Medical Bulletin of Sisli Etfal Hospital最新文献

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Identification of Risk Factors for Mastalgia and Its Relationship with Benign or Malignant Breast Diseases. 确定乳腺增生的风险因素及其与良性或恶性乳腺疾病的关系。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.75002
Banu Yigit, Gulhan Kilicarslan, Bulent Citgez
{"title":"Identification of Risk Factors for Mastalgia and Its Relationship with Benign or Malignant Breast Diseases.","authors":"Banu Yigit, Gulhan Kilicarslan, Bulent Citgez","doi":"10.14744/SEMB.2023.75002","DOIUrl":"10.14744/SEMB.2023.75002","url":null,"abstract":"<p><strong>Objectives: </strong>Mastalgia is a medical condition that primarily affects women of all age groups. Affected individuals experience excruciating pain, tightness, or a burning sensation in the breast tissue. The aim of this study is to observe the clinicopathologic features of women with mastalgia and compare these features with asymptomatic cases.</p><p><strong>Methods: </strong>A total of 524 female patients who applied to the general surgery outpatient clinic were prospectively evaluated. The patients were divided into two groups. Group 1 (G1) included patients with mastalgia, while Group 2 (G2) included asymptomatic patients. The two groups were compared in terms of clinical, radiological, and pathological features.</p><p><strong>Results: </strong>This study was conducted on 524 women, among whom the prevalence of mastalgia was found to be 61.45%. There were 322 patients in G1 and 202 patients in G2. The mean age was significantly higher in G2 compared to G1 (46.33±10.33 vs. 43.58±10.33, respectively; p=0.001). Premenopausal women rates for G1 and G2 were 73.91% and 59.4%, respectively (p=0.001). The regular exercise rate in G1 was 18.01%, while it was 25.74% in G2 (p=0.034). The past history of breast cancer rate was significantly higher in G2 than in G1 (p=0.015). The consumption of analgesics was significantly lower in G2 compared to G1 (p=0.05). Non-steroidal anti-inflammatory drugs were the most commonly used analgesic drug class in both groups, with significant intergroup differences (G1: 27.63%, G2: 19.8%, p=0.043). Screening mammography with or without ultrasound examination was performed significantly more often in G2 compared to G1 (66.33% vs. 55.27% and 82.17% vs. 72.98%, p=0.012 and p=0.016, respectively). No significant difference was found concerning the frequency of benign or malignant pathologies between the groups.</p><p><strong>Conclusion: </strong>Breast pain is common and should be considered physiological without other breast symptoms and after excluding non-breast causes. It is safe to provide symptom control advice and reassurance to patients who have breast pain but do not have signs or symptoms indicating a possible serious underlying condition requiring further medical intervention.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is Lateral Onset Cross Pin Technique Strong Enough? A Biomechanical Study. 侧向起动十字栓技术是否足够强大?生物力学研究。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.87528
Ahmet Oztermeli, Nazim Karahan, Murat Kaya
{"title":"Is Lateral Onset Cross Pin Technique Strong Enough? A Biomechanical Study.","authors":"Ahmet Oztermeli, Nazim Karahan, Murat Kaya","doi":"10.14744/SEMB.2023.87528","DOIUrl":"10.14744/SEMB.2023.87528","url":null,"abstract":"<p><strong>Objectives: </strong>It is aimed to compare biomechanically the 3 different pin techniques and the lateral onset cross-pinning (LXP) technique in supracondylar humeral fractures.</p><p><strong>Methods: </strong>Biomechanical testing was performed on 52 synthetic humeriFour pin configurations techniques were tested: crossed pins (XP), 2 lateral pins (2LP), 3 lateral pins (3LP), and LXP technique. Biomechanical testing was performed on Shimadzu Autograph measuring machine. Each pin configuration was tested in a total of 13 humeri: 4 in varus bending, 4 in valgus bending, and 5 in flexion bending. Displacement (mm), and load (N) data were sampled at 10 Hz during each test.</p><p><strong>Results: </strong>Varus values were statistically lower in 2 LP group comparing to XP, 3 LP, LXP groups (p=0.01, p=0.02, p=0.012, consequently). Flexion load values statistically lower in 2 LP group comparing to XP, 3 LP, LXP groups (p=0.03, p=0.001, p=0,031, consequently). There was no difference between the groups in terms of valgus values (p>0.05).</p><p><strong>Conclusion: </strong>LXP technique is biomechanically similar to the traditional XP technique. In situations where orthopedic surgeons choose to use medial pins in addition to lateral pins such as distal humerus fractures with medial-sided defects.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Dynamic Risk Stratification Decreases Rate of Ablative and Adjuvant Radioiodine Use in ATA Low and Intermediate Risk Papillary Thyroid Cancer Patients. 早期动态风险分层可降低 ATA 低危和中危甲状腺乳头状癌患者使用消融和辅助放射性碘的比例。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.97415
