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Objective: This study was aim to investigate the relationship of vaginal bacterial species with High-Risk Human Papillomavirus (HR-HPV) and bacterial vaginosis (BV).Methods: One hundred and twenty-one women were included in the study. Gram stain was performed for the diagnosis of BV and evaluated according to the Nugent score. HR-HPV diagnosis was made by real-time PCR . Detection of vaginal microbial species and Gardnerella vaginalis subtypes were also performed by real-time PCR.Results: The prevalence of BV was found as 38.8%. The mean number of species was found significantly higher in BV-positive samples compared to BV-intermediate and BV-negative samples (p=0.001). Lactobacillus iners (p=0.036), BVAB2 (p=0.043), Provetella spp. (p=0.015), Leptotrichia/Sneathia (p=0.001), Megaspheara (p=0.048) were found to be associated with bacterial vaginosis. Gardnerella vaginalis subtypes were evaluated in 50 randomly selected samples. The most common strain that was found was “clade 4”. The prevalence of HR-HPV was 9.9%. HPV 16 was the most common HR-HPV type (58.3%). There was no significant difference between the mean value of Lactobacillus sp. HR-HPV-positive and negative samples (p=0.23). No association was found between the specified species and HR-HPV-positive samples (p=0.436).Conclusion: Bacterial diversity was greater in BV-positive patients and BV was significantly associated with Lactobacillus iners, Megaspheara, BVAB2, Provetella spp. and Leptotrichia / Sneathia.

Objective: To assess the indications for termination of pregnancy (TOP) in pregnant patients who were followed up with suspicion of fetal anomaly in a Turkish tertiary referral center. Material and Methods: This retrospective study was carried out in patients who were followed up with suspicion of fetal anomaly between May 2016 and May 2019 at the Perinatology Clinic of Obstetrics and Gynecology Department in Pamukkale University Hospital, which is a tertiary hospital in Denizli province in Turkey. Women were divided into two depending on gestational period: group 1 23 weeks of gestation). Results: Four hundred and seventeen pregnant women were evaluated and TOP was performed at a mean gestational age of 27.7 +/- 6.3 weeks. There were 308 (73.8%) women in group 1 and 109 (26.2%) in group 2. The decision to terminate pregnancy was due to fetal anomaly in 117 (28.1%). The majority of termination pregnancies in group 2 were performed because of multiple malformations and/or central nervous system defects. All chromosomal diseases were detected in group 1. Conclusion: With a good perinatal screening program, fetal anomalies can be diagnosed early. Therefore, early TOP is possible. Thus, pregnancy termination can be made before reaching the life limit.

Purpose: Polycystic Ovary Syndrome (PCOS) is related to metabolic diseases such as endothelial dysfunction, systemic inflammation, insülin resistance and dyslipidemia. Adropin is a peptide secretion that positively affects glucose homeostasis and hepatic steatosis in patients with PCOS. Lipocalin-2 mediates obesity, insulin resistance, and apoptosis induced by IL-3. The levels of adropin and lipocalin-2 in PCOS patients were studied in this study.Materials and methods: Women with PCOS (n=37) and healthy controls (n=34) were assessed in this observational and cross-sectional study. Anthropometric measurements, demographic data, metabolic and hormonal profiles, Adropin and Lipocalin-2 levels were measured in both groups.Results: In the study it was determined that PCOS group Adropin and Lipocalin-2 levels were significantly reduced. LDL-C cholesterol, Total cholesterol, Total testosterone, LH, FAI, Triglyceride and LH/FSH values and hirsutism score considerably lower in the control group than the PCOS group.Conclusion: The fact that adropin levels were reduced significantly in PCOS patients who had not yet acquired insulin resistance or who could not be detected using existing methods suggests that adropin changes in PCOS are independent of insulin. The study shows that the level of adropin decreases significantly before insulin resistance reaches pathological levels, which is associated with the young population. Low Lipocalin-2 levels in patients with PCOS suggest that this cannot be blamed for insulin receptor dysfunction secondary to apoptosis in PCOS.

