Long-term outcomes of crystallized phenol application for the treatment of pilonidal sinus disease.

OBJECTIVE: This study aimed to better demonstrate the long-term outcomes and effectiveness of crystallized phenol treatment (CPT) by presenting our 20 years experience. METHODS: One thousand and twenty-six patients who have primer pilonidal sinus were enrolled. The operation was applied outpatient clinic under local anesthesia. Recurrence rate, application number, healing time, and factors affecting them were analyzed. RESULTS: The success rate was 84.3%. The mean number of CPT applications was 2.1 and the mean recovery time was 8.9 weeks. The rate of recurrence was higher in patients with a long disease duration prior to initiating treatment (p = .04). The rate of recurrence was higher in patients with a higher number of opening and CPT application, those with longer application time, and those with a positive family history (respectively p = .01, p = .002, p = .008). CONCLUSIONS: Long-term outcomes are also very successful in the treatment of pilonidal disease with CPT. We believe that CPT should be the first choice in the treatment of pilonidal disease because it is inexpensive, can be applied as an outpatient treatment, is a noninvasive procedure, has results comparable to surgical procedures, and does not cause loss of work and strength.

The Effect of Soluble TREM-1 in Idiopathic Granulomatous Mastitis.

BACKGROUND AND OBJECTIVES: The aim of this study is to investigate the effect of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in idiopathic granulomatous mastitis (IGM). METHODS: This case-control study was conducted in Saglik Bilimleri and Necmettin Erbakan Universities. Sixty patients with IGM diagnosis (Group P) and 25 healthy females as control group (Group C) were included. Group P was divided into two subgroups according to the activity of disease: patients with active lesion (Group PA), and patients without any symptoms, in remission (Group PR). The ELISA method was used to measure sTREM-1 level. RESULTS: Group P's sTREM-1 were higher than Group C (p < .0001). The difference between sTREM-1 levels of Groups PA, PR and C was significant statistically (p < .0001). Group PA's sTREM-1 levels were higher than Group C (p < .0001). Also, sTREM-1 levels of Group PR were higher than Group C (p = .006). When sTREM-1 levels of patients receiving steroid therapy and did not in Group PR were analyzed, the sTREM-1 levels of the patients not receiving steroid treatment were found to be statistically higher than Group C (p = .002). Although the sTREM-1 levels of the patients who did not receive steroid therapy were higher than those who received steroid therapy, the difference was not statistically significant (p > .05). CONCLUSION: We concluded that the detected high sTREM-1 levels contributed to inflammation in IGM. In particular, blockade of TREM may be a promising treatment option in resistant or multiple recurrent patients.

Breast complaints in children and the effect of family history.

BACKGROUND: To evaluate the correlation of physical examination, and radiological and pathological findings of children and adolescents with breast-related complaints. METHODS: Children and adolescents with breast complaints between January 2016 and December 2019 were analyzed retrospectively. RESULTS: A total of 118 children and adolescent patients were included. Their ages ranged from 12 to 18 years (median, 16 years). Twenty-one patients had a family history of breast cancer (17.8%). The most common complaints were pain, mass, and nipple discharge. Physical examination revealed mass (41.5%), tenderness (11%), and fullness (8.5%). Thirty-nine patients were classified ultrasonographically with Breast Imaging Reporting and Data System (BIRADS) 3 (39.4%) and four patients were BIRADS 4 (4%). Excision was applied to all patients with BIRADS 4, and 13 of 39 patients with BIRADS 3. Pathological diagnoses of the patients with BIRADS 3 were fibroadenoma (n: 12, 92.3%) and benign phyllodes tumor (n: 1, 7.7%). In patients with BIRADS 4, three patients had fiboradenomas and one patient had a benign phyllodes tumor. No recurrence was observed in any patients who had an excision. Only six of the patients with positive family history had BIRADS 3 lesions, and the others were BIRADS 1. Excision was recommended in two patients and the pathological diagnoses were fibroadenoma. CONCLUSION: In this age group, the most common complaints were pain and mass, while physical examination was normal in nearly half of the patients. All of the pathological diagnoses were benign. While evaluating the patients in this age range, the experience of the clinician and radiologist is important and we think that it is necessary to increase the awareness of the patient and family about physiological breast development and self-breast examination.

Predictive value of preoperative neutrophil-to-lymphocyte ratio while detecting bowel resection in hernia with intestinal incarceration.

BACKGROUND: The aim of this study was to evaluate the relationship between preoperative hematological inflammatory markers of the patients who underwent a surgery for incarcerated hernia and intestinal resection requirement. METHODS: The data of 102 patients who underwent a surgery for incarcerated hernia were retrospectively evaluated. Whole blood cell counts were preoperatively measured, and operation types and pathology results were recorded. The patients with intestinal resections were compared with those without any resection in terms of leukocyte number, neutrophil rate, red cell distribution width (RDW), platelet distribution width, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV). RESULTS: Eighty-one patients were operated for incarcerated groin hernia, 17 for incarcerated umbilical hernia, and 4 for incarcerated incisional hernia. Twenty-six patients (25%) had intestinal resections; in 4 of them, intestinal perforation was detected. In patients with intestinal resections,the neutrophil rate, PDW, NLR, and PLR values were significantly higher than those in the patients without any resections. CONCLUSION: High NLR rates, certainly with clinical correlation, can be used as a biomarker to predict intestinal necrosis and the need for intestinal resection in patients who will undergo surgery for incarcerated hernia, particularlyin situations with lacking radiological imaging methods.