A meta-analysis comparing phenol treatment with surgical excision for pilonidal sinus.

Pilonidal sinus is a chronic condition characterized by inflammation, swelling, and pain in the sacrococcygeal region. In recent years, the rate of recurrence and wound complications in PSD remains high, and no treatment is universally accepted. This study aimed to compare the efficacy of phenol treatment with surgical excision treatment for PSD through a meta-analysis of controlled clinical trials. We searched three electronic databases, PubMed, Embase, and Cochrane library, to comprehensively search the literature comparing phenol treatment and surgical treatment of pilonidal sinus. Fourteen publications were included, including five RCTs and nine non-RCTs. The phenol group had a slightly higher rate of disease recurrence than the surgical group (RR = 1.12, 95% CI [0.77,1.63]), but the difference was not statistically significant (P = 0.55 > 0.05). As compared to the surgical group, wound complications were considerably less common (RR = 0.40, 95% CI [0.27,0.59]). Phenol treatment resulted in a significantly shorter operating time than surgery treatment (weighted mean difference -22.76, 95% CI [-31.13,-14.39]). The time to return to daily work was considerably shorter than in the surgical group (weighted mean difference -10.11, 95% CI [-14.58,-5.65]). Postoperative complete healing time was significantly shorter than surgical healing time (weighted mean difference -17.11, 95% CI [-32.18,-2.03]). Phenol treatment is effective for pilonidal sinus disease, and its recurrence rate is not significantly different from surgical treatment. The greatest advantage of phenol treatment is the low incidence of wound complications. Moreover, the time required for treatment and recovery are significantly lower than for surgical treatment.

Comparison of crystallized phenol and Karidakis flap treatment in pilonidal sinus disease.

PURPOSE: In this study, we aimed to compare the results of Karidakis flap reconstruction with crystallized phenol in pilonidal sinus treatment. METHODS: 216 patients treated for pilonidal sinus disease with the researched methods between June 2016 and July 2019 were included in the study. RESULTS: 142 (65.7%) of the patients were treated with the KFR technique and 74 (34.3%) with the crystallized phenol method. Of the patients included in the study, 157 (72.7%) were male, and 59 (27.3%) were female. The mean age was calculated as 24.89 (± 8.4). The mean hospital stay in the KFR group was 1.21 (± 0.4) days. The mean time to return to work was 2.79 (± 1.03) days in the phenol group and 15.35 (± 3.39) days in the KFR group. In 4 (5.4%) patients, the improvement could not be achieved despite multiple sessions of phenol administration, and the procedure was considered unsuccessful. Recurrence occurred in 6 patients (4.22%) in the KFR group. The mean follow-up period was 13.44 (11-16) months in the KFR group and 13.67 (11-16) months in the phenol group. CONCLUSION: It is thought that phenol administration can be applied in selected single-pit cases with high success, low complications, hospitalization, and early return to work. While the KFR method's lower recurrence rates are advantageous, it was noteworthy that the complication rates were higher. KEY WORDS: Crystallized phenol, Karydakis flap reconstruction, Pilonidal sinus disease.

Clinical outcomes of crystallized phenol as a first treatment option in patients with recurrent pilonidal sinus.

AIM: This study aimed to observe the clinical outcomes of phenol treatment in patients with recurrent pilonidal sinus disease. MATERIAL AND METHODS: This study retrospectively collected data from 107 patients with recurrent the pilonidal disease who received phenol treatment in a single institute. Patients were divided into two groups as successful treatment (ST) and unsuccessful treatment (UST) after phenol application. A comparison was held between groups to define factors associated with failure treatment. RESULTS: There were 89 patients in ST and 18 patients in UST group. The treatment success rate after phenol treatment was 83.2%. We observed no difference between ST and UST in terms of age, gender, family history, surgical technique at the first operation, time to recurrence, procedure time, follow-up time, time to return to work, walk without pain or sit on the toilet without pain (p>0.05). However, smoking rate, presence of comorbidity, and mean BMI were statistically significantly higher in the UST group compared to the ST group (p<0.05). In addition, being obese (OR: 2.45, 95% CI: 1.07 - 5.60), having a comorbid disease (OR: 3.11, 95% CI: 1.29 - 7.47), and smoking (OR: 1.97, 95% CI: 0.85 - 4.53) were significantly associated with treatment failure. CONCLUSION: Phenol treatment is an effective and simple procedure that could be easily applied even in rural hospitals in an outpatient fashion. Therefore, it should be considered for patients suffering from recurrence without the need for an aggressive surgical excision. KEY WORDS: Crystallized phenol, Pilonidal sinus, Recurrence.

