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1.
Eur Rev Med Pharmacol Sci ; 27(5 Suppl): 6-10, 2023 10.
Article in English | MEDLINE | ID: mdl-37869942

ABSTRACT

OBJECTIVE: Since mastoid bone aeration is a pressure buffer for the middle ear, it can be accepted as a prognostic factor for tympanoplasty. Temporal bone computed tomography (TBCT) is a primary method for estimating mastoid aeration. However, due to the risk of radiation and its high cost, there is a need for a more straightforward, faster, and more reliable method in non-complicated chronic otitis media cases (COM). Tympanometric volume measurement might be used for this purpose. This study investigated tympanometric volume measurement's reliability in showing mastoid bone aeration by comparing tympanometric volume measurement with TBCT aeration grading. PATIENTS AND METHODS: Preoperative tympanometric volume measurements were performed in patients who underwent audiological examination and temporal computerized tomography (CT) with the diagnosis of COM and sequela of COM without discharge for the last three months and were indicated for surgery. CT was classified into six grades: grade 0: there is no aeration, sclerotic mastoid; grade 1: pneumatization only in the mastoid antrum; grade 2: <25% pneumatization; grade 3: 25-50% pneumatization; grade 4: >50 pneumatization, grade 5: full pneumatization. Averages of tympanometric volume values were determined according to CT degrees. RESULTS: 48 left and 52 right ears (n: 100) of 81 patients, 24 females and 57 males, were included in the study. The mean age was 37.69±13.38. Mastoid pneumatization grades of patients were 32 grade 0, 23 grade 1, 16 grade 2, 14 grade 3, 11 grade 4, and 4 grade 5, respectively. Each grade's mean tympanometric volume (mL) was grade 0: 1.1594, grade 1: 1.6991, grade 2: 2.2250, grade 3: 3.0471, grade 4: 4.0327, and grade 5: 2.9775. CONCLUSIONS: There is a statistically significant relationship between tympanometrically measured ear volume and mastoid degrees of pneumatization on temporal bone tomography. As the degree of mastoid aeration increases, the tympanometric volume also increases. According to the results of this study, tympanometric air volume can be used reliably in the preoperative evaluation of mastoid bone aeration in cases of simple COM without ear drainage.


Subject(s)
Mastoid , Otitis Media , Male , Female , Humans , Young Adult , Adult , Middle Aged , Mastoid/diagnostic imaging , Mastoid/surgery , Reproducibility of Results , Temporal Bone/diagnostic imaging , Otitis Media/diagnostic imaging , Otitis Media/complications , Otitis Media/surgery , Tomography, X-Ray Computed/methods , Chronic Disease
2.
Pulmonology ; 29 Suppl 4: S18-S24, 2023 Dec.
Article in English | MEDLINE | ID: mdl-34281801

ABSTRACT

BACKGROUND AND OBJECTIVES: In patients with pulmonary hypertension (PH), shortness of breath, fatigue, chest pain, and syncope limit exercise capacity. Exercise tests are often time-consuming, expensive, and some patients may not be able to perform such procedures and they are also difficult to apply in the studies including large samples. The aim of this study was to translate and culturally adapt the DASI into Turkish and to investigate its reliability and validity in patients with PH. METHODS: The final Turkish version of the DASI questionnaire was applied to 109 clinically stable patients with a diagnosis of PH. Exercise capacity of the patients was determined by maximal VO 2 achieved in the 6-minute walk test (6MWT) and quality of life by the EmPHasis-10 questionnaire. Cronbach alpha (internal consistency) was used to assess the questionnaire's reliability. The validity assessment was performed by using Spearman correlation. RESULTS: Internal consistency of the DASI was high (Cronbach's alpha = 0.99) and the test-retest reliability was excellent (ICC = 0.98). Validity was supported by significant correlations of DASI-VO 2 scores with estimated VO 2 (6MWT) scores (r = 0.58, p < 0.0001) and EmPHasis-10 (= -0.62, p < 0.0001). No floor or ceiling effect was present for the questionnaire. CONCLUSIONS: The Turkish version of the culturally adapted DASI questionnaire was found to be a valid and reliable assessment tool. It is a rapidly administered, simple-toscore questionnaire for assessing the functional ability of individuals with PH. The use of the DASI to assess exercise capacity in patients with PH may assist researchers and clinicians detecting functional impairment in these patients.


