Preventative effect of diclofenac sodium and/or diltiazem in rats with epidural fibrosis.

OBJECTIVE: Spinal epidural fibrosis is commonly seen after laminectomy. There is not yet proven any agent preventing fibrosis in clinical usage. We used diclofenac sodium and diltiazem, which are fibrosis inhibitors. METHODS AND MATERIALS: 40 rats were divided into four groups of equal numbers: control, diclofenac sodium, diltiazem, and diclofenac sodium + diltiazem. Laminectomies were performed at L5 and L6. After a 4 week period, the rats were decapitated and the vertebral column blocks were removed for histopathologic examination. Fibrosis percentage, spread of fibrous regions, and fibroblast numbers were evaluated in each group and compared between the groups. RESULTS: The distribution of epidural fibrosis density, percentage of fibrosis, and distribution of fibroblasts in the diclofenac sodium + diltiazem group were significantly lower than in the other groups. The fibroblast numbers of the diltiazem, and diclofenac sodium + diltiazem groups were significantly lower than in the other groups. CONCLUSION: Diclofenac sodium + diltiazem used together provided better outcomes because each of them prevented fibrosis via different ways, probably through synergistic action (Tab. 5, Fig. 3, Ref. 43).

Microvascular dysfunction affects the development and prognosis of sudden idiopathic hearing loss.

OBJECTIVE: The aim of our study is to investigate whether systemic microvascular function affects the development and prognosis of sudden idiopathic hearing loss (SHL). TYPE OF STUDY: A prospective case-control study. MATERIALS AND METHODS: Fifty patients diagnosed with SHL at our hospital between September 2015 and May 2016 were included as the SHL group, and 50 healthy volunteers who came to the hospital for medical screening were included in the control group. Thirty-one patients from the SHL group who responded to treatment and 19 patients who did not respond to treatment were identified according to the Siegel criteria and were grouped. Patients with comorbid disorders were excluded from the study. To determine microvascular function, the videocapillaroscopic examination was conducted from the nailfold, measuring the capillary density (CD) and post-occlusive reactive hyperaemia (PORH) values and statistical analysis was performed between the groups. RESULT: While CD was an average of 83.1 ± 6 in the SHL group, it was measured as 96.2 ± 10 in the control group. The CD value was significantly lower in the SHL group than the control group (P < 0.05). While the average PORH value in the SHL group was 80.5 ± 7.7, it was measured as 97.5 ± 10 in the control group. The PORH value was significantly lower in the SHL group than the control group (P < 0.05). The CD value did not differ significantly (P > 0.05) between the group that responded to treatment (83.4 ± 5.5) and the group that did not respond to treatment (82.7 ± 6.9). The PORH value was significantly lower (P < 0.05) in the group that did not respond to treatment (75.2 ± 7.9) than the group that did (83.8 ± 5.6). CONCLUSION: To our best knowledge, our study is the first study in the literature. Although the role of specific mechanisms in SHL is not entirely understood, the capillaroscopic examination can show the importance of microvascular function in SHL. CD and PORH values were found to be low in SHL patients, and a low PORH value was found to be a factor of poor prognosis.

Efficacy of preincisional levobupivacaine for adult tonsillectomy patients.

PROBLEM/OBJECTIVE: We compared the effects of preincisional peritonsillar infiltration of 5 ml levobupivacaine hydrochloride (50 mg/10 ml) on bleeding during surgery and pain after tonsillectomy in patients aged 16 years or older. METHODOLOGY: The study was conducted in 44 adult patients who underwent tonsillectomy. These patients were randomized to either the study group (SG) who received levobupivacaine infiltration to the peritonsillary fossae prior to surgery, or a control group (CG) treated with 0.9% sodium chloride infiltration to the peritonsillary fossae prior to incision. The volume of intraoperative bleeding was recorded. Pain was evaluated using a visual analogue scale (VAS). The first pain score was assessed immediately after arriving in the postoperative care unit. VAS scores were subsequently re-assessed 2, 4, 8, 12, and 24 hours postoperatively. The first analgesic requirement was assessed 24 hours postoperatively. RESULTS: The pain relieving effect in the levobupivacaine group was statistically significant 2, 4, 12, and 24 hours postoperatively (p ≤ 0.05), but there was no difference in VAS scores between groups at the first and 8-hour postoperative assessments. There were no differences between the two groups regarding analgesic requirements. The difference between the mean intraoperative blood loss in the SG and CG was statistically significant (p ≤ 0.05). No serious complications were observed in either group. CONCLUSION: Preincisional levobupivacaine infiltration seems to be a safe and easily applied medication for postoperative pain control, and decreased the volume of intraoperative blood loss in adult patients after tonsillectomy.

