MCBÜ Açıkerişim Sistemi :: Browsing by Author "Hasdemir P.S."

Browsing by Author "Hasdemir P.S."

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Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study
(2013) Guvenal T.; Dursun P.; Hasdemir P.S.; Hanhan M.; Guven S.; Yetimalar H.; Goksedef B.P.; Sakarya D.K.; Doruk A.; Terek M.C.; Saatli B.; Guzin K.; Corakci A.; Deger E.; Celik H.; Cetin A.; Ozsaran A.; Ozbakkaloglu A.; Kolusari A.; Celik C.; Keles R.; Sagir F.G.; Dilek S.; Uslu T.; Dikmen Y.; Altundag O.; Ayhan A.
Objective The objectives of this study were to examine demographic and clinicopathologic characteristics and to determine the effects of primary surgery, surgical staging and the extensiveness of staging. Methods In a retrospective Turkish multicenter study, 539 patients, from 14 institutions, with borderline ovarian tumors were investigated. Some of the demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging on survival rates were calculated by using Kaplan-Meier method. Results The median age at diagnosis was 40 years (range 15-84) and 71.1% of patients were premenopausal. The most common histologic types were serous and mucinous. Majority of the staged cases were in Stage IA (73.5%). 242 patients underwent conservative surgery. Recurrence rates were significantly higher in conservative surgery group (8.3% vs. 3%). Of all patients in this study, 294 (54.5%) have undergone surgical staging procedures. Of the patients who underwent surgical staging, 228 (77.6%) had comprehensive staging including lymphadenectomy. Appendectomy was performed on 204 (37.8%) of the patients. The median follow-up time was 36 months (range 1-120 months). Five-year survival rate was 100% and median survival time was 120 months. Surgical staging, lymph node sampling or dissection and appendectomy didn't cause any difference on survival. Conclusion Comprehensive surgical staging, lymph node sampling or dissection and appendectomy are not beneficial in borderline ovarian tumors surgical management. © 2013 Elsevier Inc.
Recent advances in the diagnosis and management of gestational diabetes; [Gestasyonel diabet tanı ve tedavisinde yenilikler]
(Turkish Society of Obstetrics and Gynecology, 2014) Hasdemir P.S.; Terzi H.; Koyuncu F.M.
Gestational diabetes is a condition which is seen in 7% of pregnancies and have potential risks for both mother and fetus. Despite its importance, there is not any golden standard approaches to the diagnosis and management of the disease. The aim of this review was to investigate the advances in the diagnosis and management of gestational diabetes in recent years. © 2014 Turkish Society of Obstetrics and Gynecology. All rights reserved.
Outcomes of patients with gestational trophoblastic disease in an university hospital; [Bir üniversite hastanesinde gestasyonel trofoblastik hastalik olgularinin değerlendirilmesi]
(Gunes Kitap Kirtasiye, 2014) Hasdemir P.S.; Özçakır H.T.; Koltan S.O.; Güvenal T.
Aim: To investigate the clinicopathologic features and treatment procedures of the patients who diagnosed as Gestational Trophoblastic Disease (GTD). Methods: Thirty-four patients who pre-diagnosed as GTD between the years 2003-2013 included to this investigation. Descriptive and clinicopathologic features, treatment and follow-up results of the patients investigated retrospectively. Results: Totally 27 hydatiform mole (HM) (15 of them complete and 12 of them partial) and 7 non-metastatic gestational trophoblastic neoplasia (NM-GTN) case was found in 10 years period of time. The mean age of the patients was 331,37± 9,27 (16-52), the pregnancy rate was 2,7± 1,5 (0-7), parity rate was 1,13± 1,03 (0-4), the abortus and history of molar pregnancy rates were 0,35± 0,58 (0-2) ve 0,15± 0,44 (0-2), respectively. Three recurrences (8,8%) was seen in HM cases and two of them needed repeat curettage (R/C) and the other one needed hystetectomy and all the three cases survived. Single agent chemotheraphy was been successful in all the GTN cases. Conclusion: GTD is a curable condition with early diagnosis, adequate management and follow-up. Complications due to treatment should be kept in mind. © 2014, Gunes Kitap Kirtasiye. All rights reserved.
