Aim: Polycystic ovary syndrome (PCOS) is associated with impaired fertility due to both ovarian dysfunction and alterations in uterine physiology. The aim of this study was to demonstrate the effect of PCOS on myometrium morphology and α-actin expression, which plays a role in the contraction mechanism, as well as on the ultrastructural morphology of myometrial smooth muscle cells (MSMCs).Material and Methods: Twenty-one female Sprague-Dawley rats (21 days old) were divided into control, vehicle and PCOS groups (n = 7 per group). PCOS was induced in the PCOS group by subcutaneous injections of 6 mg/100 g/day of dehydroepiandrosterone (DHEA) dissolved in 0.2 ml of sesame oil for 20 days. Light microscopic analyses of uterine tissue were performed. An ultrastructural examination of MSMCs was performed using transmission electron microscopy.Results: The PCOS group exhibited elevated epithelium thickness and stromal eosinophil infiltration. Masson trichrome staining revealed significant collagen deposition between the smooth muscle bundles in the myometrium, indicating fibrotic remodelling. Immunohistochemical analysis revealed decreased α-actin expression in the PCOS group. Ultrastructurally, MSMCs in the PCOS group demonstrated enlarged perinuclear spaces, while the morphology of dense bodies remained normal.Conclusion: PCOS induces significant remodelling of the myometrium, including increased collagen deposition, vascular dilation and early ultrastructural stress changes. These findings suggest that uterine dysfunction in PCOS may be caused by subtle yet functionally significant alterations to myometrial architecture. Further research incorporating functional contractility assays and contraction-related molecular pathways is required to clarify the mechanisms linking myometrial remodelling to impaired reproductive outcomes in PCOS.
Aim: Glioblastoma (GBM) is an aggressive primary brain tumor with limited treatment options. Ferroptosis, an iron-dependent cell death characterized by lipid peroxidation and oxidative stress, is a promising therapeutic target. This study investigated the anticancer effects of the imipridone derivative ONC212 in GBM cells and examined whether its cytotoxicity involves ferroptosis-related mechanisms.Material and Methods: U87 and U251 cells were treated with increasing ONC212 concentrations. Viability was assessed by CCK-8, proliferation by BrdU incorporation (24–72 h). Ferroptosis-associated changes were evaluated by measuring ferrous iron (Fe²⁺), malondialdehyde (MDA), glutathione (GSH), and reactive oxygen species (ROS). Expression of ferroptosis-related genes GPX4 and ACSL4 was analyzed by qRT-PCR. Ferrostatin-1 (Fer-1) was used to confirm ferroptosis involvement.Results: ONC212 reduced viability in a time- and dose-dependent manner [IC₅₀ (95% CI): 18.7 µM (17.3-20.1), 9.6 µM (8.8-10.4), and 6.2 µM (5.7-6.7) at 24, 48, and 72 h, respectively]. BrdU incorporation decreased by 46.9% and 79.4% at 24 h and 72 h, respectively, following treatment with the 24-hour IC₅₀ concentration (18.7 µM). Ferroptosis-associated oxidative stress was evident through increased Fe²⁺, MDA, ROS, and GSH depletion. ONC212 upregulated ACSL4 (2.14‑fold) and reduced GPX4 expression by 62%. Fer-1 pretreatment partially reversed these alterations, supporting the involvement of ferroptosis-associated mechanisms. Similar results were obtained in U251 cells.Conclusion: ONC212 exerts potent cytotoxic and anti-proliferative effects in GBM cells and provides preliminary evidence suggesting that it induces ferroptosis-associated cell death through modulation of oxidative stress and ferroptosis‑associated gene expression. Targeting ferroptosis with ONC212 may represent a promising therapeutic strategy for GBM.
