Background/Aim: Postoperative pancreatic fistula (POPF) development is a common complication after pancreaticoduodenectomy. Various surgical anastomosis techniques have been proposed to mitigate this risk. This study compares two techniques: the two-layer duct-to-mucosa pancreaticojejunostomy (TLPJ) and the modified layer-to-layer end-to-side duct-to-mucosa pancreaticojejunostomy with jejunal serosa resection (MLLPJ). Methods: A retrospective cohort study was conducted on patients who underwent pancreaticoduodenectomy between January 2012 and December 2020. The primary outcome was the rate of biochemical leak and clinically relevant POPF (grades B and C POPFs). Results: The rate of biochemical leak was significantly higher in the TLPJ group than in the MLLPJ group (54.5% vs. 4.0%, P<0.001). Clinically relevant POPFs developed in 5.2% of all patients, with rates of 6.1% in the TLPJ group and 4.0% in the MLLPJ group. Patients with longer surgery durations, increased bleeding, and a soft pancreas texture had significantly higher risk of developing clinically relevant POPFs (P=0.009, P=0.039, and P=0.022, respectively). Conclusion: The MLLPJ anastomosis technique demonstrated a significant reduction in biochemical leak rates. However, the choice between TLPJ and MLLPJ did not significantly impact the rates of clinically relevant POPFs. Other factors, such as surgery duration, bleeding volume, and pancreas texture, were identified as significant risk factors for the development of these fistulas.
{"title":"Comparison of two anastomosis techniques in terms of postoperative pancreatic fistula development: A retrospective cohort study","authors":"Gülten Çiçek Okuyan, Mehmet Talu","doi":"10.28982/josam.7888","DOIUrl":"https://doi.org/10.28982/josam.7888","url":null,"abstract":"Background/Aim: Postoperative pancreatic fistula (POPF) development is a common complication after pancreaticoduodenectomy. Various surgical anastomosis techniques have been proposed to mitigate this risk. This study compares two techniques: the two-layer duct-to-mucosa pancreaticojejunostomy (TLPJ) and the modified layer-to-layer end-to-side duct-to-mucosa pancreaticojejunostomy with jejunal serosa resection (MLLPJ).\u0000Methods: A retrospective cohort study was conducted on patients who underwent pancreaticoduodenectomy between January 2012 and December 2020. The primary outcome was the rate of biochemical leak and clinically relevant POPF (grades B and C POPFs).\u0000Results: The rate of biochemical leak was significantly higher in the TLPJ group than in the MLLPJ group (54.5% vs. 4.0%, P<0.001). Clinically relevant POPFs developed in 5.2% of all patients, with rates of 6.1% in the TLPJ group and 4.0% in the MLLPJ group. Patients with longer surgery durations, increased bleeding, and a soft pancreas texture had significantly higher risk of developing clinically relevant POPFs (P=0.009, P=0.039, and P=0.022, respectively).\u0000Conclusion: The MLLPJ anastomosis technique demonstrated a significant reduction in biochemical leak rates. However, the choice between TLPJ and MLLPJ did not significantly impact the rates of clinically relevant POPFs. Other factors, such as surgery duration, bleeding volume, and pancreas texture, were identified as significant risk factors for the development of these fistulas.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82284977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Seyfettinoğlu, B. Pekoz, G. Uysal, Gökhan Kablan
Background/Aim: Endometriosis is a condition characterized by endometrial tissue outside the uterus; it can lead to pelvic pain, although most cases remain asymptomatic. Abnormalities in the immune system have been hypothesized to contribute to development of ectopic endometrial tissues. Endometriosis is a chronic local inflammatory disorder associated with autoimmunity and thyroid disorders. This study aims to compare thyroid gland volumes between patients diagnosed with pathological endometrioma and those undergoing the removal of ovarian cysts for other gynecological reasons. Additionally, the study seeks to identify the coexistence of thyroid disease and determine the threshold value for thyroid volume in cases of endometriosis. Methods: This prospective cohort study included 64 patients who met the defined inclusion criteria. Thyroid volumes were measured in women aged 18–45 with ovarian cysts before surgery. Group 1 comprised individuals with surgically planned endometrioma diagnoses later histologically confirmed after surgery. The control group (Group 2) consisted of women with similar anthropometric characteristics undergoing gynecological surgery for non-endometrioma ovarian cysts. Thyroid volume, functional thyroid hormone levels, tumor markers, and demographic data were compared between the groups. Results: The endometrioma group exhibited a significantly higher thyroid volume. The thyroid volume variable demonstrated a diagnostic performance of 0.863 (0.771–0.956) regarding ROC-AUC in the presence of endometrioma, with a determined cutoff of 7.40. Although patients with endometrioma displayed a notably larger thyroid volume, cases of goiter were not observed. While there was no significant difference in thyroid hormones (serum TSH, T3 levels) between the groups, serum T4 was elevated in the endometrioma group, albeit within the normal laboratory range. All thyroid levels were within the normal range (euthyroid). As anticipated, serum CA-125 and CA19-9 levels were notably higher in the endometrioma group. Pathological reports did not indicate the presence of malignant cysts. Conclusions: Patients with endometriosis experience increased thyroid volume, even without clinical signs of thyroid disease. The potential clinical interplay between thyroid diseases, thyroid volume, and endometriosis warrants consideration during patient follow-ups.
