Objectives: Persistent Human Papillomavirus (HPV) infection in the cervix and the preinvasive lesions it causes are significant risk factors for cervical cancer. Therefore, a treatment strategy is necessary to facilitate the clearance of HPV and prevent the progression of preinvasive lesions without causing cervical tissue destruction. This study aimed to evaluate the effectiveness of a vaginal adsorbent gel composed of a hydroxyethyl cellulose matrix formulation containing dispersed silicon dioxide, antioxidant sodium selenite, deflamin, and citric acid in patients with HPV infection. Methods: The study was designed as a retrospective cohort study and involved 449 women infected with HPV. For the purposes of the study, the patients were divided into two groups: the treatment group (TG) comprised 207 patients who used the vaginal gel daily for a period of three months, while the control group (CG), consisting of 242 patients, received no treatment under an “active surveillance” protocol. The study’s endpoints encompassed the domains of cytology, histology, and HPV clearance. Results: The regression rate of smear pathologies was 24.8% in the control group and 29.0% in the group using the vaginal adsorbent gel. In the first year, the histological regression rate in cervical biopsies was 49.3% in the treatment group and 19.4% in the control group, with a significant difference between groups (p < 0.001). Moreover, the clearance rate of HPV types was found to be significantly higher in the group using the vaginal adsorbent gel. Conclusions: The findings of this study suggest that the outpatient treatment approach can effectively prevent the oncogenic progression of cervical dysplasia. This alternative method has been shown to be efficacious in preventing the progression of cervical dysplasia and promoting regression. Furthermore, the efficacy of this gel in eradicating HPV has been demonstrated within a 12-month period.

Background: The aim of this study was to evaluate the cervical regeneration process following monopolar electrosurgical conization (MESC), using a multimodal approach including ultrasonographic, cytologic, colposcopic, and histologic assessments, and to determine the relationship between the extent of excision and the capacity for cervical tissue regeneration. Methods: This prospective observational study included 28 patients who underwent MESC due to abnormal cervical cytology or biopsy-confirmed cervical intraepithelial neoplasia. Preoperative, postoperative one month and six month cervical measurements were obtained using two-dimensional transvaginal ultrasonography. Monthly colposcopic evaluations were conducted, cervical biopsies were taken at the third month, and a cytological assessment was performed at the sixth month. Cervical volume and length regeneration were calculated and analyzed in relation to the dimensions of the excised cone. Regeneration percentages and their correlations with excised tissue dimensions were evaluated using paired t-tests and Pearson correlation analysis. Results: Mean cervical volume and length regeneration rates at six months were 84.61% ± 5.64 and 86.36% ± 3.33, respectively. The transformation zone was histologically visible in 32.1% of patients at three months and cytologically in 75.9% at six months. An inverse correlation was observed between both cone volume and length and cervical regeneration (p < 0.005). Patients with larger preoperative cervical dimensions exhibited a higher regenerative capacity. Positive surgical margins were found in only one patient (3.4%), and no high-grade cytologic abnormalities were noted at follow-up. Conclusions: MESC may enable substantial cervical regeneration within six months. Larger excisions impair healing and delay transformation zone reformation, which may inform the optimal timing for initiating gynecological and colposcopic examinations, as well as for performing cervical interventions when indicated.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 2000 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir.Bilimsel ve düşünsel çalışmaların kalıcı belgeleri sayılan kitaplar, bilgi kayıt ortamı olarak yüzlerce yılın tanıklarıdır. Matbaanın icadıyla varoluşunu sağlam temellere oturtan kitabın geleceği, her ne kadar yeni buluşların yörüngesine taşınmış olsa da, daha uzun süre hayatımızda yer edineceği muhakkaktır.

Systemic inflammatory and nutritional indices derived from routine blood tests have been widely investigated as prognostic markers; however, their diagnostic value in differentiating benign endometrial disease from endometrial cancer (EC) remains insufficiently defined. This study aimed to evaluate the diagnostic performance of inflammatory and nutritional indices and to explore their associations with clinicopathological features in EC. This retrospective observational study included 270 patients who underwent surgical evaluation for endometrial pathology. The cohort comprised 135 patients with histopathologically confirmed endometrial cancer and 135 patients with benign endometrial conditions. Preoperative inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI), were calculated. Clinicopathological characteristics and immunohistochemical findings were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of malignancy. All inflammatory indices and PNI were significantly higher in the malignant group (all p < 0.001). In multivariable analysis, age, body mass index, haemoglobin level, SII (OR = 1.004, 95% CI 1.001-1.007; p = 0.018), and PNI (OR = 1.380, 95% CI 1.228-1.550; p < 0.001) emerged as independent predictors of malignancy. Receiver operating characteristic (ROC) analysis showed that PNI had limited discriminative ability (area under the curve [AUC] = 0.620, 95% CI 0.554-0.687), with a cut-off value of 52.0 (sensitivity 69.6%, specificity 50.4%). Within the malignant cohort, lower PNI values were significantly associated with adverse clinicopathological features, including deep myometrial invasion, cervical stromal invasion, lymph node metastasis, higher tumour grade, serous histology, and abnormal p53 expression. Systemic inflammatory and nutritional indices may provide complementary information in the evaluation of endometrial pathology. While SII appears to be associated with malignancy risk, PNI primarily reflects tumour aggressiveness rather than diagnostic discrimination. These readily available biomarkers may support preoperative risk stratification, particularly in patients with inconclusive imaging or biopsy results, where additional risk stratification may help guide the urgency or extent of surgical planning; however, further prospective studies are required to confirm their clinical utility.

