Selahattin Vural

This study aims to provide a comprehensive analysis of the endoscopic and clinical characteristics of Cameron ulcers, focusing on their morphological presentation, associated comorbidities, and therapeutic outcomes in a single-center cohort. This retrospective study evaluated 43 patients diagnosed with Cameron ulcers at our center between January 2020 and October 2024. Data were collected from medical records, endoscopy reports, and imaging. Patients’ demographic, clinical, laboratory, and histopathological parameters were analyzed. Statistical methods were applied to identify significant differences across subgroups. Cameron ulcers were predominantly associated with chronic gastritis (74.4%), followed by chronic gastritis with intestinal metaplasia (9.3%). The mean hiatal hernia size was 4.6 ± 1.8 cm, with larger sizes observed in chronic Helicobacter pylori -related gastritis (5.3 ± 2.1 cm, P = .003). Markers of systemic inflammation (C-reactive protein [CRP]) and iron metabolism (ferritin) demonstrated significant variability among pathology groups, with the chronic inflammation group exhibiting the lowest ferritin levels and highest CRP concentrations ( P < .001 and P = .025, respectively). Gender differences revealed higher ferritin and CRP levels in females, while males presented with elevated aspartate aminotransferase (AST) values. Cameron ulcers represent a multifactorial condition influenced by anatomical variations, chronic inflammation, microbial factors, and systemic iron metabolism. The findings underscore the importance of considering these ulcers in patients with large hiatal hernias presenting with anemia or gastrointestinal bleeding. Further studies are needed to establish standardized diagnostic and treatment protocols.

Inflammation plays an important role in the pathogenesis of many cancer types and is associated with thyroid malignancy. The systemic immune-inflammation index (SII) is a new inflammation marker that can be calculated from routine complete blood count (CBC). This study investigated the association between SII, a marker derived from routine CBC, and different thyroid diseases. The objective was to determine if this simple inflammation marker can distinguish between benign and malignant thyroid diseases. The medical records of all patients who underwent surgical treatment for thyroid disease between January 2018 and January 2022 were systematically evaluated. The routine preoperative CBC parameters’ demographic, clinical, and laboratory data were recorded. A total of 241 patients were included in the study, and the patients were grouped as having multinodular goiter (n = 125), lymphocytic thyroiditis (n = 44), and papillary thyroid carcinoma (PTC) (n = 73) according to pathological results. The SII was defined as the ratio of the total count of neutrophils × platelets divided by the lymphocyte count. Subgroup analysis of patients was performed according to the presence of follicular variant or thyroiditis, micro or macro carcinoma, or bilaterality of the tumor. The SII level was significantly higher in the PTC group than in the lymphocytic thyroiditis and multinodular goiter groups ( P < .001). When we grouped the patients according to the presence of PTC as benign or malignant, the optimum cutoff point for SII level was found 654.13, with 73.8% sensitivity and 72.3% specificity from ROC analysis. In the subgroup analysis of patients with PTC, the SII level was similar according to the clinicopathological characteristics of the tumor. The differential diagnosis of thyroid diseases is important for patient management. We found that preoperative SII levels were significantly elevated in patients with PTC compared to those with benign thyroid disorders, and this simple marker can be used for the differentiation of benign and malignant thyroid disease.

Objective: This study aimed to investigate the association between Helicobacter pylori (H. pylori) scolonisation and ischemic hepatitis in patients with heart failure. Material Methods: A retrospective analysis was conducted on the medical records of 80 patients with heart failure who had undergone liver function tests. The patients were divided into two groups based on their liver function tests: those who developed ischemic hepatitis and those who did not. H. pylori scolonisation status was determined using serum immunoglobulin G antibody testing. Results: Of the 80 patients, 47 (58.75%) had H. pylori colonisation. H. pylori scolonisation was more prevalent in the group of patients who developed ischemic hepatitis compared to those who did not (36.2% vs 63.8%, p<0.05). These findings suggest that H. pylori scolonisation may contribute to developing ischemic hepatitis in patients with heart failure. Conclusion: This study provides evidence for an association between H. pylori scolonisation and ischemic hepatitis in patients with heart failure. The results suggest that H.pylori may contribute to this condition's development and that further research is needed to understand the mechanisms involved fully. These findings have important implications for healthcare professionals in managing heart failure and liver disease patients.

