Publications by authors named "Derya Kilic"

13 Publications

  • Page 1 of 1

Severe Preeclampsia is Associated with Functional and Structural Cardiac Alterations: A Case-control Study.

Z Geburtshilfe Neonatol 2021 Apr 9. Epub 2021 Apr 9.

Department of Cardiology, Pamukkale University, Denizli, Turkey.

Background: The aim of the current study is to compare electrocardiographic and echocardiographic changes in patients with severe preeclampsia (PE) and those with uncomplicated pregnancies.

Methods: This is a case-controlled prospective study consisting of 21 pregnant women with severe preeclampsia and a control group consisting of age- and gestational age-matched 24 healthy pregnant women. All patients underwent electrocardiographic and echocardiographic investigation.

Results: QRS intervals were shorter and PR intervals were longer in the PE group (QRS duration: 80 (60-120) ms and 80 (40-110) ms, p=0.035; PR duration: 160 (100-240) ms and 120 (80-200) ms, respectively; p=0.046). The left ventricular end-systolic diameters of the patients with severe PE group were significantly larger than the control group (31 (24-36) mm and 30 (24-33) mm, respectively; p=0.05). Similarly, posterior wall thickness values of the PE group were significantly higher compared to the control group (9 (7-11) mm vs. 8 (6-10) mm, respectively; p=0.020). Left ventricular mass (146.63±27.73 g and 128.69±23.25 g, respectively; p=0.033) and relative wall thickness values (0.385±0.054 and 0.349±0.046, respectively; p=0.030) were also higher in the PE group. In addition, patients with early-onset severe PE had significantly a higher left ventricular end-diastolic diameter and volume compared with late-onset PE patients.

Conclusions: The structural changes detected in the severe PE group suggest a chronic process rather than an acute effect. In addition, diastolic dysfunction and left ventricular remodeling are most marked in patients with severe early-onset PE.
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http://dx.doi.org/10.1055/a-1403-3585DOI Listing
April 2021

EFFECTS OF ISOLATED POSTERIOR VAGINAL WALL PROLAPSE ON LOWER URINARY TRACT SYMPTOMS.

J Gynecol Obstet Hum Reprod 2021 Apr 13;50(4):102095. Epub 2021 Feb 13.

Department of Obstetrics and Gynecology, Mugla Sitki Kocman University, Mugla, Turkey.

Aim: To investigate the effects of isolated posterior vaginal compartment prolapse to lower urinary tract symptoms (LUTS).

Materials-methods: Patients who were admitted with any kind of LUTS and diagnosed with posterior compartment defects were retrospectively analyzed at urogynecology units of 2 different tertiary referral centers. Patients were included in the analysis if they had isolated posterior vaginal compartment defects with no clinically significant anterior and apical compartment defects. The control group consisted of patients with no pelvic organ prolapse (POP). All pelvic examinations were performed by the same 2 specialists. The responses to a detailed LUTS questionnaire in the unit were assessed.

Results: Of the 340 women with posterior POP, 280 were excluded from the analysis due to combined anterior and/or apical POP with posterior POP and stage 4 POP. When we compared the symptoms between the control group and the remaining 60 patients with isolated posterior POP, there was a statistically significant difference in urge, frequency, nocturia, abnormal emptying, vaginal winding, difficult stool passage (p = 0.031, p < 0.001, p < 0.001, p = 0.022, p = 0.041, and p = 0.039, respectively).

Conclusion: Women with posterior POP should be carefully examined not only for anorectal or bulging symptoms but also for LUTS.
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http://dx.doi.org/10.1016/j.jogoh.2021.102095DOI Listing
April 2021

Association between endometriosis and increased arterial stiffness.

Kardiol Pol 2021 01 8;79(1):58-65. Epub 2020 Dec 8.

Background: Endometriosis is a common gynecologic disease associated with systemic inflammation and atherogenic risk factors. Therefore, women with endometriosis may have increased cardiovascular risk.

Aims: We aimed to evaluate arterial stiffness using cardio-ankle vascular index (CAVI) in women with and without endometriosis.

Methods: We enrolled 44 patients with endometriosis and 76 age‑matched controls without endometriosis.Endometriosis was diagnosed based on histopathologic examination or magnetic resonance imaging. Arterial stiffness was evaluated using CAVI in all study participants.

