept talking about sex as a taboo, to examine their knowledge about Papanicolaou (Pap) smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters. Methods: We surveyed 525 women aged between 19 and 53 years to examine their knowledge about cervical cancer screening Pap smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters with a questionnaire that is consisted of 5 parts with a total of 31 items. Results: The knowledge of cervical screening was high (70%), and 51% of the subjects were at least once had a Pap smear test, but most respondents (56%) had never heard of HPV. For most women, recommendations from health workers (67%) were the major influences in deciding to get vaccinated. Conclusions: The importance of successful introduction on the vaccine by the drug providers and health care professionals in Turkey was shown in this present study with a high rate of awareness of cervical cancer vaccine. "Early-age vaccination knowledge" before any sexual contact is probably due to the correct education of mothers by health care professionals. The professionals should be educated and trained about HPV, vaccination, and its relation with cervical cancer to increase the knowledge about it.Yayın Xanthogranulomatous salpingitis as a rare pathologic aspect of chronic active pelvic inflammatory disease(MEDKNOW PUBLICATIONS, 2011) Yener, Nese; Ilter, Erdin; Midi, AhmetXanthogranulomatous salpingitis (XGS) is a rare form of chronic inflammation of the fallopian tubes. A 41-year old woman with a history of secondary infertility for 2 years is presented. The patient underwent bilateral salpingooopherectomy with presumptive diagnosis of adnexal mass with cystic component. Intraoperative pathology consultation was done. The diagnosis of bilateral XGS associated with chronic active follicular salpingitis was made. XGS is reported to be caused by an unsuccesfully treated pelvic inflammatory disease. Its association with chronic active follicular salpingitis has not been previously reported. Chronic active follicular salpingitis with xanthogranulomatous inflammation might give the impression of a cystic adnexal mass with septations on preoperative pelvic computed tomography. Frozen sections are necessary to rule out malignancy as done in our case.
