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OBJECTIVE: The aim of the present study was to evaluate the importance of visceral adiposity indicators on metabolic parameters in postmenopausal women. MATERIALS AND METHODS: This cross-sectional study included 200 postmenopausal subjects. Postmenopausal women were divided into two groups based on the presence of metabolic syndrome (MetS) as MetS+ and MetS-. Comparisons of clinical and metabolic characteristics were performed between the groups. RESULTS: The current study included 200 postmenopausal women and 63 subjects were diagnosed as having MetS. Postmenopausal women with MetS demonstrated significantly higher values with respect to systolic and diastolic blood pressures, body mass index (BMI), waist-hip ratio (WHR), triglyceride (TG), lipid ratios, Homeostasis Model Assessment Insulin Resistance (HOMA) index, TG glucose (TyG), Visceral Adiposity Index (VAI), and lipid accumulation product (LAP) when compared with women without MetS. Correlation analyses showed that LAP and VAI were positively correlated with waist circumference, WHR, BMI, TG, lipid ratios, TyG and HOMA index, and with each other. LAP was also positively correlated with blood pressures. CONCLUSION: Visceral adiposity indicators may be useful as predictors of MetS in postmenopausal women.
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OBJECTIVE: The aim of the study was to assess serum cathepsin B, D, and L concentrations in women with late-onset preeclampsia. MATERIALS AND METHODS: One hundred forty pregnant women were enrolled in the study, of which 100 subjects were preeclamptic and 40 were healthy controls. Serum concentrations of cathepsin B, D, and L were measured and compared between the preeclamptic and control groups. RESULTS: Cathepsin B and D concentrations were significantly higher in the preeclamptic group compared with the control group. There was no statistically significant difference between the groups in terms of cathepsin L concentrations. Cathepsin B concentrations were significantly higher in women with preeclampsia with severe features compared with those with preeclampsia alone. CONCLUSION: Women with late-onset preeclampsia have significantly higher serum cathepsin B and D concentrations than controls. Cathepsin B and D may be promising biomarkers in women with late-onset preeclampsia.
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This study was performed to assess the impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on clinical, hormonal, and metabolic parameters in lean women with PCOS. Retrospective analysis of 120 consecutive lean PCOS subjects was performed. Subjects were divided into two groups according to HOMA-IR, as IR + and IR-. A HOMA-IR value above 2.5 was used to indicate IR. Clinical, hormonal and metabolic parameters were compared between the two groups. Correlations between LAP and VAI and clinical, hormonal, metabolic features in women PCOS were analyzed. One hundred twenty lean PCOS subjects were enrolled, of which 39 were insulin resistant. Comparison of group means showed significantly higher values for TG levels, FAI, FGS, TG/HDL-c, TyG, LAP, and VAI indexes and lower values for glucose/insulin ratio and QUICKI in the IR + group. LAP and VAI were both found to be positively correlated with each other and with WC, FAI, FGS, TG, TC levels, lipid ratios, TyG index, and HOMA-IR and negatively correlated with Glucose/Insulin ratio, QUICKI, and HDL-c in lean women with PCOS. LAP and VAI may be promising in early identification of IR and cardiometabolic risk and may be useful for the assessment of hyperandrogenism in lean women with PCOS.
