Unusual Findings in Appendectomy Specimens of Adults: Retrospective Analyses of 1466 Patients and a Review of Literature

Background: Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis. Objectives: This retrospective study was conducted to document the unusual findings in appendectomy specimens. Patients and Methods: Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients' age, gender, clinical presentations, operative reports, pathological reports and follow up. Results: Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 +/- 19. Twenty-nine patients (50.8%) were male and 28 (49.2%) were female. Normal appendix tissues were observed in specimens of 26 (45.6%) patients and inflamed appendix in 31 (54.3%). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology. Conclusions: Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination

Hygiene Hypothesis: What Is the Current Thinking?

Purpose of Review: Our aim was to discuss the hygiene hypothesis and current thinking about it. Recent Findings: Hygiene hypothesis suggests that an underlying reason for the recent prominent rise in allergic diseases may be linked with the diminution of the incidence of early childhood infections, which can be transmitted by means of contact with older siblings. Hygiene hypothesis suggests that contact with microbes in the environment in early life through pets, unpasteurized food, and nonsterilized water may protect from atopic diseases. Exposure to microbial pathogens and animals in infancy prevents atopy by Th1-like cytokine responses or by modifying Th2-like immune responses. Chronic infection and inflammation may protect against atopic disease. Alteration of exposure to microorganisms and access to clean water as well as issues related with food, sanitation, medical and obstetric practices, and urban lifestyle may have significant roles. Decreased exposure to bacteria in the early infancy period may shift the immune system to a predominantly Th2 state which is detected in atopic cases. Environmental exposure may lead to epigenetic changes which causes a shift of immune reactions against microorganisms. Summary: The hygiene hypothesis implies that modern living conditions can be responsible for the rise in the incidences of allergic disease and asthma. Protective effect of food-borne microbes on allergic diseases is another remarkable issue. © 2017, Springer Science+Business Media, LLC