{"title":"Comparison of thyroid volumes in patients with and without endometrioma","authors":"S. Seyfettinoğlu, B. Pekoz, G. Uysal, Gökhan Kablan","doi":"10.28982/josam.7881","DOIUrl":"https://doi.org/10.28982/josam.7881","url":null,"abstract":"Background/Aim: Endometriosis is a condition characterized by endometrial tissue outside the uterus; it can lead to pelvic pain, although most cases remain asymptomatic. Abnormalities in the immune system have been hypothesized to contribute to development of ectopic endometrial tissues. Endometriosis is a chronic local inflammatory disorder associated with autoimmunity and thyroid disorders. This study aims to compare thyroid gland volumes between patients diagnosed with pathological endometrioma and those undergoing the removal of ovarian cysts for other gynecological reasons. Additionally, the study seeks to identify the coexistence of thyroid disease and determine the threshold value for thyroid volume in cases of endometriosis.\u0000Methods: This prospective cohort study included 64 patients who met the defined inclusion criteria. Thyroid volumes were measured in women aged 18–45 with ovarian cysts before surgery. Group 1 comprised individuals with surgically planned endometrioma diagnoses later histologically confirmed after surgery. The control group (Group 2) consisted of women with similar anthropometric characteristics undergoing gynecological surgery for non-endometrioma ovarian cysts. Thyroid volume, functional thyroid hormone levels, tumor markers, and demographic data were compared between the groups.\u0000Results: The endometrioma group exhibited a significantly higher thyroid volume. The thyroid volume variable demonstrated a diagnostic performance of 0.863 (0.771–0.956) regarding ROC-AUC in the presence of endometrioma, with a determined cutoff of 7.40. Although patients with endometrioma displayed a notably larger thyroid volume, cases of goiter were not observed. While there was no significant difference in thyroid hormones (serum TSH, T3 levels) between the groups, serum T4 was elevated in the endometrioma group, albeit within the normal laboratory range. All thyroid levels were within the normal range (euthyroid). As anticipated, serum CA-125 and CA19-9 levels were notably higher in the endometrioma group. Pathological reports did not indicate the presence of malignant cysts.\u0000Conclusions: Patients with endometriosis experience increased thyroid volume, even without clinical signs of thyroid disease. The potential clinical interplay between thyroid diseases, thyroid volume, and endometriosis warrants consideration during patient follow-ups.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84852578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Heavy metals are elements known for their toxic effects even at low concentrations, and human exposure to these elements spans history. This study aimed to investigate trace element levels in the bones of individuals from the Roman Imperial Period. The objectives were to determine the values of specific metals, including heavy metals, make a rough comparison with present-day values, and gain insights into the environmental conditions of that era. Methods: Due to the use of dry bone samples, ethical committee approval was not required for this research. The study analyzed element levels in human bones dated back to the Roman Imperial Period (218-244 AD), unearthed in 2018 during excavations in Turkey-Kayseri. Only bones that archaeologists verified to belong to the specified period were included, while those with uncertain origins were excluded. The samples were taken from os coxae of 15 individuals (eight males and seven females) to analyze Ca, P, Zn, Cu, Pb, and Hg levels. Instrumental techniques such as Wavelength Dispersive X-ray Fluorescence (WDXRF) (X-ray fluorescence) and ICP-MS (Inductive Coupling Plasma-Mass Spectrometer) were used to determine element concentrations. The Ca/P ratio was assessed for diagenesis evaluation, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) 22.0, with a significance threshold set at P-value <0.05. Results: The Ca/P ratio for the general population was calculated as 2.34 (0.10). The mean concentrations of heavy metals in the bones were as follows: Cu 18.27 (11.04) ppm, Pb 13.30 (5.66) ppm, Zn 27.22 (13.84) ppm, and Hg 2.45 (2.86) ppm. The corresponding P-values for Ca, P, Ca/P, Cu, Zn, Pb, and Hg were 0.109, 0.120, 0.104, 0.063, 0.113, 0.089, and 0.070. No statistically significant difference emerged when comparing elemental accumulations between males and females. Notably, copper and mercury levels were higher in Roman Imperial Period bones than contemporary ones, whereas zinc levels were lower, and lead concentrations aligned with reference values. Conclusion: The study results underscore the historical exposure of Roman Imperial Period individuals to heavy metals. These findings suggest that environmental health concerns related to heavy metal exposure date back millennia, emphasizing the long-standing nature of this issue.
