Does Previous Perianal Surgery for Benign Diseases Have an Impact on Timing of Hospital Admission in Patients with Colorectal Cancer?

Objective. Colorectal cancer (CRC) is one of the most common and fatal malignancies worldwide. Although the clinical presentation varies according to the location of the tumor, hematochezia, tenesmus, changes in the defecation habit, chronic constipation, abdominal pain, and distension are the most common findings of CRCs. We aimed to investigate whether patients with CRC who had a surgical history for benign anal disease have more negative tumoral features or not. Material and Methods. Two-hundred fifty two patients who underwent surgery for CRC between 2010 and 2016 at general surgery clinic in Ankara Numune Training and Research Hospital included in this study. Patients were classified into two groups; patients who had undergone surgery for benign perianal disease such as hemorrhoid, anal fissure, perianal abscess and fistulae (Group 1) and patients without past history for perianal surgery (Group 2). Results. A total of 252 CRC patients with a mean age of 64.2 years were included in the study. There were 95 (37.7%) females and 157 (62.3%) males. There were 25 (9.9%) patients who had surgical history for benign perianal disease. There were no statistically differences in tumor size, lymph node positivity, presence of distant metastasis, and tumor stage between the groups (p > 0.05). Conclusion. Although not statistically significant, CRC patients with a history of surgery for benign perianal disease had less lymphatic metastases and tumor size than those without prior perianal surgery. We think that this finding is important in that it indicates the importance of detailed and appropriate evaluation of patients with CRC

Hidatidinė kepenų cista ir vartų venos bei viršutinės pasaito arterijos: chirurginio gydymo galimybė

Hydatid cyst is a parasitic infestation by a tapeworm of the genus Echinococcus granulosus which can be localized in all vascularized tissues and causes cystic lesions. We present a case of hydatid liver cyst with portal vein and superior mesenteric artery invasion. Hydatid cysts are still commonly seen in Turkey. We believe that the most efficacious and least morbid treatment alternative for such rare complications of hydatid cysts is surgery.Turkijoje vis dar dažnos hidatidinės cistos. Tai parazito Echinococcus granulosus klinikinė manifestacija, kuri lokalizuojasi visuose vaskuliarizuotuose audiniuose ir sukelia cistinius darinius. Straipsnyje aptariamas hidatidinės kepenų cistos atvejis, apimantis kepenų vartų veną ir viršutinę pasaito arteriją. Daroma išvada, kad efektyviausias ir mažiausiai komplikacijų sukeliantis šios retos patologijos gydymas yra chirurgija

Evaluation of the mechanical performance of chairs without fasteners constructed of wood–based panels

The aim of this study was to evaluate the cyclic loading performance of different types of ready to assemble chairs without fastener which produced with Computer Numerical Control machines by using engineering design approach and product engineering methods including performance tests. In the production of chairs, 18 mm thick oriented strand board, medium density fiberboard and Oriental beech plywood were utilized as wood-based panels. Within the scope of the study, 4 different chair types without fasteners were designed and produced, and performance tests were carried out in 3 different loading directions (front to back, back to front and side thrust) with cyclic stepped increasing loading method according to the principles of American Library Association specification. Totally, 108 real size chairs without fastener were prepared and tested. As a result of the study, it was concluded that the chairs produced from Oriental beech plywood gave the best performances, while the chairs produced from medium density fiberboard gave performance values close to Oriental beech plywood, except for the side thrust test. However, the mechanical performance values of the chairs constructed of oriented strand board were very low. In conclusion, it could be said that the chairs constructed of Oriental beech plywood and medium density fiberboard without fastener have been found to have sufficient mechanical performance

Evaluation of the effectiveness of Ampicillin and Lactobacillus casei rhamnosus treatment in cases of preterm premature rupture of membranes remote from term

