The incidence of retained surgical foreign materials and instruments inside

patients is estimated to be 1 in 1,000 to 1,500 intra-abdominal operations. Several studies reported that the risk increases in emergency surgeries, when unplanned procedures occur and in obese patients. A change in surgical teams, excessive loss of blood and long duration of surgery are other associated factors. In our case, the first surgery was an emergency and there was a change in the procedure when converting from a laparoscopy to a laparotomy. Usually, retained foreign abdominal bodies are made of cotton and called gossypibomas. They are detected incidentally. Aseptic fibrinous inflammatory reactions and adhesions encapsulate the CDK inhibition gossypiboma that remains asymptomatic for a long time. In our case, the foreign body was not made of cotton but contained metallic and plastic matrix. Imaging techniques revealed the radio-opaque nature of the retained foreign body. To ensure that nothing has been left in the patient, counting of swabs and instruments is recommended. However, correct reconciliation is reported in the majority of incidents of retained foreign bodies. A new system

has been developed that automates counting and checking utilizing radio frequency identification of individual sponges and packs. The tags attached to the sponges are identified continuously during a procedure rather than episodically as in the traditional click here protocol. Detection does not involve X-irradiation. The increase in cost must be balanced against the potential benefits. “
“We read with great interest the article by Petta et al.1 regarding the association of 25-OH vitamin D (25[OH]D) levels with the response to interferon-based therapy in genotype 1 (G1) chronic hepatitis C (CHC). They found that low 25[OH]D levels were associated with severe fibrosis and low responsiveness to interferon-based therapy in this

patient group. Although the authors discussed their findings comprehensively, we think that there are two additional issues that need to be clarified. First, a MCE great number of studies have indicated that low serum 25[OH]D levels are associated with metabolic syndrome and obesity.2 Ford et al.3 showed that low serum 25[OH]D levels are associated with metabolic syndrome in US adults. Additionally, insulin resistance and CHC infection are clearly linked. Moreover, insulin resistance is a parameter for the response of therapy in G1 CHC.4 However, the authors apparently did not find a similar correlation in their patient group. For that reason, we think that it would have been noteworthy if the authors had taken into consideration the potential effects of metabolic syndrome and particularly insulin resistance on their results.