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Adiposidad/fisiología , Índice de Masa Corporal , Resistencia a la Insulina/fisiología , Producto de la Acumulación de Lípidos/fisiología , Lípidos/sangre , Síndrome del Ovario Poliquístico/sangre , Adulto , Andrógenos/sangre , Glucemia , Colesterol/sangre , Estudios Transversales , Femenino , Humanos , Estudios Retrospectivos , Circunferencia de la Cintura/fisiología , Relación Cintura-Cadera , Adulto JovenRESUMEN
PURPOSE: This study aimed at evaluating galectin-3 levels as a novel metabolic biomarker in women with PCOS. METHODS: Ninety consecutive women with PCOS fulfilling the inclusion criteria were divided into two groups according to the presence of metabolic syndrome as MetS+ and MetS-. Clinical, hormonal, and metabolic parameters and galectin-3 levels were compared between the groups. Correlation analyses were performed between galectin-3 and clinical and metabolic parameters. RESULTS: Ninety PCOS subjects were enrolled in the study, 25 of which were diagnosed with MetS. Waist-to-hip ratio, systolic and diastolic blood pressures, triglyceride, HOMA-IR, FAI, FGS, and galectin-3 levels were significantly higher in the MetS+ group compared with the MetS- group (13.19 ± 5.63 vs 9.37 ± 3.99 ng/mL, respectively, p = 0.001). HDL cholesterol was significantly higher in the MetS- group than in the MetS+ one. Galectin-3 levels were found to be positively correlated with systolic blood pressure (r = 0.450, p < 0.01), diastolic blood pressure (r = 0.293, p < 0.01), and triglyceride levels (r = 0.218, p < 0.05) in women with PCOS. CONCLUSIONS: Galectin-3 may be a promising novel biomarker in women with PCOS. Galectin-3 levels were significantly higher in the MetS+ group compared with the MetS- one and positively correlated with systolic, diastolic blood pressures and triglyceride levels in women with PCOS.
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Galectina 3/sangre , Síndrome del Ovario Poliquístico/sangre , Adulto , Biomarcadores/sangre , Presión Sanguínea , Proteínas Sanguíneas , Femenino , Galectinas , Humanos , Lípidos/sangre , Síndrome del Ovario Poliquístico/fisiopatologíaRESUMEN
Objective This study was performed to compare the vasomotor symptoms and bone mineral density of postmenopausal women with and without metabolic syndrome. Methods We performed a cross-sectional study of 200 postmenopausal women attending routine health check-ups at Marmara Faculty of Medicine Pendik Training and Research Hospital from June 2015 to December 2015. The vasomotor symptoms scored were hot flashes and night sweats. Metabolic syndrome was defined using the consensus criteria of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Results Women with vasomotor symptoms had no metabolic syndrome and were younger than those without vasomotor symptoms. There was no significant difference in vasomotor symptoms between patients with osteopenia in the femoral neck, total femur, and spine and patients with normal bone mineral density. The vasomotor symptoms were similar between smokers and nonsmokers. Conclusion The presence of metabolic symptoms is inversely associated with metabolic syndrome in postmenopausal women. Lipid abnormalities and a high body mass index may be important metabolic components associated with these symptoms. No relationship is present between vasomotor symptoms and the bone mineral density of the spine, femoral neck, and total femur.
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Densidad Ósea/fisiología , Sofocos/fisiopatología , Síndrome Metabólico/fisiopatología , Posmenopausia/fisiología , Sudoración/fisiología , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Calidad de Vida , Sistema Vasomotor/fisiopatologíaRESUMEN
The objective of this study was to investigate cardiotrophin-1 (CT-1) levels as a new metabolic biomarker in women with polycystic ovary syndrome (PCOS). One hundred consecutive women with PCOS were divided into two groups according to presence of metabolic syndrome as MetS+ and MetS-. Clinical, hormonal and metabolic parameters in addition to CT-1 levels were compared between the groups. Correlation analyses were performed between CT-1 and clinical and metabolic parameters in women with PCOS. One hundred PCOS subjects were enrolled in the study, of which 29 subjects were diagnosed with metabolic syndrome. WHR, systolic and diastolic blood pressures, triglyceride, total cholesterol, HOMA-IR, FAI, FGS and CT-1 levels were significantly higher in the MetS+ group compared with the MetS- group. HDL cholesterol was significantly higher in the MetS- group than the MetS+ one. CT-1 levels were found to be positively correlated with diastolic blood pressure, TG levels and FGS. Cardiotrophin-1 may be a promising new metabolic biomarker in women with PCOS. CT-1 may be beneficial for estimating the risk of long-term adverse health consequences and establishing early intervention and preventation strategies.