Sarp Kaya Gorur, Serdar Ozbas, Seyfettin Ilgan
{"title":"Early Dynamic Risk Stratification Decreases Rate of Ablative and Adjuvant Radioiodine Use in ATA Low and Intermediate Risk Papillary Thyroid Cancer Patients.","authors":"Sarp Kaya Gorur, Serdar Ozbas, Seyfettin Ilgan","doi":"10.14744/SEMB.2023.97415","DOIUrl":"10.14744/SEMB.2023.97415","url":null,"abstract":"<p><strong>Objectives: </strong>In differentiated thyroid cancer (DTC), radioiodine (RAI) therapy is most frequently employed for remnant ablation or as adjuvant therapy for the remaining disease. The application of RAI to patients classified as intermediate risk (InR) is still a matter of debate. The aim of this study is to analyze the effect of early postoperative risk assessment on RAI use on papillary thyroid cancer patients who are classified as low risk (LoR) or InR.</p><p><strong>Methods: </strong>This is a single-center, prospective registry study. One-hundred-eighty-six patients operated between January 2012 and August 2021 and categorized as LoR or InR were included in this study. All patients had total thyroidectomy and central lymph node dissection by the same endocrine surgeon. An early dynamic risk assessment (EDRA) consisting of neck ultrasonography, serum thyroglobulin (Tg) and anti-Tg levels was performed 6 weeks after surgery. Most of the patients were either followed up without RAI or received ablative low activity (30-50 mCi) RAI based on predetermined criteria.</p><p><strong>Results: </strong>Median follow-up was 63 months. Sixty-six (61%) patients in the LoR group and 43 (56%) patients in the InR group did not receive RAI treatment. Thirty-eight (35%) and 22 (29%) patients in LoR and InR groups received ablative (30-50 mCi) RAI therapy, respectively. In LoR group 5 (4.6%) patients and in InR group 12 (16%) patients received 100 mCi or more RAI activity. Only one patient in the InR group recurred during follow-up. No statistically significant difference regarding local recurrence was found between patients who didn't receive RAI or were treated with RAI within both LoR (p=0.152) and InR (p=0.272) groups.</p><p><strong>Conclusion: </strong>There is consensus for LoR patients about omitting RAI therapy after surgery. Indications for RAI treatment in InR DTC are still under debate. RAI use based on EDRA seems to be a better option than decisions solely made on histopathological risk factors and decreases adjuvant high-activity RAI use without increasing recurrence risk.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Parathyroid Gland Viability and Predicting Postoperative Hypoparathyroidism in Thyroid Surgery: The Utility of Indocyanine Green Angiography. 评估甲状旁腺活力和预测甲状腺手术后甲状旁腺功能减退症:吲哚菁绿血管造影的实用性
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.06691
Erman Sobutay, Hakan Cakit, Tarik Terzioglu
{"title":"Assessing Parathyroid Gland Viability and Predicting Postoperative Hypoparathyroidism in Thyroid Surgery: The Utility of Indocyanine Green Angiography.","authors":"Erman Sobutay, Hakan Cakit, Tarik Terzioglu","doi":"10.14744/SEMB.2023.06691","DOIUrl":"10.14744/SEMB.2023.06691","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative hypoparathyroidism is a common complication following thyroidectomy, with the potential for significant morbidity and cost. While various techniques have been proposed for intraoperative parathyroid gland (PG) identification and preservation, indocyanine green (ICG) angiography has emerged as a promising method. In this retrospective study, patients who underwent total thyroidectomy with or without central neck dissection were evaluated for the utility of ICG angiography in identifying PGs and the correlation of ICG scores with postoperative parathyroid function.</p><p><strong>Methods: </strong>ICG angiography was performed using a standardized protocol, and the degree of PG vascularization was assessed visually. A scoring system was employed based on ICG uptake intensity in PGs, as described in the literature. Pearson's correlation test examined the relationship between the total ICG score and percentage parathyroid hormone (PTH) gradient, postoperative calcium, and PTH levels. In addition, patients with at least one well-vascularized PG were also evaluated.