Melatonin may have a positive effect on both angiogenesis and wound healing.

Objective: The incidence of and risk factors for hypocalcemia following thyroidectomy were evaluated in this study. Material and Methods:One hundred and ninety thyroidectomy patients were evaluated retrospectively for factors that might contribute to postoperative hypocalcemia; age, hyperthyroidism, malignancy, the extent of surgery (total/near total/subtotal thyroidectomy), cervical lymph node dissection, and incidental parathyroidectomy. Results:The rate of transient hypocalcemia/hypoparathyroidism was 19.47%, with a permanent hypoparathyroidism rate of 4.74%. Factors affecting the development of transient hypocalcemia were found as being operated for hyperthyroidism, and use of total thyroidectomy as the surgical method. Total thyroidectomy increased the risk of postoperative hypocalcemia by 3.16 fold. Patients undergoing operations for hyperthyroidism had a 2.3 fold increase, and those undergoing total thyroidectomy had a 3.16 fold risk of postoperative hypocalcemia. Conclusion:Hyperthyroidism surgery and total thyroidectomy lead to a higher risk of developing early postoperative or transient hypocalcemia. According to our results, no significant relationship could be established between any of the study parameters and persistent hypocalcemia.

CIAD applied with a standardized technique reduced anal canal resting pressure and provided symptomatic healing that was equivalent to a LIS. Since there were no findings of incontinence, or situations which resulted in sphincter damage, we conclude that CIAD is suitable for patients with chronic anal fissures because it is less invasive than LIS, with equivalent efficacy and safety. In addition, the CIAD method may be an alternative procedure in older and multiparous women who has a higher risk of incontinence.

Laparotomy was required in only 11.1% (4/36) of the cases with LTSWs and 30.8% (4/13) of the cases with diaphragmatic injury. Diagnostic and therapeutic laparoscopy was a sufficient and necessary surgical procedure in cases with a hemodynamically stable LTSW, when emergency surgery (laparotomy or thoracotomy) was not necessary.

The presence of certain defects in both cellular and humoral immunity after thermal injury has been established. Likewise, the translocation of enteric bacteria to the mesenteric lymph nodes and to distant organs has also been observed following serious thermal injury. The effects of granulocyte colony-stimulating factor (G-CSF) on bacterial translocation, the small bowel mucosa, and cecal bacterial content were investigated in a rat model of burn wound sepsis in which albino Wistar rats were scalded over 30% of their bodies, after which the lesions were infected by 1 x 10(8) colony-forming units (cfu) Pseudomonas aeruginosa. The control group was treated with 5% dextrose solution subcutaneously starting 2 days preburn, while the treatment group received 100 microg/kg human G-CSF subcutaneously. On the 4th day post burn all animals were killed to examine the bowel and culture of the mesenteric lymph nodes (MLN), livers, and spleens. No significant differences were observed between the groups regarding the cecal bacterial content and small bowel; however, a difference was seen in the ratio of translocation in the MLN liver and spleen and quantitative MLN cultures. Based on these findings, G-CSF was thus found to be significantly effective in reducing bacterial translocation due to burn wound sepsis.

No abstract

Context: Discutăm despre rolul indicatorului de risc de laborator pentru fasceita necrozantă (LRINEC) asupra prognosticului acestei boli. Fasceita necrozantă (NF) se caracterizează prin răspândirea rapidă a infecţiei şi a necrozei ţesutului moale şi a fasciei. Metode: Treizeci de pacienţi (17 bărbaţi, 13 femei, vârsta medie 57,5 ani) au fost trataţi în perioada 2011-2016; au fost analizaţi retrospectiv în ceea ce priveşte vârsta, sexul, agenţii microbiologici izolaţi, modalităţile de tratament şi rata mortalităţii. Rezultate: Majoritatea infecţiilor au fost detectate în perineu (14, 46,7%), alte localizări ale infecţiei fiind regiunea presacrală (3, 10%), regiunea abdominală după intervenţie chirurgicală de elecţie (10,33,3%) şi intervenţie chirurgicală de urgenţă (2, 6.7%). 53,3% dintre pacienţi au prezentat cel puţin un factor comorbid predispozant, cum ar fi diabetul zaharat, hipertensiunea, cardiomiopatia şi insuficienţa cardiacă congestivă. Culturile de ţesut au fost pozitive la 12 (40%) pacienţi. Scorul mediu LRINEC la internare a fost de 8,5 ± 2,85. A existat o corelaţie puternică între scorul LRINEC şi vârsta pacientului (p = 0,018, R = 0,43). Scorul LRINEC nu a fost afectat nici de sex, nici de prezenţa oricăror comorbidităţi. Pacienţii au fost clasificaţi conform sistemului de stadializare Wang şi Wong: 1 pacient în stadiul 1 (3,3%), 15 în stadiul 2 (50%) şi 14 în stadiul 3 (46,7%); pacienţii cu stadii Wang şi Wong mai mari aveau scoruri LRINEC semnificativ mai ridicate. Rata mortalităţii este de 16,7%.

Results suggest that noninfected gallstones and sterile bile, even in combination, do not increase postoperative intraabdominal complications in rats.