Assessing quality of life in septorhinoplasty patients with two different instruments.

OBJECTIVE: Quality of life (QOL) assessment in patients with nasal obstruction has not been well studied. The main objectives of this study were to determine the QOL of patients after septorhinoplasty, to measure the efficacy of septorhinoplasty with a validated quality-of-life instrument--the Nasal Obstructive Symptoms Evaluation (NOSE) scale--and with the Glasgow Benefit Inventory (GBI) QOL scores comprising patient assessments of nasal function. PATIENTS AND METHODS: The patient population consisted of a consecutive series of 50 patients who underwent septorhinoplasty at the ages of 18 to 48 years between 2009 and 2011. Quality of life was assessed with the NOSE scale (pre- and postoperatively) and with GBI scores (postoperatively). Demographic data, along with patient assessments of nasal obstruction with a linear analogue scale, were recorded. RESULTS: The mean patient age was 28.3 +/- 14.6 years (age range, 18-48 years). Twenty-eight patients were male (56%) and 22 (44%) were women. Evaluation of each of the 5 items on the NOSE scale individually revealed that patients experienced improvement in all areas. In this study, there was a statistically significant fall in all five parameters (p = 0.000 < 0.05). The mean total GBI score was 34.89 +/- 22.53 and the mean general subscale score was 38.25 +/- 24.31. The mean social support score was 19.67 +/- 33.79 and the mean physical health score was 36.67 +/- 27.97. Each patient had improved QOL scores on the GBI and NOSE scales (P < 0.05). CONCLUSIONS: This study found improved QOL after rhinoplasty in Turkish adult patients. With proper pre-operative assessment and selection, excellent functional and psychosocial outcomes can be expected. NOSE and GBI are valuable tools for the assessment of benefit from nasal septal surgery for nasal obstruction and may be applicable in clinical practice.

Young population bladder neoplasms.

OBJECTIVE: Bladder urothelial carcinoma is a rare condition that primarily affects the elderly and is rare in people under 40 years of age. There is no definitive information about the prognosis and clinical behavior of bladder cancer in young individuals. In our study, we aimed to investigate the prognosis and clinicopathological features of bladder tumors in patients under 40. PATIENTS AND METHODS: A retrospective analysis was performed on patients diagnosed with urothelial neoplasia who underwent bladder surgery between January 2008 and December 2020. The patient's medical records in our cancer database were collected. The study included stage, grade, multifocality, smoking habits, recurrence, and survival. The cases were divided into two groups: those under 40 (Group 1) and those over 40 (Group 2). The clinical and pathological features of young and old patients were compared. RESULTS: 17 patients (14 men and 3 women) under 40 were identified. The age ranged between 19 and 40, and the average was 30.6. One infiltrating urothelial carcinoma (pT1), twelve papillary urothelial carcinomas (pTa), two papillary urothelial neoplasias with low malignant potential, and two urothelial papillomas were all identified by pathology. Dysuria was the primary symptom that initially manifested. Recurrence occurred in two of 12 patients with low-grade papillary urothelial carcinoma in the young patient group. In a similar group of patients over 40, recurrence was detected in 7 out of 10 patients. Patients with urothelial carcinoma under the age of 40 have been noted to have single, small tumors, unlike older patients. No tumor progression was detected in young patients. All young patients are still alive and have not experienced any recurrences. In the group of older patients, tumor progression was observed in 11 patients (16.4%). CONCLUSIONS: Patients under 40 typically have low-grade and low-stage bladder urothelial cancer. Because urothelial tumors in young people frequently have a good prognosis and seldom recur, transurethral excision is the preferred treatment method for bladder tumors.

