SUMMARY OBJECTIVE: The objective of this study was to describe the single-surgeon experience on transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension in patients with severe prolapse who had concomitant vaginal hysterectomy. METHODS: A total of 53 patients with severe uterine prolapse who underwent vaginal hysterectomy and transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension between January 2021 and March 2023 were included in the study. Operation time, intraoperative and postoperative complications, de novo urinary continence, and duration of hospitalization were obtained from the patient records. Initial postoperative follow-up visits were scheduled for the first week of the month. Patients were followed up yearly, and they had the opportunity to reach the surgical team at any time. Symptomatic prolapse beyond the hymen is defined as recurrence. RESULTS: Patients had a mean age of 61.7 years ±7.7 SD. All patients received bilateral opportunistic salpingectomy and salpingo-oophorectomy. The total operation time was 162±31 min, with transvaginal natural orifice transluminal endoscopic surgery taking 32.3±5.37 min. There were no intraoperative complications. 12 patients had recurrence; 8 anterior, 3 apical, and 1 posterior prolapse. The mean recurrence time was 11.5 months (range 5–23 months). The reoperation rate was 13.2% (n:7). Three of the patients had obliterative vaginal surgery, three of the patients had anterior, and one patient had posterior repair. Overall failure of apical surgical procedure was 5.6%. Two patients had de novo incontinence postoperatively. CONCLUSIONS: Transvaginal natural orifice transluminal endoscopic surgery uterosacral ligament suspension is a feasible technique to treat severe pelvic organ prolapse with promising results for short-term efficacy and safety in patients who had concomitant vaginal hysterectomy. Longer follow-up periods are needed to evaluate the long-term efficacy profile of transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension. OBJECTIVE singlesurgeon single surgeon METHODS 5 202 complications continence records followup follow month yearly RESULTS 617 61 7 61. 77 ±7. SD salpingooophorectomy. salpingooophorectomy salpingo oophorectomy. oophorectomy salpingo-oophorectomy 16231 162 31 162±3 min 323537 32 37 32.3±5.3 anterior 115 11 11. range 523 23 5–2 months. . months) 132 13 2 13.2 n7. n7 n (n:7) repair 56 6 5.6% postoperatively CONCLUSIONS shortterm short term longterm long 20 ±7 1623 16 162± 32353 32.3±5. 52 5– 13. (n:7 5.6 ± 3235 32.3±5 (n: 5. 323 32.3± (n 32.3 32.

SUMMARY OBJECTIVE: Endometriosis is a disease in which stromal cells and endometrial glands extend outside of the uterine cavity. Nevertheless, treatment failure and recurrence cause difficulties in management. This study aimed to evaluate the receptor-level components of bilateral endometriomas in the recurrence state. METHODS: Our retrospective cohort study was conducted with patients who underwent surgery for bilateral endometriomas between 2015 and 2021. In total, 113 patients were allocated. A total of 76 patients did not meet the eligibility criteria, and the data of 37 patients were evaluated. Medical treatments, recurrences, and postoperative follow-up data were collected. In archived tissue samples, measurements of progesterone receptor A and progesterone receptor B, histoscores and immunoreactivity scores, and their ratios were calculated in the group that received no postoperative medical treatment. Criteria for recurrence were a repeat operation and/or the detection of a new endometrioma>2 cm at the follow-up examination. RESULTS: No recurrence was observed in 73.0% (n=27) of the cases, whereas recurrence was observed in 27.0% (n=10) of the participants. Patients without recurrence had significantly higher progesterone receptor B histoscore/progesterone receptor A histoscore and progesterone receptor B immunoreactivity score/progesterone receptor A immunoreactivity score results (p=0.01). Nevertheless, when the histoscores and immunoreactivity scores for both receptors were contrasted separately, there was no appreciable difference between them. CONCLUSION: The dominance of progesterone receptor B over progesterone receptor A was inversely proportional to the recurrence status in bilateral endometriomas. Furthermore, our study revealed that assessing receptor levels alone did not result in a significant difference in recurrence. OBJECTIVE cavity Nevertheless management receptorlevel level state METHODS 201 2021 11 allocated 7 criteria 3 evaluated treatments recurrences followup follow up collected samples andor or endometrioma2 endometrioma 2 endometrioma> examination RESULTS 730 73 0 73.0 n=27 n27 n 27 (n=27 cases 270 27.0 n=10 n10 10 (n=10 participants histoscoreprogesterone scoreprogesterone p=0.01. p001 p p=0.01 . 01 (p=0.01) separately them CONCLUSION Furthermore 20 202 1 73. n=2 n2 (n=2 27. n=1 n1 (n=1 p00 p=0.0 (p=0.01 n= (n= p0 p=0. (p=0.0 (n p=0 (p=0. p= (p=0 (p= (p

