Browsing by Author "Güvenal, T"

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    A Comparative Study for Selectivity of Micronuclei in Cervical Exfoliated Cells on Chronic Boron Effects
    Yildirim, H; Göker, A; Demirci, H; Güvenal, T; Korkmaz, M
    Background: Cervical cancer is one of the most frequent malignancies in women. Micronucleus (MN) testing has gained popularity as a biomarker in early diagnosis of many types of cancer. Aims: This study aims to investigate the role of MN testing on early detection of cervical cancer and the effect of boron exposure on cervical cells. Settings and Design: The study population comprised women who were diagnosed to be human papillomavirus (HPV)-positive and had atypical squamous cells of undetermined significance (ASCUS) as cervical cytology in a cervical screening project. A total of 15 HPV-positive and 36 ASCUS patients were identified. Randomly selected 20 women were selected from boron-rich region (n = 10) and nonboron region (n = 10). Materials and Methods: Cervical swab specimens were dyed using Papanicolaou (PAP) and May-Grunwalds-Giemsa (MGG) techniques, and MN count in 1000 cells was performed. The results were statistically evaluated. Statistical Analysis Used: Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. Quantitative data were presented as mean +/- standard deviation. MN test scoring was compared using Mann-Whitney U-test. Results: Boron content of urine was measured to be 3.02 +/- 1.45 and 0.98 +/- 0.42 mg/day in boron-rich and nonboron regions, respectively. When MN counts were compared according to PAP and MGG staining in HPV-and ASCUS-positive women, there was statistically no significant difference (P > 0.05). Disregarding regions, HPV/control and HPV/ASCUS cases stained with PAP and MGG had statistically significant difference in MN count (P < 0.05). Conclusion: These findings suggest that MGG and PAP staining gives similar results with regard to MN count. On the other hand, it has been shown again that HPV induces MN and causes genomic instability.
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    Management of gynecological cancers in the COVID-19 era: a survey from Turkey
    Altin, D; Yalcin, I; Khatib, G; Kelesoglu, MD; Akgol, S; Önder, AB; Kahramanoglu, I; Güvenal, T; Topuz, S; Demirkiran, F
    Objective: This study aimed to investigate how gynecologic oncologists modified their patient management during Coronavirus disease-2019 (COVID-19) in Turkey. Material and Methods: An online survey was sent to gynecologic oncology specialists and fellows in Turkey. It included management questions about strategies for newly diagnosed or recurrent endometrial, cervical, ovarian and vulvar cancer during the pandemic. Participants were asked if treatment of these cancers can be delayed or not and, if yes, the duration of delay. Results: 32.9% of surgeons prescribed oral or intrauterine progesterone for early stage, low-grade endometrial cancer. Conversely, 65.7% and 45.7% of the most surgeons did not change their management for early stage high-grade and advanced stage endometrial cancers respectively, as they perform surgery. 58% and 67.1% of the surgeons continued to prefer standard surgical treatment for microinvasive and early stage cervical cancers, respectively. Radiotherapy was preferred administered with hypofractionated doses for locally advanced cervical cancer (57.1%). While 67.1% of surgeons operated early stage ovarian cancer patients, 50% administered neoadjuvant chemotherapy (NACT) to all advanced stage ovarian cancers and 50% administered more cycles of NACT in preference to interval debulking surgery. 93.7% of the surgeons responded that treatment should not be delayed beyond eight weeks. Conclusion: Most Turkish gynecologic oncologists modified their management of gynecologic cancers due to the COVID-19 pandemic. While chemotherapy was preferred for ovarian cancer, postponement of the surgery, with or without non-surgical options, was considered for early stage, low-grade endometrial cancer. Treatment of gynecologic cancers should be decided on a case by case basis, taking into account local COVID-19 infection rates and availability of health facilities. Prognosis is also an important consideration if delay is contemplated. Standard treatment and normal time-frames should be used if possible. If not, a postponement for a maximum of eight weeks or referral to another center were acceptable alternatives.