The purpose of this study was to analyze the clinical features and demographic data of patients with idiopathic granulomatous mastitis (IGM) and to compare the results of conservative versus surgical treatment protocols. The demographic data, clinical findings, microbiological and pathologic features, scanning and treatment methods, recurrence, and recovery rates of 77 patients were analyzed retrospectively. The patients were divided into two groups based on the type of treatment received. Core biopsies were used to diagnose 37 patients: 26 using incisional biopsies and 14 using excisional biopsies. Of the patient population with IGM, 31 were treated with surgical excision, one with a simple mastectomy, and one with a subcutaneous mastectomy combined with a breast implant, whereas 44 were treated with steroids. The recovery rates of the 44 patients who were treated conservatively were 6 (1-15) months while for the 33 patients who were treated surgically, it was 1 (1-5) month (p = 0.001). Nine patients from the conservative treatment group experienced a recurrence while there were no recurrences in the surgically treated group (p = 0.009). Among all patients, the recurrence rate was 11.7% (9/77) while the average follow-up period was 16.57 ± 18.57 months. As a comparative study between conservative treatment protocols and surgical ones for patients with idiopathic granulomatous mastitis (IGM), this study is the largest to date. A wide surgical excision is the preferred approach for treating patients with IGM because of the low recurrence rate.

Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, mainly because of delayed diagnosis. The objective of this study was to investigate the clinicopathologic features and prognostic factors for PSRCCR. This is a retrospective study including the data of 22 patients with PSRCCR who underwent surgery. Patients were categorized by age, sex, tumor site, and stage. Fifteen patients were male. Median age was 40 years. Sites for metastases were lymph nodes (86.4%), peritoneum (40.9%), and liver (9.1%). Most of the patients (91%) had stage III or IV tumors. The rates of curative and palliative resections performed were equal. Mean overall survival and mean progression-free survival times were found to be 33.3 6 7.1 months (95% confidence interval, 19.4-47.2 months) and 11.8 6 3.5 months (95% confidence interval, 4.9-18.7 months), respectively. It was concluded that site of the tumor, presence of bowel obstruction, peritoneum and lung metastases, adjacent organ infiltration, TNM stage, and efficiency of surgery have significant effects on survival. All in all, these aggressive tumors are generally diagnosed at advanced stages. Depending on the situation, survival is shorter. A high degree of vigilance is required for these patients to avoid the negative impact of late diagnosis on survival.

Serum PTH levels at postoperative 12 and 24 h can predict early post-thyroidectomy hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe.

Objective: Assessment of frequency and clinical findings of parasitic infections for etiology of acute appendicitis. Methods: Data of 1452 patients who were carried out appendectomy between January 1999 and December 2012 were analyzed retrospectively. Appendectomy was performed in 1159 of the patients with a pre diagnosis of acute appendicitis. Demographics, physical findings, radiologic and laboratory studies, operative findings, pathological results, presence and type of parasitosis were investigated. Results: Among the 1159 patients done appendectomy with a pre diagnosis of acute appendicitis, 719 (62%) were males and 440 (38%) were females. Parasitic infection was demonstrated in 17 (1.4%) of them. Mean average age of these patients was 36.6±20.1 years. Enterobius vermicularis was present in 15 (88.2%) and Entamoeba histolytica in 2 (11.8%) of the patients. Of the pathology specimens of appendix consisting Enterobius vermicularis, 12 (80%) were normal appendix tissues, 1 (6.6%) was acute uncomplicated appendicitis and 2 (13.3%) were perforated appendicitis. One (50%) of the two specimens consisting Entamoeba histolytica was normal appendix and the other (50%) was acute appendicitis. Conclusion: Differential diagnosis of parasitic infections in etiology of acute appendicitis should be made properly. It must be remembered that this attention can save patients from a negative laparotomy and morbidity and mortality of it. (Turkiye Parazitol Derg 2014; 38: 12-6) (Turkiye Parazitol Derg 2014; 38: 12-6)

Background:Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis.Objectives:This retrospective study was conducted to document the unusual findings in appendectomy specimens.Patients and Methods:Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients’ age, gender, clinical presentations, operative reports, pathological reports and follow up.Results:Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 ± 19. Twenty-nine patients (50.8 %) were male and 28 (49.2 %) were female. Normal appendix tissues were observed in specimens of 26 (45.6 %) patients and inflamed appendix in 31 (54.3 %). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology.Conclusions:Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.

Wound infections and seroma formations are important problems in ventral hernia repair operations using synthetic mesh grafts. The aim of this study was to investigate the effect of the use of synthetic mesh soaked in vancomycin solution on the rate of graft infection. The total number of subjects was 52. The subjects were randomized into 2 groups using a software program. Group 1 (n = 26) was the control group. In group 2 (n = 26), synthetic mesh was soaked in a Vancomycin solution before it was implanted. The patients were compared with respect to demographic characteristics and preoperative, intraoperative, and postoperative variables. There were no significant differences between the groups with respect to the available variables. Seroma development was significantly more common in group 2 (P < 0.041). Three patients (5.7%) developed superficial wound infection, and 9 (17%) developed surgical site infection 2-type wound-site infection. No significant difference was found between the groups in terms of infection. The use of synthetic mesh soaked in vancomycin solution had no beneficial effects on the rate of wound-site infection. Future randomized, controlled, large-scale studies using the same mesh and suture types, and meshes soaked in larger spectrum antibiotics are needed.

We believe that this type of fistula should be the first option in patients in whom the cephalic vein is inappropriate for a vascular access. Preoperative evaluation of the arterial system as well as a history of previous access failure may be considered predictive parameters for the patency of the fistulae.

BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation.