18 research outputs found
Impact of Laparoscopic Sleeve Gastrectomy on Fatigue in Obese Patients
No full textBackground: Fatigue with obesity negatively affects the motivation to lose weight and causes failure of treatment. So, obesity and fatigue are two related entities that worsen each other in a vicious circle. This study aimed to examine the changes in fatigue levels in obese patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods: Preoperative and postoperative BMI, fat percentage, and obesity degree were determined based on Tanita test results, and the rates of change were calculated. The Fatigue Assessment Scale (FAS) was used to assess the impact of obesity on mental and physical fatigue. Results: Six months after LSG, there was a 29.7% decrease in Body Mass Index (BMI) across all patients (45.0 to 31.4, p < 0.001). Significant reductions in the percentage of body fat, obesity grade, and HgA1C were observed in both women and men and overall (p < 0.001 for all comparisons). Scores on the Fatigue Assessment Scale (FAS) for total, mental, and physical scales decreased significantly for women, men, and all participants (p < 0.001 for all comparisons). There was a weak but significant positive correlation between the percentage change in FAS total and FAS physical scale scores and the change in BMI% (p = 0.015 and 0.004; r = 0.089, 0.106, respectively). Change in obesity grade and FAS physical subscale scores negatively correlated (p = 0.029, r = 0.080). Conclusions: LSG not only leads to significant weight reduction but also improves fatigue levels in patients with obesity
Can inflammatory indices predict sentinel lymph node status in patients with early-stage breast cancer?
No full textBreast cancer research has focused on the early detection and treatment of breast cancer. Axillary lymph node status is essential for primary breast cancer staging, recurrence, and survival. The current quest for precision medicine is to identify predictive markers that offer the advantage of individualized treatment options. This study aimed to investigate the value of inflammatory indices in predicting positive sentinel nodes in breast cancer. We studied 602 patients with early-stage breast cancer who underwent sentinel lymph node biopsies (SLNB) at the Bülent Ecevit University General Surgery Clinic. We obtained data, including the clinical and demographic characteristics of the patients, such as age, histological type, and sentinel lymph nodes. Neutrophil, lymphocyte, platelet, and monocyte counts were obtained from preoperative complete blood count test data from the patient registry. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), and sentinel lymph node biopsy were analyzed. Sentinel LAP was negative in 391 (65%) patients and positive in 211 (35%). In the receiver operating characteristic curve analysis, no significant difference was found between SLNB positivity and negativity in terms of NLR, PLR, LMR, or SII. In contrast to previous research, NLR, PLR, LMR, or SII did not affect SLNB positivity prediction in our study.</jats:p
Intragastric botulinum toxin injection: a promising alternative for obesity treatment?
No full textIntroduction
Over the past 50 years, the rise in obesity has prompted a search for new treatments. Intragastric injections of botulinum toxin A (BT-A), a safer alternative to surgery, show promise in reducing weight and caloric intake by inducing early satiety. This study examines their efficacy for weight loss.
Material and methods
From 2021 to 2023, we conducted a retrospective analysis of patients who underwent intragastric BT-A injections in a general surgery endoscopy unit. The inclusion criteria were being aged 18–65 and having a body mass index (BMI) over 25 kg/m 2 . Patients with specific medical conditions or incomplete records were excluded. We monitored patient weight and BMI values before the procedure and at monthly intervals, with further assessments conducted in the sixth month, including appetite and patient satisfaction.
Results
Our study on 67 patients, predominantly female (82.1%), aged 35.5 ±9.0 years with a mean BMI of 33.5 ±3.3 kg/m², examined BT-A injections’ effectiveness. 58.2% received injections in both gastric antrum and fundus regions, showing greater weight loss (mean: 10.7 ±7.0 kg) than those treated in the antrum alone. Side effects occurred in 16.4%, with various symptoms. High dietary compliance (80.6%) correlated with weight loss, especially among those reporting intense satiety. Patient satisfaction positively correlated with weight loss, highlighting treatment efficacy and patient response to dual-region injections.
