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Purpose Fournier's gangrene (FG) is a polymicrobial disease that affects the skin and subcutaneous tissue and is life-threatening. This study aimed to evaluate the feasibility of scoring systems in predicting mortality in FG patients. Material and Method: 53 patients diagnosed with FG and operated between March 2008-August 2020 in our clinic were included. These patients' demographic findings, laboratory values, Fournier's Gangrene Severity Index (FGSI), Uludağ Fournier's Gangrene Severity Indexi (UFGSI), the Sequential Organ Failure Assessment (SOFA), and Age-Adjusted Charlson Comorbidity Index (ACCI) scoring system values were recorded and analyzed regarding how these scoring systems affected mortality. Results 11 (21%) of the 53 patients died, and 42 (79%) survived. The mean age of the patients was 53.64±17.2 years. The mean age of the surviving patients was 49.64±15.26 years, while the mean age of the patients who died was 68.91±15.96 (p=0.002). Of the laboratory parameters, only creatinine elevation was significant in demonstrating mortality (p=0.001). When the impact of scoring systems on mortality was evaluated, it was determined that the increase in FGSI(P=0.000), UFGSI(P=0.000), SOFA(P=0.000), and ACCI(P=0.003) values were directly related to mortality and statistically significant. Conclusion The FGSI, UFGSI, SOFA, and ACCI scoring systems used in our study were correlated with mortality for FG. ACCI had the highest diagnostic confirmation value. This was followed by SOFA, FGSI, and UFGSI, respectively. We recommend that these scoring systems be used to predict mortality for FG.

OBJECTIVE: The aim was to investigate the effect of primary tumor resection (PTR) on survival in metastatic breast cancer patients and to assess the power of the neutrophil-to-lymphocyte ratio (NLR) regarding the prediction of prognosis in this patient group. MATERIALS AND METHODS: Female patients diagnosed with and starting treatment for metastatic breast cancer from 2003 to 2016 in the general surgery and oncology clinics at a single center were retrospectively reviewed. Pre-treatment NLR value and survival situations were evaluated. RESULTS: A total of 117 patients were enrolled. The disease-specific survival (DSS) of the patients was 41.4 months. When stratified into PTR and systemic treatment (ST) groups, there was no difference in the survival (p = 0.054); 43.5 months in the PTR group vs 30.7 months in the ST group. When hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative subgroups were analyzed, DSS was significantly longer (p = 0.02) in the PTR group (55.4 months) compared to the ST group (41.8 months). Finally, in patients with an NLR of

A 26-year-old shepherd man was admitted to the emergency department in June 2020 after ground current effect of lightning strike. With the severity of the trauma, the patient fell to the ground and then fainted. Since the severity of the trauma was not known exactly, there was an open wound in the head, and the patient had dyspnea and elevated liver function tests, cranial, thorax and abdominal computed tomography (CT) were performed. On CT scan, approximately 7-cm-in length grade 3 liver laceration, extending between segment V and segment VIII was seen without intra-abdominal pathology. The patient was admitted to the intensive care unit (ICU). During the follow-up, liver function tests returned to normal. Liver laceration was managed conservatively. The patient was discharged on the 6th day of hospitalization, as no complications or massive bleeding signs were observed in the intensive care follow-up, his vital signs stabilized, and his symptoms improved.

Aim: To determine the rate of colonoscopies performed in patients referred for colonoscopy due to positive fecal occult blood test in colorectal cancer screening, and the rates of cancer, polyps, and other colorectal diseases detected in those who underwent colonoscopy. Method: Colonoscopy results of the patients were recorded prospectively. Results: Of the 300 consecutive patients scheduled for colonoscopy, only 127 (42.3%) underwent the procedure. Normal colonoscopy findings were seen in 47 (37%) of the patients. Forty patients (31.5%) had benign polyps, 24 (18.9%) had diverticulosis, and 40 (31.5%) had hemorrhoids or anal fissures. One patient (0.8%) had mild dysplasia and one patient (0.8%) had malignant polyp in histopathologic examination of polypectomy specimen. Conclusion: The colonoscopy rate and the rate of detection of malignancy were very low in patients who had positive fecal occult blood test in the present study. Informing patients about the need for colonoscopy and encouraging them to have colonoscopy will be helpful for the success of colorectal screening programs.