Suprapubic catheters are surgical alternatives for bladder drainage if Foley catheters are contraindicated. Bowel obstruction is a rare post-operative complication if the catheter transfixes a bowel loop before entering the bladder. Symptoms may begin days to weeks following the procedure and treatment typically necessitates surgical intervention. We report the case of an 88-year-old patient with benign prostatic hyperplasia and a suprapubic catheter who developed a bowel obstruction 3 months after catheter placement. The suprapubic catheter was conservatively removed and replaced with a foley urethral catheter for complete symptomatic relief. This illustrates potential non-invasive treatment for bowel obstruction after suprapubic catheterization.

BACKGROUND: Breast cancer is the most common cancer in women and is the second leading cause of cancer-related deaths after lung cancer. Tumor-infiltrating lymphocyte (TIL) is a phenotype of CD4+ T lymphocytes and CD8+ T lymphocytes that infiltrate tumors. This study aims to evaluate the expression profile of TILs in breast cancer patients at Wahidin Sudirohusodo Hospital, using core biopsies to assess potential prognostic markers.METHODS: This analytic observational study employed a cross-sectional design, conducted at Dr. Wahidin Sudirohusodo Hospital in 2023. The study included female patients diagnosed with breast cancer, who had undergone neoadjuvant treatment, and whose histopathological samples were available. TIL expression was measured using immunohistochemistry, and data were analyzed using Fisher Exact. to explore correlations between TIL expressions and various clinical characteristics.RESULTS: The study included 35 breast cancer patients. The median age was 47 years, with tumor sizes ranging from 3 to 21 cm. The majority of patients were diagnosed with Invasive Breast Carcinoma of No Special Type. TIL expression was classified as low (17.1%), moderate (40%), and high (42.9%). No significant associations were found between TIL levels and factors such as age, cancer stage, histological grade, tumor size, metastasis, or chemotherapy response.CONCLUSIONS: Most patients exhibited moderate to high TIL values, with no significant relationship to clinical characteristics such as cancer stage, histological grade, and chemotherapy response. TIL expression may be a valuable prognostic marker, but further studies with larger sample sizes are necessary to validate these findings.

BACKGROUND: Para-aortic lymph node metastasis (PALNM) is a key prognostic factor in endometrial cancer (EC). This study aimed to determine the incidence and prognostic factors of lymph node metastasis (LNM) and isolated PALNM in endometrioid-type EC patients.METHODS: EC patients treated surgically between 2000 and 2015, staged by FIGO 2009 criteria, were retrospectively analyzed. Included were patients with endometrioid histology grades I-III who underwent pelvic and PALN dissection. Excluded were those without lymph node dissection or with non-endometrioid histology.RESULTS: A total of 417 patients met the criteria. Of these, 246 (59%) were grade I, 117 (28.1%) grade II, and 46 (11%) grade III. Pelvic LNM (PLNM) was found in 43 (10.3%), and PALNM in 22 (5.3%). Five patients (1.19%) had isolated PALNM. PALNM was more frequent in patients with stage III, tumors >2 cm, cervical glandular/stromal involvement, deep myometrial invasion, positive peritoneal cytology, adnexal involvement, PLNM, and LVSI. Isolated PALNM was notably higher with adnexal involvement. Independent predictors of PALNM were cervical glandular involvement and LVSI. Deep myometrial invasion, LNM, PLNM, LVSI, and adnexal involvement were linked to disease-free survival (DFS), while peritoneal cytology, PLNM, and LVSI were linked to recurrence. There was no significant difference in recurrence and DFS between PALNM and isolated PALNM.CONCLUSIONS: Isolated PALNM without PLNM is rare in EC patients but should be assessed for optimal staging and treatment.