Multicenter analysis of gestational trophoblastic neoplasia in Turkey
(Asian Pacific Organization for Cancer Prevention, 2014) Ozalp S.S.; Telli E.; Oge T.; Tulunay G.; Boran N.; Turan T.; Yenen M.; Kurdoglu Z.; Ozler A.; Yuce K.; Ulker V.; Arvas M.; Demirkiran F.; Bese T.; Tokgozoglu N.; Onan A.; Sanci M.; Gokcu M.; Tosun G.; Dikmen Y.; Ozsaran A.; Terek M.C.; Akman L.; Yetimalar H.; Kilic D.S.; Gungor T.; Ozgu E.; Yildiz Y.; Kokcu A.; Kefeli M.; Kuruoglu S.; Yuksel H.; Guvenal T.; Hasdemir P.S.; Ozcelik B.; Serin S.; Dolanbay M.; Arioz D.T.; Tuncer N.; Bozkaya H.; Guven S.; Kulaksiz D.; Varol F.; Yanik A.; Ogurlu G.; Simsek T.; Toptas T.; Dogan S.; Camuzoglu H.; Api M.; Guzin K.; Caliskan E.; Doger E.; Cakmak B.; Ilhan T.T.
Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
Endometriosis associated with relapsing ascites and pleural effusions
(Informa Healthcare, 2015) Hasdemir P.S.; Ikiz N.; Ozcakir H.T.; Kara E.; Guvenal T.
[No abstract available]
Hearing loss: An unknown complication of pre-eclampsia?
(2015) Terzi H.; Kale A.; Hasdemir P.S.; Selcuk A.; Yavuz A.; Genc S.
Aim The aim of this study was to determine whether pre-eclampsia is a risk factor for cochlear damage and sensorineural hearing impairment. Material and Methods This prospective case-control study consisted of 33 patients with pre-eclampsia and 32 normotensive pregnant patients as controls. All of the subjects underwent otoscopic examinations - pure tone audiometry (0.25-16 kHz) and transient evoked otoacoustic emission (1-4 kHz) tests - during their third trimester of pregnancy. Results The mean ages of the patients with pre-eclampsia and the control subjects were 29.6 ± 5.7 and 28.6 ± 5.3 years, respectively. The baseline demographic characteristics, including age, gravidity, parity number, and gestational week, were similar between the two patient groups. Hearing thresholds in the right ear at 1, 4, 8, and 10 kHz and in the left ear at 8 and 10 kHz were significantly higher in the patients with pre-eclampsia compared to the control subjects. The degree of systolic blood pressure measured at the time of diagnosis had a deteriorating effect on hearing at 8, 10, and 12 kHz in the right ear and at 10 kHz in the left ear. Conclusions Pre-eclampsia is a potential risk factor for cochlear damage and sensorineural hearing loss. Further studies that include routine audiological examinations are needed in these patients. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.
Application of negative pressure wound therapy in a case of severe wound infection after endometrial cancer surgery; [Endometrıal kanser cerrahısı sonrasinda şıddetlı yara enfeksıyonlu bır olguda negatıf basinçli yara tedavısının uygulanmasi]
(Gunes Kitap Kirtasiye, 2015) Solmaz U.; Ekin A.; Mat E.; Gezer C.; Demirtaş G.S.; Gökçü M.; Hasdemir P.S.; Sancı M.
Surgical site infection is still a challenging situation for every surgeon and it is continuing to be a significant cause of morbidity and mortality. Various treatment protocols such as debridement, antibiotic therapy and dressings have been recommended in the literature. Recently, negative pressure wound therapy has been suggested as a new adjunctive modality for treating wounds with signs of infection. We describe the novel application of negative pressure wound therapy for the management of a case with severe wound infection after endometrial cancer surgery. © 2015, Gunes Kitap Kirtasiye. All rights reserved.
