Prevalence of high risk human papillomavirus (HPV) infection and abnormal cervical cytology and knowledge about HPV vaccine in Eastern Turkey.

PURPOSE OF INVESTIGATION: The aim of the present study was to gather data on the high risk human papillomavirus (HPV) frequency and the distribution of HIPV types in Eastern Turkey in relation to cervical cytology and to assess the knowledge about cervical cancer, HPV, and vaccination. MATERIALS AND METHODS: The study population included 1,000 women aged between 20-65 years who attended the outpatients clinics of Department of Obstetrics and Gynecology of the Medical School of Yuzuncu Yil University Hospital. RESULTS: The overall prevalence of high risk HPV-DNA was 2.8 %. Abnormal cytology was observed in 12.9% of the cases. Abnormal cytology consisted of cervical cancer: 0.1%, LSIL: 1.6%, HSIL: 0.5%, ASC-H: 2.1%, atypical glandular cells: 0.4%, and ASCUS: 8.3 %. CONCLUSION: The prevalence of HPV was low in Eastern Turkey and the most common HPV types are similar to the literature. However, the prevalence of HPV infection is a growing problem worldwide and the awareness of the women in the region is limited.

May supplementation of coenzyme Q10 help prevent development of hydatidiform mole?.

OBJECTIVE: The pathological mechanisms of gestational trophoblastic disease have not yet been clearly determined. It is thought that oxidative damage contributes to the process. The aim of this study was to determine the levels of coenzyme Q10 (CoQ 10), DNA damage, and lipid peroxidation in patients with hydatidiform mole. MATERIALS AND METHODS: The authors studied the levels of CoQ10, 8-hydroxydeoxyguanosine (8-OHdG), malondialdehyde (MDA) by high-performance liquid chromatography (HPLC), and the activity of glutathione peroxidase (GPX) by spectrophotometric method in blood obtained from patients with a complete hydatidiform mole (n=29), healthy pregnant women (n=29), and healthy non-pregnant women (n=29). RESULTS: The 8-OHdG/dG ratio (2.8148 ± 0.81592) and MDA (10.8341 ± 4.64875 µmol) were significantly higher in patients with complete hydatidiform mole, while the ubiquinol-10/ubiquinone-10 ratio (0.2107 ± 0.15675) and GPX activity (43.4606 ± 18.31694 mU/mI) were lower (p < 0.001). CONCLUSION: The authors suggest that both mitochondrial oxidative and oxidative DNA damage play important roles in the pathogenesis of complete hydatidiform mole. Therefore supplementation of CoQ10 prevents recurrent gestational trophoblastic disease.

Rectal cancer and pregnancy: report of two cases.

Colorectal cancers are rare during pregnancy and the management is controversial and challenging. Prognosis is usually unfavorable due to late diagnosis since the presenting symptoms of colorectal cancer are attributable to the usual manifestations of pregnancy. Management depends on the patient's age and desire for future pregnancy, gestational age, cancer stage and religious principles. Thus, the treatment should be individualized. We present two cases of rectal cancer during pregnancy.

Leiomyosarcoma of the broad ligament: a case report and review of the literature.

Leiomyosarcoma of the broad ligament is a rare tumour, since only 15 cases have been reported thus far in the English literature. We describe the case of a 35-year-old patient with primary leiomyosarcoma of the broad ligament. The histologic diagnosis and management of this rapidly progressive and highly malignant tumour are also discussed. The tumor had high mitotic activity and more than ten mitotic figures were found for ten high-power fields. The treatment consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. The patient received pelvic radiotherapy and chemotherapy considering the high grade of malignancy. No evidence of metastasis has been noted after a follow-up of 12 months.

Catalase activity, serum trace element and heavy metal concentrations, vitamin A, vitamin D and vitamin E levels in hydatidiform mole.

PURPOSE OF INVESTIGATION: In this study we aimed to measure the activity of catalase, which is an antioxidant enzyme, the concentrations of some trace elements and heavy metals, and vitamin A, D and E levels in serum samples of patients with hydatidiform mole, normal pregnancies and healthy non pregnant women. METHODS: Seventy-two women were enrolled in this study. Of these, 24 were healthy women in the first trimester of pregnancy (HP), 24 were healthy non-pregnant women (NP) and 24 were patients with complete hydatidiform mole (CHM). RESULTS: Serum levels of catalase, Zn, Co, vitamin A, D and E were significantly lower in the CHM group when compared with the HP and NP groups (p < 0.001). Serum levels of Cu, Fe, and Cd were significantly higher in the CHM group when compared with the HP and NP groups (p < 0.001). CONCLUSION: The assessment of oxidant/antioxidant imbalance in pregnant women could be useful in the early determination of molar pregnancy and supplementation with antioxidants may be useful in the treatment of CHM, and may prevent recurrent molar pregnancy.

The relationship between clinico-biochemical characteristics and psychiatric distress in young women with polycystic ovary syndrome.

