Mehmet Yilmazer

Afyon Kocatepe University, Kara Hissar Sahib, Afyonkarahisar, Turkey

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Publications (55)83.73 Total impact

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    ABSTRACT: To determine whether the preoperative platelet to lymphocyte ratio (PLR) could predict invasiveness of cervical pathologies. Patients with preinvasive and invasive diseases were reviewed retrospectively, over a nine-year period, 2005-2014. The pathological records and completed blood counts of the patients were collected and recorded in the SPSS program. Patients were divided in two groups, preinvasive and invasive. The median PLR was significantly higher in the invasive group than in the preinvasive group (p=0.03). There was a correlation between invasion of cervical cancer and white blood cell count, red cell distributing width (RDW), neutrophil-lymphocyte ratio (NLR), and PLR. This study showed that patients with uterine cervical cancer may present with leukocytosis, increased RDW, NLR and PLR. These cheap and easily available parameters, especially PLR, may provide useful information about the invasiveness of cervical lesions.
    Asian Pacific journal of cancer prevention: APJCP 03/2015; 16(3):923-6. DOI:10.7314/APJCP.2015.16.3.923 · 2.51 Impact Factor
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    ABSTRACT: Hysterosalpingography (HSG) is the most commonly used method for evaluating the anatomy and patency of the uterine cavity and fallopian tubes, and is an important tool in the evaluation of infertility. The most frequent side effect is the pain associated with the procedure. To evaluate four analgesic methods to determine the most useful method for reducing discomfort associated with HSG. In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti-inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps. Instillation of the liquids used for HSG was found to be the most painful step of HSG, and this step was where the only significant difference among groups was observed. When comparing visual analogue scale scores, group 2 and group 3 reported significantly less pain than the other groups. Group 1 reported significantly higher mean (± SD) scores (7.2±1.6) compared with groups 2 and 3 (4.7±2.5 and 3.8±2.4, respectively) (P<0.001). In addition, group 2 reported significantly less pain than group 4 (4.7±2.5 versus 6.7±1.8, respectively) (P<0.02). For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.
    03/2015; 20(2):107-111.
  • Turkiye Klinikleri Journal of Medical Sciences 01/2015; 25(1):12-18. DOI:10.5336/medsci.2014-41167 · 0.10 Impact Factor
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    ABSTRACT: Objectives The present study aims to specify the role of l-carnitine in the pathogenesis of endometrial cancer by comparing the serum total l-carnitine levels of endometrial cancer patients with those of healthy women. Methods Serum total l-carnitine concentrations were measured in patients with endometrioid-type endometrial cancer (n = 20) and healthy controls (n = 20) who were matched with respect to age and body mass index (BMI). Results Stage I endometrial cancer was diagnosed in 12 women (60.0 %) whereas three women (15.0 %) had stage II disease, three women (15.0 %) had stage III disease and two women (10.0 %) had stage IV disease. The healthy controls and endometrial cancer patients were statistically similar in aspect of age, gravidity, parity, BMI, waist-to-thigh ratio, waist-to-hip ratio, menopause, complete blood count parameters, and serum biochemistry. Serum total l-carnitine levels of women with endometrial cancer were significantly lower than those of healthy women (respectively, 5,519.4 ± 2,712.5 vs 7,940.8 ± 3,566.6 ng/dl, p = 0.021). Moreover, serum total l-carnitine levels decreased significantly and progressively with advancing stage (stage I vs II vs III vs IV; 6,294.0 ± 2,885.1 vs 5,800.0 ± 441.2 vs 4,016.0 ± 2,833.3 vs 2,560.0 ± 67.9 ng/dl; p = 0.021). Conclusions This is the first study to hypothesize that l-carnitine deficiency participates in the pathogenesis of endometrial cancer by means of a mechanism which is unrelated with obesity and increased amount of fat in human body.
    Archives of Gynecology and Obstetrics 10/2014; 291(5). DOI:10.1007/s00404-014-3507-y · 1.28 Impact Factor
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    ABSTRACT: Laparoscopic surgery is performed by carbon dioxide (CO2) insufflation, but this may induce stress responses. The aim of this study is to compare the level of inflammatory mediators in patients receiving low tidal volume (VT) versus traditional VT during gynecological laparoscopic surgery. Forty American Society of Anesthesiologists (ASA) physical status 1 and 2 subjects older than 18 years old undergoing laparoscopic gynecological surgery were included. Systemic inflammatory response was assessed with serum IL-6, TNF-alpha, IL-8, and IL-1β in patients receiving intraoperative low VT and traditional VT during laparoscopic surgery [within the first 5 min after endotracheal intubation (T1), 60 min after the initiation of mechanical ventilation (T2), and in the postanesthesia care unit 30 min after tracheal extubation (T3)]. Additionally, inflammatory response was assessed with bronchoalveolar lavage (BAL) at T1 and T3 periods. An increase in the serum levels of IL-6, TNF-alpha, IL-8, and IL-1β was observed in both groups during the time periods of T1, T2, and T3. No significant differences were found in the serum and BAL levels of inflammatory mediators during time periods between groups. The results of the present study suggested that the lung-protective ventilation and traditional strategies are not different in terms of lung injury and inflammatory response during conventional laparoscopic gynecological surgery.