{"title":"Heavy metals in human bones from the Roman Imperial Period","authors":"H. Güler, Hilal Kübra Güçlü Ekinci","doi":"10.28982/josam.7878","DOIUrl":"https://doi.org/10.28982/josam.7878","url":null,"abstract":"Background/Aim: Heavy metals are elements known for their toxic effects even at low concentrations, and human exposure to these elements spans history. This study aimed to investigate trace element levels in the bones of individuals from the Roman Imperial Period. The objectives were to determine the values of specific metals, including heavy metals, make a rough comparison with present-day values, and gain insights into the environmental conditions of that era.\u0000Methods: Due to the use of dry bone samples, ethical committee approval was not required for this research. The study analyzed element levels in human bones dated back to the Roman Imperial Period (218-244 AD), unearthed in 2018 during excavations in Turkey-Kayseri. Only bones that archaeologists verified to belong to the specified period were included, while those with uncertain origins were excluded. The samples were taken from os coxae of 15 individuals (eight males and seven females) to analyze Ca, P, Zn, Cu, Pb, and Hg levels. Instrumental techniques such as Wavelength Dispersive X-ray Fluorescence (WDXRF) (X-ray fluorescence) and ICP-MS (Inductive Coupling Plasma-Mass Spectrometer) were used to determine element concentrations. The Ca/P ratio was assessed for diagenesis evaluation, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) 22.0, with a significance threshold set at P-value <0.05.\u0000Results: The Ca/P ratio for the general population was calculated as 2.34 (0.10). The mean concentrations of heavy metals in the bones were as follows: Cu 18.27 (11.04) ppm, Pb 13.30 (5.66) ppm, Zn 27.22 (13.84) ppm, and Hg 2.45 (2.86) ppm. The corresponding P-values for Ca, P, Ca/P, Cu, Zn, Pb, and Hg were 0.109, 0.120, 0.104, 0.063, 0.113, 0.089, and 0.070. No statistically significant difference emerged when comparing elemental accumulations between males and females. Notably, copper and mercury levels were higher in Roman Imperial Period bones than contemporary ones, whereas zinc levels were lower, and lead concentrations aligned with reference values.\u0000Conclusion: The study results underscore the historical exposure of Roman Imperial Period individuals to heavy metals. These findings suggest that environmental health concerns related to heavy metal exposure date back millennia, emphasizing the long-standing nature of this issue.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83886948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Delay in diagnosing and treating gastrointestinal (GI) tract foreign bodies may lead to serious complications. In this study, we aimed to retrospectively evaluate the patients who underwent emergency upper GI endoscopy for foreign body ingestion in our clinic. Methods: Between 2015 and 2022, we evaluated 68 patients who underwent emergency upper GI endoscopy with a prediagnosis of foreign body ingestion. The evaluation included factors such as age, gender, presenting complaints, foreign body type, localization, and treatment parameters. Results: Out of the 68 patients included in the study, 21 (30.89%) were female, and the mean age was 54.00 years. Among them, 43 (63.23%) presented with no active complaints, 23 (33.82%) with dysphagia and odynophagia, and two (2.94%) with vomiting. The swallowed objects were classified as follows: coin (n=2), pin (n=5), battery (n=11), drug plaque (n=6), esophageal foreign body (n=7), piece of meat (n=5), chicken bone (n=4), fish bone (n=5), razor (n=7), lighter (n=3), and toothpick (n=1). The foreign bodies were located in the esophagus in 23 cases (33.82%), in the stomach in 32 cases (47.05%), and in the duodenum in one case (1.47%). For 12 patients (17.64%), the foreign body could not be detected endoscopically but was detected using radiologic methods. Among the foreign bodies, 54 (79.41%) were successfully removed. In one patient (1.47%) who could not be removed endoscopically and another patient (1.47%) who developed gastrointestinal perforation due to a foreign body (toothpick), a surgical procedure was performed. Conclusion: Early diagnosis and treatment of foreign body ingestion are crucial in preventing serious complications. Endoscopy, a minimally invasive procedure, can be a safe alternative to surgical procedures, which may carry higher morbidity and mortality risks.
