Serum levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in predicting the severity of acute pancreatitis.

INTRODUCTION: Acute pancreatitis (AP) is a severe disease associated with significant morbidity and mortality. The overall outcome has improved, but specific treatment(s) remains elusive. The challenge is the early identification and treatment of patients who will develop severe acute pancreatitis. Therefore, the aim of the present study is to investigate plasma levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in the initial phase of predicted severe acute pancreatitis. METHODS: Between June 2014 and January 2016, 64 patients with acute pancreatitis and 36 healthy individuals were included to study. Four blood samples, for serum TWEAK measurement, were taken from each individual in each group. The first measurement was taken from the admission blood sample. The subsequent three samples were taken at 12, 24, and 48 h after the hospital admission. RESULTS: Serum TWEAK levels were significantly higher in patients with acute pancreatitis when compared with healthy controls. TWEAK plasma concentrations in severe pancreatitis patients were significantly higher than in mild pancreatitis patients. CONCLUSION: Serum TWEAK levels increase progressively with the severity of acute pancreatitis and TWEAK might be a novel early marker of severity in acute pancreatitis.

A rare localization of an extrapleural solitary fibrous tumor.

Solitary fibrous tumor (SFT) is a rare neoplasm that generally originates in the pleura. Extrapleural locations are rare. In such cases, a definitive preoperative diagnosis is often difficult, because neither radiological nor cytological examinations are exhaustive. Therefore, surgical excision is frequently the only way to reach the correct diagnosis and to provide definitive treatment. The case is here described of a solitary fibrous tumor of the soft tissue in the subscapular area in a 50-year-old male.

A rare complication of Crohn disease: Duodenocolic fistula.

Crohn disease (CD) is a chronic inflammatory disease that may be observed in random areas of gastrointestinal tract. Fistula formation is common during the course of CD, whereas duodenocolic fistulas are very rare. It is possible to safely perform surgical resection in patients who have severe symptoms of duodenal fistula. In this study, we report a rare case of CD with duodenocolic fistula that has emerged from the previous surgical resection.

A thermal dysregulation problem after breast cancer surgery; what could be?

RATIONALE: Chronic fatigue syndrome (CFS) is a complicated disorder characterized by severe fatigue that is not relieved with rest and associated with physical symptoms such as sleep problems, headache, muscle pain, or joint pain. PATIENT CONCERNS: Forty-one year old patient complained from feeling cold after breast cancer surgery. DIAGNOSES: The diagnoses of fibromyalgia, depression, neurological, psychiatric, and vascular disorders were excluded by appropriate clinical and laboratory investigations. She was diagnosed as CFS. INTERVENTIONS: The patient was treated successfully via aerobic exercise therapy that scheduled for 30 min at least 3 days per week. OUTCOMES: At 6-month follow-up, her complaints were almost resolved and the patient regained her physical health and mental attitude. LESSONS: A thermal dysregulation should be taken into consideration as one of the symptoms of CFS.

Does inguinal hernia repair have an effect on sexual functions?

INTRODUCTION: The aim of this study is to evaluate sexual functions which are affected by inguinal hernias and may change after hernia repair surgery. MATERIAL AND METHODS: A total of 47 patients who underwent Lichtenstein tension-free anterior repair and inguinal hernia surgery were evaluated in terms of erectile function, intercourse function, sexual desire, overall satisfaction and orgasm satisfaction using the International Index of Erectile function questionnaire (IIEF) scoring system before surgery and in the first and sixth months after surgery. Parameters evaluated with the IIEF score before the surgery and in the first and sixth months after surgery were compared statistically using the Wilcoxon test. RESULTS: The average age of patients was 46.2 ±11.2 years (range: 22-67). It was determined that all scores, apart from sexual desire (p = 0.08), significantly increased in the postoperative first and sixth months compared to the preoperative period. It was measured that the preoperative sexual desire score increased significantly in the postoperative sixth month (p <0.001). A significant score was also detected when all scores in the postoperative sixth month were compared to the postoperative first month. CONCLUSIONS: Inguinal hernia surgery positively affects sexual functions compared to the preoperative period. The improvement in sexual parameters in addition to the benefits of hernia removal and presence of no significant postoperative complications indicates that this surgery is useful and safe.