Amaç: Yüksek dereceli servikal intraepitelyal lezyonların (HSIL) tedavisinde eksizyon sonrası cerrahi sınırdaHSIL devamlılığı saptanır ise yeniden eksizyon veya 4-6 ay sonra kontrol seçenekleri gündeme gelmektedir.Ancak bu olgularda re-eksizyon materyalinde HSIL’in persiste edip etmediğini öngörebilen parametreler henüztanımlanmamıştır. Biz bu çalışmada lezyon persistansı ile ilişkili olabilecek klinik ve histopatolojik parametrelerideğerlendirmeyi amaçladık.Gereç ve yöntem: Elektrocerrahi ile eksizyonel tedavi sonrası cerrahi sınırda HSIL devamlılığı izlenen ve bunedenle yeniden eksizyon yapılan olguların bilgileri retrospektif olarak taranmıştır. Hastaların sosyodemografikverileri, başvuru sırasındaki HPV (Human Papillomavirus) tiplemesi (HPV tip 16/18 veya diğer yüksek risklitipler), maksimal lezyon çapları, odak sayısı, yüksek dereceli lezyonun derecesi (CIN2 veya CIN3), eksizyonelmateryalin maksimal çapı, cerrahi sınır durumu ve derecelendirilmesi (Grade 1: şüpheli veya rölatif olarak tamsınırda olan cerrahi sınır pozitifliği; Grade 2: belirgin cerrahi sınır pozitifliği) ile sonraki eksizyonel işlemde HSIL’inpersiste edip etmemesi analiz için kayıt edilmiştir.Bulgular:Çalışma kriterlerine uyan toplamda 73 hasta belirlendi. Yeniden eksizyon yapılan hastaların 23(%31,5) tanesinde yüksek dereceli lezyonun persiste ettiği saptandı. Sosyodemografik ve histopatolojik faktörler(yaş, menapoz, sigara kullanımı, başlangıçtaki yüksek riskli HPV tipi, eksizyonun büyüklüğü, histolojik tip (CIN2/CIN3) lezyon büyüklüğü, lezyonun odak sayısı ve cerrahi sınır pozitifliğinin derecesi) incelendiğinde, rezidüelhastalığın saptandığı ve saptanmadığı gruplar arasında istatistiksel anlamlı farklılık saptanmadı (p=0,116,p=0,50, p=0,601, p=0,092, p=0,719, p=0,501, p=0,699, p=0,131, p=0,884, sırasıyla).Sonuç: Olguların yaklaşık üçte birinde re-eksizyon materyalinde HSIL’in persiste ettiği saptanmıştır. Ancakne klinik özellikler ne de ilk eksizyondaki patolojik bulgular ile lezyonun varlığı arasında anlamlı bir ilişkigösterilememiştir.

Amac: β hucrelerinin fonksiyonlarindaki degisiklikler polikistik over sendromunun (PCOS) patogenezinde onemli roller oynayabilir. Pankreatic Derived Factor (PANDER), patolojik kosullar altinda pankreatik β hucre apoptozunu indukleyen sitokin benzeri bir proteindir. Bu arastirma, serum PANDER duzeylerini belirlemek ve serum PANDER duzeylerinin oksidatif stres ve PCOS'taki insulin direnci ile iliskili olup olmadigini belirlemek icin planlanmistir. Gerec ve Yontem: Bu kontrollu klinik calismada PKOS tanisi almis 27 hasta ve 24 saglikli kadin control grubu olarak degerlendirildi. Serum lipit alt fraksiyonlari, aclik glikozu, insulin, gonadotropinler ve androjenler, malondialdehit (MDA) ve PANDER duzeyleri olculdu. Insulin direncini tahmin etmek icin homeostaz model degerlendirmesi (HOMA-IR) kullanildi. Bulgular: Calisma ve kontrol grubundaki denekler bel olcumleri, gonadotropinler, lipit alt fraksiyonlari, MDA ve PANDER duzeyleri acisindan benzerdi, PKOS'lu kadinlar saglikli kadinlardan onemli olcude daha yuksek FAI ve HOMA-IR'ye sahipti. Serum PANDER duzeyleri calisilan parametrelerle iliskili degildi. Sonuc: Bu sonuclar PANDER seviyesinin PCOS'ta insulin direnci, over kaynakli hiperandrojenizm ve oksidatif stres ile iliskili olmadigini gostermistir.