Objectives: Preterm premature rupture of membranes (PPROM) remote from term is an important obstetric cause of maternal and fetal adverse outcomes. The aim of our study is to examine the efficacy of ampicillin and Lactobacillus casei rhamnosus treatment in cases of PPROM remote from term. Material and methods: The study was carried out by examining the results of cases who were given Ampicillin and Lactobacillus casei rhamnosus treatment. The patients were divided into two groups. Group 1 who didn’t develop clinical chorioamnionitis and Group 2 who developed clinical chorioamnionitis. Obstetric characteristics, neonatal outcomes, adverse events were recorded. Results: A total of 46 pregnant women, 40 in Group 1 and six in Group 2, were included in the study. The frequency of clinical chorioamnionitis developing during the treatment was found to be 13.0%. Mean gestational age at diagnosis was 28.43 ± 2.38 and 28.17 ± 1.33 for Groups 1 and Group 2, respectively. Mean gestational age at the time of delivery was 32.38 ± 2.07 31.33 ± 1.63 for Group 1 and Group 2, respectively. The mean latency period for Group 1 and Group 2 was 27.45 ± 1.71 days, 23.66 ± 4.53, respectively. Sepsis developed in six newborns (15%) in Group 1, while it developed in three newborns (50%) in Group 2. While 90% of the babies in Group 1 were discharged from the hospital, this rate was 66.7% in Group 2. Conclusions: Ampicillin + Lactobacillus casei rhamnosus is an effective treatment method in PPROM cases and positively affects perinatal outcomes

New CagL amino acid polymorphism patterns of helicobacter pylori in peptic ulcer and non-ulcer dyspepsia

Background and Objectives: Helicobacter pylori infection is associated with chronic gastritis, ulcers, and gastric cancer. The H. pylori Type 4 secretion system (T4SS) translocates the CagA protein into host cells and plays an essential role in initiating gastric carcinogenesis. The CagL protein is a component of the T4SS. CagL amino acid polymorphisms are correlated with clinical outcomes. We aimed to study the association between CagL amino acid polymorphisms and peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD). Materials and Methods: A total of 99 patients (PUD, 46; NUD, 53) were enrolled and screened for H. pylori by qPCR from antrum biopsy samples. The amino acid polymorphisms of CagL were analyzed using DNA sequencing, followed by the MAFFT sequence alignment program to match the amino acid sequences. Results: Antrum biopsy samples from 70 out of 99 (70.7%) patients were found to be H. pylori DNA-positive. A positive band for cagL was detected in 42 out of 70 samples (PUD, 23; NUD, 19), and following this, these 42 samples were sequenced. In total, 27 different polymorphisms were determined. We determined three CagL amino acid polymorphism combinations, which were determined to be associated with PUD and NUD. Pattern 1 (K35/N122/V134/T175/R194/E210) was only detected in PUD patient samples and was related to a 1.35-fold risk (p = 0.02). Patterns 2 (V41/I134) and 3 (V41/K122/A171/I174) were found only in NUD patient samples and were linked to a 1.26-fold increased risk (p = 0.03). Conclusions: We observed three new patterns associated with PUD and NUD. Pattern 1 is related to PUD, and the other two patterns (Patterns 2 and 3) are related to NUD. The patterns that we identified include the remote polymorphisms of the CagL protein, which is a new approach. These patterns may help to understand the course of H. pylori infection.Istanbul Aydin University Scientific Research Projects Uni

Post COVID-19 irritable bowel syndrome

Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. Design: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. Results: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. Conclusion: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls. Trial registration number: NCT04691895

Conversion surgery for failed adjustable gastric banding: Outcomes with sleeve gastrectomy vs roux-en-y gastric bypass

WOS: 000446158200030PubMed ID: 30022423Laparoscopic adjustable gastric banding (LAGB) was once a preferred method of obesity treatment featuring a straightforward technique, removability, and good early results. In a significant proportion of patients, however, it was not a durable weight-loss procedure and has been associated with a high longer-term complication rate. The purpose of this study was to directly compare the results of conversion to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) after failed LAGB. Post-LAGB complications and weight outcomes of conversion (absolute weight, excess weight loss [%EWL], total weight loss [%TWL]) to LSG vs LRYGB were retrospectively reviewed and statistically compared using Fisher's exact test and the independent samples t test. Over a 6-year period, 74/272 (27.2%) morbidly obese LAGB patients experienced marked complications requiring band removal. Forty-nine of these patients underwent conversion by LRYGB (n = 29) or LSG (n = 20). There was no statistically significant difference in complication rates between converted procedures and no significant difference in respective EWL and TWL (6-month EWL: LRYGB, 53.6% vs LSG, 51.3% and respective TWL, 22.8 vs 21.3%; 12-month EWL, 70.1 vs 56.1%; and TWL, 30.7 vs 23.2%; p > 0.05). All conversion patients were present at each time point. Outcomes for LSG vs LRYGB following failed LAGB were equally safe and effective

