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    Evaluating Hematological Inflammatory Markers as Predictors of Preeclampsia
    (Imr Press, 2024) Genc, Serife Ozlem; Erdal, Huseyin
    Background: Preeclampsia, affecting 2-8% of pregnancies, is characterized by new-onset hypertension, proteinuria, and edema, stemming from placental dysfunction and subsequent inflammatory cascade activation. This study aimed to test the predictive ability of hematological indices in predicting preeclampsia. Therefore, predicting the diagnosis of preeclampsia earlier with higher accuracy could potentially preserve the lives of both the mother and the fetus, while also reducing the rates of complications. Methods: This retrospective study included two groups: patients with preeclampsia and a matched control group without additional medical conditions, both having undergone childbirth in the same gestational week. The primary difference between the groups was the preeclampsia diagnosis. Hematological parameters and inflammatory indices were compared for analysis. Results: Statistical significance was observed between derived neutrophil-lymphocyte ratio (dNLR), systemic immune-inflammation index (SIRI) and pan-immune inflammation value (PIV) between groups. The dNLR and PIV showed predictive relevance for preeclampsia (p < 0.05). However, their predictive performance was weak (under the curve (AUC) <0.5). A composite index (CoI) combining these indices achieved a higher AUC of 0.62, indicating limited better predictive performance capability. Conclusions: These findings affirm the correlation between preeclampsia and increased inflammation. Inflammatory markers like the dNLR, SIRI, and PIV showed statistical significance but were not practically useful in clinical settings due to their low sensitivity and specificity. The results highlight the necessity of exploring a CoI, which combines these markers, to enhance predictive accuracy and clinical utility.
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    Gestational Oxidative Stress and OGTT: Are Pregnant Women's Fears Justified?
    (Dove Medical Press Ltd, 2024) Genc, Serife Ozlem; Erdal, Huseyin
    Purpose: Pregnancy induces significant metabolic, immunological, and endocrinological changes to support fetal growth. The 75gram oral glucose tolerance test (OGTT) is standard for gestational diabetes screening, but concerns exist about its potential to induce oxidative stress, affecting both maternal and fetal health. The aim of the study is examining changes in oxidative stress markers and thiol/disulfide homeostasis in pregnant women to evaluate these concerns. Patients and Methods: Thirty pregnant women undergoing gestational diabetes screening between the 24th and 28th weeks participated. Blood samples were collected at 0, 60, and 120 minutes as part of the OGTT protocol. Oxidative stress markers were analyzed only in samples from 0 and 120 minutes, while the 60-minute sample was used solely for glucose measurement. Results: Results showed a significant increase in TOS (p = 0.008) and OSI (p = 0.035) post-OGTT, indicating an acute oxidative stress response. Thiol and disulfide levels showed non-significant changes, suggesting that antioxidant mechanisms were largely unaffected. Conclusion: Further research is necessary to explore the long-term implications of these findings and develop strategies to mitigate oxidative stress during pregnancy. This study provides insights into the acute oxidative stress response caused by OGTT in pregnant women. Although the OGTT induces oxidative stress, it does not significantly disrupt the body's antioxidant capacity in the short term. These results highlight the need for more research to understand the effects of heightened oxidative stress on maternal and fetal health.
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    Impact of intrauterine devices on microbiota in women: Identification of bacterial colonization
    (Bayrakol Medical Publisher, 2025) Takci, Tahsin; Genc, Serife Ozlem; Cetin, Meral
    Aim: The intrauterine device (IUD) is the second most widely used contraceptive method globally due to its effectiveness, affordability, and reliability. There are two primary types: copper and hormonal. However, IUDs are associated with potential complications, including ectopic pregnancy, uterine perforation, and pelvic inflammatory disease. This study aims to assess and compare the safety and complication rates of copper and hormonal IUDs, with a focus on their impact on vaginal microbiota. Material and Methods: The study included 233 women who had their IUDs removed at our clinic. The IUDs were analyzed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) to identify the microbiota present on the devices. Results: Participants' ages ranged from 20 to 70 years, with a mean age of 39.64 +/- 8.37. The majority (84.4%) used copper IUDs, while 15.6% used levonorgestrel-releasing IUDs. Among the patients, 41.2% reported vaginal discharge, 39.5% experienced dyspareunia, and 18.5% had a history of pelvic inflammatory disease or tubo-ovarian abscess. Discussion: IUD use significantly impacts vaginal microbiota, with Escherichia coli being a common pathogen in both copper and hormonal IUD users. Regular gynecological check-ups, sterile insertion practices, and patient education on infection symptoms are crucial for mitigating risks. Probiotics may help maintain microbiota balance during IUD use. Future studies should investigate long-term microbiota changes, compare different IUD types, and explore infection prevention strategies. This research is a vital contribution to understanding the effects of IUDs on vaginal microbiota.
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    Predictive Value of PLR, PNI, and HALP Scores in Ovarian Cancer Staging
    (Dove Medical Press Ltd, 2025) Genc, Serife Ozlem; Gulturk, Esra Akaydin; Kurt, Begum
    Purpose: Ovarian cancer (OC) is a leading cause of gynecologic cancer mortality, where accurate staging is vital for prognosis and treatment. This study aims to evaluate the prognostic potential of the Platelet-to-Lymphocyte Ratio (PLR), Prognostic Nutritional Index (PNI), and Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores in OC staging. Methods: The study was conducted at the Sivas Cumhuriyet University Faculty of Medicine, Department of Obstetrics and Gynecology, between January 1, 2009, and December 31, 2021. A total of 96 OC patients were retrospectively analyzed. Preoperative PLR, PNI, and HALP scores were calculated from routine laboratory parameters. Associations between these scores and clinicopathological factors, including OC stage, were evaluated. The discriminatory power of each index was assessed through ROC curve and AUC (area under the curve) analysis. Results: The AUC for PLR was 0.689 (p < 0.05), indicating significant prognostic value, while the HALP score showed an AUC of 0.671 (p < 0.05). Both markers were significantly associated with OC stages, with higher PLR and lower HALP scores correlating with advanced stages. In contrast, PNI demonstrated a lower AUC of 0.398 (p > 0.05), indicating limited prognostic utility. Conclusion: PLR and HALP scores are useful prognostic markers for OC staging, offering cost-effective and accessible tools in clinical practice. PNI, however, was less predictive. These findings suggest that PLR and HALP could complement existing staging methods, aiding in clinical decision-making. Future large-scale studies are warranted to validate these results.
