Unraveling the Design Space of Immersive Analytics: A Systematic Review.

Immersive analytics has emerged as a promising research area, leveraging advances in immersive display technologies and techniques, such as virtual and augmented reality, to facilitate data exploration and decision-making. This paper presents a systematic literature review of 73 studies published between 2013-2022 on immersive analytics systems and visualizations, aiming to identify and categorize the primary dimensions influencing their design. We identified five key dimensions: Academic Theory and Contribution, Immersive Technology, Data, Spatial Presentation, and Visual Presentation. Academic Theory and Contribution assess the motivations behind the works and their theoretical frameworks. Immersive Technology examines the display and input modalities, while Data dimension focuses on dataset types and generation. Spatial Presentation discusses the environment, space, embodiment, and collaboration aspects in IA, and Visual Presentation explores the visual elements, facet and position, and manipulation of views. By examining each dimension individually and cross-referencing them, this review uncovers trends and relationships that help inform the design of immersive systems visualizations. This analysis provides valuable insights for researchers and practitioners, offering guidance in designing future immersive analytics systems and shaping the trajectory of this rapidly evolving field.

Comparison of three different tadalafil regimens for erectile dysfunction treatment in patients with diabetes mellitus microvascular complications.

We aimed to compare the efficacy of three tadalafil regimens for patients with type-2 diabetes mellitus (DM), at least one microvascular complication and erectile dysfunction (ED). Sixty patients attending our urology clinic with erectile problems and diagnosed with ED, having DM for at least 5 years, and at least one microvascular complication linked to DM were identified and randomly divided into three groups-Group I: used 5 mg tadalafil daily, Group II: used 20 mg tadalafil 2 h before sexual relations twice a week and Group III: used 5 mg tadalafil daily and an extra 15 mg tadalafil 2 h before sexual relations twice a week. After treatment, the median International Index of erectile function (IIEF-5) scores were significantly higher in Group III (15) compared to Groups I (8.5, p = 0.01) and II (9, p = 0.035). The groups were comparable in terms of the percentage of positive responses to the sexual encounter profile (SEP) 2 and the Global Assessment Questionnaires (GAQ)-1. However, the percentage of patients with positive responses to SEP-3 (20%, 40% and 75%, respectively) (p = 0.002) and GAQ-2 (20%, 45% and 75%, respectively) (p = 0.002) was significantly higher in Group III. Therefore, using a combination treatment (daily 5 mg + 15 mg when needed) to treat erectile function in patients with DM-related ED in the first stage may be more efficient with the same reliability and greater patient satisfaction.

Treatment of ureteral catheter related symptoms; mirabegron versus tamsulosin/solifenacin combination: a randomized controlled trial / Tratamiento de los sintomas relacionados con los catéteres: mirabegon vs tamsulosina-solifenacina en combinación: un estudio prospectivo randomizado

OBJECTIVES: The double-J (DJ) stents are commonly used to relieve the ureteral obstruction. Besides several known benefits, some of the patients encounter stent-related morbidities with considerable effects on the quality of life, general health situation, sexual matters, and daily work performance. In this study, we evaluated the effectiveness of tamsulosin/solifenacin combination and mirabegron in reducing DJ stent-related symptoms. MATERIALS AND METHODS: A total of 120 patients with 28cm 4.7fr DJ catheter inserted due to ureteral obstruction were included in this study. Patients were randomly divided into three groups of 40 each; group one received only oral hydration for six weeks; group two received 0.4 mg tamsulosin/10 mg solifenacin, and group three received 50 mg mirabegron. Preoperative and after 6 weeks, the VAPS, OAB-q index, and IPSSs forms were filled. RESULTS: The mean age of the patients was 41.60 ± 12.34 years. There was no significant difference between the groups in terms of preoperative and postoperative VAPS values (p>0.05). There was a significant difference in postop IPSSs values (p:0.001). It was higher in the hydration group than tamsulosin/solifenacin and mirabegron groups. Postoperative IPSS value of the hydration group was 21.78 ± 2.54 while the tamsulosin/ solifenacin and mirabegron groups were 15.6 ± 4.37 and 13.65 ± 4.97, respectively. The use of mirabegron and tamsulosin/solifenacin combination alleviates the LUTSs related with DJ stent. There was also a significant difference between groups in terms of postoperative OAB-q values (p:0.001). Postoperative OAB-q values in the tamsulosin/solifenacin group were significantly higher than the mirabegron group. Postoperative OAB-q value of the hydration group was 29.95 ± 5.21, while the tamsulosin/solifenacin and mirabegron groups were 23.68 ± 4.07 and 18.15 ± 4.1, respectively. Our results also showed that, as a beta-3 adrenergic receptor agonist, mirabegron can improve the OAB-q scores. CONCLUSION: Tamsulosin and solifenacin combination is a significantly good treatment option for reducing LUTS associated with DJ stents. Mirabegron single therapy showed good results in treating LUTS and better results in treating OAB symptoms related with DJ stents than other therapies

