Effect of Extractum cepae, heparin sodium and allantoin combination (ContractubexTM) on adhesion and fibrosis after neck surgery (thyroidectomy) in rats.

OBJECTIVE: Reoperative thyroid surgery is technically difficult process with increased complications due to the adhesions and fibrosis caused by the previous surgery. In this experimental animal model, we planned to investigate the effect of ContracttubexTM, a mixture of Extractum cepae, Heparin sodium and Allantoin, on adhesion and fibrosis after neck surgery (thyroidectomy). METHODS: The current study is an experimental animal model of post-thyroidectomy adhesion. Twelve Wistar-Albino male rats in two groups were used. Under sterile conditions, a midline incision on the neck was made. The anterior thyroid muscles were separated and the thyroid lodge was reached. As a minor interventional procedure, a sponge was applied to the thyroid tissue, and then a combination of 1 g Extractum capae, heparin, sodium, and allantoin was applied to the dissection site in the drug group. Rats in both groups were sacrificed on 30th day. Cervical regions were dissected and evaluated for macroscopic adhesion. Tissue samples were taken for microscopic evaluation for fibrosis and inflammation. RESULTS: In the experimental group in which ContractubexTM was applied, inflammation was not detected in five (83.3%) of six rats while no inflammation was detected in four (66.7%) of six rats in the control group (p=0.505). Considering the fibrosis score, mild or moderate fibrosis was detected in four (66.7%) of six rats in the control group, while fibrosis was found in only two (33.3%) rats in the experimental group (p=0.264). When macroscopic adhesion was evaluated, two (33.3%) rats of the control group subjects were Grade 4, and one (16.7%) was Grade 3. No rats in the experimental group were Grade 4 (p=0.392). CONCLUSION: ContractubexTM seems to be effective in preventing adhesions and fibrosis after thyroidectomy and neck surgery, but further research is needed for use in human studies.

Analysis of Trending Topics in Breast Cancer Articles From an Altmetric Perspective.

Background It is widely known that social media has an impact on politics and the economy. The Altmetric Attention Score (AAS) is a new Web-based metric that was recently developed for use in the scientific field. The objective of this study was to assess which recent studies on the topic of breast cancer received the most attention from the general public. Methodology An Altmetric Explorer search was performed on January 7, 2022, to extract the following information: journal name, impact factor (IF), year of publication, article topic, article type, and level of evidence. Results The journal that published articles that received the most attention on social media was the New England Journal of Medicine (n = 8). All of the articles were published in journals in the highest IF quartile. The most frequent top three subjects in the top 50 articles were "treatment and management," "risk factors for breast cancer," and "breast cancer screening." The number of articles with a level of evidence of 1, 2, 3, and 4 was 12, 17, 17, and 4, respectively. The correlation between AAS and citation was not significant. Conclusions The AAS seems to be a more reliable assessment of public perception of breast cancer. We propose that combining the AAS and traditional metrics may provide a more detailed description of scientific research output.

The role of complete blood count parameters in diagnosing acute appendicitis and measuring the severity of inflammation.

BACKGROUND: The diagnosis and severity of acute appendicitis (AA) are still challenging despite all the improvements in diagnosis and treatment. This study aimed to evaluate the efficacy of complete blood count (CBC) parameters in diagnosing AA and measuring severity. METHODS: Data of 521 patients were reviewed retrospectively. Fifty-three patients with CBC results influenced by various reasons were excluded from the study. Age, gender, length of stay, CBC parameters, and histopathological results were examined. RESULTS: The study included 468 patients: 90 patients with a preliminary diagnosis of AA, not undergoing surgery but receiving medical treatment (Group I), 227 patients with uncomplicated appendicitis (Group II), and 151 patients with complicated appendicitis (Group III). Of the patients, 279 were male (59.6%) and 189 were female (40.4%). The mean age was 33.37±13.05 years. Groups I and III had the lowest and highest white blood cell (WBC), neutrophil, and neutrophil-to-lymphocyte ratio (NLR), respectively. There was a statistically significant difference between the groups (p<0.05). The highest and lowest mean platelet volume (MPV) values were in Groups II and III, respectively. There was no statistically significant difference between the groups (p>0.05). CONCLUSION: AA is the most common cause of abdominal surgery. The CBC is a cost-effective and easily-accessible test with acceptable diagnostic accuracy. It provides fast results and can be used in the diagnosis of appendicitis. Neutrophil, WBC, and NLR are helpful and useful parameters for physical examination and other diagnostic methods in diagnosing AA and measuring severity. However, the use of MPV is not recommended as it has a low diagnostic rate and contradictory results.

Spontaneous perforation of pyometra: A rare cause of acute abdomen and sepsis.

