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Introduction: The aim of this study was to investigate the incidence of general psychiatric symptoms, aggression levels, and sexual dysfunction in patients with benign anorectal diseases and compare the results with those of healthy control subjects. Methods: We prospectively enrolled consecutive adult patients who presented for treatment of benign perianal diseases and healthy control subjects between June 2017 and December 2018. All patients had either grade 3 or 4 hemorrhoidal disease or perianal fistula with active discharge who had not undergone previous anorectal surgery. We also included a control group with benign subcutaneous lumps presenting for minor surgery. We used the Symptom Checklist-90-Revised Form to evaluate general psychiatric symptoms, the Buss-Perry Aggression Questionnaire (BPAQ) to evaluate aggression levels, and the Arizona Sexual Experiences Scale to evaluate sexual dysfunction. Results: A total of 563 patients were assessed for eligibility; after exclusions, 94 with anal fistula, 89 with hemorrhoids, and 59 healthy control subjects were enrolled. The groups were similar with regard to age, gender, and educational level. Physical and verbal aggression, anger, and total BPAQ score were significantly higher in patients with perianal fistula than in those with hemorrhoidal disease and healthy control subjects (P <.001). Conclusion: This study suggests that patients with perianal fistula have higher levels of aggression than healthy control subjects and those with hemorrhoidal disease. One must bear this in mind during preoperative patient evaluations and obtaining informed consent. Further studies are needed to investigate the reason for this association and potential causality. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to compare acute effects of consuming extra virgin coconut oil (EVCO) as a source of medium chain fatty acids and extra virgin olive oil (EVOO) as a source of long chain fatty acids in normal weight and obese subjects. Design: Randomised, crossover design. Participants: Metabolically healthy twenty male subjects (10 normal weight; 10 obese) aged 19–40 years. Intervention: Subjects consumed breakfast meals containing skimmed milk, fat-free white cheese, bread and EVCO (25 g) or EVOO (25 g). Outcome measures: Visual analog scale evaluations, resting metabolic rate measurements and selected blood parameters analysis (glucose, triglyceride, insulin and plasma peptide YY) were performed before and after the test breakfast meals. In addition, energy intakes were evaluated by ad libitum lunch meal at 180 min. Results: Visual analogue scale values of hunger and desire to eat decreased significantly after EVCO consumption than EVOO consumption in normal weight subjects at 180 min. There was an increase trend in plasma PYY at 30 and 180 min after EVCO breakfast compared to EVOO breakfast. Ad libitum energy intakes after EVCO and EVOO consumption in normal weight subjects were 924 ± 302; 845 ± 158 kcal (p = 0.272), respectively whereas in obese subjects were 859 ± 238; 994 ± 265 kcal (p = 0.069) respectively. Conclusion: The results of this study shows that consumption of EVCO compared to EVOO may have suppressive effect on hunger and desire to eat, may affect postprandial PYY levels differently and have no effect on postprandial energy expenditure. Trial registration: Clinical Trials NCT04738929. [ABSTRACT FROM AUTHOR]

This study aimed to postoperatively evaluate the effects of intraoperative neural monitoring (IONM) on muscles and nerves in patients who underwent modified radical mastectomy (MRM). In the 11 patients included in the study, nerves were determined and protected by nerve monitoring during the axillary dissection (IONM group). In another 11 patients, nerve monitoring was not performed; however, protection of the same nerves was attempted through careful nerve dissection (cautious nerve dissection [CND] group). The control group consisted of 22 healthy subjects. Muscle and nerve functions were blindly evaluated by an experienced physical therapy and rehabilitation specialist using electromyography (EMG) and ultrasonography (US) methods. The EMG values of the pectoralis major muscle were similar in the IONM and control groups (1.97 mV/1.98 mV, p = 0.97) but significantly lower in the CND group (1.57 mV, p < 0.05). Significant differences were found in the US values of the pectoralis major and minor muscles between the IONM and CND groups. No significant difference was found between the IONM and control groups in terms of EMG values of the serratus anterior muscle. This is the first prospective randomized study to objectively evaluate preservation of the nerve through nerve monitoring and its functional results. Monitoring of nerves during MRM is of great importance in terms of demonstrating the positive effects on muscle and nerve functions. [ABSTRACT FROM AUTHOR]

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a novel monitorization technique for nerve protection during axillary surgery of the breast cancer patients. Topics include the surgical option has evolved toward breast preservation and oncoplastic breast surgery techniques; and median intraparticular LPN and lateral localized MPN in the interpectoral dissection area are found via placing the needle electrodes in the pectoral major muscle.