<b>Background:</b> Inguinal hernia repair is one of the most frequently performed procedures in general surgery. During the last decade, wider use of mesh-based open techniques and the introduction of laparoscopic TEP/TAPP have progressively changed practice, while the COVID-19 pandemic temporarily shifted case-mix toward emergencies. Material and Method: We conducted a retrospective, longitudinal, single-center study of 1,760 adult patients ( 18 years) admitted for inguinal hernia to Surgical Clinic No. I, Emergency County Hospital Targu Mures, between July 2013 and December 2021. Demographic data, admission type, incarceration, surgical approach, anesthesia and length of stay (LOS) were analyzed. Descriptive statistics and Welch t-tests were used for comparisons, and a multivariable logistic regression model was fitted to identify independent predictors of prolonged length of stay. <b>Results:</b> Male patients predominated (91.8%), with a median age of 61 years. Elective admissions accounted for 77.7% of cases, while 22.3% were emergencies. Laparoscopic repairs increased from 0.9% in 2013 to almost 30% in 2018-2019, then decreased to ~20% during the COVID-19 period. Open repair remained dominant (84.9%). Mean LOS was 3.31 days and was significantly longer in emergency versus elective cases (3.98 vs 3.12 days), open versus laparoscopic repairs (3.52 vs 2.19 days) and incarcerated versus non-incarcerated hernias (4.13 vs 3.22 days) (all p 0.001). <b>Conclusions:</b> Our clinic followed the international trend from non-mesh open to mesh and laparoscopic techniques. Emergency presentation, incarceration and open surgery were each associated with prolonged hospitalization, while the COVID-19 pandemic temporarily reduced elective and laparoscopic repairs.

BACKGROUND: To determine safe and effective antiarrhythmic therapy in pediatric patients, it is essential to identify mechanism underlying arrhythmias, assess any associated risk factors (such as congenital cardiac defects, myocarditis), and closely monitor for potential treatment side effects. The aim of this study was to study clinical patterns of childhood arrhythmia and to study some demographic characteristics and associated factors of arrhythmia in children.METHODS: A cross-sectional study was conducted in a hospital setting from 2022 to 2023. The research included children who were suspected of having arrhythmia. Each patient had a comprehensive assessment, which included obtaining detailed medical history, doing physical examination, performing an ECG, and conducting an Echo study.RESULTS: Sixty-four (9%) of 659 pediatric patients were confirmed to have different specific types of arrhythmias, and 59.4% (N.=38) of them were males. The patients with congenital heart diseases accounted for 60.9% (N.=39), and those without accounted for 39.1% (N.=25). Supraventricular tachycardia was the most prevalent kind of arrhythmia (48.43%), followed by complete heart block (18.8%), ventricular tachycardia (10.9%), atrial fibrillation (9.4%), atrial flutter (4.7%), 2nd degree heart block (4.7%), and 1st degree heart block (3.1%).CONCLUSIONS: Supraventricular tachycardia was most prevalent form of arrhythmia in children, and the majority of cases showed positive response to amiodarone treatment. Postoperative congenital heart disease repair resulted in occurrence of ventricular tachycardia in all instances and total heart block in the majority of cases. The majority of arrhythmias were linked to preexisting congenital cardiac disease.

BACKGROUND: Anal trauma can be in the form of lacerations or excoriations that are harmless but cause discomfort. Anal trauma can be treated non-invasively using a combination of platelet-rich plasma (PRP) and stromal vascular factor cells (SVFs) taken from blood serum and adipose tissue. Collagen is very important in the wound healing process. The increase in growth factors and proteins in PRP and SVFs is expected to stimulate the formation and density of collagen, accelerating anal trauma healing.METHODS: An experimental study with 28 Wistar rats, divided into three groups. The negative control group was conducted on day 0, without anal trauma and without treatment. The positive control group, given anal trauma but without special treatment. The intervention group was given anal trauma, with PRP and SVFs injection treatment. Excisional biopsies were performed, and collagen density was assessed with histopathology scoring parameters of 0 to 4.RESULTS: The average collagen density score of the control group did not show a significant difference after treatment, whereas the average collagen density score of the intervention group showed a significant difference. The collagen density of the control group compared to the intervention group showed a significant difference on day 7 and day 14. Significant differences existed between the collagen density scores of days 1 and 7 and between days 1 and 14. No significant difference was found in the collagen density scores of the intervention group between days 7 and 14.CONCLUSIONS: PRP and SVFs injection is considered capable of significantly increasing collagen density.