Subject(s)
Cross-Cultural Comparison , Hypertension, Pulmonary , Humans , Quality of Life , Hypertension, Pulmonary/diagnosis , Reproducibility of Results , Exercise Test , Surveys and Questionnaires
3.
Actas Urol Esp (Engl Ed) ; 46(8): 464-472, 2022 10.
Article in English, Spanish | MEDLINE | ID: mdl-36089504

ABSTRACT

INTRODUCTION AND OBJECTIVES: To evaluate whether there is any difference between immediate postoperative instillation of intravesical chemotherapy (IPOIC) and continuous saline bladder irrigation (CSBI) in terms of bladder cancer (BC) recurrence in patients with primary low- or intermediate-risk non-muscle-invasive BC (NMIBC). MATERIALS AND METHODS: Medical records of 1482 patients who underwent transurethral resection of bladder tumor between March 1994 and August 2020 were reviewed retrospectively. Patients were divided into two groups according to IPOIC and/or CSBI administration status [Group-1 = CSBI alone; Group-2 = CSBI following IPOIC]. Low- and intermediate-risk NMIBC patients were also divided into subgroups according to IPOIC and/or CSBI administration status. RESULTS: A total of 594 patients with primary NMIBC were included. Of the patients, 86 (14.5%) were female and 508 (85.5%) were male with a median age of 69 (60-78) years. The frequency of patients in Group-1 and Group-2 were 361 (60.8%) and 233 (39.2%), respectively. Recurrent disease was observed in 213 (35.9%) patients. There was no difference between the groups when they were compared for recurrent disease frequency, median time to first recurrence and frequency of recurrence within first 12 months (P = .064, P = .671, and P = .145, respectively). Disease recurrence rates in low-risk NMIBC patients was lower when they were treated with "CSBI following IPOIC" when compared to "CSBI alone" (P = .042). However, no difference was observed in low-risk NMIBC subgroups when they were compared for pathological features of recurrent tumors such as number, size, grade, stage, and presence of carcinoma in situ (P > .05, for each). CONCLUSIONS: "CSBI following IPOIC" combination was not superior to "CSBI alone" for preventing adverse pathological outcomes in recurrent low- and intermediate-risk NMIBC.


Subject(s)
Neoplasm Recurrence, Local , Urinary Bladder Neoplasms , Administration, Intravesical , Aged , Female , Humans , Male , Neoplasm Recurrence, Local/prevention & control , Retrospective Studies , Urinary Bladder , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/surgery
4.
Arch. esp. urol. (Ed. impr.) ; 75(5): 410-415, Jun. 28, 2022. tab, graf
Article in English | IBECS | ID: ibc-209225

ABSTRACT

Objective: To determine whether clinical or radiological parameters can predict clinically significant prostate cancer (csPC) in patients with the Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Patients and Methods: Data were obtained from 247 patients with PI-RADS 3 lesions on mpMRI and who had received a software guided transperineal/transrectal MRI/transrectal ultrasonography (MRI/TRUS) fusion prostate biopsy with concomitant standard systematic 12-core biopsy following mpMRI in the prostate cancer and prostate biopsy database of Turkish Urooncology Association, between 2016 and 2020. The cut-off values of clinical parameters were determined using receiver operating characteristic (ROC) curve analysis. Simple and multiple logistic regression analyses were performed to determine the clinical parameters in predicting csPC. Results: A total of 56 patients (22.6%) had prostate cancer, 23 (9.3%) of whom had csPC. In the lesion- based analysis, cancer detection rates (CDRs) of each lesion in targeted biopsy were found to be 6% and 5% for ISUP GG 1 and ISUP GG ≥ 2, respectively. In the patient-based analysis, clinically insignificant CDRs were significantly higher in systematic biopsy compared with targeted biopsy, whereas no significant difference was found in terms of clinically significant CDRs (p = 0.020 and p=0.422, respectively). The cut-off values were determined as 48.3 mL (AUC [95% CI] = 0.68 [0.53–0.82]) for prostate volume, and 0.213 ng/mL/mL (AUC [95% CI] = 0.64 (0.51–0.77]) for PSAD in predicting csPC. In the multiple logistic regression analysis, only PSAD was found to be an independent risk factor in predicting csPC (OR [95% CI]: 3.56 [1.15–10.91], p = 0.024). Conclusion: Since PSAD > 0.20 ng/mL/mL was found to be positive independent risk factor in predicting csPC, in the absence of advanced radiological parameters, PSAD could be used for the biopsy decision in patients with PI-RADS 3 lesions (AU)


Subject(s)
Humans , Male , Middle Aged , Aged , Image-Guided Biopsy/methods , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Magnetic Resonance Imaging/methods , Sensitivity and Specificity , Retrospective Studies
5.
Asian J Surg ; 43(1): 315-321, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31301933

ABSTRACT

BACKGROUND: The blood supply of the native pancreas by three arterial lines from the celiac trunk system (splenic artery and common hepatic artery) and the superior mesenteric artery forces surgeons to perform vascular reconstruction to provide sufficient intra-organ blood flow into the graft. The purpose of our study was to assess the possibility of pancreas transplantation with an isolated splenic artery blood supply. METHODS: From January 2012 to July 2018, simultaneous pancreas-kidney transplantation (SPKT) was performed in 21 patients. Gender: male - 11 (52,4%), female 10 (47,6%). Recipients aged 26 to 54, the median age was 38 [34; 42] years. In 6 (28,6%) recipients, the organ perfusion was carried out through the splenic artery alone; in the rest, it was performed through the splenic and inferior pancreaticoduodenal artery exiting from the superior mesenteric artery of the graft. The transplant function, the quality of carbohydrate metabolism compensation, the objective characteristics of intra-organ blood flow was assessed. RESULTS: There were no statistically significant differences in the volume blood flow characteristics revealed by CT-perfusion and laboratory data in the study groups. CONCLUSIONS: Based on the assessment of the function and quality of blood supply to the transplant, the possibility of performing pancreas transplantation with an isolated splenic artery blood supply had been proved.


Subject(s)
Laparotomy/methods , Pancreas Transplantation/methods , Pancreas/blood supply , Splenic Artery , Transplants/blood supply , Vascular Surgical Procedures/methods , Adult , Carbohydrate Metabolism , Female , Humans , Male , Mesenteric Arteries , Perfusion/methods , Transplants/metabolism , Young Adult
6.
Andrologia ; 2018 Jan 25.
Article in English | MEDLINE | ID: mdl-29369372

ABSTRACT

Various factors are involved in the aetiology of premature ejaculation (PE). Hyperthyroidism is one of the causes of acquired PE, but the exact mechanism by which it causes the disorder is not yet understood. The aim of this study was to evaluate the role of the dopaminergic system in hyperthyroidism-induced PE by the intracerebroventricular microinjection of the preferentially active dopamine receptor agonist 7-hydroxy-2-(di-N-propylamino) tetralin (7-OH-DPAT) in a rat model of this disorder. Wistar rats were randomly divided into hyperthyroid and control groups, and ejaculation was induced by the ICV administration of 7-OH-DPAT. To evaluate the emission and expulsion phases of ejaculation, measurements of seminal vesicle pressure (SVP) and electromyographic recordings of the bulbospongiosus muscle were taken. The interval between the 7-OH-DPAT administration and the first ejaculation was significantly less in the hyperthyroid group (p < .01) than in the control group, and the maximum amplitude of the SVP values revealed a statistically significant difference between the groups (p < .01). The intervals between contractions of the seminal vesicle and bulbospongiosus muscles were also significantly less in the hyperthyroid group (p = .0187) than in the control group. No other results differed significantly between the groups. This study determined that hyperthyroidism altered only the emission phase of ejaculation.

7.
J Laryngol Otol ; 132(1): 33-40, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29151378

ABSTRACT

OBJECTIVE: Possible therapeutic and protective benefits of intratympanic autologous serum application in amikacin-induced ototoxicity were investigated. METHODS: Twenty-four guinea pigs were separated equally into two groups: therapeutic (group A) and protective (group B). Transient evoked otoacoustic emissions were recorded before and after autologous serum application. Apoptotic cells were identified in the organ of Corti, spiral limbus and spiral ganglion by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling ('TUNEL') method. RESULTS: Transient evoked otoacoustic emission responses at 1, 1.4 and 2.8 kHz improved without significance after autologous serum application in group A (p > 0.05). A significantly protective effect of autologous serum was determined at 4 kHz in group B (p < 0.05). There were significantly fewer apoptotic cells at the spiral limbus in the therapeutic and protective groups compared to the control group (p < 0.05). CONCLUSION: Autologous serum may offer protection against ototoxicity-induced hearing loss, but it cannot restore hearing. Immunohistochemically, autologous serum significantly decreases activation of the intrinsic pathway of pro-apoptotic signalling in mesenchymal cells compared to neurons and neurosensory cells.