Pyometra, the accumulation of purulent material in the uterine cavity, is a rare gynecological condition whose etiology is impaired drainage of the uterine cavity. It is uncommon in premenopausal age and occurs mainly in older and postmenopausal women. Clinical signs of pyometra are vaginal discharge, postmenopausal bleeding, and lower abdominal pain. An 87-year-old woman was admitted to our emergency department with abdominal pain, fever, and vomiting. The results of physical examination revealed rebound tenderness and muscular rigidity in the lower abdomen. Ultrasonography demonstrated free fluid in the abdomen, and percutaneous aspiration revealed that this fluid was purulent. A computed tomography scan showed a large amount of free fluid in the abdominal cavity and a uterine myoma. The patient underwent emergency laparotomy due to acute abdomen. During the laparotomy, a 2×1 cm perforation was seen at the fundus of the uterus. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. A culture of the pus grew Escherichia coli. Histopathological examination revealed degenerative uterine myoma with no evidence of malignancy. Pathological results indicated myometrial suppurative inflammation along with neutrophilia and necrosis. Pyometra is a rare event; however, it must be considered when investigating acute abdomen etiology. Because pyometra involves abscess formation, drainage and evacuation of the uterine cavity while leaving a drain in the cavity and dilating the cervical canal is the main treatment protocol. In cases of perforation, hysterectomy is the treatment choice; however, with concomitant diseases in older patients, immediate surgery is related to important morbidity and mortality risks.

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients.

OBJECTIVE: Colorectal cancer is still one of the most common causes of cancer related deaths in the world despite improvements in diagnosis and treatment modalities, and application of community-based screening methods. Symptoms of colorectal cancer are non-specific and usually manifest following local progression. A number of patients with advanced stage colorectal cancer present to emergency departments with obstruction as the first sign of disease without any previous symptoms. This presentation is an indication for emergency surgery that has a high rate of morbidity and mortality. In this study, we aimed to determine the factors associated with early diagnosis and survival by comparing postoperative results of colorectal cancer patients who underwent surgery under emergency or elective situation. MATERIAL AND METHODS: Files of colorectal patients treated between 2009-2013 were retrospectively analyzed. Data on patient age, gender, operation type, intraoperative results, length of hospital stay, co-morbidities, postoperative complications and pathological results were evaluated and compared. RESULTS: There was no statistical difference between groups in terms of age, gender, and pathology results (p>0.05). The difference between groups in terms of postoperative length of hospital stay, presence of co-morbid diseases, pathological stage, and postoperative complications was statistically significant (p<0.05). Length of hospital stay, advanced stage on admission, complications such as surgical site infection, evisceration, and anastomosis leakage rates were higher in patients in the emergency surgery group. CONCLUSION: Risk groups should be determined in order to diagnose colorectal cancer patients at an early stage while they are still asymptomatic, and this information should be incorporated into effective screening programs. This approach will be beneficial to treatment outcomes, complication rates, length of hospital stay, and survival and treatment results.

Cystic schwannoma of the axillary region: imaging findings of a rare disease. Case report.

Schwannomas are well capsulated, benign, and slowly growing tumors which originate from Schwann cells of peripheral nerve sheath. The incidence of schwannomanas in the axillary region is not common. This rarity causes misdiagnosis at the radiological evaluation. In this case we present the imaging and histopathological findings of a cystic schwannoma located in the axillary fossa of a 47-year-old female patient mimicking complex cyst, lymphadenopathy or hydatid cyst in radiological evaluation. Although lymphadenopathy, lymphatic malformation, lipoma, cyst, hidradenitis suppurativa or dermatofibroma are the most frequent lesions to be considered, peripheral nerve sheath should also be kept in mind in the differential diagnosis of axillary masses.

An incidentally detected breast cancer on tc-99m MIBI cardiac scintigraphy.

Tc-99m methoxyisobutylisonitrile (MIBI) scintigraphy is generally used as a second-line diagnostic tool for obscured breast lesions. When the entire field of view is examined carefully, it is often possible to detect additional lesions unrelated to the initial intent and purpose of the examination. Herein we present a case of breast cancer incidentally detected by cardiac Tc-99m MIBI scintigraphy. An area of uptake was detected in the breast during a cardiac imaging test. Further evaluation of this lesion revealed a histopathological diagnosis of invasive ductal carcinoma of the breast. Sensitivity of this scintigraphic technique is not enough sufficient to use this test as a screening test for breast cancer, but it may provide supplemental information. Since it is not uncommon to find incidental lesions during imaging studies, examination of the image field may help clinicians find otherwise unrecognized or undiagnosed pathologies.