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Introduction: Covid-19 is a viral epidemic disease that causes serious health problems and death worldwide. The rapid expansion of Covid-19 infection led to the disruption of healthcare services and radical re-organisation of healthcare resources due to the healthcare workers' infection. Aim: This clinical study investigated the effects of Covid-19 infection on emergency and elective cases in our general surgery clinic. Material and methods: We retrospectively analysed the clinical data of 195 patients who underwent elective (Group Elective) and emergency (Group Emergency) surgery during the Covid-19 incubation period in the Bakırköy Dr. Sadi Konuk Training and Research Hospital between March 11 - May 18, 2020. Demographic features, symptoms, surgical diagnoses, surgical methods, complications, duration of surgery, length of hospital stay and mortality, the status of Covid-19 of all patients were recorded. Results: 195 patients, including emergency and elective surgery cases, were operated on (104 and 91, respectively). The incidence of Covid-19 infection was 5.49% in patients scheduled for elective surgery and 4.8% in patients operated urgently, and all developed in the postoperative period. Two patients with emergency surgery died of respiratory failure, their mean age was 51 years. Two of 104 emergency-operated patients were positive from Covid-19 (1.92%) at the time of admission. Eighteen medical staff and nurses got Covid-19 infections. Conclusions: Due to the rapid spread of Covid-19 infection, early precautions must be taken in surgical clinics to guarantee the safety of patients all healthcare providers, and personnel.

AIM: The relationship between papillary thyroid carcinoma (PTC) and accompanying Hashimoto's thyroiditis (HT) has been investigated extensively. However, there is no agreement among the authors. We aimed with this study to investigate this relationship in a limited subtype of PTC called papillary thyroid microcarcinoma (PTMC). PATIENTS AND METHODS: Between January 1999 and December 2012, 1923 thyroids were surgically resected in two referral centers and thoroughly inspected for evidence of PTMC. Of these patients, 172 who were diagnosed with PTMC had demographic and pathological features recorded. RESULTS: Fourteen patients (8.1%) were found to have CLN metastases. Eleven (78.6%) of the patients with CLN metastases had tumors larger than 5 mm, and 3 (21.4%) patients with CLN metastases had small tumors (< 5 mm), but there was no statistical significance (p > 0.05). Accompanying Hashimoto's thyroiditis (HT) was detected in 67 (39%) patients. The CLN metastasis rate was slightly higher in cases with HT in surrounding thyroid tissue. However, there was no statistical significance; the CLN rate was 6.7% (n=7) in patients without thyroiditis and 10.4% (n=7) with Hashimoto's thyroiditis. Insufficient FNA results in patients with thyroiditis were associated with HT (p < 0.05). CONCLUSIONS: Surgeons and other clinicians who play a role in the treatment of thyroid cancers should be aware that some PTMC cases may show a worse course, as with some PTCs, contrary to expectations. [ABSTRACT FROM AUTHOR]

In this study the fertility and outcome of intracytoplasmic sperm injection (ICSI) using megalohead spermatozoa from the ejaculates and testicles was evaluated. Seventeen males with megalohead and pinhead sperm forms in their ejaculate were studied in 22 cycles. A high number of sperm heads without tails and abundant round spermatid forms were commonly observed. Round-headed spermatozoa were seldom accompanied by these severely abnormal spermatozoa. The majority of megalohead spermatozoa were observed to have multiple tails, were predominant in the sample, and were used for ICSI. Ejaculated megalohead spermatozoa were used for ICSI in 15 cycles, while testicular spermatozoa were used in seven cycles where there were no vital spermatozoa or spermatozoa of low vitality in the ejaculate. The same abnormal morphology was observed in the testicles as in the ejaculated spermatozoa in the same males. Mean (± SD) low motility 4.7 ± 5.6% and sperm count (3.8 ± 4.19 x 106) were common findings in these severely teratozoospermic patients. A low fertilization rate (43.2%) was achieved by using megalohead sperm forms (group I, n = 17) in comparison with the control group (60.2%) which had zero normal sperm morphology according to strict criteria (group II, n = 30) (P <0.01). Furthermore, a low pregnancy rate (9.1%) was obtained in the megalohead sperm group in comparison with the control group (40%) (P <0.05). Low fertilization and pregnancy rates may be due to a high incidence of chromosomal abnormalities from severely defective spermatozoa in the ejaculate. Couples should be counselled and warned about possible low fertilization and pregnancy rates with ICSI when only pinhead and megalohead forms with a high number of sperm heads without tails are present in the ejaculate. [ABSTRACT FROM PUBLISHER]

