Aktuğ Ertekin - Academia.edu (original) (raw)

Papers by Aktuğ Ertekin

Taiwanese Journal of Obstetrics & Gynecology, Dec 1, 2016

Objective: We aimed to assess the relationship among the sex hormone-binding globulin (SHBG), hom... more Objective: We aimed to assess the relationship among the sex hormone-binding globulin (SHBG), homeostasis model assessment (HOMA), glycosylated hemoglobin (HbA1c), and cholesterol panel values to predict subsequent gestational diabetes mellitus (GDM) in low-risk pregnancies. Materials and Methods: Thirty-eight pregnant women with GDM and 295 low-risk pregnant women without GDM were included in this study. Maternal blood samples were obtained during the first trimester examination to determine the SHBG, HbA1c, fasting blood glucose, insulin, thyroid stimulating hormone (TSH), free thyroxine, total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels. The variables that exhibited statistically significant differences between the groups and independent predictors for GDM were examined using logistic regression analysis. The risk of developing GDM, according to cutoff values, was determined using receiver operating characteristic (ROC) curve analysis. Results: The SHBG, HOMA, LDL, and TG levels were found to be the significant independent markers for GDM [adjusted odds ratio (OR) ¼ 0.991; 95% confidence interval (CI), 0.986e995; OR ¼ 1.56; 95% CI, 1.24 e1.98; OR ¼ 1.02; 95% CI, 1.01e1.04; and OR ¼ 1.01; 95% CI, 1.00e1.02, respectively]. The HbA1c, body mass index, and mean arterial pressure values were nonindependent predictors of GDM. The areas under the ROC curve used to determine the predictive accuracy of SHBG, HOMA, TG, and LDL-C for development of GDM were 0.73, 0.75, 0.70, and 0.72, respectively. For a false positive rate of 5% for the prediction of GDM, the values of the sensitivities were 21.1, 26.3, 21.1, and 18.4%, respectively. Conclusion: The HOMA, SHBG, TG, and LDL-C levels are independent predictors for subsequent development of GDM in low-risk pregnancies, but they exhibit low sensitivity.

PubMed, 1998

The prenatal diagnosis of the thrombocytopenia absent radius (TAR) syndrome using ultrasound and ... more The prenatal diagnosis of the thrombocytopenia absent radius (TAR) syndrome using ultrasound and cordocentesis at the 34th week of gestation is established. Two basic components of the syndrome, bilateral absence of radius and thrombocytopenia at a level 12.000/mm3 were detected. No complication during the cordocentesis and delivery occurred due to thrombocytopenia. This case report, to our knowledge, is one of a limited number of cases emphasized on prenatal diagnosis of TAR syndrome in the world.

Clinical and Experimental Obstetrics & Gynecology, 2017

Aim: The authors aimed to determine whether mild maternal glucose intolerance detected by abnorma... more Aim: The authors aimed to determine whether mild maternal glucose intolerance detected by abnormal screening by one-hour 50-gram glucose challenge test (GCT) and normal 100-gram oral glucose tolerance test (OGTT), which can be called as borderline hyperglycemia, is associated with increased risk of maternal and fetal adverse outcomes or not compared to normal and gestational diabetes mellitus (GDM) patients. Materials and Materials: Pregnant women with normal 50-gram GCT (198 cases), abnormal 50-gram GCT and normal 100-gram OGTT (160 cases), and impaired glucose tolerance (IGT) or GDM diagnosed with 100-gram OGTT (212 cases) were included. Data was collected from hospital automation system and clinical records. The authors compared demographic, obstetric, and neonatal outcomes among these three groups. Results: Mean maternal age (31.5 ± 5.2 years), history of GDM (4.2%), and the rate of cesarean section delivery in previous pregnancy (41,5%) were statistically higher in group 3 (IGT+GDM group) compared to both group 1 (normal 50-gram GCT) and group 2 (borderline hyperglycemia), respectively (p < 0.01, p < 0.01, and p < 0.01). The duration of maternal hospitalization was longer (2.40 ± 1.28 and 2.39 ± 1.25 vs. 1.79 ± 1.15 day, p = 0.001, p = 0.001, respectively) and postoperative hemoglobin values were lower (10.71 ± 1.44 and 10.69 ± 10.90 vs. 11.22 ± 1.43, p = 0.015, p = 0.006, respectively) both in groups 2 and 3 when compared with group 1. However preeclampsia was statistically more commonly developed in group 3 than in groups 1 and 2 (16% vs. 6.1% and 11.3%; p < 0.05). Neonatal hypoglycemia was more common both in groups 2 and 3 compared to group 1 (11.8%, 4.6% vs. 0%; p < 0.001, p = 0.045, respectively) and first minute apgar scores were higher in group 1 than in groups 2 and 3 (7.97 ± 0.55 vs. 7.65 ± 1.19 and 7.60 ± 1.17; p = 0.003, p = 0.001, respectively). Duration of hospitalization period for neonates was longer in groups 2 and 3 than in group 1 (2.22 ± 1.28 and 2.42 ± 1.48 vs. 1.82 ± 1.17 day; p = 0.006, p = 0.001). Conclusion: Borderline hyperglycemia can cause maternal, perinatal, and neonatal adverse outcomes. Both obstetricians and neonatologists must keep in mind the unfavorable pregnancy outcomes of borderline hyperglycemia cases and careful follow up is needed even if it is not accepted as GDM and IGT.

