Cirugia Y Cirujanos最新文献

Aim: The aim of this study was to determine the relationship between coronary angiography results and Mediterranean-type lifestyle and type D personality.

Methods: Mediterranean-type lifestyle index and type D personality scale were administered to 230 participants.

Results: In univariate analysis according to coronary angiography results, a statistically significant effect was determined between the decision for treatment with percutaneous coronary intervention (PCI) and diabetes mellitus, and total and subscale points of Mediterranean lifestyle index, and between the decision for treatment with bypass and body mass index, Mediterranean diet, physical activity, and total points. In multivariate analysis, there was determined to be an effect between the PCI and systolic pressure, and between bypass and body mass index and subscale of physical activity. When disease-free life expectancy was examined, there was seen to be a negative effect of smoking and low Mediterranean diet points for participants with PCI, and of smoking, presence of hypertension, family history, and high type D personal characteristics score for those with bypass decision.

Conclusion: The evidence-based recommendations for a Mediterranean-type lifestyle stated in cardiovascular disease (CVD) preventative guidelines may have a positive effect on the prevention of CVD, disability-free life, and mortality.

Background: The aim of this study was to investigate the prevalence, genotype, and distribution of cervical human papillomavirus (HPV) in women living in southeast Turkey.

Materials and methods: A total of 13,300 cervical smear materials were scanned and 899 cases found to be HPV-positive were included in the study. Cases were divided into seven groups according to age (under 19 years of age, 20-24, 25-29, 30-39, 40-49, 50-59, and over 60 years old) and six groups according to HPV types (HPV type 16, HPV type 18, HPV type 16-18 association, HPV type 16-high risk (HR) association, HPV Type 18-HR association, and HPV HR [31,33,35,39,45, 51,52,56,58,59,66, and 68]). SurePath liquid-based cytology preparations were evaluated, and HPV tests were performed using real-time-polymerase chain reaction.

Results: A total of 6.7% of cervical smear samples were positive for HPV DNA. The mean age of these cases was 41 years (range 15-78 years). All HPV types showed the highest rate of positivity in the 30-39 age groups. Regarding the distribution of HPV types, most of the cases were in the HPV HR group (66%). The most common atypia category detected in cytological examination was "Atypical squamous cells of undetermined significance" (ASC-US) (27%).

Conclusions: It was determined that the prevalence of HPV in the southeast of Turkey is lower than the world average, the most common HPV type in our region is HPV-HR, and HPV peaks at older ages compared to what has been reported for other regions of the world.

Purpose: Early diagnosis of necrotic bowel segment resulting from incarcerated inguinal hernia (IIH) is crucial for reducing morbidity and mortality. The aim of this study was to investigate the efficacy of the De Ritis ratio (DRR), also known as the ratio of aspartate aminotransferase to alanine aminotransferase, as a biomarker for intestinal necrosis.

Methods: This retrospective study included 132 patients who underwent emergency surgery for IIH. Patients were divided into two groups: those who underwent bowel resection for necrosis (Group 1) and those who did not (Group 2). Patients' demographic and clinical data were recorded. Using laboratory test results, DRR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and lymphocyte-to-CRP ratio (LCR) were calculated.

Results: The morbidity and mortality rates and the length of stay for Group 1 were statistically significantly different (p < 0.0001). The DRR, NLR, PLR, LMR, and LCR values of the same group were also significantly different (p < 0.05).

Conclusion: DRR can be used as a biomarker for early diagnosis of bowel necrosis in patients with IIH.

Loeys-Dietz syndrome (LDS) is a connective tissue disease related to β-transforming growth factor mutations, which causes aneurysms formation, vascular tortuosity and skeletal manifestations. The prognosis is very poor, and mortality occurs at the age of 27 in patients without surgical treatment. Despite being diagnosed in childhood, is not usual surgical aortic replacement in children. We report a case of 12 years old child with LDS and multiple aneurysms in thoracic aorta, undergoing complete aortic arch replacement and our proposal for the anesthetic management, due to surgical complexity and implications in pediatric population.

Sarcoidosis is a multisystem inflammatory disorder of unknown cause characterized by the formation of pleomorphic, non-caseating granulomas with predominantly pulmonary involvement. Although abdominal sarcoidosis represents 30% of extrapulmonary manifestations, peritoneal involvement is extremely rare. We will describe a rare case of peritoneal sarcoidosis simulating carcinomatosis in a young patient with abdominal pain who underwent laparoscopic examination.