{"title":"Removal of foreign objects seen in the upper gastrointestinal tract with the help of endoscopy: A retrospective cohort study","authors":"Alpaslan Fedayi Çalta","doi":"10.28982/josam.7842","DOIUrl":"https://doi.org/10.28982/josam.7842","url":null,"abstract":"Background/Aim: Delay in diagnosing and treating gastrointestinal (GI) tract foreign bodies may lead to serious complications. In this study, we aimed to retrospectively evaluate the patients who underwent emergency upper GI endoscopy for foreign body ingestion in our clinic.\u0000Methods: Between 2015 and 2022, we evaluated 68 patients who underwent emergency upper GI endoscopy with a prediagnosis of foreign body ingestion. The evaluation included factors such as age, gender, presenting complaints, foreign body type, localization, and treatment parameters.\u0000Results: Out of the 68 patients included in the study, 21 (30.89%) were female, and the mean age was 54.00 years. Among them, 43 (63.23%) presented with no active complaints, 23 (33.82%) with dysphagia and odynophagia, and two (2.94%) with vomiting. The swallowed objects were classified as follows: coin (n=2), pin (n=5), battery (n=11), drug plaque (n=6), esophageal foreign body (n=7), piece of meat (n=5), chicken bone (n=4), fish bone (n=5), razor (n=7), lighter (n=3), and toothpick (n=1). The foreign bodies were located in the esophagus in 23 cases (33.82%), in the stomach in 32 cases (47.05%), and in the duodenum in one case (1.47%). For 12 patients (17.64%), the foreign body could not be detected endoscopically but was detected using radiologic methods. Among the foreign bodies, 54 (79.41%) were successfully removed. In one patient (1.47%) who could not be removed endoscopically and another patient (1.47%) who developed gastrointestinal perforation due to a foreign body (toothpick), a surgical procedure was performed.\u0000Conclusion: Early diagnosis and treatment of foreign body ingestion are crucial in preventing serious complications. Endoscopy, a minimally invasive procedure, can be a safe alternative to surgical procedures, which may carry higher morbidity and mortality risks.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"2560 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86584407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Hypersensitivity pneumonitis (HP) is a lung disease from inhaling diverse environmental and occupational organic substances, such as fungi, bacteria, birds, and occasionally nonorganic materials. An immune response triggers this condition. A high-resolution chest computed tomography (HRCT) scan is typically performed as part of the initial diagnostic assessment. This study assesses HRCT findings in HP patients and examines associated factors between fibrotic and non-fibrotic patient groups. Methods: This retrospective cross-sectional study encompassed all HP patients monitored between 2010 and 2022. The analysis included data from 117 patients. HRCT findings from the patients were categorized based on fibrosis presence, leading to the division of patients into fibrotic and non-fibrotic groups. Comparative analyses were conducted between these groups. Results: Among the 117 subjects analyzed, 59 (50.4%) were male, and 58 (49.6%) were female. The mean age at diagnosis was 52.1 (13.6) years, ranging from 20 to 81. The non-fibrotic HP group comprised 70 (59.8%) patients, while the fibrotic HP group comprised 47 (40.2%). The most prevalent HRCT findings were ground-glass opacity (90.6%), mosaic attenuation (87.2%), and traction bronchiectasis (50.4%). Statistically significant disparities were observed between non-fibrotic and fibrotic HP groups in terms of HRCT findings: ground-glass opacity, irregular linear opacities, reticulation, traction bronchiectasis, honeycombing, and fibrosis (P=0.024, P<0.001). In contrast, the lymphocyte ratio in bronchoalveolar lavage fluid was 28.78 (16.2) in the non-fibrotic HP group and 14.66 (10.3) in the fibrotic HP group. The fibrotic HP group exhibited a statistically significant lower lymphocyte ratio in bronchoalveolar lavage fluid (P<0.001). Conclusion: HRCT findings are pivotal in HP diagnosis and classification. Computed tomography also assists in delineating the HP classification. This study identified ground-glass opacity and mosaic attenuation as the most prevalent HRCT findings in HP patients. Investigating the connection between fibrosis and prognosis is vital for determining patient outcomes, as fibrosis appears to be the principal determinant.