Chemical Peeling Therapy Using Phenol for the Cervico-Vaginal Intraepithelial Neoplasia.

Objective: This study aimed to validate the use of liquid phenol-based chemical peeling therapy for cervical and vaginal intraepithelial neoplasia (CIN and VaIN, respectively), with the goal of circumventing obstetric complications associated with surgical treatment and to determine the factors associated with treatment resistance. Methods: A total of 483 eligible women diagnosed with CIN, VaIN, or both, participated in this study. Participants underwent phenol-based chemical peeling therapy every 4 weeks until disease clearance. Disease clearance was determined by negative Pap tests for four consecutive weeks or by colposcopy. HPV genotyping was conducted at the onset of the study and after disease clearance in select cases. Our preliminary analysis compared the recurrence and persistence rates between 294 individuals who received phenol-based chemical peeling therapy and 189 untreated patients. Results: At 2 years following diagnosis, persistent disease was observed in 18%, 60%, and 88% of untreated patients with CIN1-3, respectively, and <2% of patients with CIN who received phenol-based chemical peeling therapy. Among 483 participants, 10 immune-suppressed patients required multiple treatments to achieve disease clearance, and 7 were diagnosed with cervical cancer. Of the 466 participants, except those with cancer or immune suppression, the number of treatment sessions until CIN/VaIN clearance ranged from 2 to 42 (average: 9.2 sessions). In total, 43 participants (9.2%) underwent surgical treatment. Six patients (1.3%) experienced recurrence of CIN2 or worse, suggesting that treatment failed in 46 patients (9.9%). No obstetrical complications were noted among the 98 pregnancies following this therapy. Factors associated with resistance to this therapy include immune suppression, ages 35-39 years, higher-grade lesions, and multiple HPV-type infections. Conclusions: Phenol-based therapy is safe and effective for CINs and VaINs. Women aged < 35 years and with persistent CIN1 or CIN2 with a single HPV-type infection are suitable candidates for phenol-based chemical peeling therapy. However, this therapy requires multiple lengthy sessions.

Non-excisional techniques for the treatment of intergluteal pilonidal sinus disease: a systematic review.

Non-excisional techniques for pilonidal sinus disease (PSD) have gained popularity over the last years. The aim of this study was to review short and long-term outcomes for non-excisional techniques with special focus on the additive effect of treatment of the inner lining of the sinus cavity and the difference between primary and recurrent PSD. A systematic search was conducted in Embase, Medline, Web of Science Core Collection, Cochrane and Google Scholar databases for studies on non-excisional techniques for PSD including pit picking techniques with or without additional laser or phenol treatment, unroofing, endoscopic techniques and thrombin gelatin matrix application. Outcomes were recurrence rates, healing rates, complication rates, wound healing times and time taken to return to daily activities. In total, 31 studies comprising 8100 patients were included. Non-excisional techniques had overall healing rates ranging from 67 to 100%. Recurrence rates for pit picking, unroofing and gelatin matrix application varied from 0 to 16% depending on the follow-up time. Recurrence rates after additional laser, phenol and endoscopic techniques varied from 0 to 29%. Complication rates ranged from 0 to 16%, and the wound healing time was between three and forty-seven days. The return to daily activities varied from one to nine days. Non-excisional techniques are associated with fast recovery and low morbidity but recurrence rates are high. Techniques that attempt to additionally treat the inner lining of the sinus have worse recurrence rates than pit picking alone. Recurrence rates do not differ between primary and recurrent disease.