Objective: The aim of this long-term follow-up study was to investigate the association of local and systemic cardiovascular complications with endothelium-dependent and-independent microvascular relaxations and blood biomarkers and biochemicals in patients with peripheral arterial disease (PAD) caused by atherosclerosis. Methods: This prospective study included 67 patients with PAD who had not undergone any endovascular intervention, peripheral arterial surgery, or major amputation. Changes in the microvascular blood flow were measured using laser Doppler imaging after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). The biochemical markers of high sensitivity C reactive protein (hs-CRP), nitric oxide (NO), total antioxidant capacity (TAC), asymmetric dimethyl arginine (ADMA), and hydrogen sulfide (H2S) levels were measured from blood samples. All the patients were followed up for 5 years to determine the development of cardiovascular adverse events (CVAEs) and major amputation. At the end of the follow-up period, the patients were classified into two groups: those who had a CVAE [CVAE (+)] and those who did not experience CVAE [CVAE (-)]. Parameters such as demographic features, atherosclerotic risk factors, chronic ischemia category, microvascular endothelial functions, and plasma biomarkers were compared between the groups. Results: A total of 67 patients comprising 61 (91%) males and 6 (9%) females with a mean age of 62.3±9.7 years were included. During the follow-up period, 29 patients had CVAE (43.3%) and 38 patients did not have CVAE (56.7%). There was no difference between the groups in terms of ACh and SNP-induced vasodilation responses. Plasma high density lipoprotein (HDL) cholesterol values were lower in the CVAE (+) group [(CVAE+HDL: 38.4±9.1), (CVAE-HDL: 44.7±11.1), p=0.02]. Plasma hs-CRP values were significantly higher in the CVAE (+) group [(CVAE+ hs-CRP: 14.3±20.6), (CVAE-hs-CRP: 5.9±10.9), p=0.004]. No significant difference was observed between the groups in terms of plasma biomarkers and other biochemical levels. Conclusion: Based on the study findings, it was concluded that only low plasma HDL and high hs-CRP levels were risk factors for the development of CVAEs during follow-up of patients with PAD. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Intermittent ischemia in remote tissues can be applied before ischemic injury, during ischemic injury or at the beginning of reperfusion of an index organ ischemia. The aim of this study was to investigate the effect of Remote Ischemic Conditioning (RIC) of the leg on changes in ischemia-induced the microvascular functions of the arm. MATERIAL AND METHODS: Ischemic microvascular injury was induced by arm ischemia (20 min) and reperfusion in healthy, nonsmoker, male volunteers (ischemia group-ISC, n: 9). In another group of volunteers, to investigate the effects of remote organ ischemic conditioning 5 cycles of reperfusion followed by leg ischemia (each lasting 60 seconds) were applied either before (preRIC, n:11), or during (perRIC, n:12) or immediately after (postRIC, n:9) 20 minutes of arm ischemia. The microvascular flow of arm was assessed before and after ischemia using iontophoresis of the endothelium-derived nitric oxide (NO) releaser acetylcholine (ACh) and the endothelium-independent NO donor sodium nitroprusside (SNP). Changes in microvascular blood flow were measured using Laser Doppler imaging. The plasma level of biomarkers related to endothelial function such as nitric oxide (NO), asymmetric dimethylarginine (ADMA), total antioxidant capacity (TAC) and hydrogen sulphide (H2S) were measured. RESULTS: No difference was determined between the groups in terms of age, BMI or blood biochemicals reflecting cardiovascular status. ACh caused a rise in microvascular blood flow in a charge dependent manner. The ACh-induced flow increase was not significantly depressed by ischemia and not affected by any of the types of RIC in the study subjects. The increase in SNP-induced microvascular flow was significantly decreased in the ISC, perRIC and postRIC groups, but not in the preRIC group. Plasma levels of NO, ADMA, TAC and H2S were not changed by ischemia and RIC. CONCLUSION: These results suggested that microvascular perfusion of human forearm skin was elevated by either endothelium or drug-derived NO. The effect of ischemia and RIC on NO-induced flow increase was affected differently by different applications in the healthy young individuals. These complicated results are taken into consideration in experimental and therapeutic interventions. [ABSTRACT FROM AUTHOR]

