Uterine tumor resembling ovarian sex cord-stromal tumor: A case report

Ovarian sex cord-stromal tumor-like uterine tumor (OSKTAUT) is an extremely rare gynecologic tumor with unclear pathogenesis but prominent polyphenotypic immunohistochemical findings. In this study, we aimed to present a 41-year-old woman who was operated on in an external center due to the presence of postmenopausal bleeding and uterine mass in the clinic and whose pathology was reported as a "uterine tumor resembling sex cord-stromal tumor of the ovary.

Evaluation of oral cancer knowledge and awareness among patients at a periodontology clinic

Objective: The current study was designed to assess the extent of knowledge and awareness regarding oral cancer among patients presenting to the periodontology clinic. Materials and methods: The research was carried out through in-person interviews with 510 volunteer patients, utilizing a questionnaire format. The questionnaire comprised two sections: the first section contained seven demographic questions addressing gender, age, education level, smoking habits, alcohol consumption, frequency of tooth brushing, and a family history of cancer. The second section consisted of 13 items aimed at evaluating the participants’ awareness and knowledge concerning oral cancer. Results: A majority of the participants, accounting for 68.6%, reported that they had not been previously aware of oral cancer. The study revealed a significant association between the levels of awareness about oral cancer and variables such as gender, education level, and oral hygiene practices (p<0.05). An increase in education level corresponded with heightened awareness, with men exhibiting greater awareness than women. The perception of risk factors among the patients varied, with smoking being recognized as a risk factor by 72% of the participants, followed by poor oral hygiene at 66.3%, a family history of cancer at 58.4%, alcohol consumption at 56.5%, malnutrition at 55.5%, and excessive sun exposure at 42.5%. Non-healing oral sores were identified as the most recognized sign of cancer, noted by 65% of the respondents. When faced with such symptoms, a significant portion of the patients, 72.4%, indicated they would consult a dentist. Meanwhile, 16.5% would choose to see an ENT (ear, nose and throat) specialist, and a smaller segment, 6.1%, would approach a general practitioner. Conclusions: This study revealed that societal knowledge and awareness of oral cancer are significantly lacking. The implementation of educational programs to enhance individual knowledge and awareness of oral cancer, coupled with the consistent and thorough examination of the oral mucosa by relevant healthcare professionals, including dentists and ENT specialists, could facilitate the prevention of the disease and promote its early diagnosis

Experience in the surgical management of children with complicated crohn's disease

Objective: To present experience in pre-surgical diagnosis, selection of surgical tactics and volume of intervention in different variants of gastrointestinal tract lesions and disease activity. Materials and methods: We undertook cross-sectional, retrospective-prospective study of 64 children who underwent surgery due to complicated CD. We analyzed CD activity via PCDAI, medications used, inflammation localization, and changes in mass-growth parameters at pre-surgery stage. Results: Three patients from the group of 44 children with two-stage surgical treatment later showed inefficacy of GEBD in post-operative period. The disease progression was revealed and, therefore, subtotal colectomy was required. Three children had secondary adhesion of surgical wounds by means of active immunosuppressive therapy at preoperative period, and five patients developed suture sinuses at post-operative period. Early adhesive intestinal obstruction was revealed in 3 (4.7%) cases, and they required re-surgery. Conclusions: Personalized approach to the surgical treatment of children with complicated CD has shown its efficacy due to the small percentage of postoperative complications with re-surgery. There was significant improvement in mass-growth parameters, recovery of albumin levels, and anemia decrease in 96.9% of cases in the long-term postoperative period (6 months or more)

Vascular resection and reconstruction in pancreatic tumors

Objective: We aimed to to present our patients who underwent pancreaticoduodectomy with vascular resection and reconstruction for borderline pancreatic tumor. Materials and methods: The retrospective study included six patients undergoing pancreaticoduodenectomy with portal vein resection due to locally advanced disease over a 2- year period. Demographic characteristics, symptoms, imaging findings, exploration findings of surgery, types of resections, perioperative complications, postoperative hospital stay were recorded. Results: The patients were cosisted of 2 females and 4 males. Tumor location was in the head of the pancreas in 4 (66.7%) patients and in the body in 2 (33.3%) patients. Vasculary reconstruction was achieved by end-to-end anastomosis in 2 (33.3%) and primary closure in 4 (66.7%) cases. The hospital stay of the patients was 11 to 35 days. Intraoperative and postoperative blood product transfusion was not required in 3 of the cases. One patient was reoperated on the second postoperative day due to bleeding in the gastroduodenal anostomosis line and the bleeding was controlled. None of the patients developed pancreatic fistula. Conclusions: In cases of pancreatic cancer with vascular invasion, vascular resection- reconstruction is inevitable to provide a negative surgical margin. Vascular resection and reconstruction can be performed safely similar to standard pancreatic surgery