Results: No differences were observed between patients and controls in terms of age (median [interquartile range, IQR], 30 [24.25-5] years and 26 years [24-35] years, respectively), body mass index (median [IQR], 23.31 [20.82-24.98] kg/m2 and 23.74 [21.13-26.78] kg/m2, respectively), or waist circumference (median [IQR], 69 [64-75] cm and 72 [65-81.25] cm, respectively). C‑reactive protein levels were higher in women with endometriosis than in controls (median [IQR], 0.27 [0.14-0.68] mg/dl vs 0.12 [0.06-0.24] mg/dl; P <0.001). Left ventricular ejection fraction, left ventricular mass index (LVMI), relative wall thickness, as well as systolic and diastolic blood pressures were similar in both groups. Women with endometriosis had higher CAVI than controls (mean [SD], 5.961 [0.644] vs 5.554 [0.654]; P = 0.001). Elevated arterial stiffness was observed in the endometriosis group also after adjustment for age and LVMI.

Conclusions: Our results indicate increased arterial stiffness measured by CAVI in women with endometriosis. Therefore,clinicians should be aware that these patients may be at increased cardiovascular risk.
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http://dx.doi.org/10.33963/KP.15706DOI Listing
January 2021

An alternative technique in surgical correction of anterior compartment prolapse; Iliococcygeal fixation of the pubocervical fascia by native tissue repair.

J Gynecol Obstet Hum Reprod 2021 Apr 6;50(4):101979. Epub 2020 Nov 6.

Department of Obstetrics and Gynecology, Mugla Sitki Kocman University, Mugla, Turkey.

Aim: To present 'bilateral iliococcygeal fixation of the pubocervical fascia' as an alternative vaginal surgical technique for anterior compartment repair with native tissue and the surgical outcomes of 30 cases.

Materials-methods: The consecutive 30 cases who admitted to urogynecology clinic with anterior vaginal prolapse/cystocele and underwent anterior compartment repair by bilateral iliococcgeal fixation of the pubocervical fascia by native tissue were included to the study. All cases attended to the postoperative follow-up visits at the sixth and the twelfth months.

Results: There were no major or minor intraoperative complications. Overall, in 28 (93.3 %) patients surgical success was achieved at the postoperative 12th month when it was defined as the maximum descent of the anterior segment was proximal to the hymen. During the study period, none of the patients requested or admitted for re-treatment for anterior compartment prolapse. Subjective cure that was assessed by the absence of bulge symptoms was achieved in 29 cases (96.7 %) at first year follow-up. Lower urinary tract symptoms (LUTS) were found to be significantly lower at the first-year postoperative visit compared to pre-operative evaluation. A clinically significant improvement in the quality of life parameters were also noted (mean PFIQ-7 scores = 8.5, 5.6 and 50.8, respectively).

Conclusion: Bilateral iliococcygeal fixation of the pubocervical fascia seems to be effective in surgical correction of anterior vaginal prolapse according to our post-operative follow-up results. It is an easy to learn procedure with low complication rates and associated with high patient satisfaction.
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http://dx.doi.org/10.1016/j.jogoh.2020.101979DOI Listing
April 2021

Arterial stiffness measured by cardio-ankle vascular index is greater in non-obese young women with polycystic ovarian syndrome.

J Obstet Gynaecol Res 2021 Feb 4;47(2):521-528. Epub 2020 Nov 4.

Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.

Aim: The association of metabolic abnormalities and polycystic ovarian syndrome (PCOS) has been documented, but few studies have focused on cardiovascular risk in these women. The aim of this study was to compare arterial stiffness by using the cardio-ankle vascular index (CAVI) in PCOS women with controls, and to evaluate whether any clinical or laboratory variables had independent associations with it.

Methods: A group of 160 women, matched for age and body mass index were recruited. Diagnosis of PCOS was made according to the Rotterdam criteria. Arterial stiffness using CAVI was evaluated in non-obese young woman, with and without PCOS.

Results: In the PCOS group (n = 80), 60 cases (75%) had findings of hyperandrogenism, 59 (73.8%) had ovulatory dysfunction, and 70 (87.5%) had an ultrasonographic appearance of polycystic ovaries. Women with PCOS had significantly higher mean CAVI values when compared to subjects without PCOS (5.78 ± 0.64 vs 5.28 ± 0.77, P < 0.001). Multiple regression analysis revealed that androgen excess was associated with increased arterial stiffness, independent of ovulatory dysfunction, polycystic ovaries, body mass index and age.