Human papillomavirus (HPV) infection is the most significant risk factor of the development of cervical cancer. The distribution of HPV prevalence and genotype varies widely between regions. In this study, it was aimed to investigate the prevalence and genotype distribution of HPV, retrospectively. One thousand one hundred and seventy patients who applied to the department of obstetrics and gynecology were included in this study. Samples were collected from patients for cervical HPV DNA and Pap smear. The Pap samples taken for Pap smear were fixed with alcohol and analyzed according to the modified Bethesda system. HPV identification and typing were performed using the "Linear Array HPV Genotyping Test (Roche Molecular System, USA)". Patients were divided into 5 groups due to their age. Total HPV ratio was most frequently found among the patients who were between 17-30 years old, while HR-HPV was most frequently found between 51-60 years. Nine hundred seventy-eight of 1170 (83.6%) patients had normal cytologic findings whereas 192 (16.4%) had abnormal cytologic findings. HPV was detected in 37.2% of the total patients. high-risk HPV (HR-HPV) rate was 21.2%, probable high risk (PR-HPV) rate was 6.4% and low risk HPV (LR-HPV) rate was 9.5%. When the relationship between cytologic findings and HPV was examined, normal cytology/HPV negative 67.8%; abnormal cytology/HPV negative 37.5%, normal cytology/HPV positive 32.2%, abnormal cytology/HPV positive 62.5% were detected. The highest prevalence of HPV was 8.9% with HPV 16, followed by 6, 53 and 52/53/35/58. A total of 354 patients were biopsied, 177 of whom were normal, 111 of whom were cervical intraepithelial neoplasia (CIN) 1, 66 of whom were CIN 2 and over. In the group with normal pathological findings, HR-HPV ratio was found as 15.8%, while in CIN 1 44.1% in CIN 2-3 63.6%. Sensitivity, specificity, positive predictive value, and negative predictive value of screening tests were examined in CIN 2 and more lesions. Sensitivity and specificity for HR-HPV were 63.6% and 73.3%, respectively, the same rates were 81.8% and 58.7% for HPV. The highest sensitivity was found in combination of HRHPV and Pap smear, the highest specificity in HPV. In conclusion, the HPV prevalence and genotype distribution in our study are similar to those reported in the world, but higher than previous studies in our country. These results may be due to our methodology and hospital based nature of our study group. We conclude that only smear or HR-HPV testing are not sufficient as a single pronged screening test, and that the participation of other genotypes of HPV in screening increases the sensitivity.

Objective: This study aimed to determine the factors associated with Human Papillomavirus (HPV) persistence in women undergoing cervical excision for pre-invasive lesions, after they have been referred from a primary HPV screening program. Methods: A retrospective study design involving patients who were treated at a Cervical Disease Screening and Treatment Unit, in a university hospital setting. After initial treatment, cervical HPV infection status was analyzed at the sixth month, first year and then subsequently after the second year. Results: Totally, 395 patients who were diagnosed with pre-invasive cervical lesions and who subsequently undergone cervical excision were identified. In the first-year visit after cervical excision, HPV 18 was cleared in almost all (95.8%) cases, followed by HPV 16 (69.9%) and other hrHPV types (65.6%). Available data documented that 88.6% of women reached clearance after the two-year follow-up. Univariate analysis revealed a significantly higher proportion of HPV clearance among women who were younger (p = 0.019), premenopausal (p = 0.002), and who had been found to have a negative cytology result on their initial Pap test (p = 0.018). However, only cervical cytology result remained as the independent predictor of HPV persistence on a multivariate logistic regression (OR 0.43; 95% CI 0.21–0.87; p = 0.019). Conclusions: A low risk of HPV persistence was found among every HPV genotype in women undergoing cervical excision for pre-invasive cervical lesions. Initial cervical cytology result was the only independent predictor of HPV clearance during surveillance, which indicates the prognostic value of Pap test in primary HPV screening. © 2020 Elsevier Inc.

