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    Awareness of cervical cancer, human papilloma virus (HPV) and HPV vaccination among women in a cancer screening, early diagnosis and education center
    (2021) Erdogan, Merve; Cihan, Fatma Goksin; Kutlu, Ruhusen; Eryilmaz, Mehmet Ali
    Aim: This study was conducted to assess the awareness of women about cervical cancer and human papilloma virus (HPV) and to evaluate their HPV DNA test results. Materials and Methods: This analytical cross-sectional study was conducted in 250 women who applied to Cancer Early Diagnosis Screening and Training Center (KETEM) at Konya Training and Research Hospital of Health Sciences University. A questionnaire prepared by the researchers was applied to determine the women's sociodemographic characteristics, cervical cancer and HPV knowledge levels. Results: The mean age of the women was 47.7 ± 7.5 years old. When the smear results of the women included in the study are examined, HPV was positive in 3.2% (n=8). Participants with higher education levels had significantly higher Pap smear test knowledge and performed more Pap smear tests than those who had lower education levels (p<0.001). Participants with higher monthly income had significantly higher levels of HPV vaccination knowledge (p=0.014). Women who had regular gynecological examinations, had higher screening test knowledge and had Pap smear tests more than those who were not screened regularly (p<0.001). Participants who know what is a Pap smear test, had a significantly higher HPV vaccine knowledge (p<0.001). Women who had higher education levels had a significantly higher knowledge level about HPV-related lesions (p<0.001). Conclusions: Pap smear test rates, awareness and knowledge regarding HPV, cervical cancer and HPV vaccine were appeared to be very low in our study. It is possible to reduce disorders caused by HPV infection and cervical cancer incidence by improving awareness for cervical cancer and HPV infection, generalizing use of preventive measures, and extending participation to screening programs and HPV vaccination.
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    Diagnostic utility of two-dimensional shear wave elastography to differentiate benign and malignant breast lesions
    (2019) Arslan, Serdar; Altunkeser, Aysegul; Durmaz, Mehmet Sedat; Eryilmaz, Mehmet Ali; Oncu, Fatih; Unlu, Yasar
    Aim: The aim of this study was to evaluate the diagnostic performance of two-dimensional shear wave elastography in the differentiation of malignant and benign breast lesions. Material and Methods: A total of 83 breast lesions in 76 patients were prospectively investigated with B-mode ultrasonography and two-dimensional shear wave elastography techniques. B-mode ultrasonography findings were classified based on BI-RADS lexicon 5th edition. The mean elasticity and the standard deviation of speed mode (m/s) and elasticity mode (kPa) were calculated for all breast lesions. Diagnostic performances of each quantitative parameters were compared. Results: Of 83 breast lesions, 45 (54.2%) were benign and 38 (45.7%) were malignant. Among the all shear wave elastography parameters, the standard deviation (ESD) of the shear wave speed (m/s) had the highest AUROC (0.953) value. When a cut-off value of 0.85 m/s was used for ESD of speed mode, sensitivity, specificity, accuracy, PPV, and NPV were detected as 94.7%, 88.8%, 91.5%, 87.8%, and 95.2%, respectively. Conclusions: Two-dimensional shear wave elastography has excellent diagnostic performance in the differentiation of benign and malignant breast lesions. The standard deviation (ESD) of speed modehad the best diagnostic performance when compared other quantitative parameters.
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    The effect of smoking cessation with or without bupropion on p wave duration and amplitude
    (2019) Ilke Yildirim, Duygu; Hayiroglu, Mert Ilker; Eryilmaz, Mehmet Ali
    Aim: In the current study, the impact of smoking cessation with and without bupropion usage on p wave duration and p wave amplitude in lead I has been analyzed. Bupropion, which is an atypical antidepressant with effects on both dopaminergic and noradrenergic systems, is approved in the medical treatment of smoking cessation. Several cardiac side effects have been presented when bupropion is prescribed in smoking cessation. Material and Methods: Our study has a prospective design which has planned to evaluate p wave amplitude in lead I and p wave duration changes of bupropion by comparing smoking patients (n=78) before and after bupropion usage. The patients prescribed bupropion were also compared to ex-smoker group (n=50) who quit smoking without bupropion usage in regard to p wave indices in lead I. Differences in the median values between groups were analyzed using Mann-Whitney U test. Categorical variables were analyzed by chi-square test or Fisher’s exact test. For repeated measurements, paired sample t-test and Wilcoxon signed rank tests were used to evaluate the significance of the difference in parameters with normal and skewed distribution. Results: The study included both seventy-eight (79.5% male) patients under bupropion treatment and fifty (88.2% male) patients stopped smoking without pharmacotherapy. P wave duration was notably higher when compared before and after smoking cessation with bupropion (99.0 ± 15.7 ms vs 96.2 ± 11.9ms; p<0.001). The frequency of the patients with P wave duration >120 ms was significantly higher in smoking patients. (p=0.014) The frequency of the patients with P wave duration <100 ms was significantly lower in smoking patients.(p=0.001). P wave amplitude in lead I was statistically lower in smoking patients. (p=0.001) The change in P wave duration and P wave amplitude in lead I were positively correlated with the smoking packet/year. (Rho: 0.512, p<0.001 and rho=0.408, p<0.001) Conclusion: Smoking cessation with or without bupropion was demonstrated to shorten P wave duration and increase P wave amplitude in lead I. Smoking cessation with or without bupropion have an effect to reverse atrial electrical remodeling