Conclusion: This data suggests that vascular compliance is decreased in young women with PCOS. Androgen excess is independently associated with increased arterial stiffness.
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http://dx.doi.org/10.1111/jog.14543DOI Listing
February 2021

Comparison of serum adiponectin and osteopontin levels along with metabolic risk factors between obese and lean women with and without PCOS.

Endokrynol Pol 2020 30;71(6):497-503. Epub 2020 Oct 30.

Department of Obstetrics and Gynaecology, Pamukkale University Medical School, Denizli, Turkey.

Introduction: The objective of this study was to investigate the possible relation between serum adiponectin and osteopontin levels as metabolic risk markers among women with different polycystic ovary syndrome (PCOS) phenotypes.

Material And Methods: In a University Hospital setting PCOS patients diagnosed according to Rotterdam Consensus Conference criteria with body mass index (BMI) between 18 and 35 were recruited.

Results: Overall, 57 PCOS patients and 57 age- and BMI-matched healthy controls were included in the study. Luteinising hormone (LH) to follicle-stimulating hormone FSH ratio (LH/FSH), free androgen index (FAI), and dehydroepiandrosterone sulphate (DHEAS-S) was found to be significantly higher in women with PCOS. There was significant interaction between PCOS status and obesity for serum adiponectin levels. Although mean adiponectin and osteopontin levels were similar among cases and controls, a further two-way ANOVA comparison within lean and obese subgroups revealed adiponectin to be significantly lower in lean PCOS women than in lean controls. LH/FSH ratio and adiponectin levels were all found to differ between lean counterparts; however, they did not show any correlation with metabolic markers [cholesterol, homeostatic model assessment (HOMA) or C-reactive protein (CRP) levels] in overall lean women or in the lean PCOS subgroup.

Conclusion: Serum adiponectin levels in lean PCOS women were significantly lower than those in lean controls. On the other hand, mean adiponectin and osteopontin levels were similar in PCOS cases and controls overall.
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http://dx.doi.org/10.5603/EP.a2020.0074DOI Listing
October 2020

Predictors of Human papillomavirus (HPV) persistence after treatment of high grade cervical lesions; does cervical cytology have any prognostic value in primary HPV screening?

Ann Diagn Pathol 2020 Dec 8;49:151626. Epub 2020 Sep 8.

Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.

Objective: This study aimed to determine the factors associated with Human Papillomavirus (HPV) persistence in women undergoing cervical excision for pre-invasive lesions, after they have been referred from a primary HPV screening program.

Methods: A retrospective study design involving patients who were treated at a Cervical Disease Screening and Treatment Unit, in a university hospital setting. After initial treatment, cervical HPV infection status was analyzed at the sixth month, first year and then subsequently after the second year.

Results: Totally, 395 patients who were diagnosed with pre-invasive cervical lesions and who subsequently undergone cervical excision were identified. In the first-year visit after cervical excision, HPV 18 was cleared in almost all (95.8%) cases, followed by HPV 16 (69.9%) and other hrHPV types (65.6%). Available data documented that 88.6% of women reached clearance after the two-year follow-up. Univariate analysis revealed a significantly higher proportion of HPV clearance among women who were younger (p = 0.019), premenopausal (p = 0.002), and who had been found to have a negative cytology result on their initial Pap test (p = 0.018). However, only cervical cytology result remained as the independent predictor of HPV persistence on a multivariate logistic regression (OR 0.43; 95% CI 0.21-0.87; p = 0.019).

Conclusions: A low risk of HPV persistence was found among every HPV genotype in women undergoing cervical excision for pre-invasive cervical lesions. Initial cervical cytology result was the only independent predictor of HPV clearance during surveillance, which indicates the prognostic value of Pap test in primary HPV screening.
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http://dx.doi.org/10.1016/j.anndiagpath.2020.151626DOI Listing
December 2020

Does apical prolapse in addition to early stage anterior prolapse have any effect on lower urinary tract symptoms?

J Gynecol Obstet Hum Reprod 2021 Jan 22;50(1):101922. Epub 2020 Sep 22.

Department of Obstetrics and Gynecology, Mugla Sitki Kocman University, Mugla, Turkey.

Objective: To investigate whether apical prolapse in addition to early-stage anterior prolapse has any effect on lower urinary tract symptoms (LUTS).