{"title":"Evaluation of high-resolution computed tomography findings and associated factors in hypersensitivity pneumonitis","authors":"A. Koyuncu, H. Ertürk","doi":"10.28982/josam.7855","DOIUrl":"https://doi.org/10.28982/josam.7855","url":null,"abstract":"Background/Aim: Hypersensitivity pneumonitis (HP) is a lung disease from inhaling diverse environmental and occupational organic substances, such as fungi, bacteria, birds, and occasionally nonorganic materials. An immune response triggers this condition. A high-resolution chest computed tomography (HRCT) scan is typically performed as part of the initial diagnostic assessment. This study assesses HRCT findings in HP patients and examines associated factors between fibrotic and non-fibrotic patient groups.\u0000Methods: This retrospective cross-sectional study encompassed all HP patients monitored between 2010 and 2022. The analysis included data from 117 patients. HRCT findings from the patients were categorized based on fibrosis presence, leading to the division of patients into fibrotic and non-fibrotic groups. Comparative analyses were conducted between these groups.\u0000Results: Among the 117 subjects analyzed, 59 (50.4%) were male, and 58 (49.6%) were female. The mean age at diagnosis was 52.1 (13.6) years, ranging from 20 to 81. The non-fibrotic HP group comprised 70 (59.8%) patients, while the fibrotic HP group comprised 47 (40.2%). The most prevalent HRCT findings were ground-glass opacity (90.6%), mosaic attenuation (87.2%), and traction bronchiectasis (50.4%). Statistically significant disparities were observed between non-fibrotic and fibrotic HP groups in terms of HRCT findings: ground-glass opacity, irregular linear opacities, reticulation, traction bronchiectasis, honeycombing, and fibrosis (P=0.024, P<0.001). In contrast, the lymphocyte ratio in bronchoalveolar lavage fluid was 28.78 (16.2) in the non-fibrotic HP group and 14.66 (10.3) in the fibrotic HP group. The fibrotic HP group exhibited a statistically significant lower lymphocyte ratio in bronchoalveolar lavage fluid (P<0.001).\u0000Conclusion: HRCT findings are pivotal in HP diagnosis and classification. Computed tomography also assists in delineating the HP classification. This study identified ground-glass opacity and mosaic attenuation as the most prevalent HRCT findings in HP patients. Investigating the connection between fibrosis and prognosis is vital for determining patient outcomes, as fibrosis appears to be the principal determinant.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78688473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: The efficacy of colchicine has been assessed in hand osteoarthritis; however, no studies have investigated its use in the more severe subtype of hand osteoarthritis, known as erosive hand osteoarthritis (EHOA). This retrospective cohort study investigated whether colchicine therapy could provide symptomatic relief and improve inflammation markers in patients with EHOA. Methods: The study included a total of 43 EHOA patients using colchicine (2×0.5 mg) + paracetamol (3×500 mg) daily (colchicine group) and 43 EHOA patients using only paracetamol (3×500 mg) (standard therapy group). Both groups were evaluated for various parameters. Results: The groups were similar in terms of age, sex distribution, and other sociodemographic variables. The decreases in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels from baseline were significantly greater in the colchicine group (P<0.001). Additionally, the visual analog scale (VAS) and Australian Canadian Osteoarthritis Hand Index (AUSCAN) scores, which include pain, stiffness, function, and total score, were significantly better in the colchicine group at 3 months compared to the standard therapy group (P<0.001). Furthermore, although both groups showed significant improvements in these parameters, the amount of improvement was significantly greater in the colchicine group (P<0.001). Conclusion: The combined use of colchicine and paracetamol improved CRP and ESR levels, VAS score, and all AUSCAN scores in patients with EHOA. Moreover, these benefits were significantly greater than standard therapy with paracetamol alone. Colchicine appears to be an effective therapeutic agent in the treatment of EHOA.