Gestasyonel trofoblastik hastalık (GTH), trofoblastik dokunun anormal çoğalmasıyla ortaya çıkan premalign bir durum olup, invazyon ve metastaz durumunda ise malign nitelikteki Gestasyonel Trofoblastik Neoplaziye (GTN) dönüşmektedir. Jinekolojik onkolojide kür oranları en yüksek hastalık grubunu oluşturan GTH'nın %80'ini komplet ve parsiyel olmak üzere ikiye ayrılan hidatiform mol oluşturur. Komplet mol, boş ovumun haploid sperm ile fertilizasyonu sonucu paternal kökenli oluşurken, parsiyel mol triploid yapıda meydana gelir. Hastalığın tanısı ultrason muayenesi ve belirgin şekilde yüksek olan kantitatif hCG düzeyleri ile konur. Tedavide hem tanı hem tahliye amacıyla dilatasyon ve evekuasyon (D&E) önerilirken, doğurganlığını tamamlamış hastalarda histerektomi alternatif bir seçenektir. Tahliye sonrasında GTN gelişimini erken teşhis etmek amacıyla hastalar seri beta hCG ölçümleri ve kontrasepsiyon eşliğinde yakından takip edilir. Kriterlere göre GTN tanısı alan hastalar, Dünya Sağlık Örgütü (WHO) prognostik risk skorlamasına göre düşük (0-6) veya yüksek (>6) riskli olarak sınıflandırılır. Düşük riskli GTN vakalarında metotreksat veya aktinomisin D gibi tek ajanlı kemoterapiler ile %100 tam kür sağlanabilirken; yüksek riskli metastatik vakalarda EMA-CO gibi çok ajanlı kemoterapiler, gerekli hallerde cerrahi, radyoterapi veya güncel immünoterapiler (pembrolizumab) tercih edilmektedir. Gestational trophoblastic disease (GTD) is a premalignant condition arising from the abnormal proliferation of trophoblastic tissue, which transforms into malignant Gestational Trophoblastic Neoplasia (GTN) in cases of invasion and metastasis. Forming the disease group with the highest cure rates in gynecologic oncology, 80% of GTD is constituted by hydatidiform mole, which is divided into complete and partial moles. While complete mole is of paternal origin, resulting from the fertilization of an empty ovum by a haploid sperm, partial mole occurs in a triploid structure. Diagnosis of the disease is established through ultrasonography and markedly elevated quantitative hCG levels. For both diagnosis and evacuation, dilatation and evacuation (D&E) is recommended in treatment, whereas hysterectomy is an alternative option for patients who have completed childbearing. Following evacuation, patients are closely monitored with serial beta hCG measurements and mandatory contraception to early detect GTN development. Patients diagnosed with GTN according to the criteria are classified as low-risk (0-6) or high-risk (>6) based on the World Health Organization (WHO) prognostic risk scoring system. While a 100% cure rate can be achieved in low-risk GTN cases with single-agent chemotherapies such as methotrexate or actinomycin D, high-risk metastatic cases require multi-agent chemotherapies like EMA-CO, and when necessary, surgery, radiotherapy, or current immunotherapies (pembrolizumab) are utilized.

Aims: Repeated cesarean deliveries are associated with intra-abdominal adhesions and pelvic anatomical distortion. This study evaluated vesicouterine thickness and its association with intraoperative adhesions compared with females undergoing their first cesarean delivery.Methods: This prospective observational study included 117 term pregnant female who underwent cesarean delivery between January and June 2024. Sixty-four female with at least one previous cesarean delivery comprised the previous CD group, while 53 females undergoing their first cesarean delivery comprised the primary CD group. Preoperative ultrasonographic evaluation included transvaginal measurement of vesicouterine thickness. Intraoperative adhesions were graded using the Nair adhesion scoring system. Correlation and receiver operating characteristic (ROC) analyses were performed. Results: Vesicouterine thickness was significantly lower in the previous CD group than in the primary CD group [4 (2-6) mm vs. 5 (3-7) mm, p