Resumen Antecedentes: La sarna es una de las enfermedades más comunes en perros. Es una amenaza para la salud animal y humana por su carácter zoonótico. Objetivo: El propósito de esta investigación fue estudiar el balance oxidante/antioxidante con hallazgos hematológicos en perros infestados por sarna sarcóptica. Métodos: Los perros del grupo Sarcoptes presentaban signos de infestación tales como prurito intenso, excoriaciones, alopecia y ampollas en el codo y márgenes auriculares. El estudio evaluó 32 perros mestizos entre 1 y 2 años de edad. Los perros se distribuyeron en dos grupos: un grupo control (animales libres de infestación; n=10), y un grupo con sarna sarcóptica (Sarcoptes; n=22). Resultados: Se encontró un aumento significativo (p<0.01) en el estado oxidante total (TOS), malondialdehído (MDA), índice de estrés oxidativo (OSI) y niveles de óxido nítrico (NO), mientras que el glutatión (GSH) y los niveles de estado antioxidante total (TAS) de los perros infestados por Sarcoptes disminuyeron significativamente (p<0.01). Además, se encontró un aumento significativo (p<0,01) en el recuento de leucocitos de los perros del grupo Sarcoptes en comparación con el control. Por el contrario, hubo disminuciones significativas (p<0,01) en los recuentos de RBC, HGB y PCV de los perros infestados. Conclusiones: Podría sugerirse una posible relación entre el desequilibrio oxidante/antioxidante y los hallazgos hematológicos en perros infestados por sarna sarcóptica. Adicionalmente, los marcadores MDA, TAS, TOS y OSI, el NO y el GSH podrían utilizarse para evaluar el estrés oxidativo en perros infectados naturalmente por Sarcoptes scabiei.

Abstract Background: Scabies is one of the most common diseases in dogs. It threatens both animals and humans due to its zoonotic potential. Objective: The purpose of this study was to evaluate the oxidant/antioxidant balance with hematological findings in dogs infested with sarcoptic mange. Methods: The animals evaluated in this study consisted of 32 mixed-breed dogs between 1 and 2 years of age. The dogs were allocated into two groups: a control group (infestation-free animals; n=10), and a sarcoptic mange-infected group (Sarcoptes, n=22). Dogs in the Sarcoptes group showed infestation signs such as intense itching, excoriations, alopecia, and blistering of the elbow and auricular margins. Results: Significant increase (p<0.01) levels were observed in total oxidant status (TOS), malondialdehyde (MDA), oxidative stress index (OSI), and nitric oxide (NO), while glutathione (GSH) and total antioxidant status (TAS) levels in dogs infested with Sarcoptes decreased significantly (p<0.01). In addition, a significant increase (p<0.01) of WBC count in dogs in the sarcoptic group in comparison with the control was found. Conversely, there was significant decrease (p<0.01) in RBC, HGB, and PCV counts in Sarcoptes-infested dogs. Conclusions: Our study suggests a possible relationship between oxidant/antioxidant imbalance and hematological findings in dogs infested with sarcoptic mange. Furthermore, in addition to MDA, TAS, TOS, and OSI markers, NO as well as GSH might be also used to assess the oxidative stress in dogs naturally infected with Sarcoptes scabiei.