International Journal of Gynecologic Cancer, 2005

The Journal of reproductive medicine, 1998

To determine the efficiency and comparison of two different protocols, human menopausal gonadotro... more To determine the efficiency and comparison of two different protocols, human menopausal gonadotropin (hMG) plus gonadotropin-releasing hormone analog (GnRH-a) and low-dose hMG to reduce multifollicular development in clomiphene-resistant polycystic ovary syndrome (PCOS) patients. Prospective comparative and pilot study in 20 patients for 31 cycles. The first group (n = 10) was treated with buserelin acetate, 600 micrograms/d, for six weeks before ovulation induction with hMG in conventional doses for 14 cycles. The other group (n = 10) was treated only with low-dose hMG for 17 cycles. All cycles were compared in terms of the number of follicles per cycle, cycles human chorionic gonadotropin withheld, estradiol level on ovulation day, treatment duration and number of ampules used per cycle. In addition, the outcome of cycles and complications of multifollicular development, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy were determined. As compared with the GnRH-a + ...

Fertility and Sterility, 2013

Ultrasound in Obstetrics and Gynecology, 1997

We describe the color Doppler sonographic features of uterine arteriovenous malformations in two ... more We describe the color Doppler sonographic features of uterine arteriovenous malformations in two cases. In both cases color Doppler imaging demonstrated hypervascularity throughout the arteriovenous malformation. The dominance of pale shades during both systole and diastole represented low-impedance, high-velocity flow within the lesion and a colored mosaic pattern representing turbulent flow was noted. Spectral analysis of the vessels within the lesion confirmed high-velocity flow during both systole and diastole, and a low resistance index. The spectral waveform trace also showed spectral broadening consistent with turbulence and the spectral envelope was irregular. These findings indicated the presence of numerous arteriovenous shunts and marked turbulence within the arteriovenous malformation. Spectral analysis of the venous flow revealed high flow velocities and systolic velocity peaks similar to an arterial pattern. The uterine artery velocity waveforms were characterized by high flow velocity and a low resistance index. The diagnosis of uterine arteriovenous malformation was confirmed by histological examination in both cases. The findings of these two cases suggest that color Doppler sonography may play an important role in the diagnosis of uterine arteriovenous malformations.

International Journal of Gynecology & Obstetrics, 2005

International Journal of Hypertension, 2020

Aim. To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensi... more Aim. To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensive pregnant women, patients with mild preeclampsia, and patients with severe preeclampsia. Methods. We collected venous blood samples from 25 normotensive pregnant women, 15 patients with mild preeclampsia, and 15 patients with severe preeclampsia. The women were at 30th to 40th weeks of gestation and in an age range of 20 to 35. The N-terminal pro-C-type natriuretic peptide levels were measured by ELISA. Statistical comparisons were made by one-way analysis of variance, Kruskal–Wallis, and Mann–Whitney U tests. Results. The median (interquartile range-IQR) values of the N-terminal pro-C-type natriuretic peptide were 6.48 (3.33) pmol/L in the normotensive women group, 7.37 (3.43) pmol/L in patients with mild preeclampsia, and 11.52 (6.13) pmol/L in patients with severe preeclampsia. The N-terminal pro-C-type natriuretic peptide was significantly elevated in the severe preeclampsia study ...