Subependymal giant cell astrocytoma (SEGA) usually arises near the foramen of Monro in patients with tuberous sclerosis complex (TSC). A 14-year-old boy presented with headache and a 6.2 × 5.8 cm extraventricular, cyst-dominant hemispheric lesion containing a mildly enhancing mural nodule. Microsurgical excision was performed. Histology demonstrated mixed spindle and polygonal epithelioid/ganglioid cells in a fibrillary, microvascular stroma. Tumor cells were positive for glial fibrillary acidic protein (GFAP) and cluster of differentiation 56 (CD56); epithelial membrane antigen (EMA), inhibin, and thyroid transcription factor-1 (TTF-1) were negative, and the Ki-67 labeling index was approximately 1%. No additional major or minor feature of TSC was identified using the 2021 International TSC Consensus criteria. At 12 months, the patient was neurologically intact and headache-free. Germline or tumor TSC1/TSC2 testing and postoperative contrast-enhanced magnetic resonance imaging (MRI) were unavailable. This case highlights the integrated assessment required for pediatric cystic tumors with mural nodules.
The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly associated with a high risk of adverse cardiac events and mortality. The isolated origin of the left anterior descending artery from the pulmonary artery (ALADAPA) is even more infrequent. Although the clinical course is generally quieter than the classic ALCAPA syndrome, it carries a high risk of sudden cardiac death. Conditions that predispose individuals to thrombogenicity can precipitate this insidious condition. In this case report, we describe a fatal instance of ALADAPA syndrome, diagnosed for the first time post-cardiac arrest in a young woman following the use of high-dose oral contraceptive pills for emergency contraception.
Amyloidosis is characterized by the extracellular deposition of abnormally folded proteins. While localized forms occur in the head and neck, nasopharyngeal involvement is rare and can mimic malignancies.We present a rare case of primary localized nasopharyngeal amyloidosis. A 67-year-old female presented with nasal congestion, throat lump sensation, and left-sided conductive hearing loss. Endoscopy revealed a yellow-colored mass in the left nasopharynx. MRI showed a homogeneously enhancing lesion without destruction. Diagnosis was confirmed by histopathology demonstrating apple-green birefringence with Congo red staining. Systemic amyloidosis was excluded through comprehensive evaluation. The patient was managed with close follow-up, and no progression was observed over five years.Nasopharyngeal amyloidosis should be considered in the differential diagnosis of nasopharyngeal masses. Histopathological confirmation is essential, and systemic involvement must be meticulously excluded.
Aim: Cerebral palsy (CP) entails lifelong impairments in movement and posture resulting from non-progressive brain damage. As overall life expectancy increases due to advancements in neonatal conditions, the significance of long-term musculoskeletal health concerns in individuals with CP has grown correspondingly. This study aims to assess bone mineral density (BMD) in pediatric and adolescent populations with CP and investigate clinical, functional, and biochemical factors associated with osteoporosis.Material and Methods: The study included 71 children and adolescents diagnosed with CP. Demographic data, anthropometric measurements, pubertal status, gross motor function classification system (GMFCS) level, treatment details, and fracture history were obtained from hospital records. Serum biochemical parameters and vitamin D levels, vertebral fractures, and lumbar spine BMD measured by dual-energy X-ray absorptiometry were evaluated. Osteoporosis classification was determined using Z-scores.Results: A significant negative correlation was found between GMFCS level and BMD. The osteoporosis group had lower albumin levels, while alkaline phosphatase (ALP) values varied between groups. Patients on anticonvulsants showed reduced calcium and corrected calcium levels, but there was no statistically significant difference in BMD. The rate of osteoporosis was similar across subgroups based on vitamin D status. Additionally, no notable differences were observed between osteoporosis groups in body mass index (BMI) or BMI-standard deviation scores.Conclusion: Metabolic factors, vitamin D levels, and functional limitations influence bone health and the development of secondary osteoporosis in children with CP. GMFCS levels are also a key determinant of bone health. A proactive, multidisciplinary evaluation of bone health is essential for preventing fractures and improving mobility.
