Person: YOLDEMİR, AHMET TEVFİK
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YOLDEMİR
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AHMET TEVFİK
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Publication Metadata only The relationship between subjective experience of childhood abuse and neglect and depressive symptoms during pregnancy(ELSEVIER SCI LTD, 2017) YOLDEMİR, AHMET TEVFİK; Inanici, Sinem Yildiz; Inanici, Mehmet Akif; Yoldemir, A. TevfikIntroduction: Childhood abuse and neglect have devastating effects in adulthood such as depression. During pregnancy, depression's effects in women have great importance due to its serious consequences for both children and families. It is aimed to find out a relationship between childhood abuse/neglect and depression among pregnant women. Method: One-hundred-forty-four married and healthy volunteer pregnant women were recruited between February-May 2015 during their regular hospital visit. Beck Depression Inventory and Childhood Trauma Questionnaire were used to evaluate depression and childhood abuse experiences. Results: The participants' mean age was 29.37 years (SD +/- 4.71) and the average duration gestation was 28.81 weeks (SD = 5.05). Depressed women tended to get marry earlier (M = 21.07, SD = 3.47) than the non-depressed group (M = 22.55, SD = 3.36) (p = 0.012) and they had higher number of lifetime gestations (M = 3.31, SD = 2.06) than their non-depressed counterparts (M = 2.33, SD = 1.26) (p = 0.001). Each abuse and neglect score helped to predict the participants' depression scores. Conclusions: Scanning of pregnant women for both depression and childhood trauma will give change to health providers to support this vulnerable group and their prospective children. (C) 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.Publication Metadata only Postmenopausal hyperandrogenism(TAYLOR & FRANCIS LTD) YOLDEMİR, AHMET TEVFİK; Yoldemir, T.Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from the adrenal glands and/or ovaries clinically manifested by the presence of terminal hair in androgen-dependent areas of the body, and other manifestations of hyperandrogenism such as acne and alopecia or the development of virilization. In such circumstances, physicians must exclude the possibility of rare but serious androgen-producing tumors of the adrenal glands or ovaries. Worsening of undiagnosed hyperandrogenic disorders such as polycystic ovary syndrome, congenital adrenal hyperplasia, ovarian hyperthecosis, Cushing syndrome and iatrogenic hyperandrogenism should be considered for differential diagnosis. Elevated serum testosterone not only causes virilizing effects, but also will lead to hypercholesterolemia, insulin resistance, hypertension and cardiac disease. An ovarian androgen-secreting tumor, which is diagnosed in 1-3 of 1000 patients presenting with hirsutism, comprises less than 0.5% of all ovarian tumors. Adrenal tumors, including non-malignant adenomas and malignant carcinomas, are less common than ovarian tumors but cause postmenopausal virilization. Measurement of serum testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate, androstenedione and inhibin B is necessary in postmenopausal women with the complaints and signs of hyperandrogenism. Some tests to discard Cushing syndrome should also be done. After an etiological source of androgen hypersecretion has been suspected, we recommend performing magnetic resonance imaging of the adrenal glands or ovaries. Medical management with gonadotropin-releasing hormone agonist/analogues or antagonists has been reported for women who are either unfit for surgery or in whom the source of elevated testosterone is unidentified.Publication Metadata only The association of osteopenia with levels of serum 25-hydroxyvitamin D and HOMA-IR values(TAYLOR & FRANCIS LTD, 2014) YOLDEMİR, AHMET TEVFİK; Yoldemir, T.; Yavuz, D. G.Objective To determine the association of osteopenia with levels of serum 25-hydroxyvitamin D and HOMA-IR values in postmenopausal women. Methods One hundred healthy postmenopausal women were included in a cross-sectional study. Venous blood was collected after an overnight fast and 25-hydroxyvitamin D, glucose and insulin levels were measured. HOMA-IR was calculated. Bone mineral density was measured with a dual X-ray absorptiometer. Results There was no difference in serum 25-hydroxyvitamin D levels and HOMA-IR values between the two groups. A weak positive correlation between serum 25-hydroxyvitamin D levels and osteopenia was detected. Insulin resistance had a weak negative association with osteopenia. Conclusions The correlations between osteopenia and serum 25-hydroxyvitamin D levels and HOMA-IR values were weak among early postmenopausal women.Publication Metadata only Comparison of anxiety scores between unexplained primary and secondary infertile couples(TAYLOR & FRANCIS LTD, 2021) YOLDEMİR, AHMET TEVFİK; Yoldemir, Tevfik; Yassa, Mahmut; Atasayan, KemalObjective To investigate the anxiety levels among infertile women and their partners also factors that may affect the anxiety status Study design A total of 403 infertile couples who applied to Infertility Outpatient Clinics of a University-affiliated Teaching and Research Hospital were included in the study. The infertile group was divided into two groups as primary and secondary infertile. One