Aim. In this study, we aimed to investigate the effects of Ultrasonic Coagulation (UC), Bipolar Energy Sealing System (BESS), Intra Operative Nerve Monitoring (IONM) and surgical experience on the complications of thyroid surgery. Method. The data of 1627 patients who underwent thyroid surgery for various indications in our department between 2009 and 2018 were analyzed retrospectively and the effects of different technological devices on complications were investigated. Results. Transient recurrent laryngeal nerve (RLN) palsy was higher between 2009 and 2013, when IONM was not in routine use (p=0.029). There were no significant differences between two energy devices (UC and BESS) in terms of transient or permanent RLN palsy, bleeding, and transient or permanent hypocalcemia. Multivariate analysis showed that young age (0.006), female gender (0.016), surgery type (p<0.001), and lateral neck dissection (p=0.026) are independent risk factors for transient hypocalcemia. Conclusion. The results indicate that there is no superior hemostatic device. IONM and specific branching decrease transient RLN palsy. Female gender, young age, completion thyroidectomy, and lateral neck dissection were independent risk factors for the development of transient hypocalcemia. [ABSTRACT FROM AUTHOR]

This study investigated the treatment of wastewater from tomato paste (TP) production using electrocoagulation (EC) and electrooxidation (EO). The effectiveness of water recovery from the pretreated water was then investigated using the membrane process. For this purpose, the effects of independent control variables, including electrode type (aluminum, iron, graphite, and stainless steel), current density (25-75 A/m 2 ), and electrolysis time (15-120 min) on chemical oxygen demand (COD) and color removal were investigated. The results showed that 81.0% of COD and 100% of the color removal were achieved by EC at a current density of 75 A/m 2 , a pH of 6.84 and a reaction time of 120 min aluminum electrodes. In comparison, EO with graphite electrodes achieved 55.6% of COD and 100% of the color removal under similar conditions. The operating cost was calculated to be in the range of $0.56-30.62/m 3 . Overall, the results indicate that EO with graphite electrodes is a promising pretreatment process for the removal of various organics. In the membrane process, NP030, NP010, and NF90 membranes were used at a volume of 250 mL and 5 bar. A significant COD removal rate of 94% was achieved with the membrane. The combination of EC and the membrane process demonstrated the feasibility of water recovery from TP wastewater., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Background: Despite advancements in technology and expertise, ERCP carries risks of significant complications, such as pancreatitis, bleeding, and perforation. Post-ERCP pancreatitis is the most common and important complication following ERCP. In our study, we aimed to examine the relationship between patient and procedure-related parameters and the development of pancreatitis., Methods: Four hundred patients who underwent ERCP between January 1, 2019 and December 31, 2020, at the General Surgery Clinic of the Bakirköy Dr. Sadi Konuk Health Application and Research Center of the University of Health Sciences Faculty of Medicine were retrospectively evaluated. Patient and procedure-related factors were analyzed statistically through univariate and multivariate analyses., Results: Age, urgent indication, ERCP history, cholangitis, precut sphincterotomy, common bile duct diameter, pancreatic cannulation, pancreatic stent, and bleeding were statistically significant risk factors for post-ERCP pancreatitis (+). In multivariate analysis, the effects of urgent indication, ERCP history, cholangitis, precut sphincterotomy, common bile duct diameter, and pancreatic cannulation on post-ERCP pancreatitis were statistically significant risk factors ( P <0.05)., Discussion: This study demonstrates that emergency indication, ERCP history, cholangitis, precut sphincterotomy, and pancreatic cannulation are significant risk factors for the development of post- ERCP pancreatitis. One notable contribution of our study to the existing literature is the unique analysis of post-sphincterotomy bleeding as an independent factor., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Bioremediation is a promising technology that can eliminate the drawbacks of conventional treatment methods in removing harmful toxic metals including chromium(VI). Therefore, in this study, fungal hyphae modified with graphite and reduced graphene oxide were synthesized and assessed for their potential to bioremediate heavy metals for the first time in the literature. The effects of the carbon-based materials on microbial structure were characterized using scanning electron microscopy analysis. Thermogravimetric, RAMAN, X-ray diffraction, and enzymatic analyzes were performed to determine the role of functional groups. In addition, batch adsorption experiments utilizing response surface methodology were conducted to optimize operating parameters such as time (1-11 h), chromium (10-50 mg/L), and graphite/reduced graphene oxide (0.1-1 g/L). The maximum adsorption capacity with the graphene fungal hyphae was determined to be 568 mg.g -1 , which is 9.7 times that of the crude fungal hyphae. The Cr(VI) removal for fungal hyphae-graphite and fungal hyphae-reduced graphene oxide biocomposites was 98.25% and 98.49%, respectively. The isothermal and kinetic results perfectly matched the 2nd order pseudo-model and Langmuir model in terms of the nature of the adsorption process. The laboratory scale test results indicate that fungal hyphae modified with graphite and reduced graphene oxide have a high adsorption capacity, suitable for the removal of chromium (VI) from wastewater.

Mining of precious metals contributes to environmental pollution, especially in coastal areas, and conventional treatment methods are not always effective in removing metal contaminants. Some of these metals, such as gadolinium, germanium and gallium, have caused increasing concern worldwide, as little is known about their current concentrations in the aquatic environment and their biological significance. Therefore, the aim of this study was to determine for the first time the variation of average G(s) concentrations (gallium, gadolinium and germanium) by month/season/site differences along the coast of Istanbul. The ecological risk index was calculated to assess the contamination of seawater and to serve as a diagnostic tool for the mitigation of water pollution. The average distribution G(s) in seawater was in the following order: Ga > Gd > Ge. In addition, the potential ecological risk in the sampling areas ranged from 68 to 1049. Of the three metals, Gd poses the highest ecological risk (grade III). In the spatial distribution of ecological risks, Gd mainly originated from discharges from wastewater treatment plants. Therefore, the sources of the anthropogenic Gd anomaly in wastewater should be identified, as this indicates the possibility of human exposure to potentially harmful anthropogenic compounds., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

There are several studies stating that many types of microplastics cannot be retained completely by conventional wastewater treatment systems. Therefore, it is necessary to prevent the discharge of these microplastics to the ecological system. The objective of this study was to investigate the biodegradation ability of two different size of PE (50 and 150 µm) by using two Gram-positive, spore-forming, rod-shaped, and motile thermophilic bacteria, called strain Gecek4 and strain ST5, which can hydrolyse starch, were isolated from the soil's samples of Gecek and Ömer hot-springs in Afyonkarahisar, Turkey, respectively. Phenotypic features and 16S rRNA analyzing of strains also studied. According to these results, Gecek4s and ST5 were identified as Anoxybacillus flavithermus Gecek4s and Bacillus firmus ST5, respectively. Results showed that A. flavithermus Gecek4s could colonise the polymer surface and cause surface damage whereas B. firmus ST5 could not degrade bigger-sized particles efficiently. In addition, morphological changes on microplastic surface were investigated by scanning electron microscopy (SEM) where dimensional changes, irregularities, crack, and/or holes were detected. This finding suggests that there is a high potential to develop an effective integrated method for plastic bags degradation by extracellular enzymes from bacteria.

