Person: ÖZGEN, LEVENT
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ÖZGEN
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LEVENT
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Publication Clinical significance of risk-reducing salpingo-oophorectomy in patients with BRCA1/2 mutation(Elsevier, 2023-10) Abay, Merve; Özgen, Levent; Yalçın, Yakup; Özerkan, Kemal; ABAY, MERVE; ÖZGEN, LEVENT; YALÇIN, YAKUP; ÖZERKAN, KEMAL; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; 0000-0003-0070-2646; CAK-3842-2022; JFT-0660-2023; HQP-3191-2023; AAH-9791-2021Objective: Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion which is located in the distal fallopian tube and causes high grade serous ovarian carcinoma (HGSOC). The incidence of STIC for women underwent risk reducing salpingo-oophorectomy for BRCA mutation varies from 0.6 to 7% and its clinical outcomes are still unclear. The aim of this study was to demonstrate the incidence of STIC and HGSOC in BRCA1/2 mutation carriers after risk reducing salpingo-oophorectomy (RRSO) and the clinical outcomes of these patients. Material and methods: We retrospectively reviewed the records of 48 BRCA1 and/or 2 mutation carriers who underwent prophylactic salpingo-oophorectomy with or without hysterectomy at the Department of Obstetrics and Gynecology, Bursa Uludag University between January 2000 and January 2022. Inclusion criteria: BRCA 1 and/or 2 mutation carriers diagnosed by genetic testing, asymptomatic patients with no abnormal findings on pelvic examination. Exclusion criteria: patients with no abnormal findings on pelvic examination and a presence of a personal history of ovarian, fallopian tube or peritoneal cancer. Results: A total of 48 BRCA 1 and/or 2 mutation carriers underwent RRSO. STIC was diagnosed in 1 (2,0%) patient and restaging surgery was not performed. Primary peritoneal carcinoma (PPC) did not develop during the 20 months follow-up period. One (2.0%) patient was diagnosed with occult ovarian cancer. Restaging surgery was performed and chemotherapy treatments were given after surgery. A pelvic recurrence developed 25 months after the occult cancer diagnosis in the follow up period. One (2.0%) patient with normal histopathological findings after RRSO was diagnosed with peritoneal cancer 57 months after the operation. Conclusion: The risk of PPC continues after RRSO. Therefore, close follow-up procedure is very important for early diagnosis and effective treatment of patients with PPC after RRSO.Publication Fibrinogen levels and total serum bile acids in intrahepatic cholestasis of pregnancy(Coll Physicians & Surgeons Pakistan, 2022-11-01) Özgen, Levent; Özgen, Gülten; Karasin, Süleyman Serkan; Bayram, Feyza; ÖZGEN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekolojik Onkoloji Cerrahisi Anabilim Dalı.; 0000-0003-0070-2646 ; JFT-0660-2023Objective: To determine the role of complete blood count and coagulation function factors as inflammatory markers in intrahepatic cholestasis of pregnancy (ICP). Study Design: Descriptive, analytical study. Place and Duration of Study: Department of Obstetrics and Gynecology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, between January 2018 and 2021. Methodology: This study was conducted with a total of 200 pregnant women, 80 with ICP and 120 control healthy pregnant women. The diagnosis of ICP was made based on elevated liver enzymes and bile acids (=10 mu mol/L) and pruritis. Routine complete blood count parameters and coagulation function tests were compared between both groups. ROC analyses were used to analyse the predictive value of fibrinogen levels in ICP. Spearman's rank correlation analysis assessed the correlation between fasting bile acid value and complete blood count and coagulation parameters. Results: Neutrophil-lymphocyte ratio (NLR), Platelet count, and Platecrit levels were significantly higher in the ICP group, and red blood cell distribution width (RDW) was lower than in the healthy group (p <0.05). The median plasma fibrinogen value was 571 mg/dl which was significantly higher in pregnant women with cholestasis (p <0.001). The prothrombin time and international normalized ratio (INR) values were also significantly different in each group (p <0.001 and 0.013, respectively). In addition, platelet