Bagcilar Medical Bulletin, 2022

Objective: Body mass index (BMI) is often used to diagnose obesity, although it has the disadvant... more Objective: Body mass index (BMI) is often used to diagnose obesity, although it has the disadvantage of not being able to reveal body fat content. Our study aimed (1) to evaluate the obesity status using BMI and body fat percentage (BF BIA %) determined by bioelectric impedance analysis (BIA) method among women aged 20-60 years who were admitted the outpatient nutrition clinic, and (2) to evaluate the relationship between BMI and BF BIA %. Method: This study enrolled 100 women aged 20-60 years. It was a descriptive study. The study data and the BF BIA % values were obtained from outpatient BMI data recorded between October 2020 and November 2020. BMI was calculated using body weight (kg) and body height (m 2). The prevalence of obesity was determined using BMI and BF BIA %. Statistical analyses were performed using the Pearson's correlation test and One-Way analysis of variance. Results: Prevalence of obesity, based on BMI and BF BIA %, was 53% and 46%, respectively and no significant difference was determined (p=0.322). Subjects determined to be obese based on the BMI had a mean BF BIA % of 40±18%. The subjects determined to be obese, overweight and normal Amaç: Obezite tanısında sıklıkla beden kütle indeksi (BKİ) kullanılmakla birlikte, vücut yağ düzeyini ortaya koymaması dezavantajlı noktasıdır. Bu çalışmanın amaçları diyet polikliniğine başvuran, (1) 20-60 yaş grubu kadın bireylerde, BKİ ve biyoelektrik impedans analiz yöntemi (BİA) ile doğrudan saptanan vücut yağ yüzdesini (VY BİA %) kullanarak obezite durumunu ve (2) BKİ ve VY BİA % arasındaki ilişkiyi değerlendirmektir. Yöntem: Çalışma 20-60 yaş arası 100 kadın bireyle yürütülmüştür. Bu araştırma tanımlayıcı tiptedir. Araştırma verileri ve vücut yağ yüzdesi (% BF BİA) değerleri, poliklinik BİA kayıtlarından Ekim-Kasım 2020 arasında elde edilmiştir. Vücut ağırlığı ve boy uzunluğu ölçümleri kullanılarak BKİ hesaplanmıştır. Bireylerde obezite görülme sıklığı BKİ ve vücut yağ yüzdesi (VY BİA %) kullanılarak belirlenmiştir. İstatistik olarak Pearson korelasyon testi ve tek-yönlü varyans analizi kullanılmıştır. Bulgular: BKİ'ye göre kadınların %53'ü, BİA ile elde edilen vücut yağ yüzdesine göre %46'sı obez bulunmuştur. BKİ ve vücut yağ yüzdesi kullanılarak saptanan obezite arasında anlamlı bir fark bulunmamıştır (p=0,322). BİA'ya göre obez bireylerin ortalama vücut yağ yüzdesi (VY BİA %) %40±18 olarak saptanmıştır. BİA yöntemi kullanılarak BKİ'ye göre şişman, hafif şişman ve normal vücut ağırlığındaki kadınların vücut

International journal of clinical and experimental medicine, 2015

To compare and evaluate the influences of expectant and aggressive management of severe preeclamp... more To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy. Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group. The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (...

Turkiye Klinikleri Journal of Case Reports, 2021

Labial adhesion is defined as flimsy or dense fusion of labia minora in the middle which may be c... more Labial adhesion is defined as flimsy or dense fusion of labia minora in the middle which may be congenital or acquired. These adhesions are usually seen in prepubertal girls but rarely in postmenopausal women. Management options include topical estrogen with or without steroids or surgery in persistent circumstances. The case reported here was an 83-year-old postmenopausal woman who was presented with urinary retention and recurrent urinary tract infections. On examination, she had complete labial fusion leaving only a pinhole opening for voiding. A surgical approach was performed via a midline incision and complete excision of bilateral labia minora. Her urinary complaints were
dissolved. Surgical management options for postmenopausal complete labial fusion cases will be discussed.
Keywords: Complete labial fusion; incomplete voiding; recurrent urinary tract infection

Metabolism, 2012

The aim of the present study was to predict the development of gestational diabetes mellitus (GDM... more The aim of the present study was to predict the development of gestational diabetes mellitus (GDM) after 24 weeks of gestation by using first-trimester insulin indices. A total of 298 nondiabetic pregnant women underwent 3-hour oral glucose tolerance test (OGTT) in the first trimester of pregnancy. The normoglycemic women underwent second OGTT between 24 and 28 weeks. Insulin sensitivity and resistance indices were calculated by using the Matsuda index (composite insulin sensitivity from OGTT), quantitative insulin sensitivity check index, and homeostasis model assessment for insulin resistance and sensitivity by using the results of the first-trimester OGTT. These indices were compared between subjects who were diagnosed as having GDM and subjects with normal glucose tolerance in the second OGTT. The overall prevalence of GDM was 15.49% (24 in the first trimester and 16 between 24 and 28 weeks). First-trimester fasting plasma insulin greater than 7.45 μU/mL was able to predict GDM with sensitivity and specificity of 80% and 57.4%, respectively. The negative predictive value for this parameter was 0.97. Values of firsttrimester composite insulin sensitivity from OGTT less than 5.5 had sensitivity and specificity of 71.4% and 62.5% for the prediction of GDM. First-trimester hyperinsulinemia preceded the onset of hyperglycemia between 24 and 28 weeks of gestation and would predict the development of GDM with limited sensitivity and specificity.