Synchronous primary endometrial and ovarian cancers: A multicenter review of 63 cases
(Wichtig Publishing Srl, 2016) Solmaz U.; Karatasli V.; Mat E.; Dereli L.; Hasdemir P.S.; Ekin A.; Gezer C.; Sayhan S.; Sanci M.; Guvenal T.
Aims: To investigate clinicopathologic characteristics, therapeutic methods, and prognostic factors in women with synchronous primary endometrial and ovarian cancers (SEOCs). Methods: A retrospective review of 2 cancer registry databases in Turkey was conducted to identify patients diagnosed with SEOCs between January 1995 and December 2012. Patients with recurrent, metastatic, and metachronously occurring tumors were excluded. Multivariate logistic regression models were used to identify prognostic predictors for progression-free survival (PFS) and overall survival (OS). Results: The analysis included 63 women with SEOCs. Seventy-six percent of the patients had stage I endometrial cancer, and 60% of the patients had stage I ovarian cancer. Thirty-seven patients (58.7%) had endometrioid/ endometrioid histology. Optimal cytoreduction was obtained in 47 (74.6%) patients. Recurrence developed in 17 patients (27%). Multivariate analysis confirmed lymphovascular space invasion (LVSI) as an independent poor prognostic factor for OS (odds ratio [OR] 3.1, p = 0.045), whereas early-stage disease and optimal cytoreduction were found to be independent good prognostic factors for both PFS (OR 12.85, p<0.001 and OR 4.58, p = 0.004, respectively) and OS (OR 7.31, p = 0.002 and OR 2.95, p = 0.028, respectively). The 3- and 5-year OS rates were 74% and 69%, respectively. Conclusions: Our study demonstrated that optimal cytoreduction, early-stage disease, and LVSI are the most significant factors affecting survival in women with SEOC.
The Role of Adenomyosis in the Pathogenesis of Preeclampsia
(Georg Thieme Verlag, 2016) Hasdemir P.S.; Farasat M.; Aydin C.; Ozyurt B.C.; Guvenal T.; Pekindil G.
Introduction: Adenomyosis can cause defective deep placentation. Preeclampsia is known to be associated with abnormal placentation. The aim of this study was to compare the presence of adenomyosis on magnetic resonance imaging in patients with and without history of preeclampsia in order to investigate the possible role of adenomyosis in the pathogenesis of preeclampsia. Materials and Methods: This prospective, randomized study consisted of patients with (n = 35) and without (n = 34) history of preeclampsia. Direct (submucosal microcysts, adenomyoma and cystic adenomyoma) and indirect (maximal thickness of junctional zone, ratio of maximal thickness of junctional zone to myometrial thickness, junctional zone differential, focal thickening of junctional zone, globally enlarged uterus and non-uniform junctional zone contours) signs of adenomyosis were assessed by pelvic magnetic resonance imaging. Results: The prevalence of adenomyosis was found to be more common in patients with preeclampsia und fetal growth restriction compared to patients without fetal growth restriction (94.4 vs. 64.7%; p = 0.041), respectively. There was a strong association between maximal thickness of junctional zone (9 vs. 13 mm, p = 0.005), ratio of maximal thickness of junctional zone to myometrial thickness (0.42 vs. 0.66, p = 0.001) and junctional zone differential (3 vs. 5 mm, p = 0.02) and late-onset preeclampsia. Conclusions: Presence of adenomyoma is more common in patients with preeclampsia complicated with fetal growth restriction. Indirect signs of adenomyosis detected on pelvic magnetic resonance imaging might have a role in the pathogenesis of late-onset preeclampsia. © Georg Thieme Verlag KG Stuttgart New York.
Borderline ovarian tumors: A contemporary review of clinicopathological characteristics, diagnostic methods and therapeutic options
(Zerbinis Publications, 2016) Hasdemir P.S.; Guvenal T.