distribution width (PDW), plasma fibrinogen, and prothrombin time (PT) showed significant association with the bile acid values (p values=0.007, 0.03, and 0.04 respectively). Each 1-unit elevation of the fibrinogen increased the risk of cholestasis by 1.02 times. There was a positive correlation of 0.24-fold between the plasma fibrinogen value and acids. Conclusion: The plasma fibrinogen value was the highest predictor of cholestasis diagnosis by analyzing blood parameters. Elevated fibrinogen levels correlated with bile acid levels, can potentially detect ICP.Publication Can early pregnancy decorin levels be a potential predictor for preterm birth?(Professional Medical Publications, 2022-11-01) Özgen, Gülten; Özgen, Levent; ÖZGEN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı; JFT-0660-2023Objective: This study investigates the role of maternal decorin levels measured in the early second trimester of pregnancy in detecting the potential for preterm birth in late pregnancy.Methods: The prospective, case-control study was carried out in tertiary university hospital from June to December 2021.Maternal serum samples were collected from 350 women aged 18-40 years with a singleton pregnancy during early second-trimester screening for aneuploidy, and stored at -80 degrees C. All participants were followed up until delivery and 25 patients diagnosed with preterm birth group and 40 full-term healthy women were included in the study.Results: The median maternal serum decorin level was 3.82 (1.15-12.37) ng/ml in the preterm birth (PTB) group and 4.63 (1.20-10.02) ng/ml in the control group, there was no statistically difference between the groups (p = 0.111). The mean gestational age was statistically significantly lower in the preterm birth group (33.1 +/- 2.7 weeks) than in the control (39 +/- 1.16 weeks) ( p <0.001). The mean fetal weight was statistically significantly lower in the preterm birth group (2023.8 +/- 477 g) than in the control group (3309.7 +/- 353 g) (p < 0.001).Conclusion: Early second-trimester serum levels of decorin alone may not be a sufficiently accurate biomarker as a biochemical model for the prediction of preterm birth in asymptomatic women.Publication The predictive value of halp score and systemic immune inflammation (sii) index in hyperemesis gravidarum(Wiley, 2023-05-21) Bayram, Feyza; Özgen, Gülten; Karasın, Süleyman Serkan; ÖZGEN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; JFT-0660-2023Aim: Hyperemesis gravidarum (HG) is one of the most common serious diseases in early pregnancy. This study aimed to investigate the clinical significance of hemoglobin, albumin, lymphocyte, and platelet (HALP) score and systemic immune inflammation (SII) index in the presence and severity of HG.Methods: This retrospective case-control study was conducted in a training and educational university hospital between January 2019 and July 2022. A total of 521 pregnant women, of whom 360 were diagnosed with HG at 6-14 weeks of gestation and 161 were low-risk pregnancies, were included in the study. Patients' demographic characteristics and laboratory parameters were recorded. Patients with HG were divided into three categories: mild (n = 160), moderate (n = 116), and severe (n = 84), according to disease severity. The modified PUQE scoring was used to determine the severity of HG.Results: The mean age of the patients was 27.6 (16-40) years. We divided the pregnant women into the control group and HG group. The HALP score was significantly lower in the HG group (average, 2.8 +/- 1.3), whereas the SII index was found to be significantly higher (average, 895.8 +/- 458.1). A negative correlation was found between the increase in the severity of HG and HALP score. The HALP score was the lower in severe HG (mean, 2.16 +/- 0.81) and was significantly different from other HG categories (p < 0.01). Moreover, a positive correlation was noted between increased HG severity and SII index levels. The SII index was higher in the severe HG group and was significantly different from the others (1001.2 +/- 437.2) (p < 0.01).Conclusions: The HALP score and SII index can be useful, cost-effective, and easily accessible objective biomarkers to predict the presence and severity of HG.Publication Early effect of pelvic organ prolapse surgery on