Corporal body adiposity (BAI) and abdominal volume (AVI) indices: Relationship with obesity scales in the working population

Objective: Obesity is a growing pandemic and body mass index (BMI) is insufficient to assess the risk of complications. Other estimates of adiposity are used.Materials and methods: Cross-sectional study in 193,462 workers. BMI, CUN-BAE (Clínica Universitaria de Navarra Body adiposity Estimator), Cordoba Equation (ECORE-BF), Relative Fat Mass (RFM), Metabolic Score for Visceral Fat (METS-VF) and Palafolls formula. Their correlation with body adiposity index (BAI) and abdominal volume (AVI) was estimated. SPSS 27.0 was used, considering statistical significance p<0.05.Results: With all scales AVI and BAI are higher in obesity. AVI is higher in men, except with METS-VF. BAI in women has higher values in all scales. The highest values of AVI and BAI are with METS-VF, the lowest with PALAFOLLS. There is a good correlation of BMI with AVI and BAI and with the RFM and METS-VF scales and a very good correlation with Palafolls, ECORE-BF and CUN BAE. AVI and BAI show good correlation with Palafolls, ECORE-BF and CUN BAE and very good correlation with RFM and METS-VF.Conclusions: AVI and BAI show differences in their values according to sex. With METS-VF, both indexes are higher in men and women. AVI and BAI show good correlation with BMI and RFM. With METS-VF very good correlation with AVI. With the rest of the scales BAI and AVI show moderate or good correlation. The simplicity of these formulas and of both indexes makes them recommendable in clinical practice

Visceral and dysfunctional adiposity indexes: Relationship with cardiometabolic risk factors

Objective: Obesity is a worldwide disease in which visceral obesity is related to increased cardiometabolic risk. The aim of this study was to estimate the associative capacity of visceral adiposity index and dysfunctional adiposity index on cardiometabolic risk in the working population. Material and methods: Descriptive study of 418,343 workers during health surveillance in their companies. VAI and DAI were calculated according to their equations and cardiometabolic risk with arterial hypertension, diabetes and atherogenic dyslipidemia, lipid triad, diabesity, and hypertriglyceridemic waist. Mean VAI and DAI values and associative capacity with ROC curves were calculated. The statistical program used SPSS 27.0, with statistical significance p<0.05. Results: Percentage values of all parameters and assessment methods used are higher in men than in women (p<0.0001) Mean values of VAI are higher than those of DAI and higher in men (p<0.0001). VAI and DAI show high associative capacity for atherogenic dyslipidemia, lipid triad and hypertriglyceridemic waist in both sexes with the area under the AUC curve>0.9 in all cases. In diabesity only AUC>0.8 values are obtained for VAI and for diabetes, both VAI and DAI only in women exceed AUC>0.8, in men In HT, VAI, and DAI do not show associative capacity in men or in women (AUC<0.7). Conclusions: Cardiometabolic risk estimation is different in men and women and varies according to the method used. Adiposity indices VAI and DAI show high associative capacity in cardiometabolic risk, especially in atherogenic dyslipidemia, lipid triad, and hypertriglyceridemic waist in both sexes

The diagnostic value of alterations in potassium and phosphate levels during an oral glucose tolerance test for hyperinsulinemia

