Purpose: To describe clinical and virologic outcomes after topical 5% imiquimod for VaIN (vaginal intraepithelial neoplasia) within routine clinical practice, including the assessment of available post-treatment high-risk HPV status, and to evaluate its relationship with treatment outcomes. Methods: In this retrospective-cohort study, twenty patients with histologically confirmed VaIN (low-grade VaIN = 10, high-grade VaIN = 10) were evaluated between October 2020 and October 2022. The treatment varied based on the initial VaIN grade. The primary endpoint was complete response, defined as negative cytology and/or benign follow-up biopsy. Secondary endpoints included partial response (downgrading from high-grade to low-grade), persistence/progression, adverse events, and available post-treatment high-risk HPV status. Results: Among seventeen evaluable patients, a complete response was observed in 69.2% (9/13) imiquimod-treated patients. In high-grade VaIN imiquimod-treated patients, complete response was observed in 66.7% (6/9), while 33.3% (3/9) downgraded to low-grade VaIN on biopsy as a secondary outcome, with no persistence over a median follow-up of 24 months. Low-grade VaIN showed 75% clearance with either imiquimod or observation at a median follow-up of 24 months. In one low-grade imiquimod-treated, persistent HPV16 was observed, and the lesion progressed to high-grade VaIN; however, no invasive cancers were observed during follow-up. Adverse events related to imiquimod were mild; there were no discontinuations. Among baseline high-risk HPV positive imiquimod-treated patients, post-treatment follow-up HPV testing was available in a limited subset group, and clearance was confirmed in 44% (4/9) among those with follow-up testing and presented descriptively as exploratory. Conclusions: In this single-center retrospective cohort, outcomes after topical 5% imiquimod are reported as observed findings. Complete and partial responses were observed in high-grade VaIN with acceptable tolerability and no invasive events at available intermediate follow-up (median 24 months). Post-treatment HPV testing provided complementary virologic information alongside clinical outcomes, consistent with recommendations incorporating HPV testing into VaIN follow-up, and longer surveillance is required to assess long-term oncologic outcomes.

Background/Objectives: Preeclampsia can be divided into two groups (with and without severe features) based symptom severity. We aimed to distinguish these two entities with the aid of fibrinogen to albumin ratio (FAR), uric to acid albumin ratio (UAR) and LDH to albumin ratio (LAR). Methods: This retrospective study was conducted in Istanbul Basaksehir Cam and Sakura City Hospital between 2020 and 2023. Seventy-three patients with preeclampsia were included in this study which were categorized into two groups according to disease severity: 40 patients with preeclampsia without severe features and 33 patients with severe features. Additionally, 30 healthy pregnant women were included as a control group. Neutrophil–lymphocyte ratio (NLR), monocyte–lymphocyte ratio (MLR), platelet–lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW), mean platelet volume (MPV), Uric acid, LDH, AST, ALT, fibrinogen, albumin, FAR, UAR and LAR were compared among the groups. Results: FAR was significantly higher in preeclampsia patients with and without severe features compared to control group (Odds ratio 8.32 for ≥0.139 vs. <0.139, p < 0.001). There was no significant difference in FAR levels between preeclampsia patients according to disease severity. UAR and LAR were significantly different between preeclampsia patients with and without severe features and the control group (p < 0.001). Receiver operating characteristics (ROC) curves for UAR showed that a cut-off value of 1.727 had a sensitivity of 73% and a specificity of 68% in discriminating between preeclampsia with and without severe features (Odds ratio 5.53 for ≥1.727 vs. <1.727). ROC curves for LAR showed that a cut-off value of 79.09 had a sensitivity of 85% and a specificity of 73% in discriminating between preeclampsia with and without severe features (Odds ratio 14.76 for ≥79.09 vs. <79.09). Conclusions: UAR and LAR appear to be better markers than FAR for identifying preeclamptic patients who require delivery due to severe features. They are easily accessible and promising biomarkers, and to our knowledge, this is the first study to evaluate LAR in this context. Further studies are needed to validate their diagnostic accuracy and compare their performance with established biomarkers.

Objective: This study aims to assess Bisphenol-A levels in serum samples from preeclampsia patients and determine potential distinctions by comparing them against samples from healthy pregnant women Material-Methods: This single-center prospective case-control study aimed to investigate the potential differences in serum Bisphenol-A (BPA) levels between pregnant patients diagnosed with preeclampsia and healthy pregnant women. The study encompassed two distinct groups: the study group consisted of 30 pregnant patients diagnosed with preeclampsia, while the control group included 30 healthy pregnant women matched in terms of gestational weeks and demographic characteristics, maintaining a 1:1 ratio. Serum samples were subjected to analysis using a BPA ELISA kit Results: The study encompassed a total of 60 patients, who were categorized into two groups: preeclampsia (n=30) and control (n=30). Upon comparison of the BPA values between the two groups, no statistically significant difference was detected (p=0.579). Conclusion: Clear-cut scientific evidence establishing a conclusive causal link between BPA and preeclampsia is still lacking. Further research is needed in this area

Objective: The purpose of this study is to evaluate the prenatal sonographic features and postnatal outcomes in fetuses with ductus venosus agenesis (DVA) in a tertiary center. Material and Methods: We performed a retrospective study of 15 consecutive cases of DVA diagnosed in our perinatology department between January 2020 and October 2023. All clinic records, fetal echocardiograms, any accompanying anomalies, obstetrical ultrasounds, and postnatal echocardiograms were reviewed. Results: Of the 15 cases detected, umbilical vein had extrahepatic type connection in 8 fetuses (53.3%) and intrahepatic type connection in 7 fetuses (46.7%). 11 patients had associated anomalies including hydrops (n=3, 20%), cardiac (n=6, 40%), extracardiac structural (n=7, 46.7%) and chromosomal anomalies (n=3, 20%). In our patient group, only 4 cases (26.7%) presented with isolated DVA, of which 3 had intrahepatic type connection. Prenatal genetic testing including karyotype and microarray was performed in 8 patients (53.3%) and 3 (20%) of them had abnormal results. 4 women (26.7%) underwent legal termination of pregnancy. There were 2 (13.3%) neonatal deaths, and the remaining 9 cases (60%) were alive at last follow-up. Conclusion: DVA is associated with cardiac, extracardiac, and genetic anomalies independent of the site of umbilical venous connection. Postnatal outcomes in cases with DVA depend on the presence of additional anomalies. Fetuses with DVA and extrahepatic connection have additional risk for cardiac failure, hydrops and portal venous system agenesis which worsen the outcomes. DVA cases with intrahepatic connection associated with no or minor anomaly tend to have more favorable outcomes.