Celiac disease and COVID-19 pandemic: should we worry?

BACKGROUND AND STUDY AIMS: The Coronavirus Disease 2019 (COVID-19) epidemic especially worries people with chronic diseases the entire world. In this study, the frequency, and clinical course of COVID-19 infection in patients with Celiac disease (CD) were investigated. CD patients' adherence to purchasing gluten free products (GFPs), the strict diet, and how patients' anxiety affects CD symptoms during the COVID-19 outbreak were also examined. PATIENTS AND METHODS: A detailed questionnaire was administered by telephone and emailed to the CD patients to determine the status of these patients in obtaining GFPs, and dietary compliance during the COVID-19 pandemic. State and trait anxiety levels of patients were evaluated using the State-trait Anxiety Inventory (STAI) scale. Additionally, whether patients with CD were diagnosed with COVID-19, and if diagnosed, their clinical course of the disease were investigated. RESULTS: One hundred and one patients were included in the study. The total number of patients who could obtain GFPs decreased significantly in the pandemic than before the pandemic. The patients' state anxiety index was 40.7±7.9, and the trait anxiety index was 44.5±8.5, and all patients were evaluated as mildly anxious. During the pandemic, two female patients were diagnosed with COVID-19. CONCLUSION: CD patients did not have any additional risk compared to other individuals in terms of becoming infected with COVID-19 for patients under gluten free diet, and these patients will have a similar clinical course as individuals without CD.

Unpredictable behavior of breast phyllodes tumors.

OBJECTIVE: Phyllodes Tumor is a rare fibroepithelial breast tumor with variable malignant potential. These tumors that currently accepted nomenclature are benign, borderline and malignant according to the World Health Organization. It tends to behave in a benign way but it may undergo a malignant transformation. The purpose of this study was to present our Case load of phyllodes tumor, and evaluate the management and follow-up the behavior of these tumors. PATIENTS AND METHODS: 36 patients with phyllodes tumor were treated in Bezmialem Vakif University and Okmeydani Training and Research Hospitals analyzed retrospectively. Demographics, presenting symptoms, history, local examination, preoperative clinical diagnosis, treatment, postoperative histopatology, follow-up period were evaluated retrospectively and studied. RESULTS: A total of 36 patients treated for phyllodes tumor were analyzed. Mean age of the patients was 38 (14-79) and all were females. The presentation of the patients was breast lump in all cases, either as a primary or recurrent lump presentation. The right and left breast were affected 58% and 42% respectively. 34 of these 36 cases are briefly mentioned in this paper but the two cases, one with sarcomatous malignant transformation and the other with fatal metastatic phyllodes tumor in an adolescent female are discussed in detail. The mean duration of the symptomatic mass was 9.8 ± 7.3 months (range 0.5 to 24). CONCLUSIONS: Phyllodes tumor is a type of tumor that may be benign or malignant. The type with malignant features may be fatal. The tumors diagnosed as benign may transform and become malignant because of unknown reasons and may be an aggressive tumor.

A randomized, placebo controlled study: EMLA in minor breast surgery.

AIM: Patients undergoing excision for breast lumps prefer general anesthesia or local anesthesia plus sedation, because of the fear of pain for local anesthesia alone. The aim of this study is to show the efficacy of an eutectic mixture of local anesthetic lignocaine and prilocaine (EMLA®) in these patients. METHODS: This study has been designed randomized, placebo-controlled. Forty five patients undergoing excision for breast lumps were divided into three groups. The first group was administered local EMLA cream preoperatively (Group I, N.=15), the second group (Group II, N.=15) had no preoperative preparation and the third group was placebo group (Group III, N.=15). All groups underwent the operation under local anesthesia. Pain during the local anesthesia and three hours after the operation were assessed using the visual analog scale. The amount of local anesthetic used during the operation and the anesthetic need of patients after the operation were assessed. RESULTS: When the three groups were compared, it was found that the intensity of pain in the group with EMLA was considerably lower during and after the operation (P<0.05). The amount of local anesthetic used during the operation was lower (P<0.05) and the need for post-operative analgesic was also less than the usual (P<0.05). CONCLUSION: Topical EMLA use decreases the pain, provides per-operative and postoperative patient and physician comfort, improved patient's compliance, and simplifies the surgical procedure. This is the first study demonstrating that a topical anesthetic provides a non-invasive analgesia during benign breast mass excision.