Use of the laser in the pilonidal sinus alone or in combination with phenol.

OBJECTIVE: We investigated the effectiveness of combining laser treatment with phenol in the management of pilonidal sinus. METHODS: We present here a retrospective analysis of patients with pilonidal sinus disease who were treated in the general surgery clinic of the Balikesir University Hospital between October 2019 and February 2022. RESULTS: Recurrence was observed in three patients (13.6%) in the laser treatment group and one patient (4.8%) in the laser-phenol treatment group after the fourth month. Notably, 22 (91.7%) patients in the laser treatment group and 21 (95.5%) patients in the laser-phenol treatment group had complete healing. CONCLUSION: Although not statistically significant, the laser-phenol treatment group exhibited a lower recurrence rate and a higher complete healing rate.

Oral administration of terpenoids and phenol fraction of Padina gymnospora stimulates the nonspecific immune response and expression of immune genes, and protects the common carp (Cyprinus carpio) from experimental Aeromonas hydrophila infection.

Common carp (Cyprinus carpio), a valuable aquaculture species susceptible to various infections, requires effective immune enhancement strategies. This study investigates the immunomodulatory effects of orally administered terpenoids and phenol fraction (TPF) from Padina gymnospora in C. carpio, focusing on stimulation of nonspecific immune response, immune gene expression, and protection against experimental infection. P. gymnospora is a brown seaweed species known for its bioactive compounds and medicinal properties. TPF was extracted using the Harborne fractionation method, and the presence of terpenoids and phenol compounds was confirmed by qualitative analysis and high-performance thin layer chromatography (HPTLC). TPF was administered orally in different doses to carp. Nonspecific immune responses were evaluated by measuring cellular ROS, RNI, and peroxidase production. The expression of immune genes (lysozyme and interleukin-1ß) was assessed by reverse transcriptase PCR. Furthermore, the protective efficacy of TPF was determined by infecting carp with a virulent pathogen, Aeromonas hydrophila, and monitoring mortality rates and disease symptoms. The results demonstrate that oral TPF administration significantly enhances nonspecific immune responses, with increased ROS, RNI, and peroxidase production, indicating improved immune function. Expression levels of lysozyme and interleukin-1ß were upregulated, suggesting immune system activation. Moreover, TPF exhibited significant protection against experimental infection, with lower mortality rates compared to the control group. These findings highlight TPF's potential as an effective immunostimulatory agent, enhancing immune responses and providing infection protection in carp. In conclusion, oral TPF administration stimulates nonspecific immune responses, modulates immune gene expression, and confers protection against experimental infection in carp, displaying its potential for enhancing immune responses and disease resistance in aquaculture species, and contributing to sustainable fish health management.

Comparison of the effectiveness of laser and crystallized phenol in the treatment of sacrococcygeal pilonidal sinus.

BACKGROUND: The aim of this study was to compare the effectiveness of crystallized phenol and laser in the treatment of sacrococcygeal pilonidal sinus (SPS) disease. RESULTS: A total of 80 patients (40 crystallized phenol, 40 laser) were included in the study. The procedure time was significantly shorter in the crystallized phenol group than in the laser group (543 and 837 s, p < 0.001). While there was no significant difference in recurrence and patient satisfaction between the groups (p > 0.05), the visual pain scale pain score and post-procedural complications were significantly lower in the laser group (p < 0.05). There was no significant difference between the number of sinuses and recurrence, bleeding, pain, and patient satisfaction (p > 0.05). CONCLUSIONS: Crystallized phenol and laser used in the treatment of SPS disease have a low recurrence and similar long-term patient satisfaction. However, laser treatment has fewer intraoperative complications and post-operative pain severity than crystallized phenol.

