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Background The COVID-19 pandemic caused by SARS-CoV-2 commenced in Wuhan China in 2019 and soon spread worldwide. SARS-CoV-2 enters the cell by binding to the ACE II receptor and begins viral replication. The effects and clinical findings of SARS-CoV-2 on the liver, kidney, heart, gastrointestinal (GI) system and especially lungs have been widely discussed. However, the effects on the pancreas—another organ that also expresses ACE II—have not been studied. Methods This work prospectively evaluated data from 316 patients who were admitted with a diagnosis of COVID-19 pneumonia. The patients were categorized into three according to the severity of pneumonia (mild, severe, critical). Demographic data, rate of pancreatitis, biochemical parameters, and radiological images from each group were analyzed. The patients were divided into two groups and outcomes were compared: COVID-19 patients with acute pancreatitis (Group P) and without acute pancreatitis (Group C). Results The median age was 54 (18–87), and the median age for patients with acute pancreatitis was 55 (26–84). As an expected finding, we found a positive correlation between advanced age and mortality (p = 0.0003). 12.6% of the patients had acute pancreatitis. While pancreatitis was not seen in patients on mild status, the rate of pancreatitis was 32.5% in critical patients. Hospitalization and mortality rates were higher in patients with COVID-19 accompanied by acute pancreatitis (p = 0.0038 and p

Introduction:Thyroid surgery for benign and malign diseases is one of the most common procedures performed in surgical practice. Complication rates are higher in malignant and inflammatory diseases, recurrent surgeries and in hyperthyroid patients. Hypocalcemia is one of these complications. There are many studies investigating the effect of incidental parathyroid tissue removal on hypocalcemia in thyroidectomy operations and investigating the risk factors for incidental parathyroidectomy. However, there are no studies investigating the effect on bone mineral density (BMD). In our study, we aimed to reveal the effect of incidental parathyroidectomy during total thyroidectomy (TT) on BMD and osteoporosis.Methods:Between January 2013 and December 2016, pathology reports of 983 patients who underwent TT, completion thyroidectomy, TT + central neck dissection, TT + functional neck dissection, TT + modified radical neck dissection were retrospectively reviewed. Seventy-two female patients with incidental parathyroid tissue were included in the study. Demographic information, post-operative biochemical values (calcium, albumin, parathyroid hormone, vitamin D, phosphorus, alkaline phosphatase), BMD, The World Health Organization Frakture Risk Assessment Tool (FRAX) fracture risks were recorded and the relationship between them was evaluated.Results:Patients were divided into three groups according to BMD: normal, osteopenic and osteoporotic. Patients in menopause and patients older than 45-years were more in osteopenic and osteoporotic group. Patients undergoing extended surgery had more parathyroids removed. There was no correlation between the number of parathyroid glands removed and hypocalcemia. After the surgery, the patients had no harmful effects on BMD and FRAX fracture risk.Conclusion:In our study, one or two parathyroid glands were removed. No effect on BMD was detected.

Introduction: Hypocalcaemia due to transient or definitive hypoparathyroidism is the most frequent complication after total thyroidectomy. We aimed to compare the impact of age on postoperative hypocalcemia and to determine which risk factors are important for hypocalcemia incidence.Methods: Eight hundred seventy-one patients, who underwent total thyroidectomy, completion thyroidectomy, and central/lateral neck dissection, were evaluated retrospectively. Data were analyzed according to age, sex, surgery for hyperthyroidism, surgery for malignancy, presence or absence of neck dissection, and secondary procedures.Results: Symptomatic hypocalcemia developed in 28.7% of patients. In logistic regression analysis, young age and female sex were found to be independent predictors of postoperative hypocalcemia.Conclusion: Age is significantly associated with postoperative hypocalcemia. Younger patients should be more carefully evaluated before discharge.