Resumo Antecedentes: A sarna é uma das doenças mais comuns em cães, e também ameaça a saúde humana e animal devido ao seu caráter zoonótico. Objetivo: O objetivo da pesquisa foi estudar o equilíbrio oxidante/antioxidante com achados hematológicos em cães infestados com sarna sarcóptica. Métodos: Os cães do grupo Sarcoptes apresentavam sinais de infestação como prurido intenso, escoriações, alopecia e bolhas no cotovelo e margens auriculares. O material deste estudo consistiu em 32 cães sem raça definida, entre 1 e 2 anos de idade. Os cães foram divididos em dois grupos que foram grupo controle (animais livres de infestação, n=10), bem como o grupo sarna sarcóptica (Sarcoptes; n=22). Resultados: Os resultados do estudo demonstraram que houve aumentos significativos (p<0,01) no total oxidant status (TOS), malondialdeído (MDA), oxidative stress index (OSI) e nos níveis de óxido nítrico (NO), enquanto glutationa (GSH) e os níveis de status antioxidante total (TAS) dos cães infestados por Sarcoptes diminuíram significativamente (p<0,01). Além disso, foi encontrado um aumento significativo (p<0,01) da contagem de leucócitos dos cães do grupo Sarcoptes em comparação com o controle. Por outro lado, houve reduções significativas (p <0,01) nas contagens de RBC, HGB e PCV em cães infestados por Sarcoptes. Conclusões: Pode-se sugerir uma possível associação entre desequilíbrio oxidante/antioxidante e achados hematológicos nos cães infestados por sarna sarcóptica. Além disso, além dos marcadores MDA, TAS, TOS e OSI, NO e GSH também podem ser usados para descobrir o estresse oxidativo em cães naturalmente infectados por Sarcoptes scabiei.

Abstract Background Tumor Necrosis Factor-α (TNF-α) and Interleukin-1β (IL-1β) are among the cytokines released secondary to the surgical stress response. The objective of this study was to investigate the effect of a Transversus Abdominis Plane (TAP) block on postoperative pain and its immunomodulatory activity through proinflammatory cytokines. Methods TAP (study group; n = 40) or p-TAP (placebo group; n = 40). Patients in the TAP group underwent an Ultrasound (US) guided unilateral TAP block using 20-cc 0.5% bupivacaine solution. Patients in the p-TAP group underwent a sham block using 20-cc isotonic solution. The TNF-α and IL-1β levels were measured three times at preoperative hour-0 and postoperative hours 4 and 24. Visual Analog Scale (VAS) scores were recorded at 0-hours, 30-minutes, 4-hours, and 24-hours. Analgesic use within the first 24-hours following surgery was monitored. Results The postoperative VAS score was decreased in the TAP group at all time points (0, 4, and 24 hours), and the differences between groups were statistically significant (p < 0.001 for all comparisons). In the TAP group, the TNF-α and IL-1β levels at 4 and 24 hours post operation were significantly lower than the preoperative levels (p < 0.001 for all comparisons). Conclusion The TAP block for pre-emptive analgesia enabled effective hemodynamic control during the intraoperative period, provided effective pain control in the postoperative period, and decreased inflammation and surgical stress due to the decreased levels of the proinflammatory cytokines TNF-α and IL-1β in the first postoperative 24 hours, indicating immunomodulatory effect.

Resumen Introducción: La extracción de muestras de orificio natural (NOSE) para resecciones colorrectales, que mejoran aún más las ventajas de la cirugía mínimamente invasiva, se utilizan cada vez con mayor frecuencia. En este estudio, nuestro objetivo fue comparar los métodos de extracción de muestras de nariz y transabdominales en casos de resecciones de colon derecho totalmente laparoscópicas. Métodos: Se incluyeron datos de 52 pacientes que se sometieron a cirugía laparoscópica de colon derecho entre 2013 y 2019. La extracción de muestras transabdominales se realizó en 35 pacientes, mientras que 17 pacientes fueron sometidos a NOSE. Se compararon datos demográficos, hallazgos operativos, resultados patológicos y datos de seguimiento. Resultados: Las mujeres (94% frente a 28%, p = 0,0001), comórbidas (76% frente a 40%, p = 0,01) y antecedentes de cirugía abdominal previa (75% frente a 23%, p = 0,001) fueron más altas en el grupo NOSE . Todas las otras características preoperatorias de los grupos fueron comparables. La pérdida de sangre intraoperatoria, el tiempo de operación y las tasas de complicaciones fueron similares en ambos grupos. La escala VAS postoperatoria (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) y los puntajes cosméticos fueron mejores en el grupo NOSE (10 vs. 7, p = 0.0001). Los resultados oncológicos fueron similares después de un seguimiento medio de 27.4 ± 20.5 (1-77) meses. Conclusión: El método NOSE después de la resección laparoscópica del colon derecho fue un método más ventajoso en términos de cosméticos y dolor postoperatorio que la extracción de muestras transabdominales.