Subject(s)
Blood Component Transfusion/methods , Hearing Disorders/prevention & control , Serum , Spiral Ganglion/pathology , Amikacin/toxicity , Animals , Apoptosis , Disease Models, Animal , Female , Guinea Pigs , Hearing Disorders/chemically induced , Hearing Disorders/physiopathology , Immunohistochemistry , Otoacoustic Emissions, Spontaneous/drug effects , Treatment Outcome
8.
Clin Transplant ; 31(7)2017 07.
Article in English | MEDLINE | ID: mdl-28444815

ABSTRACT

AIM: An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. MATERIALS AND METHODS: From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications. Endoscopic stenting of the main pancreatic duct with plastic stents and three-stage endoscopic hemostasis were conducted to correct the identified complications. RESULTS: Endoscopic methods showed high efficiency in the timely diagnosis and adequate correction of complications after retroperitoneal pancreas transplantation.


Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/methods , Kidney Transplantation/methods , Pancreas Transplantation/methods , Pancreas/diagnostic imaging , Retroperitoneal Space/diagnostic imaging , Adolescent , Adult , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Young Adult
9.
Acta Endocrinol (Buchar) ; 13(4): 393-399, 2017.
Article in English | MEDLINE | ID: mdl-31149207

ABSTRACT

INTRODUCTION: Irisin is a recently discovered novel adipomyokine that induces an increase in total body energy expenditure, improves insulin sensitivity and glucose tolerance. It has been shown that circulating levels of irisin are low in patients with obesity, diabetes mellitus and impaired glucose tolerance. However, the information about the level of circulating irisin in gestational diabetes mellitus (GDM) is controversial. MATERIAL AND METHODS: Serum irisin was measured by an ELISA in a longitudinal prospective cohort study in 221 women. There were 156 healthy pregnant and 65 women with GDM. RESULTS: Circulating irisin levels were significantlly higher in the middle pregnancy compared with early pregnancy levels in healthy pregnant women and in women with GDM. Serum irisin levels were found to be lower in GDM compared to healthy pregnant women during first trimester but the difference was not observed throughout the pregnancy and it was comparable in middle pregnancy. There was a significant inverse correlation of BMI with serum irisin (r = -0.193, p = 0.004) and between HbA1c and mean glucose of OGTT with serum irisin (r =-0.377, p =0.0001) and (r = -0.147, p:0.03) in the early pregnancy of pregnant women repectively. CONCLUSIONS: The present study shows that serum irisin level increases throughout the gestational period from early to middle pregnancy in women with GDM, but there is no effect of irisin on the development of GDM.

10.
Allergol Immunopathol (Madr) ; 45(2): 160-168, 2017.
Article in English | MEDLINE | ID: mdl-27955890

ABSTRACT

BACKGROUND: Despite growing evidence suggesting potential association between innate and adaptive immunity in viral-induced acute asthma, there is paucity of data in this area. OBJECTIVE: This study aimed to investigate the association of innate and adaptive immunity with acute asthma attacks by analysing the role of IFN-γ-inducible protein 10 (IP-10), TLR2, cathelicidin, vitamin D and cytokines. MATERIAL AND METHODS: This prospective study included 33 patients with viral-induced acute asthma and 30 children with controlled asthma. Nasopharyngeal swab samples were collected for virus identification and asthma attack scores assessed in acute asthma group. Blood sampling for IP-10, TLR2, cathelicidin, vitamin D levels, and spirometric indices were employed. RESULTS: Serum IP-10 and cathelicidin levels of acute asthma group were significantly higher and vitamin D levels were lower than controlled asthma group (IP-10; p=0.006, cathelicidin; p=0.002, vitamin D; p<0.001). Serum IP-10 levels showed a significant negative correlation with age (p=0.009), TLR2 (p=0.05) and spirometric indices (p=0.002) in all asthmatics and a significant positive correlation with parameters of asthma attack severity (p=0.03) in acute asthma group. Higher cathelicidin values showed significant positive relation to IP-10 (beta coefficient: 33, p=0.02). Serum IP-10 levels higher than 38.9pg/ml (sensitivity: 85%, specificity: 47%, p=0.002) were predictive of virus-induced asthma. Serum IP-10 and vitamin D levels were found to be significantly related to viral-asthma attacks (IP-10; aOR: 8.93, p=0.03 and vitamin D; aOR: 0.82, p=0.001). CONCLUSIONS: Innate immunity biomarkers such as serum IP-10 and cathelicidin can be used to predict viral-induced acute asthma. These biomarkers may provide potential new treatment targets for acute asthma.


Subject(s)
Antimicrobial Cationic Peptides/blood , Asthma/diagnosis , Biomarkers/blood , Chemokine CXCL10/blood , Virus Diseases/diagnosis , Vitamin D/blood , Adaptive Immunity , Adolescent , Asthma/etiology , Child , Cytokines/metabolism , Disease Progression , Female , Humans , Immunity, Innate , Male , Prognosis , Prospective Studies , Toll-Like Receptor 2/metabolism , Virus Diseases/complications , Cathelicidins
11.
Clin Microbiol Infect ; 21(11): 1008.e9-1008.e18, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26232534

ABSTRACT

We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae.


Subject(s)
Tuberculosis, Spinal/epidemiology , Tuberculosis, Spinal/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Antitubercular Agents/administration & dosage , Endemic Diseases , Female , Humans , International Cooperation , Male , Mediterranean Region/epidemiology , Middle Aged , Retrospective Studies , Surgical Procedures, Operative , Survival Analysis , Treatment Outcome , Tuberculosis, Spinal/drug therapy , Tuberculosis, Spinal/surgery , Young Adult
12.
Actas urol. esp ; 38(8): 499-505, oct. 2014. tab
Article in Spanish | IBECS | ID: ibc-128829

ABSTRACT

Objetivos: Examinar los resultados del tratamiento en pacientes con cáncer de próstata (CP) tratados con prostatectomía radical (PR) que podrían ser buenos candidatos para vigilancia activa (VA) y evaluar la confianza y fiabilidad de los criterios de VA para predecir la enfermedad en estadios avanzados (puntuación de Gleason en PR ≥ 7 o estadio patológico T3). Métodos: Entre 2005 y 2012 se examinaron los registros de 401 pacientes sometidos a PR con un diagnóstico de CP. De estos pacientes 173 resultaron ser candidatos para VA. Los criterios de inclusión fueron los siguientes: estadio clínico T2a o inferior, PSA < 10 ng/ml, 2 o menos núcleos afectados por cáncer, ningún núcleo con una afectación máxima por cáncer del 50% o más y ninguna puntuación de Gleason mayor de 3 en la muestra. Resultados: Los análisis univariantes revelaron que los pacientes con un estadio más avanzado de la enfermedad tenían una densidad del antígeno prostático específico (PSAD) más elevada, un mayor porcentaje máximo (% máx) de núcleos positivos y un mayor volumen tumoral en PR. En los análisis multivariantes la PSAD, el % máx de núcleos positivos y el volumen tumoral en PR eran factores estadísticamente significativos de enfermedad en estadios avanzados. Los análisis ROC revelaron que el volumen tumoral en PR es un buen test de la enfermedad en estadio avanzado. Conclusiones: Se debería considerar reducir los valores umbral de PSAD y % máx en núcleos positivos como criterios de inclusión para VA. Si se pudiera calcular el volumen tumoral antes de la PR podríamos minimizar los fracasos del tratamiento (exceso o falta de tratamiento) de CP. Quizás los nuevos protocolos de biopsias, los biomarcadores de tejidos y la tecnología de imágenes moleculares puedan perfeccionar los criterios para VA


Objectives: To examine the treatment outcomes of the prostate cancer (PCa) patients treated by radical prostatectomy (RP) who could be good candidates for active surveillance (AS) and test the confidence and reliability of the AS criteria for predicting advanced stage disease (RP Gleason score ≥7 or pathological stage T3). Methods: Between 2005 and 2012 the records of the 401 patients who underwent RP with a diagnosis of PCa were examined. Of these patients, 173 were found to be candidates of AS. The inclusion criteria were as follows; clinical stage T2a or less, PSA < 10 ng/ml, 2 or fewer cores involved with cancer, no single core with 50% or greater maximum involvement of cancer, and no Gleason grade greater than 3 in the specimen. Results: Univariate analyses revealed that patients with advanced stage disease have higher prostate specific antigen density (PSAD), higher maximum percent (max %) in positive cores and higher RP tumor volumes. In multivariate analyses PSAD, max % in positive cores and RP tumor volumes were statistically significant determinants for advanced stage disease. ROC analyses revealed that the RP tumor volume is a good test on advanced stage disease. Conclusions: Decreasing the cutoff values for PSAD and max% in positive cores should be considered for AS inclusion criteria. If we could calculate the tumor volume before RP, we can minimize the treatment failures (over or under treatment) of PCa. Perhaps new biopsy protocols, tissue biomarkers, and molecular imaging technology may refine AS criteria