ANTECEDENTES: El objetivo de este estudio fue comparar la efectividad del fenol cristalizado y el láser en el tratamiento de la enfermedad del seno pilonidal sacrococcígeo (SPS). RESULTADOS: Se incluyeron en el estudio un total de 80 pacientes (40 con fenol cristalizado, 40 con láser). El tiempo del procedimiento fue significativamente más corto en el grupo de fenol cristalizado que en el grupo de láser (543 y 837 segundos, p < 0.001). Si bien no hubo diferencias significativas en la recurrencia y la satisfacción del paciente entre los grupos (p > 0.05), la puntuación de dolor VAS y las complicaciones posteriores al procedimiento fueron significativamente más bajas en el grupo de láser (p < 0.05). No hubo diferencia significativa entre el número de senos paranasales y recurrencia, sangrado, dolor y satisfacción del paciente (p > 0.05). CONCLUSIONES: El fenol cristalizado y el láser utilizados en el tratamiento de la enfermedad del SPS tienen una baja recurrencia y una satisfacción del paciente similar a largo plazo. Sin embargo, el tratamiento con láser tiene menos complicaciones intraoperatorias y severidad del dolor postoperatorio que el fenol cristalizado.

A case report of sacrococcygeal foreign body presenting as pilonidal sinus.

Pilonidal disease occurs most commonly in those males who have to sit long hours at their work place e.g. online office workers or drivers. It is caused by piercing of broken hairs into the sacrococcygeal region which causes localised inflammation. Inflammation in this area due to any other foreign body is very rare. Among many treatment options for pilonidal sinus, instillation of crystalloid phenol showed promising results in terms of low recurrence rates, low post-operative complications and less healing time. Here, we present the case of a 13-year-old female student who had pilonidal sinus in sacrococcygeal region for six months and was unresponsive to multiple treatments. Later, on exploration it was revealed to contain a small foreign body of 3cm of hard straw of grass. The patient was treated with crystalloid phenol and on regular follow-up she was completely fine by the end of the third week.

In vitro and in silico perspectives to explain anticancer activity of a novel syringic acid analog ((4-(1H-1, 3-benzodiazol-2-yl)-2, 6-dimethoxy phenol)) through apoptosis activation and NFkB inhibition in K562 leukemia cells.

Syringic acid (SA) is an active carcinogenesis inhibitor; however, the low bioavailability and unstable functional groups hinder its activity. Here, a chemically synthesized novel SA analog (SA10) is evaluated for its anticancer activity using in-vitro and in-silico studies. K562 cell line study revealed that SA10 had shown a higher rate of inhibition (IC50 = 50.40 µg/mL) than its parental compound, SA (IC50 = 96.92 µg/mL), at 50 µM concentration. The inhibition ratio was also been evaluated by checking the expression level of NFkB and Bcl-2 and showing that SA10 has two-fold increase in the inhibitory mechanism than SA. This result demonstrates that SA10 acts as an NFkB inhibitor and an apoptosis inducer. Further, molecular docking and simulation have been performed to get insights into the possible inhibitory mechanism of SA and SA10 on NFkB at the atomistic level. The molecular docking results exemplify that both SA and SA10 bind to the active site of NFkB, thereby interfering with the association between DNA and NFkB. SA10 exhibits a more robust binding affinity than SA and is firmly docked well into the interior of the NFkB, as confirmed by MM-PBSA calculations. In a nutshell, the Benzimidazole scaffold containing SA10 has shown more NFkB inhibitory activity in K562 cells than SA, which could be helpful as an ideal therapeutic NFkB inhibitor for treating cancers.

[Palliative treatment of proximal femur fracture: results of intrathecal phenol (SPING block) in frail older patients]. / Palliatieve pijnbehandeling bij proximale femurfractuur.