hundred and thirty-two fertile couples who applied to Gynecology Outpatient Clinics composed the control group. Hamilton Anxiety Rating Scale (HAM-A) form was filled by the infertile couples to evaluate the anxiety status before they started their treatment. Results Three hundred and twenty infertile and 84 fertile couples completed the study. The mean total scores of HAM-A of women were similar between the groups. So were the scores of their husbands. In all groups, women had significantly higher mean total HAM-A scores than their husbands. There was no association between the mean HAM-A score of women and age, BMI, AFC, duration of marriage, duration of infertility, number of previous treatment cycles. Education status, working status and family structure of women did not correlate with the mean HAM-A score. Conclusion Unexplained primary and secondary infertile couples had similar anxiety scores before the commencement of fertility treatments. However, the scores were higher in women than their male partners. Since the burden of treatment and the likelihood of treatment failure might increase the level of anxiety the women could be offered proper cognitive coping and relaxation interventions.Publication Metadata only The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients(SPRINGER, 2020) YOLDEMİR, AHMET TEVFİK; Paudel, Ashok; Tigen, Kursat; Yoldemir, Tevfik; Guclu, Mehmet; Yildiz, Ipek; Cincin, Altug; Sunbul, Murat; Gurel, Emre; Sayar, Nurten; Ozben, BestePreeclampsia is a maternal disorder of pregnancy characterized by concomitant increase in preload and afterload with end organ dysfunction. The aim of our study is to evaluate left ventricular (LV) and right ventricular (RV) functions with speckle tracking echocardiography in preeclamptic patients. Fifty-five preeclamptic (mean age: 30.7 +/- 5.9 years) and 35 healthy pregnant women (mean age: 28.8 +/- 5.7 years) of the same race, similar age and gestational week were consecutively included. The diagnosis of preeclampsia was based on the criteria proposed by the American College of Obstetricians and Gynecologists. LV and RV functions were assessed by both conventional and speckle tracking echocardiography after the 30th gestational week and at the postpartum 6th months. The preeclamptic patients had significantly larger left atrium, thicker interventricular septum, higher systolic pulmonary artery pressure and mitral E/e ' ratio compared to controls during pregnancy while LV ejection fraction was similar. Preeclamptic patients had significantly lower LV and RV global longitudinal strain (GLS) during pregnancy compared to controls (- 18.0 +/- 2.6% vs. - 19.8 +/- 2.1% p = 0.001 and - 26.7 +/- 3.3% vs. 28.9 +/- 3.3% p = 0.002, respectively). In the postpartum period, while LVGLS values of preeclamptic patients increased significantly (- 18.0 +/- 2.6% vs. - 20.4 +/- 2.4% p < 0.001) and became similar to those of controls at the sixth month, the RVGLS decreased significantly (- 26.7 +/- 3.3% vs. - 25.8 +/- 2.7% p = 0.003) making the difference in RVGLS between the preeclamptic patients and controls more prominent. Preeclampsia may impair LV and RV function. Long-term follow up with larger sample is needed to determine the clinical relevance of the observed changes in strain.Publication Metadata only Obstetric outcomes of recurrent pregnancy loss patients diagnosed with inherited thrombophilia(SPRINGER LONDON LTD, 2017) YOLDEMİR, AHMET TEVFİK; Karadag, C.; Yoldemir, T.; Karadag, S. D.; Inan, C.; Dolgun, Z. N.; Aslanova, L.Background Recurrent pregnancy loss (RPL) is defined by two or more failed pregnancies. The relation between RPL and inherited thrombophilia requires anticoagulant therapy during pregnancy. However the obstetric outcomes have not been well defined in these RPL patients diagnosed with inherited thrombophilia, who have been given anticoagulant therapy. Aim To investigate the obstetric outcomes in pregnant women with RPL who are given low molecular weight heparin (LMWH) and low-dose aspirin due to diagnosis of inherited thrombophilia. Methods A hundred and eight RPL women were diagnosed with inherited thrombophilia, and 98 women were diagnosed with unexplained RPL. The patients with inherited thrombophilia were given LMWH and low-dose aspirin. Unexplained RPL patients were not given any medicine. The obstetric outcomes of participants were noted. Results In thrombophilic group, the live-birth levels were significantly higher [90 (83%) vs 67 (68%) p < 0.05], and the miscarriage levels were significantly lower than that in the control group [14 (13%) vs 27 (28%) p < 0.01]. The number of patients with preeclampsia was significantly higher in the thrombophilic group [16 (15%) vs 6 (6%) p < 0.05]. The number of preterm births was significantly higher than that of the controls [25 (23%) vs 10 (10%) p < 0.05]. The median gestation age of delivery was 35 weeks for thrombophilic patients and 38 weeks for controls (p < 0.05). Conclusion The RPL patients diagnosed with inherited thrombophilia and who were given LMWH with low-dose aspirin had higher live-birth rates and lower miscarriage rates than those in the unexplained RPL patients. Increased risk of preeclampsia is seen in RPL patients with inherited thrombophilia despite thrombophilia prophylaxis.Publication Metadata only Comparison of depression between primary and