Objectives: Despite strong evidence regarding the impact of radioactive iodine (RAI) on the hematopoietic, genitourinary, and gastrointestinal systems, its role in the cardiovascular system needs to be clarified. We hypothesized that the presence of a presystolic wave could be predictive for cardiovascular dysfunction in subjects receiving RAI. Thus, we investigated presystolic wave presence in differentiated thyroid cancer (DTC) patients with and without RAI therapy after undergoing total thyroidectomy. Methods: Patients were included in the study within 1-5 years after thyroidectomy or thyroidectomy and RAI treatment. Participants were divided into three groups as follows: the first group included patients with DTC who received RAI following total thyroidectomy (Group 1; n = 33), the second group included patients with DTC who did not receive RAI following total thyroidectomy (Group 2; n = 34). The third group of age-matched subjects who underwent total thyroidectomy with suspicion of DTC and resulted in benign pathologies was also selected (Group 3; n = 37). All subjects underwent transthoracic echocardiography. The presence of a presystolic wave was assessed with Doppler imaging of the left ventricular outflow tract. Results: Presystolic wave was more common in subjects receiving RAI (Group 1) compared to Group 2 (those without RAI) (90.9% vs. 61.8% respectively, p = 0.003), and its prevalence in Group 3 was 54.1%. Multiple logistic regression analysis revealed that receiving RAI (OR: 4.922, 95% CI: 1.640 – 20.022, p = 0.004) was independently associated with a 5-fold higher risk for the presence of a presystolic wave. Conclusions: RAI following total thyroidectomy in patients with DTC is associated with a five-fold increase in the presence of the presystolic wave, as a proxy marker for subclinical left ventricular dysfunction.

Background: Burn injuries are one of the main causes of morbidity and mortality throughout the world, and burn patients have higher chances of recovery if they are treated with effective fluid and colloid management. Fresh frozen plasma (FFP) and albumin suspension used as a colloid treatment agent are very useful for the treatment of severe burns. Methods: This retrospective clinical trial was conducted at the Numune Education and Research Hospital Burn Center, Ankara, Turkey. Two hundred and nine patients who had severe burns that involved more than 30% of their total body surface area (TBSA) were studied. After the first 24 hours, 13 patients were deceased, leaving 196 patients remaining in the study, including 139 patients in the fresh frozen plasma group and 57 patients in the albumin group. Both the fresh frozen plasma and albumin groups received the standard therapy of the burn center, which was based on a standard protocol. Then, these patients were compared according to their clinical findings and mortality. Results: There were no significant differences between the groups with respect to age, gender, and comorbidities. The laboratory findings, blood, urine, and wound culture results were also similar between groups. The mortality rate was higher in the group receiving albumin than in the group receiving fresh frozen plasma (78.9% and 33.8%, respectively; p=0.0007). Conclusions: According to this study, there was a significant relationship between the improvement in mortality and the mode of colloid treatment in patients with major burns.

OBJECTIVE: Colon cancer is a primary human cancer that accounts for approx-imately one-tenth of all cancers and is one of the three most common cancers in incidence and mortality. This study investigated the relation-ship between serum preoperative carcinoembry-onic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), patient characteristics and lymph node (LND) involvement in early-stage colon cancer.PATIENTS AND METHODS: A total of 154 pa-tients who had undergone surgery for early-stage colon cancer were included in this study. Patient demographics regarding age and gender, labo-ratory parameters, tumor size, and tumor later-ality were recorded. CEA and CA19-9 positivi-ty was defined as patients whose tumor markers were above the cut-off values, and patients were grouped according to CEA and CA19-9 positivity. Patients were compared according to the CEA and CA19-9 status and pathological LND involvement.RESULTS: We found that patients in the CEA (+) and CA19-9 (+) groups were significantly older than the others. Our study detected LND involve-ment in histopathological examination in 25% of patients. LND pathological participation was sig-nificantly higher in the CEA (+) CA19-9 (+) group, and being age 65 years or older was found to be a risk factor for pathological LND involvement.CONCLUSIONS: Clinicians should pay more attention to LND involvement when both CEA and CA19-9 are elevated preoperatively in ear-ly-stage colon cancer patients. Preoperative CEA and CA19-9 status of patients is important in predicting LND involvement and, as a result, the prognosis of these patients.