    Inflammation 10/2014; 38(1). DOI:10.1007/s10753-014-0039-3 · 2.21 Impact Factor
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    B S Unlu · G Koken · F Celik · N Mert · Y Yildiz · B Koca · M Yilmazer
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    ABSTRACT: Premenstrual syndrome (PMS) is a disorder related to mood and appetite changes during the premenstrual phase. Unfortunately, the understanding of the pathophysiology of PMS is quite poor. Though, ghrelin and leptin play important roles in the control of food intake. The aim of this study was to evaluate leptin and ghrelin serum concentrations in PMS patients.
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    ABSTRACT: AimThe present study aims to determine whether mean platelet volume (MPV) specified in late first trimester of pregnancy can be used to predict pre-eclampsia and intrauterine growth restriction (IUGR).Methods This study prospectively reviews 200 healthy women with 11–14-week-old pregnancies.ResultsAverage pregnancy-associated plasma protein-A (PAPP-A) multiples of the median (MoM) value was significantly lower and MPV was significantly higher in pre-eclamptic pregnancies (P = 0.001 for both). MPV values of 10.5 fl or more can predict pre-eclampsia with 66.7% sensitivity and 63.8% specificity. The combination of MPV of 10.5 fl or more and PAPP-A MoM of 0.33 or less can predict pre-eclampsia with 75% sensitivity and 70.0% specificity. MPV values of 10.5 fl or more can predict IUGR with 82.4% sensitivity and 60.0% specificity. The combination of MPV of 10.5 fl or more and PAPP-A MoM of 0.33 or less can predict IUGR with 85.3% sensitivity and 62.0% specificity.Conclusion Increased MPV reflects enhanced platelet activation which may be caused by impairment in uteroplacental circulation. When MPV of 10.1 or more and PAPP-A MoM of 0.33 or less are combined as a threshold, the pregnancies that are destined to develop IUGR and pre-eclampsia can be predicted with considerably high sensitivity and specificity. The MPV and PAPP-A combination can be addressed as a useful biochemical tool for the prediction of IUGR and pre-eclampsia in late first trimester.
    Journal of Obstetrics and Gynaecology Research 07/2014; 40(7). DOI:10.1111/jog.12433 · 0.93 Impact Factor
  • E Yesildager · G Koken · A N C Gungor · R Demirel · D Arioz · F Celik · M Yilmazer
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    ABSTRACT: We examine the perinatal outcomes of borderline diabetic pregnant women who have impaired 50 g oral glucose challenge test (OGCT) results, but normal 100 g oral glucose tolerance test (OGTT) results. Our study group included 70 pregnant women who had increased 50 g OGCT results, but normal 100 g OGTT results, and a control group of 122 pregnant women with normal 50 g OGCT results. Polyhydramnios, macrosomia and neonatal birth weight were significantly higher in the study group. After adjusting the results for possibly affecting variables, the risk of polyhydramnios remained significant, while the risk of macrosomia and neonatal birth weight was not significant between the groups. The results from the study group were similar to the control group, when adjusted for other risk factors. Increased 50 g OGCT results in pregnant women can be accepted as a benign state if the 100 g OGTT results are normal.