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Citocinas/sangre , Resistencia a la Insulina/fisiología , Síndrome Metabólico/sangre , Síndrome del Ovario Poliquístico/sangre , Adulto , Biomarcadores/sangre , Glucemia/metabolismo , Índice de Masa Corporal , Colesterol/sangre , Femenino , Humanos , Triglicéridos/sangre , Adulto JovenRESUMEN
AIM: To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology. METHODS: One hundred and six parous women aged 33-48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow. The women were followed up at 1, 3, 6, 12, 18, and 24 months following the insertion of the intrauterine device. RESULTS: One hundred and two women completed the follow-up period and had a significant reduction in the amount of menstrual blood loss. The LNG-IUS was well tolerated by all women. Pre-treatment of the use of the LNG-IUS, endometrial biopsy patterns for irregular proliferative endometrium and for atypical simple hyperplasia were 34/106 (32.08%) and 61/106 (57.55%) respectively and after treatment no abnormal pathologic findings were determined (p < 0.001). CONCLUSION: Our findings indicate that the LNG-IUS is effective for significantly reducing the amount of menstrual blood loss in women with HMB.
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Anticonceptivos Femeninos/administración & dosificación , Endometrio/patología , Dispositivos Intrauterinos Medicados/efectos adversos , Levonorgestrel/administración & dosificación , Menorragia/terapia , Adulto , Anticonceptivos Femeninos/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Levonorgestrel/efectos adversos , Menstruación/efectos de los fármacos , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , TurquíaRESUMEN
This study was performed to assess insulin resistance (IR) in lean women with polycystic ovary syndrome (PCOS). Retrospective analysis of 100 consecutive lean (body mass index <25 kg/m2) PCOS subjects was performed. Subjects were divided into two groups according to homeostasis model assessment IR index (HOMA-IR), as IR + and IR-. A HOMA-IR value >2.5 was used to indicate IR. A total of 100 lean PCOS subjects were enrolled in the study, of which 47% were insulin resistant. Comparison of group means showed significantly higher values for waist-to-hip ratio (WHR), diastolic blood pressure and Ferriman-Gallwey score (FGS) in IR + group. HOMA-IR values were found to be positively correlated with WHR (r = 0.500, p < 0.01), systolic blood pressure (r = 0.265, p < 0.01), diastolic blood pressure (r = 0.273, p < 0.01), estradiol levels (r = 0.218, p < 0.05), FGS (r = 0.456, p < 0.01) and total testosterone levels (r = 0.291, p < 0.01). When evaluating PCOS subjects, the insulin resistant group should be separated as unique and IR should also be evaluated in lean women with PCOS.
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Estradiol/sangre , Resistencia a la Insulina , Síndrome del Ovario Poliquístico , Testosterona/sangre , Delgadez , Relación Cintura-Cadera/métodos , Adulto , Determinación de la Presión Sanguínea , Índice de Masa Corporal , Femenino , Humanos , Síndrome del Ovario Poliquístico/diagnóstico , Síndrome del Ovario Poliquístico/epidemiología , Síndrome del Ovario Poliquístico/metabolismo , Estudios Retrospectivos , Estadística como Asunto , Delgadez/diagnóstico , Delgadez/metabolismo , Turquía/epidemiologíaRESUMEN
OBJECTIVE: To investigate the impact of urinary albumin excretion (UAE) and cystatin C on the metabolic components of polycystic ovary syndrome (PCOS). METHODS: Seventy-five women with PCOS were divided into two groups according to metabolic syndrome as MetS + and MetS-. Clinical, metabolic and renal parameters were compared between the groups. Correlation analyses were performed between cystatin C, microalbuminuria and clinical and metabolic parameters in women with PCOS. RESULTS: Waist/hip ratio (WHR), body mass index, LDL cholesterol, triglyceride, total cholesterol, cystatin C, UAE were significantly higher in the MetS + group compared with the MetS - one. HDL cholesterol was significantly higher in the MetS - group than the MetS + one. The UAE positively correlates with LDL cholesterol, triglyceride and total cholesterol levels. Cystatin C positively correlates with UAE, WHR, LDL cholesterol, triglyceride, total cholesterol levels. CONCLUSIONS: Evaluating UAE and cystatin C may be important for the detection of target subjects at high risk for future metabolic syndrome and cardiovascular disease.