Methods: Patients with early-stage pelvic organ prolapse (POP) were retrospectively analyzed at the urogynecology unit of a tertiary referral center. Cases with posterior POP were excluded, and the remaining women were distributed across four main groups: (1) no determinable anterior and/or apical POP (control); (2) isolated anterior POP; (3) anterior + apical POP; and (4) isolated apical POP. Each LUTS symptom in these groups was recorded. Women with isolated anterior POP and women with anterior + apical POP were then compared to define the additional effects of apical prolapse on LUTS. In order to asses; symptoms of urgency, urinary incontinence, stress urinary incontinence, frequency, abnormal emptying, hesitancy, interrupted stream, nocturia, post-micturition dribble, and dysuria were noted and Incontinence Impact Questionnaire (IIQ-7), and domains of Urinary Distress Inventory (UDI-6) were compared between the groups.

Results: Of the 225 patients, 66 were excluded from the analysis due to accompanying posterior compartment defect. There was no statistically significant difference for age, systemic disease history, or smoking status between the groups (p > 0.05). However, history of traumatic vaginal delivery was significantly lower in the control group than in the other groups (p = 0.039). The prevalence of hesitancy and interrupted stream were found to be significantly higher in the anterior + apical POP group than in the isolated POP group (p<0.05). Obstructive subscale of the Urinary Distress Inventory was higher both in the isolated anterior POP and anterior + apical POP groups than the control group (p<0.05).

Conclusion: The current study demonstrates that even minimal loss of apical support accompanying anterior prolapse exacerbates LUTS.
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http://dx.doi.org/10.1016/j.jogoh.2020.101922DOI Listing
January 2021

Does cervicovaginal cytology have a role in the diagnosis and surveillance of endometrial adenocarcinoma?

Diagn Cytopathol 2020 Jul 25;48(7):629-634. Epub 2020 Apr 25.

Department of Pathology, Izmir Katip Celebi University Ataturk Teaching and Research Hospital, Izmir, Turkey.

Objective: To examine the role of cervicovaginal cytology in diagnoses and surveillance of the patients with endometrial carcinoma (EC).

Methods: Patients who underwent EC surgery that included a follow-up were reviewed retrospectively. The cohort was limited to the patients who had an available cervical cytology result within 12 months before the primary surgery took place. The glandular abnormalities were classified in the following subclassifications: "atypical glandular cells" (AGC)-not otherwise specified (NOS), AGC-favor neoplasia, endocervical AIS, and adenocarcinoma.

Results: A total of 411 patients were eligible for the study. The cervical cytology was found to be normal and recorded as negative for intraepithelial lesion or malignancy in 368 (89.5%) patients. In 43 (10.5%) patients, cervical cytology was interpreted as: AGC-NOS (n = 11), AGC-FN (n = 7), adenocarcinoma (n = 20), malignant epithelial tumor (n = 3), and squamous carcinoma (n = 2). During the follow-up, recurrence was observed in 53 (12.9%) patients. Among six isolated vaginal cuff recurrences, two of the cases presented with malignant cytology, and the additional four cases were suspected during clinical examination. Among women with recurrence (n = 53), there were malignant cytological findings in four of the patients. In the whole population (n = 411), there were four other abnormal cytological findings detected within the surveillance. These four cytology results were nonmalignant and no recurrence was identified.

Conclusion: There is no significant clinical advantage of cervicovaginal cytology testing before diagnosis or during the surveillance of EC.
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http://dx.doi.org/10.1002/dc.24444DOI Listing
July 2020

Multicenter analysis of gestational trophoblastic neoplasia in Turkey.

Asian Pac J Cancer Prev 2014 ;15(8):3625-8

Department of Obstetrics and Gynecology, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey E-mail :

Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey.

Materials And Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated.

Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients.

Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
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http://dx.doi.org/10.7314/apjcp.2014.15.8.3625DOI Listing
January 2015

Vegetation geography of western part of Elmacik mountain, Turkey.

J Environ Biol 2012 Apr;33(2 Suppl):293-305

Department of Geography, Faculty of Science and Art, Sakarya University, Sakarya, 54187, Turkey.

