Görkem Aktaş

Aims: High-grade squamous intraepithelial lesion (HSIL) is among the important precursor lesions of cervical cancer, and progression to invasive cancer can be largely prevented with early diagnosis and appropriate treatment. Excisional procedures, especially loop electrosurgical excision procedure (LEEP), are commonly used to treat HSIL. However, the persistence or recurrence of the lesion after excisional treatment in some patients remains a clinically significant problem. Surgical margin status, human papillomavirus (HPV) infection, and various clinical factors are thought to play a role in the development of persistence. Therefore, identifying the factors that affect persistence after excisional treatment is important for optimizing follow-up and management strategies for patients. The aim of this study is to evaluate demographic, clinical, and pathological factors associated with post-treatment persistence in patients diagnosed with HSIL and treated with conization.Methods: This retrospective study was conducted at a tertiary referral center and included patients diagnosed with HSIL and treated with conization between 2024 and 2025. A total of 69 patients with histopathologically confirmed HSIL were included in the study. Persistence was observed in 46 patients (66.7%), while no persistence was observed in 23 patients (33.3%). Demographic characteristics, clinical findings, and pathological data of the patients were retrospectively reviewed from their patient files. Data collected included age, surgical margin status, length of the removed specimen, and HPV status during follow-up. Patients were divided into two groups based on whether persistence developed during follow-up. Correlation analyses and logistic regression models were used to evaluate factors associated with persistence. Results: No significant differences were found between patients with and without persistence in terms of age, menopausal status, marital status, and smoking (p>0.05). However, positive surgical margins were significantly associated with persistence (p=0.003). In the evaluation of clinicopathological factors, the persistence rate was significantly higher in patients with positive high-risk HPV types (e.g., HPV 16, HPV 31) during follow-up (p=0.002). In logistic regression analysis, positive surgical margins and positive HPV status at follow-up were significant predictors of persistence. Conclusion: Positive surgical margins and HPV positivity during follow-up are significantly associated with persistence after excisional HSIL treatment.

This study aimed to evaluate the educational quality of laparoscopic hysterectomy videos for advanced endometriosis (ASRM stage III − IV)

Aim: To evaluate the predictive value of the first-trimester Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for fetal growth restriction (FGR), and to examine whether combining the HALP score with maternal body mass index (BMI) enhances risk prediction.Materials and Methods: We retrospectively analyzed prospectively collected data from pregnant women followed at a tertiary center between January 2023 and June 2025. A total of 176 singleton pregnancies were included, consisting of 88 women diagnosed with FGR and 88 gestational age–matched controls. First-trimester hematological parameters were used to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and HALP score. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis, and subgroup analyses were performed according to maternal BMI.Results: The HALP score was significantly lower in the FGR group than in controls (p<0.001). A higher HALP score was independently associated with a lower likelihood of FGR (OR: 0.40, 95% CI: 0.25–0.62; p<0.001). ROC analysis demonstrated that the HALP score had the highest diagnostic accuracy, with an AUC of 0.845 (95% CI: 0.783–0.895). At a cutoff value of ≤3.31, the sensitivity and specificity were 80.68% and 78.41%, respectively. In exploratory subgroup analyses among women with low HALP scores, overweight women (BMI 25.0–29.9 kg/m²) had a lower likelihood of FGR than women with a BMI <25 kg/m². However, no formal HALP × BMI interaction analysis was performed.Conclusions: The first-trimester HALP score is a valuable predictor of FGR. Exploratory analyses suggest that the combined evaluation of HALP and maternal BMI may improve risk stratification, although formal interaction analyses are required to confirm this observation. Prospective multicenter studies are warranted to validate these findings.

Objective This study aimed to investigate follicle-stimulating hormone receptor (FSHR) polymorphisms (Thr307Ala and Asn680Ser), estrogen receptor 1 (ESR1) polymorphisms (PvuII and XbaI), and ESR2 polymorphisms (RsaI and AluI) in Turkish women with follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH) discordance. Method Genotyping was performed in 60 patients aged 21-35 with FSH-AMH discordance and/or low ovarian reserve and 20 age-matched controls with normal FSH and AMH levels. The patients were investigated in four groups of 20 women according to their FSH and AMH levels. Groups 1, 2, 3, and 4 were as follows: normal FSH and low AMH levels, normal AMH and high FSH levels, high FSH and low AMH levels, and normal FSH and AMH levels. Genomic DNA was obtained from 3 cc peripheral blood, and polymorphisms were analyzed using TaqMan genotyping assays. Relations between groups of categorical variables were analyzed with a chi-square test. Differences between the groups were assessed using a student’s t-test or Mann-Whitney U test. Results Women with discordant FSH and AMH levels (group 1 and group 2) were not statistically different from women with concordant FSH and AMH levels (group 3 and group 4) in terms of FSHR, ESR1, and ER2 single nucleotide polymorphisms (SNPs). Body mass index (BMI) was statistically significant between groups 1 and 2 as well as groups 2 and 3 (p = 0.004). Conclusions This study showed that FSHR, ESR1, and ESR2 SNPs have not had any effect on AMH-FSH discordance in reproductive age Turkish women.

AIMS: The purpose of this study is to determine if heat shock protein 70 (Hsp-70), a marker of cellular stress, is elevated in maternal serum and umbilical cord in pregnancies complicated by gestational diabetes mellitus (GDM) and to determine whether altered serum Hsp-70 concentrations in umbilical cord are related to serve as an indicator of early term delivery (37 0/7–38 6/7 weeks of gestation) in women with GDM and control group. METHODS: The study included 62 patients with GDM (GDM group) and 22 non-diabetic, healthy women before caesarean section in this case-control study. We analyzed serum levels of Hsp-70 in pregnancies and umbilical cord sera and other biochemical and anthropometric markers, early term delivery in all subjects. RESULTS: Maternal Serum levels of Hsp-70 were significantly higher in patients with GDM than in healthy pregnant women. The umbilical cord levels of Hsp-70 in GDM patients were also increased as compared to healthy pregnant women but missed the commonly acceptable significance level. Cord Hsp-70 levels showed a negatively significant correlation with time of delivery, in women with GDM patients. Cord Hsp-70 levels showed a negatively significant correlation with time of delivery, also in the whole group. CONCLUSIONS: Maternal Hsp-70 was significantly higher in patients with GDM. The obtained results seem to indicate that elevated umbilical cord Hsp-70 values may potentially be used as indicators of risk factor for early term delivery in pregnancies.