Summary The objective of this study was to compare the block durations and haemodynamic effects associated with intrathecal levobupivacaine or bupivacaine in elderly patients undergoing transurethral prostate surgery. Eighty patients were prospectively randomised to receive plain 1.5 ml levobupivacaine 0.5% (group levobupivacaine) or 1.5 ml plain bupivacaine 0.5% (group bupivacaine) in combination with fentanyl 0.3 ml (15 μg) for spinal anaesthesia. The time to reach T10 and peak sensory block level, and to maximum motor block were significantly shorter in group bupivacaine compared to group levobupivacaine (p < 0.05). Peak sensory block level was also significantly higher in group bupivacaine. In group bupivacaine, mean arterial pressure was significantly lower than group levobupivacaine, starting from 10 min until 30 min after injection (p < 0.05). Hypotension and nausea were less common in group levobupivacaine than group bupivacaine (p < 0.05). Because of the better haemodynamic stability and fewer side‐effects associated with levobupivacaine, it may be preferred for spinal anaesthesia in elderly patients.

Cases with traumatic CSF leakage pose a higher risk of meningitis than the cases with spontaneous CSF leakage. Topical application of fluorescein is highly specific and sensitive in identifying preoperative, intraoperative, and postoperative CSF leakage. It is a simple, quick, and sensitive technique. The surgeon should be vigilant for multiple defects.

, 46 women were prospectively enrolled in the study. Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared with histopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy.Results: Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph node dissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and 100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients. Conclusion:Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinel lymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and low accuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could not replace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique's sensitivity. These issues should be determined by comprehensive clinical trials.Keywords: Breast cancer, axillary ultrasound, axillary staging, axillary lymph node sampling, axillary fine-needle aspiration biopsy Ulus Cerrahi Derg 2016; 32: 191-196 DOI: 10.5152/UCD.2015.2913 Original Investigation and/or ultrasound or had palpable breast lump confirmed by tru-cut biopsy as invasive breast cancer constituted the study group. ABSTRACT Patient Selection CriteriaThis study included clinically node-negative early breast cancer patients. Patients with a previous history of axillary-breast surgery and/or axillary-breast radiotherapy and those diagnosed with excisional biopsy were excluded. Patients who received neo-adjuvant chemotherapy were also excluded.All patients' demographic properties, tumor characteristics (size, grade, estrogen, progesterone receptor status, HER-2 neu status), cytopathology results of FNAB and SLNB, and post-operative pathologic findings were prospectively recorded. The FNAB, SLNB, and ALND data were compared and evaluated along with patient and tumor characteristics. Radiologic Technique and CriteriaPatients who were histopathologically diagnosed with breast cancer preoperatively were referred to the interventional radiology department for axillary lymph node FNAB. The FNABs were performed by one particular radiologist experienced in breast ultrasound before the surgical intervention, after evaluating the axillary lymph node status in gray-scale using 13.5 mHz linear probe and Hitachi Avius High Vision device.

Background: To determine and compare the effects of different honey types on wound healing in an animal model, with silver sulfadiazine as the standard treatment. Materials and Methods: Five different groups were created with eight rats in each group. Partial-depth burns were created, and different types of honey and silver sulfadiazine were applied to the respective groups. Rats were monitored for 21 days, and wound cultures were obtained. Histopathological evaluation and cytokine analysis of final tissue samples were performed. In addition, the biochemical and microbiological analyses of the four types of honey used in the study were performed. Results: Wound shrinkage comparisons showed that all four honey-treated groups (Bingöl, Konya, cotton, and citrus) performed better than the silver sulfadiazine group (honey groups, respectively, 86.86%, 84.72%, 89.61%, and 95.33% vs. control 82.90%). However, only citrus honey caused a significant difference in wound shrinkage rate when compared with other groups as well with control group (95.34% vs. 82.9%, P < 0.05). In tissues, all honey groups had higher cytokine (interleukin [IL]-6, IL-1B, tumor necrosis factor [TNF]-α) values compared with controls (P < 0.001). Honey analysis showed a significant inverse relationship between Fe (iron) and the number of diastases. Conclusions: The results of this study support the role of honey in wound healing, due to its antibacterial and immunomodulatory effects. More studies are needed to identify the role of honey composition in wound healing.

Appendix vermiformis duplex is an infrequent malformation. However if it is missed out, there might be some complications and medicolegal troubles. A surgeon must be aware of any other appendix during appendectomy. Therefore, the possible locations and shapes described in the Cave-Wallbridge classification should be considered by the surgeon. In this case report, we present a patient with a horseshoe-type dupplication of appendix in a perforated appendicitis diagnosed during an emergency laparotomy.