In this randomized controlled trial, we assessed the effects of using a virtual reality (VR) and communication intervention on pain and anxiety in patients undergoing lipoma excision under local anesthesia. We conducted the study at a large hospital in Turkey between March 15 and September 15, 2019, with 100 participants. We used a pretest and posttest design to collect data with a personal information form, the Numeric Pain Rating Scale, and the State‐Trait Anxiety Inventory. The intervention group participants watched a video using a VR headset during the procedure and communicated with an investigator; the control group participants only received routine surgical treatment. The intervention had a significant effect on pain during the procedure (P < .001) and a moderate effect on anxiety 60 minutes after the procedure (P = .01). Use of VR and active communication may help reduce pain and anxiety for patients undergoing procedures performed with local anesthesia.

Aggressive angiomyxoma (AA) is an uncommon mesenchymal tumor that is mostly derived from the female pelvic and perineal regions. AA is a locally infiltrative slow growing tumor with a marked tendency to local recurrence. Painless swelling located around the genitofemoral region is the common symptom; thus, it is often misdiagnosed as a gynecological malignancy or a groin hernia. A 35-year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. The tumor was completely excised with free margins. Histopathologic examination revealed an AA. The tumor size was measured as 24 × 12 × 6 cm with a weight of 4.2 kg. Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor. S100, MUC4, CD34, and SMA were negative in the tumor cells. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age. The principle treatment should be complete surgical excision with tumor-free margins. Long-term follow-up and careful monitoring are essential due to its high tendency of local recurrence in spite of wide excision of the tumor. Adjuvant antihormonal therapy yields promising results for preventing recurrence.

Phyllodes tumours are uncommon breast neoplasms constituting 1-2% of breast malignancies. Metastasis is usually haematogenous, and axillary lymph node dissection is not routinely performed. A phyllodes tumour with concomitant invasive ductal carcinoma (IDC) is even rarer. When IDCor ductal carcinoma in-situ (DCIS) is detected, the management of the condition changes completely. We report a case of a 22-year female presenting with a mass in the right breast and palpable axillary lymph nodes. The pathological examination demonstrated a malignant phyllodes tumour with concomitant IDC and DCIS. The patient elected to have modified radical mastectomy, and the pathological examination showed metastasis in the axillary lymph nodes. The patient was administered appropriate therapy. At the last visit, she did not have the clinical signs of disease. This is the first youngest case of axillary lymph node metastases with both DCIS and IDC on pathological examination in malignant phyllodes tumour.

Purpose: To investigate experimentally the effects of Tropifexor, a farnesoid X receptor agonist, on liver injury in rats with obstructive jaundice. Methods: Forty healthy Wistar albino female rats were divided randomly in selected groups. These groups were the sham group, control group, vehicle solution group, Ursodeoxycholic acid group and Tropifexor group. Experimental obstructive jaundice was created in all groups, except the sham one. In the blood samples obtained, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin and direct bilirubin levels were established and recorded. Additionally, liver malondialdehyde, myeloperoxidase and catalase enzyme activity in the tissue samples were studied. Histopathological analysis was also performed. Results: No statistical difference was found between the control group and the Tropifexor group when AST, ALT and ALP values were compared. However, it was found that the Tropifexor group had statistically significant decreases in the values of GGT, total bilirubin and direct bilirubin (p < 0.05). Additionally, Tropifexor decreased the median values of malondialdehyde and myeloperoxidase, but this difference was not statistically significant compared to the control group. Finally, the Tropifexor group was statistically significant in recurring histopathological liver damage indicators (p < 0.05). Conclusion: Tropifexor reduced liver damage due to obstructive jaundice.

Lokal anestezi altında gerçekleştirilen cerrahi işlemlerde bireylerde oluşan ağrı ve anksiyete yönetilmesi gereken önemli sağlık bakım sorunlarındandır. Bu araştırma lipom eksizyonu sırasında stres küpü kullanılarak dikkati başka yöne çekmenin ağrı ve anksiyete üzerine etkisinin değerlendirilmesi amacı ile gerçekleştirilmiştir. Gereç ve Yöntem: Araştırma 1 Ekim 2019-1 Mart 2020 tarihleri arasında gerçekleştirilmiştir. Lokal anestezi altında lipom eksizyonu yapılacak, 18 yaşından büyük, yeterli görme, işitme ve konuşma işlevlerine sahip, Türkçe bilen, çalışmaya katılmayı kabul eden bireyler çalışmaya dahil edilmiştir. Verilerin toplanmasında Kişisel Bilgi Formu, Durumluk Kaygı Envanteri ve Sayısal Derecelendirme Ölçeği kullanılmıştır. Çalışma müdahale grubunda 46 kontrol grubunda 46 olmak üzere toplam 92 bireyle gerçekleştirilmiştir. Müdahale grubu lipom eksizyonu sırasında stres küpü kullanmış, kontrol grubu hastanedeki rutin tedavisini almıştır. Bulgular: Katılımcıların %68,5'i erkek, %31,5'i kadındır. Araştırmaya katılan bireylerin yaş ortalaması müdahale (41,67±11,48) ve kontrol (44,59±13,83) grubunda benzerdir (p=0,275). Eksizyon işlemi sırasındaki ağrı şiddeti ortalamaları bakımından müdahale (2,67±1,69) ve kontrol (4,46±2,82) grubu arasında istatistiksel anlamlı bir fark vardır (p<0,001). Eksizyon işlemi öncesi müdahale (38,63±5,24) ve kontrol (40,39±6,04) grubunun anksiyete puan ortalamaları benzerdir (p=0,139). Girişim sonrası gruplar arasında (Müdahale grubu=42,63±5,26; Kontrol grubu= 41,76±5,50) anksiyete puan ortalamaları arasında anlamlı fark yoktur (p=0,440). Sonuç: Bu araştırma sonucunda yapılan girişimin lipom eksizyonu sırasındaki ağrıyı azalttığı ancak anksiyete üzerine etkisinin olmadığı belirlenmiştir. Bu girişimin lokal anestezi altında gerçekleştirilen lipom eksiyonlarında işlem sırasındaki ağrının azaltılmasında rutin olarak kullanılması önerilmiştir.