Objectives: To examine the treatment outcomes of the prostate cancer (PCa) patients treated by radical prostatectomy (RP) who could be good candidates for active surveillance (AS) and test the confidence and reliability of the AS criteria for predicting advanced stage disease (RP Gleason score ≥7 or pathological stage T3). Methods: Between 2005 and 2012 the records of the 401 patients who underwent RP with a diagnosis of PCa were examined. Of these patients, 173 were found to be candidates of AS. The inclusion criteria were as follows; clinical stage T2a or less, PSA < 10 ng/ml, 2 or fewer cores involved with cancer, no single core with 50% or greater maximum involvement of cancer, and no Gleason grade greater than 3 in the specimen. Results: Univariate analyses revealed that patients with advanced stage disease have higher prostate specific antigen density (PSAD), higher maximum percent (max %) in positive cores and higher RP tumor volumes. In multivariate analyses PSAD, max % in positive cores and RP tumor volumes were statistically significant determinants for advanced stage disease. ROC analyses revealed that the RP tumor volume is a good test on advanced stage disease. Conclusions: Decreasing the cutoff values for PSAD and max% in positive cores should be considered for AS inclusion criteria. If we could calculate the tumor volume before RP, we can minimize the treatment failures (over or under treatment) of PCa. Perhaps new biopsy protocols, tissue biomarkers, and molecular imaging technology may refine AS criteria


Subject(s)
Humans , Male , Middle Aged , Public Health Surveillance/methods , Prostatic Neoplasms/complications , Prostatic Neoplasms/pathology , Prostatic Neoplasms/prevention & control , Prostatic Neoplasms/therapy , Prostatectomy/mortality , Prostatectomy/methods , Prostatectomy/trends , Tumor Burden/physiology , Biopsy/classification , Biopsy/methods , Biopsy , Neoplasms/pathology , Neoplasms/therapy
13.
J Hosp Infect ; 87(2): 122-5, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24814159

ABSTRACT

This article describes an outbreak of meningitis caused by Serratia marcescens in patients who had undergone spinal anaesthesia for caesarean section. Bacterial meningitis was diagnosed in 12 of the 46 patients who underwent a caesarean section under spinal anaesthesia in a 75-bed private hospital between 6(th) and 14(th) March 2011. S. marcescens was isolated from samples taken from four prefilled syringes and one bag containing 5% dextrose with norepinephrine, suggesting that medications used in spinal anaesthesia were contaminated extrinsically. Strategies for prevention of anaesthesia-associated infections in operating theatres are discussed.


Subject(s)
Anesthesia, Spinal/adverse effects , Disease Outbreaks , Meningitis/epidemiology , Serratia Infections/epidemiology , Adolescent , Adult , Drug Contamination , Female , Humans , Male , Meningitis/microbiology , Serratia Infections/microbiology , Serratia marcescens , Young Adult
14.
Actas Urol Esp ; 38(8): 499-505, 2014 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-24646919

ABSTRACT

OBJECTIVES: To examine the treatment outcomes of the prostate cancer (PCa) patients treated by radical prostatectomy (RP) who could be good candidates for active surveillance (AS) and test the confidence and reliability of the AS criterias for predicting advanced stage disease (RP Gleason score≥7 or Pathological stage T3). METHODS: Between 2005 and 2012 the records of the 401 patients who underwent RP with a diagnosis of PCa were examined. Of these patients, 173 were found to be candidates of AS. The inclusion criteria were as follows; clinical stage T2a or less, PSA<10ng/ml, 2 or fewer cores involved with cancer, no single core with 50% or greater maximum involvement of cancer, and no Gleason grade greater than 3 in the specimen. RESULTS: Univariate analyzes revealed that patients with advanced stage disease have higher prostate specific antigen density (PSAD), higher maximum percent (max%) in positive cores and higher RP tumor volumes. In multivariate analyzes PSAD, max% in positive cores and RP tumor volumes were statistically significant determinants for advanced stage disease. ROC analyzes revealed that the RP tumor volume is a good test on advanced stage disease. CONCLUSIONS: Decreasing the cutoff values for PSAD and max% in positive cores should be considered for AS inclusion criteria. If we could calculate the tumor volume before RP, we can minimize the treatment failures (over or undertreatment) of PCa. Perhaps new biopsy protocols, tissue biomarkers, and molecular imaging technology may refine AS criteria.