High-energy proximal humeral fractures (PHFs), resulting from severe trauma such as falls or vehicular accidents, present a significant challenge in orthopedic surgery due to their complex nature and variable outcomes. This literature overview examines recent advancements in understanding and managing these fractures, emphasizing the latest classification systems, surgical techniques, and rehabilitation strategies. Current evidence highlights the importance of individualized treatment plans that balance anatomical restoration with functional recovery. The review also addresses outcomes related to non-surgical approaches and emerging trends in patient-specific factors influencing prognosis. This overview aims to enhance clinical decision-making and improve patient outcomes in high-energy PHFs by synthesizing current research.

Congress) and Prof. Ctlin Copescu (President of the 16 th Romanian Symposium of Bariatric and Metabolic Surgery).The main theme of the meeting was: "Knowledge and Practice in MIS -the Education Imperative", highlighting the commitment of the society to advancing minimally invasive surgery through education, innovation, and international collaboration.The scientific program was intense and diverse, comprising an outstanding Masterclass on Rectal Surgery, three pre-congress hands-on courses, more than 30 scientific sessions across all MIS domains, plenary lectures, keynote addresses, and roundtables, video sessions and interactive debates, oral and e-poster presentations, and several industry-sponsored symposia.The congress brought together over 300 participants, including surgeons, residents, and students, with a remarkable presence of young surgeons who actively engaged in both educational and scientific sessions.A total of 106 speakers and faculty members, representing 15 different countries, contributed to the scientific program, further strengthening the role of RAES and RSMS as leading regional platforms for MIS education and innovation.The event was supported by 22 partners and 5 sponsors, whose contribution was essential in maintaining the high scientific and educational standards of the meeting.The exhibition area featured national and international companies showcasing cutting-edge technologies in minimally invasive surgery -from advanced laparoscopic platforms, energy devices, and stapling systems to novel imaging equipment and robotic assisted solutions.On September 24 th , three pre-congress courses were held simultaneously in two locations -the Faculty of Medicine, Ovidius University of Constana, and Ana Hotels Europa, Eforie Nord -and all of them were very well attended.

Leziunile canalului biliar comun (CBC) sunt cel mai frecvent de natur iatrogen i rareori apar n contextul traumatismelor abdominale penetrante.Diagnosticul acestora este adesea ntrziat din cauza manifestrilor clinice i imagistice nespecifice.Prezentm cazul unui pacient de sex masculin, n vrst de 36 de ani, cu leziune combinat a CBC i a ficatului, consecutiv unei plgi njunghiate.Evaluarea iniial a evideniat o pacient stabil hemodinamic i respirator, cu semne abdominale nespecifice.Tomografia computerizat a identificat dilacerri hepatice i o cantitate redus de lichid liber intraperitoneal.n timpul monitorizrii clinice, simptomatologia abdominal s-a agravat, motiv pentru care s-a decis explorarea chirurgical.Laparoscopia de urgen a evideniat o zon de coloraie verzui-glbuie la nivelul plcii hilare, motiv pentru care s-a decis conversia la laparotomie, care a confirmat leziunea CBC.S-a practicat repararea primar fr montarea unui stent sau a unui tub n T, cu plasarea unui dren adiacent.Evoluia postoperatorie a fost favorabil; colangiografia prin rezonan magnetic (MRCP) efectuat la o lun nu a evideniat stenoz.Acest caz subliniaz fezabilitatea reparrii primare fr stentare n anumite situaii selecionate de leziuni traumatice ale CBC.