The ovarian cancers in geriatric population: the validity of inflammatory markers, malignancy risk indices 1, 2, 3, 4, and CA-125 levels in malignancy discrimination of adnexal masses.

PURPOSE: To investigate the predictive value of the Risk of Malignancy Index (RMI), CA-125, and inflammatory markers in discriminating ovarian cancers (OCs). MATERIALS AND METHODS: The postmenopausal (PM) women (n= 139) with adnexal masses who un- derwent surgery were included. The predictive value of CA-125, RMI (1, 2,3, and 4) and inflammatory markers [neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR)] were calculated in geriatric (G) and non-geriatric women. RESULTS: OCs had significantly increased NLR and PLR. RMI models were highly reliable in PM (Kappa: 0.642-0.715; AUC: 0.907-0.934). CA-125 measurement alone had good accuracy and moderate reliability in PM (kappa: 0.507-0.587), excellent accuracy and moderate reliability in G, NLR, and PLR predicting OCs, showed fair agreement in the PM, while PLR had a moderate agreement with G. CONCLUSION: RMI algorithms were the best models for malignancy prediction. However, the rise of PLR and CA-125 levels in a G population may be used as refer- ring adnexal masses to gynecologic oncologists.

Efficacy and acceptability of risedronate 5 mg daily compared with 35 mg once weekly for the treatment of postmenopausal osteoporosis.

OBJECTIVE: Risedronate is a bisphosphonate used in the treatment of osteoporosis. It has a strong effect in inhibiting osteoclast activity. The primary objective of this study was to evaluate the effectiveness and adverse events of two different forms of risedronate (5 mg and 35 mg) using a rapid biochemical marker for comparison of C-terminal telopeptide (CTx) type I collagen cross-links. METHODS: The study was designed at Bakirkoy Dr. Sadi Konuk Education & Research Hospital, between January and June 2004. A total of 123 postmenopausal osteoporotic women were randomly assigned in blocks of three to one of the following groups: control, risedronate 5 mg/day and risedronate 35 mg once a week. RESULTS: Of the 123 women enrolled, 103 (83.7%) completed the study. Adverse events were experienced by 53.6% in the control group, 56% in the risedronate 5 mg/day group and 53.6% in the group receiving risedronate 35 mg once per week. The most common adverse events were gastrointestinal (21.9% of subjects in group 1, 29.2% of subjects in group 2, 24.3% of subjects in group 3). The women in groups receiving risedronate either 5 mg/day and 35 mg once per week had similarly decreased levels of CTx but the control group was not as effective. CONCLUSION: The results support the hypothesis that risedronate 35 mg given once per week has the same therapeutic efficacy and safety as a daily 5 mg regimen. Taking the medicine once a week is likely to be easier and more satisfactory than the daily regimen. However, patients taking a once-a-week regimen may forget to take it due to the 7-day break without medicine.

Evaluation of tubal patency by transvaginal sonosalpingography.

OBJECTIVE: To evaluate tubal patency by transvaginal sonosalpingography. DESIGN: Comparative study of transvaginal sonosalpingography with chromolaparoscopy in subjects with unknown tubal function. SETTING: Outpatient infertility clinic at Zeynep Kamil Maternity Hospital in Istanbul, Turkey. PATIENTS: Forty-two cases of unknown tubal function with infertility complaints were included. INTERVENTIONS: Isotonic saline was injected into the uterine cavity through a catheter. MAIN OUTCOME MEASURES: Transvaginal sonosalpingography is a safe, easy, and cost-effective procedure for screening tubal status. RESULTS: The results obtained from transvaginal sonosalpingography and laparoscopy were completely consistent for 29 cases (76.32%) and partially consistent for 8 cases (21.05%). Transvaginal sonosalpingography accurately showed patency in 26 patients and bilateral nonpatency in 3 patients. CONCLUSIONS: Transvaginal sonosalpingography, with its accuracy and safety, is a promising screening and diagnostic technique in the evaluation of tubal patency on ambulatory basis.