Reconstruction of congenital rectovestibular fistula in an adult. Case report.

Anorectal malformations are common congenital anomalies but diagnosis and treatment in adulthood are quite rare. Treatment during adulthood may be challenging due to anatomic and physiologic changes. Posterior sagittal anorectoplasty may provide good cosmetic and functional results even in adult patients.

Can omentin-1 be a prognostic marker in surgical intensive care patients?

Background/aim: A member of the adipokine family, omentin-1 is selectively secreted from visceral fat tissue and the omentum. It has been shown that omentin-1 is involved in the pathogenesis of certain diseases and can be used as a prognostic marker. This study first investigated the prognostic significance of omentin-1 in surgical intensive care patients.

Air leak syndrome after endoscopic retrograde cholangiopancreatography: a rare and fatal complication.

Endoscopic retrograde cholangiopancreatography (ERCP) is a state of the art diagnostic and therapeutic procedure for various pancreatic and biliary problems. In spite of the well-established safety of the procedure, there is still a risk of complications such as pancreatitis, cholangitis, bleeding and perforation. Air leak syndrome has rarely been reported in association with ERCP and the optimal management of this serious condition can be difficult to establish.

Lessons learned from the first quadruple extremity transplantation in the world.

Background: Limb transplantation is emerging as a promising area of surgery and is an indispensable alternative for prosthetic rehabilitation of amputees, the severity of which is increasing because of combat-related injuries. Successful unilateral and bilateral limb transplantations have already been performed before this operation.

Methods: We performed the first ever quadruple limb transplantation in February 2012.

The effect of problem-based learning with cooperative-learning strategies in surgery clerkships.

Background: Cooperative learning is used often as part of the problem-based learning (PBL) process. But PBL does not demand that students work together until all individuals master the material or share the rewards for their work together.

Objective: A cooperative learning and assessment structure was introduced in a PBL course in 10-week surgery clerkship, and the difference was evaluated between this method and conventional PBL in an acute abdominal pain module.

Scoring systems in the diagnosis of acute appendicitis in the elderly.

Background: Although special features of acute appendicitis in the elderly have been described in some studies, no studies evaluating the applicability of appendicitis scores exist in the literature. The aim of this study was to compare Alvarado and Lintula scores in patients older than 65 years of age.

Methods: Patients older than 65 years with appendicitis confirmed by pathology report were matched by year of admission with a group of patients admitted to the emergency department with non-specific abdominal pain.

Resuscitation and monitoring in gastrointestinal bleeding.

Introduction: Gastrointestinal bleeding is a common life-threatening problem, causing significant mortality, costs and resource allocation. Its management requires a dynamic multidisciplinary approach that directs diagnostic and therapeutic priorities appropriately.

Materials And Methods: Articles published within the past 15 years, related to gastrointestinal bleeding, were reviewed through MEDLINE search, in addition to current guidelines and standards.

A novel fuzzy-logic inference system for predicting trauma-related mortality: emphasis on the impact of response to resuscitation.

Introduction: Trauma scoring aims for quantification and uniform reporting of trauma-related outcomes. Despite significant advances in trauma scoring, the exact time period at which relevant calculations should be made is not clear. Considering the importance of response to resuscitation, calculation of trauma scores after a period of resuscitation can allow better discrimination of patients who will survive.

A gastrointestinal stromal tumor in Meckel diverticulum in an 86-year-old patient.

Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract. Its prevalence is approximately 2% of the general population. Complications because of Meckel diverticula are rare and almost nil beyond the age of 40 years.

Iliopsoas hemophilic pseudotumor with bowel fistulization.

Haemophiliac pseudotumors are usually observed in the diaphysis of long bones. Pseudotumors due to psoas muscle hematoma are rare and surgical management is difficult. Surgical treatment of these lesions is usually associated with high morbidity and mortality rate.

Case report: local allergic reaction of bowel wall secondary to ruptured hydatid cyst.

This is a report of a case of local allergic reaction which developed secondary to a ruptured hydatid cyst with a diffuse bowel thickening detected by computed tomography.

[Effects of autologous and homologous blood transfusion on TNF-alpha levels and survival in an intraabdominal infection model].

Background: Autologous blood transfusion is one of the approaches used for prevention of the undesirable immunomodulatory effects of homologous blood transfusion that can cause an increase in cancer recurrence and surgical site infections. On the other hand, the benefits of autologous blood transfusion in that respect are not yet clearly identified. In this experimental study, we investigated the differences in effects of autologous and homologous blood transfusion on tumor necrosis factor (TNF)-alpha levels and survival in an intraabdominal infection model in rats.

A novel fuzzy logic inference system for decision support in weaning from mechanical ventilation.

Weaning from mechanical ventilation represents one of the most challenging issues in management of critically ill patients. Currently used weaning predictors ignore many important dimensions of weaning outcome and have not been uniformly successful. A fuzzy logic inference system that uses nine variables, and five rule blocks within two layers, has been designed and implemented over mathematical simulations and random clinical scenarios, to compare its behavior and performance in predicting expert opinion with those for rapid shallow breathing index (RSBI), pressure time index and Jabour' weaning index.

Preputial skin can be used in all boys with burns requiring grafting.

Background: In patients with extensive burns, all unburned areas can be used as donor sites. In male patients with small burns, preputial skin graft may be a good choice in order to avoid donor site problems.

Methods: We retrospectively reviewed 12 patients treated in our burn center from January 1997 to August 2007 with preputial skin grafting.

External validation of prognostic models among cancer patients undergoing emergency colorectal surgery.

Background: The aim of this study was to evaluate the predictive accuracy of different scoring systems on patients undergoing emergency colorectal surgery.

Methods: The Acute Physiology and Chronic Health Evaluation II or III, the Simplified Acute Physiology Score II, the Mortality Probability Model II, and the Colo-rectal POSSUM scoring systems were applied to 102 patients who underwent colorectal resection for cancer. Validation of scoring systems was tested by assessing calibration and discrimination.

Comparison and validation of scoring systems in a cohort of patients treated for perforated peptic ulcer.

Background And Aims: The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic ulcer referred to an academic department of general surgery in a tertiary reference center.

Patients And Methods: Seventy-five consecutive patients (Male/female ratio = 64:11; mean age, 44 years; range, 16-85) with perforated peptic ulcer disease were investigated. Disease severity scores and mortality predictions were calculated using the collected data during admission.