The effects of intraperitoneal chemotherapeutic agents on adhesion formation.

PURPOSE: Intra-abdominal adhesions are a major complication of healing. Furthermore these adhesions may cause morbidity and sometimes mortality for patients, and also are a financial burden to the health system. MATERIALS AND METHODS: Cecum abrasion was performed in all rats and solutions containing saline to group 1, 5-fluorouracil to group 2, cisplatin to group 3, paclitaxel to the group 4, and mitomycin-C were administered into the abdomen of the groups, respectively. The intra-abdominal adhesions were scored after the macroscopic evaluation. RESULTS: Among the chemotherapeutic drugs, paclitaxel significantly increases occurring of intra-abdominal adhesions in comparison with the control group and the other drugs according to the evaluation of scoring and statistical studies. CONCLUSION: It is suggested to use the drugs which have a proven anti-adhesion feature or barriers to the patients who are going to be applied intraperitoneal chemotherapy with paclitaxel.

Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study.

PURPOSE: There is a common doubt regarding the application of polypropylene mesh to treat incarcerated and strangulated hernias due to the possibility of surgical site infection. We aimed to investigate the results of mesh repair of incarcerated and strangulated hernias, and to evaluate the incidence of wound infection and recurrence. METHODS: One hundred and fifty-three consecutive patients with incarcerated and strangulated hernias underwent surgery with mesh repair. The patients were divided into two groups: a resection group and a nonresection group. Fisher's exact test, the Chi-square test and independent samples t test were used to determine the statistical significance level (p < 0.05). RESULTS: While 53 patients required organ resection, the remaining 100 patients did not. The most frequently incarcerated organs were the omentum (86), small bowel (74) and colon (15). Most of the resections were performed in the omentum (36), small bowel (23) and colon (2). While five of the 53 patients (9.4%) in the resection group developed wound infections, no infections were observed in the nonresection group (p = 0.004). The infection rate in all patients was 3.3% (five of 153 patients). None of the infected patients required mesh removal. There were no mortalities or recurrence in either group. CONCLUSIONS: The findings revealed effective and safe usage of mesh along with antibiotic therapy in patients undergoing incarcerated and strangulated hernia repair.

Can myocardial dysfunction be detected in patients with rheumatoid arthritis with no cardiac symptoms?

OBJECTIVE: The aim of our study was to investigate the role of tissue Doppler and Myocardial Performance Index (MPI) in evaluating cardiac involvement in patients with rheumatoid arthritis (RA) with no cardiac symptoms, to determine whether these measurements differ between healthy controls and RA patients, and whether they can be used to determine the risk of cardiovascular disease and predict prognosis. PATIENTS AND METHODS: 50 RA patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA criteria and 50 healthy volunteering controls were included in the study. All patients and controls were assessed using electrocardiography (ECG), echocardiography, conventional Doppler echocardiography and tissue Doppler echocardiography. MPI values were calculated. In addition, RA patients were compared after being divided into two subgroups: seropositive and seronegative RA. Disease activity levels of the patients were determined based on Disease Activity Score in 28 Joints (DAS28). RESULTS: The control group and RA group were compared in terms of PR interval, left atrial diameter, E/A, E/e', and MPI values. Comparisons between the groups yielded statistically significant differences in left atrial diameter, E/A, E/e', and MPI values and no significant difference in PR intervals. These parameters were also compared between seropositive and seronegative patients. Left atrial diameter was significantly higher in seronegative patients than in seropositive patients. There was no significant difference in the other values. DAS28 scores had no correlation with cardiac parameters. CONCLUSIONS: Early detection of ventricular dysfunction in RA may be useful in clinical practice when predicting prognosis and optimizing treatment. The present study found that RA patients had impaired tissue Doppler measurements and MPI results compared to controls. MPI and tissue Doppler may be useful in early detection of ventricular dysfunction.