</p><p><strong>Results: </strong>Twenty-two patients were included in the study. Significant positive correlations were found between the total ICG score and postoperative PTH levels (r=0.549, p=0.008), and a negative correlation with the percentage of PTH gradient (r=-0.504, p=0.01). However, six patients with well-vascularized PGs on ICG angiography still developed postoperative hypoparathyroidism.</p><p><strong>Conclusion: </strong>ICG angiography offers a potential tool for evaluating PG vascularization during thyroidectomy and predicting the risk of postoperative hypoparathyroidism. However, its application should be used judiciously, and the technique should be improved for PG preservation. Further studies are warranted to better understand its benefits and limitations in thyroid surgery.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Many Bundles Does the Anterior Cruciate Ligament Consist of? A Case Report. 前十字韧带由多少束组成?病例报告。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2022.12844
Burak Gunaydin, Tugba Ilkem Kurtoglu Ozcaglayan, Cem Sever, Meltem Oznur, Mehmet Umit Cetin, Erdem Can, Osman Tugrul Eren
{"title":"How Many Bundles Does the Anterior Cruciate Ligament Consist of? A Case Report.","authors":"Burak Gunaydin, Tugba Ilkem Kurtoglu Ozcaglayan, Cem Sever, Meltem Oznur, Mehmet Umit Cetin, Erdem Can, Osman Tugrul Eren","doi":"10.14744/SEMB.2022.12844","DOIUrl":"10.14744/SEMB.2022.12844","url":null,"abstract":"<p><p>In some cases with anterior cruciate ligament (ACL) injury, physical examination and magnetic resolution imaging cannot clearly identify whether the ACL is intact or partially or completely ruptured. A 40-year-old female patient was admitted to our clinic with complaints of knee pain. After the requested examinations, we could not clearly identify whether the ACL was intact or partially or completely ruptured. Arthroscopic knee surgery was planned for the patient. In diagnostic arthroscopy, it was also determined that there was a multibundle ACL that was not surrounded by the synovium and was tight in the figure 4 position. The surgery was completed by repairing the meniscal tear. It was seen in the current case report that the ACL was a multibundle structure without overlying synovium around. In such cases, it is difficult to evaluate the ACL, and it should be kept in mind that there may also be variations of the ACL.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67343188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Pelvic Ultrasound in Evaluating the Success of Tension-free Vaginal Tape (TVT). 盆腔超声在评估无张力阴道胶带 (TVT) 成功率中的作用。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.33497
Fatih Sahin, Ramazan Adan, Cagdas Nurettin Emeklioglu, Savas Ozdemir, Veli Mihmanli
{"title":"The Role of Pelvic Ultrasound in Evaluating the Success of Tension-free Vaginal Tape (TVT).","authors":"Fatih Sahin, Ramazan Adan, Cagdas Nurettin Emeklioglu, Savas Ozdemir, Veli Mihmanli","doi":"10.14744/SEMB.2023.33497","DOIUrl":"10.14744/SEMB.2023.33497","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the lack of response to treatment in individuals undergoing mid-urethral sling surgery for stress urinary incontinence (SUI) using ultrasound findings of the pelvic floor.</p><p><strong>Methods: </strong>The study included patients who underwent the tension-free vaginal tape (TVT) procedure for stress urinary incontinence within the period spanning from January 2016 to January 2021. The physical examination involved maintaining bladder filling at an average volume of 200-400 mL, and treatment failure was determined by the presence of SUI during the Valsalva maneuver.</p><p><strong>Results: </strong>The study comprised a total of 214 patients, where it was observed during the stress test that 32 patients (25.8%) had an unsuccessful outcome following mid-urethral sling surgery. In the unsuccessful group, the distance of the mesh-posterior urethra was lower (4.09±0.39 vs. 4.91±0.51; p<0.001), the posterior urethrovesical angle was lower when at rest, but the angle increased more significantly during the Valsalva maneuver, and the bladder neck angle was narrower (p<0.001).</p><p><strong>Conclusion: </strong>We obtained lower mean values of mesh-posterior urethral distance in unsuccessful patients compared to those found in the group of cured patients. Pelvic floor ultrasound can predict the success of TVT surgeries but there is as yet little data and there is a need to find in the near future more standard and objective parameters for the diagnosis of urinary incontinence.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Holt-Oram Syndrome with Sacrococcygeal Teratoma - A Rare Association. 霍尔特-奥拉姆综合征与骶尾部畸胎瘤--一种罕见的关联。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2022.02359
Ozmert Muhammet Ali Ozdemir, Musa Turgut, Gulay Sonmez Demir, Osman Uzunlu, Hacer Ergin
