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.

The problem of preventable public health: Evaluation of demographic characteristics of patients followed up and treated for corrosive esophagitis

Objective: This study aims to evaluate the demographic characteristics of patients treated for corrosive esophagitis, highlighting key risk factors and the importance of immediate endoscopic evaluation. Materials and methods: Retrospective demographic data of 340 (age, gender, number of siblings, maternal education level, region of incidence, type of treatment) patients with corrosive esophagitis who were followed up and treated and between the ages of 0 and 18 was examined. All patients had endoscopies 24-36 hours after exposure to stage their esophagitis, and the Zargar classification was applied for this staging. Results: Corrosive esophagitis was shown to occur equally in both sexes. Patients were mainly exposed to 27.94% bleach, 15% air conditioner cleaner, and 12.64% sink cleaner. Pre-kindergarten age group had the highest exposure rate (40.58%), while rural residents had the highest exposure rate (64.12). Mothers with primary school education level were 55.2%. In 42.64% of the patients, the number of siblings in the household was 4 or more. 71.87% of patients had Stage 2A or below, while 25.29% had esophageal dilatation. Conclusions: This study highlights the urgent need for preventive measures and education to reduce corrosive esophagitis, especially in vulnerable populations. Stricter regulations and targeted interventions are essential for effective prevention

A case of vitiligo developed after isotretinoin therapy

Oral isotretinoin, a 13-cis retinoic acid and a derivative of the retinoids, is very effective for severe nodulocystic acne and papulopustular acne, which at times turns scar-forming and resistant. Common mucocutaneous and ocular dryness are the side effects. Also, musculoskeletal symptoms such as back pain, arthralgia, and myalgia may be seen in about 16% of adults post-isotretinoin therapy, usually resolving after treatment discontinuation. Depressive side effects and suicidal thoughts are concerns voiced against its use. Vitiligo is an autoimmune disorder characterized by the selective loss of melanocytes and depigmented patches on the skin. Recently, it has been classified to include metabolic, oxidative stress, genetic, and environmental factors. We present a very rare case of vitiligo developing after systemic isotretinoin therapy in a 24-year-old female patient with severe nodulocystic acne. The patient responded well to topical treatment, and her lesions improved significantly during the five months of follow-up. This case points out that, when prescribing isotretinoin, dermatologists should consider all possible dermatological adverse effects, including vitiligo, and conduct timely intervention and monitoring

Effects of anesthesia methods applied in ureter upper end stone operations on early postoperative quality of life

Objective: Urinary system Stone disease (urolithiasis) is a disease that changes and is increasingly prevalent depending on many factors, and nowadays, monitoring, medical removal therapy, shock wave lithotripsy (SWL), ureterorenoscopy (URS), laparoscopic surgeries and open surgery to treat proximal ureter stones. In our study, we aimed to investigate the comparison of intraoperative tolerance and early postoperative quality of life levels of general anesthesia, spinal anesthesia and spinal anesthesia with adjuvant agent in patients to be operated for upper ureteral calculi. Materials and methods: This study was  conducted  prospectively. In our study, we aimed to investigate the comparison of intraoperative tolerance and early postoperative life quality levels of patients with general anesthesia, spinal anesthesia and adjuvant spinal anesthesia in patients who will be operated on for upper ureteral stones, and for this purpose, 75 patients who were operated on and met the inclusion criteria were recruited. In our study, patients who were operated under general anesthesia were named as group 1, those who were operated under spinal anesthesia using only bupivacaine, group 2, and those who were operated using bupivacaine + fentanyl were named as group 3. Each group consisted of 25 patients. Statistical analyses were performed using SPPS v.20.0. Results: It was observed that the duration of anesthesia, operation time, VAS pain scale, intraoperative heart rate change and intraoperative diastolic blood pressure did not show statistically significant difference between the groups. İt was determined that intraoperative systolic blood pressure was higher inboth groups that underwent spinal anesthesia compared to the group that was applied general anesthesia, and the spo2 level was lower. Conclusions: In this study, in which we evaluated spinal anesthesia as an alternative to general anesthesia, we found that spinal anesthesia is also safe and effective in proximal ureter stone operations. Therefore we think that spinal anesthesia should be preferred more frequently due to the lower risk of postoperative nausea and vomiting, postoperative analgesia, early mobilization and early nutrition compared to general anesthesia

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

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

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)

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