Purpose: One of the most common and significant complications following thyroid surgery is postoperative hypocalcemia due to postoperative hypoparathyroidism. This study aimed to observe the effect of parathyroid gland autotransplantation on postoperative hypocalcemia in cases of incidental parathyroidectomy in total thyroidectomy cases. Methods: Patients who underwent bilateral total thyroidectomy surgery were retrospectively analyzed. Patients in the study population were divided into group A (no incidental parathyroidectomy), group B (incidental parathyroidectomy with no autotransplantation), and group C (incidental parathyroidectomy with autotransplantation). The patients’ calcium levels on day 1, transient and permanent hypocalcemia times, time to return to normocalcemia, and surgery duration were examined. Results: A total of 647 patients meeting the research criteria were included in the study. Group A consisted of 443 patients (68.5%), group B consisted of 176 patients (27.2%), and group C consisted of 28 patients (4.3%). The rate of incidental parathyroidectomy in the entire patient population was 31.5% (n = 204). Transient and permanent hypocalcemia rates in the entire patient population were 27.7% (n = 178) and 0.6% (n = 4), respectively. It was observed that the frequency of day 1 hypocalcemia was higher in group B than in group C among incidental parathyroidectomy groups (P = 0.005). Furthermore, group B had a significantly higher frequency of transient hypocalcemia compared to group C (P = 0.006). There was no significant difference in terms of permanent hypocalcemia. Conclusion This study showed that parathyroid gland autotransplantation reduces transient hypocalcemia in patients with 2 or fewer incidental parathyroids.

Purpose: One of the most common and significant complications following thyroid surgery is postoperative hypocalcemia due to postoperative hypoparathyroidism. This study aimed to observe the effect of parathyroid gland autotransplantation on postoperative hypocalcemia in cases of incidental parathyroidectomy in total thyroidectomy cases. Methods: Patients who underwent bilateral total thyroidectomy surgery were retrospectively analyzed. Patients in the study population were divided into group A (no incidental parathyroidectomy), group B (incidental parathyroidectomy with no autotransplantation), and group C (incidental parathyroidectomy with autotransplantation). The patients’ calcium levels on day 1, transient and permanent hypocalcemia times, time to return to normocalcemia, and surgery duration were examined. Results: A total of 647 patients meeting the research criteria were included in the study. Group A consisted of 443 patients (68.5%), group B consisted of 176 patients (27.2%), and group C consisted of 28 patients (4.3%). The rate of incidental parathyroidectomy in the entire patient population was 31.5% (n = 204). Transient and permanent hypocalcemia rates in the entire patient population were 27.7% (n = 178) and 0.6% (n = 4), respectively. It was observed that the frequency of day 1 hypocalcemia was higher in group B than in group C among incidental parathyroidectomy groups (P = 0.005). Furthermore, group B had a significantly higher frequency of transient hypocalcemia compared to group C (P = 0.006). There was no significant difference in terms of permanent hypocalcemia. Conclusion This study showed that parathyroid gland autotransplantation reduces transient hypocalcemia in patients with 2 or fewer incidental parathyroids.

Purpose: One of the most common and significant complications following thyroid surgery is postoperative hypocalcemia due to postoperative hypoparathyroidism. This study aimed to observe the effect of parathyroid gland autotransplantation on postoperative hypocalcemia in cases of incidental parathyroidectomy in total thyroidectomy cases. Methods: Patients who underwent bilateral total thyroidectomy surgery were retrospectively analyzed. Patients in the study population were divided into group A (no incidental parathyroidectomy), group B (incidental parathyroidectomy with no autotransplantation), and group C (incidental parathyroidectomy with autotransplantation). The patients’ calcium levels on day 1, transient and permanent hypocalcemia times, time to return to normocalcemia, and surgery duration were examined. Results: A total of 647 patients meeting the research criteria were included in the study. Group A consisted of 443 patients (68.5%), group B consisted of 176 patients (27.2%), and group C consisted of 28 patients (4.3%). The rate of incidental parathyroidectomy in the entire patient population was 31.5% (n = 204). Transient and permanent hypocalcemia rates in the entire patient population were 27.7% (n = 178) and 0.6% (n = 4), respectively. It was observed that the frequency of day 1 hypocalcemia was higher in group B than in group C among incidental parathyroidectomy groups (P = 0.005). Furthermore, group B had a significantly higher frequency of transient hypocalcemia compared to group C (P = 0.006). There was no significant difference in terms of permanent hypocalcemia. Conclusion This study showed that parathyroid gland autotransplantation reduces transient hypocalcemia in patients with 2 or fewer incidental parathyroids.

Background: Acute kidney injury (AKI) is a serious pathology that causes dysfunction in concentrating urine due to kidney damage, resulting in blood pressure dysregulation and increased levels of toxic metabolites. Dexpanthenol (DEX), a pantothenic acid analog, exhibits anti-inflammatory and anti-apoptotic properties in various tissues. This study investigated the protective effects of DEX against systemic inflammation-induced AKI. Methods: Thirty-two female rats were randomly assigned to the control, lipopolysaccharide (LPS), LPS+DEX, and DEX groups. LPS (5 mg/kg, single dose on the third day, 6 h before sacrifice) and DEX (500 mg/kg/d for 3 d) were administered intraperitoneally. After sacrifice, blood samples and kidney tissues were collected. Hematoxylin and eosin, caspase-3 (Cas-3), and tumor necrosis factor alpha (TNF-α) staining were performed on the kidney tissues. The total oxidant status (TOS) and total antioxidant status were measured using spectrophotometric methods. Aquaporin-2 (AQP-2), silent information regulator 1 (SIRT1), and interleukin-6 (IL-6) were detected using quantitative reverse transcription-polymerase chain reaction analysis. Results: Histopathological analysis revealed that DEX treatment ameliorated histopathological changes. In the LPS group, an increase in the blood urea nitrogen, creatinine, urea, IL-6, Cas-3, TNF-α, and TOS levels and oxidative stress index was observed compared with the control group, whereas AQP-2 and SIRT1 levels decreased. DEX treatment reversed these effects. Conclusions DEX was found to effectively prevent inflammation, oxidative stress, and apoptosis in the kidneys via the SIRT1 signaling pathway. These protective properties suggest DEX’s potential as a therapeutic agent for the treatment of kidney pathologies.