OBJETIVO: El catéter doble J se utiliza para desobstruir el uréter. A parte de los ya conocidos beneficios, algunos pacientes tienen efectos adversos derivados de llevar el catéter que empeoran su calidad de vida, su vida sexual, sus actividades laborales. En este estudio, evaluamos la efectividad de la tamsulosina/solifenacina en combinación y mirabegron en reducir estos síntomas. MATERIAL Y MÉTODOS: Un total de 120 pacientes con cateteres de 28 cm/4.7 Ch fueron incluidos en el estudio. Los pacientes se randomizaron en 3 grupos, 40 en cada grupo (un grupo recibio hidratación oral durante 6 semanas, otro grupo tamsulosina 0,4 mg/10 mg solifenacina y el tercero 50 mg mirabegron). VAPS, OAB q index y IPSS cuestionarios se rellenaron en el preoperatorio y a las 6 semanas de tratamiento. RESULTADOS: La mediana de edad fue de 41ª. No había diferencias significativas en los grupos en términos de valores VAPS preoperatorios y postoperatorios. Se evidenció una diferencia significativa en los valores IPSS (p = 0,001), ya que fue más elevado en el grupo de hidratación oral que el grupo de tamsulosina/solifenacina y mirabegron. El valor postoperatorio de IPSS en el grupo de hidratación fue de 22, mientras que en la tamsulosina y mirabegron fue de 15 y 13, respectivamente. El uso de mirabegron y tamsulosina mejora los síntomas tracto urinario inferior por el catéter. También se evidencio una diferencia significativa entre los grupos en términos de OAB-q (p = 0,001). Los valores postoperatorios OAB-q en el grupo tamsulosina fueron más altos que en el grupo mirabegron. El valor OAB-q postoperatorio en el grupo de hidratación oral fue de 29, tamsulosina 23 y mirabegron 18, respectivamente. Nuestros resultados también demuestran que mirabegron puede mejorar los resultados de OAB-q. CONCLUSIONES: Tamsulosina/solifenacina es un buen tratamiento para mejorar los STUI asociados a catéteres. Mirabegon demuestra también buenos resultados en el tratamiento de los síntomas de vejiga hiperactiva relacionados en el catéter mejor que otras terapias

Treatment of ureteral catheter related symptoms; mirabegron versus tamsulosin/solifenacin combination: A randomized controlled trial. / Tratamiento de los sintomas relacionados con los catéteres: mirabegon vs tamsulosina-solifenacina en combinación: un estudio prospectivo randomizado.