{"title":"Holt-Oram Syndrome with Sacrococcygeal Teratoma - A Rare Association.","authors":"Ozmert Muhammet Ali Ozdemir, Musa Turgut, Gulay Sonmez Demir, Osman Uzunlu, Hacer Ergin","doi":"10.14744/SEMB.2022.02359","DOIUrl":"10.14744/SEMB.2022.02359","url":null,"abstract":"<p><p>Holt-Oram syndrome (HOS) is characterized by upper-limb defects and congenital heart malformation, and its prevalence is very rarely. Mature cystic teratoma is the most common tumor seen in neonates and its most common location is sacrococcygeal region. Diagnosis of a sacrococcygealteratoma should be confirmed by pathology. Surgical resection is the mainstay therapeutic approach of this tumor. Some malformations such as genitourinary system, musculoskeletal anomalies, neural defects, cardiovascular anomalies, and pulmonary disorders associated with this tumor have been reported. Herein, we reported a male neonate diagnosed with HOS associated with sacrococcygealteratoma. To our knowledge, it has been not reported a case with HOS associated with sacrococcygealteratoma. Patients with sacrococcygealteratomas (SCTs) may have multiple and extreme congenital abnormalities; therefore, patients with SCTs should be carefully evaluated clinically, laboratory, and radiologically and it should be also considered that HOS may accompany them.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67342963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Higher Levels of Plasma Fetuin-A, Nrf2, and Cytokeratin 18 in Patients with Hashimoto's Disease. 桥本氏病患者血浆 Fetuin-A、Nrf2 和细胞角蛋白 18 水平较高。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.95826
Esma Yetim, Mehmet Ali Eren, Huseyin Karaaslan, Tevfik Sabuncu
{"title":"Higher Levels of Plasma Fetuin-A, Nrf2, and Cytokeratin 18 in Patients with Hashimoto's Disease.","authors":"Esma Yetim, Mehmet Ali Eren, Huseyin Karaaslan, Tevfik Sabuncu","doi":"10.14744/SEMB.2023.95826","DOIUrl":"10.14744/SEMB.2023.95826","url":null,"abstract":"<p><strong>Objectives: </strong>Fetuin-A is a protein that exhibits proatherogenic, pro-inflammatory, and anti-inflammatory effects with increased insulin resistance and adipocyte dysfunction. The nuclear factor erythroid 2-related factor (Nrf2) is a transcription factor that is crucial for protecting cells against oxidative damage. As a cell death product, cytokeratin 18 (CK18) levels increase during necrosis and apoptosis of both normal and tumor cells. We analyzed the plasma levels of three biomarkers based on the hypothesis that they might be related to some pathophysiological pathways in Hashimoto's disease.</p><p><strong>Methods: </strong>We compared 34 female patients with overt hypothyroidism due to Hashimoto's disease (Group 1) with 34 age-matched healthy females (Group 2). For comparison, plasma levels of thyroid-stimulating hormone (TSH), fetuin-A, Nrf2, and CK18 were measured in all participants.</p><p><strong>Results: </strong>In group 1, the mean TSH levels (31.4±15.3) were significantly higher than those in group 2 (2.6±1.0) (p<0.001). The levels of mean fetuin-A (606.7±34.2) and Nrf2 (1.3±0.6) were found to be significantly higher in group 1 than in group 2 (440.0±34.2 vs. 0.7±0.2) (p<0.001 for both). CK18 levels in group 1 (0.36±0.13) were also significantly higher than in group 2 (0.26±0.16) (p=0.020). A significant correlation was observed between TSH levels and fetuin-A (r=0.401, p=0.001).</p><p><strong>Conclusion: </strong>Increased levels of fetuin-A, Nrf2, and CK18 may be a consequence or cause of the pathophysiological pathways of Hashimoto's disease. The clinical significance of increased levels of these biomarkers requires further investigation.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Frozen Section Examination in Thyroid Surgery. 冷冻切片检查在甲状腺手术中的作用。
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.91129
Mehmet Uludag, Isik Cetinoglu, Mehmet Taner Unlu, Mehmet Kostek, Ozan Caliskan, Nurcihan Aygun
{"title":"The Role of Frozen Section Examination in Thyroid Surgery.","authors":"Mehmet Uludag, Isik Cetinoglu, Mehmet Taner Unlu, Mehmet Kostek, Ozan Caliskan, Nurcihan Aygun","doi":"10.14744/SEMB.2023.91129","DOIUrl":"10.14744/SEMB.2023.91129","url":null,"abstract":"<p><p>In endocrine pathology, frozen section (FS) examination is most commonly used for the intraoperative evaluation of thyroid and parathyroid tumors, as well as cervical lymph nodes. In the past, frozen section was considered a fundamental tool in thyroid surgery. However, with advancements in preoperative ultrasound and fine-needle aspiration biopsy (FNAB), there have been increasing queries about its routine use due to the improved preoperative diagnosis. Nowadays, while the use of FS during thyroidectomy has