Nicolau syndrome, also known as embolia cutis medicamentosa, is a rare ischemic complication of parenteral drug administration. Ceftriaxone-associated cases are exceptionally uncommon. We report a 53-year-old man who developed severe pain, swelling, erythema and violaceous necrotic discoloration involving the left gluteal region and extending to the left femoral area after four intramuscular ceftriaxone injections administered by a non-healthcare professional. Examination revealed a tender, warm, livedoid-necrotic plaque measuring approximately 20 cm. Histopathology demonstrated epidermal and dermal necrosis, fibrinoid necrosis of dermal vessels and a neutrophil-rich panniculitis-like infiltrate. Doppler ultrasonography did not show arterial or venous occlusion and the clinical course was not compatible with necrotizing fasciitis. Nicolau syndrome was diagnosed. Conservative wound care, anti-inflammatory therapy and empiric antibiotics led to complete healing with residual hypopigmented atrophic scarring at six months, highlighting the importance of early recognition and proper injection technique.
Aim: To establish reference intervals for chemical elements in hair samples of children and adolescents living in the Western region of Kazakhstan.Material and Methods: This cross-sectional study was conducted in the Western region of Kazakhstan, including the Aktobe, Mangistau, West Kazakhstan, and Atyrau regions. A total of 2,279 healthy children and adolescents (1,099 boys and 1,180 girls) aged 5 to <18 years participated in the study. Thirteen chemical elements were analyzed in hair samples: calcium (Ca), magnesium (Mg), zinc (Zn), selenium (Se), cobalt (Co), manganese (Mn), copper (Cu), iron (Fe), aluminum (Al), arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg). Hair element concentrations were determined using an Agilent 8900 ICP-MS. Reference intervals were established according to the International Union of Pure and Applied Chemistry (IUPAC) recommendations.Results: Reference intervals (95% reference intervals with 90% confidence intervals for the lower and upper limits) were established for all analyzed chemical elements in hair samples of healthy children and adolescents. Significant sex differences were observed, with boys having higher concentrations of Ca, Zn, Se, Co, Mn, Fe, Al, As, Cd, and Pb than girls.Conclusion: The reference intervals established in this study provide regional reference values for chemical element concentrations in children and adolescents living in Western Kazakhstan. The determined values may be used as a preliminary screening tool in assessing the impact of environmental factors, as well as in implementing preventive measures, providing necessary information and complementing other types of diagnostic procedures.
Aim: Evidence regarding the association of the visceral adiposity index (VAI) and dysfunctional adiposity index (DAI) with gallstone presence remains limited. This study evaluated their associations with gallstone presence and their discriminative performance.Material and Methods: This retrospective observational study included 721 adults who underwent abdominal ultrasonography between 2018 and 2024. Demographic, anthropometric, and laboratory data were retrieved from medical records. VAI and DAI were compared between patients with and without gallstones.Results: Gallstones were identified in 362 patients, while 359 patients served as gallstone-negative controls. Patients with gallstones were older (48.6±12.3 vs. 44.1±11.8 years, p<0.001), more frequently female (62.4% vs. 54.3%, p=0.028), and had higher BMI values (29.4±4.7 vs. 27.8±4.3 kg/m², p<0.001). Fasting glucose, triglyceride, and low-density lipoprotein cholesterol (LDL-C) levels were higher, whereas high-density lipoprotein cholesterol (HDL-C) levels were lower in the gallstone group. VAI (3.42±1.11 vs. 2.87±1.04) and DAI (1.74±0.52 vs. 1.49±0.47) were also significantly higher in patients with gallstones (both p<0.001). Receiver operating characteristic (ROC) curve analysis demonstrated moderate discrimination for VAI (area under the curve (AUC)=0.71, 95% confidence interval (CI): 0.66-0.75, p<0.001) and DAI (AUC=0.69, 95% CI: 0.65-0.74, p<0.001). Age (odds ratio (OR)=1.03, 95% CI: 1.01-1.05, p=0.001), female sex (OR=1.38, 95% CI: 1.02-1.89, p=0.037), VAI (OR=1.62, 95% CI: 1.25-2.10, p<0.001), and DAI (OR=1.47, 95% CI: 1.12-1.93, p=0.005) were found independently associated with gallstone presence.Conclusion: Higher VAI and DAI values were independently associated with gallstone presence. However, their moderate discriminative performance suggests that they should be considered complementary metabolic indicators rather than stand-alone diagnostic tools.