Borderline ovarian tumors (BOTs) differ from the epithelial ovarian malignancies with their excellent prognosis, curability with surgery, and being seen in relatively young ages. Thus, fertility sparing and conservative surgical approaches are currently recommended. Preoperative diagnosis of BOTs can be challenging because, clinical and ultrasonographic features might overlap with invasive carcinomas and sometimes with benign adnexal masses. Certain characteristics such as stage at diagnosis, age of the patient and histologic features are important while deciding the extensiveness and the type of surgery. Detailed evaluation of the entire abdominal cavity and sampling all suspected areas are imperative during operation. Frozen section is essential for the intraoperative diagnosis, despite the fact that the diagnostic value of frozen section is not as high as in invasive ovarian carcinomas. Routine appendectomy and/or contralateral ovarian biopsy in cases of isolated tumor with normal appearing appendix and/or contralateral ovary are not recommended. Conservative approach might improve the recurrence rate without worsening the overall survival. The exact role of laparoscopic surgery with its advantages and disadvantages in the treatment of BOTs needs to be confirmed with further studies.
Evaluation of the surgical outcome and complications of total laparoscopic hysterectomy in patients with enlarged uteruses
(Elsevier Ltd, 2016) Terzi H.; Hasdemir P.S.; Biler A.; Kale A.; Sendag F.
Objective The aim of this study was to investigate whether uterine weight has a deleterious effect on the operation time, complication rates, length of hospital stay and incidence of intraoperative haemorrhage during total laparoscopic hysterectomy operation. Methods A total of 282 patients who underwent total laparoscopic hysterectomy for benign gynaecologic indications were retrospectively analyzed. The median operation time of 70 min was accepted as an index number, and a cut-off point of ≥300 g was calculated for uterine weight by using reciever operator characteristics (ROC) curve analysis. Results There was no statistically significant relationship between the uterine weight and haemoglobin drop rate (1.27 ± 0.89 vs 1.21 ± 0.88, p = 0.905), complication rate (10.83% vs 9.26%, p = 0.062) and length of hospital stay (3.27 ± 1.23 vs 3.37 ± 1.35 days, p = 0.505) based on this cut. Lee-Huang point was preferred for abdominal entry in cases with uteruses reached the level of umbilicus −2 cm in physical examination. Conclusions Uterine weight was not effected the complication rate, estimated blood loss and length of hospital stay in total laparoscopic hysterectomy operation. A cut-off value of 300 g could be used for an increased operation time. © 2016 IJS Publishing Group Ltd
Analysis of clinical and pathological characteristics, treatment methods, survival, and prognosis of uterine papillary serous carcinoma
(Wichtig Publishing Srl, 2016) Solmaz U.; Ekin A.; Mat E.; Gezer C.; Dogan A.; Biler A.; Peker N.; Hasdemir P.S.; Sanci M.
Purpose: Uterine papillary serous carcinoma (UPSC) is an atypical variant of endometrial carcinoma with a poor prognosis. It is commonly associated with an increased risk of extrauterine disease. The aim of this study was to investigate clinical and pathological characteristics, therapeutic methods, and prognostic factors in women with UPSC. Methods: All patients who underwent surgery for UPSC at a single high-volume cancer center between January 1995 and December 2010 were retrospectively reviewed. Patients who did not undergo surgical staging and those with mixed tumor histology were excluded. Univariate and multivariate regression models were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS). Results: A total of 46 patients were included, the majority of whom having stage I disease (IA, 13 [28.2%] and IB, 12 [26.7%]). Stages II, III, and IV were identified in 5 (10.9%), 8 (17.4%), and 8 (17.4%) women, respectively. Optimal cytoreduction was obtained in 67.3% of patients. Recurrences developed in 8 (17.4%) patients. Multivariate analysis confirmed that lymphovascular space invasion (LVSI) (odds ratio [OR] 26.83, p = 0.003) was the only independent prognostic factor for OS, whereas LVSI and optimal cytoreduction were found to be independent prognostic factors for PFS (OR 6.91, p = 0.013 and OR 2.69, p = 0.037, respectively). The 5-year overall survival rate was 63%. Conclusions: Our study demonstrated that LVSI is the only independent prognostic factor for OS, whereas LVSI and optimal cytoreduction are independent prognostic factors for PFS in patients with UPSC. © 2016 Wichtig Publishing.
