Prognostic Factors Affecting Survival of Patients With Single Primary Breast Cancer vs Patients With Multiple Primary Cancers in Lifetime, One of Which is Breast Cancer.

PURPOSE: The aim of this study was to investigate the demographic and molecular characteristics, overall survival (OS), cancer-specific survival (CSS), and prognostic factors affecting the survival of patients with single primary breast cancer (SPBC) and patients with multiple primary cancers in their life time in which one of them is breast cancer (MPC). METHODS: Using data from SEER 17 Research Plus, patients with breast cancer diagnosed between 2010 and 2019 were included in this study. Race, marital status, laterality, tumor size, molecular subtype, grade, stage, radiotherapy-chemotherapy treatment, and surgery data were analyzed in the data obtained after excluding patients with missing values. Kaplan-Meier survival analysis was used for survival analysis, and Cox regression analysis was used to evaluate the prognostic factors. RESULTS: 573175 patients were included in the study. The mean age of MPC patients was significantly higher than SPBC patients (65.99 ± 12.68, 60.33 ± 13.47, P < .001, respectively). Patients with SPBC had significantly more hormone receptor (HR)-positive/Her2 positive, HR-negative/Her2-negative, and HR-negative/Her2-positive molecular subtypes; patients with MPC had more HR-positive/Her2-negative subtypes (P < .001). Grade 3 tumor status, locoregional spread, and distant metastasis were significantly higher in SPBC patients (P < .001). Overall survival and CSS rates were significantly higher in SPBC patients (P < .001). In MPC patients, overall hazard ratio was 1.631 times higher than SPBC, and the cancer-specific hazard ratio was 1.096 times higher (95% CI [1.606-1.656], 95% CI [1.071-1.121], respectively). CONCLUSION: Although patients with SPBC have worse prognostic tumor characteristics, OS and CSS rates are better than patients with MPC.

Angiographic measurement of the superficial temporal artery for potential use in cerebral bypass surgery: a combined radiological and cadaveric study.

PURPOSE: This study aims to investigate the microsurgical anatomy of the superficial temporal artery (STA), explore the relationship between STA length and lumen diameter, and develop a reliable radiologic method for selecting STA segments for bypass surgery. METHODS: This study used 10 cadaveric dissections (20 STAs, both sides) and 20 retrospective radiological examinations (40 STAs, both sides), employing curved multiplanar reformation and flow color lookup table (CLUT) DICOM processing. Measurements included vessel lumen diameters and luminal cross-sectional thicknesses 3 mm proximal to the STA bifurcation, 3 mm distal to the frontal branch, 5 cm distal to the frontal branch, 3 mm distal to the parietal branch, and 5 cm distal to the parietal branch. The distance between the STA bifurcation and the superior zygomatic border (SZB) was also measured. In our analysis, descriptive statistics encompassed mean, standard deviation (SD), standard error, minimum and maximum values, and distributions. Comparative statistics were performed using Student's t-test, with statistical significance set at p < 0.05. RESULTS: There were no statistically significant differences between STA measurements of bifurcation distances (p = 0.88) and lumen diameters (p = 0.46) between cadavers and radiological measures. However, lumen thicknesses were larger in frontal branches than parietal branches at the seventh and eighth centimeter (p = 0.012, p = 0.039). Branches became thinner distally from the zygoma in both cadavers and radiological image measurements. CONCLUSION: The CLUT DICOM processing radiological measures provided the high-precision required to enable pre-surgical vessel selection for extracranial-intracranial bypass. The results show that STA vessel luminal diameters are sufficient (> 1 mm) for bypass surgery in the first 9 cm but gradually decrease after that. Also shown is that the choice of frontal versus parietal branches depends on individual anatomical features; therefore, careful preoperative radiological examination is critical.

Secretory Carcinoma of Breast: A Population-Based Study.