Aim: People living with HIV (PLWH) face a heightened risk of acquiring hepatitis B virus (HBV) infection because these two viruses share common transmission pathways. HIV/HBV coinfection is associated with accelerated liver disease progression. Consequently, hepatitis B vaccination is a critical preventive measure for PLWH. This study was designed to assess the serological response to hepatitis B vaccination in PLWH.Material and Methods: PLWH followed at the Infectious Diseases and Clinical Microbiology Clinic who were seronegative for HBsAg, anti-HBs, and anti-HBc IgG were retrospectively identified. Anti-HBs levels measured 1 month to 1 year after the final vaccine dose were assessed. Criteria associated with low response (anti-HBs titer: <100 mIU/mL) and high response (≥100 mIU/mL) were also evaluated.Results: A total of 54 patients were included in the final analysis. The median age was 43 (range, 22–80) years and 25.9% of the patients were female. Forty-nine patients (90.7%) had anti-HBs levels ≥10 mIU/mL. Anti-HBs levels ≥100 mIU/mL were observed in 10 (28.6%) patients who had received at least one double-dose vaccination versus 3 (15.8%) patients who had not (p=0.341), and in 18 (51.4%) patients with undetectable HIV RNA versus 5 (26.3%) patients with detectable HIV RNA (p=0.091), without reaching statistical significance.Conclusion: Adherence to the hepatitis B vaccination schedule was found to be suboptimal. Identifying the underlying causes of poor vaccination adherence and implementing strategies to improve compliance are essential in PLWH.
Aim: Readmission to intensive care unit (ICU) after discharge is an indicator of increased mortality and prolonged hospitalization. While perioperative assessment traditionally focuses on acute physiological parameters, frailty has emerged as a marker of reduced physiological reserve and vulnerability to decompensation. This study aims to assess the relationship between frailty and ICU readmission in elective surgical patients with planned ICU admission.Material and Methods: This retrospective observational study included patients admitted to ICU after elective surgery between January 2021 and January 2024. Demographics, comorbidities, perioperative data, Clinical Frailty Scale (CFS), APACHE II, SAPS II scores were collected. ICU readmission during the same hospitalization was the primary outcome. Analyses were considered exploratory due to low number of readmission events.Results: Of 1360 screened patients, 145 with complete data were included. ICU readmission occurred in four patients (2.8%). Readmitted patients had longer ICU and hospital stays and higher mortality. Although preoperative CFS did not differ significantly between patients with and without ICU readmission, the median values corresponded to clinically different frailty categories (6 vs. 3; p=0.067). Readmitted patients had longer initial ICU stays and higher initial illness severity scores.Conclusion: ICU readmission after planned postoperative ICU admission was uncommon but was associated with poor clinical outcomes. Although the difference in CFS did not reach statistical significance, the observed CFS pattern may be clinically relevant but should be interpreted as exploratory because of the low number of readmission events. Larger multicenter studies are needed to clarify the role of frailty assessment in ICU discharge planning and postoperative risk stratification.