This case series describes the clinical outcomes of intrathecal phenol (SPING block) as palliative, non-operative treatment of proximal femur fracture (PFF) in frail older patients with comorbidities and pre-morbid limited mobility. The goal of treatment is to provide adequate pain relief. Ten patients (mean age 89.9, SD 6.4 years) were treated with SPING block. Mean pain score (using NRS) decreased from 5.7 at admission to 1.0 within 4-8 hours after treatment, and 0.5 at discharge; without additional analgesics and irrespective of the type of fracture. Mean hospital stay was 1.9 (SD 0.9) days. Only 2 patients experienced side effects after treatment, i.e. temporary hypotensia and fever. Based on this case series, SPING block could be a promising palliative pain treatment in frail older patients with PFF. Further research is necessary to determine the effects of this treatment on quality of life and cost-effectiveness in this increasing group of patients.

Avaliação da taxa de recidiva do tratamento da onicocriptose com matricectomia parcial seguida de fenolização da matriz ungueal por 45 segundos / Assessment of the recurrence rate of onychocryptosis treatment with partial matricectomy followed by phenolization of the nail matrix for 45 seconds

Introdução: A onicocriptose é uma das queixas mais comuns envolvendo as unhas dos pés nos consultórios médicos. Recentemente, a matricectomia do corno lateral da matriz ungueal seguida da fenolização foi considerada a técnica mais eficaz para o tratamento da onicocriptose. As principais variações na técnica cirúrgica envolvem o questionamento quanto ao tempo de contato do fenol com a matriz ungueal. Objetivo: Avaliar a taxa de recidiva do tratamento da onicocriptose através da quimiocauterização do corno lateral da matriz ungueal com fenol 88% por 45 segundos. Metodologia: Estudo observacional, retrospectivo, baseado na análise de registros fotográficos dos pacientes submetidos à matricectomia parcial seguida de fenolização da matriz ungueal por 45 segundos no Hospital do Servidor Público Municipal de São Paulo entre os anos de 2010-2022. Os pacientes foram acompanhados por 6 meses após o procedimento, com registro fotográfico do sítio operado. Foi considerada recidiva a presença de qualquer espícula ungueal ou sinal de encravamento decorrente da presença dela em qualquer momento do seguimento. Resultados: Avaliadas um total de 802 cirurgias. 52,1% da amostra era do gênero feminino e a dobra mais acometida foi a lateral (54,5%). As unhas mais acometidas foram as do hálux esquerdo e hálux direito (49,3 e 48% respectivamente). A taxa de recidiva em 6 meses foi igual a 1,87% (Intervalo de Confiança de 95%: 0,93% - 2,81%). Pacientes com cirurgia na dobra medial apresentaram maior risco de recidiva em relação a pacientes com cirurgia na dobra lateral (p-valor = 0,008). Conclusão: A redução do tempo de contato do fenol 88% com a matriz ungueal é eficaz, apresentando baixas taxas de recidiva. São necessários estudos prospectivos para melhor avaliar a morbidade pós-operatória. Palavras-chave: Unhas encravadas. Fenol. Cirurgia ambulatorial. Recidiva.

Phenol neurolysis in people with spinal cord injury: a descriptive study.

STUDY DESIGN: Descriptive study. OBJECTIVES: The study's main objective was to describe the common targets of phenol neurolysis and review the safety and efficacy of the dose used for this spasticity management procedure in people with spinal cord injury (SCI). SETTING: An acute rehabilitation hospital. METHODS: Data from people with SCI who underwent phenol neurolysis procedures for spasticity management between April 2017 and August 2018 were included in this study. We collected demographics and phenol neurolysis procedure-related information. RESULTS: A total of 66 people with SCI and spasticity underwent phenol neurolysis of 303 nerves over 102 encounters. During these encounters, 97% of procedures were performed using both electrical stimulation and ultrasound guidance. The median (IQR) total volume of 6% aqueous phenol used per encounter was 4.0 (2.0-6.0) ml with a median (IQR) of 1.5 (1.0-2.3) ml per nerve. The most frequent target was the obturator nerve (33%), followed by the pectoral nerves (23%). Immediate post-phenol neurolysis improvement or reduction in spasticity was reported for 92% of all documented encounters. There was no documentation of any post-procedure-related adverse events in this cohort during this specified time frame. CONCLUSIONS: Our findings suggest that phenol neurolysis can be safely used to manage spasticity in people with SCI under combined electrical stimulation and ultrasound guidance. Further research is required to assess the procedure's safety, efficacy, and cost-effectiveness on patient-reported outcomes compared to other spasticity interventions.