    Journal of Obstetrics and Gynaecology 06/2014; 34(8):1-3. DOI:10.3109/01443615.2014.920788 · 0.60 Impact Factor
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    ABSTRACT: The role and applicability of three-dimensional ultrasound (3D-US) in perinatology has been repeatedly discussed in the literature. Regardless, our knowledge about patient expectations remains limited. We aimed at determining the expectations, perception and knowledge of pregnant women about 3D-US. Upon admission to the labor unit, the women filled out a questionnaire, with the help of a doctor investigating sociodemographic data, pregnancy and delivery history previous experiences and expectations for US imaging. A total of 644 pregnant women were included in the study Respondents declared that approximately 70% of all kinds of structural abnormalities could be detected by 3D-US and estimated its reliability at nearly 70%. While 60% of the participants underwent 3D-US, 70% of them believed that every pregnant woman should undergo such test. Also, 457 (70.9%) of the participants were of the opinion that every pregnant woman must undergo 3D-US imaging, whereas 173 (26.8%) did not think 3D-US imaging was necessary To the best of our knowledge, this has been the first study on patient opinions regarding the need for 3D-US imaging during pregnancy Although the participants were not certain about the harmful effects of 3D-US, the majority believed that it was necessary for every pregnant woman to undergo such testing. Obviously patients must be instructed on the limitations of US imaging before the examination to clarify any misunderstandings about the possibilities such a technique may offer
    Ginekologia polska 01/2014; 85(1):31-6. DOI:10.17772/gp/1687 · 0.68 Impact Factor
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    ABSTRACT: Abstract Objective: The present study aims to determine the efficiency and reliability of TENS in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. Methods: A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2) while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4) Results: The patients in Group 2 had statistically lower VAS and VNS scores than the patients in Group 1 (p<0.001 for both). The patients in Group 4 had statistically lower VAS and VNS scores than the patients in Group 3 (p=0.022 and p=0.005 respectively). The analgesic requirement at the eighth hour of cesarean section was significantly lower in the patients who were treated with TENS (p=0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p=0.830). Conclusion: TENS is an effective, reliable, practical, and easily available modality of treatment for postpartum pain.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2013; 27(15). DOI:10.3109/14767058.2013.870549 · 1.21 Impact Factor
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    ABSTRACT: Abstract Objective: This study investigates whether maternal sociodemographic and clinical characteristics influence the site of placental implantation so that placental localization and associated abnormalities can be predicted. Methods: This study reviews 500 healthy women with singleton pregnancy that were consecutively admitted to the study center and eventually delivered healthy newborns. Results: The most frequently observed sites of placentation were anterior uterine wall (53.2%), posterior uterine wall (28.8%), lateral uterine walls (10.0%) and uterine fundus (8.0%) respectively. The women with fundal placentation had significantly higher systolic and diastolic blood pressures (respectively p=0.044 and p=0.040). Supine sleeping position was more frequent in women with anterior placenta and (OR: 11.568, 95% CI: 2.720-49.193) and prone sleeping position was more frequent in women with posterior placenta (OR: 15.449, 95% CI: 2.151-52.978) (p=0.001). The women who favored to sleep in right lateral position were more likely to have lateral placentation while the women who used to sleep in left lateral position were more likely to have fundal placentation (p=0.001). Conclusions: Sleeping position in early pregnancy may influence placental implantation site. The probable mechanism may refer to the alterations in uterine perfusion which is induced by the change in systemic blood pressure and dominant sleeping position.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2013; 27(15). DOI:10.3109/14767058.2013.870547 · 1.21 Impact Factor
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    ABSTRACT: ABSTRACT Objective: This study aims to compare the serum total L-carnitine concentrations of obese and non-obese pregnant women and to identify the role of L-carnitine in both maternal and fetal weight gain during pregnancy. Methods: This study reviews 118 healthy women with singleton term pregnancy (≥37 weeks). The characteristics of the recruited subjects were analyzed according to their pre-pregnancy body mass index (BMI). Results: The women with pre-pregnancy BMI<18.5 kg/m(2) had significantly higher serum L-carnitine levels whereas the women with BMI>29.9 kg/m(2) at term pregnancy had significantly lower serum L-carnitine levels (p=0.001 for both). The neonates born to women with BMI > 29.9 kg/m(2) at term pregnancy had significantly longer height and wider head circumference (p=0.001 for both). Serum total L-carnitine levels correlated significantly and negatively with pre-pregnancy body weight, pre-pregnancy BMI, pregnancy body weight, pregnancy BMI and serum triglyceride levels (r=-0.397, p=0.001; r=-0.357, p=0.001; r=-0.460, p=0.001; r=-0.463, p=0.001 and r=-0.216, p=0.019 respectively). There was a significant and positive correlation between L-carnitine and HDL values (r=0.243, p=0.008). Conclusions: The crucial role of L-carnitine in pregnancy metabolism suggests that nutritional supplementation of this amino acid can be offered to women who are either overweight or obese at the beginning of the pregnancy.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 04/2013; 26(15). DOI:10.3109/14767058.2013.789847 · 1.21 Impact Factor
  • 01/2013; 6(3):128-132. DOI:10.5505/ptd.2013.40469
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  • 12/2012; 4(12):659-61. DOI:10.4103/1947-2714.104322
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    D T Arioz · M Tosun · C Polat · A Saylan · M Yilmazer
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    ABSTRACT: We aimed to explore the effects of ischaemic preconditioning (IP) used to reduce ischaemic injury during laparoscopy on ovarian apoptosis and p53 expression. A total of 32 rats were randomly allocated into four groups consisting of eight in each as follows: Group I was subjected to a sham operation without pneumoperitoneum (Pp). Group II was subjected to 5 min of Pp with 15 mmHg pressure of CO(2) followed immediately by 5 min of deflation, after that, 60 min of Pp and deflation. Group III was subjected to 10 min of Pp and deflation. Group IV was subjected to 60 min of Pp and deflation. The ovarian tissues were histologically and immunohistochemically processed. The number of apoptotic and p53(+) cells were measured. All the data revealed that ovarian apoptosis and p53 expression were highest in group IV. Apoptotic cells and p53(+) cells were lower in IP groups. Additionally, group II had significantly lower p53(+) cells compared with group III. Pp induces higher amount of apoptosis and p53 expression in ovary but preconditioning may have protective effects during laparoscopy. Furthermore, 5 min of preconditioning may be more effective. Therefore, the effects of Pp and preconditioning should be considered for the ovary during laparoscopy.