Menopause, 2005

Objective: An elevated plasma homocysteine level is a risk factor for cardiovascular diseases. Ho... more Objective: An elevated plasma homocysteine level is a risk factor for cardiovascular diseases. Hormone therapy (HT) may reduce fasting plasma homocysteine levels. We studied 80 postmenopausal women to determine the effect of medroxyprogesterone acetate (MPA) combined with conjugated equine estrogens (CEE) on fasting plasma homocysteine levels. Design: In a randomized, double blind, prospective, placebo-controlled study, we randomly assigned 80 healthy postmenopausal women between CEE 0.625 mg/d combined with MPA 2.5 mg/d (n = 20), CEE 0.625 mg/d combined with MPA 5 mg/d (n = 20), unopposed CEE 0.625 mg/d (n = 20), and placebo (n = 20) all given for a duration of 6 months. Fasting plasma homocysteine levels were measured before and at the end of the treatment. Results: Before treatment, plasma homocysteine concentrations were similar in all groups. After 6 months of unopposed CEE, the mean fasting plasma homocysteine levels decreased by 19.02% when compared with baseline levels (P , 0.05). The mean fasting plasma homocysteine concentrations decreased by 17.63% and 19.56% from baseline in both the CEE plus MPA 2.5 mg/d and CEE plus MPA 5 mg/d groups, respectively (P , 0.05 for each group). In contrast, plasma homocysteine levels increased by 11.66% in the placebo group. The homocysteine lowering effect did not differ significantly among the three groups of women receiving unopposed CEE alone and CEE plus MPA at two different doses. Conclusion: Six months of estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) significantly lower fasting plasma homocysteine levels in healthy postmenopausal women with equal efficacy.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2012

The study was approved by the local ethics committee, and written informed consent was obtained f... more The study was approved by the local ethics committee, and written informed consent was obtained from all participants.

Turkiye Klinikleri Journal of Forensic Medicine, 2011

Has ta ne mi zin, Ka dın Has ta lık la rı ve Do ğum Bö lü mü ne baş vu ran ad li ol gu la rın baş... more Has ta ne mi zin, Ka dın Has ta lık la rı ve Do ğum Bö lü mü ne baş vu ran ad li ol gu la rın başvu ru se bep le ri, de mog ra fik özel lik le ri ve ge çi ci ra por ve ril me si ne et ken olan fak tör le rin be lir lenme si dir. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Ça lış ma mız da Ha zi ran 2007-Ey lül 2009 ta rih le ri ara sın da ad li ra por is te miy le has ta ne mi zin Ka dın Has ta lık la rı ve Do ğum bi ri mi ne baş vu ran 800 ol gu ret ros pek tif olarak in ce len di. Ol gu la rın res mi ka yıt la rı, baş vu ru ne den le ri, yaş la rı, sevk eden ku rum lar, baş vu ru saat le ri, ya zı lan ad li ra por so nuç la rı açı sın dan de ğer len di ril di. B Bu ul l g gu u l la ar r: : 800 ad li va ka nın %66'sı (527 ol gu) id det müd de ti, %21'i (168 ol gu) cin sel sal dı rı, %8'i (64 ol gu) himen mu a ye ne si, %2.5'i (20 olgu) ev li li ğe psi ko lo jik ve fi zik sel ola rak uy gun luk, %1.5'i (12 ol gu) trav ma ve %1'i (9 ol gu) di ğer sebep ler den do la yı baş vur muş tu. İddet müd de ti ol gu la rın da %100, himen mu a ye ne si ol gu la rın da %47, cin sel sal dı rı su çu ol gu la rın da %6 ora nın da ke sin ra por ve ril di ği tes pit edil di. Tüm ol gu la rın %80'i (642 ol gu) me sa i sa at le rin de, %20'si (158 ol gu) me sa i sa at le ri dı şın da baş vur muş ol du ğu tespit edil di. Ol gu la rın %21'inin (172 ol gu) ka ra kol dan, %78'inin (622 ol gu) sav cı lık tan, %1'inin (7 ol gu) jan dar ma ta ra fın dan gön de ril miş ol du ğu an la şıl dı. S So o n nu uç ç: : İddet müd de ti dı şın da ki ad li ra porla rın dev let has ta ne le ri ye ri ne ad li tıp uz man la rı ta ra fın dan ve ril me le ri in san gü cü ve za man kaybı nı önem li öl çü de azal ta ca ğı gi bi, ad li olay la rın çok da ha kı sa sü re de ve de lil kay bı na uğ ra ma dan açık lı ğa ka vuş ma sı nı sağ la ya cak tır. Ça lış ma mız da ki id det müd de ti ol ma yan ol gu lar da ke sin ra por ora nı nın (%23) dü şük lü ğü ka dın do ğum uz man la rı nın ad li ko nu lar hak kın da ye ter li do na nı ma sahip ol ma ma la rı ve ya ad li açı dan faz la so rum lu luk al mak is te me me le ri ile açık la na bi li nir.