Factors affecting the success of crystallized phenol treatment in sacrococcygeal pilonidal sinus disease.

There are 2 mainstays of sacrococcygeal pilonidal disease (SPD) treatment: non-operative and surgical. None of them was superior, and it was associated with some degree of recurrence. Crystallized phenol treatment is a non-operative procedure performed in outpatient settings. This retrospective study aimed to asses crystallized phenol treatment in patients with primary and recurrent SPD and the factors that influence disease recurrence. A total of 92 patients were included and followed up. Crystallized phenol was administered in an outpatient setting under local anesthesia. All demographic, patient, sinus features, procedure and outcome data were recorded and analyzed for treatment success and factors for recurrence were identified. Between January 2019 and December 2021, 92 patients (77 male and 15 female) with a mean age of 28.4 were treated with 1, 2, or 3 doses of crystallized phenol. Recurrence rate after the procedure was 20.7%. Univariate regression analysis showed that the grade of hirsutism, initial presence of abscess, pit number and number of showers per week had statistically significant effect on recurrence. Multivariate logistic regression analysis pointed on the hirsutism grade (P = .008) and the number of pit openings (P = .003) as a statistically significant factors for recurrence. Crystallized phenol application for primary and recurrent SPD is safe, inexpensive and efficient non-operative method with few minor complications, even when is repeated. Factors responsible for the recurrence of the procedure are grade of hirsutism and sinus pit number.

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study.

BACKGROUND: Cancer-related pelvic pain can be difficult and debilitating to treat. Superior hypogastric plexus neurolysis (SHPN) is a good choice for adequate pain relief with fewer side effects. The current study compared between fluoroscopic anterior approach and ultrasound guided SHPN in the management of cancer-related pelvic pain. METHODS: Patients were randomly allocated into two equal groups. The ultrasound group (US group) (n = 48) received SHPN by an ultrasound-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol, while the fluoroscopy group (n = 48) received SHPN by a fluoroscopy-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol. RESULTS: The time of the procedure was shorter in the fluoroscopic group (21.31 ± 4.79 min) than the US group (24.88 ± 6.02 min) (P = 0.002). Patient satisfaction was higher in the fluoroscopy group (5.38 ± 1.482) than the US group (2.98 ± 1.495) (P˂0.001). The need for analgesia using morphine was significantly limited in each group, at 1, 2 and 3 months intervals (P1˂0.001, P2 ˂0.001 and P3 ˂0.001). There were statistically significant differences between both groups regarding fatigue at baseline, drowsiness at 3 months, nausea and vomiting at 1, 2 and 3 months and anorexia at 3 months. Group comparison also revealed statistically significant differences regarding depression at one month, anxiety at 2 and 3 months and insomnia at baseline. CONCLUSION: The fluoroscopic anterior approach SHPN was more superior than the US guided SHPN regarding the time of the procedure and patient satisfaction, while both technique were similar regarding the numeric rating scale and the complications during block. TRIAL REGISTRATION: Registered in the ClinicalTrials.gov (Identifier: NCT05299047) at 28/03/2022.

l-Amino Acid Based Phenol- and Catechol-Functionalized Poly(ester-urethane)s for Aromatic π-Interaction Driven Drug Stabilization and Their Enzyme-Responsive Delivery in Cancer Cells.

