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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 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 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 Plasma cell vulvitis: A vulvar itching dilemma(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2012) Celik, Aygen; Hallioglu, Berna; Tannover, Yonca; Iiter, Erdin; Gunduz, Tonguc; Ulu, Ipek; Midi, Ahmet; Ozekici, Umit…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 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.
