Purpose: Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD. Methods: A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6. Results: The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively). Conclusion This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060

Purpose: The objective of this study was to evaluate the effects of Polyhexanid+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin, in the treatment of 3rd degree burn wounds.M ethods: Twenty eight Wistar albino rats were divided into 4 groups, each containing 7 animals. The experimental groups received every other day treatment with (A) Polyhexanid+poloxamer, (B) Sodium pentaborate pentahydrate (C) Diphenylhydantoin, (D) Control. In dorsum of all rats, third degree skin burn was performed. Three days later burn eschar was removed by fascial excision and skin substitude Nevelia® was applied to the wound. Then the wounds were applied locally with agents embedded in the dressing. In (Group A) %0,1 Polyhexanid+poloxamer, (Group B) %2 Sodium pentaborate pentahydrate, (Group C) Diphenylhydantoin and (Group D) Control-Saline solution. These treatments were performed every other day for 12 days. At the end of treatments, burn wounds were obtained and processed for immunohistochemical and histopathologic analysis. Results: Histologic evaluation of the Polyhexanide+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin-treated wound regions revealed an increased collagen deposition, fibroblast number, epithelization, and vascularization when compared to control group (P＜0.05). In all treatment groups wound regions demonstrated a strong immunostaining for Vascular Endothelial Growth Factor, Transforming Growth factor-β, and Basic fibroblast Growth factor according to control group. Conclusion Results of this study showed that treatment of burn wounds with Polyhexanid+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin enhanced collagen deposition, epithelization, and vascularization in healing of 3rd degree burn wounds.

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.

OBJECTIVE: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. METHODS: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. RESULTS: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). CONCLUSION: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.
Adenocarcinoma, Clear Cell ; Chemotherapy, Adjuvant ; Cohort Studies ; Disease-Free Survival ; Endometrium ; Female ; Humans ; Neoplasm Invasiveness ; Omentum ; Prognosis ; Retrospective Studies ; Standard of Care ; Uterine Diseases

No abstract available.
Isotretinoin ; Purpura, Schoenlein-Henoch

No abstract available.
Isotretinoin ; Purpura, Schoenlein-Henoch

BACKGROUND AND OBJECTIVES: Fragmented QRS complexes (fQRS) are associated with increased morbidity and mortality. The causative relationship between fQRS and cardiac fibrosis has been shown, but whether the presence and the number of fQRS on admission of electrocardiogram (ECG) predicts ST segment resolution in patients undergoing primary percutaneous coronary intervention (p-PCI) has not been investigated until now. SUBJECTS AND METHODS: This study included one hundred and eighty-four consecutive patients with ST elevation myocardial infarction (STEMI) who underwent p-PCI. The presence or absence of fQRS on pre and post-PCI ECG and their relation with myocardial infarction and reperfusion parameters were investigated. RESULTS: Patients with fQRS on admission of ECG or newly developed fQRS after p-PCI had increased inflammatory markers, higher cardiac enzyme levels, increased pain to balloon time, prolonged QRS time, more extended coronary involvement and more frequent Q waves on ECG in comparison to patients with absence or resolved fQRS. The presence and higher number of fQRS on admission or post-PCI ECGs were significantly related with low percent of ST resolution and myocardial reperfusion parameters. The area under the receiver operating characteristics curve values for the presence and number of fQRS to detect Thrombolysis in Myocardial Infarction Blush Grade 0 and 1, were 0.682 and 0.703. CONCLUSION: In our study, fQRS was significantly related to infarction and myocardial reperfusion parameters before and after p-PCI. Successful myocardial reperfusion by p-PCI caused the reduction in number of fQRS and QRS time with higher ST resolution. fQRS may be useful in identifying the patients at higher cardiac risk with increased ischemic jeopardized or infarcted myocardium, and persistent or newly developed fQRS may predict low percent of ST segment resolution in patients undergoing p-PCI.
Electrocardiography ; Fibrosis ; Humans ; Infarction ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Reperfusion ; Myocardium ; Percutaneous Coronary Intervention ; Reperfusion ; ROC Curve