Burcu Özata

Background: The optimal extent of cervical excision according to transformation zone anatomy remains uncertain. This study evaluated the association of transformation zone (TZ) type with surgical margin status, margin localization, and conization specimen dimensions and explored TZ-specific cone length estimates associated with negative surgical margins. Methods: This retrospective cohort study included 323 women who underwent cervical conization for high-grade squamous intraepithelial lesions (HSIL; cervical intraepithelial neoplasia grades 2 and 3 [CIN2–3]) between January 2022 and November 2025. TZ types were classified as TZ1, TZ2, or TZ3. Cone dimensions and surgical margin outcomes were compared across TZ types. Multivariable logistic regression was performed to evaluate factors associated with positive surgical margins, and receiver operating characteristic (ROC) analysis was used to explore overall and TZ-specific cone length estimates associated with negative surgical margins. Results: Overall positive surgical margin rates did not differ significantly across TZ types (TZ1, 18.2%; TZ2, 12.0%; TZ3, 19.0%; p = 0.319). In the multivariable model excluding surgical excision dimensions, TZ type was not significantly associated with margin positivity. In a separate conditional-on-length model, TZ2 (OR 3.94, 95% CI 1.36–11.43) and TZ3 (OR 6.92, 95% CI 2.40–20.00) were associated with higher odds of positive margins compared with TZ1, whereas greater cone length was associated with lower odds of margin positivity (OR 0.037, 95% CI 0.014–0.099). Conclusions: TZ type was associated with distinct patterns of surgical margin localization following cervical conization. Although overall margin positivity did not differ significantly across TZ types, the conditional-on-length analysis indicated that the relationship between TZ anatomy, excision length, and margin status is interdependent. These findings highlight the relevance of TZ anatomy when interpreting surgical margin patterns, while the proposed TZ-specific cone length estimates remain exploratory and require prospective external validation before clinical application.

Aim: This research evaluates the accuracy of information provided in Instagram posts about placenta previa. Method: The two most frequently utilized hashtags about placenta previa have been identified and selected for further analysis. The selected hashtags are #placenta and #placentaprevia. The Instagram search algorithm returned 595,000 posts for the hashtag #placenta and 31,000 posts for the hashtag #placentaprevia. For each hashtag, the 'Top 100 Posts' were recorded (n = 100), and 139 out of 200 posts were found to meet the research criteria. Two independent medical professionals assessed the information's reliability through a modified DISCERN analysis that included five questions. Descriptive statistics were computed, and assessments were conducted utilizing the Kruskal-Wallis test and the Mann-Whitney U test to assess the interactions of variables and identify statistically significant differences among groups (p < 0.05; statistical significance set at α = 0.05). Results: Of the posts, 20.1% (n = 28) were authored by physicians, 11.5% (n = 16) by patients, and 68.3% (n = 95) by other healthcare professionals. A comparison of the credibility of the information presented in the posts revealed a notable discrepancy between those shared by medical professionals and those from other groups (p < 0.001). Conclusion: While the posts of medical professionals are typically more reliable and useful than other content on the platform, it is important to note that Instagram posts often lack accuracy and reliability in the information provided for patients.

Aim: The aim of this study is to compare the obstetric outcomes of preeclamptic pregnant women in two different centers.Material andMethod: In this retrospective study, biochemical, hemogram, and obstetric data of pregnant women who presented to obstetrics clinics due to preeclampsia in Şanlıurfa (n=363) and Bolu (n=72) were analyzed.Results: A total of 435 pregnant women diagnosed with preeclampsia were included in the study. No significant differences were observed between Şanlıurfa and Bolu in terms of age, hemoglobin levels, and mode of delivery. However, systolic (SBP) and diastolic (DBP) blood pressures, AST, ALT, gravidity, and parity were significantly higher in Şanlıurfa compared to Bolu. Although proteinuria was more frequently observed in Bolu, it was more severe in Şanlıurfa. Additionally, Rh antigen positivity was found to be more common in preeclamptic pregnancies.Conclusion: Our study demonstrated that preeclamptic pregnant women in Şanlıurfa exhibited more severe laboratory findings and a higher rate of preeclampsia-related complications compared to those in Bolu.