Objective: To evaluate the preoperative tomographic characteristics of the nose and paranasal sinuses of children with chronic dacryocystitis.

Method: Prospective, observational, cross-sectional, and descriptive study. CT scans of the paranasal sinuses of patients candidates for endoscopic dacryocystorhinostomy were evaluated for two years. Demographic characteristics, radiological findings, inflammatory processes and anatomical variants were identified using the Lund-Mackay classification. Statistic analysis. Stata 10.0, descriptive analysis, Student's t: mean difference and χ². Logistic studies to estimate the probability between variables.

Results: 27 men and 11 women (n = 38) were included. Of these, 22 had unilateral and 16 bilateral nasolacrimal duct involvement. Lund-Mackay score range: 2-20. Eleven patients had associated pathology. The most affected were anterior and maxillary ethmoidal sinus (69%), osteomeatal complex (68%), posterior ethmoidal (51%). Patients with severe rhinosinusitis are 12 times more likely to develop dacryocystitis than patients with < 12 points. Men presented greater severity, affectation, and clinical repercussion.

Conclusions: There is radiological rhinosinusal involvement in dacryocystitis, which must be evaluated and treated preoperatively to avoid postoperative complications or reinfections.

Background: Papillary thyroid cancer is the most common endocrine neoplasia. There are prognostic factors that establish risk of recurrence and mortality; however, patients considered low risk may have a less favorable evolution and hence the importance of finding new markers.

Objective: To assess whether the mean platelet volume (MPV) and the platelet-lymphocyte index (PLI) show a relationship with the clinical staging in papillary thyroid cancer.

Method: Retrospective, observational and analytical study. Preoperative MPV and PLI were recorded, its relationship with TNM and MACIS systems was sought, as well as locally advanced invasion and tumor focality.

Results: 107 cases treated from November 2017 to February 2020. No statistically significant difference was observed in these two preoperative parameters with advanced and initial stages, risk groups or tumor focality. The statistical analysis used was one-way ANOVA with SPSS 25, a 95% confidence interval and p < 0.05.

Conclusions: Despite the logical reasoning of tumor pathophysiology, our study did not find a relationship between papillary thyroid carcinoma with MPV and PLI, and should be complemented with more extensive studies.

Aim: This study aimed to examine the prognostic significance of the KI-67 proliferation index, especially in breast cancer (BC) patients without HER-2 expression and no nodal involvement.

Material and methods: The database of hormone-receptor-positive patients who underwent surgery for BC in our Surgical Oncology Clinic between 2008 and 2020 was retrospectively reviewed and recorded. Patients were categorized based on their KI-67 level, considering the cutoff value of 20%.

Results: Our study revealed that tumors with high KI-67 levels were more likely to have a more advanced histological grade (p = 0.00) and size (p = 0.038). In the univariant analysis, KI-67 level was effective on overall survival (p = 0.044) and disease-free survival (p = 0.048). However, we found that there was no independent prognostic factor in the multivariant analysis.

Conclusion: Although the Ki-67 proliferation index does not yet have an agreed threshold value and scoring methodology, it can also be used to determine prognosis and evaluate treatment response in some patients.

Background: The effect of tissue adhesives on coronary grafts in cardiac surgery is a controversial issue.

Objective: The aim of this study is to investigate the effect of fibrin glue (FG) applied around the saphenous vein grafts (SVG) in preventing cellular damage resulting from intraluminal pressure increase.

Methods: Twenty volunteer patients were included in this ex vivo study. The SVGs remained after coronary artery bypass grafting were connected to the arterial line of the cardiopulmonary bypass circuit. The grafts were divided into two segments and one segment received perivascular FG applied whereas the other part was used plain. SVGs were kept in circulation at 120 mmHg pressure 250 mL/min flow rate for 60 min. The tissues were sent for histopathological examination to determine the endothelial damage.

Results: Endothelial damage was more pronounced in the control group when compared with the FG group. In the FG group, no damage was seen in 13 samples and no Type 3 endothelial damage was observe whereas Type 1 injury was detected in seven specimens, Type 2 injury was observed in seven specimens, and Type 3 injury was detected in two specimens in the control group.

Conclusion: Perivascular application of FG on the SVG showed a protective effect against endothelial damage resulting from increased intraluminal pressure.