Aim: To compare clinical outcomes, radiographic parameters, and mechanical complications between 2-rod and 3-rod posterior instrumentation systems in patients undergoing long-segment fusion for degenerative spinal disorders.Material and Methods: This retrospective study included 66 patients who underwent posterior-only corrective spinal fusion for degenerative spinal disorders. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiographic parameters including Cobb angle, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope were evaluated preoperatively, in the early postoperative period, at 1 year, and at final follow-up. Mechanical complications, including mechanical failure associated with pseudarthrosis requiring revision surgery and proximal junctional kyphosis, were recorded.Results: A total of 66 patients were included, including 34 patients in the 2-rod group and 32 patients in the 3-rod group. Both groups demonstrated significant improvements in radiographic parameters and patient-reported outcomes during follow-up. Mechanical failure associated with pseudarthrosis requiring revision surgery occurred in four patients (11.7%) in the 2-rod group and in none of the patients in the 3-rod group. Proximal junctional kyphosis developed in 14.7% and 15.6% of patients, respectively. Repeated-measures analysis demonstrated significant improvements over time in VAS and ODI scores in both groups, without significant differences between groups.Conclusion: Both 2-rod and 3-rod posterior instrumentation systems were associated with significant improvements in clinical and radiographic outcomes. Although mechanical failure was more frequently observed in the 2-rod group, no corresponding differences were observed in patient-reported outcomes. Given the retrospective, non-randomized design, these findings should be interpreted with caution and confirmed in larger prospective studies.
This letter comments on the article “The Effect of Bispectral Index Monitoring on Emergence Delirium in Pediatric Patients: A Retrospective Observational Study.” The study addresses an important clinical issue in pediatric anesthesia by evaluating the potential role of bispectral index monitoring in reducing emergence delirium and improving postoperative recovery. In this commentary, we highlight several clinically relevant points, including anesthetic depth monitoring, volatile anesthetic exposure, pain assessment, and standardized delirium evaluation, and offer suggestions based on recent evidence to support future research in this field.
Aim: The aim of this study was to evaluate the effectiveness of kinesio taping on acute pain, comfort, and patient satisfaction after cesarean section.Material and Methods: The single-center, participant-blinded, randomized placebo-controlled trial was conducted between December 2024 and May 2025. The intervention group (n=32) received a kinesio taping application on the lumbar and trochanteric regions, specifically designed to avoid direct incision sensitivity. The placebo group (n=32) received sham taping. Pain intensity was the primary outcome; comfort and patient satisfaction were secondary. Data was collected at baseline and at 1, 24, and 48 hours post-intervention.Results: Before intervention, the intervention group had higher pain scores (p = 0.030). Post-intervention, no significant differences in pain scores were found at 1 hour (p = 0.828) or 24 hours (p = 0.179). However, at 48 hours, the intervention group reported significantly lower pain scores than the placebo group (p = 0.021). Within group analysis showed significant decrease in pain only for the intervention group (p < 0.001). Body Mass Index was significantly higher in the placebo group (p = 0.024). Overall comfort levels did not differ between the groups (p = 0.572), but satisfaction was significantly higher in the intervention group (p = 0.011).Conclusion: Distal kinesio taping is an effective and safe non-invasive method for reducing postoperative pain at 48 hours and improving patient satisfaction, offering an alternative to around the surgical site. Despite unchanged comfort scores, improved pain and satisfaction support this technique as a valuable adjunct in nursing care.
