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Labor induction is widely used in term pregnancies; however, accurately predicting induction success remains challenging, particularly in nulliparous women

Özet Amaç: Son trimester gebe kadınlarda rekto-vajinal Grup B Streptokok kolonizasyon sıklığını, kolonizasyon sıklığına etkili olduğu düşünülen risk faktörlerinin kolonizasyon sıklığına etkisini ve antibiyotik duyarlılığını araştırmak . Gereç ve Yöntemler: TC Sağlık Bakanlığı Bakırköy Doğumevi Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi doğumhanesine kabul edilen 500 anne adayından başvuru anında rektal ve vajinal kültür örnekleri alındı. Alınan kültür örnekleri Cerrahpaşa Tıp Fakültesi Çocuk Hastalıkları Hastanesi Mikrobiyoloji Laboratuarında değerlendirildi. Bulgular : Çalışmaya alınan anne adaylarından toplam 41 (%8.2) kadında Grup B Streptokok kolonizasyonu saptandı. Anne yaşı, gebelik sayısı, doğum sayısı, evlilik süresi, sigara kullanımı, eğitim durumu, erken doğum eylemi, gebelikte penisilin grubu antibiyotik kullanımı gibi faktörlerle rekto­ vajinal Grup B Streptokok kolonizasyon sıklığı arasında anlamlı bir ilişki izlenmedi. Grup B Streptokok taşıyıcısı olduğu saptanan gebelerin bebekleri doğum sonrası birinci hafta ve üçüncü ayda menenjit , sepsis ve pnömoni gelişimi yönünden sorgulandı ve hiçbir bebekte bu komplikasyonların olmadığı izlendi. Üretilen Grup B Streptokok suşlarının antibiyotik direnç paternleri incelendiğinde penisilin, vankomisin, kloramfenikol, siprofloksasin ve seftriaksona % 100 duyarlılık, eritromisine %95, klindamisine %87, tetrasikline %15 duyarlılık saptandı. Sonuç: Toplumumuzda anne adaylarında rekto-vajinal Grup B Streptokok kolonizasyon sıklığını araştırmaya yönelik stratejilerin rutin uygulamaya geçilmesi anne ve bebekte mevcut potansiyel risklerin kontrol altına alınmasını sağlayabilir.

Objective: The effect of Ulipristal Acetate on endometriosis foci created in rats was investigated. Methods: The study was conducted with 12-week-old rats weighing approximately 280 grams. After creating an autologous endometriosis model, the group that did not receive ulipristal acetate negative was administered with oral saline daily, and the group given ulipristal acetate positive was administered with 0.5 mg/kg (0.125 mg/rat/day) orally for 4 weeks. Ectopic endometrial tissues were removed for histopathological and immunohistochemical evaluations. Staining was performed with Hematoxylin Eosin, Ki-67, and Cyclooxygenase-2. Results: The Hematoxylin-Eosin Staining score of the ectopic endometrium surface epithelium was found to be 2.5 points in the ulipristal acetate negative group, and 0.5 points in the ulipristal acetate positive group. In the immunohistochemical evaluation, Ki-67 positivity of the ectopic endometrial surface epithelium was found to be 71.2% in the ulipristal acetate negative group vs. 31.7% in the ulipristal acetate positive group. Cyclooxygenase-2 positivity was detected as 67% in the ulipristal acetate negative group vs. 27% in the ulipristal acetate positive group. Conclusions: Hematoxylin-Eosin staining revealed that ulipristal acetate negative group was 2.5 (well-moderately preserved epithelium), and the ulipristal acetate positive group was 0.5 (epithelium was rarely present or absent). It was found that the percentage of Ki-67 and Cyclooxygenase-2 immunohistochemical positivity was decreased in the ulipristal acetate positive group compared to the ulipristal acetate negative group at a statistically significant level. More literature data are needed on this subject.

OBJECTIVE: The persistence of high-risk human papillomavirus infections, most of which are known to be transient is of critical importance for the development of precursor lesions and cancer in the cervix. The aim of the present study is to investigate the persistence and clearance of genotype-based human papillomavirus infections and also some cofactors that could be effective in persistence. STUDY DESIGN: Data of 115 patients whose human papillomavirus and genotype detection was made with multiplex Polymerase chain reaction, and capillary electrophoresis were categorized as low-risk human papillomavirus/high risk human papillomavirus and single/multiple human papillomavirus infections, and clearance/persistence data of two years were investigated. RESULTS: While 82 (71.3%) out of 115 patients (mean age 40.1 years) had a single human papillomavirus infection, the remaining had two or more human papillomavirus infections. Of all human papillomavirus infections, 81.5% (128/157) were high risk-human papillomavirus. Clearance rates of human papillomavirus infections during the first two years was 85.4% (134/157), persistence was 14.6% (23/157). The most frequently persisted high risk-human papillomavirus genotypes were 31, 52, 68, 16, and 35, respectively. A statistically significant difference was not found in human papillomavirus persistence with regard to the infection’s being single/multiple or low-ris/high risk. A significant difference was not found between age groups and persistence. CONCLUSIONS: Of human papillomavirus infections, 85.4% are cleared during the first two years while the most frequently persisted high risk-human papillomavirus genotypes were 31, 52, 68, 16, and 35, respectively. Being aware of population-based clearance/persistence results of type-specific infections may specify screening strategies.