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Enfermedades Cardiovasculares/sangre , Cistatina C/sangre , Síndrome Metabólico/sangre , Síndrome del Ovario Poliquístico/sangre , Adulto , Biomarcadores/sangre , Femenino , Humanos , Síndrome Metabólico/orina , Síndrome del Ovario Poliquístico/orina , Adulto JovenRESUMEN
Severe methotrexate toxicity due to medical treatment of an ectopic pregnancy is presented. The feasibility of low-dose use and success of methotrexate makes it the first drug in the medical treatment of ectopic pregnancies. Besides its advantages, it should be used with caution and severe toxicity should be kept in mind.
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OBJECTIVE: A randomized trial to compare the effects of two oral contraceptive pills containing either chlormadinone acetate or drospirenone as the progestogen, in women with PCOS for a period of two-year follow-up. METHODS: Group A received ethinyl-estradiol 0.03 mg + drospirenone 3 mg (EE + DRSP; n = 56) and Group B received ethinyl-estradiol 0.03 mg + chlormadinone acetate 2 mg (EE + CMA; n = 50). Clinical, hormonal and biochemical parameters were compared at baseline, 6 months, 12 months and 24 months. RESULTS: The increase in total cholesterol and hsCRP levels was statistically significantly higher at 6, 12 and 24 months in Group B when compared with Group A. The change in the high-density lipoprotein cholesterol level at the 24 months of treatment was statistically significantly higher in Group A. Group A has a significantly higher reduction in FAI at 6 and 24 months, in FGS at 6, 12 and 24 months and in HOMA-IR index at 12 and 24 months when compared with Group B. CONCLUSIONS: Drospirenone containing combined oral contraceptive (COC) is found to have more favorable effects on lipid profiles, hsCRP levels, insulin resistance and hyperandrogenism when compared with the CMA containing COC and appears to be more beneficial for the long-term cardiovascular and metabolic aspects of PCOS.
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Androstenos/uso terapéutico , Acetato de Clormadinona/uso terapéutico , Anticonceptivos Orales Combinados/uso terapéutico , Anticonceptivos Sintéticos Orales/uso terapéutico , Etinilestradiol/uso terapéutico , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adulto , Glucemia/metabolismo , Presión Sanguínea , Proteína C-Reactiva/metabolismo , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Femenino , Hormona Folículo Estimulante/metabolismo , Estudios de Seguimiento , Humanos , Resistencia a la Insulina , Estudios Longitudinales , Hormona Luteinizante/metabolismo , Síndrome del Ovario Poliquístico/metabolismo , Resultado del Tratamiento , Triglicéridos/metabolismo , Relación Cintura-Cadera , Adulto JovenRESUMEN
OBJECTIVE: To evaluate retinol-binding protein 4 (RBP4), leptin, and asymmetric dimethylarginine (ADMA) levels in young women with polycystic ovary syndrome (PCOS) and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. DESIGN: Clinical study. SETTING: University hospital. PATIENT(S): Fifty-seven young women with PCOS (obese [n = 27] and nonobese [n = 30]) and 27 age-matched healthy controls. INTERVENTION(S): History and physical examination, peripheral venous blood sampling. MAIN OUTCOME MEASURE(S): Asymmetric dimethylarginine, RBP4, leptin, LH, FSH, DHEAS, total T, E(2), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride (TG), and homeostasis model assessment insulin resistance index (HOMA-IR). RESULT(S): Obese women with PCOS had significantly higher HOMA-IR, DHEAS, leptin, RBP4, and ADMA levels. Leptin levels were significantly increased in nonobese subjects with PCOS. Leptin and ADMA levels were positively correlated with HOMA-IR in PCOS. There was no correlation between RBP4 and HOMA-IR. Leptin, RBP4, and ADMA levels are positively correlated in PCOS. CONCLUSION(S): [1] Young obese women with PCOS have increased ADMA, RBP4, and leptin levels, and they are positively correlated with each other. [2] The increased levels of leptin are independent of obesity, and leptin seems to have an association with IR. [3] Levels of RBP4 may not reflect IR in PCOS.