 OBJECTIVES: The double-J (DJ) stents are commonly used to relieve the ureteral obstruction. Besides several known benefits, some of the patients encounter stent-related morbidities with considerable effects on the quality of life, general health situation, sexual matters, and daily work performance. In this study, we evaluated the effectiveness of tamsulosin/solifenacin combination and mirabegron in reducing DJ stent-related symptoms. MATERIALS AND METHODS: A total of 120 patients with 28cm 4.7fr DJ catheter inserted due to ureteral obstruction were included in this study. Patients were randomly divided into three groups of 40 each; group one received only oral hydration for six weeks; group two received 0.4 mg tamsulosin/10 mg solifenacin, and group three received 50 mg mirabegron. Preoperative and after 6 weeks, the VAPS, OAB-q index, and IPSSs forms were filled. RESULTS: The mean age of the patients was 41.60 ± 12.34 years. There was no significant difference between the groups in terms of preoperative and postoperative VAPS values (p>0.05). There was a significant difference in postop IPSSs values (p:0.001). It was higher in the hydration group than tamsulosin/solifenacin and mirabegron groups. Postoperative IPSS value of the hydration group was 21.78 ± 2.54 while the tamsulosin/ solifenacin and mirabegron groups were 15.6 ± 4.37 and 13.65 ± 4.97, respectively. The use of mirabegron and tamsulosin/solifenacin combination alleviates the LUTSs related with DJ stent. There was also a significant difference between groups in terms of postoperative OAB-q values (p:0.001). Postoperative OAB-q values in the tamsulosin/solifenacin group were significantly higher than the mirabegron group. Postoperative OAB-q value of the hydration group was 29.95 ± 5.21, while the tamsulosin/solifenacin and mirabegron groups were 23.68 ± 4.07 and 18.15 ± 4.1, respectively. Our results also showed that, as a beta-3 adrenergic receptor agonist, mirabegron can improve the OAB-q scores. CONCLUSION: Tamsulosin and solifenacin combination is a significantly good treatment option for reducing LUTS associated with DJ stents. Mirabegron single therapy showed good results in treating LUTS and better results in treating OAB symptoms related with DJ stents than other therapies.

OBJETIVO: El catéter doble J se utiliza para desobstruir el uréter. A parte de los ya conocidos beneficios, algunos pacientes tienen efectos adversos derivados de llevar el catéter que empeoran su calidad de vida, su vida sexual, sus actividades laborales. En este estudio, evaluamos la efectividad de la tamsulosina/solifenacina en combinación y mirabegron en reducir estos síntomas.MATERIAL Y MÉTODOS: Un total de 120 pacientes con cateteres de 28cm/4.7 Ch fueron incluidos en el estudio. Los pacientes se randomizaron en 3 grupos, 40 en cada grupo (un grupo recibio hidratación oral durante 6 semanas, otro grupo tamsulosina 0,4 mg/10 mg solifenacina y el tercero 50 mg mirabegron). VAPS, OAB q index y IPSS cuestionarios se rellenaron en el preoperatorio y a las 6 semanas de tratamiento. RESULTADOS: La mediana de edad fue de 41ª. No había diferencias significativas en los grupos en términos de valores VAPS preoperatorios y postoperatorios. Se evidenció una diferencia significativa en los valores IPSS (p=0,001), ya que fue mas elevado en el grupo de hidratación oral que el grupo de tamsulosina/solifenacina y mirabegron. El valor postoperatorio de IPSS en el grupo de hidratación fue de 22, mientras que en la tamsulosina y mirabegron fue de 15 y 13, respectivamente. El uso de mirabegron y tamsulosina mejora los síntomas tracto urinario inferior por el catéter. También se evidencio una diferencia significativa entre los grupos en términos de OAB-q (p=0,001). Los valores postoperatorios OAB-q en el grupo tamsulosina fueron mas altos que en el grupo mirabegron. El valor OAB-q postoperatorio en el grupo de hidratación oral fue de 29, tamsulosina 23 y mirabegron 18, respectivamente. Nuestros resultados también demuestran que mirabegron puede mejorar los resultados de OAB-q. CONCLUSIONES: Tamsulosina/solifenacina es un buen tratamiento para mejorar los STUI asociados a catéteres. Mirabegon demuestra también buenos resultados en el tratamiento de los síntomas de vejiga hiperactiva relacionados en el catéter mejor que otras terapias.

Sensitivity and specificity of Briganti nomogram in Turkish patients undergoing radical prostatectomy and pelvic lymph node dissection.