AIM: In this study, it was aimed to evaluate the characteristic features and survival of secretory carcinoma of the breast (SCB), which is one of the rare malignant tumors of the breast. METHODS: Data of patients with histopathological diagnosis of SCB between 2010 and 2019 were extracted from the SEER database. These patients were evaluated in terms of age, race, molecular subtype, grade, estrogen receptor (ER), progesterone receptor (PR), HER2 receptor, TNM stage, surgical status, chemotherapy and radiotherapy treatment. Overall survival (OS) and breast cancer-specific survival (BCSS) of the whole population and subgroups [in terms of surgery procedure (mastectomy/breast-conserving surgery), and hormone receptor status (positive/negative)] were analyzed. RESULTS: 70 patients were included in the study. The mean age was 57 years (range 2-82). 32.9% of the patients were diagnosed under the age of 50. 97.1% of the patients were female; 2.9% were male. The vast majority of patients were white race (81.4%). Although the rates of localization were higher in the upper outer quadrant (31.4%), centrally located tumors (18.5%) were also quite common. The most frequently detected molecular subtype was hormone positive/HER2 negative. All patients were non-metastatic, 81.4% of patients did not have lymph node metastases, and most of the patients were stage IA. Median follow-up was 37 months (range 0-118 months). Considering all patients, OS was 76.3%, 5-year OS was 91.8%, and BCSS was 88%, 5-year BCSS was 97.8%. There was no statistically significant difference in OS and BCSS according to subgroups (P > .01). CONCLUSION: SCB, a rare histopathologic type, has high OS and BCSS rates.

Is There a Survival Difference Between Male and Female Breast Cancer Subtypes According to the Prognostic Staging System? A Population-Based Cohort Study.

BACKGROUND: In retrospective studies investigating the difference in survival by gender, there are conflicting results. It was aimed to compare overall survival (OS) and breast cancer-specific survival (BCSS) in male and female breast cancer subtypes according to the prognostic staging system. METHODS: Overall survival rates and BCSS rates of patients diagnosed with breast cancer between 2010 and 2019 compared by gender for all cohorts, stages, and molecular subtypes using the SEER Database. The stage has been rearranged according to the eighth edition of the AJCC. RESULTS: 364 039 patients were included in the study. .7% (n = 2503) of all breast cancers were male breast cancer. Overall survival (male: 5-year OS 73.9%, female = 5-year OS 86%) and BCSS rates (male: 5-year BCSS 78.9%, female = 5-year BCSS 94.7%) were significantly higher in females than in males for all cohorts. OS (male: 5-year OS 66.2% vs female: 5-year OS 88.3%), and BCSS (male: 5-year BCSS 88.4% vs female: 5-year 93.6%) rates were higher in hormone receptor (HR)-positive/Her2-negative female patients. Overall survival rate is higher in females in stage I (male: 5-year OS 81.5%, female: 5-year OS 92.8%), and BCSS rate is higher in stage I (male: 5-year BCSS 94.8%, female: 5-year BCSS 97.5%). Males have 2 times (HR = 2.023) higher overall mortality risk than females, but the risk of dying from breast cancer is only 1.6 times (HR = 1.596) higher. CONCLUSIONS: Breast cancer-specific mortality is significantly higher in male breast cancers, especially in the early stage, and HR-positive subtype than females.

Should the Breast Cancer Staging System be Revised?

OBJECTIVE: The purpose of this study was to determine whether breast cancer patients at stage T2N0 with tumor size ≥4 cm and <4 cm. METHOD: Patients with T2N0 stage breast cancer diagnosed between 2010 and 2019 were analyzed in 2 groups as <4 cm (T2a) and ≥4 cm (T2b) in the study using the SEER 17 Research Plus database. The patients' clinicopathological characteristics and oncological outcomes were included. Group comparisons of prognostic factors, overall survival (OS), and cancer-specific survival (CSS) were made. RESULTS: In this study, which involved 70971 patients, the T2a group had higher 5-year OS rate (87.2 ± .2 vs 80.8 ± .5%) and 5-year CSS rate (93.7 ± .1% vs 89.4 ± .4%) than the T2b group (P < .001). Univariate analysis revealed that the overall risk of death was 1.5 times higher in T2b than T2a (HR: 1.533 [95% CI: 1.450-1.622], P < .001), whereas multivariate analysis demonstrated the risk was 1.4 times higher (HR: 1.384 [95% CI: 1.307-1.466], P < .001). The risk of cancer-specific death was 1.7 times higher in univariate analysis (HR: 1.691 [95% CI: 1.561-1.832], P < .001) and 1.4 times higher in multivariate analysis (HR: 1.420 [95% CI: 1.309-1.541], P < .001). CONCLUSION: Overall survival and BCSS rates in stage T2b breast cancer patients are significantly lower than in T2a patients. Tumor size ≥4 cm in breast cancer is a negative predictor of prognosis.