Cantharidin-podophylotoxin-salicylic acid versus cryotherapy in the treatment of plantar warts: a randomized prospective study.

BACKGROUND: Plantar warts are refractory to any form of treatment. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin and 30% salicylic acid (CPS). However, no data exists comparing the efficacy of this formulation with another treatment. Cryotherapy is a method that is also widely used in the treatment of plantar warts. Likewise, there is no evidence that it is more effective than any topical treatment. OBJECTIVE: We aim to compare the efficacy of topical CPS and cryotherapy in the treatment of plantar warts. METHODS: Patients with plantar warts were consecutively treated with either cryotherapy or topical CPS. Both treatments were performed every 2 weeks for up to five sessions. In patients without complete clearance, the therapy was switched to the other treatment option. RESULTS: Twenty-six patients with a total of 134 warts were included. Fourteen patients were completely cleared of their warts with topical CPS, whereas only in five of 12 patients (41.7%) warts were completely cleared with cryotherapy (P=0.001). In seven patients without complete clearance, the therapy was switched to CPS. Four of these patients missed the follow-up. While the two of the remaining three patients were cleared of their warts, one patient's warts still failed to clear. CONCLUSION: Topical CPS is more effective than cryotherapy in the treatment of plantar warts.

Our experience with carotid body paragangliomas.

Carotid body paragangliomas (CBP) are rare neoplasms arising from the small chemoreceptor organ in the adventitia of the common carotid bifurcation. The aim of this study is to present the diagnostic process, performed treatment and obtained results in patients with carotid body paragangliomas of the Department of Otolaryngology of Istanbul Education and Research Hospital between March 1997 and November 2008. Retrospective analysis was carried out, based on the medical documentation of 5 patients with carotid body paragangliomas (3 women and 2 men), age range 44 to 68 years with a mean of 59.6 years. Four of the patients were diagnosed and treated with Shamblin type II tumor, one of the patients with type I. Physical examination, radiological evaluation, method of the treatment and post-treatment complications were studied. The most common and single symptom was nonspecific neck mass. Preoperative diagnostic evaluation consisted of a color duplex ultrasonography, computerized tomography with contrast enhancement, magnetic resonance imaging and digital subtraction angiography. In all patients with Shamblin type I and II, blunt dissection of the tumor was conducted smoothly in the subadventitial plane. Postoperative vagus nerve and hypoglossal nerve deficit were reported in one case. Carotid body paraganglioma excision has higher risk of cranial nerve paresis and carotid artery injury, so it requires careful handling and good surgical skills to ensure complete removal.

Prognostic nutritional index is an independent prognostic factor for treatment response, survival and drug choice in metastatic castration-resistant prostate cancer treated with abiraterone acetate or enzalutamide.

PURPOSE: We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. METHODS: 101 mCRPC patients were included. PNI was calculated using formula 10 x serum albumin value (gr/dL) + 0.005 × total lymphocyte count (per mm3). ROC analysis was used for determining prognostic PNI value. RESULTS: The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30 %-50%-90% PSA response at any time) were much better in PNI > 46.62 group than the PNI ≤ 46.62 group (p < 0.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: 0.42, p < 0.01), radiologic PFS (HR: 0.53, p < 0.01), and OS (HR: 0.42, p < 0.01). In the PNI ≤ 46.62 group, median OS was 7.4 months (95% CI: 4.1-10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1-25.1) for enzalutamide subgroups (p < 0.01). CONCLUSION: PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide.

Effectiveness of temozolomide treatment used at the same time with radiotherapy and adjuvant temozolomide; concomitant therapy of glioblastoma multiforme: multivariate analysis and other prognostic factors.