Abstract Introduction: Natural orifice specimen extraction (NOSE) for colorectal resections, which further enhance the advantages of minimally invasive surgery, are being used increasingly more often. In this study, we aimed to compare NOSE and transabdominal specimen extraction methods in cases of totally laparoscopic right colon resections. Methods: Data of 52 patients who underwent laparoscopic right colon surgery between 2013 and 2019 were included in the study. Transabdominal specimen removal was done in 35 patients, while 17 patients underwent NOSE. Demographic data, operative findings, pathological results, and follow-up data were compared. Results: Female (94% vs. 28%, p = 0.0001), co-morbid (76% vs. 40%, p = 0.01), and previous abdominal surgery history (75% vs. 23%, p = 0.001) were higher in the NOSE group. All the other pre-operative features of the groups were comparable. Intraoperative blood loss, operation time, and complication rates were similar in both groups. Post-operative visual analog scale (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) and cosmetic scores were better in the NOSE group (10 vs. 7, p = 0.0001). Oncologic results were similar after a mean follow-up of 27.4 ± 20.5 (1-77) months. Conclusion: The NOSE method following laparoscopic right colon resection was a more advantageous method in terms of cosmetics and post-operative pain than transabdominal specimen extraction.

Abstract Purpose: To investigate the possible effects of argan oil on the healing of colorectal anastomoses. Methods: I n Group 1 (sham), laparotomy was performed and the colon was mobilized. In the control (Group 2) and argan oil (Group 3) groups, colonic resection and anastomosis were applied. To the control and sham groups, 2 mL of 0.9% NaCl was administred rectally, and in the argan oil group, 2 mL/day argan oil was applied rectally for 7 days. Results: The mean bursting pressures of the argan oil and sham groups were significantly higher than the values in the control group. A significant difference was determined between the tissue hydroxyproline and prolidase levels of control group and other groups. Histopathologically, argan oil showed significant beneficial effects on colonic wound healing. In the argan oil and sham groups, the tissue malondialdehyde and fluorescent oxidation product levels were found to be lower and total sulfhydryl levels were higher than the control group. Conclusions: The rectally administered argan oil was observed to have significantly ameliorated wound healing parameters and exerted a significant antioxidant effect. This is the first study in the literature about the beneficial effects of argan oil on colorectal anastomoses.

Abstract Background Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. Materials and methods A retrospective case–control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010–December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients’ medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Results Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6 ± 1.9 days (median: 7 days, range: 2–38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n = 15, 62.5%), ventilator-associated pneumonia (n = 4, 16.6%), ventriculitis (n = 2, 8.3%), intraabdominal infections (n = 2, 8.3%), and urinary tract infection (n = 1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7–37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2–40.1), neutropenia (OR: 13.8; 95% CI: 3.1–61.0) and previous surgical procedure (OR: 7.4; 95% CI: 1.9–28.5) as independent risk factors for carbapenem-resistant Klebsiella pneumoniae infection in patients colonized with carbapenem-resistant Klebsiella pneumoniae. Out of 24 patients with carbapenem resistant Klebsiella pneumoniae infection, 4 (16.6%) died of carbapenem-resistant Klebsiella pneumoniae sepsis. Conclusion Asymptomatic colonization with carbapenem-resistant Klebsiella pneumoniae in intensive care units of pediatric departments should alert health care providers about forthcoming carbapenem-resistant Klebsiella pneumoniae infection. Those carbapenem-resistant Klebsiella pneumoniae colonized patients at risk of developing infection due to carbapenem-resistant Klebsiella pneumoniae may be targeted for interventions to reduce subsequent infection occurence and also for timely initiation of empirical carbapenem-resistant Klebsiella pneumoniae active treatment, when necessary.