To have correct and complete information is very important for the prediction and prevention of t... more To have correct and complete information is very important for the prediction and prevention of the complications during pregnancy and determining the optimal therapy. The periodic examinations during pregnancy will prevent the occurance of the serious problems. Although there is some differences for the number of periodic examinations of the pregnant patients among countries, generally there is a standart periodic examination procedure. At least 4 examinations, 2 ultrasonographic (USG)examinations, urine analysis and complete blood count (CBC-at least 4 times), blood group and Rh typing, HBSAg analysis, first or second trimester screening and 50 gr glucose challenge tests are advised for pregnant patients. For high risk patients 12-14 times examinations, CBC and urine analysis and USG examinations more than 10 times is performed during the pregnancy period. Normal pregnant patients are examined 9 times during pregnancy period. For high risk patients the number of examinations, anal...

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1996

Överin seyrek görülen tümörlerinden olan mikst •me zodermal tümörlerde olgu sayısı rz. olduğu içi... more Överin seyrek görülen tümörlerinden olan mikst •me zodermal tümörlerde olgu sayısı rz. olduğu için tedavi yaklaşımlannda tam bir fikir birliği yoktur. Bu nedenle üç ol gumuzda elde ettiğimiz sonuçları tartıştık. Çalışmanın Yapıldığı Yen GATA Haydarpaşa Eğitim Hastanesi Kadın Hastalıklan ve Doğum Kliniği. Materyal ve Metod: 1985 yılından bugüne kadar kliniğimizde saptadığımız 3 olguyu çalışmamıza aldık. Bulgular Hastalann yaş ortalaması 57.7 (46-68) idi. İki hasta postmenopozal dönemde, iki ve daha az doğum yapmıştı. Hastalığın kliniğimizde saptadığımız tüm over tümörleri içinde görülme sıklığı %7 idi. Hastalann tümünde asit mev cut idi. Hastalara primer cerrahi tedaviyi takiben postoperatif kemoterapi (PAC+CHAP) ve bir hastaya rad yoterapi uygulandı. İki hasta 12. ayda eksitus oldu. Bir hasta tanıdan itibaren 54 aydır takipte ve son kontrolunda bilgisayarlı tomografide pelviste lenfadenopati kitlesi sap tanması ve tümör belirtecinin yüksek bulunması üzerine tekrar İkinci sıra kemoterapiye başlandı.

Journal of Obstetrics and Gynaecology Research, 2011

To study the relationship between cervical lengths measured by ultrasound and risk of preterm del... more To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery. We examined 209 women with singleton pregnancies. The inclusion criteria were women who presented with regular and painful contractions (≥2 contractions at intervals of 10 min for at least 1 h). Transvaginal scan was performed to measure the cervical length. The clinical management of the women, including hospitalization and administration of tocolytics, was determined by the attending obstetricians, who were blinded about cervical length. The primary outcome was delivery within 7 days of presentation. Delivery within 7 days of presentation occurred in 19/209 (9%) of pregnancies who were presenting with regular and painful uterine contraction at 31 weeks of gestation, and this was inversely related to cervical length. Logistic regression analysis demonstrated that cervical length and history of abortion remain as significant contributors to predicting delivery within 7 days. Of the patients who presented with threatened preterm labor, 117 (56%) received tocolytics, and 92 (44%) did not. In the group with a cervical length of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 mm, delivery within 7 days occurred in 15/21 (71.4%) who were treated with tocolytics and 2/5 (40%) that were managed expectantly. Women with threatened preterm labor and a cervical length of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 mm at presentation are at high risk of delivering preterm within 7 days. Sonographic measurement of cervical length helps to avoid over-diagnosis of preterm labor.

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995