NLR might be used as an early marker of AP and may have a role in prediction of disease severity.

Implementing a HPV vaccination program is currently under evaluation by the Turkish health ministry. For screening and vaccination programs to be successful, the cooperation of nurses is essential. We aimed to evaluate (1) basic knowledge of nurses and nursing interns regarding HPV infection and cervical cancer, (2) their attitudes towards smear testing and HPV vaccination, and (3) their viewpoint on vaccination of school age children. This cross-sectional study was undertaken at Bezmialem Vakif University. The survey was designed to assess knowledge about HPV infection, Pap smear testing, cervical cancer, HPV vaccine, attitudes towards HPV vaccination, and school-based vaccination programs. Validity content was determined by expert gynecologists, and a pilot study was performed on 10 nurses. A total of 550 questionnaires were handed out; 499 were completed. Our response rate was 90.7%. Fifty-nine participants answered all the knowledge questions correctly. The calculated knowledge score of the female participants was 6.99 ± 2.22, the male participants was 5.89 ± 2.92. Female participants were more knowledgeable (p < 0.0001). Out of the 353 female participants, 18.6% (n = 66) had undergone smear testing. There were 20 (5.6%) female and 6 (4%) male participants who were vaccinated against HPV. The leading answer for not having a HPV vaccine was "I'm not at risk for a HPV infection" (n = 106, 34.9%). There was a statistical relationship between "HPV knowledge score" and answering "Yes" to "Do you want your children/future children to be vaccinated? (p = 0.001) and "Do you think including the vaccine in the Turkish immunization program is necessary?" (p = 0.001). Nurses in our cohort seem to have satisfactory basic knowledge regarding HPV infection; however, their viewpoints on vaccination were not favorable. Strategies and intervention materials for HPV vaccination will be necessary if a national immunization program will be initiated.

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Objective:To investigate whether there were any differences in the quality of life, sexual function, and self-esteem of patients who underwent total laparoscopic hysterectomy (TLH) (n=42) and total abdominal hysterectomy (TAH) (n=42).Materials and Methods:All premenopausal patients who underwent TLH or TAH because of benign uterine disorders were enrolled. The sexual function and quality of life status were assessed preoperatively and 6 months postoperatively using three standardized validated questionnaires: the Arizona Sexual Experiences Scale (ASEX), the Symptom Checklist-90-Revised (SCL-90-R), and the Rosenberg Self-Esteem Scale (RSES).Results:Preoperative ASEX, SCL-90-R and RSES scores were not different among the hysterectomy subgroups. The postoperative SCL-90-R scores were also not different among the hysterectomy subgroups. The postoperative RSES scores were significantly lower (p<0.05) than the preoperative scores for all procedures (indicating improved self-esteem) but did not differ among the groups. The postoperative ASEX scores were significantly decreased (p<0.01) as compared with the preoperative scores (indicating improved sexual function). When the average score of each item of the ASEX score was compared in both groups, significant differences were observed in sexual drive and arousal in the laparoscopy group (p<0.01).Conclusion:Women undergoing TLH for benign uterine disease may have better outcomes related to certain sexual function parameters than women undergoing TAH.

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Objective:To evaluate the course and outcomes of pregnant patients with complicated gallstone disease and to reveal the experience of a tertiary center.Materials and Methods:The records of 92.567 patients were evaluated using searches for diagnoses with the terms of pregnant, pregnancy, gallstone, cholecystitis, cholangitis, choledocholithiasis, pancreatitis, and endoscopic retrograde cholangiopancreatography in pregnancy in the hospital database. Patients’ age, week of gestation, parity, body mass index, definitive diagnosis, attack episodes, treatment modalities, and obstetric and neonatal complications were evaluated.Results:Overall, 59 women were diagnosed as having complicated gallstone disease in pregnancy. Acute cholecystitis was the most commonly diagnosed complicated gallbladder disease (62.7%). Cholecystectomy was performed in 15 women during gestation. Perinatal outcomes were as follows: one (1.7%) maternal death, 4 (6.8%) preterm deliveries, 5 (8.5%) low-birth-weight fetuses, and 1 (1.7%) missed abortion were encountered. No fetal abnormalities were encountered.Conclusion:A significant proportion of women experience biliary disease during pregnancy. Herein, we presented our clinical experience because the diagnosis, course, and management of complicated gallstone disease in pregnancy is complicated.

We aimed to compare ovarian (O), uterine (U) and spiral (S) artery (A) resistance of patients diagnosed as fertile, unexplained infertility (UI) and tubal factor infertility (TFI) in the peri-implantation period and independent from the impact of the treatment. UI (n = 70), TFI (n = 75) and fertile (n = 72) patients' ovarian, uterine and spiral artery pulsatility index (PI), resistance index (RI) and the endometrial thickness, serum estradiol and progesterone levels were compared. The specificity and sensitivity values were calculated according to determined cutoff values. Both TFI and control groups' UA PI values were significantly lower than the UI group's PI values. The highest UA RI values were found in UI group and the lowest values were in the control group. UI and TFI groups' OA PI/RI values were significantly higher than the control group. Both the control and TFI groups' SA PI/RI values were significantly lower than UI group's PI/RI values. UI patients' uterine and spiral arteries PI values >1.86 and >0.85, RI values >0.80 and >0.53 can be used as a valuable test showing reduced uterine perfusion. Ovarian artery PI values >0.96 and RI values >0.58 can be used as tests showing decreased ovarian perfusion in patients with TFI. In these patients, embryo cryopreservation can be considered.

Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. Medical treatment options can be successful in endometrioma smaller than 1 cm, but ineffective for growing and symptomatic endometriomas. Conservative surgical interventions that preserve fertility, such as laparoscopic removal or destruction of endometriotic tissue or aspiration of cystic content are typically used to treat the condition. One of the most frustrating aspects of endometrioma treatment is disease recurrence. The underlying mechanisms explaining recurrence are uncertain. Several risk factors have been evaluated in order to predict recurrence after cystectomy. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, presence of preoperative symptoms of non-cyclic pelvic pain, dysmenorrhoea and adhesion extension may be associated with recurrent endometrioma. In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients. Impact statement What is already known on this subject: Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. One of the most frustrating aspects of endometrioma treatment is disease recurrence. Several risk factors have been evaluated in order to predict recurrence after cystectomy. However, the risk factors have not been precisely defined. What the results of this study add: This study aimed to investigate the contribution of possible risk factors to the recurrence of endometrioma after laparoscopic surgery. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, adhesion extension, presence of preoperative symptoms of non-cyclic pelvic pain and dysmenorrhoea may be associated with recurrent endometrioma. What the implications of these findings are for clinical practice and/or further research: In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients. Detection of preoperative risk factors would be helpful in counselling patients on their future prognosis. This may also increase treatment success by providing accurate preoperative treatment planning and by assisting the scheduling of postoperative follow-ups.