A comparison of success rates of embryo transfer on weekdays and weekends
(Royan Institute (ACECR), 2016) Hasdemir P.S.; Kamali M.B.; Calik E.; Ozcakir H.T.
Background: The aim of this study is to examine the effect of the embryo transfer (ET) day on clinical pregnancy success rates in in vitro fertilization-ET (IVF-ET) cycles. Materials and Methods: In this retrospective study, we divided patients with infertility who underwent IVF-ET with fresh embryos into two groups depending on whether the ET was performed on weekdays or weekends. The main outcome measure was to compare the clinical pregnancy rates of patients with similar demographic and clinical characteristics who underwent ET on weekdays or weekends. Results: A total of 188 patients underwent IVF-ET on weekdays (n=156) or weekends (n=32). Both groups had similar demographic and cycle characteristics. The overall pregnancy rate was 42.8%. Among the study groups, the weekday group had a 40.2% ET success rate and the weekend group had a 54.8% success rate (P=0.517). Although no statistically significant difference existed between the two groups, we observed an absolute 14.6% increase in pregnancy rate for ETs performed during weekends compared to those performed on weekdays, with a 35% statistical power. Conclusion: ETs performed during weekends were more successful than ETs performed during weekdays with an absolute 14.6% increase in clinical pregnancy rate. This finding should be confirmed by conducting further studies with larger groups of patients. © 2016, Royan Institute (ACECR). All rights reserved.
Vulvar Cancer with Bilateral Axillary Lymph Node Metastasis
(Taylor and Francis Ltd, 2016) Hasdemir P.S.; Aras F.; Solmaz U.; Guvenal T.
[No abstract available]
What are the best surgical techniques for caesarean sections? A contemporary review
(Taylor and Francis Ltd, 2016) Hasdemir P.S.; Terzi H.; Guvenal T.
The aim of this study was to evaluate the reported techniques used in caesarean sections in order to form a general perspective of the procedural options for this frequently performed operation. The PubMed database and Cochrane Reviews were searched separately with the key words caesarean, abdominal entry, abdominal incision, uterine repair, peritoneal repair, closure of abdominal incision, suture materials, extraction of the placenta and review. Reviews, meta-analyses and prospective randomised trials were included in this review. In conclusion, although caesarean delivery is a very common operation, standardised and globally accepted techniques for caesarean section have not been described. The best surgical techniques for this operation are still unknown. Although the long-term follow-up results from two large, prospective, randomised studies are pending, further research is needed to establish an evidence-based, standardised approach for caesarean sections. © 2015 Taylor & Francis Group, LLC.
Effect of Pirfenidone on Vascular Proliferation, Inflammation and Fibrosis in an Abdominal Adhesion Rat Model
(Taylor and Francis Ltd, 2017) Hasdemir P.S.; Ozkut M.; Guvenal T.; Uner M.A.; Calik E.; Koltan S.O.; Koyuncu F.M.; Ozbilgin K.
Aim: To study the efficacy of pirfenidone for prevention of postoperative adhesion formation in an adhesion rat model. Materials and Methods: Eighteen female Wistar rats were subjected to right-sided parietal peritoneum and right uterine horn adhesion model. Rats were randomized into three groups: group 1 (control) (closure of midline abdominal incision without any agent administration), group 2 (closure of incision after intraperitoneal administration of pirfenidone), and group 3 (closure of incision and only oral administration of pirfenidone for 14 days). Relaparotomy was performed 14 days after the first surgery. Effect of pirfenidone on adhesion formation was assessed on light microscopy by scoring vascular proliferation, inflammation, fibrosis, and collagen formation in the scarred tissue. Effect of pirfenidone on inflammation was assessed by measurement of transforming growth factor-β and interleukin-17 levels in scarred tissue. Results: The degree of vascular proliferation (1.32 ± 0.39 versus 2.34 ± 0.46, p < 0.001), inflammation (1.60 ± 0.70 versus 2.60 ± 0.52, p < 0.01), and fibrosis (1.50 ± 0.53 versus 2.40 ± 0.52, p < 0.01) were less prominent in group 2 compared to group 1, respectively. Only vascular proliferation was found to be less prominent in group 3 compared to group 1 (1.60 ± 0.42 versus 2.34 ± 0.46, p < 0.01). Intraperitoneal and oral administration of pirfenidone reduced tissue levels of inflammatory markers (TGF-β and IL-17) in parietal and visceral peritoneum compared to control group. Intraperitoneal administration of pirfenidone compared to oral administration was more effective in reducing tissue levels of inflammatory markers. Conclusion: Pirfenidone is an effective agent on the prevention of postoperative vascular proliferation, inflammation and fibrosis in scarred tissue particularly with intraperitoneal administration. Copyright © 2017 Taylor & Francis Group, LLC.