Persistent high-risk human papillomavirus (HPV) infection is the primary etiological factor in cervical cancer, with HPV16 and HPV18 posing the greatest oncogenic risk. Although systemic inflammation and nutritional indices such as the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and Prognostic Nutritional Index (PNI) have prognostic value in various malignancies, their role in predicting HPV persistence remains unclear. This study aimed to evaluate the predictive value of HALP and PNI scores for one-year HPV persistence and additionally assessed other inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). This retrospective study included 470 HPV-positive women aged 31-67 years who were followed for at least one year between January 2021 and March 2025. Participants were categorized into Group N (HPV clearance, n = 271) and Group P (HPV persistence, n = 199) according to one-year HPV results. Baseline demographic, clinical, histopathological, and laboratory data were collected. HALP and PNI scores were calculated from hemoglobin, albumin, lymphocyte, and platelet counts, and inflammatory markers including NLR, PLR, and CRP were evaluated. Group comparisons were performed using appropriate statistical tests, and predictive performance was assessed using receiver operating characteristic (ROC) analysis. Continuous variables were standardized using Z-score transformation before multivariate logistic regression to minimize scale differences among predictors. Within a year, 271 (57.7%) of the 470 women achieved viral clearance, whereas 199 (42.3%) had persistent infection. No substantial differences were observed in demographic or histological parameters. Vaccination after diagnosis did not affect clearance rates. The median HALP and PNI scores were similar between groups and provided no discriminatory ability [HALP AUC = 0.475 (95% CI: 0.422-0.528); PNI AUC = 0.487 (95% CI: 0.434-0.540)], as did PLR [AUC = 0.513 (95% CI: 0.460-0.566)] and CRP [AUC = 0.462 (95% CI: 0.409-0.515)]. In contrast, NLR was significantly higher in the persistence group (p < 0.001) and demonstrated modest discriminatory ability [AUC = 0.623 (95% CI: 0.573-0.673)]. HPV16 and HPV18 positivity was strongly associated with persistence. When the researchers evaluated the subjects' systemic inflammatory and nutritional status, they found that HALP, PNI, PLR, and CRP did not provide effective predictive value for one-year HPV persistence. Conversely, NLR exhibited a promising capacity to function as a straightforward systemic inflammatory marker. The presence of HPV16 and HPV18 was found to be significantly associated with the persistence of the infection, thereby corroborating the established immune evasion mechanisms associated with these types. These findings underscore the necessity for prognostic markers that integrate both local mucosal immune responses and systemic inflammatory pathways to enhance risk stratification and management of HPV-related disease.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder among women of reproductive age, associated with hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Insulin resistance and lipid metabolism abnormalities are common in PCOS, increasing the risk of metabolic syndrome and type 2 diabetes mellitus (T2DM). Isthmin-1 (ISM1) is a novel adipokine that regulates glucose and lipid metabolism, but its role in PCOS remains unknown. This study aimed to investigate whether serum ISM1 levels are altered in women with PCOS compared to healthy controls and whether ISM1 is associated with key metabolic (e.g., insulin resistance, homeostasis model assessment of insulin resistance [HOMA-IR]) and hormonal parameters (e.g., follicle-stimulating hormone [FSH], luteinizing hormone [LH], estradiol [E2], testosterone, dehydroepiandrosterone sulfate [DHEA-S]). Emerging evidence highlights the role of novel adipokines in the metabolic dysregulation associated with PCOS. Among these, ISM1 has gained attention due to its insulin-mimetic effects and its role in glucose and lipid metabolism. Given the central role of insulin resistance and obesity in PCOS pathogenesis, investigating whether ISM1 is altered in women with PCOS could provide new insights into its potential role in disease mechanisms. Furthermore, exploring its association with insulin resistance markers may help determine whether ISM1 can serve as a supportive metabolic biomarker. Therefore, this study aimed to compare serum ISM1 levels between women with PCOS and healthy controls, and to examine the relationship between ISM1 levels and key metabolic and hormonal parameters. This case-control study included 60 women aged 18-45 years: 30 women with PCOS diagnosed using the Rotterdam 2003 criteria and 30 age-matched healthy controls. Anthropometric measurements (body mass index [BMI], waist circumference), metabolic parameters (fasting/postprandial glucose, fasting insulin, HOMA-IR, hemoglobin A1c [HbA1c], lipid profile), and hormonal markers (FSH, LH, estradiol, testosterone, DHEA-S, prolactin, thyroid-stimulating hormone [TSH], free thyroxine [FT4]) were assessed. Serum ISM1 concentrations were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analyses included independent t-tests, Mann-Whitney U tests, Spearman correlation, and ROC analysis. Median ISM1 concentration was significantly higher in the PCOS group (1.60 ng/mL) compared to the control group (1.34 ng/mL, p = 0.03). ISM1 levels positively correlated with fasting insulin (r = 0.26, p = 0.04) and HOMA-IR (r = 0.29, p = 0.03). No significant correlation was found between ISM1 and reproductive hormones or lipid profile components. ROC analysis demonstrated that ISM1 had moderate diagnostic performance in identifying PCOS, with an area under the curve (AUC) of 0.658 (95% CI: 0.52-0.77, p = 0.026). At an optimal cut-off value of 1.85 ng/mL, the sensitivity was 43.3% and specificity was 90.0%. Elevated serum ISM1 levels and their correlation with insulin resistance suggest that ISM1 may contribute to the metabolic pathophysiology of PCOS. Although its diagnostic performance is limited due to low sensitivity, ISM1 may serve as a supportive biomarker in identifying metabolic risk in women with PCOS. Further large-scale and mechanistic studies are needed to validate these findings and clarify the functional role of ISM1.

Objective The study aimed to determine the level of anemia in pregnant women in the first trimester and in the preconception period by conducting nationwide research. Methods The study was designed as retrospective, cross-sectional, and multicenter research. A total of 17 centers from 13 provinces were included in the study. The study was conducted […] Abstract Objective The study aimed to determine the level of anemia in pregnant women in the first trimester and in the preconception period by conducting nationwide research. Methods The study was designed as retrospective, cross-sectional, and multicenter research. A total of 17 centers from 13 provinces were included in the study. The study was conducted […]