Background Idiopathic granulomatous mastitis (IGM) is a benign disorder of the breast, for which the optimal treatment modality remains missing. Methods A total of 124 patients with a histopathologically proven diagnosis of IGM were enrolled in a prospective, randomized parallel arm study. Patients were treated with topical steroids in Group T (n: 42), systemic steroids (0.8 mg/kg/day peroral) in Group S (n: 42), and combined steroids (0.4 mg/kg/day peroral + topical) in Group C (n: 40). Compliance with the therapy, response to the therapy, the duration of therapy, side effects and the recurrence rates were compared. Results Sixteen patients did not comply with the treatment, and the highest ratio of compliance with therapy was seen in Group T (p < 0.05). Complete clinical regression (CCR) was observed in 90 (83.3%) patients. Response to the treatment (RT) was evaluated radiologically and observed in 89.8% of the patients. There was no statistically significant difference between groups regarding CCR, RT and the recurrence rate. The longest duration of therapy was observed in Group T (22 ± 9.1‐week), whereas the shortest was observed in Group S (11.7 ± 5.5‐week) (p < 0.001). The systemic side effects were significantly lower in Group T in comparison with Groups S and C (2.4% vs. 38.2% and 30.3%, respectively) (p < 0.001). Conclusions The efficiency of the treatment was similar for all groups, both clinically and radiologically. Although the duration of therapy was longer in Group T, the lack of systemic side effects increased the compliance of the patients with the therapy. Therefore, topical steroids would be among first‐line treatment options of IGM.

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Aim: The aim of this study is to show the effect of simvastatin on intra-abdominal adhesion formation. Method: Adhesion formation was achieved by scratching the cecum and anterior abdominal wall following median laparotomy. Three different groups of 10 rats each were formed. In group I, 0.57 mg/kg/day simvastatin was injected intraperitoneally right after the operation and for 5 days thereafter. In group II, an equal dose of simvastatin to that used in group I was given via gavage. A physiological saline solution was given to group III for the same period of time. On the 6th and 14th day, blood samples were taken and peritoneal lavage was performed to measure the tissue-type plasminogen activator (t-PA) activity. Adhesions were graded via re-laparotomies on the 14th day after the first operation. Results: The adhesion scores were 1.40 ± 0.22, 1.50 ± 0.26, and 2.90 ± 0.34 in groups I, II, and III, respectively (p = 0.007), and the score was higher in group III than in the other groups (p = 0.005, p = 0.011). Conclusion: Intraperitoneal simvastatin application decreases adhesion formation by increasing the t-PA level in abdominal surgery.

Background To investigate the relationship between primary hyperparathyroidism (pHPT) and papillary thyroid cancer (PTC). Methods The perioperative findings of 275 patients with pHPT who underwent surgery between January 2014 and December 2017 were retrospectively reviewed. Thirty-one patients were diagnosed with pHPT and PTC concurrently. Pathology results and demographic findings of these patients were compared with 186 patients who underwent thyroidectomy and diagnosed with PTC at the same time interval. ResultsThe co-occurrence of pHPT and PTC was 11.3% (31/275). The median ages of the pHPT, pHPT ? PTC, and PTC groups were 55, 57, and 50 years old, respectively (p \ 0.001). The diameter of tumor was smaller in the pHPT ? PTC group [median 7 mm (range 0.5-25 mm) vs. 15 mm (range 1-100 mm)], with higher rates of microcarcinomas (p \ 0.001), than the patients in the PTC group. Examination of tumor morphology showed higher rates of tumor capsule invasion and multicentricity in the pHPT ? PTC group than those in the isolated PTC group (p = 0.02, p = 0.04, respectively). Conclusion The pHPT ? PTC group had significantly smaller tumor diameter than the PTC group. This result may support the idea that pHPT leads to overdiagnosis of PTC. However, observation of high rates of tumor capsule invasion and multicentricity in the pHPT ? PTC group may suggest an associative etiology with more aggressive PTC.

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Aim: Postoperative intra-abdominal adhesion formation is a significant cause of morbidity. The aim of this study was to assess the effects of heparin and Seprafilm, which is considered the gold standard, on the prevention of intra-abdominal adhesions. Method: Four groups consisting of 25 rats each were formed. Cecal abrasion was performed in all animals. Group 1 was the control group with no treatment; in group 2, heparin was applied intraperitoneally; in group 3, Seprafilm was used underneath the abdominal wall, and group 4 animals were treated with both heparin and Seprafilm. Two weeks after the surgical procedure, animals were sacrificed and specimens were removed for the measurement of the grade of adhesions, according to the Mazuji classification. Results:Formation of adhesions was prevented in the three study groups treated with heparin only, Seprafilm only and both heparin and Seprafilm (p < 0.001) compared with the control group. There was no statistical difference between the treatment groups. Autopsy results of the animals that died within the first week after the surgical procedure revealed intra-abdominal abscess formation and infections, which were considered as possible causes of death. Conclusion:Seprafilm seems to be more effective in the prevention of adhesions. In the combined application of Seprafilm and heparin, heparin showed no additive impact. Future studies are needed to detect the suitable dose and side effects of heparin for humans.