The effects of pirfenidone on T helper cells in prevention of intraperitoneal adhesions
(Elsevier (Singapore) Pte Ltd, 2017) Ozbilgin K.; Üner M.A.; Ozkut M.; Hasdemir P.S.
Abdominal surgery is linked with peritoneal adhesions. We investigated that the anti-fibrotic agent pirfenidone (PFD) has immune modulating activities and evaluated its effects on the function of T helper type 1 (Th1), Th2 and T regulatory (Treg) cells, which may play important roles in peritoneal adhesions. Eighteen female Wistar rats underwent right-sided parietal peritoneal and right uterine horn adhesion model. Rats were randomized into 3 groups as group 1 (control) (closure of midline abdominal incision without any agent administrations), group 2 (closure of incision after intraperitoneal administration of PFD) and group 3 (closure of incision and only oral administration of PFD for 14 days). Relaparotomy was performed 14 days after the first surgery. Effect of PFD on adhesion formation was assessed on Th1, Th2 and Treg cells counts using Anti-T-bet, Anti-GATA-3 Anti-FOXP3 antibodies respectively. Th1 counts were moderate in the control group, and didn't show a significant difference between all groups. Th2 cell counts were very high in the control group, but both intraperitoneal and oral administration of PFD resulted in a significant reduction in Th2 cell counts. Treg cell counts were low in number in the control group. In the intraperitoneal administration of PFD group, Treg cell counts were significantly lower than control group. There was no difference of the Treg cells between control groups and the oral administration of PFD group. PFD has prevention effect on intraperitoneal adhesions. This prevention effect seems to be related with the reduction in the numbers of Th2 and Treg cells. © 2017
Comparison of Postoperative Analgesic Efficacy of Different Methods after Cesarean-Section; [Sezaryen Sonrası Farklı Yöntemlerin Arasında Postoperatif Analjezik Etkinliğin Karşılaştırılması]
(Anestezi Dergisi, 2020) Ok G.; Çevikkalp E.; Ülkümen B.A.; Erbüyün K.; Hasdemir P.S.; Özyurt B.C.; Aydın D.
Objective: In this research study,we compared postoperative analgesic effects of general anesthesia followed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia and we aimed to figure out the efficacy of TAPB for the postoperative pain. Method: After approval of the ethics committee (date: 03.25.2015; decision no: 142) for the study was obtained, the study population scheduled for elective cesarean operations was divided in three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases that underwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epidural anesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All cases received 75 mg IM diclophenac sodium after the operation. Data about the postoperative pain (the onset time of the pain, and the severity of the pain evaluated with VAS (Visual Analog Scale) and the need for adjuvant analgesics) were recorded. In addition, heart rate, blood pressure, peripheric oxygen saturation, respiration rates at postoperative 0., 1., 4., 6. and 12. hours and side effects seen were recorded. If the patient needed any additional postoperative analgesics, 50 mg tramadol was injected intravenously. Results: There was no significant difference between the groups regarding postoperative analgesia need (Table II). The need for postoperative tramadol was minimum for patients in Group E and maximum for patients in Group S (p<0.05). VAS scores at postoperative 0., 1. and 6. hours were significantly lower for patients in Group E (p<0,05). Regarding the groups T and S, VAS scores at 6. hours were significantly lower in Group T when compared with Group S (p<0.05). Conclusion: We found that the efficacy of the epidural anesthesia was more prominent and the best method for decreasing postoperative consumption of tramadol. Epidural anesthesia increased the postoperative analgesic efficacy and decreased the tramadol consumption in patients undergoing TAP block. In order to increase the comfort of the mother and newborn, TAPB may be an option for patients who are not candidates for epidural anaesthesia. © Copyright Anesthesiology and Reanimation Specialists’ Society.