AIM: Prognostic factors which affect treatment results of glioblastoma multiforme (GBM; WHO Grade IV) patients has been investigated in many researches. For these patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University Medical School, Neurosurgery Clinic, Adana Medical Research Center, specific characteristics of GBM patients who have surgery retrospectively investigated and factors which affect prognosis has been determined. METHODS: Between January 2005 and January 2009, 59 patients (25 female, 34 male) who have GBM have been evaluated retrospectively. Mean follow-up period was 27.4 (+/-17.3) months. Headache (66.1%) was the most seen symptom. Time of diagnosis was 1-2 months for most of the patients (54.2%). Fifty-nine patients had 67 operations totally. Preoperative Karnofski Performance Scale (KPS) was >or=70 for 43 operations, or=70, for 26 operations KPSor=70 (P=0.0000) , postoperative KPS 2 was >or=70 (P=0.0000), type of tumor resection (P=0.00002), multiple operations (P=0.001), adjuvant RT (P=0.0000) and ConcT with adjuvant TMZ (P=0.0000) were all positive prognostic factors which extend the survival. After multivariate analysis, post operative KPS was >or=70 (P=0.003; OR:0.89; % 95 CI:0.83-0.96), type of resection (P=0.055; OR:0.37; % 95 CI:0.13-0.12) and multiple operations (P=0.042; OR:2.65; % 95 CI:1.03-6.82) were independent prognostic factors. CONCLUSION: When independent prognostic factors were examined ,median survival found out 7.8 months longer fort he patients whose postoperative KPS were >or=70, 5.7 months longer for the patients who had radical resection, 6.6 months longer for the patients who had multiple operations. Although patients who had ConcT with adjuvant TMZ had 1.7 months longer survival compared to patients who had only adjuvant RT, it was not determined as an independent prognostic factor.

Evaluation of the risk of systemic fat mobilization and fat embolus following liposuction with dry and tumescent technique: an experimental study on rats.

BACKGROUND: Clinical studies have revealed that liposuction causes systemic fat mobilization. However, the degree of the risk it causes is not clear. In this study we investigated the risk of systemic fat mobilization and fat embolus in rats following liposuction using dry and tumescent techniques. METHODS: At the end of the procedures, the rats were sacrificed and specimens were obtained from the lungs, kidneys, liver, brain, and skin. Histological examinations of the specimens were carried out. Liposuction was not performed in the control group (n = 8), but blood and tissue specimens for histological examinations were obtained. RESULTS: We found signs of fat embolus in both blood specimens and histological examinations of tissue samples in the study groups. However, the results of the examinations were normal in the control group. Although there were no fat particles in the blood before liposuction, blood specimens obtained following the procedures and in the long-term had fat particles.

A Retrospective Evaluation of 728 Kidney Donors Who Applied for Organ Donation.

OBJECTIVE: The aim of this study was to determine the sociodemographic characteristics of people who applied to be kidney donors at an organ transplantation center. MATERIAL AND METHODS: A total of 728 participants in the kidney donor program were included in the study between 2015 and 2018 at Istanbul Yeniyüzyil University Gaziosmanpasa Hospital. The sociodemographic data of the participants were retrospectively analyzed through computer records, and data were analyzed. RESULTS: Two hundred thirty-nine men and 489 women were included into the study. Six hundred ten were live donors, and 118 were cadaveric donors. Of the donors included in the study, 24.9% were illiterate, 52.1% were primary school graduates, 17.3% were high school graduates, and 5.7% were university graduates. Of the living donors, 156 (25.5%) were spouses, 91 (14.9%) were mothers, 72 (11.9%) were siblings, 65 (10.5%) were fathers, 64 (10.7%) were children, 46 were (7.5%) were other relatives, and 116 (19.0%) were nonrelatives. CONCLUSIONS: In recent years, the number of live kidney transplantations has increased. Therefore, it is necessary to protect their well-being by using evidence-based donor evaluation and treatment strategies to prevent and treat negative consequences of donations.

Relation between sarcopenia and dose-limiting toxicity in patients with metastatic colorectal cancer who received regorafenib.

