Cirugia y cirujanos最新文献

Objective: The objective of this study was to investigate the presence of sarcopenia in fibromyalgia and whether there is any relationship between physical performance, disease activity, pain levels, and the existence of sarcopenia.

Method: Fifty female patients diagnosed with fibromyalgia syndrome (FMS) based on the classification criteria of the 2016 American College of Rheumatology and 50 healthy controls were admitted. Disease activity was evaluated with the Fibromyalgia Impact Questionnaire (FIQ) and pain level was evaluated with the Numerical Rating Scale. Sarcopenia was screened by the SARC-F questionnaire and the presence of sarcopenia was evaluated according to ISarcoPRM criteria. Furthermore, right-hand grip strength was evaluated with a dynamometer. Ultrasound was used to measure the anterior thigh muscle thickness on the quadriceps femoris.

Results: SARF-C scores were significantly higher in patients with FMS (p < 0.001). The presence of sarcopenia was found as 20 (40%) in FMS patients and 6 (12%) in healthy controls (p < 0.001). Right-hand grip strength was significantly different in patients with FMS (p = 0.007). Right anterior thigh muscle thickness was similar in the two groups (p = 0.875). A positive correlation was observed between FIQ score and SARF-C score in FMS patients with sarcopenia (r = 0.708, p < 0.001).

Conclusion: Sarcopenia was thought of as a common problem in patients with FMS. Evaluating sarcopenia in patients with FMS could enhance the effectiveness of FMS treatment.

Misdiagnosis and delay in the treatment of acute appendicitis increases the risk of complications secondary to visceral perforation. Appendicular rupture into the bladder is an uncommon complication, but possibly to happen; treatment generally consists of a laparotomy with appendectomy and repair of the bladder wall. The laparoscopic approach is a viable option in cases of complicated appendicitis, even in complex and infrequent clinical scenarios. The aim of this paper is to describe a case of complicated appendicitis with bladder perforation, treated with a laparoscopic right hemicolectomy, terminal ileostomy and closure of the urinary bladder wall.

Objective: This is a prospective study and visfatin values of patients with aneurysmal bone cysts (ABC) were compared with those of healthy individuals.

Method: This study consists of 20 patients diagnosed with ABC (Group 1) and 30 healthy patients (Group 2). Age, gender, cyst sizes, and visfatin values of all patients were recorded and evaluated.

Results: A total of 50 patients, 20 from Group 1 and 30 from Group 2, were included in our study. The mean age was 13.80 ± 3.98 years in Group 1 and 14.67 ± 4.24 years in Group 2, and no statistically significant difference was found between the groups (p > 0.05). While 60% of the patients in Group 1 were male, in Group 2, 53% of the patients were male. Cyst area was recorded as 1171 (512-2310) mm². The visfatin value was 10.70 ± 5.91 ng/mL in Group 1 and 15.23 ± 5.86 ng/mL in Group 2. The visfatin value in the ABC group was found to be statistically significantly lower than the control group (p < 0.05). No correlation was found between cyst area and visfatin (p > 0.05).

Conclusion: Our study found that visfatin levels are significantly lower in patients with ABC s compared to healthy controls, suggesting its potential as a diagnostic biomarker. The ROC analysis showed a good diagnostic ability.

Objective: We aimed to investigate patients who were managed and followed up in our clinic for ureteroceles.

Method: We retrospectively analyzed 52 patients' records with ureterocele diagnoses who were treated at the Pediatric Surgery Clinic of the Medical School of Dicle University between January 2009 and December 2017.

Results: Of the patients 29 were female and 23 were male. Thirty-six patients had left-sided ureteroceles, 12 had right-sided ureteroceles, and four had bilateral ureteroceles. Thirty-three were intravesical and 19 were ectopically located. Twenty-seven were on a duplex system. Ureterocele was diagnosed antenatally in 12 patients and 21 in the first 6 months of the post-natal period. Ultrasonography was the most common diagnostic method. Urinary infection was the most frequent symptom (38.4%). Except for a patient who received conservative follow-up, all ureteroceles were decompressed. Vesicoureteral reflux (VUR), urinary tract infection (UTI), and renal scarring were all significantly higher in patients with the duplex system. Significantly decreased UTI rates were observed in early-diagnosed patients (p = 0.04).

Conclusion: Ureterocele is still a challenging problem due to the high risk of UTI, VUR, and renal scarring. Endoscopic decompression is the most preferable intervention for ureteroceles. UTI and renal scarring could be decreased with early detection and treatment.

Bile duct injury remains one of the most feared complications after cholecystectomy. The Prometheus device, through intrinsic illumination, facilitates intraoperative anatomical identification of biliary structures. In a case of cholecystitis, it was used during a conventional cholecystectomy, advancing it through Hartmann's pouch to the confluence with the common hepatic duct, illuminating the biliary structures and enhancing critical view of safety. This device proved to be a safe and accessible method, with potential for use in most healthcare centers.