Improving effect of voluntary exercise on high fructose diet induced kidney dysfunction and oxidant status in rats

Fruktoz tüketimindeki artışın oksidatif stresi artırarak böbrek fonksiyonlarını olumsuz etkilediği bilinmektedir. Egzersizin böbrek için koruyucu etkileri olduğu gösterilmiş olmasına karşın fruktozdan zengin beslenmeye bağlı değişimlerde istemli koşu egzersizinin etkileri bilinmemektedir. Çalışmamızda yüksek fruktozla beslenmenin böbrek fonksiyonu ve histolojisi üzerine meydana getirdiği olası etkiler ve oksidatif hasarda istemli fiziksel aktivitenin rolünü araştırdık. Deneyde kullanılan 21 adet erkek Sprague Dawley sıçan 3 gruba ayrıldı. Sekiz hafta süren deney boyunca Sedanter+su (kontrol) grubu içme suyu alırken sedanter+fruktozlu su (F) ve aktivite+fruktozlu su (A+F) grupları %20 fruktoz içeren içme suyu aldılar. A+F grubu 8 hafta boyunca dönen tekerlek bulunan kafes yardımıyla istemli fiziksel aktivite yaptı. Deney sonunda alınan kan örneklerinde üre ve kreatinin seviyeleri, böbrek dokularında malondialdehit ve glutatyon düzeyleri incelendi. Ayrıca böbrek dokusunun histopatolojik incelemesi yapıldı. Böbrek fonksiyonlarının göstergesi olan serum kreatinin seviyesi F grubunda kontrol grubuna göre yüksek bulundu (p=0,012). Malondialdehit (MDA) seviyesi F grubunda kontrol grubuna göre yüksek iken A+F grubunda kontrol grubuyla benzerdi (sırasıyla p=0,024 ve p>0,99). Glutatyon (GSH) seviyesi F ve A+F gruplarında kontrol grubuna göre yüksekti (sırasıyla p=0,015 ve p=0,001). GSH seviyesi A+F grubunda F grubuna göre anlamlı düzeyde yüksekti (p=0,014). Kontrol grubuna kıyasla F grubunun böbrek kesitlerinde glomerüler çap, glomeruloskleroz oranı ve kollajen yoğunluğunda artış görüldü. A+F grubunda kontrol grubuna benzer histolojik görünüm saptandı. Bu çalışma ile yüksek fruktozla beslenmeye bağlı böbrek yapısı ve fonksiyonlarında meydana gelen olumsuz etkilerin ve oksidatif hasarın istemli fiziksel aktivite ile önlenebileceği ortaya konmuştur.It is known that the increase in fructose consumption negatively affects kidney functions by increasing oxidative stress. Although exercise has been shown to have protective effects for the kidney, the effects of voluntary jogging exercise on changes due to fructose-rich diet are unknown. In our study, we investigated the possible effects of high fructose feeding on kidney function and histology and the role of volun tary physical activity in oxidative damage. The 21 male Sprague Dawley rats used in the experiment were divided into 3 groups. During the experiment, which lasted eight weeks, the sedentary + water (control) group received drinking water, while the sedentary + fructose water (F) and activity + fructose water (A + F) groups received drinking water containing 20% fructose. The A + F group performed voluntary physical activity for 8 weeks with the help of a cage with a rotating wheel. Urea and creatinine levels in blood samples taken at the end of the experiment, malondialdehyde and glutathione levels in kidney tissues were examined. In addition, histopathological examination of the kidney tissue was made. Serum creatinine level, which is an indicator of renal functions, was found to be higher in the F group compared to the control group (p = 0.012). While the malondialdehyde (MDA) level was higher in the F group compared to the control group, it was similar to the control group in the A + F group (p = 0.024 and p> 0.99, respectively). Glutathione (GSH) level was higher in F and A + F groups compared to the control group (p = 0.015 and p = 0.001, respectively). GSH level was significantly higher in the A + F group com pared to the F group (p = 0.014). Compared to the control group, an increase in glomerular diameter, glomerulosclerosis rate and collagen density were observed in the kidney sections of the F group. Histological appearance similar to the control group was detected in the A + F group. As a result of this study, it was revealed that the negative effects and oxidative damage on kidney structure and functions due to high fructose feeding can be prevented by voluntary physical activity