BACKGROUND: Sarcopenia is related to poor prognosis and drug toxicities in solid tumors. The aim of our study is to investigate the predisposition of patients with metastatic colorectal carcinoma who started regorafenib treatment to sarcopenia and prolonged survival. METHODS: Patients with metastatic colorectal carcinoma who receives regorafenib were search retrospectively. Dose-limiting toxicity was defined as dose reduction or toxicity requiring drug withdrawal. Sarcopenia evaluation was made with computed tomography performed within a month before treatment. Progression-free survival and overall survival were estimated. RESULTS: Thirty-six patients were found as suitable for the study. 63.9% of patients were found as basally sarcopenic. Dose-limiting toxicity occured 13 of 23 patients (56.5%) with basal sarcopenia, whereas only 1 of 13 patients (7.6%) with no sarcopenia exhibited dose-limiting toxicity (p = 0.005). Three patients suffered from grade 3-4 toxicity. Hand-foot syndrome, hypertension, and mucosal rash were the most seen side effects. Mean regorafenib treatment duration was 3.36 months. There was no significant difference in the progression-free survival (PFS) and the overall survival (OS) between sarcopenic patients and patients with no sarcopenia. Durations were as OS 24.2 weeks in patients with sarcopenia (95% CI 16.7-31.7), 28.1 weeks in patients with no sarcopenia (95% CI 20.5-35.7) (p = 0.36), and as PFS 14.2 weeks in patients with sarcopenia (95% CI 12.1-16.4), 14.8 weeks in patients with no sarcopenia (95% CI 9.7-20.1) (p = 0.65). CONCLUSION: Dose-limiting toxicity was significantly higher in basally sarcopenic patients who were started regorafenib as treatment of metastatic colorectal carcinoma. There was no significant relationship between overall survival and progression-free survival with sarcopenia.

Skeletal muscle loss during anti-EGFR combined chemotherapy regimens predicts poor prognosis in patients with RAS wild metastatic colorectal cancer.

PURPOSE: We aimed to assess whether anti-EGFR combined chemotherapy regimens are related with loss of skeletal muscle mass and to compare cetuximab and panitumumab therapies in the aspect of skeletal muscle area change as well as to assess whether skeletal muscle mass loss has prognostic significance in the RAS wild mCRC patients. MATERIALS AND METHODS: A total of 56 patients (30 patients in cetuximab arm and 26 patients in panitumumab) who had computed tomography images were retrospectively evaluated at the diagnosis and follow up during the treatment period before progression. RESULTS: During treatment period 24 patients (42.8%) had muscle loss. Of these, 7 (29.2%) patients were treated at first-line and 17 (70.8%) patients were treated at second-line setting. There was no significant difference in the aspect of skeletal muscle loss among cetuximab and panitumumab combined treatment regimens. Median PFS was 9.1 (8.6-9.6) months in muscle loss group and 13.9 (7.2-20.6) months in muscle stable group (p = 0.001). Median OS was 23.4 (95% CI 15.8-31.0) months in muscle stable group and 19.1 (95% CI 17.0-21.3) months in muscle loss group (p = 0.57) at first-line setting. For second-line, median OS was 21.2 (14.7-27.7) months in muscle stable group and 14.4 (6.0-22.4) months in muscle loss group (p = 0.003). CONCLUSIONS: Decrease in skeletal muscle mass before progression on CT imaging is an independent indicator for shorter PFS value in RAS WT mCRC patients who received anti-EGFR combined chemotherapy regimens at both the first and second-line settings. Beside that shorter overall survival values also were significantly seen in patients who had muscle loss during anti-EGFR therapy in the second-line setting.

The comparison of Nail Psoriasis Severity Index with a less time-consuming qualitative system.

OBJECTIVE: Reliable assessment of severity in nail psoriasis is essential to document treatment responses in clinical trials and routine clinical usage. In this study the correlation between Nail Psoriasis Severity Index (NAPSI) and Cannavo's scoring system was assessed, and inter-rater correlation of NAPSI scores were evaluated. MATERIALS AND METHODS: Forty-five patients with nail psoriasis were included. Target nails were selected and graded by the first dermatologist with both scoring systems. The nails were reevaluated by the second dermatologist with NAPSI. RESULTS: The two systems were highly correlated (P < 0.001). For NAPSI inter-rater correlation was also significant (P < 0.001). CONCLUSION: Our results showed that the qualitative and quantitative evaluations of the same rater were similar. Although the qualitative scoring system of Cannavo's is less time consuming than NAPSI, to suggest this system inter-rater correlations should be evaluated.

The administration sequence of propofol and remifentanil does not affect the ED50 and ED95 of rocuronium in rapid sequence induction of anesthesia: a double-blind randomized controlled trial.