Objective: The aim of this study was to investigate the current awareness status of nurses on the "Treatment Guidelines for Sepsis and Septic Shock."

Methods: According to the "International Guidelines for Management of Sepsis and Septic Shock 2021," a self-made questionnaire on nursing knowledge related to sepsis and septic shock was used to evaluate nurses' level of knowledge-attitude-belief-practice (KAP) in sepsis and septic shock, and to explore the influential factors on their awareness level.

Results: The awareness rate of nurses was 46.67% toward the treatment guidelines for sepsis and septic shock. Nurses' mastery rate was < 60.00%; and 85.00% of nurses scored 10-18 points using the sepsis and septic shock-related questionnaire. The power order of related factors affecting the KAP level of nurses on sepsis and septic shock was listed as follows: years of service > guideline-related training duration > guideline-related training or not > professional title > degree of education. The years of service had the most significant impact on nurses' level of KAP in sepsis or septic shock (r = 0.521).

Conclusion: Nurses have poor awareness of the "Treatment Guidelines for Sepsis and Septic Shock." The findings suggest that guidelines- and standards-based training with longer duration should be carried out to improve the KAP level of nurses.

Objective: This study aimed to analyze pregnancy and perinatal outcomes in singleton and twin pregnancies undergoing ultrasonography (USG)-indicated and clinically indicated cervical cerclage.

Methods: The study population included pregnant women with a cervical length of < 15 mm as determined by transvaginal ultrasonography between 16 and 27 weeks of gestation or a cervix < 4 cm open as observed through USG measurement, who subsequently underwent emergency cervical cerclage. The study compared pregnancy and perinatal outcomes between the two groups.

Results: A comparison of the data according to USG (n = 18, 37%) or clinical (n = 31, 63%) indication revealed that the weeks of cerclage, weeks to delivery, and duration of pregnancy were similar between the groups (p = 0.509, p = 0.095, p = 0.090, respectively). In pregnancies involving a single fetus (n = 36, 73%) and those involving two fetuses (n = 13, 27%), the week of cerclage, the week of delivery, and the duration of pregnancy exhibited no statistically significant differences (p = 0.344, p = 0.309, p = 0.762, respectively).

Conclusions: In both singleton and twin pregnancies, emergency cerclage between 16 and 27 weeks of gestation in patients with cervical shortening or dehiscence has been demonstrated to prolong the gestation period under appropriate conditions by experienced specialists.

Objective: This study aimed to investigate the hepatoprotective effects of Rosmarinic acid (RA) against cyclophosphamide (CP)-induced liver injury in rats.

Methods: Twenty-one male Wistar Albino rats were divided into three groups: Control, CP, and CP + RA. Hepatotoxicity was induced by administering CP (20 mg/kg/day) intraperitoneally for 14 days. RA (20 mg/kg/day) was administered for 14 days after CP induction. Serum biochemical parameters including malondialdehyde (MDA), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured. Liver tissues underwent histological and immunohistochemical analysis for B-cell lymphoma 2 (Bcl-2), apoptotic protease activating factor 1 (Apaf-1), nuclear factor erythroid 2-related factor 2 (Nrf-2), and tumor necrosis factor (TNF)-α. In addition, in silico analysis was performed to explore potential molecular targets of RA and their biological pathways.

Results: CP significantly increased liver weight, MDA content, ALT and AST enzyme activities, indicating hepatic oxidative stress and injury. Histologically, CP caused severe hepatocellular damage characterized by hepatocyte degeneration, hemorrhage, and disrupted hepatic architecture. Immunohistochemically, CP exposure upregulated pro-apoptotic (Apaf-1), oxidative stress (Nrf-2), and inflammatory (TNF-α) markers, while downregulating anti-apoptotic (Bcl-2) proteins. RA administration significantly reversed these biochemical and histopathological changes. In silico analysis revealed RA interacts with multiple inflammatory and oxidative stress pathways, reinforcing its hepatoprotective role.

Conclusion: RA demonstrates significant hepatoprotective activity against CP-induced liver toxicity by attenuating oxidative stress, inflammation, and apoptosis pathways. RA represents a promising therapeutic agent to manage drug-induced hepatotoxicity.

Objective: To identify opportunities of shortening surgical deferral with a time-motion study, in the preoperative phase of cataract surgery.

Methods: Non-clinical, prospective, cross-sectional and analytical time-motion study; a group of experts estimated minimal, usual and maximal durations for twelve activities in the preoperative phase of cataract surgery. We used a beta distribution to estimate the dispersion of each activity's duration, as well as the mean time by activity and for the entire preoperative sequence, from initial ophthalmic evaluation to surgery.

Results: Mean preoperative time in cataract surgery was 269 days; the activity with larger dispersions were the time between receiving surgical inputs and surgery; preoperative risk evaluations and studies accounted for 40.9% of the time, and ophthalmic preoperative studies consumed 17.4%.

Conclusions: Shortening the length of preoperative evaluations by having an easier access to diagnostic studies, might reduce by 60% the duration of the preoperative phase of cataract surgery.