Normative reference values of major thoracic arterial vasculature in Turkiye.

OBJECTIVE: The aim of this study was to determine normative reference values for major thoracic arterial vasculature in Turkiye and to evaluate differences according to age and gender. METHODS: Low-dose unenhanced chest computerized tomography images acquired with pre-diagnosis of COVID-19 between March and June 2020 were evaluated retrospectively. Patients with known chronic lung parenchymal disease, pleural effusion, pneumothorax, chronic diseases such as diabetes, hypertension, obesity, and chronic heart diseases (coronary artery disease, atherosclerosis, congestive heart failure, valve replacement, and arrhythmia) were excluded from the study. The ascending aorta diameter (AAD), descending aorta diameter (DAD), aortic arch diameter (ARCAD), main pulmonary artery diameter (MPAD), right pulmonary artery diameter (RPAD), and the left pulmonary artery diameter (LPAD) were measured in the same sections by standardized methods. The variability of parameters according to age (<40 years; ≥40 years) and gender (male to female) was evaluated by statistical methods. The Student's t test was used to compare the normal distribution according to the given quantitative age and gender, while the data that did not fit the normal distribution were compared with the Mann-Whitney U test. The conformity of the data to the normal distribution was tested with the Kolmogorov-Smirnov, Shapiro-Wilk test, and graphical examinations. RESULTS: Totally 777 cases between the ages of 18-96 (43.80±15.98) were included in the study. Among these, 52.8% (n=410) were male and 47.2% (n=367) were female. Mean diameters were 28.52±5.13 mm (12-48 mm in range) for AAD, 30.83±5.25 mm (12-52 mm in range) for ARCAD, DAD 21.27±3.57 mm (11-38 mm in range) for DAD; 23.27±4.03 mm (14-40 mm in range) for MPAD, 17.27±3.19 mm (10-30 mm in range) for RPAD, and 17.62±3.06 mm (10-37 mm in range) for LPAD. Statistically significantly higher values were obtained in all diameters for cases over 40 years of age. Similarly, higher values were obtained in all diameters for males compared to females. CONCLUSION: The diameters of all thoracic main vascular structures are larger in men than in women and increase with age.

Effect of COVID-19 infection on the erectile function.

OBJECTIVE: It has been understood that COVID-19, which has become a global pandemic in a short time, is a disease affecting multiple organs and systems. Some of the organs and systems affected by the disease also play a role in the pathophysiology of erectile dysfunction (ED), which led us to consider the possible effects of the disease on the erectile function. In this study, we aimed to evaluate changes in the erectile functions of patients with COVID-19 among those that had previously diagnosed with mild and moderate ED in our urology outpatient clinic. MATERIAL AND METHODS: Eighty-one patients aged 18-65 years who were confirmed to have COVID-19 were included in the study. According to disease severity, these patients were divided into two groups as mild (non-hospitalized, n = 60) and moderate (hospitalized but did not require intensive care, n = 21). The patients' pre- and post-disease scores in the five-item International Index of Erectile Function (IIEF-5) ​​and hormone panel results were compared. RESULTS: The changes in the IIEF-5 scores of the patients from the pre-disease to the post-disease period were statistically significant for both the mild and moderate groups (p < 0.05). When these changes were compared between the mild and moderate groups, the difference was not statistically significant (p = 0.156). There was also no statistically significant change in the testosterone, follicle-stimulating, luteinizing, and prolactin hormone levels before and after the disease. CONCLUSION: In this study, we determined that SARS-CoV-2 infection caused deterioration in existing ED in sexually active male individuals, regardless of the severity of the disease.

Predicting axillary nodal metastasis based on the side of asymmetrical cortical thickening in breast cancer: Evaluation with grayscale and microvascular imaging findings.

