Background: The pathogenesis of endometriosis is still debatable, and many studies reported a predisposition to infectious and immunological factors. In this study, we aimed to evaluate the human papillomavirus (HPV) positivity in endometriosis pain-related symptoms and infertility. Methods: In this cross-sectional study, 410 endometriosis patients were enrolled in this study. HPV-positive (n = 202) and HPV-negative (n = 208) patients compared with pain-related symptoms, infertility, and endometrioma presence. The term “Other HPV” was utilized to encompass all HPV types with the exception of HPV 16 and 18, which were specifically identified as HPV 16/18. Results: Dyspareunia in the “Other HPV”-positive group (12.8 %) was statistically higher than in the HPV-negative group (4.8%; p = 0.007). The infertility rate was significantly higher in the HPV 16/18 positive group (high-risk HPV) 35.8% than in the HPV-negative (7.6%), and “Other HPV” positive group (8%; p < 0.001). Endometriosis-related pain symptoms were significantly higher in high-risk HPV (49%) than in the HPV-negative (37%), and “Other HPV” positive group (46.3%; p = 0.046). The ovarian endometrioma rate was slightly higher in group HPV 16/18 positive population (16.9%) than in “Other HPV” types positive (11.4%), and HPV-negative groups (7.2%; p = 0.08). Conclusions: Our results could provide a potential predisposing role of HPV infection in pain in endometriosis clinics and infertility. Moreover, HPV subtypes may have a different impact on clinical conditions.

High sympathetic nerve activity, is thought to be a cardiovascular risk factor, has been shown to correlate with circulating high testosterone levels. However its role on the pathophysiology of the...

Objective: To report a case with Crigler-Najjar syndrome type 2 of elevated bilirubin levels who was treated with triple therapy. Case(s): Crigler-Najjar syndrome is a rare congenital disorder that causes non-obstructive non-hemolytic unconjugated jaundice. The syndrome is divided into two groups according to the severity and the clinical presentation of the disease. In these cases, there is an elevated risk of antenatal death or permanent neurological impairment of the fetus due to fetal kernicterus caused by excessively increased unconjugated bilirubin levels. Phototherapy, phenobarbital and plasmapheresis can be useful in reducing serum total bilirubin concentrations, thus adverse maternal and neonatal risks. Conclusion: At her 37 weeks of gestation, the patient delivered a healthy girl. No pathological neurological findings were found and the baby had normal growth with intact neurological development.

Background: Torsion is a condition that affects the adnexa completely or partially and causes circulatory disorders in the ovary. To the best of our knowledge, it is unclear how long it takes for the damage to the ovary during the torsion process to become irreversible. The aim of our study was to evaluate the pathology results and ovarian ischemia status of patients who underwent surgery with the indication of adnexal torsion in our clinic, and to determine the relationship between operation timing, and ovarian viability. Methods: The study was conducted retrospectively in the department of gynecology and obstetrics at Dokuz Eylul University Hospital between April 2023 and October 2023. Cases who presented to our clinic with acute abdominal pain and decided to undergo surgery due to suspicion of torsion were included in the study. Patients who were decided to undergo surgery within 6 hours after the onset of symptoms constituted group 1 (n = 26), and patients who were decided to undergo surgery after 6 hours after the onset of symptoms constituted group 2 (n = 36). Statistical analyses were conducted using IBM SPSS Statistics version 26.0 (IBM Inc., Chicago, IL, USA). Results: The average age of the patients in group 1 was significantly lower than that in group 2 (p < 0.001). When both groups were compared, the rate of previous torsion history in group 1 was found significantly higher than that in group 2 (p = 0.04). When both groups were compared in terms of laboratory and imaging findings, no difference was detected between the groups. When both groups were compared in terms of torsion type, ligamentopexy application, torsion area, and torsion direction, no difference was found between the groups. The surgery time in group 2 was found significantly longer than that in group 1 (p < 0.0001). When both groups were compared in terms of intraoperative necrosis, no significant difference was found between the groups (p = 0.3). Conclusions: With the current data, there is no definitive time limit for the effect of the timing of surgical intervention on ovarian viability in adnexal torsion.

Our aim was to compare preoperative and postoperative hematological inflammatory parameters in women with endometriosis. Data were collected from 411 patients who underwent laparoscopy surgery between January 2018 and December 2023. Postoperatively, the pathology reports indicated ovarian endometrioma in 201 patients (48.9%) and other benign ovarian cysts in 210 patients (51.1%). Subgroups were categorized as stage 1–2 endometriosis (n = 26, 6.3%), stage 3–4 endometriosis (n = 175, 42.6%) and benign ovarian cysts (n = 210, 51.1%). Hematological inflammatory markers and ultrasound findings were evaluated one week before the operation and six weeks after the operation and compared between groups. Statistical analysis was performed by SPSS version 26.0 Not normally distributed parameters were analyzed with the Kruskal Wallis, post hoc and Mann-Whitney U tests. Wilcoxon signed-rank test was used to determine changes before and after treatment. Chi-square test and Fisher precision test were used in the analysis of categorical data. Receiver operating characteristic analysis was performed to calculate the area under the curve, which indicates the average sensitivity of variables and its 95% confidence interval are reported for each assessed parameter. The appropriate cut-off value indicating the sum of the highest sensitivity and specificity was calculated for the most predictive variable. The p value considered statistically significant was < 0.05. When comparing the postoperative and preoperative parameters of the main groups, it was determined that the NLR, MLR, and PLR values of both groups increased in the postoperative period, whereas the CA-125 value decreased. In a similar comparison within the subgroups, it was determined that NLR and PLR increased in all three groups in the postoperative period. MLR was found to increase in the stage 3–4 endometriosis and benign ovarian cyst groups. CA-125 decreased in the stage 3–4 endometriosis and benign ovarian cyst groups. RDW > 13.5, PLR > 123.4 and CA-125 > 35 were determined as the cut-off value to predict endometriosis. During the follow-ups, we revealed that CA-125 still maintains its effectiveness. There is a lack of existing literature that directly compares hematological inflammatory parameters before and after treatment for endometriosis.