AIM: To investigate the accuracy of Briganti nomogram in patients who underwent Pelvic lymph node dissection (PLND). METHODS: Hundred and sixty-five patients who underwent radical prostatectomy and PLND between 2012 and 2018 in our clinics were included, and their data were retrospectively screened. RESULTS: The mean age of patients was 63.6 ± 5.8 (range: 49-76) years. Hundred and thirty-five (81.8%) patients had a Briganti score of <5, whereas 30 (18.2%) had a Briganti score of ≥5. The preoperative T-PSA levels, biopsy grades and the incidence of T2b and T2c stages in patients with a Briganti score of ≥5 was significantly higher than that in patients with a Briganti score of <5 (p: .026; p: .000; p: .001, respectively). The incidence of lymph node positivity in patients with a Briganti score of ≥5 (76.7%) was significantly higher than that in patients with a Briganti score of <5 (25.2%) (p: .000). The sensitivity of the Briganti score to detect lymph node positivity was 40.35%, specificity was 93.52%, positive predictive value was 76.67% and the negative predictive value was 74.81%. The accuracy of the test was 75.15%. CONCLUSION: Nomograms provide useful information regarding prostate cancer. Risk estimates should be carefully considered, and treatment decisions should be given with a patient-specific approach.

Three different urogenital carcinoma in an aging patient: a rare case presentation.

Urogenital cancers are frequently encountered in daily practice. Prostate cancer is the second most common type in adult males, and 2-3% of all adult cancers are renal cell carcinoma. Kaposi's sarcoma originates from vascular endothelial cells and is the most common type of sarcoma observed in HIV-positive patients. However, the development of all these types of cancer in a patient without immunodeficiency is very rare. Incidence of urological malignancies increase with aging. In contrast to normal population, patient who have one urological malignancy have increased risk of getting another urological malignancy in a follow-up. So follow-up of this kind of patients is crucial and needs to be done carefully. In this case report, we aimed to discuss a 68-year-old patient who was diagnosed with concurrent prostate and kidney cancer and developed penile Kaposi's sarcoma in follow-up.

Results of purified micronized flavonoid fraction in the treatment of categorized type III chronic pelvic pain syndrome: a randomized controlled trial.

OBJECTIVES: The management of chronic pelvic pain syndrome (CPPS) is controversial because of the unclear pathogenesis of this disease. In one theory, prostatitis has been proposed to be associated with pelvic venous diseases such as varicocele and hemorrhoids, dilatation of the Santorini plexus. In this study, we investigated the effect of micronized flavonoid fraction (an agent used in venous insufficiency) in the treatment of type III CPPS. METHODS: Patients diagnosed with type III chronic prostatitis were randomized and divided into 3 groups. Group 1 consisted of patients using antibiotics + anti-inflammatory + alpha-blocker (n = 47), Group 2 consisted of patients using antibiotics + anti-inflammatory + purified micronized flavonoid fraction (n = 45), and Group 3 consisted of patients using only purified micronized flavonoid fraction (n = 35). RESULTS: The mean age of the patients was 32.93 ± 4.70 (range; 23-44) years. There was a statistically significant difference between the groups in terms of the 6th month NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) total scores (p = .000). Also, it was found that NIH-CPSI total scores at month 12 in Group 3 were significantly higher than those in Group 1 and 2 (p1 = .000, p2 = .002). NIH-CPSI total scores at month 12 in Group 2 were significantly higher than those in Group 1 (p = .000). CONCLUSION: The use of purified micronized flavonoid will decrease prostatic inflammation occurring due to increased perineal venous return.it can also be preferred as part of multimodal therapy because of its profile with relatively less side effects and being more affordable compared with alpha-blockers.

Worry and anger are associated with latent classes of problematic smartphone use severity among college students.

BACKGROUND: Problematic smartphone use (PSU) is associated with depression and anxiety symptom severity throughout the literature. However, many important psychopathology constructs have not been examined for associations with PSU severity. Worry and anger are two psychopathology constructs receiving little empirical scrutiny in relation to PSU, but theoretically should demonstrate significant relationships. Furthermore, few studies have used person-centered analyses, such as mixture modeling, to analyze possible latent subgroups of individuals based on PSU symptom ratings. METHOD: We conducted a web survey of 300 American college students, using the Smartphone Addiction Scale-Short Version, Penn State Worry Questionnaire-Abbreviated Version, and Dimensions of Anger Reactions-5 Scale. RESULTS: Conducting mixture modeling using latent profile analysis, we found most support for a three-class model of latent groups of individuals based on their PSU item ratings. Adjusting for age and sex, worry and anger scores were significantly higher in the more severe PSU classes. DISCUSSION: Results are discussed in the context of uses and gratifications theory, as well as compensatory internet use theory, in terms of individual differences explaining excessive technology use. LIMITATIONS: Limitations include the non-clinical nature of the sample. CONCLUSIONS: Worry and anger may be helpful constructs in understanding the phenomenology of PSU, and psychological interventions for worry and anger may offset PSU.

