Background/Objectives: This study aimed to evaluate the association between the clinical parameters of vaginal infection—specifically the presence, type, number of concurrent symptoms, and recurrence frequency—and cervical cytology findings, including inflammation severity, Candida, bacterial vaginosis, cellular abnormalities, and Human Papillomavirus (HPV) positivity. Methods: This prospective, cross-sectional, observational study included 458 women attending our gynecology outpatient clinic for Pap smear screening. Vaginal symptoms were documented through face-to-face interviews using a structured data collection form. Cervical samples were evaluated via liquid-based cytology by a single, experienced cytopathologist, who was blinded to the clinical data; cellular abnormalities, the degree of inflammation and cytomorphological findings indicative of infection were reported. HPV analysis was performed on the 218 women for whom results were available. Chi-square and trend chi-square tests were used in the statistical analysis. Results: No significant association was found between the clinical parameters of vaginal symptoms—specifically presence, concurrency, and recurrence frequency—and cytological abnormalities, HPV positivity and bacterial vaginosis (p > 0.05). In contrast, the prevalence of moderate-to-severe inflammation was significantly higher in women with vaginal discharge and a greater symptom burden (p < 0.05). Pruritus, dysuria, and vaginal burning were significantly associated with Candida positivity (p < 0.05). However, no significant association was found between the severity of cervical inflammation and abnormal cytology or HPV positivity (p > 0.05). In multivariable logistic regression analyses, neither symptom burden nor cervical inflammation severity was independently associated with abnormal cytology or HPV positivity. Conclusions: Our findings indicate that vaginal symptoms and the severity of cervical inflammation may not serve as definitive or independent discriminatory markers for cellular abnormalities or HPV positivity in this context. Nevertheless, specific symptom patterns may assist clinicians in evaluating localized infectious processes. Consequently, while standard cytological and molecular protocols remain essential for oncogenic screening, evaluating the overall symptom burden provides clinicians with a valuable framework for identifying benign dysbiotic and inflammatory processes. These findings remained consistent after adjustment for major clinical confounders.

Tubo-ovarian abscesses (TOAs) are identified as a severe and complex form of inflammatory disorder, marking an advanced progression of pelvic inflammatory disease (PID), mainly resulting from the escalation of polymicrobial infections within the female genital tract. This literature review is dedicated to elucidating the contemporary management strategies and associated complications of TOAs, amalgamating the current scholarly discourse while spotlighting the emerging therapeutic trends. The inherent complexity of TOAs, manifesting through a broad array of clinical presentations from mild symptoms to acute pelvic discomfort and fever, necessitates a comprehensive, multidisciplinary approach to achieve effective management. Traditional management has predominantly focused on antibiotic therapy, the cornerstone of initial treatment modalities. Nonetheless, this review expands on the increasing acknowledgment of minimally invasive surgical interventions, like ultrasound-guided drainage, especially in scenarios where medical therapy falters or in the presence of sizable abscesses, underscoring scenarios where antibiotic treatment may be insufficient. The discourse further explores the pivotal decision-making concerning surgical interventions, juxtaposing the benefits of abscess resolution against potential risks and complications, such as damage to adjacent structures and implications for future fertility. The review emphasizes the criticality of addressing PID’s risk factors and root causes to avert TOA development. It also ventures into the ramifications of the emergence of antibiotic-resistant bacterial strains for empirical antibiotic therapy selection, highlighting the imperative for continuous research and the adaptation of therapeutic guidelines. The complications associated with TOAs, including sepsis, infertility, and chronic pelvic pain, are meticulously examined to underscore the potential for significant long-term morbidity. Advocating for prompt diagnosis and encompassing management strategies to curtail these adverse outcomes, the review ultimately calls for intensified, quality research to refine TOA management further, particularly against the backdrop of evolving microbial resistance and the advancements in minimally invasive surgical technologies.

Climate change is increasingly recognized as a major global health threat, disproportionately affecting vulnerable populations such as pregnant women. However, limited research has examined its psychological impacts on this group. This study aimed to examine whether higher climate change awareness is associated with increased symptoms of depression, anxiety, and stress among pregnant women in Türkiye. A cross-sectional study was conducted between April 2025 and June 2025 with 267 pregnant women attending routine obstetric care at a public hospital. Data were collected using a personal information form, the Pregnancy-Specific Climate Change Awareness Scale (PS-CCAS), and the Depression Anxiety Stress Scale. Descriptive statistics, Pearson correlation, and multiple linear regression analyses were used to assess relationships between variables. The mean total PS-CCAS score was 66.81 ± 20.97. Although no significant association was observed with depression, both climate change awareness (PS-CCAS) and climate change knowledge, assessed as a separate variable, emerged as significant predictors of anxiety and stress. Depression was more common among participants with lower education, longer marriage duration, urban residence, and pregnancy-related illness. Anxiety and stress were significantly linked to urban living and pregnancy-related illness, while stress was additionally associated with lower income. These findings highlight the need for targeted, psychologically safe climate education programs during pregnancy. Sociodemographic factors such as education level, income, and urban living should be considered when designing perinatal mental health interventions in the context of climate change.