Aim: Advanced endoscopic procedures such as endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) require deep sedation, during which respiratory complications remain a major concern. This study aimed to compare the effects of propofol and a ketamine–propofol combination (ketofol) on hypoxemia and airway intervention.Material and Methods: This retrospective, single-center observational study included 125 adult participants who underwent EUS or ERCP and received either propofol (n=63) or ketofol (n=62) sedation. The primary outcome was hypoxemia, defined as peripheral oxygen saturation (SpO₂) <90% sustained for at least 10 seconds, and the secondary outcome was the requirement for an airway intervention. Clinical, procedural, and sedation-related variables were analyzed.Results: Hypoxemia occurred in 18 (28.6%) participants in the propofol group and 9 (14.5%) participants in the ketofol group (p=0.056). The lowest recorded SpO₂ was lower in the propofol group than in the ketofol group (91.2±4.8% vs 93.6±3.9%, p=0.003). Airway intervention was required in 14 (22.2%) and 6 (9.7%) participants, respectively (p=0.056). Ketofol sedation was independently associated with a lower risk of hypoxemia (adjusted odds ratio: 0.42, 95% confidence interval: 0.18-0.98, p=0.044). Older age, higher body mass index, American Society of Anesthesiologists physical status class III-IV, and longer procedure duration were independently associated with an increased risk of hypoxemia.Conclusion: Ketofol sedation was independently associated with a lower risk of hypoxemia than propofol alone in patients undergoing advanced endoscopic procedures. These findings suggest that ketofol may offer a potential respiratory safety advantage, although prospective randomized studies are needed to confirm this association.
In non-small cell lung carcinoma (NSCLC), TTF-1 and p40 are well-established immunohistochemical markers for the separation of adenocarcinoma from squamous cell carcinoma. These markers typically occur in distinct and separate tumor types; however, TTF-1 and p40 coexpression has been increasingly documented in recent years. Such tumors usually exhibit a basaloid cellular architecture, with the same neoplastic cells showing diffuse nuclear positivity for both markers. Molecular studies often detect mutations in TP53 as the main alteration in these tumors. Several reported cases have demonstrated aggressive behavior and have been associated with poor outcomes. The coexpression of TTF-1 and p40 may reflect a dual cell differentiation process driven by alterations in the p53 signaling pathway. Recent studies suggest that these tumors represent a distinct subtype of NSCLC within the current WHO and IASLC classification systems. Here, we present a rare case of TP53-mutant NSCLC exhibiting coexpression of TTF-1 and p40.
Aim: To compare mid- to long-term outcomes of tibiotalar arthrodesis (TTA), triple arthrodesis (TA), and tibiotalocalcaneal arthrodesis (TTCA). Outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analog scale (VAS), complications, revision, and adjacent joint osteoarthritis.Material and Methods: This retrospective study included 32 patients who underwent arthrodesis between 2015 and 2024: TTA with cannulated screws (n=15), TA with cannulated screws and staples (n=8), or TTCA with a retrograde intramedullary nail (n=9). Follow-up duration was 4.0 (2.75–7.0) [1–10] years. Functional outcomes were assessed using the AOFAS ankle-hindfoot score and VAS. Complications, revision surgery, and adjacent joint osteoarthritis were also evaluated.Results: AOFAS scores were comparable among groups (p=0.542), whereas VAS scores differed significantly (p=0.037). Post hoc comparisons showed lower VAS scores after TTCA than after TA (adjusted p=0.036); TTA did not differ from TA (p=0.305) or TTCA (p=0.135). Postoperative complications occurred in three TTA patients (20.0%), no TA patients, and one TTCA patient (11.1%), without a group difference (p=0.670). One TTA patient underwent revision for nonunion; revision rates were comparable (p=1.000). Adjacent joint osteoarthritis occurred in one patient.Conclusion: The procedures provided comparable AOFAS scores and low complication and revision rates. TTCA was associated with lower pain than TA, but this finding requires caution given the retrospective design, small groups, and differing indications. Procedure selection should reflect joint involvement, deformity, bone quality, and patient characteristics.