{"title":"Colchicine is an effective therapeutic agent in erosive hand osteoarthritis","authors":"Adem Ertürk, Alper Sarı","doi":"10.28982/josam.7857","DOIUrl":"https://doi.org/10.28982/josam.7857","url":null,"abstract":"Background/Aim: The efficacy of colchicine has been assessed in hand osteoarthritis; however, no studies have investigated its use in the more severe subtype of hand osteoarthritis, known as erosive hand osteoarthritis (EHOA). This retrospective cohort study investigated whether colchicine therapy could provide symptomatic relief and improve inflammation markers in patients with EHOA.\u0000Methods: The study included a total of 43 EHOA patients using colchicine (2×0.5 mg) + paracetamol (3×500 mg) daily (colchicine group) and 43 EHOA patients using only paracetamol (3×500 mg) (standard therapy group). Both groups were evaluated for various parameters.\u0000Results: The groups were similar in terms of age, sex distribution, and other sociodemographic variables. The decreases in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels from baseline were significantly greater in the colchicine group (P<0.001). Additionally, the visual analog scale (VAS) and Australian Canadian Osteoarthritis Hand Index (AUSCAN) scores, which include pain, stiffness, function, and total score, were significantly better in the colchicine group at 3 months compared to the standard therapy group (P<0.001). Furthermore, although both groups showed significant improvements in these parameters, the amount of improvement was significantly greater in the colchicine group (P<0.001).\u0000Conclusion: The combined use of colchicine and paracetamol improved CRP and ESR levels, VAS score, and all AUSCAN scores in patients with EHOA. Moreover, these benefits were significantly greater than standard therapy with paracetamol alone. Colchicine appears to be an effective therapeutic agent in the treatment of EHOA.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90977937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Oktay, Selin Akyuz Oktay, Bahriye Uzun Kenan, Emine Nur Sunar Yayla, B. Öğüt, Bahar Büyükkaragöz, Deniz Gezgin Yıldırım, S. Bakkaloğlu
Granulomatous polyangiitis (GPA) is the most common anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), characterized by necrotizing inflammation of small and medium-sized vessels. It can affect various organs, particularly the lung, kidneys, upper respiratory tract, ears, and skin. Diagnosis of AAV poses significant challenges due to its diverse clinical features. This report presents two interesting cases of GPA: one with rare ocular involvement, who subsequently developed end-stage kidney disease (ESKD), and the other with palpable purpura mimicking immunoglobulin A vasculitis, who relapsed with mastoiditis while in renal remission. Early and effective treatment can improve patient prognosis, highlighting the importance of increasing disease awareness during initial diagnosis and in pediatric AAV patients experiencing relapses.
{"title":"Pediatric ANCA-associated vasculitis presented with various clinical findings mimicking IgA Vasculitis and IgG4-related disease: Two cases","authors":"M. A. Oktay, Selin Akyuz Oktay, Bahriye Uzun Kenan, Emine Nur Sunar Yayla, B. Öğüt, Bahar Büyükkaragöz, Deniz Gezgin Yıldırım, S. Bakkaloğlu","doi":"10.28982/josam.7276","DOIUrl":"https://doi.org/10.28982/josam.7276","url":null,"abstract":"Granulomatous polyangiitis (GPA) is the most common anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), characterized by necrotizing inflammation of small and medium-sized vessels. It can affect various organs, particularly the lung, kidneys, upper respiratory tract, ears, and skin. Diagnosis of AAV poses significant challenges due to its diverse clinical features. This report presents two interesting cases of GPA: one with rare ocular involvement, who subsequently developed end-stage kidney disease (ESKD), and the other with palpable purpura mimicking immunoglobulin A vasculitis, who relapsed with mastoiditis while in renal remission. Early and effective treatment can improve patient prognosis, highlighting the importance of increasing disease awareness during initial diagnosis and in pediatric AAV patients experiencing relapses.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87042285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An inguinal hernia is a condition characterized by the protrusion of the intestine through an opening in the abdominal wall into the inguinal canal. There are various techniques available for the surgical repair of inguinal hernias, including open and laparoscopic approaches. On the other hand, a hydrocele refers to the accumulation of fluid within the scrotum and is often referred to as a "water hernia." In adults, hydroceles can be caused by factors such as injury, infection, or radiation therapy. Definitive treatment typically involves a surgical approach, which has an excellent prognosis. This case report presents the clinical scenario of a 58-year-old male patient, who presented with pain in the right inguinal region that radiated to the right scrotum. Upon examination, mild swelling was observed in the right inguinal region, along with significant edema of the right scrotum, which was tender to touch. Following admission, the patient underwent surgical treatment. The purpose of this case presentation is to enhance understanding of inguinal hernias and hydroceles, facilitating their identification and diagnosis.