Protective effects of Tadalafil and darbepoetin against ischemia - reperfusion injury in a rat testicular torsion model

ABSTRACT Objectives: To evaluate protective effects of darbepoetin and tadalafil against ischemia-reperfusion injury in ipsilateral and contralateral testicle. Materials and Methods: Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion. Results: There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000). Conclusion: The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

Protective effects of Tadalafil and darbepoetin against ischemia - reperfusion injury in a rat testicular torsion model.

OBJECTIVES: To evaluate protective effects of darbepoetin and tadalafil against ischemiareperfusion injury in ipsilateral and contralateral testicle. MATERIALS AND METHODS: Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/ tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion. RESULTS: There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000). CONCLUSION: The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

The effect of darbepoetin alfa on renal fibrosis in rats with acute unilateral ureteral obstruction.

OBJECTIVES: The most important treatment strategy for obstructive nephropathy is to protect renal tissue from the deleterious effects of fibrosis. Therefore, we sought to investigate the renoprotective effects of darbepoetin alfa on unilateral ureteral obstructions. METHODS: We used 12 female and 12 male 3-monthold Wistar rats weighing between 250 and 350 g. The rats were divided equally into sham, darbepoetin and control groups. With the exception of the sham group, left unilateral obstructions were applied to all of the rats. The darbepoetin group received perioperative darbepoetin alfa at a dose of 10 mg/kg. The rats were sacrificed on postoperative day 7, and 3-cc blood samples and bilateral renal specimens were collected from each rat. RESULTS: Renal ectasia was observed significantly less frequently in the darbepoetin group than the obstruction group (p<0.001). Additionally, the uptake rates of cortical TNF and medullary SMA in the darbepoetin group were comparable to those in the sham group but lower than those in the ureteral obstruction group (p<0.001 and p<0.008, respectively). When biomarkers of renal injury, including cystatin-C, malondialdehyde, and B2 microglobulin, were evaluated in combination, B2 microglobulin was found at higher levels in the ureteral obstruction group (p<0.004). CONCLUSION: As we know pelvicalyceal ectasia reflects intrapelvic pressure into renal tubular system via renal reflux. Therefore pelvicalyceal ectasia can be used as an indicator of renal tubular pressure. Although as a limitation of our study, renal tubular pressure was not quantitatively evaluated, parallelism between levels of renal ectasia detected in the rats of the sham, and DPO groups can predict that this drug (darbepoetin-a) can decrease renal tubular pressure in acute ureteral obstruction. Moreover, B2 microglobulin levels in the sham, and DPO groups differed from those of ureteral obstruction group, which suggested that DPO does not impair renal perfusion in addition to its decreasing effects on renal tubular pressure. We think that in countries with higher incidence rates of stone disease similar to our country, DPO may be used among medical treatment alternatives, which aim to preserve renal reserve.

Translation and Validation of the Nomophobia Questionnaire in the Italian Language: Exploratory Factor Analysis.

BACKGROUND: Nomophobia, which is a neologism derived from the combination of "no mobile," "phone," and "phobia" is considered to be a modern situational phobia and indicates a fear of feeling disconnected. OBJECTIVE: No psychometric scales are available in Italian for investigating such a construct. We therefore planned a translation and validation study of the Nomophobia Questionnaire (NMP-Q), which is an instrument developed by Yildirim and Correia. Subjects were recruited via an online survey using a snowball approach. METHODS: The NMP-Q was translated from English into Italian using a classical "backwards and forwards" procedure. In order to explore the underlying factor structure of the translated questionnaire, an exploratory factor analysis was carried out. A principal component analysis approach with varimax rotation was performed. Multivariate regression analyses were computed to shed light on the psychological predictors of nomophobia. RESULTS: A sample of 403 subjects volunteered to take part in the study. The average age of participants was 27.91 years (standard deviation 8.63) and the sample was comprised of 160 males (160/403, 39.7%) and 243 females (243/403, 60.3%). Forty-five subjects spent less than 1 hour on their mobile phone per day (45/403, 11.2%), 94 spent between 1 and 2 hours (94/403, 23.3%), 69 spent between 2 and 3 hours (69/403, 17.1%), 58 spent between 3 and 4 hours (58/403, 14.4%), 48 spent between 4 and 5 hours (48/403, 11.9%), 29 spent between 5 and 7 hours (29/403, 7.2%), 36 spent between 7 and 9 hours (36/403, 8.9%), and 24 spent more than 10 hours (24/403, 6.0%). The eigenvalues and scree plot supported a 3-factorial nature of the translated questionnaire. The NMP-Q showed an overall Cronbach alpha coefficient of 0.95 (0.94, 0.89, and 0.88 for the three factors). The first factor explained up to 23.32% of the total variance, while the second and third factors explained up to 23.91% and 18.67% of the variance, respectively. The total NMP-Q score correlated with the number of hours spent on a mobile phone. CONCLUSIONS: The Italian version of the NMP-Q proved to be reliable.