The study examines the western part of Elmacik mountain from the perspective of vegetation geography. Research area is within the phytogeographical region of Euro-Siberian that is among the flora and phytogeographical region of Turkey. According to Turkey's grid square system, the research area is located in the A3 square. The main elements of forest formation consist of Fagus orientalis, Abies nordmanniana subspp. bommuelleriana, Pinus nigra subsp. pallasiana, Pinus sylvestris, Quercus spp., Platanus orientalis and Tilia argentea. Humid forests are dominant and the main elements of shrub formation consist of Buxus sempervirens, Rubus sanctus and especially Rhododendron ponticum subsp. ponticum. The main herbaceous formation area consists of Digitalis ferruginea subsp. ferruginea, Fragaria vesca, Euphorbia falcata, Crocus colchicum kotschyi and Verbascum sp. Distribution of natural vegetation varies due to climate, soils and morphologic character and of the research area. This situation was examined and defined by applying field surveys and geographical information systems.
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April 2012

Remote sensing and GIS-based integrated analysis of land cover change in Duzce plain and its surroundings (north western Turkey).

Environ Monit Assess 2013 Feb 16;185(2):1699-709. Epub 2012 May 16.

Department of Geography, Art and Science Faculty, Sakarya University, 54100 Sakarya, Turkey.

The aim of this study is to research natural land cover change caused by the permanent effects of human activities in Duzce plain and its surroundings, and to determine the current status of the land cover. For this purpose, two Landsat TM images were used in the study for the years 1987 and 2010. These images are analysed by using data image processing techniques in ERDAS Imagine©10.0 and ArcGIS©10.0 software. Land cover change nomenclature is classified according to the Coordination of Information on the Environment Level 2 Classification (1--urban fabric, 2--industrial, commercial and transport units, 3--heterogeneous agricultural areas, 4--forests, and 5--inland wetlands). Furthermore, the image analysis results are confirmed by the field research. According to the results, a decrease of 33.5 % was recorded in forest areas from 24,840.7 to 16,529.0 ha; an increase of 11.2 % was recorded in heterogeneous agricultural areas from 47,702.7 to 53,051.7 ha. Natural vegetation, which is the large part of land cover in the research area, has been changing rapidly because of rapid urbanisation and agricultural activities. As a result, it is concluded that significant changes have occurred on the natural land cover between the years 1987 and 2010 in the Duzce plain and its surroundings.
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http://dx.doi.org/10.1007/s10661-012-2661-6DOI Listing
February 2013

The effects of ageing and sulfur dioxide inhalation exposure on visual-evoked potentials, antioxidant enzyme systems, and lipid-peroxidation levels of the brain and eye.

Authors:
Derya Kilic

Neurotoxicol Teratol 2003 Sep-Oct;25(5):587-98

Department of Physics, Faculty of Arts and Science, Akdeniz University, Kampus, 07058, Antalya, Turkey.

The effects of ageing and 10 ppm sulfur dioxide (SO(2)) inhalation exposure on visual-evoked potentials (VEPs), thiobarbituric acid reactive substances (TBARS), a product of lipid peroxidation, and the activities of Cu, Zn superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) of brain and eye were investigated in young (3-month), adult (12-month), and mature (24-month) Swiss male albino rats. The experimental groups were placed in an exposure chamber containing a constant level of 10 ppm SO(2), while control groups were placed in an exposure chamber, which was continually pumped with filtered air, for 1 h/day x 7 days/week for 6 weeks. SO(2) inhalation exposure caused increased levels of brain, retina, and lens Cu, Zn SOD activity, and decreased levels of brain and lens GSH-Px activity in all experimental groups with respect to their corresponding control groups, whereas no change was observed in the level of retina GSH-Px activity. No alterations were observed in brain CAT activity. On the other hand, retina CAT activity was slightly decreased in SO(2)-exposed rats, but no change was observed in their lens CAT activity. The brain and lens TBARS levels of all SO(2)-exposed groups were significantly increased in comparison with their respective control groups. The amount of TBARS was only increased in the retina of the SO(2)-exposed 3-month group compared with its control. Of the SO(2)-exposed rats, the mean latencies of the P(1), N(1), P(2), and P(3) components of the 3-month group, P(1), N(1), and N(2) components of the 12-month group, and only P(3) of the 24-month group were significantly prolonged in comparison with those of their control groups. The amplitudes of N(1)P(2) and P(2)N(2) in the 12- and 24-month control groups were significantly decreased compared with those of the 3-month group. On the other hand, no differences were observed among those of SO(2)-exposed groups. These findings suggest that ageing and SO(2) inhalation exposure have the potential to induce antioxidant enzymes in the brain and eye, and VEP alterations, which are the primary target for air pollutants. It could be concluded that lipid peroxidation could play a critical role in the mechanism responsible for VEP alterations with ageing.
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http://dx.doi.org/10.1016/s0892-0362(03)00090-4DOI Listing
December 2003