OBJECTIVE: Breast cancer is a leading cause of death not only in the young population but also in the elderly. There are no consensus treatment guidelines for elderly breast cancer patients. We purposed to discuss surgical treatment options for breast cancer cases over 80 years concerning morbidity and mortality.METHODS: This retrospective study includes 58 patients over 80 years of age at the time of surgery for breast cancer between 2006 and 2017. A sum of 58 cases (54 females and 4 males), over 80 years of age, with an average age of 84.5 +/- 4.07 (80-94) years were included in the study. The modified radical mastectomy was the most common surgical modality in 30 (51.7%) cases, and the axillary intervention was performed on 41 (70.7%). Axillary dissection and sentinel lymph node biopsy were performed for 30 (51.7%) and 11 (18.9%) cases, respectively.RESULTS: Minor and major complications were observed in 8 (13.8%) cases. The average follow-up period of the patients was 37.5 (1-120) months. During the follow-up period, breast cancer-related mortality was observed in 9 (15.52%) cases. No statistical differences were detected in mortality with/without axillary intervention and chosen surgical modality.CONCLUSIONS: Comorbidity, the American Society of Anesthesiologists score, and life expectancy should be considered in the management and surgical planning of patients over 80 years of age with breast cancer. Minimally invasive approaches should be preferred for the elderly whenever feasible and applicable in the light of oncologic surgery principles in order to reduce complications and mortality rates.

A Deucalione, acute abdomen remains significant in abdominal pain. The entity of acute abdomen accounts for up to 10% of all emergency admissions. The differences between countries' income and level of prosperity are pertinent, particularly in terms of severity, radiological modalities, and surgical management of the condition. Of note, surgical modalities have been the most widely used treatment modality, and current evidence indicates that the laparoscopic approach, per se, is the most effective surgical therapy with a lower incidence of wound infection, post-intervention morbidity, shorter hospital stay, and better quality of life scores compared to the conventional method. In light of this, the present study aimed to evaluate ambulatory appendectomy in a series of sequential laparoscopic appendectomies (LApp), which included both complicated and uncomplicated cases.

Objective: Red cell distribution width (RDW) ,an index of heterogenity of circulating red blood cell, has recently been found to be associated with multiple diseases and used as a marker to predict outcome in these patients. In the present study we aimed to investigate if RDW value is associated with cholelithiasis and symptoms of the disease.Material- Method: A total of 204 women (101 with cholelithiasis and 103 without the disease ) were included to the study. The demographic and the laboratory data of the routine complete blood cell parameters including RDW values were recorded. Women with cholelithiasis were divided into symptomatic or non-symptomatic group according to presence of biliary colic or pain. The patients were compared in terms of their demographic and laboratory characteristics.Results: Age and BMI were similiar between groups in the study population. In our study population mean RDW value was signifi¬cantly higher in women with cholelithiasis than without disease. However in subgroup analysis there was no significant difference of RDW value between symptomatic group and nonsymptomatic group Conclusion: In conclusion we demonstrated an association between serum RDW level and cholelithiasis in our study but not with disease symptom. However further studies are needed to understand the role of RDW in patients with cholelithiasis and if this simple , inexpensive and routinely reported parameter can be used for prognostic information in this disease.

Background/Aim: Fibrocystic breast disease (FBD) is the most frequent benign breast disease. Increased estrogen and decreased progesterone concentrations are thought to be involved in the pathogenesis of FBD. But there is insufficient data on benign breast disease and endometrial pathology. This study evaluates the association between FBD and endometrial pathology in women complaining of abnormal uterine bleeding. Methods: This study was designed as a retrospective case-control study. The medical records of women who had endometrial sampling for abnormal uterine bleeding between 2018 and 2020 were evaluated. Patients with FBD were included in the study group, while the first patients who had endometrial sampling after patients with FBD and without breast disease were recruited as the control group. Demographic, laboratory data, and endometrial histopathological results were obtained from hospital records and compared between the groups. Results: In total, 250 women (106 women with FBD and 144 without breast disease) were recruited for the study. There was no statistically significant difference in mean age, gravidity, parity, and BMI between FBD and control groups. Endometrial hyperplasia without atypia (19.8% versus 10.5%, respectively, P = 0.037) and endometrial polyp (12.2% versus 4.8%, respectively, P = 0.033) were found to be significantly increased in patients with FBD than women without the disease. There was no statistically significant difference in terms of other histopathological results between the groups. Conclusion: Evaluation of the endometrium for abnormal uterine bleeding is essential for early diagnosis and treatment of endometrial pathology, especially for endometrial cancer. In this study, we found that women with FBD have an increased risk for endometrial hyperplasia and endometrial polyp. 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Cancer incidence and mortality worldwide: sources, methods and major patterns in...