At present there is no widely accepted biomarker for monitoring of vascular functions. The purpose of this prospective study was to investigate the association of some blood biomarkers with vascular reactivity in patients with peripheral arterial diseases (PAD). A prospective evaluation was made of 3 groups comprising a control group of healthy individuals, and patients with PAD caused by either atherosclerosis or Buerger's disease. Microvascular perfusion was examined using laser Doppler imaging of cutaneous erythrocyte flux after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). The correlation of microvascular reactivity with endothelium-related biomarkers was assessed. AChinduced and SNP-induced vasodilations were significantly diminished in the PAD groups. The plasma nitric oxide (NO) levels of PAD patients were significantly higher than those of the control group, but asymmetric dimethylarginine, total antioxidant capacity and hydrogen sulphide levels were similar. Plasma NO level was negatively correlated with ACh and SNP-stimulated microvascular flow increase, whereas a positive correlation was detected with blood glucose and glycated hemoglobin (HbA1c) levels in all groups. These results indicate that a high plasma level of NO in PAD patients is associated with diminished endothelium-dependent and independent flow increase in the microvascular bed. An excessive amount of NO-induced nitrosative stress in an inflammatory condition that might be a reason for vascular dysfunction should be taken into consideration in the diagnostic and therapeutic approaches to PAD. [ABSTRACT FROM AUTHOR]

Appendiceal mucocele is a rare entity which is characterised by cystic dilatation due to abnormal accumulation of mucus in the lumen of the appendix. Patients are often diagnosed incidentally by abdominal screening or abdominal surgery for other causes. Pain in the right lower quadrant of the abdomen, which may present as acute or chronic appendicitis, is the most common symptom of appendix mucocele, when the patient is symptomatic. This study describes the case of a 26 year old female for whom surgical intervention for a complex ovarian cyst was planned, but who instead underwent laparoscopic appendectomy because appendiceal mucocele was determined during laparoscopic exploration. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the relationship between eating behavior, eating awareness, and depression in young adults. Young adults aged between 18 and 25 years were included in the study. Questionnaires and body composition measurements were made face‐to‐face by the researcher in the interview room. The demographic characteristics were questioned through the questionnaire form. Three Factor Eating Questionnaire (TFEQ), Mindful Eating Questionnaire (MEQ), and Beck Depression Inventory (BDI) were used. It was determined that the Mindful Eating Questionnaire total score and Beck Depression Inventory total score affected emotional eating. A statistically significant positive correlation was found between the Beck Depression Inventory total score and the Three Factor Eating Questionnaire sub‐scores. There was a statistically significant negative correlation Beck Depression Inventory total score and the Mindful Eating Questionnaire total score and sub‐scores of mindless eating and emotional eating. In summary, depression seems to be a factor that triggers emotional eating, and emotional eating is a factor that negatively affects mindful eating. [ABSTRACT FROM AUTHOR]

Necrotizing fasciitis (NF) is an aggressive, necrotic, life-threatening infection of the soft tissues. The delay on treatment is generally accompanied by almost 90 % lethality according to the development of septic shock and its associated complications. Primary Necrotizing Fasciitis of the Breast (PNFB) is seen extremely rare. To date, breast necrotizing fasciitis have been reported only as a limited number of case reports in the literature. PNFB is commonly misdiagnosed as cellulitis, mastitis, abscess or inflammatory breast cancer. Although PNFB is a very rapid and aggressive disease, which can be fatal. Delayed cases were unfortunately resulted in mortality due to several consequential reasons. Therefore, careful and detailed evaluation of all cases irrespective of age, especially those with risk factors and comorbidities, could be life saving in respect of early diagnosis and timely treatment. Our aim is to to present the analysis and treatment modalities of five primarily seen PFNB, in this case series. [ABSTRACT FROM AUTHOR]