Objective: The history, electrocardiogram, age, risk factors, troponin (HEART), the thrombolysis in myocardial infarction (TIMI), and Global Registry of Acute Coronary Events (GRACE) scores are useful risk stratification tools in the emergency department (ED). However, the accuracy of these scores in the cancer population is not well known. This study aimed to compare the performance of cardiac risk stratification scores in cancer patients with suspected acute coronary syndrome (ACS) in the ED. Methods: This prospective cohort study recruited patients with cancer who visited the ED because of suspected ACS. The development of any major adverse cardiac events (MACE) within 6 weeks was recorded, with the study outcome being a MACE within 6 weeks of ED admission. Results: A total of 178 patients participated in this study, of whom 5.6% developed a MACE. Statistically significant differences were found between the mean HEART and TIMI scores in predicting MACE. The HEART score had the highest area under the curve (0.64; 95% confidence interval, 0.48–0.81), highest sensitivity (80%), and highest negative predictive value (97.5) in patients with cancer. Conclusion We found a similar rate of MACE in cancer patients with low-risk chest pain compared to that in the general population. However, the HEART, TIMI, and GRACE scores had a lower performance in cancer patients with MACE compared to that in the general population.

BACKGROUND AND OBJECTIVES: Contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (pPCI) and is associated with high mortality and morbidity and long hospital stay in patients with ST elevation myocardial infarction (STEMI). The Syntax Score (SS) has previously been studied in STEMI patients, and it was associated with increased CIN development and long-term mortality. This study investigates a possible relationship between CIN development and Syntax Score II (SSII) and compares SS and SSII by assessing CIN risk in STEMI patients treated with pPCI. METHODS: A total of 1,234 patients who underwent pPCI were divided into 2 groups according to CIN development. Patients with CIN were further divided into 2 groups according to whether or not they required hemodialysis. Reclassification tables, net reclassification improvement, and integrated discriminative improvement methods were used to assess the additive predictive value of SSII for predicting CIN. RESULTS: In the present study, 166 patients (13.5%) had CIN. Although both SS and SSII were significantly higher in CIN patients, only SSII was an independent predictor of CIN (odds ratio [OR], 1.031; 95% confidence interval [CI], 1.012–1.051; p < 0.001) and hemodialysis requirement (OR, 1.078; 95% CI, 1.046–1.078; p < 0.001). When comparing SSII and SS in their ability to determine CIN risk, we found SSII to have a reclassification improvement of 27.59% (p < 0.001) and an integrated discrimination improvement of 9.1% (p < 0.001). CONCLUSIONS: The combination of clinical and anatomic variables can more accurately identify patients who are at high risk for CIN after pPCI. While SSII is harder to calculate than SS, it provides better prediction for CIN and hemodialysis requirement than SS.
Discrimination (Psychology) ; Humans ; Length of Stay ; Mortality ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Renal Dialysis

Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal system and comprise only 1% to 3% of all gastrointestinal tract tumors, with the majority of them arising in the stomach. In this report, we present the unique findings of a case of gastroduodenal intussusception caused by an underlying gastric GIST and complicated with severe acute pancreatitis.
Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Intussusception* ; Pancreatitis* ; Pancreatitis, Acute Necrotizing ; Stomach

BACKGROUNDPrevious studies have shown that prostaglandins (PGs) dramatically stimulate healing processes in bone. However, the effect of prostaglandin I2 (PGI2) on fracture healing remains unclear. To investigate the effect of PGI2, a study on fracture healing process in closed tibia fractures was designed.

METHODSThirty-six Sprague-Dawley male rats were randomized into two groups. On the first day, their right tibias were fractured by three-point bending technique. The study group (n = 18) received a single injection of 10 µg/kg iloprost for 5 days, while the control group (n = 18) received saline solution in the same way. On the 7th, 14th and 28th days following the fracture, six rats were sacrificed and their right legs were harvested in each group. The progression of fracture healing was assessed for each specimen by the scores of radiography (by Lane-Sandhu) and histology (by Huo et al).

RESULTSOn the 7th day, the radiographic and histologic scores were equal. On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group, whereas radiographic total score was 11 and histologic total score was 33 in the control group. On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group (P < 0.05). On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group, whereas radiographic total score was 15 and histologic total score was 40 in the control group. On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group, it was not statistically significant (P > 0.05).

CONCLUSIONIloprost delays fracture healing in early stage in rats.

Animals ; Epoprostenol ; pharmacology ; Fracture Healing ; drug effects ; Fractures, Bone ; pathology ; Iloprost ; pharmacology ; Male ; Rats ; Rats, Sprague-Dawley ; Tibial Fractures ; pathology ; Wound Healing ; drug effects

Adult ; Arterial Occlusive Diseases ; diagnosis ; Celiac Artery ; Crohn Disease ; diagnosis ; Humans ; Ligaments ; Male ; Syndrome