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Arginina/análogos & derivados , Leptina/sangre , Obesidad/sangre , Síndrome del Ovario Poliquístico/sangre , Proteínas Plasmáticas de Unión al Retinol/metabolismo , Adulto , Arginina/sangre , Biomarcadores/sangre , Biomarcadores/metabolismo , Femenino , Humanos , Obesidad/complicaciones , Síndrome del Ovario Poliquístico/complicaciones , Estudios Prospectivos , Adulto JovenRESUMEN
PURPOSE: To evaluate the effectiveness of hysteroscopy as a method for the diagnosis of tubal patency using saline distention media. METHODS: In this prospective study, 62 women between 21 and 38 years with a history of at least 1 year of infertility who underwent hysteroscopy and hysterosalpingography (HSG) on two consecutive cycles were studied. Transvaginal ultrasonography carried out before and after hysteroscopy in order to measure the abdominal fluid (in ml) in the peritoneal cavity of the cul-de-sac. The difference between the two results was calculated. A next cycle HSG was performed and patients were divided into three groups according to whether there was no tubal occlusion (group 1), a unilateral occlusion (group 2) or a bilateral occlusion (group 3): Peritoneal fluid measurements were compared among the three groups. Finally, pain and discomfort were recorded at the end of the process. RESULTS: According to the HSG, 34 women were in group 1, 13 in group 2 and 9 in group 3. Peritoneal fluid measurements were 6.88 +/- 2.7 ml in group 1, 4.21 +/- 0.9 ml in group 2 and 1.08 +/- 0.7 ml in group 3. Statistical differences were found between groups 1 and 3 and between groups 2 and 3 (P < 0.05). All of the patients reported significantly less pain during hysteroscopy in response to HSG. CONCLUSIONS: Using saline distension media during hysteroscopic evaluation was effective to allow measurement of the accumulating fluid in the peritoneal cavity and to confirm at least one patent tube with minimal pain.
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Líquido Ascítico/diagnóstico por imagen , Pruebas de Obstrucción de las Trompas Uterinas/métodos , Histeroscopía , Infertilidad Femenina/diagnóstico por imagen , Adulto , Femenino , Humanos , Histerosalpingografía , Estudios Prospectivos , Cloruro de Sodio , Ultrasonografía , Adulto JovenRESUMEN
PURPOSE: To compare the results in terms of effectiveness, side effects, and patient satisfaction when diclofenac and indomethacin suppositories were used for the relief of perineal pain after episiotomy or tearing during childbirth. METHODS: A total of 200 women who had undergone mediolateral episiotomy or suffered lacerations while giving birth vaginally were randomly assigned to receive either rectal diclofenac or indomethacin. Pain ratings were recorded before the administration of drugs and at 1, 3, 6, 9, 12, and 24 h after the first dose on a 10 cm visual analog scale. Side effects and overall opinion on the two treatments were assessed at 24 h. RESULTS: The prophylactic use of diclofenac suppositories reduced perineal pain more than the use of indomethacin suppositories, although the difference was not significant. Overall additional analgesia requirement was correspondingly lower in the diclofenac group. There were no significant differences in overall patient satisfaction between the two groups. CONCLUSIONS: Since the two analgesics were rated similarly and gave satisfactory pain relief, diclofenac may be preferred because it is administered in a single dose and requires less nursing time to dispense and is a substantially less costly alternative to the new pain treatment technologies currently in use.