Objective: To prevent unnecessary laparotomies by evaluating the effectiveness of conservative approach in abdominal trauma cases due to drilling-cutting instruments. Methods: Demographic data, effected region of the body, additional findings of trauma, hemodynamic parameters, duration of admission, diagnostic methods and treatment modalities were retrospectively evaluated in 217 cases with abdominal injury (lower thoracic region, abdominal wall and back) among 1 128 victims with drilling-cutting instrument injuries between January 1, 2012 and December 31, 2017. The conservative approach was based on physical examination, hemogram follow-up and hemodynamic evaluation. Results: Totally 177 (81.6%) cases of 217 patients were followed conservatively while 25 cases were operated at early (1-8 hours) and 15 were operated at late (9-48 hours) periods. Two patients who underwent surgery in the early period and two patients who underwent surgery in the late period were accepted as negative laparotomy while 1 patient in the late operated group was regarded as non-therapeutic laparotomy. Diagnostic laparoscopy was performed in 81 cases. Complications developed in 7 patients who were operated in the early period and 10 patients who were operated in the late period. The mean hospital stay period was 5.3 days (1-33) in all cases, 4.5 days (2-20) in conservative treatment group and 8.4 days (3-33) in the operated patients; and the difference was statistically significant. Conclusions: Detailed physical examination, accurate assessment and effective use of different diagnostic methods reduce the frequency of negative and non- therapeutic laparotomies in abdominal stab wound injuries.

Objectives: Currently, diagnostic laparoscopy (DL) is recommended for the left thoraco-abdominal region penetrating injuries (LTARP). However, organ and diaphragmatic injury may not be detected in all of these patients. Our aim is to focus on this LTARP patient group without any operative findings and to highlight the evaluation of diagnostic tools in the high-tech era for a possible selected conservative treatment. Material and methods: The patients who were admitted to ED due to LTARP, and who underwent routine DL were evaluated retrospectively in terms of demographic, clinical, radiological, and operative findings of the patients. Results: The current study included 79 patients with LTARP. In 44 of 79 patients, abdominal injury was not detected. In 30 patients an isolated diaphragmatic injury was revealed and in 4 patients a visceral injury was accompanying to diaphragmatic injury. Surgical findings revealed that the diaphragm was the organ most likely to sustain injury. In patients with more than one positive diagnostic findings need for surgery rate was 61.5%, however; in patients with one positive diagnostic finding (n = 53), positive surgical finding rate was only 35.8%, (p = 0.03). Regarding the combined use of all diagnostic tools in these patients; such as physical examination, plain chest X-ray, and computed tomography, when this method was used for pre-operative diagnosis, sensitivity was measured as 82.7%, specificity 84.1%, PPV 77.4% and NPV 88.1%. Conclusion: Although DL is reliable for diagnosis of diaphragmatic and visceral injury in patients with LTARP. However, individual decision making for laparoscopic intervention is needed to prevent morbidity of an unnecessary operation under emergent setting due to high rates of negative intraabdominal findings. Keywords: Wounds penetrating, Physical examination, Diagnostic imaging, Treatment outcome

Objective:The aim of this retrospective clinical study was to evaluate the accuracy and feasibility of two different clinical scales, namely the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Tenon’s axillary scoring system, which were developed for predicting the non-sentinel lymph node (NSLN) status in our breast cancer patients.Material and Methods: The medical records of patients who were diagnosed with breast cancer between January 2010 and November 2013 were reviewed. Those who underwent sentinel lymph node biopsy (SLNB) for axillary staging were recruited for the study, and patients who were found to have positive SLNB and thus were subsequently subjected to axillary lymph node dissection (ALND) were also included. Patients who had neoadjuvant therapy, who had clinically positive axilla, and who had stage 4 disease were excluded. Patients were divided into two groups. Group 1 included those who had negative NSLNs, whereas Group 2 included those who had positive NSLNs. The following data were collected: age, tumor size, histopathological characteristics of the tumor, presence of lymphovascular invasion, presence of multifocality, number of negative and positive NSLNs, size of metastases, histopathological method used to define metastases, and receptor status of the tumor. The score of each patient was calculated according to the MSKCC nomogram and Tenon’s axillary scoring system. Statistical analysis was conducted to investigate the correlation between the scores and the involvement of NSLNs.Results: The medical records of patients who were diagnosed with breast cancer and found to have SLNB for axillary staging was reviewed. Finally, 50 patients who had positive SLNB and thus were subsequently subjected to ALND were included in the study. There were 17 and 33 patients in Groups 1 and 2, respectively. Both the MSKCC nomogram and Tenon’s axillary scoring system were demonstrated to be significantly accurate in the prediction of the involvement of NSLNs (p

Primary sarcomas of the breast are rare, malignant tumors arising from the mesenchymal tissue of the mammary gland. The peak incidence of breast liposarcoma occurs in adults between the fourth and the sixth decades. Our case is the third liposarcoma case of the breast in the literature observed in the third decade. We report a case of liposarcoma of the breast and discuss this rare malignant tumor and other types of sarcoma of the breast in the light of the previously published literature.