Amaç: Toksoplazma gondii, Rubella, Sitomegalovirüs (CMV) gibi enfeksiyöz ajanlar gebelik döneminde intrauterin enfeksiyonlara yol açarak fetal morbidite, mortalite ve anomalilere sebep olabilmektedir. Bu çalışmada Toksoplazma gondii, Rubella, CMV seroprevalanslarının saptanması amaçlanmıştır. Gereç ve Yöntem: Tanımlayıcı retrospektif tipteki araştırmada bir eğitim ve araştırma hastanesi kadın hastalıkları ve doğum polikliniğine 01/01/2017- 01/07/2021 tarihleri arasında gebelik takibi amacıyla başvurarak Toksoplazma gondii, Rubella ve CMV taraması yapılmış olan gebelerin antikor düzeyleri hastane kayıtlarından retrospektif olarak elde edilmiş, yıllara ve yaş gruplarına göre seropravalans değerleri hesaplanmıştır. Bulgular: Bu çalışmada Toksoplasma gondii için 4897, Rubella için 4903 ve CMV için 4600 gebenin test sonuçları değerlendirilmiştir. Sırasıyla Toksoplasma gondii IgM, IgG %1.1, %24.5, Rubella IgM, IgG pozitifliği %0,4, %92.3, CMV IgM, IgG pozitifliği %1.9, %98.6’dır. Toksoplazma IgM(-) saptananların oranı 25-29 yaş grubundaki gebelerde diğer yaş kategorilerine göre yüksektir. 30 yaş ve üzeri gebelerde 25-29 yaş grubuna göre, 25-29 yaş grubu gebelerde 24 yaş ve altındaki gebelere göre Toksoplazma IgG (-) saptananların oranı düşüktür (p0.05). Sonuç: Türkiye’de yapılan çalışmalara göre Toksoplazma IgM (+), IgG (+), Rubella IgG (+) seroprevalansları düşüktür, CMV IgG seropozitifliği ise Türkiye’de yapılan çalışmalara benzerdir. 25-29 yaş grubundaki gebelerde Toksoplazma IgM (-) oranı diğer yaş gruplarına göre yüksektir. Gebelerin yaşının artmasıyla Toksoplazma IgG (-) oranı azalmaktadır. Sitomegalovirüs (CMV) için taramanın cost effektif olmadığı söylenebilir, Toksoplazma gondii ve Rubella için ise taramaların yapılması önerilir.

Background: This study aimed to evaluate the phenotype-specific profiles of serum Isthmin-1 (ISM-1), Trimethylamine N-Oxide (TMAO) and Nitric Oxide (NO) levels in women diagnosed with Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly known as Polycystic Ovary Syndrome—PCOS) according to the Rotterdam criteria. Methods: This cross-sectional study enrolled 90 reproductive-aged women, divided equally into five groups (n = 18 per group) with similar baseline metabolic parameters: healthy controls and PMOS Phenotypes A, B, C, and D. To minimize confounding effects, individuals with recent use of specific medications were excluded, and 24 h dietary recalls were obtained. Fasting blood samples were collected during the early follicular phase. Serum ISM-1, TMAO, and NO levels were quantified via ELISA, and insulin resistance was determined using the HOMA-IR index. Data were adjusted for potential confounders, including age, BMI, and smoking status, using multivariate linear regression models. Results: No statistically significant differences were observed between the groups in key parameters such as BMI and HOMA-IR. Serum ISM-1 levels did not show a significant difference between the groups (p = 0.501). In contrast, NO levels were found to be significantly lower in all PMOS phenotypes compared to the control group (p < 0.001), and this reduction remained independent in regression models. TMAO levels, however, exhibited a phenotype-specific distribution; in the non-hyperandrogenic Phenotype D, they were found to be significantly lower than in the control group and hyperandrogenic phenotypes A and B. In the multivariate regression analysis, it was confirmed that Phenotype D was independently associated with low TMAO levels (B = −0.131, p = 0.027). Conclusions: Although PMOS patients share a similar profile of obesity and insulin resistance, they exhibit marked biochemical heterogeneity. Whilst the reduction in NO levels may indicate a generalised vascular change affecting all phenotypes, the observation of low TMAO levels specifically in the non-hyperandrogenic Phenotype D highlights a distinct biochemical signature associated with this subgroup, observed in the absence of hyperandrogenism. Our findings support the notion that adopting phenotype-specific, individualised approaches in the management of PMOS may be beneficial.

Background: The aim of this study was to evaluate the clinical and diagnostic utility of metabolic and systemic inflammatory marker indices in adolescent patients with polycystic ovary syndrome (PCOS). Methods: This retrospective case–control study included 63 adolescent girls diagnosed with PCOS, based on the strict presence of both menstrual irregularity and hyperandrogenism, and 63 healthy controls matched for age and body mass index (BMI). Fasting blood glucose (FBG), fasting insulin (FI), and lipid profiles were measured. Metabolic indices, including the Triglyceride-Glucose (TyG) index, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Metabolic Score for Insulin Resistance (METS-IR), as well as systemic inflammatory indices (Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and the Aggregate Index of Systemic Inflammation (AISI)), were calculated. The diagnostic performance of these markers was evaluated using Receiver Operating Characteristic (ROC) curves and binary logistic regression analyses. Results: No statistically significant difference was observed between the PCOS and control groups in terms of age and BMI (p > 0.05). FBG levels (p = 0.001) and the TyG index (p = 0.028) were found to be significantly higher in the PCOS group. However, no significant differences were observed between the groups in terms of other metabolic indices (HOMA-IR, METS-IR) and systemic inflammatory markers (SII, SIRI, AISI). In the ROC analysis, only the TyG index demonstrated statistically significant but weak discriminatory power for PCOS (AUC = 0.614; 95% CI: 0.515–0.712; p = 0.028). Furthermore, binary logistic regression analysis revealed that the TyG index was not an independent predictor of PCOS after adjustment. Conclusions: While early metabolic signals such as elevated FBG and TyG index were detected, the evaluated systemic inflammatory indices did not demonstrate significant differences. However, the weak discriminatory capacity of the TyG index and the failure of other composite indices restrict their clinical utility. Therefore, these biomarkers cannot be recommended as reliable standalone diagnostic tools in adolescent PCOS.