Circumcision and its potential effects on children's mental health state / Circuncisión y sus efectos potenciales sobre el estado de salud mental infantil

Objectives. Circumcision is one of the oldest elective surgical interventions in the history of mankind. Though many studies have been conducted on the surgical complications of circumcision, the potential effects on the mental state of the children has not been satisfactorily reviewed. In this prospective study, we analyzed potential effects of circumcision on their mental state, anxiety levels and moods using updated scales. Material and methods. One hundred and two male children aged between 6 and 8 and their families were included in the study. Children with their families completed sociodemographic data form Anxiety Sensitivity Index For Children, the Strengths and Difficulties Questionnaire (SDQ), Depression Scale for Children during the preoperative period. All children received oral 0.5mg/kg midazolam as a premedication before circumcision procedure. Circumcisions were performed under general anesthesia in the operating room. During the 6th week of the postoperative period, the children and their families were returned to the facility and parents were asked to complete the questionnaire again. Results. Mean score of the preoperative depression scale was statistically and significantly higher than the mean postoperative depression scale score (P=0.001; P<0.01). Pre-, and post-operative depression scale scores of the children with divorced parents showed a higher statistical significance higher than those of the children whose family togetherness was not broken (P=0.001; P<0.01). Conclusion. Before circumcision, in all children to be circumcised a tendency to depression and an increase in anxiety were observed regardless of the presence of subgroups. At the end of the study, it was found that low socioeconomic level, disrupted family dynamic, and/or the presence of mental disease in a parent could increase the predisposition to pre and post-operative depression. At this stage the main factor determining the level of anxiety is the procedure of circumcision itself (AU)

Objetivos. La circuncisión es una de las intervenciones quirúrgicas electivas más antiguas de la historia de la humanidad. Aunque muchos estudios se han realizado sobre las complicaciones quirúrgicas de la circuncisión, su efecto potencial sobre el estado mental de los niños no se ha aclarado mucho. En este estudio prospectivo se analizaron los efectos potenciales de la circuncisión en su estado mental, los niveles de ansiedad y estados de ánimo que por medio de escalas actualizadas. Material y métodos. Ciento dos niños varones de edades comprendidas entre los 6 y los 8 años y sus familias fueron incluidos en el estudio. Los niños con sus familias completaron el formulario de datos sociodemográficos Ansiedad Índice de Sensibilidad Para los niños, Capacidades y Dificultades (SDQ), escala de depresión para los niños durante el período preoperatorio. Todos los niños recibieron por vía oral 0,5mg/kg de midazolam como premedicación antes de procedimiento de circuncisión. Las circuncisiones se realizaron bajo anestesia general en la sala de operaciones. Durante la sexta semana del postoperatorio, los niños y sus familias regresaron y completaron las mismas encuestas una vez más. Resultados. La media de puntuación de la escala de depresión preoperatoria fue estadística y significativamente más alta que la puntuación media postoperatoria escala de depresión (p=0,001; p<0,01). Las puntuaciones pre y post operatorias en la escala de depresión de los niños con padres divorciados mostraron una mayor significación estadística que las de los niños cuyo núcleo familiar no estaba roto (p=0,001; p<0,01). Conclusión. Antes de la circuncisión, en todos los niños que iban a ser circuncidados se aprecia una tendencia a la depresión y el aumento de la ansiedad, independientemente de la presencia de subgrupos. Una vez concluida la investigación, se observó que un bajo nivel de ingresos, una dinámica familiar desequilibrada y/o la presencia de un trastorno mental en un progenitor podrían predisponer a la depresión pre y postoperatoria. En esta etapa el factor principal que determina el nivel de ansiedad es el procedimiento de la circuncisión sí mismo (AU)

A case of seminoma presented with clinical manifestations of testicular torsion.

