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Öğe Independent predictors of cardiovascular risk in polycystic ovarian syndrome(Taylor & Francis Ltd, 2011) Turkcuoglu, Ilgin; Kafkasli, Ayse; Meydanli, Mehmet Mutlu; Ozyalin, Fatma; Taskapan, CagatayWe aimed to determine the independent predictors of cardiovascular risk in polycystic ovarian syndrome (PCOS). Ninety-one PCOS and 51 control patients were enrolled to our prospective cross sectional case-control study. In early follicular phase hormonal and lipid profile, fasting insulin and CRP (hs-CRP) levels and glucose levels on fasting and 2 h after the 75 g glucose intake were determined. Insulin resistance (IR) was evaluated with homeostasis model assessment and free testosterone was determined with free androgen index. PCOS was found to be associated with dyslipidemia, hyperandrogenism, IR and sub-clinical inflammation. The prevalence of overweight-obesity (41.8% vs. 25.5%, p = 0.038), IR (42.9% vs. 23.5%, p = 0.035) and glucose intolerance (15.38% vs. 1.96%, p = 0.043) were significantly higher in PCOS compared to control group. Independent predictors of the risk of elevated hs-CRP level were PCOS status (OR = 5, 95% CI: 1.55-16.14, p = 0.007) and high BMI (OR = 4.2, 95% CI: 1.2-14.2, p = 0.022) and high BMI (OR = 1.2, 95% CI: 1.05-1.4, p = 0.007) and of TC/HDL ratio was high BMI (OR = 1.21, 95% CI: 1.05-1.4, p = 0.009) and increasing age (OR = 1.11, 95% CI: 1.01-1.2, p = 0.04). The presence of PCOS, independent from obesity and IR, is the strongest predictor of elevated hs-CRP level. Obesity and advanced age further increases the cardiovascular risk in PCOS.Öğe Meydanli Compression Suture: New surgical procedure for postpartum hemorrhage due to uterine atony associated with abnormal placental adherence(Wiley, 2008) Meydanli, Mehmet Mutlu; Turkcuoglu, Ilgin; Engin-Ustun, Yaprak; Ustun, Yusuf; Kafkasli, AyseAim: To inform about the clinical results of a new uterine compression suture technique used in the surgical management of postpartum hemorrhage due to uterine atony associated with abnormal placental adherence. Methods: Postpartum hemorrhage due to uterine atony associated with abnormal placental adherence was diagnosed in seven out of 1819 (0.38%) cesarean sections performed between January 2004 and February 2007, and a new uterine compression suture technique was used for surgical management. Age, parity, gestational age and cesarean section indications, amount of transfusion performed, length of hospital stay, postoperative complications, and number of patients in whom the uterus was preserved were evaluated. Results: The mean age of the cases was 30.5 +/- 3.7 (24-35) years. Cesarean indications were previous cesarean section plus placenta previa totalis in three cases (43%), previous cesarean section in two cases (29%), a twin pregnancy as a result of in vitro fertilization-embryo transfer in one case (14%) and preterm premature rupture of membranes in one case (14%). Six out of seven cases (85%) were successfully treated with the Meydanli compression suture and the uterus was preserved. Conclusion: The Meydanli compression suture seems to be a simple, quickly applicable and safe uterine compression suture technique, which decreases maternal mortality and peripartum hysterectomy rates.Öğe Risk factors for cervical stromal involvement in endometrioid-type endometrial cancer(Wiley, 2021) Toprak, Serhat; Sahin, Eda Adeviye; Sahin, Hanifi; Tohma, Yusuf Aytac; Yilmaz, Ercan; Meydanli, Mehmet MutluObjectiveThe aim of this study was to identify predictors of cervical stromal involvement in women with endometrioid-type endometrial cancer (EEC). MethodsA total of 795 patients with EEC who underwent comprehensive surgical staging including pelvic and para-aortic lymph node dissection between January 2007 and December 2018 were retrospectively analyzed. Data including age, menopausal status, serum CA-125 levels, tumor size, lymphovascular space invasion (LVSI), depth of myometrial invasion, positive peritoneal cytology, cervical stromal involvement, histologic grade, recurrence, and follow-up duration were recorded. ResultsMedian follow up was 49 months. Cervical stromal invasion was found in 88 patients. Multivariate analysis revealed that presence of LVSI (hazard ratio [HR] 2, 95% confidence interval [CI] 1.02-4.25, P = 0.045), a primary tumor diameter of at least 3 cm (HR 3, 95% CI 1.31-7.25, P = 0.010), and at least 50% deep myometrial invasion (HR 2.7, 95% CI 1.37-5.41, P = 0.004) were independent risk factors for cervical stromal involvement in patients with EEC. ConclusionOur study results suggest that presence of LVSI, a primary tumor diameter of at least 3 cm, and LVSI of at least 50% seem to be independent predictors of cervical involvement in women with EEC. Tumor diameter of >= 3 cm, and lymphovascular space invasion >= 50% seem to be independent predictors of cervical involvement in patients with endometrioid-type endometrial cancer.