PURPOSE: To investigate the relationship between sonographic findings and the axillary status, especially the side of thickening in the presence of cortical asymmetry. METHODS: Patients with biopsy-proven axillary lymph node (ALN) metastasis were included in this study. The lymph nodes were divided into three groups depending on the type of cortical thickening as diffuse, closer (eccentric cortical thickening on the side near the tumor and/or breast) and distant (thickening on the further side) asymmetry. Longitudinal to transverse axis (L/T) ratio, the largest cortical thickness, cortex to hilum ratio (C/H), hilar status (normal/displaced/absent), orientation (parallel/vertical), capsular integrity (sharp/indistinct), vascularisation pattern (hilar/peripheral/penetrant/anarchic/avascular) on superb microvascular imaging (SMI) and presence of conglomeration were recorded for each lymph node. Axillary nodal status on 18F-FDG PET-CT/MRI scans was recorded, if available. Features of the breast lesions like size, laterality, nuclear grade, hormone receptor status and the level of Ki-67 expression have been added. RESULTS: A total of 219 metastatic ALNs [diffuse (n = 122), closer asymmetry (n = 71), distant asymmetry (n = 26)] were evaluated. By the univariate analysis, ALN metastasis was significantly associated with the presence of closer asymmetrical cortical thickening (p < 0,0001), C/H ratio (p = 0.001), cortical thickness (p = 0.001), hilar status (p < 0.005) and vascular pattern (p < 0.005). L/T ratio was only a statistically significant parameter for lymph nodes with diffuse cortical enlargement in predicting metastasis, and conglomeration was also observed only in this group (p < 0.05). By multivariate analysis, nodal metastasis was significantly associated with asymmetrical cortical thickening (p = 0.001), C/H ratio (p = 0.005) and vascular pattern (p < 0.0001). CONCLUSION: Asymmetrical cortical enlargement on the side closer to the breast, C/H ratio and abnormal microvascular pattern are the independent predictors of axillary nodal involvement. Closer asymmetry is an eligible, easy-to-detect grayscale US finding to decide sampling that highly predicts ALN metastasis.

Effectiveness of pre-operative routine blood tests in predicting complicated acute appendicitis.

BACKGROUND: Early prediction and diagnosis of perforation in acute appendicitis allow surgeons to choose the most appropriate treatment. The purpose of this study is to evaluate whether pre-operative routine laboratory examinations have a role in predicting complicated acute appendicitis. METHODS: In the study, 783 patients operated with the diagnosis of acute appendicitis between the years 2014 and 2019 were analyzed retrospectively. Among the patients with non-perforated and perforated acute appendicitis, pre-operative laboratory tests include leukocyte (WBC), neutrophil, lymphocyte, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP), and neutrophil-to-lymphocyte rate (NLR) parameters were compared. RESULTS: Appendicitis was not detected histopathologically in 81 cases. In the study, 89.9% (n=631) of the 702 patients were non-perforated and 10.1% (n=71) were perforated acute appendicitis cases. Perforation rate was higher in elderly patients (p<0.01). It was seen that lymphocyte count was significantly lower in the perforated group, and CRP and NLR were significantly higher (p=0.048, p=0.001, p=0.028, respectively). In the diagnosis of perforated acute appendicitis, cutoff values were 44.0 mg/dL for CRP, 7.65 for NLR and 1.7/mm3 for lymphocytes. There was no statistical difference between the groups in terms of WBC, neutrophil, PLT, MPV, and PDW values. CONCLUSION: Low lymphocyte count, high CRP, and high NLR were found to be reliable and strong predictive parameters in the diagnosis of complicated acute appendicitis.

Investigating the correlation between severe acute pancreatitis and pancreatic necrosis with some serum parameters.

BACKGROUND: Acute pancreatitis (AP) is a disease related to significant morbidity and even mortality. Various factors are involved in the etiology, especially gallstones and excessive alcohol consumption. Although, the course of the disease in most of the cases is generally mild, in some cases, the disease can be severe and lead to pancreatic or peripancreatic necrosis. Radiologically, 'Balthazar computed tomography severity index' (CTSI) is used to assess the severity and presence of necrosis in pancreatitis. In this study, we classified the severity of AP in patients with Balthazar CTSI and investigated whether there is a correlation between some serum parameters and AP severity and which serum parameters can be used as a safe marker to predict the AP severity and the development of pancreatic necrosis (PN). METHODS: A total of 341 patients diagnosed with AP and hospitalized in our general surgery clinic between the years 2012 and 2018 were included in this study. Hematological and biochemical parameters of the patients were recorded. Abdominal CT's of the patients were evaluated according to the Balthazar CTSI. The correlation between these parameters and AP severity evaluated by Balthazar CTSI was investigated. RESULTS: PN was detected in 19.4% of 341 patients who participated in the study. Patients whose PN detected in their abdominal CT's by Balthazar CTSI; neutrophil counts, neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio, plateletlymphocyte ratio, and neutrophil/monocyte ratio (NMR) were significantly higher and the serum albumin was significantly lower than patients with PN. CONCLUSION: Neutrophil count, serum albumin levels, NLR, LR, and NMR can be used as predictive markers to determine AP severity.