Testicular tumors rarely manifest themselves with clinical picture of testicular torsion. In this presentation of ours, we reported a 30-year-old patient whose post-orchiectomy histopathology report revealed the presence of seminoma. The patient consulted us with acute scrotum whose physical examination and Doppler ultrasonographic findings showed testicular torsion. Though rarely seen patients, in cases who consulted with acute scrotum, the possibility of testicular tumor should not be discarded. For the establishment of differential diagnosis detailed anamnesis and physical examination findings should be supported with laboratory tests and imaging modalities.

Contralateral Ovarian Metastasis of Clear-Cell Renal Carcinoma: A Rare Case Report and Review of the Literature.

Renal cell carcinoma (RCC) constitutes 2-3% of all types of cancers. RCCs metastasize into lungs (50-60%), lymph nodes (36%), bones (30-40%), liver (30-40%), and brain (5%) in respective percentages. RCC rarely metastasizes into ovary. Only 25 cases of ovarian tumor, which metastasized into kidneys, have been presented. In the literature, a kidney-ovary axis has been defined, and its interrelationship begins with embryological life. With this case report, we aimed both to present a very rarely seen metastasis of RCC into contralateral ovary and also to review the literature.

Preoperative Glasgow prognostic score as a predictor of primary bladder cancer recurrence.

The correlation between systemic inflammatory markers and malignancies has been assessed by a number of recent studies. The aim of this study was to prospectively assess preoperative inflammation markers and Glasgow prognostic scores (GPS) in patients who underwent surgery for primary bladder cancer (BC), and evaluate the predictive value of GPS for disease recurrence and progression. A total of 38 patients (mean age, 60.16±9.71 years; range, 33-76 years) who were treated in our department between May, 2014 and August, 2015 were enrolled in the present study. Preoperatively, patient information regarding gender, body mass index, serum C-reactive protein (CRP) and albumin levels, GPS and comorbidities, were collected and recorded. Transurethral resection of the bladder was performed, followed by histopathological evaluation of the resected material. The tumor size, stage and grade and the presence of necrosis were determined. According to the international TNM classification, the results of the histopathological analysis were as follows: Ta low- (n=24) and high-grade (n=4); and T1 low- (n=2) and high-grade (n=8). The median follow-up period was 10.1 months (range, 6-12 months). During this period, recurrence was observed in 10 cases and disease progression was detected in 1 patient. Hypoalbuminemia was encountered in 40% of the cases with recurrence, which was significantly higher compared with that in patients without recurrence (7.1%; P=0.031). In patients who had recurrence, a GPS of 1-2 points and tumor necrosis were more frequently detected compared with those without recurrence (60 vs. 7.1%, P=0.002; and 80 vs. 7.1%, P=0.001, respectively). Excluding a cystectomized case with a diagnosis of muscle-invasive BC, disease progression was not detected in any of the cases with recurrence during follow-up. Therefore, we consider that GPS and serum markers of systemic inflammatory response may be used as predictors of recurrence in patients with transitional cell BC.

The effect of asymptomatic histological prostatitis on sexual function and lower urinary tract symptoms.

