The factors that affect the prediction of lymph node metastasis in prostate cancer.

OBJECTIVE: We aimed to demonstrate the effects of clinical evaluations as well as biopsy characteristics in terms of lymph node involvement (LNI) despite the small number of patients in our study. MATERIALS AND METHODS: A total of 221 patients who underwent radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) in our clinic between 2010 and 2015 and who met the inclusion criteria were enrolled in our study group. All of the patients were evaluated in terms of age, prostate-specific antigen (PSA) value before transrectal ultrasound-guided prostate biopsy (TRUSPB), digital rectal examination, Gleason score (GS) on TRUSPB, percentage of positive cores on TRUSPB, total number of positive cores, highest percentage of cancer in positive cores, and number of lymph nodes removed at RP. Pathological examination of the data of RP specimens, PSA values in follow-up after surgery, and follow-up periods was recorded. The TNM 2009 classification was used for staging. RESULTS: In the evaluation of LNI risk, as regards the assessment of predictors and outcomes with respect to the univariate and multivariate analyses, LNI was found in the univariate analysis to be associated with GS, clinical stage, number of lymph nodes removed according to the D'Amico risk classification. In the multivariate analysis, however, the number of lymph nodes removed was found significant. CONCLUSION: Risk stratification should be considered in patients with prostate cancer while selecting the patients who would undergo pelvic lymphadenectomy. In addition, ePLND should be performed to patients undergoing lymphadenectomy.

The factors predicting biochemical recurrence in patients with radical prostatectomy.

OBJECTIVE: The main objective of this study was to evaluate the factors predicting recurrence in patients who underwent radical prostatectomy (RP) for localized prostate cancer. MATERIALS AND METHODS: A total of 275 patients who underwent RP between 2000 and 2012 years in our clinic were evaluated retrospectively and 238 patients who met our criteria were included in the study. The effect of PSA values at diagnosis in addition the histopathological variables on the risk of recurrence was evaluated. Biochemical recurrence (BCR) is defined as "an increase of > 0.2 ng/ml or more in the serum total PSA count". The statistical analysis of this study was done using SPSS for Windows Version 15.0 package program. Values below p < 0.05 are accepted as statistically significant. RESULTS: The mean follow up, age and PSA of patients were 37,2 months, 66,01 ± 6,85 years and 11,12 ng/ml, respectively. BCR rate was 28% (68/238). Univariate analysis revealed that PSA levels during initial diagnosis (p < 0.0001), Gleason score (GS) (p < 0.0001), prostatic capsule involvement (p < 0.005), extracapsular extension (p = 0.0001), seminal vesicle involvement (p < 0.003) and surgical margin positivity (p < 0.014) were significant factors in predicting recurrence, while multivariate analysis showed that PSA at initial diagnosis (p = 0.002) and GS (p = 0.003) were independent prognostic factors. PSA > 10 ng/ml and Gleason score > 7 are considered as the risk factors for BCR. CONCLUSION: Our study results showed that PSA value during initial diagnosis as well as Gleason score were independent factors in predicting BCR following radical prostatectomy.

Factors determining biochemical recurrence in low-risk prostate cancer patients who underwent radical prostatectomy.

OBJECTIVE: This study was conducted to research the factors determining biochemical recurrence (BCR) in low-risk localized prostate cancer patients who underwent radical prostatectomy (RP). MATERIALS AND METHODS: We retrospectively analyzed the data of 504 patients who had undergone RP between 2003 and 2013 at our clinic. One hundred and fifty-two patients who underwent RP for low-risk prostate cancer were included in the study. RESULTS: The mean follow-up period for patients was 58.7 (21-229) months. The mean age of the patients was 63.7±7.2 years (49-79). The mean prostate specific antigen (PSA) value was 5.25±4.22 ng/mL (3.58-9.45). The BCR rate after the operation was 25% (38/152). In the univariate analysis, recurrence determining factors were shown to include extracapsular involvement (ECI) (p=0.004), capsular invasion (CI) (p=0.001), age (p=0.014), and tumor size (p=0.006). However, only CI was found to be significant in multivariate analysis (p=0.001). CONCLUSION: Capsular invasion is an independent risk factor in low-risk prostate cancer patients who underwent RP for BCR.

[Investigation of prevalance and risk factors for hospital-acquired urinary tract infections in patients with severe burn injury]. / Ciddi yanik travmasi olan hastalarda hastane kaynakli idrar yolu enfeksiyonu sikligi ve risk faktörlerinin arastirilmasi.

BACKGROUND: This study aimed to investigate the prevalence and risk factors for hospital-acquired urinary tract infections in patients with severe burn injuries. METHODS: In this study, patients treated due to their burn injuries of greater than 20% between August 2009 and April 2012 in Bozyaka Training and Research Hospital Burn Center were assessed retrospectively. Sixty nine patients (30 [43.5%] males, 39 [56.5%] females; mean age 40.1±16.7 years) were included into the study. RESULTS: DM, duration of the catheter and catheter care showed a statistically significant correlation with hospital-acquired urinary tract infections (p<0.005). DISCUSSION: A large number of hospital-acquired urinary tract infections are associated with urinary catheterization. In addition, removing urinary catheter within the shortest time possible is another issue to be considered for the prevention of these infections. If the catheter has to remain for a longer time, regular catheter care is recommended.

Effect of preputial type on bacterial colonization and wound healing in boys undergoing circumcision.

PURPOSE: In this study, we evaluated the effect of preputial type on bacterial colonization and wound healing in boys undergoing circumcision. MATERIALS AND METHODS: This study consisted of 78 boys consecutively admitted to our clinic for circumcision between 2009 and 2011. Preputial status was classified into five types on the basis of preputial retractability. One sterile culture swab was swept circumferentially once around the surface of the glans starting just proximal to the urethral meatus. Three weeks following circumcision, control swabs from the same regions of the same patients were taken and inoculated. Thus, the same patients formed the control group. Patients were evaluated on days 1 and 7 after the operation to assess whether the preputial type affected healing. RESULTS: The mean age of the children was 46.3 months. In our study, the growth rate was 71.8% in pre-circumcision patients, whereas the rate was 10.25% in the post-circumcision group. Types 1, 2, 3, 4, and 5 had 100%, 93.8%, 71.4%, 44.4%, and 53.6% colonization, respectively. A significant difference was observed among these types in terms of colonization. The most common agent was Enterococcus species (33%). When postoperative patients were evaluated, all had local swelling and hyperemia on postoperative day 1, whereas there was a significant difference on day 7. CONCLUSIONS: There was a significant correlation between preputial type and bacterial colonization, and the preputial type affected post-circumcision wound healing. Practitioners should keep in mind that the healing period will be longer in patients with type 1, 2, and 3 preputium.