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1.
Turk J Obstet Gynecol ; 21(2): 78-84, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38853482

RESUMO

Objective: The objective of this study was to assess the effectiveness of myoinositol (4 g myoinositol + 400 mcg folic acid/day) compared with metformin (average 1700 mg/day), as well as the combined efficacy of both treatments in managing insulin-resistant polycystic ovary syndrome (PCOS) among women. Materials and Methods: We retrospectively analyzed the records of 68 reproductive-age PCOS patients with insulin resistance over a 3-month period. Oral glucose tolerance tests (OGTT) (75 gr) were conducted to measure glucose levels at 0 and 120 min. Moreover, changes in prolactin, thyroid stimulating hormone, high-density lipoprotein, low-density lipoprotein, triglyceride levels, total cholesterol, follicle-stimulating hormone, luteinizing hormone, total testosterone, free testosterone, and dehydroepiandrosterone sulfate (DHEA-S) levels were evaluated pre- and post-treatment over a 3-month period. Results: Statistically significant improvements were observed in menstrual regularity, body mass index (BMI), modified Ferriman Gallwey scores, OGTT glucose levels at 0 and 120 min, total testosterone, free testosterone, and DHEA-S levels across all groups (p<0.005). Conclusion: No significant variances were observed in terms of BMI, modified Ferriman Gallwey scores, or androgen levels across the three treatment cohorts. The combination of myoinositol and metformin did not confer additional benefits compared with either treatment alone.

2.
Turk J Obstet Gynecol ; 20(2): 97-104, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37260166

RESUMO

Objective: This study aimed to present our single-center clinical experience regarding tumor clinicopathologic features, treatment modalities, and reproductive and oncologic outcomes in patients with non-epithelial ovarian cancer (NEOC) over 25 years. Materials and Methods: A total of 100 patients with clinicopathological diagnosis of NEOC who were treated at our tertiary care center between 1996 and 2022 were included in this retrospective cohort analysis study. Data on demographic, clinical and obstetric characteristics of patients at the time of initial diagnosis as well as tumor clinicopathologic features, treatment modalities, and oncological and reproductive outcomes were recorded. Results: NEOCs involved germ cell tumors (GCTs) in 46 (46%) patients and sex cordstromal tumors (SCSTs) in 54 (54%) patients. Thirty patients with GCTs and thirty-four patients with SCSTs possessed histological subtypes with malignant features. Most patients with GCTs (37%) and SCSTs (55.6%) had FIGO Stage 1 disease at the time of initial diagnosis. Overall, 76.6% of patients in the GCT group (n=23) underwent fertility-sparing surgery (FSS), while 76.5% of the patients in the SCST group (n=26) were treated with non-fertility-sparing surgical procedures. All patients who underwent FSS and had a recurrence in their follow-up (n=4) was stage 3 patients. Seven out of 10 patients (2 patients at stage 3 and 5 patients at stage 1) who desired pregnancy delivered between 38 and 40 gestational weeks without any congenital anomaly. The prognosis was excellent in both groups, with 5-year overall survival (OS) rates of 93.5% in GCTs and 96.3% in SCST groups. The 5-year disease-free survival was 89.1% in GCTs and 94.4% in SCSTs. FSS was not associated with worse oncologic outcomes. Conclusion: NEOCs usually have a good prognosis because they are detected at an early stage. FSS may be indicated for women of reproductive age with early-stage NEOCs.

5.
Int J Clin Exp Pathol ; 15(7): 289-295, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35949811

RESUMO

Ovarian torsion refers to partial or complete rotation of the ovary on its ligamentous support, often resulting in partial or complete obstruction of its blood supply. It is one of the most common gynecologic surgical emergencies and may affect females of all ages, but it is relatively rare in postmenopausal women. Chronic adnexal torsion with complete occlusion of the ovarian blood supply results in necrosis and loss of ovarian function. Clinical symptoms and signs are not specific and definitive diagnosis is often challenging. In this case report, we present a 65-year-old woman with chronic ovarian torsion that was detected 7 years after vaginal hysterectomy. Approximately 3% of postmenopausal cases with adnexal torsion are associated with malignancy. Ovarian torsion incidence is low in postmenopausal ovarian cancer due to the progression of accompanying inflammation, which causes immobility of the ovarian mass.