Objective: We aimed to test whether the potassium and phosphate level alterations during the OGTT test are useful to diagnose hyperinsulinemia/insulin resistance. Materials and methods: The study comprised patients who applied at our clinic for obesity or hyperglycemia and were scheduled for an oral glucose tolerance test (OGTT) because of high HbA1c levels or impaired fasting glucose levels. During the OGTT, blood glucose, insulin, potassium and phosphate patterns were measured at 0-30-60-90 and 120 minutes. Then potassium (K) and phosphate (P) changes were calculated (ΔK and ΔP). Results: A total of 58 patients were included in the study, 63.8% (37 patients) were female and 36.2% (21 patients) were male. Mean age: 14.35±1.83 years, 79.3% were obese. A significant difference was found in the 90 min phosphate, ΔP2, and ΔP3 values of the patients with hyperinsulinemia were compared to the patients without hyperinsulinemia (respectively; p=0.018; p=0.040; p=0.005). There was no difference between ΔK values of the patients with and without hyperinsulinemia. While potassium level decreased to 3.6 mmol/L during OGTT, phosphate level decreased to 1.8 mg/dl. Conclusions: ΔP2 and ΔP3 can be used as additional diagnostic parameters in the diagnosis of hyperinsulinemia. Phosphate and potassium should be checked before the test, as hypokalemia and hypophosphatemia may develop, especially in patients with significant hyperinsulinemia during the OGTT

Commentary for Factors affecting extracorporeal shock wave lithotripsy (ESWL) success

Dear Editor, I recently had the opportunity to read the article titled "Factors affecting extracorporeal shock wave lithotripsy (ESWL) success" authored by Suleyman Sagir and Halil Sagir (1). I found this study to be quite insightful and believe that it contributes significantly to our understanding of the predictive properties of success in patients undergoing ESWL for kidney stones. However, I also have some critical points to consider

Pathophysiological mechanisms of renal damage in obstructive uropathies as potential therapeutic targets: A literature review

Obstructive uropathies are a group of conditions characterized by urinary tract blockages, leading to impaired urine flow and renal damage. This comprehensive literature review aims to explore the pathophysiological mechanisms underlying renal damage in obstructive uropathies and identify potential therapeutic targets for intervention. The review synthesizes current knowledge from a wide range of studies and provides an overview of the complex cellular and molecular processes involved in renal damage progression, including hemodynamic alterations, oxidative stress, interstitial inflammation, and tubulointerstitial fibrosis. Key players in the pathogenesis of renal damage, such as the renin-angiotensin-aldosterone system, reactive oxygen species, immune cells, and fibrogenic factors, are discussed in detail. Furthermore, potential therapeutic targets, including renin-angiotensin inhibitors, antioxidants, anti-inflammatory agents, and anti-fibrotic strategies, are identified based on preclinical and experimental studies. Additionally, emerging therapeutic modalities like mesenchymal stem cells and extracellular vesicles derived from MSCs are explored for their potential in attenuating renal damage and promoting tissue repair. Understanding the pathophysiological mechanisms and identifying potential therapeutic targets is crucial for the development of effective interventions to mitigate renal damage in obstructive uropathies, ultimately improving patient outcomes and quality of life. Further research and clinical trials are needed to translate these promising findings into clinical practice and address the unmet therapeutic needs in this patient population

Analysis of endoscopic and histopathological features of gastric polyps

Objective: Gastric polyps are sessile or pedunculated lesions that originate from the gastric epithelium or submucosa and protrude towards the lumen, with a rate of 2-6%. There is a risk of malignant transformation in gastric polyps. In our study, we aimed to evaluate the characteristics of gastric polyps in our region. Materials and methods: The study was carried out with the retrospective evaluation of esophagogastroduodenoscopy performed in the Gastroenterology clinic of our hospital between July 2020 and June 2022. Results: Esophagogastroduodenoscopy was performed in a total of 2669 patients, and 182 polyps detected in 96 patients were examined. Thirty-six (37.5%) of the patients were male, 60 (62.5%) were female, and the median age was 59 (22-88). Sixty-two (34%) of the polyps were in the antrum, 109 (59.9%) were in the corpus, and 11 (6.1%) were in the fundus. Histopathologically, 151 (83%) polyps were hyperplastic polyps, 4 (2.2%) adenomas, 24 (13.2%) fundic gland polyps, and 3(1.6%) neuroendocrine tumors. There was no statistical relationship between gender and intestinal metaplasia, atrophy and hp positivity. There was also no statistical relationship between hp positivity and intestinal metaplasia. Conclusions: The frequency, anatomical locations and histopathological types of gastric polyps may vary according to the geographical region where the study is performed. In our study, polyps were most common in the corpus and most of them were hyperplastic. Unlike colorectal hyperplastic polyps, gastric hyperplastic polyps have the potential to become malignant. it would be appropriate to remove all gastric polyps and examine them histopathologically