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Antiinflamatorios no Esteroideos/administración & dosificación , Diclofenaco/administración & dosificación , Episiotomía/efectos adversos , Indometacina/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Administración Rectal , Adulto , Método Doble Ciego , Femenino , Humanos , Dimensión del Dolor/efectos de los fármacos , Satisfacción del Paciente , Estudios Prospectivos , Estadísticas no Paramétricas , Supositorios/administración & dosificaciónRESUMEN
PURPOSE: To investigate the correlation between serum 25-hydroxyvitamin D (25-OH-VD) concentrations and metabolic parameters in obese and non-obese women with polycystic ovary syndrome (PCOS). METHODS: One hundred women with PCOS were divided into two groups, obese and non-obese, according to their body mass index (BMI). Waist-to-hip ratio (WHR), Ferriman-Gallwey score, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, triglycerides, calcium, 25-OH-VD, LH/FSH, total testosterone, and DHEAS were measured. RESULTS: The serum 25-OH-VD mean levels were 56.31% lower in the obese PCOS patients. There was an association of increased HOMA-IR, BMI, WHR, triglycerides, total testosterone, and DHEAS with decreased 25-OH-VD concentrations in the obese PCOS patients. CONCLUSION: Low serum 25-OH-VD concentrations result from the presence of obesity and insulin resistance. However, the dependency between PCOS and hypovitaminosis D is questionable. Hypovitaminosis D should be kept in mind while managing obese women with PCOS.
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Resistencia a la Insulina , Obesidad/sangre , Síndrome del Ovario Poliquístico/sangre , Vitamina D/análogos & derivados , Adulto , Femenino , Humanos , Obesidad/complicaciones , Síndrome del Ovario Poliquístico/complicaciones , Estudios Prospectivos , Vitamina D/sangre , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study is to compare the effect of ethinyl estradiol 0.03 mg/gestodene 0.075 mg (EE/GSD) with ethinylestradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) administered according to conventional 21/7 regimen on body mass index (BMI), blood pressure (BP), lipid metabolism and hemostatic parameters. METHOD: In this study, 160 healthy women were randomized to EE/GSD mg or EE/DRSP for 12 months. Mean differences in BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) levels and BP compared to baseline were assessed. RESULTS: One hundred and forty-five (89%) of the women completed all 12 treatment cycles. The subjects randomly assigned into two treatment groups. Group EE/GSD (n = 71) and group EE/DRSP (n = 72). In group B, BMI values were significantly lower than baseline at the sixth cycle. DRSP/EE had more favorable effects on BP than GSD/EE with the mean systolic and diastolic BPs remaining lower in the DRSP/EE group. The difference between the two preparations was not statistically significant at the end of the study. TC levels remained similar in both groups throughout the study period. In both groups LDL-C levels decreased, triglyceride and HDL-C levels significantly increased from baseline levels. These changes result in increasing HDL-C/LDL-C ratio, demonstrating anti-atherogenic effect. Menstrual cycle patterns and the incidence of adverse events were similar between groups. The duration of withdrawal bleeding decreased during the study for both groups and was similar. CONCLUSION: The EE/DRSP regimen provides good cycle control with reliable contraceptive efficacy and low incidence of adverse events. Compared with the EE/GSD preparation, the EE/DRSP preparation demonstrated a more favorable effect on BMI and BP with the mean BMI and mean BP remaining lower than baseline mean. The new formulation may be especially beneficial for women susceptible to body weight gain and rise in BP.
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Androstenos/farmacología , Presión Sanguínea/efectos de los fármacos , Anticonceptivos Orales Combinados/farmacología , Metabolismo de los Lípidos/efectos de los fármacos , Norpregnenos/farmacología , Adulto , Índice de Masa Corporal , Estrógenos/farmacología , Etinilestradiol/farmacología , Femenino , Humanos , Lípidos/sangre , Adulto JovenRESUMEN
OBJECTIVE: To investigate the prevalence of domestic violence against infertile women in a Turkish setting. METHODS: A total of 122 women with primary infertility attending an obstetrics and gynecology outpatient clinic were interviewed using the Abuse Assessment Screen questionnaire to investigate their experiences of domestic violence. RESULTS: In total, 41 (33.6%) women had experienced domestic violence because of their infertility. Of these women, 32 (78%) had experienced domestic violence for the first time in the relationship with the current partner following diagnosis of female factor infertility. The percentage of nonabused and abused infertile women who were mostly satisfied with their sexual lives was 56.87% and 29.2%, respectively (P<0.05). CONCLUSION: Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services.