    Journal of Obstetrics and Gynaecology 07/2012; 32(5):467-71. DOI:10.3109/01443615.2012.663015 · 0.60 Impact Factor
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    ABSTRACT: Vaginal cavernous hemangioma is a considerably rare condition during pregnancy. There has only been one reported case to date. A multiparous, 24-year-old woman in the 32nd week of pregnancy was admitted with a mass prolapsed from the vagina, which had suddenly increased in size over the previous few days. A necrotic mass obstructing the vaginal canal and originating from the posterior wall was observed in a pelvic physical examination and carefully excised. The patient had contractions after the intervention and was administered tocolytic treatment with bed-rest and fluids. Her obstetric clinical status was stable after treatment and she gave birth without complication at 37 weeks and 5 days from the vaginal canal. The main approach to these very rare tumors of pregnancy, especially in the presence of necrosis, infection and/or obstruction, should be excision. But the potential for increased blood loss that may occur due to the hypervascular structure of the tumor should be taken into account.
    Journal of Obstetrics and Gynaecology Research 03/2012; 38(5):889-91. DOI:10.1111/j.1447-0756.2011.01793.x · 0.93 Impact Factor
  • Turkiye Klinikleri Journal of Medical Sciences 01/2012; 32(1):80-87. DOI:10.5336/medsci.2010-22258 · 0.10 Impact Factor
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    ABSTRACT: To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) for decreasing pain related with office endometrial biopsy. In this prospective study, 65 women undergoing office endometrial biopsy were randomly allocated to receive 550 mg oral naproxen sodium plus active TENS (Group I, n = 33) or 550 mg oral naproxen sodium plus placebo TENS (Group II, n = 32). The intensity of pain perceived by the patients was measured using a 10-cm visual analog scale (VAS) before insertion of the speculum, when the cervix grasped, immediately after biopsy, and 15 min after the procedure. The effect of anxiety (Spielberger's state anxiety inventory) on pain scores was also investigated. There were no statistical significant differences between groups in age, weight, body mass index, gravidity, parity, education, and menopausal status (p > 0.05). The pain scores before insertion of the speculum, when the cervix grasped, and immediately after biopsy were similar in both groups (p > 0.05). But at 15 min after the procedure, there was a significant reduction of the mean VAS pain score in naproxen sodium plus TENS group, compared with the naproxen sodium plus placebo TENS group (0.14 ± 0.47, 1.44 ± 1.37, respectively, p < 0.0001). The mean anxiety scores were 48.19 ± 6.71 and 45.85 ± 6.22 in Group I and Group II, respectively. We did not find any significant correlation between anxiety and VAS pain scores (p > 0.05). TENS appears to be successful in decreasing pain only after the procedure undergoing office endometrial biopsy. It can be used as a simple, cheap, safe, and effective pain relief method.
    Archives of Gynecology 10/2011; 285(4):1059-64. DOI:10.1007/s00404-011-2111-7 · 1.28 Impact Factor
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    ABSTRACT: In this study, we looked for a relationship between the extent of angiogenesis and mast cell density (MCD) in human leiomyomas and endometrial carcinomas (EC), and investigated the clinicopathological relevance of mast cells (MCs) in EC. Specimens of 15 control, 20 leiomyoma, and 23 EC patients were investigated immunohistochemically using anti-CD31 and anti-tryptase antibodies. In EC, both stromal and myometrial expressions of CD31 were significantly higher than in the controls (p<0.01 and p=0.013; respectively). Stromal tryptase expression was not significantly lower than that of leiomyoma. In addition, in the leiomyoma group, CD31 and tryptase expressions were not much different compared to the controls. Moreover, a correlation was detected between cancer histological grade and both stromal and myometrial expressions of CD31 (p=0.017 and p=0.005; respectively). The findings show that high grade EC has a higher degree of vascularization than EC of lower grade, but MCD does not increase in parallel with the histological grade. This study has demonstrated that MCD does not correlate with angiogenesis and progression of grade in EC. Moreover, MCD in EC was found to be lower than in benign lesions of the uterus. In conclusion, MCs may not account for the angiogenic process which facilitates tumor growth.
    Pathology - Research and Practice 08/2011; 207(10):618-22. DOI:10.1016/j.prp.2011.07.002 · 1.56 Impact Factor