Conclusions
Our study suggested that intragastric BT-A injections in the antrum and fundus are effective and safe for satiety and weight loss, with few side effects. Individual responses vary, and diet adherence is crucial. More studies are needed to assess the treatment’s efficacy in obesity
Lumbar Suturing with Pack Needle in the Management of Low Back Pain: A False Non-Medical Manipulation
No full textLow back pain is a common pathology in all societies and it has an important effect on health costs. Although low back pain is too often, problems are being still experienced in the management of it and these problems sometimes lead to seeking of non-medical methods. Herein, we present method of lumbar suturing with pack needle performed by a health merchant and results of this application
Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy
No full textAxillary staging is 1 of the major issues of current breast cancer management after neoadjuvant systemic therapy (NST). Sentinel lymph node biopsy (SLNB) is an option for clinically node negative patients. Axillary reverse mapping (ARM) was introduced to identify and preserve the lymphatic drainage from the arm. The aim of the presented study is to employ triple mapping (radiocolloid, blue dye and indocyanine green [ICG]) to assess the crossover rate and metastatic involvement of ARM nodes after NST. Clinically node positive patients before NST who were converted to N0 and scheduled for targeted axillary dissection were included. sentinel lymph node (SLN) mapping was performed via dual agent mapping. ICG was used for ARM procedure. Blue, hot and fluorescent nodes and lymphatics were visualized in the axilla using infrared camera system and dual opto-nuclear probe (Euoroprobe3). Fifty-two patients underwent targeted axillary dissection and ARM procedures 12 out of whom had axillary node dissection. 45 of the 52 patients had at least 1 hot or blue SLN identified intraoperatively. Of these, 61.5% cases had hot SLNs, 42.3% had hot and blue, 15.4% had hot/blue/fluorescent, 7.7% had blue/fluorescent, 6 11.5% had hot/fluorescent and 7 13.5% had only clipped nodes. The overall identification rate of ARM-nodes by means of ICG technique was 86.5%. Overall crossover of ARM nodes with SLNs was determined in 36.5%. The ICG intensity was found to be higher in both hot and blue SLNS (8 out of 18 ICG positive cases, 44.4%). In 3 of 52 patients (5.7%) metastatic SLNs were hot or blue but fluorescent which predicts metastatic involvement of the ARM-nodes. More than 1-third of the patients revealed a crossover between arm and breast draining nodes. The higher observed rate of overlap might partially explain why more patients develop clinically significant lymphedema after NST even after sentinel lymph node biopsy alone. The triple mapping provides valuable data regarding the competency of lymphatic drainage and would have the potential to serve selecting patients for lymphovenous by-pass procedures at the index procedure. NST reduces the metastatic involvement of the ARM nodes. However, conservative axillary staging with sparing ARM nodes after NST necessitates further studies with larger sample size and longer follow-up.</jats:p
The Cure for Idiopathic Granulomatous Mastitis without Surgery and Steroids: One Size Does Not Fit All
No full textAim: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking malignancy with no consensus on the optimal treatment. We aimed to present a single-center algorithm for IGM treatment without surgery and steroids. Material and Methods: This study was conducted at Bülent Ecevit University Hospital, Zonguldak, Turkey, between 2010 and 2020. A prospective database was reviewed to identify patients with biopsyproven IGM who were managed through observation and ultrasound-guided interventions over a 10- year period. Results: Seventy-eight female patients with a confirmed diagnosis of IGM via reevaluation were determined. Of these, 34.61% required ultrasound-guided abscess aspiration and 10.25% required incisional abscess drainage without surgical resection. Complete clinical resolution was achieved within 6 months in 58.97% cases. The overall recurrence rate was 12.82%, and surgical drainage was required in one patient. Univariate logistic regression analysis revealed no statistically significant association between recurrence and the demographic or pathologic factors evaluated. Twenty-two (28.2%) patients with a histopathologic diagnosis of cystic İGM who received antibiotics (doxycycline) achieved complete resolution within 2 weeks and experienced no recurrence. Conclusion: IGM is a self-limiting disease that resolves spontaneously independent of medical intervention and without resection in up to 18 months. After diagnosis, surgery with or without steroids as the first line of therapy should be replaced with close observation and ultrasound-guided interventions according to patients’ preferences.</jats:p