Successful treatment of severe refractory post-cesarean pyoderma gangrenosum with intravenous immunoglobulin
(Blackwell Publishing Inc., 2020) Gündüz K.; Gülbaşaran F.; Hasdemir P.S.; Temiz P.; Inanır I.
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressing necrolytic ulceration of the skin. Proper treatment is crucial since it can result in devastating consequences. First-line treatments include systemic corticosteroids or cyclosporine. However, no standardized treatment regimens for refractory cases exist and treatment outcomes are affected by underlying conditions. PG after cesarean section, which is believed to occur in association with underlying pregnancy- and parturition-related immune changes, is extremely rare, and all reported cases in the literature have been successfully treated with systemic or topical corticosteroids. We report a case of a 32-year-old patient with severe PG occurring on her cesarean scar 3 days after the cesarean delivery. Treatment with systemic corticosteroids and first-line immunomodulatory agents resulted in insufficient response and serious complications. Intravenous immunoglobulin (IVIG) was then initiated, and a rapid clinical response was seen. Corticosteroid dose was gradually decreased and ceased. IVIG infusion was continued for 3 months until complete recovery. Reactivation was not observed in a 1-year follow-up period. Due to its cost, IVIG infusion is less suitable as a first-line agent. However, IVIG may be an important therapeutic option in resistant postpartum PG, in which first-line agents have failed or led to complications. © 2020 Wiley Periodicals LLC.
Maternal psychiatric status and infant wheezing: The role of maternal hormones and cord blood cytokines
(John Wiley and Sons Inc, 2021) Yilmaz O.; Yasar A.; Caliskan Polat A.; Ay P.; Alkin T.; Taneli F.; Odabasi Cingoz F.; Hasdemir P.S.; Simsek Y.; Yuksel H.
Rationale: Maternal psychosocial stress might be associated with development of allergic diseases in the offspring. Objectives: To evaluate the association of maternal depression and anxiety with ever wheezing and recurrent wheezing among infants and to assess the role of maternal hypothalamo-pituatary-adrenal axis changes and fetal immune response in this association. Methods: This study encompasses two designs; cohort design was developed to evaluate the association of prenatal depression with development of wheezing in infants while nested case–control design was used to assess the role of maternal cortisol and tetranectin and cord blood interleukin 13 and interferon γ. Results: We enrolled 697 pregnant women. Elementary school graduate mother (odds ratio [OR] = 1.5, p =.06), maternal smoking during pregnancy (OR = 3.4, p =.001), familial history of asthma (OR = 2.7, p <.001) increased the risk of ever wheezing. Elementary school graduate mother (OR = 2.6, p =.002), maternal smoking during pregnancy (OR = 4.8, p <.001) and familial history of asthma (OR = 1.7, p =.01) increased the risk of recurrent wheezing. Maternal previous psychiatric disease, or Edinburgh Postnatal Depression Scale or Spielberger State-Trait Anxiety Inventory scores were not associated with wheezing. Maternal tetranectin levels were significantly higher among never wheezers compared to the ever wheezers (264.3 ± 274.8 vs. 201.6 ± 299.7, p =.04). Conclusions: In conclusion, the major risk factors for ever wheezing and recurrent wheezing were maternal smoking, level of education and family history of asthma. However, maternal depression and anxiety were not determined as risk factors for wheezing. Maternal tetranectin carries potential as a biomarker for wheezing in the infant. © 2021 Wiley Periodicals LLC

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