Paclitaxel and carboplatin therapy in stage I fallopian tube carcinoma.
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Biomedical subjects
Publications and source records attributed to L Mollamahmutoglu.
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OBJECTIVE: To evaluate the iatrogenic effect of different protocols of hormone replacement therapy (HRT) on endometrial polyp formation adjusting for the confounding effects of other factors such as age, parity, weight and menopausal status at menopause. METHODS: Out of 2685 menopause patients 375 (13.9%) eligible patients were enrolled. Patients were randomized to three HRT types and three equal groups were formed. The first group received Premelle 2.5 mg (Group-I) (0.625 mg conjugated estrogen + 2.5 mg medroxyprogestorone), the second received Kliogest (Group-II) (2 mg estradiol + 1 mg norethisterone) and the last received Livial (Group-III) (2.5 mg tibolone) at least for 36 months without giving a break. After the first 18 months patients had their first office hysteroscopy and it was repeated in every 6 months until the end of third year to find out new and recurrent endometrial polyps. RESULTS: Multiple regression analysis revealed that the type of HRT, late menopause and obesity increased the occurrence of endometrial polyps. In Group-I five polyps, in Group-II ten polyps and in Group-III two polyps were detected. There were significant differences between G-II and G-I and G-II and G-III (P < 0.05), but there was no significant difference between G-I and G-III (P > 0.05). 82.3% of the polyps were detected in the third and fourth hysteroscopic examinations. Endometrial polyp recurrence was encountered in 4 (23.5%) patients, 1 in G-I and 3 in G-II without a significant difference (P > 0.05). No malignancy was detected in any of the specimen. CONCLUSION: We observed that endometrial polyp formation may be dependent on the type and dosage of the estrogen and progestogen. Especially a progestogen with high antiestrogenic activity may play an important preventive role in the development of endometrial polyps.
OBJECTIVE: To evaluate the outcome of myomectomy during cesarean section and to compare it with a control group. MATERIALS AND METHODS: Using a retrospective case-control design; 40 patients who underwent myomectomy at time of cesarean delivery were compared with the control group consisted of 80 patients with myomas who underwent cesarean delivery alone. RESULTS: The mean size of fibroids removed was 8.1+/-4.7 cm (range, 3-25 cm). In control group it was 5.7+/-2.7 cm (range, 2-14 cm). The incidence of hemorrhage in the study group was 12.5% as compared with 11.3% in the control group (p>0.05). There was also no significant differences in the incidence of postoperative fewer and frequency of blood transfusion between myomectomy and control groups (p>0.05). CONCLUSION: Myomectomy during cesarean section is not always a hazardous procedure and it can be performed without significant complications by experienced obstetricians.
OBJECTIVES: The aim of this study was to assess the efficacy of topically applied trichloroacetic acid (TCA) for endometrial ablation in patients with dysfunctional uterine bleeding (DUB). This trial has also compared the advantages of prethinning the endometrium with danazol and goserelin acetate before ablation with TCA. METHODS: This prospective trial was conducted on 90 volunteer cases. Patients were allocated into three treatment groups comprised of 30 patients. In group I cases underwent dilatation and curettage before endometrial ablation. In group II cases were administered danazol before ablation. Cases in group III received goserelin acetate on the same day and 28 days after ablation. Endometrium was evaluated by biopsy, transvaginal ultrasonography and hysteroscopy. Endometrial ablation was performed with 95% TCA. All of the patients were evaluated 3 and 6 months after TCA application. RESULTS: After 6 months of treatment, the success rate was recorded as 83% in the first group, 92.3% in the second group and 96.6% in the third group. The mean length of uterine cavity was reduced in all groups, being only significant in Goserelin group (P<0.5). Endometrial thickness was decreased significantly in all treatment groups (P<0.001). CONCLUSIONS: This study concluded that endometrial ablation by TCA may readily be performed as an alternative treatment method in the management of DUB. Moreover, suppression of endometrium with danazol or especially with goserelin acetate before ablation, resulted in significant success rate.
To assess the efficacy of GnRH-agonist therapy in the treatment of endometriomas with or without surgical intervention, 26 women with laparoscopically proven endometriomas larger than 3 cm were recruited to the study. Fourteen women with 19 endometriomas (5 bilateral), had drainage of endometrioma at initial laparoscopy. After the procedure, ovarian suppression was done with GnRH-a therapy for 6 months. The second group which consisted of 12 women, had 17 endometriomas. No surgical procedure was performed. They received only GnRH-a therapy for 6 months. On repeat laparoscopy, in the first group, the rates of decrease in ovarian AFS scores of endometriomas and complete resolution were found as 100% and 37% respectively. In the second group the response was only 18% (p < 0.0001). It was concluded that drainage of the cyst (surgical therapy) combined with postoperative GnRH-a suppression is a better treatment modality than the use of GnRH-a (medical therapy) alone for endometriomas.
We investigated the relationship between serum leptin concentration, serum lipid profile and other blood biochemistry parameters in healthy post-menopausal women. Blood samples for analysis of serum leptin concentration, blood biochemistry and hormonal status, and urine samples for calcium measurement were taken from 122 women. No significant correlation was found between serum leptin concentration and serum lipid profile. The concentration of serum leptin was significantly associated with body mass index (BMI), luteinizing hormone (LH) and alanine transaminase (ALT). BMI was found to be a statistically significant independent factor for serum leptin concentration. We conclude that leptin was not associated with serum lipids and lipoproteins in post-menopausal women. Leptin was associated with BMI, ALT and LH, however, with BMI being an independent predictor of leptin concentration. There was a relationship between LH and serum leptin concentration even after menopause, and ALT correlated with serum leptin concentration through BMI.