{"title":"Inguinal herniation associated with hydrocele","authors":"Mladen Kasalovic, Igrutinović Gojko, Jakovljević Aleksandar, Miljković Nikola, Milentijević Milica","doi":"10.28982/josam.7549","DOIUrl":"https://doi.org/10.28982/josam.7549","url":null,"abstract":"An inguinal hernia is a condition characterized by the protrusion of the intestine through an opening in the abdominal wall into the inguinal canal. There are various techniques available for the surgical repair of inguinal hernias, including open and laparoscopic approaches. On the other hand, a hydrocele refers to the accumulation of fluid within the scrotum and is often referred to as a \"water hernia.\" In adults, hydroceles can be caused by factors such as injury, infection, or radiation therapy. Definitive treatment typically involves a surgical approach, which has an excellent prognosis. This case report presents the clinical scenario of a 58-year-old male patient, who presented with pain in the right inguinal region that radiated to the right scrotum. Upon examination, mild swelling was observed in the right inguinal region, along with significant edema of the right scrotum, which was tender to touch. Following admission, the patient underwent surgical treatment. The purpose of this case presentation is to enhance understanding of inguinal hernias and hydroceles, facilitating their identification and diagnosis.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82231034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: The Human Papilloma Virus (HPV) infection is the most common sexually transmitted disease and has been shown to cause cancer. Both sexes have a lifetime risk of at least 50% of exposure to HPV. Male HPV vaccinations can yield advantages for both the individual and community, including reduced transmission of HPV and protection of male and female health. The approval of vaccinations is mainly influenced by parental perspectives on this matter. It is essential to examine the subject in terms of physicians, who have the highest knowledge about HPV in society. This cross-sectional study aims to investigate physicians' attitudes and knowledge about vaccinating their male children against the human papillomavirus. Methods: A total of 1670 physicians were included in this study. Working as a physician and having a son were determined as inclusion criteria. A digital questionnaire was given to the physicians participating in the study. The answers to the survey questions were rated on a 4-point Likert scale (agree, do not know, disagree, strongly disagree). The responses were compared with the variables, and statistical analysis was performed. Results: Of the physicians participating in the study, 34.4% were male and 65.6% were female. A small percentage of the physicians (6.2%) reported that they would vaccinate their boys against HPV, and 59.9% of them indicated that they would not but they would consider it. The physicians’ who were most likely to vaccinate their sons worked in the fields of radiology (97.3%), orthopedics (80%), and gynecology (78.8%). It was determined that the physicians who said they would never have their sons vaccinated against HPV were most frequently specialists in anesthesiology and reanimation, infectious diseases, and clinical microbiology. Conclusions: This study determined that physicians in some specialties hesitated to give the HPV vaccine to their sons. The HPV vaccine is crucial for boys, and it is essential to point out the significance of providing seminars to physicians, particularly in developing nations like Turkey, regarding this issue and its consequences.
{"title":"HPV vaccinations in males; Knowledge, attitudes, and practices of physicians on human papilloma virus vaccinations for their sons","authors":"S. Seyfettinoğlu, Betül Dağoğlu Hark","doi":"10.28982/josam.7858","DOIUrl":"https://doi.org/10.28982/josam.7858","url":null,"abstract":"Background/Aim: The Human Papilloma Virus (HPV) infection is the most common sexually transmitted disease and has been shown to cause cancer. Both sexes have a lifetime risk of at least 50% of exposure to HPV. Male HPV vaccinations can yield advantages for both the individual and community, including reduced transmission of HPV and protection of male and female health. The approval of vaccinations is mainly influenced by parental perspectives on this matter. It is essential to examine the subject in terms of physicians, who have the highest knowledge about HPV in society. This cross-sectional study aims to investigate physicians' attitudes and knowledge about vaccinating their male children against the human papillomavirus.\u0000Methods: A total of 1670 physicians were included in this study. Working as a physician and having a son were determined as inclusion criteria. A digital questionnaire was given to the physicians participating in the study. The answers to the survey questions were rated on a 4-point Likert scale (agree, do not know, disagree, strongly disagree). The responses were compared with the variables, and statistical analysis was performed.\u0000Results: Of the physicians participating in the study, 34.4% were male and 65.6% were female. A small percentage of the physicians (6.2%) reported that they would vaccinate their boys against HPV, and 59.9% of them indicated that they would not but they would consider it. The physicians’ who were most likely to vaccinate their sons worked in the fields of radiology (97.3%), orthopedics (80%), and gynecology (78.8%). It was determined that the physicians who said they would never have their sons vaccinated against HPV were most frequently specialists in anesthesiology and reanimation, infectious diseases, and clinical microbiology.