Subject(s)
Prostatectomy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Watchful Waiting , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Neoplasm Staging , Prognosis , Prostate-Specific Antigen , Prostatectomy/methods , Retrospective Studies , Treatment Outcome , Tumor Burden
15.
Biotech Histochem ; 89(6): 446-56, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24665937

ABSTRACT

The increasing frequency of obesity is important because of its accompanying related health problems. The effects of obesity on peripheral nerves have not been elucidated. We investigated the effects of obesity on sciatic nerve regeneration using electrophysiology, stereology, immunohistochemistry, histopathology and functional tests. We used control, obese, control injured and obese injured groups of rats. Electrophysiological results showed that nerve conduction velocity and EMG were same in the experimental groups, but the amplitude of the compound action potential of the control group was significantly higher than that of the obese group. Examination of the nerves showed that the control and obese groups had both larger axon diameters and thicker myelin sheaths. The number of myelinated axons was decreased in both of the injured groups. Axon diameters and myelin sheath thicknesses of the control injured group were significantly greater those of the obese injured group. There were no significant differences in functional tests among the groups. Although growth associated protein 43 immunostaining in the control injured group was significantly greater than that of the obese injured group, no significant difference was observed between the control and obese groups. There was no significant difference in immunohistochemical staining for transforming growth factor beta 3 between the control injured and obese injured groups. Our results suggest that obesity may affect peripheral nerve regeneration negatively after crush injury.


Subject(s)
Diet, High-Fat , GAP-43 Protein/metabolism , Nerve Regeneration/physiology , Obesity/metabolism , Transforming Growth Factor beta/metabolism , Animals , Axons/metabolism , Axons/pathology , Female , Myelin Sheath/metabolism , Myelin Sheath/pathology , Obesity/pathology , Rats, Sprague-Dawley
16.
Phys Rev E Stat Nonlin Soft Matter Phys ; 85(3 Pt 1): 031146, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22587077

ABSTRACT

The Ising models S=1/2 and S=1 are studied by efficient Monte Carlo schemes on the (3,4,6,4) and the (3,3,3,3,6) Archimedean lattices. The algorithms used, a hybrid Metropolis-Wolff algorithm and a parallel tempering protocol, are briefly described and compared with the simple Metropolis algorithm. Accurate Monte Carlo data are produced at the exact critical temperatures of the Ising model for these lattices. Their finite-size analysis provide, with high accuracy, all critical exponents which, as expected, are the same with the well-known 2D Ising model exact values. A detailed finite-size scaling analysis of our Monte Carlo data for the S=1 model on the same lattices provides very clear evidence that this model obeys, also very well, the 2D Ising model critical exponents. As a result, we find that recent Monte Carlo simulations and attempts to define effective dimensionality for the S=1 model on these lattices are misleading. Accurate estimates are obtained for the critical amplitudes of the logarithmic expansions of the specific heat for both models on the two Archimedean lattices.


Subject(s)
Algorithms , Models, Chemical , Models, Molecular , Monte Carlo Method , Phase Transition , Computer Simulation
17.
Dentomaxillofac Radiol ; 41(7): 564-70, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22499129

ABSTRACT

OBJECTIVE: To determine the frequency of concha bullosa (CB) and the association between the degree of pneumatization and the severity of septum deviation in both paediatric and adult groups by CT evaluation and to investigate whether the pneumatization of middle turbinates is compensatory or congenital. METHOD: We retrospectively reviewed digitally stored paranasal sinus CT images of 86 paediatric and 204 adult patients. The severity of the deviation and cross-sectional area of the pneumatized area of the CB were determined using tomography images. The septums were divided into three groups according to the severity of deviation. The cross-sectional area of the contralateral side divided by the cross-sectional area of the deviation was calculated and described as the interturbinate ratio. RESULTS: When bilateral CB was found, the pneumatization of the CB was more prominent on the contralateral side than on the deviation side in both the paediatric and the adult groups. However, we found that the interturbinate ratios were not statistically different between the paediatric and adult groups. Also, the interturbinate ratios were independent degrees of deviation in children and adults. The frequency of CB was low in the adult group compared with the paediatric group. CONCLUSION: Interturbinate ratios were not statistically different between paediatric and adult groups and were independent of the severity of deviation. These findings suggest that the pneumatization process is not compensatory.


Subject(s)
Turbinates/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Anatomy, Cross-Sectional/methods , Child , Child, Preschool , Frontal Sinus/diagnostic imaging , Humans , Image Processing, Computer-Assisted/methods , Middle Aged , Nasal Septum/abnormalities , Retrospective Studies , Sphenoid Sinus/diagnostic imaging , Tomography, X-Ray Computed/methods , Turbinates/abnormalities , Young Adult
18.
Actas Urol Esp ; 34(6): 555-9, 2010 Jun.
Article in Spanish | MEDLINE | ID: mdl-20510120

