Parathyroid hormone in washout fluid seems to be superior to cytology for localization of the lesion in MIBI-negative patients with primary hyperparathyroidism

Background/aim: Primary hyperparathyroidism (PHPT) is characterized by increased calcium (Ca) and parathyroid hormone (PTH) levels. Surgical removal of the culprit hyperfunctioning parathyroid gland is the preferred treatment. In this study, we aimed to determine whether PTH-washout or cytological examination of suspicious lesions was superior in MIBI-negative patients diagnosed with PHPT

Evaluation of Preoperative Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for their Predictive Value in Determining Short-Term Mortality in Patients with Operable Colorectal Cancers

Aim: The aim of this study was to investigate whether preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have a predictive value in short-term mortality in patients with operable colorectal cancer (CRC).Material and Methods: A total of 231 (93 female, 138 male) patients with operated CRC between 2016 and 2021 in a university hospital were analyzed retrospectively. Median age was 68 (range, 26-92) years and patients had been under follow-up for a median of 25 (range, 0-54) months. Patients were grouped with respect to survival, those who were alive (n=175) and those who died (n=56) during the follow-up.Results: The area under the curve for NLR was 0.649 (95% CI: 0.563-0.734, p=0.001), optimal cut-off was 5.08 and demonstrated a sensitivity of 48.2% and a specificity of 81.7% for predicting mortality. The area under the curve for PLR was 0.635 (95% CI: 0.546-0.723, p=0.002), optimal cut-off was 221.5 and demonstrated a sensitivity of 55.4% and a specificity of 72.0%. Multiple regression analysis revealed that recurrence (OR: 60.910, 95% CI: 9.807-378.319, p=<0.001), leakage (OR: 10.724, 95% CI: 1.281-89.747, p=0.029), high NLR (OR: 3.735, 95% CI: 1.602-8.711, p=0.002) and higher age (OR: 1.136, 95% CI: 1.081-1.193, p<0.001) were independently associated with mortality.Conclusion: The results of this study support studies indicating that preoperative NLR and PLR are effective in predicting short-term mortality in CRC patients who underwent surgical resection. Although further studies are necessary, these biomarkers are promising for future use as prognostic tools in CRC patients

The effects of obstructive jaundice on the brain: An experimental study

The study aims to evaluate the alterations in the brain due to oxidative stress and lipid peroxidation resulting from obstructive jaundice. Forty-one Wistar albino rats were used in this study. Simple laparotomy was performed in the sham group (n = 5). In the remaining 36 rats, the common bile duct (CBD) was found and ligated. They were divided into six groups. Group I, Group II, and Group III were sacrificed at the 3rd, 7th, and 14th day of ligation, respectively. In Group Id, Group IId, and Group IIId ligated bile ducts were decompressed at the 3rd, 7th, and 14th day, respectively. One week after decompression these rats were also sacrificed and samples were taken. After the CBD ligation, serum levels of bilirubin and malondialdehyde were found to be increased progressively in parallel to the ligation time of the CBD. After decompression these values decreased. In electron microscopy evaluation, the damage was found to be irreversible depending on the length of the obstruction period. In Group II, the damage was mostly reversible after the internal drainage period of 7 days. However in Group III, the tissue damage was found to be irreversible despite the decreased values of oxidative stress and bilirubin. Ultrastructural changes in brain tissue including damage in the glial cells and neurons, were found to be irreversible if the CBD ligation period was >7 days and did not regress even after decompression. It is unreliable to trace these changes using blood levels of bilirubin and free radicals. Therefore, timing is extremely critical for medical therapies and drainage

Spontaneous Gastrosplenic Fistula Resulting From Primary Gastric Lymphoma: Case Report and Review of the Literature

A fistulous tract between the stomach and the spleen is a rare manifestation. Spontaneous gastrosplenic fistula formation resulting from primary gastric lymphoma is extremely rare and should be managed as an emergency. To date, four gastrosplenic fistulas originating from gastric lymphoma have been reported, of which three were spontaneous and one occurred following chemotherapy. We report a case of spontaneous gastrosplenic fistula in a 35 years-old-man with gastric malignant B-cell non-Hodgkin’s lymphoma who was diagnosed by computed tomography and endoscopically, followed by successful treatment with total gastrectomy and splenectomy