Update of the 100 Most Cited Articles on Breast Cancer: A Bibliometric Analysis.

Objective: The aim of this study was to perform a bibliometric analysis of the 100 most cited articles related to breast cancer. Materials and Methods: The research was done on the Web of Science (WOS) database. Only research articles were included in the study. Results were obtained by typing the term "breast cancer" in the WOS Search box. The results were sorted according to the number of WOS core citations and all database citations, the first author of the article, the institution of the first author, publication year, article category, and countries. Results: The most cited article had 10236 citations. Nearly three-quarters (70%) of the articles were from the USA and most articles were published by Harvard University. Thirty-seven percent of the articles were in the medicine, general and internal medicine categories. Conclusion: This bibliometric analysis identified the 100 most cited research articles about breast cancer and provided a record of historical developments and trends in breast cancer research.

An investigation into the predictive role of serum inflammatory parameters in the diagnosis of complicated acute cholecystitis.

BACKGROUND: Gallbladder gangrene and perforation are an important complication of acute calculous cholecystitis and are dif-ficult to detect preoperatively. Therefore, in this study, we aimed to evaluate whether serum inflammatory parameters are predictive factors for complicated cholecystitis (CC). METHODS: In the present study, histopathological findings of 250 patients who were operated on with the diagnosis of acute chole-cystitis (AC) in the emergency department between 2014 and 2019 were evaluated and the cases were divided into two groups as AC and CC. Parameters, including age, gender, body mass index, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil-to-lym-phocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW), were examined for their ability to predict CC. RESULTS: The findings obtained in this study showed that WBC, CRP, and NLR were significantly higher in the CC group (p<0.05). WBC >9.000 cells/ml, CRP >29.0, and NLR >4.3 were the factors that could predict CC. There was no significant difference between the two groups concerning MPV and PDW (p>0.05). CC was observed more frequently in patients over 65 years of age, but there was not a statistically significant difference (p=0468). CONCLUSION: WBC, CRP, and NLR are valuable biochemical markers in predicting complicated AC. Advanced age may be a help-ful predictive factor for CC. These factors may be helpful in making an early cholecystectomy decision.

Circumcision with Thermocautery after Local Anesthesia in Males: A Retrospective Single-center Study with 1821 Patients.

PURPOSE: This study aimed to examine the short and long-term complications of thermocautery-assisted circumcisions with local anesthesia done in a sterile environment in operating room conditions, accompanied by literature. MATERIALS AND METHODS: The participants who consecutively underwent thermocautery-assisted circumcision with local anesthesia from June 2018 to May 2019 included in the study. They were one month-17 years old, same ethnic origin, in same location. The age groups were compared in terms of complications. RESULTS: The participant age and surgical duration means were 4.89 ± 2.08 (30 days-17 years) years old and 7.484 ± 1.524 (5-20 minutes) minutes, respectively. Complications were observed in fifty-three participants or 2.9% of the whole observation set. The participants under intervals of one six months and over 6 years of age had significantly lowered complication rates when compared to the other participants, and this comparison was statistically significant (P = 0.001). CONCLUSION: The study results demonstrated that circumcision with thermocautery after local anesthesia viable, reliable, and effective method. It can be assumed that circumcisions in males especially may be effective in 1-6 months, and over 6 years of age. Parents choose this method because it is more appropriate and eliminates the risk of general anesthesia.

Effects of in utero exposure to valproate or levetiracetam on the seizures and newborn histopathology of genetic absence epilepsy rats.

