Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. Material and Method:Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared.Results: Th e mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. Th ere was significant diff erence with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively Th e most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). Conclusion:In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women. Bulgular: Ortalama hasta yaşı 38.9±10.2 idi. Tüm grup değerlendiril-diğinde, %25 hastada HPV pozitif olarak saptandı. Anormal sitolojisi olanlarda HPV pozitifl iği %57 iken normal pap testi olanlarda HPV pozitifl iği %27 oranında tespit edildi. Hastaların yaşam dekadları ile HPV pozitifl iği arasında anlamlı bir ilişki bulundu (p<0,05) HPV pozitifl iği ASCUS, ASC-H, LSIL, HSIL, glandüler anormallikler ve skuamöz hücreli karsinom için sırasıyla %37, %9, %27, %20, %22, %41 idi. En sık görülen HPV tipleri sırasıyla HPV 16 (%32), HPV 6 (%17), HPV 11 (%9), HPV 18 (%8), HPV 31 (%6), HPV 51 (%5), HPV 33 (%3) idi.Sonuç: Bu hastane temelli retrospektif analizde HPV tipleri gelişmiş batı ülkelerinde rapor edilen tiplerle benzer olarak tespit edildi. Ülkemizdeki gerçek popülasyon temelli HPV prevalansı ve tiplerinin belirlenmesi için hastane temelli olmayan çok merkezli geniş sayıda hasta içeren serilere ihtiyaç vardır.
Awareness of HPV by the target population is an important determinant of vaccine acceptance. The aim of this study is to evaluate the awareness of HPV infection and acceptability of the HPV vaccines among Turkish college students. College students aged 18-30 who were attending a large public university in Ankara participated in this study. The participants were asked to complete a questionnaire to elicit demographic characteristics, awareness level of HPV and HPV vaccine, and willingness to be vaccinated. One thousand one hundred sixty students responded to the invitation email and completed the questionnaire. The mean scores of female students about HPV and HPV vaccine were 7.1/15 and 3.6/9, respectively, while these scores were 7.9/15 and 3.4/9 among male students, respectively. While 51 % percent of female and 33.5 % of male students had heard of HPV and 32.8 % and 18 % of them had heard of HPV vaccine, respectively, only 1.5 % of female and 0.4 % of male students had been vaccinated against HPV. A total of 507 students (43.7 %) had previously heard of HPV. Only 309 (26.6 %) of the participants had previously heard of the HPV vaccine, and 45.1 % of the students were willing to receive HPV vaccination. The main predictors for willingness to be vaccinated were the following: sexual experience, sexual behavior, past history of sexually transmitted infection (STI), and knowledge about HPV and HPV vaccine. Higher awareness levels of HPV and HPV vaccine are significantly related to greater willingness to be vaccinated, and the main reasons for rejecting the vaccine were insufficient information about the vaccine and possible unknown side effects.
Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases (35.2±10.9 versus 50.8±13.4, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity , PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.
The low hemoglobin values at third trimester gestation were associated with low birth weight and length in Turkish women. The anemia can be a direct cause of deterioration of in utero fetal growth due to lack of oxygen flow to placental tissue or can be an indirect indicator of maternal nutrition deficit. In both circumstances this study reveals that treatment of anemia is directly correlated with better fetal outcomes.
High-risk HPV persistence may be encountered after CKC procedures. It is important to evaluate persistent HPV infections after treatment because affected women are at increased risk for disease persistence, recurrence, and progression.
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