Exploiting aromatic π-interaction for the stabilization of polyaromatic anticancer drugs at the core of the polymer nanoassemblies is an elegant approach for drug delivery in cancer research. To demonstrate this concept, here we report one of the first attempts on enzyme-responsive polymers from aryl-unit containing amino acid bioresources such as l-tyrosine and 3,4-dihydroxy-l-phenylalanine (l-DOPA). A silyl ether protection strategy was adopted to make melt polymerizable monomers, which were subjected to solvent free melt polycondensation to produce silyl-protected poly(ester-urethane)s. Postpolymerization deprotection yielded phenol- and catechol-functionalized poly(ester-urethane)s with appropriate amphiphilicity and produced 100 ± 10 nm size nanoparticles in an aqueous solution. The aromatic π-core in the nanoparticle turns out to be the main driving force for the successful encapsulation of anticancer drugs such as doxorubicin (DOX) and topotecan (TPT). The electron-rich catechol aromatic unit in l-DOPA was found to be unique in stabilizing the DOX and TPT, whereas its l-tyrosine counterpart was found to exhibit limited success. Aromatic π-interactions between l-DOPA and anticancer drug molecules were established by probing the fluorescence characteristics of the drug-polymer chain interactions. Lysosomal enzymatic biodegradation of the poly(ester-urethane) backbone disassembled the nanoparticles and released the loaded drugs at the cellular level. The nascent polymer was nontoxic in breast cancer (MCF7) and WT-MEF cell lines, whereas its DOX and TPT loaded nanoparticles showed remarkable cell growth inhibition. A LysoTracker-assisted confocal microscopic imaging study directly evidenced the polymer nanoparticles' biodegradation at the intracellular level. The present investigation gives an opportunity to design aromatic π-interaction driven drug stabilization in l-amino acid based polymer nanocarriers for drug delivery applications.

Effect of treatment of pilonidal sinus with phenol on patients' clinical condition and quality of life.

BACKGROUND: Pilonidal sinus is a common disease. Curative treatment is surgical excision. However, minimally invasive surgery is preferred day by day. Our study aimed to compare the effects of phenol and excision on postoperative results and quality of life in the treatment of pilonidal sinus. METHODS: The patients who underwent surgery with the diagnosis of the pilonidal sinus in our clinic between June 2019 and June 2021 were examined. Demographic data, anthropometric measurements, clinical information, treatment, and postoperative data of the patients were recorded. Daily pain follow-up with daily visceral pain scale (VPS) was performed in the first ten days postoperatively, and a short form 36 (SF-36) questionnaire was used in the first and fourth weeks. The patients were grouped as phenol and excision groups and compared. RESULTS: The study included 145 patients. Phenol was applied to 83 (57.2%) patients, and excision was applied to 62 (42.8%) patients. There was no statistically significant difference between the groups regarding age, gender, BMI, number of pilonidal sinuses, and family history (p>0.05). Return to work, painless walking and sitting on the toilet, and mean daily VPS values in the phenol group were significantly shorter than the excision group (p<0.05). All subscale values in the postoperative first week SF-36 results were significantly higher than in the excision group (p<0.001) in the phenol group. CONCLUSION: Phenol is effective in the treatment of pilonidal sinus. Despite excision, treatment with phenol affects the patient's quality of life less in the early postoperative period. KEY WORDS: Minimally invasive surgery , Pilonidal sinus, Phenol, Quality of life.

Comparing Crystallized Phenol and Surgical Excision Treatments in Pilonidal Sinus Disease.