secondary infertile couples(TAYLOR & FRANCIS LTD, 2020) YOLDEMİR, AHMET TEVFİK; Yoldemir, Tevfik; Yassa, Mahmut; Atasayan, KemalObjective We aimed to compare the depression levels between primary and secondary infertile couples and to investigate the related factors that may affect depression. Study design Two hundred and fifty primary and secondary infertile couples, who admitted to Gynecology and Infertility Clinics of Pendik Teaching and Research Hospital affiliated with Marmara University were enrolled in this study. Sixty-four BMI-matched fertile female patients who applied to the General Gynecology Clinic and their husbands were taken as the control group. Beck Depression Inventory (BDI) form was filled by the infertile couples to evaluate the depression status before they started their cycles. Results The mean total BDI scores were alike between groups among women. Mild depression was found to be higher in the primary infertile women and moderate depression was higher in women of the control group. Women had statistically higher depression scores than male partners. Primary infertile, secondary infertile, and fertile women had higher depression scores than their male partners in the corresponding groups. There was no significant difference in mean total BDI scores among males between the groups. The percentage of distribution of male partners in each level of depression was similar between the groups. Conclusions Only a weak positive correlation between the mean total BDI score and the number of previous treatment cycles was found. Psychiatric support before and during the upcoming fertility treatment might reduce the perception of the probable treatment failure.Publication Metadata only Follicular dominance on the fifth day of controlled ovarian stimulation reduces implantation in long down-regulated ICSI cycles(ELSEVIER SCIENCE BV, 2011) YOLDEMİR, AHMET TEVFİK; Yoldemir, Tevfik; Erenus, Mithat; Durmusoglu, FatihObjective: To determine if follicular dominance on the fifth day of controlled ovarian stimulation (COS) predicts implantation rates in down-regulated intracytoplasmic sperm injection (ICSI) cycles. Study design: One hundred and sixty-two consecutive women undergoing ICSI treatment with long down-regulation and recombinant follicle-stimulating hormone injections were included in a prospective cohort analysis. The clinical pregnancy and implantation rates per transfer were compared between two groups, one with and the other without follicular dominance detected by ultrasound on the fifth day of COS. Results: There was no significant difference between the groups regarding the number of good quality embryos transferred, but clinical pregnancy and implantation rate per transfer were higher in group with follicular synchrony. Conclusions: Follicular dominance on COS day 5 results in reduced implantation rates after ICSI. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only The impact of serum FSH and estradiol on postmenopausal osteoporosis related to time since menopause(TAYLOR & FRANCIS LTD, 2012) YOLDEMİR, AHMET TEVFİK; Yoldemir, Tevfik; Erenus, Mithat; Durmusoglu, FatihAim: To determine the impact on osteopenia/osteoporosis of serum follicle-stimulating hormone (FSH), estradiol levels and time since menopause in a group of Turkish postmenopausal women. Methods: Four hundred and thirty-three healthy postmenopausal women seen at the Marmara University Menopause Outpatient Clinic were enrolled for this prospective cohort study. The women were allocated to one of three groups according to the bone mineral density (BMD) of the lumbar vertebrae and total hip, as measured by dual energy X-ray absorptiometry (DEXA). Serum FSH, estradiol levels, age and time since menopause were compared between the groups. Results: The mean serum FSH, LH, estradiol and testosterone levels for women with normal, osteopenic and osteoporotic BMD at lumbar vertrebra L1-L4 and total hip were comparable. Time since menopause had a stronger predictive value for low BMD (osteopenia or osteoporosis) in the lumbar and hip areas than did serum FSH or estradiol levels. Conclusions: Our study showed that neither FSH nor E2 has a strong impact on postmenopausal BMD. However it appears that time since menopause has a weak non-significant association with postmenopausal osteopenia and osteoporosis.Publication Metadata only Quality of life among infertile PCOS patients(SPRINGER HEIDELBERG, 2019) YOLDEMİR, AHMET TEVFİK; Angin, Pinar; Yoldemir, Tevfik; Atasayan, KemalObjectiveTo investigate whether quality of life differs between PCOS and non-PCOS infertile women.Study designTwo questionnaire forms of quality of life (PCOSQ, SF-36) were given to 238 women. Patients were asked to answer all of the questions in both of the questionnaires. Of these 238 women, only 49 infertile PCOS patients, 47 infertile non-PCOS patients and 62 fertile PCOS patients flled the forms completely.ResultsBoth PCOSQ and SF-36 scores are lowest in infertile PCOS group. Although total PCOSQ score of infertile non-PCOS group was better than non-infertile PCOS and fertile PCOS groups; there was trend for lower scores when infertility is added on PCOS status.ConclusionThe quality of life is lowest among infertile PCOS women. Both PCOS and infertility as individual factors may have negative impact in quality of life of reproductive age women.