Valproate (VPA) and levetiracetam (LEV), the two broad spectrum antiseizure drugs with antiabsence effects were previously tested for their antiepileptogenic effects when administered in the early postnatal period and revealed possible modification of the epileptogenic process though the effect being not persistent. The aim of this study was to investigate the effects of in utero exposure to these drugs on the absence epilepsy seizures of Genetic Absence Epilepsy Rats from Strasbourg (GAERS) rats on electroencephalogram (EEG) which are characterised by bilateral, symmetrical, and synchronized spike-and-wave discharges (SWDs). Considering LEV was proposed as a safer drug of choice in pregnancy, its effects on the newborn histopathology of GAERS was also investigated. Adult female GAERS were randomly grouped as VPA-(400 mg/kg/day), LEV- (100 mg/kg/day), and saline-treated. The drugs were injected into the animals intraperitoneally starting before pregnancy until parturition. The lungs, kidneys, and brains of the LEV-exposed newborns were evaluated histologically to be compared with unexposed naïve Wistar and GAERS newborns. Rest of the VPA-, LEV-, and saline-exposed offsprings were taken for EEG recordings on postnatal day 90. VPA or LEV did not show significant effect on mean cumulative duration and mean number of SWDs on EEG. The lungs of the LEV-exposed offsprings showed thickened alveolar epithelium in most regions, suggesting incomplete development of the alveoli. The renal examination revealed dilated Bowman's spaces in some renal corpuscles, which may be interpreted as a deleterious effect of LEV on the kidney. In addition, brain examination of LEV- and saline-exposed groups revealed irregularities in cortical thickness compared to Wistar control group. Lack of significant difference on SWD parameters may indicate that the mechanism responsible for the antiepileptogenic effects of VPA and LEV may not be operating in the prenatal period. The detrimental effect of LEV exposure observed in our study on the lungs and the kidneys of the newborns should be investigated by further studies with advanced molecular and biochemical techniques.

Systemic Inflammatory Biomarkers as Surrogate Markers for Stage in Colon Cancer.

BACKGROUND: This study aimed to investigate whether the systemic inflammatory parameters currently in use in staging the disease can be used as biomarker tests operated colon cancer patients. Neutrophil, lymphocyte, monocyte, platelet, neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR), neutrophil/monocyte ratio (NMR), CRP, albumin, lymphocyte/CRP ratio, CRP/albumin ratio, and neutrophil/albumin ratio as systemic inflammatory biomarkers and prognostic nutritional index (PNI) were evaluated. METHODS: This retrospective study included 592 patients. Patients with colon cancer in the cohort were divided into 2 subgroups: Tumor, nodes, metastases (TNM) stage 0, TNM stage 1, and TNM stage 2; early stage (n: 332) and TNM stage 3 and TNM stage 4; late stage (n: 260) colon cancer patients. RESULTS: LDH (P < .001), NLR (P < .001), PLR (P < .05), CRP/albumin (P < .01), and neutrophil/albumin (P < .01) were significantly higher, while monocyte count (P < .05) and PNI (P < .01) were found to be significantly lower in late stage colon cancer patients than in early stage colon cancer patients. Moderate negative correlation was found between the PNI and the neutrophil/albumin ratio in late stage colon cancer patients (r: -.568, P < .001). CONCLUSIONS: Our data suggest that high serum LDH, NLR, PLR, CRP/albumin, and neutrophil/albumin may be useful predictive markers for advanced stage in colon cancer. According to the receiver operating characteristic analysis results, CRP/albumin ratio can be used to discriminate early from late stage. Preoperative low monocyte count and PNI are associated with postoperative staging patients with colon cancer.

Comparison of Olfactory Cleft Width and Volumes in Patients with COVID-19 Anosmia and COVID-19 Cases Without Anosmia.

INTRODUCTION: The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia. METHODS: This study consisted of PCR-proven COVID-19 patients. Cases with COVID-19-related anosmia constituted Group 1 and cases without any olfactory dysfunction (OD) throughout COVID-19 infection or after recovery constituted Group 2. A total of 50 patients were included in the study, comprising 24 cases in Group 1 and 26 cases in Group 2. Group 1 patients underwent a 4-item-odor identification test during active symptoms and a Sniffin' Sticks test after reconversion of PCR results to negative. All patients in Group 2 also underwent the Sniffin' Stick test to document normosmia. All cases had paranasal sinus CT performed. Olfactory cleft widths and olfactory volumes were measured. The differences in width and volume between groups and the correlation with odor test scores (threshold-discrimination-identification [TDI]) were calculated. In addition, regression analyzes analysis was performed for cleft widths, volumes, and TDI scores according to age. RESULTS: Olfactory cleft widths and olfactory volumes were significantly higher in Group 1 than those in Group 2 (p = 0.001; p < 0.01). There was a significant negative correlation between total TDI scores and olfactory cleft widths and total olfactory volumes (r = -0.665; r = -0.731, respectively). Patients younger than 40 years of age had significantly higher right olfactory cleft width, left olfactory cleft width, and olfactory cleft volume than those in patients older than 40 years of age (p = 0.004, p = 0.005, p = 0.003; p < 0,01, respectively). However, patients younger than 40 years of age had a significantly lower total TDI score and in all other values individually (t-d-i) than those in patients older than 40 years of age (p = 0.004; p < 0.01). CONCLUSION: Patients with COVID-19-related OD had larger olfactory cleft width and volumes than those without OD in this study. Total TDI score was found to be inversely correlated with cleft width and volume.