Aim: High-fructose corn syrup (HFCS) has been associated with metabolic and inflammatory disturbances, including pulmonary inflammatory injury. Due to its known anti-inflammatory and tissue-protective properties, this study aimed to investigate the protective effects of dexpanthenol (DEXP) against HFCS-induced structural and molecular lung damage in rat lungs.Material and Methods: Thirty-two male Wistar rats were allocated at random into four groups (Control, HFCS, HFCS+DEXP, DEXP). HFCS (30%) was provided in drinking water for 8 weeks. DEXP was administered intraperitoneally at a dose of 500 mg/kg/day for the last 2 weeks. Lung tissues were processed for hematoxylin–eosin and Picro Sirius Red staining. Hyperemia, edema, epithelial loss, inflammatory cell infiltration, and fibrosis were evaluated semi-quantitatively. The immunohistochemical expression of NF-κB and Caspase-3 was assessed as markers of inflammatory and apoptotic activities.Results: Exposure to HFCS produced alterations such as thickened alveolar walls, interstitial edema, vascular hyperemia, degeneration and loss of epithelial cells, accumulation of inflammatory cells, and early deposition of collagen compared with the control group. Histopathological scores for inflammation, edema, hyperemia, epithelial loss, and fibrosis were significantly increased in the HFCS group (p=0.001, p=0.001, p=0.001, p=0.006, and p=0.011, respectively). In addition, NF-κB and Caspase-3 expression levels were significantly elevated in the HFCS group compared with the control group (p=0.001). DEXP treatment significantly reduced histopathological scores (p=0.001), as well as NF-κB and Caspase-3 expression levels compared with the HFCS group (p=0.001 and p=0.0018, respectively). In the DEXP-only group, lung morphology was preserved.Conclusion: Chronic ingestion of HFCS elicits prominent inflammatory, apoptotic, and fibrotic responses in rat lung tissue. DEXP exerts strong histoprotective and immunomodulatory actions, suggesting potential therapeutic value against HFCS-induced pulmonary injury.
Silent corticotroph pituitary neuroendocrine tumors are a rare subtype of non-functioning pituitary neuroendocrine tumors that lack the clinical and biochemical manifestations of Cushing disease. These tumors are associated with an aggressive clinical course because of a tendency for rapid progression and invasive growth, as well as a high recurrence rate. We present a 41-year-old woman without Cushingoid symptoms who presented with headache, bitemporal hemianopia, and diplopia. MRI revealed a mass extending into the suprasellar region, measuring approximately 2 × 4 cm, with internal necrotic areas and post-contrast enhancement. Following transsphenoidal resection, immunohistochemical staining demonstrated positivity for adrenocorticotropic hormone, confirming the diagnosis of a silent corticotroph pituitary neuroendocrine tumor. This case highlights the importance of recognizing silent corticotroph pituitary neuroendocrine tumors, the treatment approach, and long-term follow-up.
Aim: Postoperative intensive care unit (ICU) care after pancreaticoduodenectomy (PD) is essential for managing perioperative complications. This study evaluated ICU outcomes, mortality, reoperation, and major postoperative complications following PD.Material and Methods: This retrospective cohort study included patients undergoing PD between January 1, 2015, and August 1, 2025, who required postoperative ICU admission. Postoperative ICU admission was reserved for selected high-risk patients based on perioperative clinical assessment. Descriptive statistical analyses were performed. Demographic characteristics, comorbidities, need for continuous renal replacement therapy (CRRT), length of ICU stay, reoperation rates, major postoperative complications, and mortality were analyzed.Results: A total of 80 patients fulfilled the inclusion criteria among the 179 who underwent PD. The cohort had a median age of 65 years, with males constituting the majority of the population (53,66.2%). Common comorbidities included hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, and almost all patients were categorized as ASA physical status III. Preoperative epidural catheterization was performed in 22 patients (27%). Reoperation was required in 3 patients (3.8%), CRRT was required in 3 patients (3.8%), and 8 patients (10%) required ICU readmission, while ICU mortality occurred in 7 patients (8.8%).Conclusion: Due to its complexity, PD is frequently linked to notable morbidity and mortality rates and typically requires close postoperative monitoring in the ICU. This descriptive analysis provides insight into postoperative ICU outcomes following pancreaticoduodenectomy. Early recognition of clinical deterioration during postoperative ICU monitoring may facilitate timely intervention and potentially improve clinical outcomes.
