Our experience suggests that the use of primary repair in grade III injury may be associated with higher duodenum-related morbidity. Our recommendation is to use complex repair for grade III duodenal injuries.

Background: Approximately 20% of the thyroid biopsies render an indeterminate (ID) cytology. We evaluated the diagnostic value of preoperative modified systemic inflammation score (mSIS) in predicting the malignancy of ID thyroid nodules (TNs). Methods: Data of 162 patients with indeterminate TNs were examined retrospectively. The mSIS was calculated as follows: mSIS 0 [patients with albumin (ALB) ! 4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) ! 3.4], mSIS 1 [ALB < 4.0 g/dL or LMR < 3.4], and mSIS 2 [ALB < 4.0 g/dL and LMR < 3.4]. Results: Patients were classified into mSIS 0 (n ¼ 105), mSIS 1 (n ¼ 34) and mSIS 2 (n ¼ 23) groups. The malignancy rates for the mSIS 0, 1 and 2 groups were 34.3%, 64.7% and 100% respectively. Preoperative mSIS was significantly associated with the presence of thyroid malignancy (p < 0.001). Conclusions: If the mSIS of patients with ID cytology is 1 or 2, appropriate surgical treatment should be performed without delay, due to the increased risk of malignancy.

This study aimed to establish a strong regression model by revealing the preoperative predictive factors for sentinel lymph node (SLN) positivity in patients with early stage breast cancer (ESBC). In total, 445 patients who underwent SLN dissection for ESBC were included. All data that may be potential predictors of SLN positivity were retrospectively analyzed. Tumor size >2 cm, human epidermal growth factor receptor 2 (HER2) + status, lymphovascular invasion (LVI), palpable tumor, microcalcifications, multifocality or multicentricity, and axillary ultrasonographic findings were defined as independent predictors of SLN involvement. The area under the receiver operating characteristic (ROC) curve (AUC) values were 0.797, 0.808, and 0.870 for the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram, MD Anderson Cancer Center (MDACC) nomogram, and our regression model, respectively (P < .001). The recent model for predicting SLN status in ESBC was found to be stronger than existing nomograms. Parameters not included in current nomograms, such as palpable tumors, microcalcifications, and axillary ultrasonographic findings, are likely to make this model more meaningful.

earthquake struck the Pazarcık district of Kahramanmaras, Türkiye at 04:17 A.M. local time, followed by another magnitude of 7.6 (Mw) earthquake in the Elbistan district of Kahramanmaras at 01:24 P.M. local time on the same day. A large area in Türkiye and Syria was affected by these successive earthquakes. Hundreds of thousands of individuals were injured and thousands lost their lives due to collapsed buildings. As a result of the destructive impact of the earthquake, millions of individuals were forced to migrate.The injury patterns of those trapped under the rubble vary widely, ranging from severe organ injuries that lead to sudden death to non-fatal minor skin abrasions. While musculoskeletal injuriesObjectives: This study aims to investigate the types of wounds and wound care in earthquake victims rescued from collapsed buildings after the 2023 Kahramanmaras earthquake. Patients and methods: Between February 8 th , 2023 and March 1 st , 2023, a total of 94 patients (46 males, 48 females; mean age: 40.2±15.5 years; range, 16 to 77 years) with earthquake-related wounds who were trapped under rubble were retrospectively analyzed. Data including age, sex, duration of being trapped under rubble, type and location of the wound, bacterial cultures from deep tissue, and wound care methods used were recorded. Results:The mean duration of being trapped under rubble was 58±38.1 h. Wounds were most commonly located on the lower extremities, followed by the upper extremities. The most common type of wounds were abrasions, followed by necrotic wounds due to crushing. Wound and skin antiseptics, debridement and negative pressure wound therapy (NPWT) were the most common wound care methods used. Conclusion: Various types of injuries and wounds may occur after natural disasters. Chronic wound care is as important as the management of life-threatening acute pathologies. Preparations should be made properly for the long-term treatment of patients after disasters. Methods such as NPWT, debridement creams containing collagenase, wound and skin antiseptics, and hyperbaric oxygen therapy can provide satisfactory short-term results. A broader and more intense application of these treatments is thought to be beneficial, particularly in crush injuries.

The aim of this study is to compare patients with and without mastalgia and to analyze the factors affecting mastalgia and its severity. The patient’s age, height, weight, educational status, marital status, and occupation were recorded in all subjects. In addition, the women were asked about the presence of any risk factors for mastalgia, such as tea and coffee consumption, smoking, alcohol consumption, and weight gain. The sternal notch to nipple distance (SNND) was measured to determine whether there was breast sagging. Mastalgia was significantly more common in women with BMIs of > 30 kg/m2 (OR: 2.94, CI 1.65–5.24), those who were primary school graduates or illiterate (OR: 2.96, CI 1.6–5.46), and those with SNND values of 22–25 cm (OR: 2.94, CI 1.79–4.82). In these women, drinking more than 6 cups of tea a day (OR: 2.15, CI 1.32–3.5), smoking at least 10 cigarettes a day (OR: 2.94, CI 1.78–4.83), and drinking alcohol at least once a week (OR: 2.1, CI 1.12–3.91) were found to be important factors that increased the risk of mastalgia. As a result, it has been found that severe mastalgia complaints cause by obesity, sagging breasts, never giving birth, unemployment anxiety, regular smoking, alcohol use, and excessive tea consumption.