Purpose: Although not as life-threatening as anastomotic leakage, anastomotic stricture reduces the quality of life. The risk factors for such an important life complication have not been revealed. This article examines the risk factors affecting anastomotic strictures due to colorectal cancers., Methods: Patients who underwent anterior and low anterior resection for colorectal cancer under elective conditions between 2015 and 2021 were included in the study. The patients were divided into two groups, those who developed anastomotic stricture and those who did not. The parameters determined between the two groups were compared, and multivariate analysis of statistically significant parameters was performed., Results: A total of 375 patients were included in the study. The anastomotic stricture was detected in 36 (9.6%) patients. In the multivariate analysis, non-mobilization of the splenic flexure and a proximal clean surgical margin of < 10 cm and a distal surgical margin of < 2 cm were identified as risk factors affecting anastomotic stricture. The risk factor with the highest odds ratio in the development of anastomotic stricture is the non-mobilization of the splenic flexure (p = 0.001, OR 11.375)., Conclusion: It is recommended that the mobilization of the splenic flexure to reduce the development of strictures. In addition, a clean surgical margin of 10 cm proximally and 2 cm distally and high ligation of the inferior mesenteric artery may reduce the development of stricture., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In recent years, the demand for critical raw materials such as gallium, gadolinium and germanium (G(s)) has steadily increased in various industries. However, treatment or recycling rates of these elements are extremely low, which can lead to environmental pollution. An assessment of the ecological risks was also not possible until now, as there were no calculated toxicity coefficients for G(s). In this study, a well-known method, the so-called potential ecological risk index (PERI), was used for the first time to calculate the toxicity coefficients of these elements using data from recent literature studies on G(s) elements. The toxicity coefficient of each of the three elements was determined as five (5). The results show that G(s) have the same toxicity coefficient as Cu and Pb and are higher than that of Cr. The ecological risk index results varied from 4 to 414, 0.98 to 25.98 and 2.50 to 284.64 for Ga, Gd and Ge, respectively. The results show that Ga and Ge pose high ecological risk while the Er i of Gd is low. The toxicity coefficients of these elements have been calculated for the first time in the literature and provide a practical use for calculating the potential ecological risk index., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study aims to understand the influence of wastewater treatment plant discharge on the microplastic status in the surface seawater of Istanbul. For this purpose, for the first time, the distribution, composition, and ecological risk of microplastics at nine sampling stations on the southern coast of Istanbul, Marmara, were investigated at monthly intervals over a one-year period. The results showed that the microplastic abundance ranged from 0 to over 1000 particles per liter. Fibers were the dominant form at all stations. Microplastics 249-100 μm were the dominant size, and transparency was the color most found at all stations. Polyethylene and ethylene-vinyl acetate were the major types of microplastics, accounting for 50% overall. The pollution load index revealed that over 70% of sampling stations were at hazard level I. However, the hazardous index was categorized as level III with a value of 662.3 due to the presence of the most hazardous polymer named polyurethane. Further investigations into the risk assessment of MP can reveal crucial knowledge for understanding the microplastic cycle., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: To evaluate our experience and short term surgical outcomes between two robotic systems., Methods: The present study retrospectively analyzed 38 cases, who underwent robotic adrenalectomy between 2012-2019 at our center. The patients were divided into Group Si (n=11) and Group Xi (n=27), and the results of these two groups were compared., Results: Demographic characteristics of both groups were similar between two groups. While, 42% of the patients had Cushing syndrome, 22% had Pheochromocytoma and 22% had Conn syndrome in the Xi group, 72% of the patients were non-secreting adrenocortical adenoma in Si group (p=0.005). The mean docking time in Group Xi was shorter than Si group (p=0.027). Console and total operation times were similar in both groups (p=0.312 and p=0.424; respectively). The intraoperative complication rate (p=0.500) and hospital stay (3.2±1.0 vs. 2.52±1.42 days, respectively, p = 0.077) were similar in both groups. Postoperative 4th and 12th hour Visual Analog Scale (VAS) scores were similar (p=0.213 and p=0.857; respectively). The average cost of robotic consumables was $210 higher in Xi group (p=0.495)., Conclusion: Our study shows that; the Xi robotic system is as safe as the Si system for adrenalectomy operations., Key Words: Adrenal gland surgery, Minimally invasive adrenalectomy, Robotic surgery.

Microplastics (MPs) pose potential public health challenges because of their widespread occurrences in all environmental compartments. While most studies have focused on the occurrence fate of microplastics in wastewater treatment systems, the biodegradation of microplastics in wastewater is generally little understood. Therefore, we used two Gram-positive and thermophilic bacteria, called strain ST3 and ST6, which were identified by morphological, biochemical, physiological, and molecular analyses, to assess the growth and biodegradation potential of two different sized (50 and 150 m) polyethylene particles. The degradation was monitored based on structural and surface morphological changes. According to 16S rRNA analyses, ST3 and ST6 were identified as Anoxybacillus flavithermus ST3 and Anoxybacillus sp. ST6, respectively. The occurrence of cracks, holes, and dimensional changes was detected by scanning electron microscopy. Moreover, critical characteristic absorption band formation and modifications were determined by Fourier transform infrared spectroscopy. In addition to these, it was found that Anoxybacillus flavithermus ST3 and Anoxybacillus sp. ST6 produced high level of alpha-Amylase. These results showed that thermophilic bacteria are capable of the biodegradation of microplastics and production of alpha-Amylase., Competing Interests: The authors declare no conflict of interest.