PurposeTo evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease.MethodsConsecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10–100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present.ResultsFour cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10–100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10–100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease.ConclusionBasal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.

ObjectiveThis study aimed to evaluate the outcomes of rectosigmoid resection (RR) and Douglas peritonectomy (DP) on postoperative complications and survival in advanced-stage ovarian cancer surgery.Methods/MaterialsPatients who underwent optimal cytoreductive surgery including RR and DP between January 2007 and January 2013 were included. Patients with deeper invasion into the muscularis and mucosal layer reported in pathology results and colon wall injury necessitating suturing or resection suggesting invasion of implants into the colon wall were excluded. The decision for RR or DP was made according to the surgical team and patients’ preference. Resections were performed with the suspicion of colon wall invasion. The collected data were age, previous operations, preoperative cancer antigen 125 and albumin levels, surgical procedures, duration of surgery, tumor histology, recurrence, hyperthermic intraperitoneal chemotherapy, and length of hospital stay. Kaplan-Meir survival estimates were calculated and compared between the groups using the log-rank test. Cox proportional models were built to evaluate factors that affected disease-free and overall survival.ResultsAge, body mass index, preoperative cancer antigen 125 levels, albumin levels, and amount of ascites were similar between the groups. Neoadjuvant chemotherapy followed by interval debulking surgery was performed in 15% of both groups. End colostomy was performed in 23.7% of the RR group, and only 5.08% of the patients underwent diverting ileostomy procedures. There was no significant difference in terms of surgical complications between the groups. Recurrence occurred in the RR and DP groups at rates of 42% and 47%, respectively. Only primary debulking surgery had an effect on overall survival (odds ratio, 0.5; 95% confidence interval, 0.31–0.88). Overall survival and disease-free survival were similar in the RR and DP groups.ConclusionsDouglas peritonectomy showed similar survival and surgical outcomes to RR and provided shorter hospital stay and earlier admission to chemotherapy in the management of serosal implants during advanced-stage ovarian cancer surgery.

Myeloid sarcoma is a rare aggressive tumour that originates from immature extramedullary myeloid cells. It can be seen as a relapse in patients with acute myeloid leukaemia. Sometimes it can be seen in the form of a solid tumour without any evidence of leukaemia. A case of a 44-year-old male patient who was admitted with symptoms and signs of mechanical intestinal bowel obstruction was operated on. The operation findings showed small bowel obstruction due to a mass. The mass was then resected with end-to-end intestinal anastomosis. The resected mass pathology results were consistent with myeloid sarcoma. The post-operative period was uneventful and adjuvant therapy was applied. In this case report we aimed to evaluate the clinical signs and treatment modalities of small intestinal myeloid sarcoma.

Araştırmada tüket c ler n yöresel ürün satın alma davranışları ve Doğu Anadolu Bölges yöresel ürünler hakkındak b lg düzeyler n n bel rlenmes amaçlanmıştır. Araştırma 2016 yılında 226 tüket c ye yarıyapılandırılmış anket uygulanarak yapılmıştır. Araştırmanın sonuçlarına göre tüket c ler n yaklaşık %70' yöresel ürünler satın almak stemekted r. %56 oranında tüket c bu ürünler doğrudan yöres nden almayı terc h etmekted r. Genel olarak yöresel olmasını sted kler ürünler; peyn r çeş tler , bal ve tereyağıdır. Tüket c ler yöresel ürünler ; doğal, lezzetl ve sağlıklı olarak konumlandırmaktadır. Tüket c ler n coğrafi şaretler konusundak b lg düzey n n %5 g b düşük b r oranda olduğu tesp t ed lm şt r. Tüket c ler, yöresel ürünlere ortalama olarak %20 daha fazla bedel ödemeye hazırdır. Yöresel ürünler terc h eden ve daha fazla bedel ödemeye hazır olan k ş ler n orta ve üzer gel r düzey ndek orta yaşlı, evl erkek tüket c ler grubunda yoğunlaştığı tesp t ed lm şt r. DAP Bölges ürünler çer s nde en fazla peyn rler, etl yemekler ve kebaplar, meyveler ve bala lg göster lmekted r. DAP Bölges ller n n bölge dışındak büyük pazarlara coğrafi şaretler çatısı altında özell kle peyn r ve bal ürünler nden başlayarak açılmaları gerekmekted r. Anahtar kel meler: Yöresel ürün, coğrafi şaret, tüket c terc h , DAP Bölges

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