decreased, it is still used as an additional method for different purposes intraoperatively. FS may not always provide definitive results. If FS will alter the surgical plan or extent, it should be applied. Routine FS is not recommended for evaluating thyroid nodules. But in addition to FNAB, if FS results may change the operation plan or extent, they can be utilized. FS should not be applied for thyroid lesions smaller than 1 cm, and the entire lesion should not be frozen for FS. For the assessment of thyroid nodules, the use of FS is recommended based on the Bethesda categories of FNAB. In Bethesda I category nodules, FS may contribute to distinguishing between malignant and benign lesions and guide surgical treatment. In Bethesda II nodules, where the malignancy rate is low, the performance of FNAB and FS can be compared, but it's not recommended due to the lack of a significant contribution to the surgical strategy. The sensitivity of FS in Bethesda III and IV nodules is low; its contribution to the diagnosis is limited, and it does not provide an apparent benefit to treatment; therefore, it is not recommended. In Bethesda V nodules, FS can effectively confirm the malignancy diagnosis, contribute to the surgical strategy, and reduce the possibility of completion thyroidectomy, and accordingly, it is recommended for use. Nonetheless, in Bethesda V nodules with a benign FS report, the malignancy rate remains high, so it should not be used to rule out malignancy. In Bethesda VI nodules, the performance of FS is lower or comparable to FNAB and does not significantly contribute to the treatment strategy; hence, it is not recommended. Particularly in patients with papillary thyroid cancer, intraoperative FS can be effective in detecting extrathyroidal extension and can assist the surgeon in determining the extent of thyroid surgery and central neck dissection. FS has high sensitivity and specificity in evaluating the lymphatic status of the central region intraoperatively and can be used to determine the extent of central compartment node dissection. During thyroidectomy, FS examination can be used in recognizing parathyroid tissue and distinguishing it from fatty tissue, thymus, thyroid, lymph nodes, especially in differentiating metastatic lymph nodes.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Could Blood Cell-Based Inflammatory Markers Be Used to Monitor Response to Biologic Therapy in Psoriasis? 基于血细胞的炎症标记物能否用于监测银屑病患者对生物疗法的反应?
IF 1
Medical Bulletin of Sisli Etfal Hospital Pub Date : 2023-12-20 eCollection Date: 2023-01-01 DOI: 10.14744/SEMB.2023.43569
Sevgi Kulakli, Isil Deniz Oguz, Burak Aksan
{"title":"Could Blood Cell-Based Inflammatory Markers Be Used to Monitor Response to Biologic Therapy in Psoriasis?","authors":"Sevgi Kulakli, Isil Deniz Oguz, Burak Aksan","doi":"10.14744/SEMB.2023.43569","DOIUrl":"10.14744/SEMB.2023.43569","url":null,"abstract":"<p><strong>Objectives: </strong>Despite extensive research, there is currently no specific biomarker that reliably and universally indicates treatment response in psoriasis. Multiple studies have evaluated systemic inflammation markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic immune response index (SIRI) in psoriasis patients. However, there are limited studies investigating changes in these markers with biologic therapy. The goal of this study was to investigate the impact of biologic therapy on parameters including NLR, PLR, MLR, SII, and SIRI in patients with psoriasis.</p><p><strong>Methods: </strong>In this cohort study, we retrospectively evaluated 108 psoriasis patients who were on biological treatment, including interleukin (IL)17, IL23, and IL12/23 inhibitors, for a minimum of 12 weeks. We analyzed Psoriasis Area Severity Index (PASI) scores, complete blood count parameters, and C-reactive protein (CRP) levels both before and after 12 weeks of treatment.</p><p><strong>Results: </strong>The NLR, PLR, MLR, SII, SIRI, and CRP values all demonstrated a significant decrease, regardless of the specific type of biologic agent (p=0.001, 0.007, 0.011, <0.001, <0.001 and <0.001, respectively). Furthermore, we observed a statistically significant but low correlation between the reduction in PASI scores and PLR, SII, and SIRI values (p=0.036, r=0.202; p=0.042, r=0.196; p=0.023, r=0.219, respectively).</p><p><strong>Conclusion: </strong>The NLR, MLR, especially PLR, SII, and SIRI might be used as simple, convenient, and inexpensive laboratory markers to monitor the degree of inflammation and response to treatment after biologic therapy in daily practice.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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