Evaluation of Multiparametric Shear Wave Elastography Indices in Malignant and Benign Breast Lesions.

RATIONALE AND OBJECTIVES: To evaluate the shear wave elastography indices (multiparametric SWE) of breast lesions based on patient and lesion dependent features and assess the contribution of different elastographic parameters to radiological diagnosis. MATERIALS AND METHODS: Effect of patient-dependent (age and menopausal status) and lesion-dependent (distance from the areola, quadrant location, size, depth, margin and shape) factors on SWE parameters (Vmean, Vsd, Vmax, Vmin) in benign breast lesions were assessed. Only mass lesions were included in the study. Sensitivity, specificity, PPV, NPV and cut-off values for each elastography parameter was calculated. RESULTS: A total of 496 mass lesions of breast were evaluated. 467 of the lesions were benign and 29 were malignant. There was no significant relationship among SWE indices and age, menopausal status, lesion shape and distance to the areola in benign lesions (p>0.05). SWE indices were found to be associated with lesion margin, depth from the skin, and lesion size in benign lesions (p<0.05). All BI-RADS 3 lesions that underwent biopsy were benign (n:35); 23.5% of 4a lesions were malignant (n:4/17) and all 4b-4c-5 lesions were malignant (n:25/25). The cut-off values for malignant lesions were: Vmean 3.38 m/s, Vsd 0.81, Vmax 6.87 m/s, Vmin 1.53 m/s. All SWE parameters were statistically significant in predicting malignancy on ROC analysis, Vmax was the most sensitive (96.3%) and specific (94.7%) parameter. Cut-off values for Vmax was 6.87 m/s with an accuracy rate of 94.7%, and 3.37 m/s for Vmean and 0.8 for Vsd with 92.5% accuracy. CONCLUSION: The SWE parameters to predict malignancy in breast lesions can be affected by lesion dependent features, whereas no significant effect of patient's age or menopausal status on stiffness of the lesions was observed. Vmax had the highest sensitivity for predicting malignancy.

Short-term effects of COVID-19 on semen parameters: A multicenter study of 69 cases.

OBJECTIVE: COVID-19, which is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health problem that can cause multiorgan damage because of its use of the angiotensin-converting enzyme 2 (ACE2) receptor in its pathophysiology. We aimed to investigate whether SARS-CoV-2 had a short-term effect on spermatogenesis, which plays an important role in male reproductive health as it has abundant ACE2 expression in testicular tissue. MATERIAL AND METHODS: This multicenter study included 69 patients aged 20-45 years, who admitted to our hospitals between April 2020 and October 2020 with a history of a positive test result for SARS-CoV-2 based on the nasopharyngeal or oropharyngeal swab samples and had recovered from the disease at least three months earlier and who had undergone a spermiogram test in the hospital database within the last year before the onset of disease. The patients were divided into two groups according to their COVID-19 symptoms being mild or moderate, depending on whether they had received home treatment or required hospitalization for oxygen therapy. Semen samples taken before and after COVID-19 were compared within and between the groups in terms of sperm parameters. RESULTS: The mean age of the patients included in the study was 30.4±4.8 years in the mild symptomatic COVID-19 group and 31.06±4.2 years in the moderate symptomatic group. When the spermiogram samples of the patients before and after COVID-19 were evaluated, it was found that motility and vitality significantly decreased in the mild symptomatic group, while the decrease in all semen parameters was statistically significant in the moderate symptomatic group. CONCLUSION: Although the mechanism by which COVID-19 causes testicular involvement remains uncertain, its short-term results on spermatogenesis reveals that COVID-19 negatively affects sperm parameters.