Breast cancer in association with thyroid disorders

BACKGROUND: The relationship between breast cancer and thyroid diseases is controversial. Discrepant results have been reported in the literature. The incidences of autoimmune and nonautoimmune thyroid diseases were investigated in patients with breast cancer and age-matched control individuals without breast or thyroid disease. METHODS: Clinical and ultrasound evaluation of thyroid gland, determination of serum thyroid hormone and antibody levels, and fine-needle aspiration of thyroid gland were performed in 150 breast cancer patients and 100 control individuals. RESULTS: The mean values for anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than in control individuals (P = 0.030). The incidences of autoimmune and nonautoimmune thyroid diseases were higher in breast cancer patients than in control individuals (38% versus 17%, P = 0.001; 26% versus 9%, P = 0.001, respectively). CONCLUSION: Our results indicate an increased prevalence of autoimmune and nonautoimmune thyroid diseases in breast cancer patients

Prognostic factors affecting overall survival in right colon cancer

Background: The prognosis of patients who have carcinoma of the colon is dependent on several factors that are clinical, pathological, and biological. Adequate lymph node staging in patients with colon cancer is important for determining prognosis and planning further treatment. We aimed to determine what factors might predict survival in patients with right colon cancer. Methods: Between 2007 and 2014, consecutive patients undergoing operation for adenocarcinoma of the right-sided colon were enrolled in this study. The following factors were analyzed with the Cox regression model: age, gender, localization of the tumor, recurrence, pTNM stage, removed and invaded lymph node status (MLN) and survival rate. Multivariate models were used to assess the adjusted effects and to explore the interaction between survival and other factors. Results: A total of 56 (38,1%) men and 91 (61,9%) women, mean age being 61,8 ± 15,9 years, were included. The mean survival time was 46,5 ± 43,2 months. The mean LN number was 18,8 ± 9,44; MLN number was 2,66 ± 5,13. Age, total LN, MLN number and postoperative stage were significant in the univariate analysis for survival. Independent predictors of survival in multivariate analysis were age (p=0,019), postoperative stage (p=0,039), and MLN (p=0,003). Conclusions: LN metastasis is a prognostic feature in patients by means of colon cancer. It could not be changed independent of a number of prognostic factors, such as age, but LN number was dependent on operation in right colon cancer surgery. LN yields have been linked to improved survival and its determination is reliant on both the surgeon and the pathologist. [Arch Clin Exp Surg 2017; 6(1.000): 17-32

Hospital Experience, Body Image, and Cosmesis After Laparoscopic or Open Splenectomy

Background: Laparoscopic splenectomy (LS) is becoming the "gold standard" technique for splenectomy. The aim of this study was to evaluate the hospital experience, body image, and cosmesis after LS or open splenectomy (OS)

The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats

The aims of the study are to demonstrate the effect of probiotic use on the healing of radiation proctitis (RP) and evaluate the efficiency of fecal biomarkers at follow-up of the treatment. Thirty-two male/female rats were randomly separated into four groups of eight rats. The first group (control) was not radiated. RP was created by 17.5 Gy single dose rectal irradiation. The second group (RP) was subjected to RP, but not treated. The third group (RP+ASA) was treated with 5-aminosalicylic acid (5-ASA) 250 mg/kg daily by gastric lavage for 14 days after the irradiation, and the forth group (RP+LGG) was treated with Lactobacillus GG (LGG) 25x100 million CFU daily. Feces samples were taken at the 7th and 14th day of the treatment for fecal biomarkers. Rectums of the rats were resected at the 14th day by laparotomy. Samples were evaluated both macroscopically and microscopically. RP was achieved both macroscopically and microscopically. Weight loss of RP group is statistically significant (p<0.005) than other groups. The healing ratio of RP+ASA and RP+LGG groups was significantly better than the RP group (p<0.005) both macroscopically and microscopically. But there was no significant difference between ASA and LGG groups. Biochemically, fecal calprotectin was found to be more effective than fecal myeloperoxidase and fecal lactoferrin to show the efficacy of treatment of radiation proctitis. The results of our study demonstrate that probiotic is as effective as 5-aminosalicylic in the treatment of radiation proctitis, and fecal calprotectin is a useful biomarker in determining the response to the treatment

Anti-adhesive effects of Budesonide combined with spraygel in a cecal abrasion model: an experimental study

Many methods have been described for preventing or reducing postoperative adhesions. In this work, we evaluated the effectiveness of Budesonide in combination with SprayGel in a reducing postoperative adhesion in rats as the model. Cecal abrasion was achieved in 60 male Sprague-Dawley rats, by brushing and by applying 70% alcohol. The rats were separated into six groups and treated with six solutions (Group I - saline; II - Budesonide 50 mu g; III - Budesonide 250 mu g; IV - SprayGel; V and VI - SprayGel + Budesonide 50 and 250 mu g). Serum Budesonide, glucose, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and blood urea nitrogen levels were measured at postoperative day (POD) 2 and 14. The rats were killed on POD 14, and intra-abdominal adhesion formation was scored. Histopathological samples were obtained from the cecum and terminal ileum to evaluate microscopic adhesion formation. Our results showed that Group VI had both the minimum macroscopic adhesion score and the minimum microscopic score. All other groups had significantly lower microscopic adhesion scores than Group I. However, there was no statistical significance among any other groups. Serum AST levels of Group III were significantly higher than in Groups I, II, IV, and V (p < 0.046). Serum AST levels of Group III on POD 14 were also significantly higher than that of all other groups (p < 0.02). On POD 14, there was no Budesonide in the sera of Groups II and V. However, Groups III and VI had trace amounts of Budesonide (0.009 and 0.007 mu g, respectively). In conclusion, we have showed that the effect of Budesonide is dosedependent. Both anti-adhesive and hepatotoxic side effects of Budesonide increased as the dose increased. Combining Budesonide with SprayGel synergistically increased the anti-adhesive benefits and prevented hepatotoxicity from the slower release of Budesonide

