Objective: To evaluate the clinical and microbiological effects of antimicrobial underwear as an adjunct to standard treatment in women with acute vaginitis. Methods: Sixty reproductive-age women with acute vaginitis received a 7-day intravaginal regimen of metronidazole and miconazole. Participants were assigned either to a group wearing antimicrobial underwear or to a control group wearing non-antimicrobial underwear. Vaginal symptoms and culture results were assessed before and after treatment. Results: The antimicrobial-underwear group showed significant improvement in vaginal symptoms, including discharge (96.7%→6.9% vs. 72.5%→27.5%; p < 0.001), pruritus (37.5% vs. 68.4%; p = 0.044), odor (19.6% vs. 53.8%; p = 0.016), and irritation (36.4% vs. 75%; p = 0.013). Dyspareunia was similar between groups. While no microbiological change was observed in controls (p = 0.950), negative cultures increased from 40% to 80% in the antimicrobial-underwear group (p = 0.018), with marked reductions in Candida spp., Gardnerella vaginalis, E. coli, and Klebsiella spp. Conclusions: Antimicrobial underwear, when used in conjunction with standard treatment, can enhance symptom relief and maintain genital hygiene. By improving the vulvovaginal microenvironment, antimicrobial textiles can reduce moisture and the persistence of pathogens.

Background: This study aimed to evaluate the clinical utility of shear wave elastography (SWE) in assessing abscess wall stiffness and its potential contribution to predicting the need for surgical intervention in patients with tubo-ovarian abscess (TOA). Materials and methods: This prospective cross-sectional study included 34 women diagnosed with TOA who underwent SWE evaluation upon admission. Demographic characteristics, laboratory parameters, abscess size, abscess wall elasticity, and abscess content elasticity were recorded. These patients were categorized as either medically managed or surgically treated. Group comparisons, receiver operating characteristic (ROC) curve analysis, and multivariable binary logistic regression were performed to identify independent predictors of surgical intervention. Results: There were no significant differences between the operated and non-operated groups regarding age, body mass index, and laboratory parameters (p > 0.05). The median length of hospital stay was significantly longer in the operated group (15 vs. 12 days, p = 0.017). Abscess diameter was significantly larger in the operated group (6.75 ± 1.17 cm vs. 4.65 ± 1.20 cm; p = 0.001). Likewise, the median abscess wall SWE value was significantly higher in the operated group (3.12 vs. 1.47 kPa; p = 0.027). The optimal cut-off value for abscess wall SWE was 2.04 kPa (AUC: 0.721, 95% CI: 0.551–0.892, sensitivity: 64.7%, specificity: 70.6%). Abscess size demonstrated a higher predictive performance (AUC: 0.905, 95% CI: 0.796–1.000). However, in the multivariable logistic regression analysis, only abscess size remained an independent predictor of surgical intervention (OR: 4.14, 95% CI: 1.50–11.39, p = 0.006), whereas abscess wall SWE and baseline C-reactive protein were not independently associated with treatment failure. Conclusions: Increased abscess wall stiffness measured by SWE was associated with the need for surgical intervention in patients with TOA. Although SWE was not an independent predictor after adjustment for abscess size and baseline C-reactive protein, it may serve as a complementary imaging biomarker when interpreted together with established clinical, laboratory, and conventional ultrasonographic findings.

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.