Medicina
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Background: Surgical inflammatory pain decreases the innate and adaptive immune antitumor response and favors residual circulating tumor cells. Objectives: This study investigated whether minimally invasive surgeries (laparoscopic and robotic procedures), which are less painful and inflammatory, improved oncological outcomes after colorectal resection compared to laparotomy. Methods: This research was a single-center propensity score-matched study involving patients who underwent colectomy and rectum resection from July 2017 to December 2019. ⋯ Lidocaine infusion (HR 0.39, p = 0.04) was a positive predictor for RFS. Conclusions: Minimally invasive procedures reduce postoperative complications and shorten the length of hospital stay compared to major surgeries without improving prognosis. However, the administration of local anesthetics through neuraxial anesthesia or intravenous infusion could improve survival and decrease the occurrence of relapses.
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Randomized Controlled Trial
Effects of Sling-Suspension-Based Active Shoulder Joint Exercise on Shoulder Joint Subluxation, Pain, Muscle Strength, and Upper Limb Function in Patients with Subacute Stroke.
Background and Objectives: We investigated the effects of sling-suspension-based active shoulder joint exercise training on shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke. Materials and Methods: Twenty-eight patients with subacute stroke were randomly assigned to either the sling-suspension-based active shoulder joint exercise (SASE) group (n = 14) or the motorized upper extremity exercise (MUEE) group (n = 14). The SASE group actively performed shoulder joint flexion, extension, abduction, adduction, external and internal rotation, and horizontal abduction and adduction using a sling suspension system, whereas the MUEE group underwent an exercise program using a motorized upper extremity exercise machine. ⋯ A significant time-group interaction was observed in the FMA, with F-values of F(1, 26) = 13.243, p < 0.001. When comparing the interaction effects between time and group for MFT scores, a significant difference was observed, with F-values of F(1, 26) = 32.386, p < 0.001. Conclusions: This study confirmed that sling-suspension-based active shoulder joint exercises are effective in improving shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke.
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Comparative Study
A Comparison of Pre- and Post-Treatment Cranial MRI Characteristics in Patients with Pediatric Epilepsy Receiving Levetiracetam.
Background and Objectives: This study was performed for the purpose of assessing whether antiepileptic levetiracetam treatment produces a change in brain volumes in children with epilepsy. To that end, we compared the volumes of the basal ganglia (caudate nucleus, putamen, globus, hip-pocampus, and thalamus) at magnetic resonance imaging (MRI) before and after treatment (months 18-24) in pediatric epilepsy patients using levetiracetam. Materials and Methods: This retrospective study involved a volumetric comparison of patients presenting to the Balikesir University Medical Faculty pediatric neurology clinic between 01.08.2019 and 01.11.2023 and diagnosed with epilepsy, and who underwent cranial MRI before and 18-24 months after treatment at the radiology department. ⋯ Conclusions: In conclusion, differing findings are encountered at cranial imaging in patients with epilepsy, depending on the seizure frequency, activity, and the type of antiepileptic drugs used. This study compared basal ganglia volumes on cranial MRIs taken before and 18-24 months after treatment in pediatric epilepsy patients using levetiracetam. A significant increase was observed in the volumes of basal ganglia (caudate nucleus, putamen, globus pallidus, hippocampus, and thalamus) on the MRIs of pediatric epilepsy patients using levetiracetam.
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Background and Objectives: COVID-19 disease, caused by the SARS-CoV-2 virus, has presented significant challenges to global health, with acute and chronic implications for various aspects of well-being, including sleep and quality of life. This study aimed to investigate the impact of SARS-CoV-2 infection on sleep quality, daytime sleepiness, and quality of life in hospitalised and home-treated patients after three and six months. Materials and Methods: A longitudinal cohort study was conducted, enrolling hospitalised patients from a single clinical university hospital and home-treated participants through a survey spread through social networks. ⋯ Most patients (n = 36) were treated at home and 30 at hospital. Six months after SARS-CoV-2 infection, home-treated patients reported a higher prevalence of poor sleep quality (52.8%, n = 19, p = 0.015, PSQI) and hospitalised patients showed a lower prevalence of depressive symptoms (p < 0.001, PHQ-9) as 90% (n = 27) had minimal or no symptoms compared to 30.6% (n = 11) in a home-treated group. Conclusions: These findings mark the importance of the COVID-19 patients' management settings as people treated at home had worse sleep quality and more depressive symptoms six months after infection indicating worse life quality.
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Background and Objectives: In the surgical treatment of benign prostatic hyperplasia (BPH), laser enucleation of the prostate is recommended as an alternative to transurethral resection (TURP) and open prostatectomy (OP). The thulium fiber laser, with its superficial penetration depth, can offer a rapid learning process by causing less heat injury and capsule damage. This study compares the first 60 cases of an endourologist performing thulium fiber enucleation of the prostate (ThuFLEP) without a mentor to the results of OP and TURP performed by experienced surgeons. ⋯ Postoperative Qmax and IPSS values showed no significant differences among the three ThuFLEP groups (p > 0.05). Conclusions: For large prostates, ThuFLEP provides better postoperative results than TURP and offers shorter catheterization and hospital stay times than OP. Its short learning curve makes it a preferable method for treating BPH compared to other laser techniques.