The decreasing age of menarche in Turkey: global warming, socioeconomic development, and environmental factors.

OBJECTIVE: The age at menarche varies over time in line with the development level of society. The aim of the present study was to assess and compare secular trends of the age of menarche in Ankara, Turkey. PATIENTS AND METHODS: One thousand thirty-five patients who presented for regular gynecological control were examined retrospectively between 2011 and 2015. The patients were asked when they had experienced their first period. The data were evaluated in 10-year periods (<1964, 1965-1974, 1975-1984, and 1985-2000). The mean age at menarche presents trends that have changed over the years. RESULTS: The mean age at menarche decreased from 13.29 years in < 1964 to 13.24 years in 1965-1974, 13.20 years in 1975-1984, and 13.10 years in 1985-2000. When the < 1964 and 1985-2000 groups were compared, there was a two-fold increase in young age (≤ 11 years) at menarche. CONCLUSIONS: There is a continuing secular trend (a two-fold increase) in earlier age at menarche (i.e., ≤ 11 years). The effects of global warming and rising socioeconomic levels in Turkey may be implicated in the increase in earlier age at menarche.

Obesity is not a descriptive factor for oxidative stress and viscosity in follicular fluid of in vitro fertilization patients.

BACKGROUND: Obesity's impact on micro-environmental oxidative stress and follicular fluid (FF) viscosity and whether or not it has any effect on in vitro fertilization (IVF) success is a matter of debate. AIMS: In this study, our aim was to evaluate the levels of oxidative stress markers and the FF viscosity in obese and non-obese patients. METHODS: Eighty norm-responder patients undergoing IVF were prospectively grouped according to their body mass indexes (BMI). Group 1 (n = 40) and group 2 (n = 40) had BMI values of ≤24.9 and ≥25.0, respectively. Total sulfhydryl (RSH) levels (nmol/m) and the formation of thiobarbituric acid-reactive substances (malondialdehyde, or MDA) (µmol/ml) in FFs were quantified. For the first time in our study, FF viscosity with changing BMI values was also determined. RESULTS: The mean levels of MDA (µmol/ml) and RSH (nmol/ml) were not significantly different between groups (1.37 ± 0.51; 1.51 ± 0.51; p > 0.05 for MDA and 0.42 ± 0.30; 0.41 ± 0.20; p > 0.05 for RSH, respectively). Similarly, the FF viscosity (centipoise) was not different between groups (1.28 ± 0.28; 1.30 ± 0.19; p < 0.05, respectively). Independent of BMI, no correlation was found between FF levels of oxidative markers and the number of oocytes retrieved or the fertilization rates. CONCLUSIONS: In our study, we found no difference in the levels of follicular oxidative and anti-oxidative markers or the follicular fluid viscosity with changing BMI values. We also demonstrated that the levels of oxidative stress markers and the viscosity of follicular fluid did not affect clinical outcomes.

Immediate risk of HSIL presence in women who have both ASC-US cytology and negative high-risk HPV test.

PURPOSE: The authors aimed to detect immediate risk of having high grade squamous lesions (HSIL) in atypical squamous cells of uncertain significance(AS-CUS) and concomitant high-risk human papillomavirus (HrHPV) testing as negative [HrHPV(negative)AS-CUS]. MATERIALS AND METHODS: The authors performed immediate/baseline colposcopy on concomitant HrHPV (negative)AS-CUS cases. Pap tests were evaluated with liquid-based cytology (LBC) and HrHPV detection was performed in LBC material with PCR. Colposcopic diagnoses and biopsy results were compared with Pap test and HrHPV test results. RESULTS: There were 104 patients over a one-year period. In all, 84 cases were included. Colposcopic biopsies revealed low grade squamous intraepithelial lesion (LSIL) in 19 cases (23%) and HSIL in three cases (4%). Intrauterine device use and smoking were significantly correlated with presence of HSIL (p = 0.005 and p = 0.007 respectively). CONCLUSION: Similar data in literature, 4% of ASC-US-HrHPV (negative) cases are expected to have HSIL in follow-up periods less than six months. The present authors believe clinicians should be more open with their patients about limitations of Pap-HPV testing.

A breast cancer patient with pelvic and gastric malignancy after adjuvant tamoxifen treatment for breast cancer.

As is known, tamoxifen therapy is related to endometrial proliferation, hyperplasia, polyp formation, invasive carcinoma and uterine sarcoma. In this study, we present a 75-year-old woman who had five children. Gastric tumor, endometrial carcinoma and cervical adenocarcinoma in situ were detected after treatment with tamoxifen for breast cancer. It seems that being aware of the undesirable affects of tamoxifen treatment during the chemotherapy and post-chemotherapy period is very important.