Comparison of Different Cystic Duct Closure Methods in Laparoscopic Cholecystectomy: Silk Suture, Surgical Clip, Harmonic Scalpel and PlasmaKinetic

Background: Harmonic Scalpel and PlasmaKinetic have become popular with the promise of quick and effective vascular control. Their excellent outcomes encouraged surgeons to use these instruments for closure of the bile ducts with little or no data, establishing their efficacy or safety. Aim: The aim of this experimental study was to compare the safety and feasibility of different cystic duct closure methods (suture ligation, clip application, Harmonic Scalpel and PlasmaKinetic). Methods: Sixty non-perforated gallbladders extracted during laparoscopic cholecystectomy were studied in this ex vivo study. Gallbladders were randomly divided into four groups and the distal end of cystic ducts remaining with sacs was reclosed by one of the four different methods. By means of a catheter, air insufflation was administered into gallbladders with a pressure-controlled pump. Bursting pressure and lateral thermal injury were measured for each group, and groups were compared with each other. Results: In the Harmonic Scalpel group, a 1.4 mm lateral thermal injury was detected, while it was 1.6 mm in the PlasmaKinetic group. But, in terms of bursting pressure, there was not a statistically significant difference between the groups. Conclusion: Cystic duct closure with the new devices may be an alternative to surgical clips. Further trials are needed to evaluate the feasibility and safety of PlasmaKinetic usage in the clinical setting. [Arch Clin Exp Surg 2012; 1(3.000): 168-171

Factors affecting operative morbidity and long-term outcomes in patients undergoing surgery for presacral tumours: a multicentric cohort study from the Turkish Collaborative Group for Quality Improvement in Colorectal and Pelvic Surgery

Aim: Data regarding the operative management of presacral tumours present various dilemmas due to their rarity and heterogeneous nature. The aim of this study was to evaluate the management strategy, factors associated with operative morbidity and long-term postoperative outcomes in a large group of patients undergoing surgery for presacral tumours. Method: This study was designed as a multicentre retrospective cohort study. Records of patients who underwent surgery for presacral tumours at 10 tertiary colorectal centres between 1996 and 2017 were evaluated. Results: One hundred and twenty seven patients (44 men) with a mean age of 46 years and body mass index of 27 kg/m2 were included. Fifty eight per cent of the patients had low sacral lesions (below S3). The operative approaches were transabdominal (17%), transsacral (65%) and abdominosacral (17%). The postoperative morbidity was 19%. Thirty per cent of the patients had a malignant tumour. Longer duration of symptoms (p = 0.001), higher American Society of Anesthesiologists score (p = 0.01), abdominosacral operations (p = 0.0001) and presacral tumours located above S3 (p = 0.004) were associated with an increased risk of postoperative morbidity. Overall long-term postoperative recurrence and mortality were 6% and 5%, respectively, within a 3-year mean follow-up period in patients with presacral malignant tumours. Conclusion: Reduced physical condition, omission of symptoms prior to surgery, combined resections and high sacral tumours are the risk factors associated with postoperative complications in patients undergoing surgery for presacral tumours. Meticulous planning of the operation and intensified perioperative care may improve the outcomes in high-risk patients

Fall Of Another Myth For Colon Cancer: Duration Of Symptoms Does Not Differ Between Right- Or Left-Sided Colon Cancers

Background/Aims: Patients with colorectal cancer continue to present with relatively advanced tumors that are associated with poor oncological outcomes. The aim of the present study was to assess the association between localization, symptom duration, and tumor stage. Materials and Methods: A prospective, multicenter cohort study was conducted on patients newly diagnosed with a histologically proven colorectal adenocarcinoma. Standardized questionnaire-interviews were performed. Data were collected on principal presenting symptoms, duration of symptoms (time to first presentation to a doctor and time to diagnosis) and treatment, diagnostic procedures, tumor site, and stage of the tumor (tumor, node, and metastasis (TNM)). Results: A total of 1795 patients with colorectal cancer were interviewed (mean age: 60.76 +/- 13.50 years, male patients: 1057, patients aged >50 years: 1444, colon/rectal cancer: 899/850, right side/left side: 383/1250, stage 0-1-2/stage 3-4: 746/923). No statistically significant correlations were found between duration of symptoms and either tumor site or stage. Principal presenting symptoms were significantly associated with left colon cancer. Patients who had “anemia,” “change in bowel habits,” “anal pruritus or discharge,” “ weight loss,” and “tumor in right colon” had a significantly longer symptom time. Conclusion: Symptom duration is not associated with localization, nor is the tumor stage. Diagnosis of colorectal cancer at an earlier stage may be best achieved by screening of the population.WoSPubMe