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Biomedical subjects

M B Tiras

Publications and source records attributed to M B Tiras.

9 recordsLinked to original sources
PubMed2004

The effect of recombinant GM-CSF on IL-6 and TNF-alpha levels in epithelial ovarian cancer patients who received paclitaxel and cisplatinum: preliminary results.

OBJECTIVE: We investigated the effects of GM-CSF factor on IL-6 and TNF-alpha levels prior to paclitaxel-cisplatinum combination chemotherapy for advanced epithelial ovarian cancer. MATERIALS AND METHODS: Twenty-three consecutive patients with FIGO (International Federation of Gynecology and Obstetrics) Stage III-IV epithelial ovarian cancer were enrolled in the study. Following cytoreductive surgery patients received 175 mg/m2 paclitaxel and 75 mg/m2 cisplatinum on the same day. These 23 patients also received RhuGM-CSF five days before at a dose of 5 microg/kg/day by subcutaneous injection for three days. IL-6 and TNF-alpha levels were measured before and 24 hours later following the last dose of RhuGM-CSF. RESULTS: White blood cell counts on the 10th day of the cycle were lower than preGM-CSF white blood cell counts and the difference was statistically significant (p = 0.003). Platelet levels on the 10th day of the chemotherapy cycle were lower than pre GM-CSF levels, however were not statistically significant (p = 0.097). Post GM-CSF TNF-alpha and IL-6 levels were higher than pre GM-CSF levels. This difference was statistically significant for TNF-alpha (p = 0.002) however for IL-6 a statistically significant difference was not detected (p = 0.55). GM-CSF does not significantly effect IL-6 levels in contrast to TNF-alpha. CONCLUSION: Clinical implications of increased levels of TNF-alpha are unclear and for a precise determination further studies are needed.

Adult↗
PubMed2003

Insulin secretion and insulin sensitivity in normal pregnancy and gestational diabetes mellitus.

The purpose of this study was to evaluate insulin sensitivity, beta-cell function and islet-cell-directed autoimmunity in pregnant women with normal glucose tolerance and gestational diabetes mellitus (GDM). A total of 21 women with normal glucose tolerance and 21 women with GDM were evaluated at 24-36 weeks' gestation. Insulin resistance and beta-cell function were evaluated using the continuous infusion of glucose with model assessment (CIGMA) method, which aims to give a near-physiological stimulus and to evaluate the endogenous insulin and glucose response. Islet-cell autoantibody was positive in one woman with GDM, and glutamic acid decarboxylase autoantibodies were negative in both groups. The calculated CIGMA insulin resistance (CIGMA IR) was 2.04 +/- 1.74 and 1.08 +/- 1.22 in patients with GDM and in control subjects, respectively (p < 0.05). CIGMA percentage beta-cell values were 64.04 +/- 44.55% and 87.07 +/- 52.77% in patients with GDM and control subjects, respectively (p > 0.05). Decreased insulin sensitivity in late pregnancy was more evident in lean GDM subjects with mild hyperglycemia who did not require insulin therapy, and beta-cell function was partially preserved in this group of patients.

Adult↗
PubMed2001

Transvaginal sacrospinous colpopexy for marked uterovaginal and vault prolapse.

OBJECTIVE: The transvaginal sacrospinous ligament fixation technique was used as part of the vaginal repair procedure for marked uterovaginal prolapse, and in the treatment of vault prolapse. METHOD: Out of the 26 women treated with sacrospinous ligament suspension of the vaginal vault, 23 had marked uterovaginal prolapse and three had vault prolapse following hysterectomy. Patients with vault prolapse underwent posterior vaginal repair, obliteration of the enterocele sac and sacrospinous colpopexy. Patients with marked uterovaginal prolapse underwent vaginal hysterectomy with high ligation of the enterocele sac, anterior and posterior vaginal repair, and sacrospinous colpopexy. Bilateral salpingoopherectomy was added to the procedure in five patients. All patients were examined 6 weeks after the operation and, subsequently, on an annual basis. The mean follow-up period was 2.6 years (1-5 years). RESULTS: Out of the three patients with previous vault prolapse, none had recurrences. Out of the 23 patients with previous marked uterovaginal prolapse, only two had small cystocele, and one had small enterocele at 36 months following the operation. These patients were asymptomatic and did not need an operation. Vaginal vault prolapse was not observed in any of these patients. Two women had post-operative urinary tract infection and five had buttock discomfort, which subsided after 2 months. No other intra- or post-operative complications occurred. CONCLUSION: Transvaginal sacrospinous colpopexy can be performed together with vaginal hysterectomy, and anterior and posterior vaginal wall repair in patients with marked uterovaginal prolapse because of its high success in avoiding possible vault prolapse, and low intra- and post-operative complication rates.

