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    Factors affecting parametrial involvement in cervical cancer patients with tumor size ?4 cm and selection of low-risk patient group
    (Galenos Yayincilik, 2021) Akilli, Huseyin; Tohma, Yusuf Aytac; Gunakan, Emre; Kucukyildiz, Irem; Tunc, Mehmet; Haberal, Nihan Reyhan; Ayhan, Ali
    Objective: The primary aim of this study was to evaluate the factors affecting parametrial involvement in cervical cancer patients with tumor size <= 4 cm and selection of the low-risk patient group based on long-term oncologic outcomes. Material and Methods: Cervical cancer patients operated in the gynecologic oncology division between 2007 and 2013 were retrospectively evaluated. One-hundred and sixty-eight patients with tumor size <= 4 cm were identified. Of these, 159 (86.8%) underwent radical hysterectomy plus pelvic-para- aortic lymphadenectomy and nine (13.2%) underwent fertility-sparing surgery [radical trachelectomy (n= 7); large conization (n=2)]. Factors affecting parametrial invasion, including lymphovascular space invasion (LVSI), deep stromal invasion (DSI), lymph node metastases, and tumor size, were evaluated. Statistical analyses were performed using SPSS 23.0 (IBM Corp., Armonk, NY, USA). Results: Median age was 49.5 years and median tumor size was 2.5 cm ( 0.45-4 cm). In both univariate and multivariate analyses, the risk of parametrial involvement was increased with LVSI with a hazard ratio (HR) of 3.45 [95% confidence interval (CI): 1.1-10.8] and DSI with a HR of 4.1 (95% CI: 1.18-14.8), while tumor size of <= 2 cm was only significant in univariate analyses. Furthermore, 26 early-stage patients were identified with low-risk factors and they had no parametrial involvement, lymph node metastases, recurrence, or death from disease over 77 months. Conclusion: Parametrial involvement in low-risk cervical cancer is very rare and less radical procedures may be safe in these patients.
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    Initial serum lactate levels of COVID-19 patients
    (Bayrakol Medical Publisher, 2021) Yolcu, Sadiye; Sener, Kemal; Yilmaz, Nurettin; Tunc, Mehmet; Aktas, Ahmet; Dogan, Nurettin O.
    Aim: In this study, we aimed to research whether the serum lactate of the COVID-19 patients presented to the initial emergency department can be used to make prognosis of the patients. Materials and Methods: A total of 39 COVID-19 patients were included in the study. Fourteen (35.8%) patients were over 65 years old (Group 1). Twenty-five patients (64.2%) were under 65 years old (Group 2). The diagnosis was made via the oro-nasopharyngeal swab PCR test. We noted the demographic data (age, gender, comorbidities), initial (emergency service presentation) complete blood count parameters including WBC, Plt/Lymp ratio, CRP, procalcitonin and serum lactate levels. We also noted the hospitalization unit (clinic/intensive care unit), hospitalization length, and the outcomes. Patients were divided into two groups according to 65 years and the groups' laboratory results with the prognosis. Results: The mean age of the study group was 55 years. Fourteen (35.8%) patients were over 65 years old. Serum lactate levels did not significantly differ between groups. Hospital length of stay was significantly longer in patients over 65 years of age. Age and hospitalization length were positively correlated with age in all patients. Discussion: Serum lactate level measurement has recently become an important parameter especially for critically ill patients. It is beneficial for predicting the severity and prognosis in severe infections. Serum lactate levels in COVID-19 patients did not differ between age groups. Hospitalization length was longer in elderly patients.