female sexual functions(Bayrakol Medical Publisher, 2023-06-01) Abay, Merve; Özgen, Levent; Özgen, Gülten; Aydın, Derya Sivri; Göksedef, Behiye Pınar; ABAY, MERVE; ÖZGEN, LEVENT; Özgen, Gülten; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7283-0930; JFT-0660-2023; HDL-9272-2022; CAK-3842-2022Aim: In this study, we aimed to detect changes in sexual functions before and after surgery in women who underwent pelvic reconstruction for pelvic organ prolapse and urinary incontinence. Material and Methods: This prospective cross-sectional study included 60 patients who underwent anterior and posterior vaginal repair due to cysto-rectocele and/or uterine prolapse. One day before and three months after the operation, FSFI scoring was performed. Patients were divided into 3 groups according to age: 30-40 years old (Group 1), 41-49 years old (Group 2) and 50-59 years old (Group 3). Results: There was no significant difference in the total FSFI score of the patients after the operation (p = 0.072). There was a statistically significant increase in sexual desire and arousal scores (p = 0.011 and p = 0.049, respectively) but there was no statistically significant difference in the other subscale scores. There was a statistically significant difference in the sexual desire and arousal scores of Group 1 and the sexual desire score of Group 3 patients (p = 0.028, 0.046 and 0.017, respectively). There was a decrease in the total FSFI score and sexual desire, lubrication, orgasm, satisfaction subscale scores after the operation but this decrease was not statistically significant. Discussion: There was no change in the total FSFI score in the 3rd month after pelvic organ prolapse operation, but there was a statistically significant increase in sexual desire and arousal scores. We believe that this increase may be due to the changing body image and sexual self-confidence of the patients in the postoperative period.Publication The distinctive role of systemic immune-inflammatory parameters in gestational trophoblastic diseases(Bayrakol Medikal Yayınevi, 2023-06-01) Özgen, Levent; ÖZGEN, LEVENT; Uludağ Üniversitesi/Tıp Fakültesi/Jinekoloji Onkoloji Cerrahi Bölümü; JFT-0660-2023Aim: In this study, we aimed to distinguish molar pregnancies from healthy pregnancies with the parameters that make up simple hematological tests that can be easily applied in the routine and to increase diagnostic sensitivity.Material and Methods: This retrospective cohort study was conducted between January 2018 and September 2022 at the University Hospital Gynecology Clinic. The study included 80 partial hydatidiform moles (PMH), 45 complete hydatidiform moles (CMH) and 50 healthy pregnant women. Before surgical curettage in molar pregnants and in routine antenatal examinations in healthy pregnant women, white blood cell (WBC) counts, neutrophil (NC) counts, lymphocyte (LC) and platelet counts (PLT), red cell distribution width (RDW), mean platelet volume (MPV), platelet distribution width (PDW), hemoglobin (Hb) and fibrinogen results were recorded. The Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII) were calculated based on the results of complete blood count.Results: WBC [8.5 & PLUSMN;2.30] vs [10.2 & PLUSMN;5.6]103/mm3, NC [6.05 & PLUSMN;5.56] vs [7.5 & PLUSMN;6.05]103/mm3, PDW [16.59 & PLUSMN;0.9] vs [16.87 & PLUSMN;0.75]% in PMH and CMH groups, respectively and NLR [3.23 & PLUSMN;2.4] vs [3.61 & PLUSMN;3.1], Fibrinogen [354 & PLUSMN;79]vs[347 & PLUSMN;82 ] mg/dl and SII [689.2 & PLUSMN;76.1] vs [701.16 & PLUSMN;52] were measured. These parameters were found significantly higher in molar pregnancy group then the controls. However, MPV [10.4 & PLUSMN; 0.1]fL and RDW [14.5 & PLUSMN;1.21] % values were significantly higher in healthy pregnancies than in molar pregnancies (p<0.05 for two parameters).Discussion: A higher inflammatory response is observed in molar pregnancies than in healthy pregnancies due to uncontrolled trophoblastic growth. Accelerating the diagnosis of GTD allows for early treatment with simple prognostic variables available from the measurement of peripheral blood cells.Publication Role of increased plasminogen activator inhibitor-1 and vitronectin in gestational diabetes mellitus(Assoc Medica Brasileira, 