RETRACTED: Outcomes of Laparoscopic Cholecysectomy in Geriatric Population

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).After publication of this article, concerns were raised about the validity of the study design and conclusions reported. Following a post-publication assessment involving editor members of our Editorial Board, the International Journal of Gerontology Editors decided to retract this article due to the study design, methodology, and interpretation of the data, which the peer review process did not adequately address such that the results of the study were determined to be unreliable. Issues include:1. The study had no IRB approval and informed consent from patients.2. The authors did not report a power calculation to support the sample size and demonstrate it was adequate to assess the outcomes of laparoscopic cholecystectomy.3. Further concerns were raised about the statistical analysis methods and reporting: the authors did not report a statistical analysis plan and methodology clearly in their Methods section. The authors did not state how to choose variables to adjust in the multivariate analysis. In the statistics analysis section and tables, the authors did not list the variables which have been adjusted for. It makes the results difficult to interpret.4. In Table 2 the authors incorrectly interpreted the results by considering that OR<1 for the association between post-operative operation and prolonged hospitalization in the text.5. The data in the table 1 and table 2 are inconsistent, for example, it is stated in table 1 that elder patients had longer hospital stay. But in table 2, elder patients were associated with short hospital stay.In light of the above concerns about the study design and methods used, the International Journal of Gerontology Editors consider that the conclusions of this study are not supported by the data presented and retract this article

Evaluación de pacientes con linfocele luego de trasplante renal

Introduction: The lymphocele is a common complication following renal transplantation and may cause significant clinical problems especially when reachs to big volumes. The aim of this study is to present the clinical characteristics, diagnostic approaches, and therapeutic strategies of lymphocele formations in a group of Turkish patients. Methods: A total of 244 renal transplantations were included in this retrospective study. Data of patients who were diagnosed with lymphocele during the postoperative period were analyzed. Results: Ten (2.4%) patients have been diagnosed with lymphocele. There were six males and 4 females, with a mean age of 46 years. The median onset was 19 days posttransplantation. The median size of the lymphoceles was 53 mm. All lymphoceles were localizated between the lower pole of the transplanted kidney and urine bladder. On presentation, one patient had hydronephrosis and three patients had elevated serum creatinine while the remaining six ones were asymptomatic. Five patients were successfully treated by percutaneous aspiration whereas two patients required surgery. Three patients’ lymphoceles dissolved spontaneously. Conclusion: Preventive strategies including preserving the lymphatics of the recipient, careful organ retrieval and ‘back table’ work are of great importance to reduce the incidence of lymphocele. Early decision of radiological or surgical intervention should be considered in patients with symptomatic lymphoceles in order to prevent further complications.Introducción: El linfocele es una complicación frecuente luego de un trasplante renal y puede ocasionar problemas clínicos importantes, especialmente, cuando alcanza volúmenes elevados. El objetivo de este estudio es presentar las características clínicas, métodos de diagnóstico y estrategias para el tratamiento del linfocele en un grupo de pacientes turcos. Material y métodos: Se incluyeron 244 pacientes en este estudio retrospectivo. Se analizaron los datos de pacientes diagnosticados con linfocele durante el período postoperatorio. Resultados: Se diagnosticó linfocele a diez pacientes (2,4%). Eran seis hombres y cuatro mujeres con una edad promedio de 46 años. El comienzo promedio fue 19 días luego del trasplante. El tamaño medio de los linfoceles fue de 53 mm. Todos se encontraban entre el polo inferior del riñón trasplantado y la vejiga urinaria. En la consulta, un paciente presentó hidronefrosis, y tres pacientes, creatinina sérica elevada, mientras que los seis restantes eran asintomáticos. Cinco pacientes fueron tratados con éxito por aspiración percutánea; en cambio, otros dos pacientes requirieron cirugía. Tres pacientes mostraron disolución espontánea de los linfoceles. Conclusión: Las estrategias preventivas, que incluyen la preservación de los vasos linfáticos del receptor, la extracción cuidadosa de los órganos y la preparación de estos antes de realizar el trasplante, son de gran importancia para reducir la incidencia de linfocele. Debe considerarse tempranamente la intervención radiológica o quirúrgica en pacientes con linfoceles sintomáticos para prevenir complicaciones adicionales