Impact of magnesium on intraperitoneal adhesion in an experimental rat model
No full textIntraperitoneal adhesions are fibrous bands that form between tissues and organs in the abdominal cavity, which can result from the body's healing process after surgery, leading to pain, bowel obstruction, and infertility in severe cases. Magnesium (Mg), known for its anti-inflammatory and anticoagulant properties, has been hypothesized to influence adhesion formation.This study is designed to explore the hypothesized benefits of Mg, known for its anti-inflammatory and anticoagulant properties, on the prevention of intraperitoneal adhesions that commonly occur following abdominal surgeries. It seeks to provide a comprehensive understanding of Mg's potential role in mitigating adhesion formation, aiming to contribute valuable insights into postoperative recovery processes and outcomes.We employed an experimental model of intestinal abrasion in male Wistar rats. The rats were categorized into control and treatment groups, with the latter receiving varying doses of Mg sulfate. Intraperitoneal adhesions were induced using a multi-abrasion model.Based on both the Evans model and histopathological evaluations, it was observed that there were significant differences in adhesion scores between the groups. Magnesium-treated groups showed significantly fewer adhesions than the control group. Histopathological analyses indicated variations in adhesion characteristics and inflammatory responses among the groups.Preliminary results indicated the potential role of Mg in mitigating postoperative intraperitoneal adhesions. These findings suggest the need for further research to confirm the efficacy of Mg and to explore its mechanisms of action in clinical settings
Utilizing Surgeon-Performed Intraoperative Translaryngeal Ultrasound for Verifying Vocal Fold Function: A Troubleshooting Approach for Intraoperative Neuromonitoring in Neck Surgery
No full textWe investigated transcutaneous laryngeal ultrasonography (TLUS) for assessing vocal fold (VF) mobility during thyroid and parathyroid surgeries, emphasizing its precision and utility in signal loss scenarios.Between October 2020 and January 2023, we performed TLUS, Doppler sonography, laryngeal twitch response (LTR) palpation, and electromyography (EMG) to monitor recurrent laryngeal nerve function during neck surgeries. Postoperatively, the VF activity was verified using fiberoptic video laryngoscopy (FL). Concordance with FL was categorized based on VF activity.Of the 443 VF evaluations, no instances of permanent bilateral paralysis were noted. Temporary unilateral palsy was found in 3.38% and permanent in 0.45%. TLUS displayed 97.8% agreement with EMG and was diagnostically superior (99.7% vs 98.2%) and more affordable (300) compared to analogous operative durations.TLUS rivals EMG in terms of intraoperative neuromonitoring accuracy and outperforms LTR. Being cost-effective, TLUS can effectively address signal loss situations, thereby averting additional surgeries
Predicting coexisting thyroid cancer with primary hyperparathyroidism in an endemic region of multinodular goiter: evaluating the effectiveness of preoperative inflammatory markers
No full textThe aim is to examine the efficacy of inflammatory indicators to predict thyroid cancer in patients with primary hyperparathyroidism (PHPT) in an endemic region of nodular goiter.The prospective database was reviewed to identify patients operated on with the diagnosis of PHPT and thyroid disease between April 2015 and June 2021. Permanent pathologic reports were used as the gold standard for diagnosis. Detailed imaging data with peripheral blood inflammation indices were analyzed to assess their predictive values for concomitant PHPT with thyroid cancer. Postoperative complications and the duration of hospitalization were also reviewed.Thyroid malignancy accompanying PHPT was found in 13 patients (26.0%) out of 50 who had concurrent surgery. The analysis regarding inflammatory indexes revealed nothing significant between thyroid cancer and preoperative blood biochemistry (P > 0.05). In the concurrent surgery group, recurrent laryngeal nerve injury was observed in 1 patient (2.0%) and the mean hospital stay was longer.In endemic regions of nodular thyroid disease, thyroid cancer might accompany PHPT. The value of inflammatory indexes to predict thyroid malignancy in PHPT is controversial and should not be employed in the surgical decision-making process