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    Prognostic value of hematological indexes in endometrioid type endometrial cancer
    (2024) Genc, Serife Ozlem; Kurt, Begüm; Gültürk, Esra
    Endometrial cancer remains a significant health concern, particularly in developed nations where its prevalence is increasing. Reliable prognostic markers are paramount to enhance disease management and patient outcomes. This study explores the prognostic capabilities of various hematological indices, including the eosinophil-lymphocyte ratio (ELR) and the prognostic nutritional index (PNI), in relation to endometrioid type endometrial cancer (ETEC) staging and grading. We retrospectively analyzed data from ETEC patients, categorizing them by tumor grade and stage, and evaluating their hematological indices from preoperative blood samples. Our results indicated that higher ELR and lower PNI levels correlate with more advanced tumor grades and stages. Additionally, the plateletlymphocyte ratio (PLR) was found to be the most significant marker for staging, with PLT, SII, SIRI, ELR, and PNI also showing significant differences across stages. These findings suggest that hematological indices such as ELR and PNI could be instrumental in predicting tumor grade and stage, offering valuable insights for clinical practice. Future research should focus on prospective studies to confirm these findings and consider the integration of these markers into standard diagnostic protocols.
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    Rethinking the Risk: Evalution of the Malignant Potential of Non-16 and 18 HPV Types VIA Colposcopic Results
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Genc, Serife Ozlem; Kurt, Begum; Koç, Tulay; Erdal, Huseyin
    Introduction: The malignancy risks of high-risk HPV types like 16 and 18 are well-known. The oncogenic potential of other HPV types, however, remains unclear. This study reevaluates malignancy risks across HPV types, stressing comprehensive colposcopic evalu ations in cervical cancer screening. Materials and Methods: Conducted at a tertiary care center (January 2021-July 2023), this retrospective study included 138 women divided into two groups: those infected with HPV 16/18 and those with other HPV types. We analyzed and compared colposcopic a nd histopathological outcomes, correlating colposcopic results with biopsy outcomes to assess cervical neoplasia. Statistical analysis was performed using GraphPad Prism 10 (GraphPad Software Inc.; San Diego, CA, USA). Descriptive statisti cs, including means and standard deviations for continuous variables and frequencies and percentages for categorical variables, were calculated. The chi-square test was used to compare categorical variables between the two groups, and an independent t-test was employed to compare continuous variables. A p-value of less than 0.05 was considered statistically significant. Results: Significant differences were noted between groups. While HPV 16 and 18 are linked to higher cervical neoplasia incidences, non-16/18 HPV types were also frequently associated with smear abnormalities. The average age of first sexual intercourse was 20.49 ± 4.2 years. Forty-nine percent of the women were smokers, 8% had only primary school education, and 78% were homemakers. High rates of known risk factors like low educational and socioeconomic status, and smoking were also significant. Conclusion: Our findings suggest that non-16/18 HPV types might have a higher malignancy potential than HPV 16-18, highlighting their importance in cervical cancer screenings and colposcopic evaluations. The study's small sample size limits its conclusions, pointing to the need for larger studies to refine cervical cancer screening strategies globally. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Serum Bcl-2, caspase-9 and soluble FasL levels as perinatal markers in late preterm pregnancies with intrauterine growth restriction
    (Turkish J Pediatrics, 2019) Genc, Serife Ozlem; Karakus, Savas; Cetin, Ali; Cetin, Meral; Dogan, Halef Okan; Korgali, Elif Unver
    Intrauterine growth restriction (IUGR) is the inability of the fetus to grow and develop in the expected pattern. It occurs in about 5% of pregnancies and is associated with severe fetal mortality and morbidity. Affected infants are also highly vulnerable to diseases such as perinatal asphyxia, cerebral palsy, meconium aspiration syndrome, coagulation disorders, and immune system disorders that require long-term treatment. Apoptosis is thought to play a key role in the etiopathogenesis of IUGR. In conclusion, fetal complications are thought to be related to the severity of apoptosis in pregnancies complicated with IUGR. The aim of the study was to test the measurability of the severity of apoptosis using Bcl-2, caspase-9, soluble Fas ligand (sFasL) markers and the maternal blood sample in addition to the diagnostic methods commonly used to diagnose IUGR; and to decrease the rates of adverse perinatal outcomes due to IUGR and to evaluate the fetal well-being status without feeling a need for invasive procedures. One hundred and fifty-nine late preterm pregnancies were included in the study. Eighty were diagnosed with IUGR and the others were the control group. During delivery, maternal and umbilical cord blood samples were taken. Bcl-2, caspase-9, sFasL marker levels in maternal and umbilical cord sera were determined using ELISA method. Bcl-2 levels were found to be significantly high in the maternal and umbilical cord sera in the IUGR group. There was also no significant difference between umbilical cord sera of the two groups in terms of sFasL and caspase-9 levels. The results suggest that maternal serum Bcl-2 levels may also be helpful in the diagnosis of IUGR when used besides the ultrasonographic findings. Multicenter studies with large patient groups will increase knowledge in this area.