Amacımız, yaş ve aile hikayesinden bağımsız olarak merkezimizde over (OC) ve endometriyum kanseri (EC) tanısı ile cerrahisi ve ardından genetik mutasyon analizi uygulanan hastalarımızın mutasyon sıklığını ve sekanslarını araştırmaktır. Son yıllarda önleyici stratejilerin gelişimi dışında tedavi seçeneklerindeki fırsatlar ve genetik çalışmaların artışı herediter kanserlere ilgiyi arttırmıştır. En sık görülen herediter jinekolojik kanserler; herediter meme over kanseri (HBOC) ve Lynch Sendromu (LS) dur. Hastalığın düşük prevalansı, test pahalılığı ve etik sebepler popülasyon bazlı taramayı kullanışsız hale getirmektedir. Birimimizde 01.04.2018-01.10.2019 tarihleri arasında genetik araştırması yapılan 37 EC ve 15 OC tanısı almış hastamız çalışmaya dahil edilmiştir. BRCA1/2 ve LS genlerini de içeren (MLH1, MSH2, MSH6, PMS 2) 25 genden oluşan geniş ailevi panel testi uygulanmıştır. Ailevi gen paneli testi yapılan 27 EC hastamızda, 1 MLH1 ve 1 ATM geninde patolojik mutasyon saptandı (%3.7 LS,%3.7 non LS). 11 hastada önemi belirsiz varyant mutasyon (VUS) görüldü (%40.7). BRCA mutasyon araştırması yapılan 20 EC’li hastamızda patolojik mutasyon saptanmadı. BRCA mutasyonu araştırılan 14 OC’lu hastamızda 3 patolojik varyant identifiye edildi ve hepsi BRCA1 genindeydi (HBOC %21,4). Ailevi kanser paneli değerlendirilen 4 OC’lu hastada 1 MSH6 ve 1 ATM geninde patolojik mutasyonlar izlendi. Over ve endometriyum kanserlerinde ailevi geniş mutasyon verilerinin çoğalması ve literatürde paylaşımı VUS oranlarını azaltacak, BRCA ve LS dışındaki genlerin jinekolojik kanserlerdeki rolünü ortaya çıkartacak ve yeni tarama algoritmalarını oluşturacaktır.

Introduction: HPV (Human papilloma virus) is the most common sexually transmitted infection and constitutes an important part of cancers for which infectious agents are blamed in its ethology. The most important duty of informing the public about HPV and the HPV vaccine with a high protection rate belongs to doctors. The curriculum and scope of this subject in medical education in our country is uncertain. We aimed to determine the knowledge, attitudes, and behaviours of our students about HPV and the HPV vaccine before the internship and to find out the change in their knowledge, attitudes, and behaviour status after the internship. Method: The population of the study consists of a total of 257 third and sixth grade students studying in the Faculty of Medicine at Çanakkale Onsekiz Mart University during the 2018-2019 academic year. A questionnaire, including questions and suggestions about sociodemographic characteristics, and knowledge, attitudes and behavioural status about HPV infection and the HPV vaccine, was administered under supervision to third and sixth grade students between April and June 2019 without specifying their name and surname. Chi-square test was used for statistical evaluation. For statistical significance, p <0.050 was accepted.Results: 108 third grade and 91 sixth grade students participated in our study. Although HPV is known to play a role in the ethology of cervical cancer and anogenital warts (91%, 91.2%), this awareness was as low as 35.4%, 37.9% and 38.8%, respectively, in penis, anus and head and neck cancers. The knowledge level was statistically significant in favour of the sixth-grade students (p 0.05). The reason why the students did not have the HPV vaccine was related to the fact that they found the vaccine expensive and did not consider it necessary. Only 46.7% of the sixth-grade students thought that they could give their patients enough information about the HPV virus and vaccine when they graduated.Conclusion: The frequency of vaccination in our country is very low even among doctors. Training strategies should be developed to enable doctors to graduate with full knowledge of HPV and the HPV vaccine with multidimensional training programs.