OBJECTIVE: To compare the results of commonly used treatments (Karydakis Flap method and crystallized phenol application) in the treatment of pilonidal sinus. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Adana Seyhan State Hospital, Adana City Hospital, and Hisar Intercontinental Hospital Pediatric Surgery Clinic, from January 2016 to December 2020. METHODOLOGY: Patients who were treated for pilonidal Sinus and treated with surgical repair (karydakis flap method) and crystallized phenol method were included in the study. The efficacy and complications of both treatments were compared. RESULTS: Of the patients, 111 (34.7%) were treated with surgical repair, and 208 (65.3%) with the crystallized phenol method. Of the patients included in the study, 166 (52%) were male and 153 (48%) were female. The mean age was calculated as 15.5 (± 1.4). The mean hospital stay in the surgery group was 1.6 ± 0.4 days. The mean time to return to school was 2.8 ± 1.02 days in the phenol group and 12.3 ± 2.2 days in the Surgery group. Despite the third session of phenol application, recovery could not be achieved in 12 (5.7%) patients. Among those who had surgery, recurrence occurred in 7 (6.3%) patients and they had to be operated once more. CONCLUSION: Crystallized Phenol application can be applied in uncomplicated cases due to high success, low complication, rapid recovery, early return to daily activities. KEY WORDS: Crystallized phenol, Surgical treatment, Pilonidal sinus disease.

2-Methoxy-5((3,4,5-trimethosyphenyl) seleninyl) phenol causes G2/M cell cycle arrest and apoptosis in NSCLC cells through mitochondrial apoptotic pathway and MDM2 inhibition.

Nonsmall cell lung cancer (NSCLC) is one of the most common malignancies and needs novel and effective chemotherapy. In this study, our purpose is to explore the anticancer effects of 2-methoxy-5((3,4,5-trimethosyphenyl) seleninyl) phenol (SQ) on human NSCLC (A549 and H460) cells. We found that SQ suppressed the proliferation of NSCLC cells in time- and dose-dependent manners, and blocked the cells at G2/M phase, which was relevant to microtubule depolymerization. Additionally, SQ induced A549 and H460 cell apoptosis by activating the mitochondrial apoptotic pathway. Further, we demonstrated that SQ enhanced the generation of reactive oxygen species (ROS), and pretreatment with N-acetyl- L-cysteine (NAC) attenuated SQ-induced cell apoptosis. Meanwhile, SQ mediated-ROS generation caused DNA damage in A549 and H460 cells. Our data also revealed that SQ-induced apoptosis was correlated with the inhibition of mouse double minute 2 (MDM2) in A549 and H460 cells. In summary, our research indicates that the novel compound SQ has great potential for therapeutic treatment of NSCLC in future.

Evaluation of Phenol-Substituted Diphyllin Derivatives as Selective Antagonists for Ebola Virus Entry.

Ebola virus (EBOV) is an aggressive filoviral pathogen that can induce severe hemorrhagic fever in humans with up to 90% fatality rate. To date, there are no clinically effective small-molecule drugs for postexposure therapies to treat filoviral infections. EBOV cellular entry and infection involve uptake via macropinocytosis, navigation through the endocytic pathway, and pH-dependent escape into the cytoplasm. We report the inhibition of EBOV cell entry via selective inhibition of vacuolar (V)-ATPase by a new series of phenol-substituted derivatives of the natural product scaffold diphyllin. In cells challenged with Ebola virus, the diphyllin derivatives inhibit viral entry dependent upon structural variations to low nanomolar potencies. Mechanistically, the diphyllin derivatives had no effect on uptake and colocalization of viral particles with endocytic marker LAMP1 but directly modulated endosomal pH. The most potent effects were reversible exhibiting higher selectivity than bafilomycin or the parent diphyllin. Unlike general lysosomotrophic agents, the diphyllin derivatives showed no major disruptions of endocytic populations or morphology when examined with Rab5 and LAMP1 markers. The dilated vacuole phenotype induced by apilimod treatment or in constitutively active Rab5 mutant Q79L-expressing cells was both blocked and reversed by the diphyllin derivatives. The results are consistent with the action of the diphyllin scaffold as a selective pH-dependent viral entry block in late endosomes. Overall, the compounds show improved selectivity and minimal cytotoxicity relative to classical endosomal acidification blocking agents.