The article describes the case of a 24-year-old woman who was diagnosed with appendicocutaneous fistula due to appendicitis. Her symptoms included nausea, vomiting and abdominal pain. Information on the results of her physical and laboratory examinations is provided. Plastron appendicitis was detected via abdominal computerized tomography (CT). She also developed an increase in leukocyte count and abdominal mass during her hospital stay. She underwent appendectomy and resection of the fistula.

Background: Traumatic diaphragm ruptures (TDR) are rarely seen. Although TDR does not cause morbidity in the acute period, undiagnosed TDR may cause clinical states, such as herniation, strangulation, pneumonia, pleural effusion, empyema, and cardiac tamponade, which have high morbidity and mortality rates in the late period. This study aims to evaluate the epidemiology, clinical characteristics, diagnosis and treatment methods of TDR encountered in thoracoabdominal trauma and to identify the factors affecting mortality.
 METHODS: A retrospective examination was carried out on the patients who were operated in our clinic because of traumatic diaphragm injury between January 2012 and December 2017. Each patient operated because traumatic diaphragm injury was evaluated in respect of age, gender, manner of injury, preoperative examination findings, laboratory test results, imaging methods, time of diagnosis, operation findings, concomitant injuries to other organs, operations performed, length of stay in hospital, the development of postoperative morbidity and mortality, and the calculated Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS).
 RESULTS: Between January 2012 and December 2017, a total of 1066 patients were operated in our clinic because of thoracoabdominal trauma, and of 1066 patients, 45 of the patients were determined with TDR. Of the 45 patients, surgery was applied because of penetrating trauma in 32 cases (7 firearms injuries, 25 penetrating cutting injuries), blunt trauma in nine cases, and in four cases, diaphragm rupture was seen to have developed associated with iatrogenic injury during an operation. The most common injuries concomitant to traumatic diaphragm rupture were hemopneumothorax (70%), liver (43%), spleen (32%), colon (20%), stomach (17%) injuries and rib fractures (15%), respectively. Mortality developed in seven (17%) patients; five patients were lost because of hemorrhagic shock intraoperatively or in the early postoperative hours, and two because of multiorgan failure during follow-up in the intensive care unit.
 CONCLUSION: In high energy blunt and penetrating thoracoabdominal traumas, diaphragm injuries should be suspected. Factors affecting mortality were found to be the AISS, ISS, number of concomitant organ injuries and the combination with pneumohemothorax.

Background: The aim of the present study was to investigate the role of body mass index (BMI) and trauma severity score systems on the mortality rates of patients undergoing surgery due to falls from height., Methods: This retrospective study included 45 consecutive adult patients with multitrauma who were admitted and operated on due to a fall from height between January 2008 and December 2016. Patients were divided into mortality and recovery groups (n=10 and n=35, respectively). The groups were compared in terms of age, gender, weight, cause of the fall, height of the fall, location of the fall, BMI, trauma scores (Injury Severity Score [ISS], New Injury Severity Score [NISS], Glasgow Coma Scale [GCS], Abbreviated Injury Score [AIS], Revised Trauma Score [RTS]), hospital stay, and postoperative complications., Results: There was no statistically significant difference between the two groups in terms of age, gender, and height or cause of the fall (p>0.05), whereas there was a statistically significant difference with respect to weight and BMI values (p<0.01). A statistically significant difference was determined between the groups in terms of hospital stay and postoperative complications (p<0.01) and ISS, NISS, GCS, AIS, and RTS scores (p<0.05)., Conclusion: The effect of weight and BMI on the mortality rate of patients presenting with trauma as a result of a fall from height was objectively demonstrated in the present study.