ABSTRACT

INTRODUCTION AND OBJECTIVES: Prostate stones are frequently encountered during transurethral resection of the prostate in urology practice. We aimed to demonstrate the physical and chemical properties of prostate stones. We also aimed to determine possible relationship between inflammation of prostate gland and prostate stones. METHODS: The consecutive patients (excluding subjects with PSA>or=4ng/ml and urolithiasis), who underwent TURP operation and who were observed to have prostatic calculi during TURP, were included in the study. The prostatic stones obtained from each patient during TURP were analysed for chemical composition and observed under electron microscopy (SEM) for structure and surface morphology. The pathological specimens were assessed by the uropathologist for the final diagnosis and existence and degree of inflammation. RESULTS: Five patients were included in the study. From each patient at least three (range 3-8) samples of stones (diameter varying from 1mm up to 5mm) were obtained. The stones were made of mixed composition of calcium phosphate and calcium carbonate. The stones were found to have lobular surface made up of small spheres under SEM. Histopathological examination of the TURP specimens revealed being prostatic hyperplasia accompanied with inflammation of mild to severe degree. CONCLUSIONS: Prostatic stones are concentrically precipitated calcium stones within the prostatic ductuli with granular grape like morphology. Histopathological inflammation seems to be associated with these prostatic calculi.


Subject(s)
Calculi/chemistry , Calculi/ultrastructure , Prostatic Diseases/pathology , Calculi/diagnosis , Humans , Incidental Findings , Male , Prostatic Diseases/complications , Prostatic Diseases/diagnosis
19.
Actas urol. esp ; 34(6): 555-559, jun. 2010. ilus
Article in Spanish | IBECS | ID: ibc-81895

ABSTRACT

Introducción y objetivos: En la práctica urológica se encuentran con frecuencia cálculos prostáticos durante la resección transuretral de la próstata. Nuestro objetivo era demostrar las propiedades físicas y químicas de los cálculos prostáticos, así como determinar la posible relación entre la inflamación de la próstata y los cálculos prostáticos. Métodos: Se incluyó en el estudio a pacientes consecutivos (excluidos los sujetos con PSA≥4ng/ml y urolitiasis) sometidos a resección transuretral de la próstata (RTUP) en quienes se observaron cálculos prostáticos. Se analizó la composición química de los cálculos prostáticos obtenidos de cada paciente durante la RTUP, que se observaron también al microscopio electrónico (MEB) para determinar su estructura y morfología superficial. El uroanatomopatólogo valoró las muestras para emitir el diagnóstico definitivo y determinar la existencia y el grado de la inflamación. Resultados: Se incluyó en el estudio a cinco pacientes. Se obtuvieron de cada paciente al menos tres (de 3–8) muestras de cálculos (con un diámetro de 1–5mm). Los cálculos tenían una composición mixta de fosfato cálcico y carbonato cálcico. En la MEB se observó que los cálculos tenían una superficie lobular formada por pequeñas esferas. El examen histopatológico de las muestras de RTUP reveló hiperplasia prostática benigna acompañada de inflamación entre leve e intensa. Conclusiones: Los cálculos prostáticos son cálculos de calcio precipitados concéntricamente situados dentro de los conductillos prostáticos con una morfología granular arracimada. Estos cálculos prostáticos parecen ir acompañados de inflamación histopatológica (AU)


Introduction and Objectives: Prostate stones are frequently encountered during transurethral resection of the prostate in urology practice. We aimed to demonstrate the physical and chemical properties of prostate stones. We also aimed to determine possible relationship between inflammation of prostate gland and prostate stones. Methods: The consecutive patients (excluding subjects with PSA≥4ng/ml and urolithiasis), who underwent TURP operation and who were observed to have prostatic calculi during TURP, were included in the study. The prostatic stones obtained from each patient during TURP were analysed for chemical composition and observed under electron microscopy (SEM) for structure and surface morphology. The pathological specimens were assessed by the uropathologist for the final diagnosis and existence and degree of inflammation. Results: Five patients were included in the study. From each patient at least three (range 3–8) samples of stones (diameter varying from 1mm up to 5mm) were obtained. The stones were made of mixed composition of calcium phosphate and calcium carbonate. The stones were found to have lobular surface made up of small spheres under SEM. Histopathological examination of the TURP specimens revealed being prostatic hyperplasia accompanied with inflammation of mild to severe degree. Conclusions: Prostatic stones are concentrically precipitated calcium stones within the prostatic ductuli with granular grape like morphology. Histopathological inflammation seems to be associated with these prostatic calculi (AU)


Subject(s)
Humans , Male , Prostatic Diseases/diagnosis , Calculi/ultrastructure , Prostatic Hyperplasia/diagnosis , Microscopy, Electron, Scanning/methods , Urolithiasis/diagnosis , Transurethral Resection of Prostate
20.
J Postgrad Med ; 56(1): 26-7, 2010.
Article in English | MEDLINE | ID: mdl-20397311
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