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    Outcomes of random start versus clomiphene citrate and gonadotropin cycles in occult premature ovarian insufficiency patients, refusing oocyte donation: a retrospective cohort study
    (Taylor & Francis Ltd, 2018) Hatırnaz, Şafak; Başbuğ, Alper; Akarsu, Süleyman; Hatırnaz, Ebru; Demirci, Hakan; Dahan, Michael H.
    The aim of this study is to present the clinical outcomes of a random start, a spontaneous folliculogenesis protocol versus Clomiphene Citrate and Gonadotropin treatment in women with occult premature ovarian insufficiency. Women underwent treatment between 1 February 2009, and 30 May 2016. 41 women were treated with the random start protocol while 48 cases received ovarian stimulation with clomiphene and gonadotropins. All included cases met the criteria of 4 months of oligo-ovulation, follicular-stimulating hormone levels over 30 IU/L and anti-Mullerian hormone levels below 0.30 ng/mL. The random start protocol involved following the subjects for up to 6 months until spontaneous folliculogenesis occurred. The mean number of oocytes collected, mature oocytes, fertilized oocytes, and grade II embryos were significantly higher in the random start protocol (p < .05). The doses of gonadotropin administration and hCG were significantly lower in the random start protocol (p < .05). The clinical pregnancy and live birth rates were significantly higher in the random start protocol (p < .05). Likely stimulation is of little benefit in women with occult premature ovarian insufficiency. Observation while waiting for spontaneous folliculogenesis results in better outcomes, and less oocyte collections.
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    Prevalence of High-Risk Human Papillomavirus Types and Their Association with Cervical Squamous Cell Carcinoma, and High- and Low-Grade Squamous Intraepithelial Lesions in Turkish Women
    (Iranian Scientific Society Medical Entomology, 2023) Erkinueresin, Taskin; Kartal, Esra; Ustunyurt, Emin; Demirci, Hakan; Kilitci, Asuman; Onal, Binnur
    Background: This study aimed to investigate human papillomavirus (HPV) type prevalence in our region and the relationship between uterine cervical HPV types and squamous cell carcinoma (SCC)/intraepithelial lesions.Methods: HPV test results were obtained from patient file archives of the Gynecology and Obstetrics Clinic. Pathology report results were obtained from the digital records of the Pathology Laboratory and the patient file archives of the Gynecology and Obstetrics Clinic in 2018.Results: The most frequently detected was HPV16 (29.2%), followed by HPV51 (13.1%), HPV56 (11%), HPV31 (9.2%), HPV52 (8.4%), and HPV68 (8.2%). HPV16 was positive in 50% of patients diagnosed with SCC, 54.9% of patients with HSIL, 27% of patients with LSIL, and 25% of cases diagnosed as benign (P<0.001). HPV18 was positive in 25% of patients diagnosed with SCC, 11% of patients with HSIL, 4.7% of patients with LSIL, and 5.2% of cases diagnosed as benign (P=0.019).Conclusion: The most frequent hrHPV genotype was HPV16, followed by HPV51, HPV 56, and HPV 31. There is an increase in the frequency of HPV51 and HPV56. HPV51, not included in HPV vaccines and is the second most frequent, should be included in these vaccines. In addition, although the frequency of HPV18 has decreased, HSIL and SCC generation is still high together with HPV16.
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    Prevalence of High-Risk Human Papillomavirus Types and Their Association with Cervical Squamous Cell Carcinoma, and High-and Low-Grade Squamous Intraepithelial Lesions in Turkish Women
    (Tehran University of Medical Sciences, 2023) Erkinüresin, Taşkın; Kartal, Esra; Üstünyurt, Emin; Demirci, Hakan; Kilitçi, Asuman; Önal, Binnur
    Background: This study aimed to investigate human papillomavirus (HPV) type prevalence in our region and the relationship between uterine cervical HPV types and squamous cell carcinoma (SCC)/intraepithelial lesions. Methods: HPV test results were obtained from patient file archives of the Gynecology and Obstetrics Clinic. Pathology report results were obtained from the digital records of the Pathology Laboratory and the patient file archives of the Gynecology and Obstetrics Clinic in 2018. Results: The most frequently detected was HPV16 (29.2%), followed by HPV51 (13.1%), HPV56 (11%), HPV31 (9.2%), HPV52 (8.4%), and HPV68 (8.2%). HPV16 was positive in 50% of patients diagnosed with SCC, 54.9% of patients with HSIL, 27% of patients with LSIL, and 25% of cases diagnosed as benign (P<0.001). HPV18 was positive in 25% of patients diagnosed with SCC, 11% of patients with HSIL, 4.7% of patients with LSIL, and 5.2% of cases diagnosed as benign (P=0.019). Conclusion: The most frequent hrHPV genotype was HPV16, followed by HPV51, HPV 56, and HPV 31. There is an increase in the frequency of HPV51 and HPV56. HPV51, not included in HPV vaccines and is the second most frequent, should be included in these vaccines. In addition, although the frequency of HPV18 has decreased, HSIL and SCC generation is still high together with HPV16. © 2023 Erkinüresin et al.
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    Relationship between the Empathy of Emergency Personnel and Their Approach to Acute Stroke Patients
    (2022) Demirci, Hakan; Haki, Cemile
    Aim: The aim of this study was to investigate the relationship between the empathy level of emergency department physicians and nurses and the referral of patients for intravenous thrombolytic and/or endovascular thrombectomy treatment. Material and Methods: This cross-sectional study was carried out with the emergency department physicians and nurses of hospitals that did not have a stroke clinic in Bursa in July 2019, and included 198 emergency personnel. Participants’ sociodemographic characteristics, professional working conditions, and stroke history in their immediate environment (friends and family) were recorded and empathy level was measured. The health professions version of the Jefferson Scale of Empathy was used in the assessment of empathy status among emergency physicians and nurses. Results: The mean empathy score of the study group, by the Jefferson scale of empathy, was found 98.63±14.83 points. In this study, no significant relationship was found between the empathy score and the number of referrals (p=0.962). The total empathy score did not differ by the role of the participants in the hospital (p=0.161) or observation of stroke cases in their family or their friends (p=0.694). Healthcare professionals who had received emergency education (p<0.001), were older (p<0.001), spent more time in their profession (p=0.005), and had observed stroke cases in their family or friends (p=0.005) transferred more stroke cases. Conclusion: This study suggests that interventions for increasing the empathy levels of emergency medicine specialists and nurses will not have a general effect on the referral of acute stroke cases for intravenous thrombolytic and endovascular thrombectomy treatment.