Kortikal tabaka oluşumuyla sonuçlanan nöral migrasyon olarak adlandırılan süreç 3. ve 6. aylar arasında olmakla birlikte bu sürecin sağlıklı bir şekilde ilerleyememesi durumunda nöral migrasyon defekti oluşur. Ultrasonografi ve Manyetik rezonans görüntüleme ile bu durumun ve ek anomalilerin tespiti her geçen gün artmaktadır. Ultrasonografi ve Manyetik rezonans görüntüleme günümüzde fetusa ait bir çok anomali hakkında bilgi verebilirken, özellikle belirli haftalarda uygulandığında fetal beyin anomalilerini göstermede çok faydalıdır. Bu bildiride, literatür eşliğinde gebelikte fetal beyin yapılarının görüntüleme yöntemleri ile nöral migrasyon defekti bulguları tartışıldı.

İnsan papillomavirüs (HPV) enfeksiyonu servikal kanser gelişmesinde en önemli risk faktörüdür. Yapılan çalışmalar HPV prevalansı ve genotip dağılımının bölgeler arası büyük farklılık gösterdiğini ortayakoymuştur. Bu çalışmada HPV prevalansı ve genotip dağılımının retrospektif olarak araştırılması amaçlanmıştır. Çalışmaya Kadın Hastalıkları ve Doğum Anabilim Dalına başvuran 1170 hasta dahil edilmiştir.Çalışmaya dahil edilen hastaların Bethesda sistemine göre incelenmiş olan servikal sürüntü örneklerininsitolojik olarak incelenmesi olan “Pap smear” sonuçları ile servikal HPV moleküler test sonuçları değerlendirilmiştir. HPV tanımlama ve tiplendirmesinde “Linear Array HPV Genotyping Test (Roche MolecularSystem, ABD)” kullanılmıştır. Hastalar yaşlarına göre beş gruba ayrılarak incelenmiştir. HPV oranı en fazla17-30 yaş arasında görülürken yüksek riskli HPV (HR- HPV) en sık 51-60 yaş arasında saptanmıştır. Bin yüzyetmiş hastanın 978 (%83.6)’i normal sitolojik bulgulara,192 (%16.4)’si anormal sitolojik bulgulara sahipbulunmuştur. Hastaların toplam %37.2’sinde HPV saptanmıştır. HR-HPV oranı %21.2, olası yüksek riskliHPV oranı %6.4, düşük riskli HPV oranı %9.5 olarak tespit edilmiştir. Sitolojik bulgularla HPV arasındakiilişkiye bakıldığında normal sitoloji saptanan hastaların %67.8’inde HPV negatif, %32.2’sinde HPV pozitifsaptanırken, anormal sitoloji saptanmış olan hastaların %37.5’inde HPV negatif, %62.5’inde HPV pozitifliği saptanmıştır. En yüksek HPV prevalansı %8.9 ile HPV 16 olarak bulunmuştur. Toplam 354 hastayabiyopsi yapılmış, bunların 177’si normal, 111’i servikal intraepitelyal neoplazi (CIN) 1.66’sı CIN 2 ve üzeriolarak rapor edilmiştir. Normal patolojik bulgulara sahip grupta HR-HPV oranı %15.8 iken, CIN 1’de%44.1, CIN 2-3’te %63.6 olarak bulunmuştur. CIN 2 ve daha üzeri lezyonu olanlarda tarama testlerininduyarlılık, özgüllük, pozitif prediktif ve negatif prediktif değerleri incelenmiştir. HR-HPV’de duyarlılık veözgüllük sırasıyla %63.6 ve %73.3 olarak bulunurken, HPV’de aynı oranlar sırasıyla %81.8 ve %58.7olarak saptanmıştır. En yüksek duyarlılık HPV’de, en yüksek özgüllük ise HR-HPV ve pozitif smear sonucuolarak belirlenmiştir. Sonuç olarak, çalışmamızda bulduğumuz HPV prevalansı ve genotip dağılımı dünyada bildirilen oranlara benzer, fakat ülkemizde daha önce yapılan çalışmalardan yüksektir. Bu durumun kullanılan yönteme ve çalışma grubumuzun hastaneye başvuran hastalardan oluşmasına bağlı olduğudüşünülmüştür. Tarama testi olarak yalnız smear veya HR-HPV testleri yeterli olmayıp, HPV’nin diğer genotiplerinin de taramalara katılmasının duyarlılığı artıracağı kanaatine varılmıştır.