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    Our sentinel lymph node experience in patients diagnosed with DCIS and microinvasive breast carcinoma
    (2021) Bayramoglu, Zeynep; Omeroglu, Ethem; Koksal, Hande; Eryilmaz, Mehmet Ali; Unlu, Yasar
    Aim: Along with the increased availability of radiologic imaging methods, early identification of tumor tissue, and patient surveillance programs; ductal carcinoma in situ (DCIS) and microinvasive DCIS became more commonly identified in the tru-cut biopsy specimens and resected samples of patients. Pathological examinations of the excision materials from these patients reveal invasive tumors, microinvasions or DCIS alone. Recently, it has become debatable whether to perform a sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS or microinvasive DCIS. In this present study, we evaluated the diagnosis made by examining the excision material, any presence of lymph node metastases, and the relationship of hormone profile to the presence of metastases in the patients diagnosed with DCIS or microinvasive DCIS by the examination of tru-cut biopsy specimens. Based on our study results, we discussed the requirement for SLNB in patients with a tru-cut diagnosis of DCIS or microinvasive DCIS. Materials and Methods: The study included 172 patients, who underwent surgical excision and SLNB after receiving a tru-cut biopsy diagnosis of DCIS and microinvasive DCIS in our hospital from the year 2010 to 2018. Results: Tru-cut biopsy diagnoses were DCIS and microinvasive DCIS in 69.8% (120 patients) and 30.2% (52 patients) respectively. SLNB metastases were identified in 35.8% (n=43) of the DCIS positive patients and 44.2% (n=23) in the microinvasive DCIS positive patients. The diagnosis of invasive ductal carcinoma after mastectomy was made at a rate of 90.0% (n=108) among the DCIS positive patients and 92.3% (n=48) among the microinvasive DCIS positive patients. Conclusion: SLNB metastases were found in 35.8% (n=43) and 44.2% (n=23) of the DCIS positive patients and microinvasive DCIS positive patients, respectively. We conclude that SLNB should be favorably proper to perform in the patients with tru-cut diagnoses of DCIS and microinvasive DCIS because a high rate of SLNB metastases was detected in our DCIS and microinvasive DCIS patients and a high rate of invasive ductal carcinoma diagnosis was made after examining the excision material of these patients.
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    Skin and Gut: Psoriasis and irritable bowel syndrome. Is there an association?
    (2020) Urun Unal, Gulbahar; Marakoglu, Kamile; Eryilmaz, Mehmet Ali; Unal, Mehmet; Kulahci, Orhan
    Aim: The frequent occurrence of psoriasis with gastrointestinal system diseases indicates that psoriasis may also be associated with IBS. We aimed to evaluate the frequency of irritable bowel syndrome in patients with psoriasis and psoriatic arthritis.Material and Methods: Study included 111 patients with psoriasis, and 214 healthy volunteers. The presence of IBS in the psoriasis and control groups was evaluated according to the Rome III diagnostic criteria (Recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months associated with two or more of the following: Improvement with defecation, onset associated with a change in frequency of stool, onset associated with a change in form (appearance) of stool). The participants were also asked about the presence of findings supporting the diagnosis of IBS. The participants were asked about the frequency of defecation, and the stool type was evaluated according to the Bristol stool form scaleResults: 41 (36.9%) patients in the psoriasis group and 27 (12.6%) controls were detected to have IBS( p 0.001). Passage of mucus, abdominal distension, and straining were found more frequently in the psoriasis group than in the control group (p = 0.023, 0.001, and 0.001, respectively). The mean defecation frequency per week was significantly higher in the psoriasis group than in the control group (p = 0.000). The mean value for the Bristol stool scale was 4.12 ± 1.13 for the psoriasis group and 3.72 ± 1.16 for the control group (p = 0.003).Conclusion: The increased frequency of IBS and the findings supporting the diagnosis of IBS in these patients suggest that they have a tendency to develop IBS. The indication of a higher frequency of IBS in patients with psoriatic arthritis is another important outcome of the present study.
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    Zinc oxide, lidocaine, hot water, and lateral internal sphincterotomy for fissure-in-ano: Randomized controlled study
    (2019) Ay, Serden; Eryilmaz, Mehmet Ali; Oku, Ahmet; Karahan, Omer
    Aim: Aim of this study is to compare the effect of zinc oxide pomade, lidocaine pomade, hot water sitting bath and lateral internal sphincterotomy for treatment of chronic anal fissure in terms of healing and complications. Material and Methods: One hundred and forty five patients who were diagnosed with chronic anal fissure between May 2011 and September 2012 at our clinic were enrolled for this prospective randomized trial. All cases were randomized into four groups. Group 1: The patients would apply 15% of zinc oxide pomade twice a day after the 10 minutes of hot water sitting bath. Group 2: The patients would apply 5% of lidocaine pomade twice a day after the 10 minutes of hot water sitting bath. Group 3: The patients would make only 10 minutes of hot water sitting bath twice a day.Group 4: Lateral internal sphincterotomy was performed to the patients. Healing rates, recurrences,changes in symptoms after the treatment and complications were recorded. Results: There were not any difference within the groups in terms of age and gender. The healing in the Sphincterotomy group significantly much more when compared to the other groups at both the third and the sixth weeks(p<0,001).The other groups were similar with the each other(p>0,05). Conclusion: LIS is superior to zinc oxide, lidocaine or hot water applications. There was no difference between the non-operative treatments.