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Violencia Doméstica/estadística & datos numéricos , Infertilidad Femenina/psicología , Adulto , Femenino , Humanos , Prevalencia , Turquía , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study was to evaluate women with adnexal masses in the preoperative period by creating 2 logistic regression models, 1 including sonographic morphologic characteristics and the other including both morphologic and color Doppler characteristics, to compare the diagnostic accuracy of these 2 models with the risk of malignancy index (RMI). METHODS: This prospective study included 38 malignant, 7 borderline, and 244 benign ovarian masses. The menopausal status, presence of septa, presence of papillary projections, location of the tumor, presence of ascites, presence of metastases, cancer antigen 125 level, tumor volume, septa thickness, and percentage of the solid component were included in the initial analysis. A second regression analysis was performed with the addition of Doppler parameters (location of blood flow and lowest resistive index) in the data set. Diagnostic performance of the 2 regression models and RMI were described and compared by generating receiver operating characteristic curves for each model. RESULTS: The area under the curve values for the morphologic model (model 1), Doppler model (model 2), and RMI were 0.907, 0.971, and 0.889, respectively. Significance levels of model 1 and the RMI were similar (P = .23), whereas model 2 had a significantly higher area under the curve compared with both model 1 (P = .037) and the RMI (P = .018). CONCLUSIONS: The addition of Doppler parameters in the regression model significantly increases the predictive performance. Nevertheless, in low-resource settings, the RMI remains the method of choice for distinguishing adnexal masses and referral to gynecologic oncology clinics.
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Enfermedades de los Anexos/diagnóstico por imagen , Enfermedades de los Anexos/epidemiología , Modelos de Riesgos Proporcionales , Medición de Riesgo/métodos , Ultrasonografía/estadística & datos numéricos , Enfermedades de los Anexos/cirugía , Adulto , Femenino , Humanos , Persona de Mediana Edad , Cuidados Preoperatorios/métodos , Cuidados Preoperatorios/estadística & datos numéricos , Prevalencia , Análisis de Regresión , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad , Turquía/epidemiologíaRESUMEN
INTRODUCTION: We report a case of unusual co-existence of multiple primary neoplasms of female genital tract. CASE: A 62-year-old gravida 2, para 2 was referred with spotting and vaginal discharge for about 6 months. Fractionate curettage was performed and documented endocervical squamous cell carcinoma in situ. Subsequently total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed. Final pathological report demonstrated cervical squamous cell carcinoma, right ovarian Brenner tumor, left ovarian granulosa tumor and endometrial polyps. DISCUSSION: Multiple primary neoplasms of female genital tract is a well-recognized yet rare occurrence. Although the presented case is probably an incidental event, the pathogenesis of the neoplastic process affecting the tissues with different embryological origin needs further research and evaluation. It is important to distinguish multiple primary neoplasms from metastatic disease because of the fact that overall survival as well as treatment would vary considerably.
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Neoplasias Endometriales/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Ováricas/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Tumor de Brenner/diagnóstico , Tumor de Brenner/patología , Tumor de Brenner/cirugía , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Diagnóstico Diferencial , Neoplasias Endometriales/patología , Neoplasias Endometriales/cirugía , Trompas Uterinas/cirugía , Femenino , Humanos , Histerectomía , Persona de Mediana Edad , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Ovariectomía , Pólipos/diagnóstico , Pólipos/patología , Pólipos/cirugía , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugíaRESUMEN
Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01-0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy). Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.