See and treat strategy by LEEP conization in patients with abnormal cervical cytology

Objectives: To determine the overtreatment and re-LEEP rates of see and treat strategy (S & T) in women who underwent S & T by LEEP and to identify the risk factors for overtreatment and surgical margin and/or endocervical curettage positivity. Material and methods: A total of 800 patients who underwent S & T in Istanbul University Cerrahpasa Medical Faculty between June 2010 and June 2016 were retrospectively analyzed. Results: Overtreatment rate was found to be 46.6%, decreasing with higher grade of cervical smear abnormalities. Age more than 45, low grade of cervical cytologic abnormality and absence of glandular involvement were associated with higher overtreatment rates. The more advanced the histopathology, the more increased risk of surgical margin on LEEP and ECC positivity (p < 0.0001, for both). Glandular involvement was associated with both surgical margin and ECC positivity. Conclusions: S & T can be used in patients with high grade cytologic anomaly with an acceptable overtreatment rate. In addition, bigger pieces of specimens may need to be removed during LEEP in patients who have suspicious images of higher grade of abnormalities on colposcopy to reduce surgical margin or ECC positivity. When high rate of ECC positivity in patients with HSIL cytology is considered, we suggest performing ECC to every patients with HSIL

Seroprevalence rates of Toxoplasma gondii, Rubella, Cytomegalovirus among first trimester pregnant women in Istanbul

Background: Toxoplasma Gondii, Rubella, and Cytomegalovirus (CMV) are the most common causes of congenital infections worldwide. There is not a consensus on these infectious agents should be screened during pregnancy. The aim of this study is to determine the prevalence of toxoplasma, rubella, and CMV infections in order to know the need for antenatal screening.Methods: This retrospective cross-sectional study was performed on 1309 ambulatory pregnant patients who applied to the obstetric clinic of a university hospital between October 2016 and April 2018. Documents of patients in the first trimester were reviewed and serologic data of Toxoplasma gondii, CMV, Rubella infections were retrieved from the computer database.Results: Of 1309 pregnant women, positivity for anti-Toxoplasma IgG antibody was 352(26.9%), while 17(1.3%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody. These positivities of the pregnant women for anti-Rubella IgG and IgM were 1147(87.6%) and (0.1%), respectively. These positivities of the pregnant women for anti-CMV IgG and IgM were 1163(88.8%) and 17(1.3%), respectively.Conclusions: We detected high rates of immunity against Rubella and CMV but low rates of immunity against Toxoplasma in this retrospective cohort of pregnant women. Due to high rates of seropositivity against Rubella and CMV, routine nationwide screening may not be necessary

Kallistatin as a Potential Biomarker in Polycystic Ovary Syndrome: A Prospective Cohort Study

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with significant metabolic implications, including an increased risk of cardiovascular diseases and diabetes. Kallistatin, a serine proteinase inhibitor with anti-inflammatory and antioxidative properties, has been identified as a potential biomarker for PCOS due to its role in modulating inflammation and oxidative stress. Methods: This prospective cohort study was conducted at a university hospital’s gynecology clinic. It included 220 women diagnosed with PCOS and 220 healthy controls matched for age and body mass index. Kallistatin levels were quantitatively assessed using enzyme-linked immunosorbent assay (ELISA) techniques. Associations between kallistatin levels and clinical manifestations of PCOS, including hyperandrogenism and metabolic profiles, were examined. Results: Kallistatin levels were significantly lower in patients with PCOS (2.65 ± 1.84 ng/mL) compared to controls (6.12 ± 4.17 ng/mL; p p = 0.035). No significant associations were found between kallistatin levels and insulin resistance or lipid profiles. Conclusions: The findings indicate that reduced kallistatin levels are closely associated with PCOS and could serve as a promising biomarker for its diagnosis. The specific correlation with hyperandrogenism suggests that kallistatin could be particularly effective for identifying PCOS subtypes characterized by elevated androgen levels. This study supports the potential of kallistatin in improving diagnostic protocols for PCOS, facilitating earlier and more accurate detection, which is crucial for effective management and treatment

How do platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio change in women with preterm premature rupture of membranes, and threaten preterm labour?

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.The aim of the study was to investigate peripheral blood platelets, neutrophils and lymphocytes counts in women with preterm premature rupture of membranes (PPROM) and threatened preterm labour (TPL) compared with gestation-matched controls in order to learn how they change. This study was conducted on 60 women with PPROM, 50 women with TPL and 47 healthy pregnant women. Laboratory parameters (including complete blood count, C-reactive protein (CRP)) of all the participants were recorded. The neutrophil-to-lymphocyte ratio (NLR) values were significantly higher in PPROM group than TPL group and healthy control group (6.1 ± 3.9, 4.4 ± 1.7, 4.4 ± 2.2, p =.007, p =.018, respectively). At a cut-off level of 5.14, NLR accurately predicted occurrence of neonatal sepsis (AUC = 0.717 (95% confidence interval 0.610–0.824), p =.001) with sensitivity and specificity rates of 69.7% and 72.0%, respectively. In the management of the patients with PPROM, NLR can be used as a more cost-effective method than other blood parameters that require the use of a kit.IMPACT STATEMENTWhat is already known on this subject? There is only one study in the literature evaluating blood count parameters (such as platelet-to-lymphocyte ratio (PLR), NLR) in PPROM pregnancies. That study demonstrated PLR and NLR were both higher in the PPROM group. What do the results of this study add? The present study demonstrates that only NLR is higher in the PPROM group. Furthermore, we have also demonstrated distinctively that NLR can predict occurrence of neonatal sepsis. What are the implications of these findings for clinical practice and/or further research? High values of NLR may be useful for predicting adverse outcomes in PPROM and TPL patients as a cost-effective method. Further studies are needed to determine whether these parameters can be used to predict if a pregnant woman who is at risk of preterm labour will result in adverse perinatal outcome