The relationship between clinico-biochemical characteristics and self reported psychological parameters in 42 women with polycystic ovary syndrome (PCOS) and 42 age-matched healthy controls was examined. The General Health Questionnaire was used (GHQ-12) to ascertain emotional distress and the Beck Depression Inventory (BDI) to determine depressive symptoms. Emotional distress, depressive symptoms, hirsutism score, body mass index (BMI), waist-to-hip ratio (WHR), luteinizing hormone/follicle-stimulating hormone ratio, serum total testosterone, dehydroepiandrosterone sulphate levels and the insulin resistance index were significantly greater in women with PCOS than in healthy women. The BDI and GHQ-12 scores of the women with PCOS were significantly higher than those of the control group (BDI, 11.69 +/- 9.49 vs 5.80 +/- 4.58; GHQ-12, 3.38 +/- 3.38 vs 1.54 +/- 1.97, respectively), and BMI and WHR were positively correlated with the BDI and GHQ-12 scores. Clinicians should be aware of the increased risk of emotional distress and depression in women with PCOS, especially those who are obese, and of the need to screen these patients for such symptoms.

Ovarian stimulation in obese and non-obese polycystic ovary syndrome using a low-dose step-up regimen with two different starting doses of recombinant follicle-stimulating hormone.

Sixty-seven infertile women with polycystic ovary syndrome (PCOS) were divided into two groups, obese and non-obese, according to their body mass index. Waist-to-hip ratio, insulin resistance, total testosterone and dehydroepiandrosterone sulphate levels were significantly elevated in obese, compared with non-obese, patients. Both groups were treated with a low-dose step-up protocol of recombinant follicle-stimulating hormone (rFSH) with a starting dose of 50 IU/day and, every third day, a 25-IU increase in the dose until the appropriate dose was achieved for each individual, up to a maximum of 175 IU/day. In the obese group only, repeat therapy commenced in the second ovulatory cycle in women who had not become pregnant, however a starting dose of 75 IU/day was then used, with incremental and maximum dose as before. The results of the starting dose of 75 IU/day rFSH were compared with the results of a 50 IU/day rFSH starting dose in the obese group. A starting dose of 50 IU/day rFSH in a low-dose step-up regimen was found to be effective, safe and well-tolerated for inducing follicular development in non-obese infertile women with PCOS. However, for obese PCOS patients, a starting dose of 75 IU/day rFSH is recommended.

Catalase activity, serum trace element and heavy metal concentrations, and vitamin A, D and E levels in pre-eclampsia.

Catalase (antioxidant enzyme) activity in erythrocytes and serum levels of trace elements (copper, iron, zinc), heavy metals (cadmium, cobalt) and vitamins A (retinol), D (cholecalciferol) and E (alpha-tocopherol) were measured in 145 subjects comprising 47 pre-eclamptic pregnant women (PE), 48 healthy pregnant women (HP) and 50 healthy non-pregnant controls (NP). Catalase, vitamins A, D and E and levels of cobalt were significantly lower in the PE group compared with the HP and NP groups, whereas levels of copper, iron and cadmium were significantly higher in the PE group than in the HP and NP groups. Levels of zinc were significantly lower in both the PE and HP groups compared with the NP group. This assessment of oxidant/antioxidant imbalance in pregnant women could be useful in the early identification of pre-eclampsia and antioxidant supplementation in the early weeks of gestation might be useful.

Ovarian hemangioma with elevated CA125 and ascites mimicking ovarian cancer.

We report a case of a very rare tumor of the ovary with an unusual presentation; an ovarian hemangioma with massive ascites and elevated CA125. A 57-year-old woman presenting with elevated CA125, massive ascites and a left solid adnexal mass of 60 x 47 mm, with calcification and increased blood flow at Doppler examination, was submitted to laparotomy. Frozen section was inconclusive and a staging procedure which complicated the patient was performed. Pathologic examination revealed cavernous hemangioma which is an extremely rare tumor of the ovary. Although it is very unusual, an ovarian hemangioma may present with ascites and elevated CA125 and the differential diagnosis from ovarian cancer should be considered.

Reversible acute cortical blindness associated with eclampsia in complete hydatidiform mole.

BACKGROUND: Eclampsia is rare in molar pregnancy. Sudden cortical blindness in eclampsia is an uncommon but very dramatic experience for the patient. Because of its rarity, blindness associated with eclampsia may pose a significant problem for the obstetrician. CASE REPORT: We describe cortical blindness and posterior reversible encephalopathy syndrome (PRES) complicating molar pregnancy-related eclampsia. The clinical presentation in our patient was consistent with PRES associated with eclampsia together with magnetic resonance imaging (MRI) findings. CONCLUSION: Preeclampsia and eclampsia are regarded as common causes of PRES, which is considered to be the result of vasogenic brain edema caused by a rapid raise in blood pressure. Clinical and imaging findings are usually reversible. Early diagnosis and elimination of possible causes are important in order to avoid permanent visual or brain injury. Imaging (especially MRI) should be carried out in eclamptic patients with visual disturbance in order to exclude other causes of blindness.