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Introduction: Wide-awake local anesthesia (WALA) with epinephrine has been demonstrated to be effective in orthopedics and hand surgery, as it offers adequate local anesthesia and obviates the requirement for patient sedation and even the use of a tourniquet to block the blood supply to the proximal extremity., Aim: To evaluate the effect of wide-awake local anesthesia on pain and bleeding levels in patients who received cardiac implantable electronic device implantation., Material and Methods: The patients were randomly assigned to two groups: Group 1, consisting of 21 patients, referred to as the WALA group; and Group 2, consisting of 21 patients, which served as the control group and received local anesthesia. After surgery, the primary operator assigned a bleeding score ranging from 1 to 10 to each patient. The Visual Analog Scale was employed to assess pain., Results: The control group had a significantly higher median bleeding score compared to the WALA group (5 vs. 2, p < 0.001). The median intra-procedural and post-procedural pain scores were significantly lower in the WALA group compared to the control group (2 vs. 4, p < 0.001, and 1 vs. 3, p < 0.001, respectively). No surgical revision was necessary for any pocket hematoma., Conclusions: WALA anesthesia significantly reduces intra- and post-procedural bleeding and pain. The potential benefits of the technique, such as preventing the formation of pocket hematoma, shortening the duration of the procedure, and accelerating the recovery period, must be demonstrated in randomized trials conducted on a larger number of patients., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Termedia Sp. z o. o.)

Introduction: Although there are studies comparing methods for leg fasciotomy in compartment syndrome after fractures, choice of single or double fasciotomies in disasters was not investigated. The aim of this study was to compare the efficacy of single and double incision leg fasciotomy in the setting of disaster., Methods: Patients that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were retrospectively analyzed. The cases were separated into two groups as single incision and double incision according to the method of the first fasciotomy. The number of debridements after each fasciotomy, muscle group excisions, completion time of treatment, presence of amputation, the method of closure (primary closure or graft/flap) and positive results of wound cultures were analyzed and compared between two groups., Results: 62 legs of 52 patients (22 females, 30 males, age 36.9 ± 11.2 years) with compartment syndrome that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were included in the study. Single-incision group included 27 legs and double incision group included 35 legs. Amputation was needed in 15 patients (%24.2), six in single incision group and nine in double incision group. (p = 0.75). Compartment excision (eight patients in single incision, nine patients in double incision groups, p = 0.81), number of debridements (median 4 in both groups, p = 0.55), wound closure time (median 17 days in single incision, 22 days in double incision groups, p = 0.52), graft or flap requirement (11 patients in single incision, 16 patients in double incision groups, p = 0.53), positive culture results (15 patients in single incision, 16 patients in double incision groups, p = 0.44) were not different statistically between two groups., Conclusion: Single and double incision fasciotomy methods are equally effective and safe in treatment of compartment syndrome of the leg in disaster situations. To our knowledge, this is the first study comparing outcomes of single and double incision fasciotomy in disaster settings., Competing Interests: Declaration of competing interest Authors have no conflict of interest to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: It is suggested that serglycin has important functions in fibrin stabilization and inflammation but there is limited information on its clinical value for atherosclerotic heart disease., Objective: The purpose of this study is to find out serum serglycin levels in acute myocardial infarction patients and in the control group individuals; and to investigate the association between serglycin levels with inflammation markers and infarct size markers., Methods: The study population consisted of 75 patients with ST-segment elevation myocardial infarction (STEMI) and 57 patients with normal coronary arteries (NCA) (control group). Patient characteristics, serum serglycin levels, high-sensitivity C-reactive protein (hs-CRP) levels, peak troponin T levels and other biochemical parameters were recorded. A p value <0.05 was considered statistically significant., Results: The control group consisted of individuals who are younger and smoke less than those of the STEMI group. The number of females in the control group was higher than in the STEMI group. Serum serglycin levels were significantly higher in the STEMI group than in control group (102.81±39.42 vs. 57.13±32.25, p<0.001). Correlation analyses revealed a significant positive correlation between serglycin and troponin (Spearman's Rho: 0.419; p<0.001) and between serglycin and hs CRP (Spearman's Rho: 0.336; p<0.001). Multivariate logistic regression analysis demonstrated that serum serglycin levels were independently associated with STEMI. Using a cutoff level of 80,47 μg/L, the serglycin level predicted the presence of STEMI with a sensitivity of 75.7% and specificity of 68.4%., Conclusion: Serum serglycin levels were significantly higher in the STEMI group than in the control group. Serum serglycin levels were positively correlated with both hs CRP levels and troponin levels.

Background: Sirtuins may act in many cellular processes like apoptosis, DNA repair and lipid/glucose metabolism. Experimental studies suggested some sirtuin types may have protective effects against endothelial dysfunction, atherosclerosis, cardiac hypertrophy and reperfusion injury. Data about sirtuins in acute myocardial infarction (AMI) patients are scarce., Objectives: To investigate temporal changes of serum sirtuin 1,3 and 6 levels in AMI patients; to compare the serum sirtuin 1,3 and 6 levels between AMI patients and control subjects; and to investigate the association of serum sirtuin 1,3 and 6 levels with prognostic markers of AMI., Methods: Forty patients with AMI and 40 patients with normal coronary arteries were included. Left ventricular ejection fraction (LVEF), serum proBNP, CRP, sirtuin1, sirtuin 3 and sirtuin 6 levels were processed. Peak troponin T levels, GRACE score, first day / second day sirtuin levels were recorded of AMI patients. A p value < 0.05 was considered statistically significant., Results: Serum sirtuin 1,3 and 6 levels in AMI patients were similar to those in normal coronary patients. No temporal change in serum sirtuin 1,3 and 6 levels were found in AMI course. No correlation was evident between the sirtuin levels and the following parameters: proBNP, CRP, peak troponin and LVEF. Baseline sirtuin 1 and 6 levels were positively correlated with reperfusion duration. Baseline sirtuin 3 levels were negatively correlated with GRACE score., Conclusion: Serum sirtuin 1,3 and 6 levels in AMI patients were similar to those in normal coronary patients. This study does not represent evidence of the possible protective effects of sirtuin1, 3 and 6 in AMI patients.

Objectives: Primary ovarian fibrosarcomas are extremely rare neoplasms, and only 50 cases have been reported in the English literature. Diagnosis can be difficult because of this condition's rarity, and other similar appearing mesenchymal lesions should be ruled out., Methods: A 50-year-old postmenopausal woman came to our hospital because of abdominopelvic pain. Ultrasonography revealed a 41x33 mm heterogeneous solid mass in the right ovary. Total blood counts, biochemical parameters, and tumor markers were within normal ranges. Total abdominal hysterectomy, and bilateral salpingo oophorectomy were performed. Examination of a frozen, specimen revealed fibroma; however, the final histopathological diagnosis was low grade fibrosarcoma of the ovary. Microscopic examination demonstrated densely cellular, spindle-shaped tumor cells with increased mitotic activity (5 to 6 mitoses per 10 high-power fields)., Results: Immunohistochemical analysis revealed that the tumor cells were positive for vimentin and negative for actin and desmin and that the Ki 67 proliferation index was 30% to 40%. The patient did not receive adjuvant treatment, and remained free of disease after a follow up of 6 months., Conclusions: Although ovarian fibrosarcomas are unusual causes of solid masses in postmenopausal women, they should be considered when adnexal masses are examined in these patients. Mitotic activity and Ki-67 positivity were identified as important diagnostic factors for ovarian fibrosarcoma.