7.
Int J Surg Oncol ; 2021: 8290659, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34567803

RESUMO

AIM: To evaluate the clinicopathological features affecting the recurrence and survival of 9 cases of neuroendocrine cancer of the cervix. METHOD: We retrospectively analyzed 9 cervical neuroendocrine cancer cases identified among 453 cervical cancer patients between 2004 and 2021 at Akdeniz University Gynecological Oncology Outpatient Clinic. Kaplan-Meier survival analysis was used for progression-free survival (PFS) and overall survival (OS). Mathematical functions of mean, standard deviation, median, Min-Max values, and frequencies were used for descriptive statistics. The categorical data were expressed in numbers and percentages (%). RESULTS: Nine patients with neuroendocrine histological subtype were selected out of 453 patients diagnosed with cervical cancer (1.98%). The average overall survival time of the patients was 26 months. The 5-year survival rate was 53.3%, while the PFS was 62.5%. The most common subtype was small cell neuroendocrine cancer. Tumours were mostly locally advanced at the time of diagnosis. 3 patients' stage was 1b2, while 4 patients were 2b, 1 patient was 3c2r, and 1 patient was 4b. All tumours showed the immunohistochemical staining properties of neuroendocrine cancer. The main treatment modality applied to our patients was surgery + adjuvant CRT. The most used chemotherapeutic agents were cisplatin/carboplatin and etoposide. Recurrence was found in 3 cases, including 5 deaths. CONCLUSION: Neuroendocrine tumour of the cervix is a rare subtype with a poor prognosis. Unfortunately, there is not yet a standard treatment protocol due to the limited number of comparative studies of surgery, chemotherapy, and radiotherapy based treatment schemes.


Assuntos
Carcinoma Neuroendócrino , Neoplasias do Colo do Útero , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/tratamento farmacológico , Carcinoma Neuroendócrino/cirurgia , Cesárea , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
8.
Int J Clin Exp Pathol ; 14(6): 741-745, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34239676

RESUMO

Cholesterol granuloma is a consequence of a chronic inflammatory reaction with accumulation of cholesterol crystals in the tissue. Ovarian cholesterol granuloma is rarely reported in the literature and can be misdiagnosed as ovarian cancer during surgery due to pelvic fibrosis and adhesion secondary to chronic inflammation, especially in postmenopausal women. We present a patient who had been referred to our gynecologic oncology clinic. The patient was a 65-year-old overweight female. She was referred to our tertiary hospital due to suspicion of ovarian cancer since she had CA 125 level above 3000 U/ml with a pelvic mass. To date, no cases of cholesterol granuloma causing CA 125 level above 3000 U/ml have been reported in the literature. We performed an elective diagnostic laparotomy to rule out occult malignancy. After removing the mass, it was sent for frozen section intraoperative consultation. Grossly the mass had irregular surface with yellow-brown appearance. The final diagnosis of cholesterol granuloma with serous cystadenofibroma was made. No evidence of malignancy was found. Symptoms, clinical and intraoperative findings of ovarian choloesterol granuloma can be misdiagnosed as cancer. Since the final diagnosis of a pelvic mass depends on histologic analysis, cholesterol granuloma should be kept in mind as a differential diagnosis of pelvic mass.

9.
J Matern Fetal Neonatal Med ; 26(9): 920-5, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23330916

RESUMO

OBJECTIVE: Increased neonatal morbidity and mortality rates resulting from preterm delivery (PTD) remain as a problem despite increasing evidence about the physiology of uterine contractility process. More predictive signs of preterm labor detected on prenatal ultrasonography like the presence of cervical gland area (CGA) on transvaginal ultrasonography can be a reassuring finding among patients with threatened labor risk. METHODS: In this prospective study, 85 pregnant patients at 24-34 weeks of gestation who attended to our high risk pregnancy clinic for threatened labor between March 2011 and March 2012 have been examined by transvaginal ultrasonography to evaluate CGA located around the endocervical canal. Following discharge, the gestational week at birth, birth weight and birth route of patients have been recorded. RESULTS: Among patients with a cervical length (CL) <30 mm and ≥30 mm measured by transvaginal ultrasonography on admission, 82.4% of the patients with a short cervix exhibiting echolucent endocervical glandular area and 42.3% of the patients with short cervix exhibiting echogen endocervical glandular area on sonography delivered at term (p = 0.013). CONCLUSION: The presence of CGA detected on transvaginal ultrasonography especially when combined with the evaluation of CL during the management of patients with threatened labor can be a reassuring sign for actual probability of PTD.


Assuntos
Colo do Útero/diagnóstico por imagem , Trabalho de Parto Prematuro/diagnóstico por imagem , Nascimento Prematuro/prevenção & controle , Tocólise , Ultrassonografia Pré-Natal/métodos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Masculino , Trabalho de Parto Prematuro/tratamento farmacológico , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Gravidez de Alto Risco , Nascimento Prematuro/diagnóstico por imagem , Nascimento Prematuro/epidemiologia , Prognóstico , Vagina/diagnóstico por imagem , Adulto Jovem
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