OBJECTIVE: Prostatitis affects 10-14% of men of all ages and ethnicities. More than 50% of the men experience episodes of prostatitis at one time of their lives. Patients with CP typically have longlasting genitourinary/pelvic pain and obstructive and/or irritative voiding symptoms. Sexual dysfunction and psychological symptoms are frequently added to these symptoms. We also investigated the relationship between sexual functions, and lower urinary system symptoms, and asymptomatic histological prostatitis detected on transrectal ultrasound-guided (TRUS) biopsy performed with the indication of high PSA levels. METHODS: Sixty cases compliant with the study criteria among patients who underwent prostate biopsies between September 2014 and June 2015 with the indication of higher PSA levels were included in the study. All patients were requested to complete IIEF-5 and IPSS forms one day previously. Based on histological analysis of biopsy materials, the patients were allocated into groups of BPH (simple BPH without histological prostatitis) (n:30) and histological chronic prostatitis (combination of BPH and histological prostatitis) (n:30). RESULTS: Mean age of the cases was 65.73±5.01 (range, 56-75 yrs) years. PSA levels ranged between 4-15 ng/ml. A statistically significant intergroup difference was not found regarding mean age, BMIs, PSA levels, incidence rates of hypertension and coronary artery disease (p>0.05). Prostate volumes of the HCP group were higher than those of the BPH group , with statistically significant differences (p:0.001; p<0.01). Questionnaire forms of the patients included in the study were statistically evaluated, and mean IPSS score of the HCP group was found to be higher when compared with that of the BPH group, with statistically significant differences. (p:0.016; p<0.05). However mean IIEF score of the BPH group was higher than that of the HCP group, with statistically significant differences (p:0.039; p<0.05). DISCUSSION: These findings suggested the presence of a correlation between chronic inflammation and lower urinary tract symptoms (LUTS). In addition, statistically significant lower IIEF values in patients with histological chronic prostatitis relative to those without suggested negative effects of even asymptomatic inflammation on sexual functions and mechanism of erection.

Effects of obesity surgery (laparoscopic sleeve gastrectomy technique) on lower urinary tract symptoms, depression and quality of life of males: Prospective study.

PURPOSE: Technically, obesity weakens the pelvic base muscles by causing an increase in the intraabdominal pressure and intravesical pressure due to increasing fat and it triggers the occurrence of lower urinary tract symptoms. However it is believed that weight loss will cause recovery of these symptoms. Our purpose in this study is to research about the effects of the weight loss achieved by using especially the Laparoscopic Sleeve Gastrectomy (LSG) technique of bariatric surgery which is being more and more widely used today. MATERIALS AND METHODS: Out of all patients who had LSG surgery due to obesity earlier in our center during the period between April 2014 and March 2015, 22 applicable male patients were considered after a brief exclusion criteria application. Age, height, weight, and body mass index (BMI) data of these patients were recorded before the operation. International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire - short from) (ICIQ-SF), Beck depression inventory (BECK) and Short form - 36 (SF-36) were filled for the patients and the data were recorded. Also, the weight loss amounts and BMI decreases of the patients after the operation were recorded. RESULTS: After the procedure, the decrease in the averages of BECK depression inventory, IPSS, ICIQ-SF and the increase in the Mental and Physical subgroup scores of SF-36 were found statistically coherent. CONCLUSION: The adverse effect of obesity, which is observed more and more often in today's world, on lower urinary tract symptoms and on the quality of life is undeniable. In our study, we think that the bariatric surgery made by using the LSG technique, not only causes serious amount of weight loss, but also reduces urinary dysfunction and enhances the quality of life among males.

Late-onset secondary nocturnal enuresis in adolescents associated with post-traumatic stress disorder developed after a traffic accident.

Secondary nocturnal enuresis is generally seen between 5 and 7 years of age and it is rarely encountered when compared with the primary incontinence. Patients with suggested diagnosis of secondary nocturnal enuresis should be examined for neurological and spinal anomalies and diabetes mellitus, diabetes insipidus, renal failure and urinary tract infection should be ruled out in differential diagnosis (1-3). Herein, we are presenting case reports of adolescent patients with secondary nocturnal enuresis refractory to medical therapy and developed after in-vehicle and extravehicular accidents.

Contralateral tumor seeding of renal cell carcinoma mimicking late metastasis of liver after laparoscopic nephrectomy: A case report with review of the literature.

Laparoscopic surgery has been increasingly used every day in the management of urologic malignancies. Even though it seems as a minimally invasive surgery, during these interventions tumor seeding, as seen in open surgery, confronts us as a rarely seen serious risk. Herein, we have reported a case who demonstrated peritoneal tumor implantation at 12 month postoperative follow up after laparoscopic radical nephrectomy (LRN) performed for Furhman grade 1 (T2N0M0) renal cell cancer.