2023-01-01) Özgen, Gülten; Dinçgez, Burcu; Bayram, Feyza; Özgen, Levent; ÖZGEN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; JFT-0660-2023OBJECTIVE: The aim of this study was to analyze the second-trimester levels of vitronectin and plasminogen activator inhibitor-1 in gestational diabetes mellitus.METHODS: This study was conducted between September 2020 and December 2020 at the University of Health Sciences, Bursa Yuksek Ihtisas Research and Training Hospital, Department of Obstetrics and Gynecology. A total of 30 pregnant women with gestational diabetes mellitus and 60 healthy controls between 24 and 27/6 weeks of gestation were included. The inclusion criteria were as follows: being between 18 and 45 years old and 24-27/6 gestational weeks, having singleton pregnancy, diagnosed with gestational diabetes mellitus by using a two-step challenge test. The exclusion criteria of this study were as follows: chronic inflammatory or infectious disease, fasting blood glucose>126 mg/dL, intolerance to glucose tolerance testing, abnormal liver or kidney function tests, as well as pregnancy with pre-gestational diabetes history of adverse perinatal outcomes. Serum vitronectin and plasminogen activator inhibitor-1 levels were measured using the enzyme-linked immunosorbent assay method.RESULTS: Vitronectin and plasminogen activator inhibitor-1 levels were higher in the gestational diabetes mellitus group compared with controls [91.85 (23.08) vs. 80.10 (39.18) ng/mL, for vitronectin and 6.50 (1.05) vs. 4.35(1.0) ng/mL, for plasminogen activator inhibitor-1 (for both p<0.001)]. vitronectin >84.7 ng/mL was found to predict gestational diabetes mellitus with a sensitivity of 70% and specificity of 63.3%. Moreover, vitronectin had a significant positive correlation with fasting blood glucose (r=0.476, p<0.001), postprandial blood glucose (r=0.489, p<0.001), HbA1c (r=0.713, p<0.001), and plasminogen activator inhibitor-1 (r=0.586, p<0.001).CONCLUSION: This study revealed that second-trimester vitronectin and plasminogen activator inhibitor-1 are increased in gestational diabetes mellitus and vitronectin could be a candidate for the prediction of gestational diabetes mellitus.Publication Impact of uterine adenomyosis on survival outcome of patients with non-endometrioid endometrial cancer(Bmj Publishing Group, 2023-09-01) Özgen, Levent; ÖZGEN, LEVENT; Yalçın, Yakup; YALÇIN, YAKUP; Özerkan, Kemal; ÖZERKAN, KEMAL; Abay, Merve; ABAY, MERVE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri Anabilim Dalı.Publication Are women diagnosed with early pregnancy loss at risk for anxiety, depression, and perinatal grief?(Saudi Med J, 2022-09-01) Özgen, Levent; Özgen, Gülten; Şimsek, Deniz; Dinçgez, Burcu; Bayram, Feyza; Midikhan, Ayten N.; ÖZGEN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı/Jinekolojik Onkoloji Cerrahisi Bilim Dalı.; JFT-0660-2023Objectives: To examine the effects of early pregnancy loss on emotions such as depression, grief, or a sense of hopelessness, while investigating different types of diagnoses, hospital stays, and treatments. Methods: A prospective cohort epidemiological study was carried out in Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, between January and September 2019. The study included women diagnosed with early pregnancy loss classified into 3 groups: missed abortus, anembryonic pregnancy, and spontaneous abortion. The patients were screened via the Spielberger state-anxiety inventory (STAI-1) before initiating treatment. The Edinburgh postpartum depression scale (EPDS) and Perinatal Grief Scale (PGS) were also carried out in the first week of their hospital discharge. Results: The study was carried out with a total of 116 patients. The median gestational week of the patients was calculated at 9, their median hospital stay was 2 days, and their median dose of misoprostol was 800 mcg. The STAI-1 revealed that median values computed for women in all groups indicated moderate anxiety. The EDPS also demonstrated depression-positive median values for women in all 3 groups (EPDS>13). However, no statistically significant difference was noted in comparisons of the 3 groups apropos STAI-1, EPDS, and PGS. Conclusion: Moderate anxiety, depressed mood, and perinatal grief were found in women diagnosed with early pregnancy loss, regardless of the type of abortion.