OBJECTIVE: The topic of drug administration sequence in rapid sequence induction (RSI) is still an object of interest in terms of rocuronium effectiveness. The aim of this prospective, randomized trial was to evaluate the effect of administration sequence of propofol and remifentanil on ED50 and ED95 of rocuronium in a RSI model. PATIENTS AND METHODS: Eighty-four patients were randomized into Group Remifentanil (Group R, n = 43), where induction of general anesthesia started with remifentanil (2 µg/kg) and followed by propofol (2 mg/kg) and rocuronium administrations; and Group Propofol (Group P, n = 41), where induction of general anesthesia started with propofol and followed by remifentanil and rocuronium. First patients in each group were paralyzed by 0.8 mg/kg rocuronium. In case of acceptable intubation as evaluated according to the criteria described by Viby-Mogensen et al, rocuronium dose was decreased by 0.1 mg/kg for the next patient; otherwise, rocuronium dose was increased by 0.1 mg/kg. After three crossover points, increments or decrements in rocuronium dosage were set to 0.05 mg/kg. The process was repeated until a total of ten crossover points were obtained. RESULTS: The ED50 and ED95 doses of rocuronium were similar in Group R (0.182 mg/kg, and 0.244 mg/kg, respectively) and Group P (0.121 mg/kg, and 0.243 mg/kg, respectively) according to 95% CI of the estimates. There was no statistically significant difference in terms of clinically acceptable intubation conditions between the two groups (56.1% in Group R vs. 59% in Group P, p = 0.795). CONCLUSIONS: The choice of administration sequence of propofol and remifentanil does not have an impact on estimated ED50 and ED95 of rocuronium in providing acceptable intubation conditions in the RSI technique.

Possibly new multiple congenital anomaly syndrome: cranio-fronto-nasal dysplasia with Poland anomaly.

We present a possibly new multiple congenital anomaly syndrome of craniosynostosis, Poland anomaly, cranio-fronto-nasal "dysplasia," and genital and breast anomalies. A similar pattern of anomalies was observed in two previous cases from the literature; however, some peculiar findings suggest that these cases might represent a new multiple congenital anomaly syndrome.

Alteration by Iloprost of the vasospastic effects of endothelin-1 in rabbit cerebral vessels.

The reversal of endothelin-1 induced cerebral vasospasm with Iloprost was studied in the rabbit. Vasospasm in the basilar artery was evaluated by angiography; cerebral ischaemia by 'red-neurone-count' on light microscopy and morphological changes by electron microscopy. A potent antagonistic effect of Iloprost against ET-1 was observed in each of the parameters measured.

Central nervous system hydatidosis in Turkey: a cooperative study and literature survey analysis of 458 cases.

OBJECT: Hydatidosis is both a medical and an economic problem in Turkey. The aim of this study was to analyze central nervous system (CNS) involvement in this disease, the related problems the disease causes, and its diagnostic and therapeutic aspects. METHODS: The authors conducted an extensive literature survey of the subject, in which papers published by Turkish authors in international and domestic journals were carefully analyzed. In addition, the authors conducted a cooperative study in which data were gathered from 47 neurosurgery departments across the country. The purpose was to determine the current status of the disease in Turkey; thus, each unit was questioned about their experience over the past 5 years. Contrary to common belief, the incidence of hydatidosis has not decreased significantly in Turkey. However, computerized tomography and magnetic resonance imaging have tremendously increased diagnostic specificity. Incidences of morbidity and mortality have improved over time, according to the results of the cooperative study, although these changes are not statistically significant. This may be attributed to experience that has been gained and to more frequent use of chemotherapy, as reflected by the cooperative study data. The two statistically significant findings of that study were expanded use of chemotherapy in the management of hydatidosis, and a higher rate of extraneural involvement in the disease. The cooperative study revealed that chemotherapy was being used more often and that there was a wider range of indications for this treatment than previously reported. The higher rate of extraneural involvement was predictable because lesions in the CNS are typically secondary in this disease. With regard to the studies' findings on cases of spinal hydatid cysts, the authors found that administration of chemotherapeutic drugs was the only statistically significant parameter (t = 3.78, p < 0.05), with the rate of chemotherapy higher in the cooperative study. CONCLUSIONS: Morbidity, mortality, and recurrence rates of hydatidosis uncovered by the cooperative study and the literature survey were not statistically significant.