\u0000Conclusions: This study determined that physicians in some specialties hesitated to give the HPV vaccine to their sons. The HPV vaccine is crucial for boys, and it is essential to point out the significance of providing seminars to physicians, particularly in developing nations like Turkey, regarding this issue and its consequences.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83995956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: There are numerous treatment methods available for obesity, with bariatric surgery being the most effective. However, these techniques come with the risk of serious complications. This study presents a novel obesity treatment device that can shorten the length of the small intestine without the need for surgical intervention. Methods: Our new device comprises three main components: a 25 cm long rope, with one end attached to a 1 cm diameter plastic ring and the other end attached to a 2 mm diameter, 5 g sphere. Twenty-one male Wistar albino rats (6 months old, mean weight 400 g, outbred) were divided into three equal groups. Laparotomy and gastrotomy were performed on the subjects in Group 1, and all three parts of the device were placed into the gastrointestinal tract. In Group 2, only the plastic ring was placed in the stomach, and in Group 3, only a gastrotomy was performed. All subjects were followed for 3 months, during which their body weight, serum ghrelin, leptin, and nesfatin-1 levels were recorded, and the amount of food they consumed was measured. After sacrificing the animals, the stomach, proximal, and distal intestines were resected for histopathological evaluation. Results: The subjects in Group 1 experienced weight loss, whereas those in Groups 2 and 3 showed statistically significant weight gain (P<0.001 and P=0.022, respectively). Serum ghrelin levels were significantly increased in Groups 1 and 3 (P=0.015 and 0.031, respectively), while serum leptin levels were significantly decreased in Group 1 (P=0.015). Plasma nesfatin-1 levels were significantly higher in Group 1 compared to the other groups (P=0.014). There was no statistically significant difference in feed consumption between the groups. Histopathological examination revealed significantly higher fibrosis and inflammation scores in the proximal small intestine of Group 1 compared to the other groups (P=0.008 and P=0.005, respectively). Conclusions: This new device facilitates rapid and effective weight loss without the need for restricting oral food intake or organ resection. Changes in serum ghrelin, leptin, and nesfatin-1 levels did not affect these results. We hypothesize that the effective weight loss is linked to the shortening of the small intestine length. Our future plans involve modifying the device for endoscopic application in humans.
{"title":"A new obesity treatment method that does not require restriction in food intake and organ resection","authors":"E. Aysan, Ebru Kanimdan, U. Idiz","doi":"10.28982/josam.7505","DOIUrl":"https://doi.org/10.28982/josam.7505","url":null,"abstract":"Background/Aim: There are numerous treatment methods available for obesity, with bariatric surgery being the most effective. However, these techniques come with the risk of serious complications. This study presents a novel obesity treatment device that can shorten the length of the small intestine without the need for surgical intervention.\u0000Methods: Our new device comprises three main components: a 25 cm long rope, with one end attached to a 1 cm diameter plastic ring and the other end attached to a 2 mm diameter, 5 g sphere. Twenty-one male Wistar albino rats (6 months old, mean weight 400 g, outbred) were divided into three equal groups. Laparotomy and gastrotomy were performed on the subjects in Group 1, and all three parts of the device were placed into the gastrointestinal tract. In Group 2, only the plastic ring was placed in the stomach, and in Group 3, only a gastrotomy was performed. All subjects were followed for 3 months, during which their body weight, serum ghrelin, leptin, and nesfatin-1 levels were recorded, and the amount of food they consumed was measured. After sacrificing the animals, the stomach, proximal, and distal intestines were resected for histopathological evaluation.\u0000Results: The subjects in Group 1 experienced weight loss, whereas those in Groups 2 and 3 showed statistically significant weight gain (P<0.001 and P=0.022, respectively). Serum ghrelin levels were significantly increased in Groups 1 and 3 (P=0.015 and 0.031, respectively), while serum leptin levels were significantly decreased in Group 1 (P=0.015). Plasma nesfatin-1 levels were significantly higher in Group 1 compared to the other groups (P=0.014). There was no statistically significant difference in feed consumption between the groups. Histopathological examination revealed significantly higher fibrosis and inflammation scores in the proximal small intestine of Group 1 compared to the other groups (P=0.008 and P=0.005, respectively).\u0000Conclusions: This new device facilitates rapid and effective weight loss without the need for restricting oral food intake or organ resection. Changes in serum ghrelin, leptin, and nesfatin-1 levels did not affect these results. We hypothesize that the effective weight loss is linked to the shortening of the small intestine length. Our future plans involve modifying the device for endoscopic application in humans.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83066894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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