Isolated Abdominal Wall Actinomycosis Associated with an Intrauterine Contraceptive Device: A Case Report and Review of the Relevant Literature

Isolated abdominal wall actinomycosis in the presence of an intrauterine contraceptive device (IUCD) is extremely rare and only six such cases have been reported in the literature. We report a case where clinical and radiological examinations revealed a pseudotumor within the anterior abdominal wall. After being lost to follow-up, the patient presented two years later with the enlargement of the mass. The mass including the affected anterior abdominal wall was completely excised. The diagnosis of actinomycosis was established postoperatively by histopathological examination. Further questioning concerning her gynecological history revealed long-term use of the same IUCD. Surgical excision of the actinomycotic pseudotumour and removal of the IUCD followed by antibiotic therapy resulted in the full recovery of the patient

Evaluation of risk factors associated with pancreatic adenocarcinoma in Black Sea region, Turkey

Aim: To evaluate the risk factors in patients with pancreatic adenocarcinoma in Turkey's Black Sea region and to determine groups at high risk for pancreatic cancer. Methods: 106 newly diagnosed pancreatic adenocarcinoma patients living in Black Sea region of Turkey who applied to our clinic between January 2015 and December 2016 were included in this study. In the same period a control group was formed with 92 patients of similar age. Both groups were asked to fill out a form that questioned the pancreatic cancer risk factors. Data were analyzed. Results: Pancreatic cancer risk was 3.5 times higher in people over 65 years of age. Patients with deficient level of serum vitamin D level (<20 ng/ml) had 10.2 times more risk of pancreatic cancer than patients with normal level of Vitamin D (≥30 ng/ml). While newly diagnosed type 2 diabetics had 19.5 times higher risk of pancreatic cancer, long term type 2 diabetics had 1.2 times higher risk than normal individuals. Those with pancreatic cancer in family had 4.3 times higher risk than those who did not. It was observed that people with rhesus (Rh) antigen negative blood group has 70% less risk of pancreatic cancer. Conclusion: Determination of pancreatic cancer risk factors, organization of imaging and screening programs for high-risk people can provide early diagnosis of the disease and prolong survival

The Evaluation of Variations of The Hyoid Bone with Multidetector Computerized Tomography

The hyoid is a U shaped bone with a backward concavity. Locates at the lower edge of the mandible and lies parallel to the floor — functions as an attachment point for muscles and soft tissues of head and neck. The aim is to examine the variations and ossification of the hyoid. This study was performed retrospectively in 2010 - 2013 on 200 CT images. 3D volume rendering images of pure hyoid bone created from the axial CT images in 1 mm slice thickness. The morphological variation count was 23; ossification variations were 9 cases. No difference observed by gender, but there are differences between the age groups for ossification. Ossification rates were found as; partial 34 %, unilateral 33%, complete 22%, early 11%. Most of the morphologic variation were belong to minor horn (57%), variations of major horn were 30%. The clinical importance of hyoid bone has realized in recent years. Due to the close relationship of this bone with the muscles, ligaments, fascias, sternum, clavicles, its dysfunction can lead to general problems. Studies about the variations of hyoid bone found to be quite low, and we believe that our research will contribute to the content of literature

Thyroid fine needle aspiration reporting rates and outcomes before and after Bethesda implementation: A single-center experience over 8 years

Aimː To evaluate data from our hospital system before and after the implementation of the Bethesda System for Reporting Thyroid Cytology (TBSRTC) and comparison of our data with the previously published studies. Methods: Seven hundred seventy-one patients with thyroid nodules who underwent fine needle aspiration biopsy (FNAB) and surgery at our institution were analyzed retrospectively. FNAB results were divided into two parts in terms of the period they related to: pre-TBSRTC (between 2005 and 2010) and TBSRTC (between 2011 and 2013). Results: 341 FNAB were applied in the period of TBSRTC. Of the 341 FNAB, 53(16%) were non diagnostic, 82(24%) were benign, 62(18%) were atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), 28(8%) were follicular neoplasms and/or suspicion of follicular neoplasms (FN/SFN), 95(28%) were suspicion for malignancy (SuspM), and 21(6%) were malignant. Rates of malignancy reported on follow-up histopathological examination were non diagnostic in 11%, benign in 4.9%, AUS/FLUS in 23%, FN/SFN in 32%, SuspM in 44%, and malignant in 95.3%. Conclusions: In this study, the distribution of cases in TBSRTC categories and malignancy rates, differed from, recommended by TBSRTC and some studies. Implementation of TBSRTC did significantly affect our institution’s reporting rates

Effects of evening primrose oil and 5-fluorouracil on the healing of colonic anastomoses in rats

Aim: This study was designed to evaluate the efficacy of evening primrose oil (EPO) on colonic anastomosis. Methods: Sixty rats with colonic anastomosis were randomly divided into six groups. EPO and 5-Fluorouracil (5-FU) were administered at doses of 5 g/kg/day and 20 mg/kg/day, respectively.  Group 1 served as sham control. The rats in Group 2 (EPO) received EPO (14 days preoperatively), in Group 3 (Extended EPO) received EPO (14 days preoperatively and 7 days postoperatively), in Group 4 (5-FU) received intraperitoneally 5-FU (5 days preoperatively), in Group 5 (5-FU+EPO) received EPO (14 days preoperatively), and 5-FU (5 days preoperatively), in Group 6 (5-FU+ extended EPO) received EPO (14 days preoperatively and 7 days postoperatively)  and 5-FU (5 days preoperatively). Histopathological examination, bursting pressure, and hydroxyproline content were used for evaluation. Results: Significant differences were found between the Groups 1, 2, and 3 and Groups 4, 5, and 6 in bursting pressures. Polymorphonuclear leukocyte (PMNL) and lymphocyte infiltration was significantly less in group 3, compared to the control and group 2. The least PMNL infiltration was in group 6 compared to groups 4 and 5.  The hydroxyproline level was different in group 3 compared to the control and group 2. Furthermore, groups 5 and 6 were different compared to group 4. Conclusion: EPO had favorable effects on colonic anastomosis even in groups where 5-FU was used

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Whole rat embryo culture; as a tool for teratological screening

[Abstract not Available

Species-specificity of growth-promoting effects of prolactin during rat embryogenesis

In the early stages of embryonic development, many growth-promoting molecules must be provided by the maternal system. The molecules involved in growth processes may be either hormones or growth factors, or molecules that interact with such factors. The pregnancy related hormone, prolactin (PRL, MW 23 kDa) has been implicated in the control of embryonic growth. The growth-promoting potential of PRL and its species-specificity was investigated by culturing 9.5 d rat embryos in vitro for 48 h in depleted serum in the presence and absence of PRL from 3 different species. The growth-supporting capacity of the serum was reduced by removal of low molecular weight molecules by prolonged filtration of the serum using filters with a molecular weight exclusion of 30 kDa. This method provided a ‘semidefined’ medium (retenate) in which embryonic growth and development was significantly reduced, demonstrating that the low molecular weight fraction of serum may contain some growth-promoting factors. Addition of PRL (0.4–25.6 ng/ml) from different species (human, sheep and rat) to retenate significantly improved embryonic growth and development, suggesting that the developing embryo may utilise PRL. Amongst PRLs, rat PRL was found to be active at much lower concentrations than either of the other molecules, and human PRL had more effect in low concentrations than sheep PRL suggesting a species-specificity for this hormone. It may be that the PRL receptors of the rat embryos have greater affinity for the rat hormone as different responses for hormones from different species have been shown. These findings suggest that embryos may be able to utilise maternally derived PRL during organogenesis