Female↗
PubMed2001

Comparison of microlaparoscopy and conventional laparoscopy for tubal sterilization under local anesthesia with mild sedation.

STUDY OBJECTIVE: To compare tubal sterilization performed by microlaparoscopy and conventional laparoscopy. DESIGN: Prospective, randomized trial (Canadian Task Force classification I). SETTING: Gazi University School of Medicine. PATIENTS: Twenty women undergoing surgical sterilization. INTERVENTION: Ten sterilizations by conventional laparoscopy and 10 by microlaparoscopy. MEASUREMENTS AND MAIN RESULTS: The techniques were comparable in quality of visualization, operating time, amount of drugs used for sedation and local anesthesia, and intraoperative pain scores. However, the postoperative analgesic requirement was significantly less in women treated by by microlaparoscopy. CONCLUSION: Tubal sterilization by microlaparoscopy does not differ greatly from conventional laparoscopic sterilization.

Adult↗
PubMed1997

Small diameter versus conventional laparoscopy: a prospective, self-controlled study.

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 +/- 5.6 versus 7.6 +/- 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in micro-oriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Adult↗
PubMed1996

The incidence of congenital malformations in a Turkish population.

OBJECTIVE: To determine the incidence and types of congenital anomalies in a Turkish population. METHOD: The total number of neonates (9160) born in the Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine during 1988-1995 were studied retrospectively. Newborns with congenital anomaly were identified from their birth registries. The total incidence, types and combined anomalies were determined. Also, the relationship between congenital anomalies and maternal age and/or gender were investigated. For statistical evaluation, Chi-square test, Yates correction and Fisher's exact tests were used where appropriate. RESULTS: The overall congenital anomaly incidence was 1.11% and the NTD incidence was 0.27% in our population. Anencephaly was the second most common NTDs with the ratio of 40%, following the spina bifida cases. There was a significant difference between female and male newborns with ancephalocele (P < 0.05). Urogenital system anomalies were found to be the second most common type of malformation with an incidence of 0.21%. Facial and musculoskeletal system abnormalities were the third and fourth most common malformations. Omphalocele incidence in our population was 5 in 9160 births and gastrochisis was 1 in 9160 births. CONCLUSION: The overall congenital anomaly incidence in newborns in our population is 1.11%. The most common malformations were CNS and urogenital abnormalities. NTDs incidence was 0.27% in a Turkish population.

Age Factors↗
PubMed1996

An extraperitoneal burch procedure: a case report.

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.

Catheterization↗
PubMed1996

Endometrial assessment by vaginal ultrasonography might reduce endometrial sampling in patients with postmenopausal bleeding: a prospective study.

The purpose of this study is to compare transvaginal sonographic endometrial assessment with histology obtained by endometrial curettage in postmenopausal patients and to determine a cut-off point for endometrial thickness to reduce unnecessary diagnostic curettage for postmenopausal bleeding. A total number of 289 postmenopausal women were studied prospectively; 192 patients with postmenopausal bleeding and 97 postmenopausal women without bleeding comprised the study and control groups respectively. All patients were scanned by ultrasound transvaginally, then dilatation and curettage was performed for endometrial evaluation. In all women with and without postmenopausal bleeding, endometrial thickness of 4 mm or less as depicted by sonography correlated well with 'atrophic endometrium' (100%). Of 158 women with an endometrium > 4 mm in both groups, 40 women (25.1%) had a negative result (tissue insufficient for diagnosis or atrophic endometrium), while 118 patients (74.8%) had a positive result which included proliferative and secretory endometrium, endometrial hyperplasia, polyps and cancer. As the endometrial thickness increased, the probability of finding pathology with curettage was increased linearly in postmenopausal bleeding (PMB) positive and negative groups and there was a significant linear positive correlation between PMB (+) and (-) cases (Linear regression, R = 0.91, p < 0.03). A significant difference was found between endometrium carcinoma and all other endometrial pathologies concerning the mean endometrial thickness of 22.7 +/- 10.2 mm (chi-square, p < 0.0001). Also, the mean endometrial thickness of 4.7 +/- 3.3 mm for atrophic endometrium and 6.1 +/- 3.7 mm for 'tissue insufficient for histological diagnosis' were found significantly different than all other endometrial pathologies (chi-square, p < 0.0001). Endometrial thickness of < or = 4 mm may serve as cut-off point for predicting pathology negative cases with an accuracy of 100% in postmenopausal bleeding positive and negative cases. Then as the endometrial thickness increases, the probability of finding endometrial pathology in curettage increases linearly with a positive predictive value of 74.6%.

Adult↗