Relationship between psoriasis and urolithiasis.

The aim of the present study was to investigate whether patients with psoriasis are prone to urolithiasis. Prospective analysis of 67 patients diagnosed as psoriasis (PS group) and 65 volunteers who had never been diagnosed as psoriasis (NPS group) was performed. The levels of oxalate, citrate, calcium, uric acid, magnesium, creatinine, and sodium were evaluated by analyzing the 24-h urine samples. Stone events were detected in 13 patients (19.4%) in the PS group and in five participants (7.7%) in the NPS group, respectively (P < 0.05). The median value of 24-h citrate was significantly lower in the PS group than in the NPS group (P = 0.029). The median value of 24-h urine uric acid was significantly higher in the PS group than the NPS group (P = 0.005). Hypernatriuria was significantly higher in the PS group (P = 0.027). Hyperuricosuria was detected in the 10.4% and 1.5% of patients who had severe and mild disease, respectively (P = 0.027). Patients with psoriasis are more prone to urolithiasis. Hypocitraturia, hyperuricosuria, and hypernatriuria were the main metabolic abnormalities detected in psoriasis. Hyperuricosuria has been associated with the severity of the disease.

Evaluation of atherosclerotic risk in rosacea patients through serum fetuin-A and carotid intima media thickness.

BACKGROUND: The link between rosacea and various systemic conditions has been growing in prominence, even though the relationship between rosacea and cardiovascular disease remains a subject of debate in current research. AIMS: Detecting the connection between rosacea and subclinical atherosclerosis using laboratory and ultrasonographic parameters. METHODS: Fifty rosacea patients and 49 control were included in the study. Demographic, clinical, and laboratory data, including serum high sensitivity C-reactive protein (hs-CRP), fetuin-A (FA), and matrix gla protein levels were assessed. Carotid intima-media thickness (CIMT) was measured by carotid ultrasonography. RESULTS: Serum hs-CRP levels (p = 0.009) and mean CIMT (p = 0.001) were significantly higher, while serum FA levels were significantly lower (p < 0.001) in the rosacea patients compared with control. The number of patients with mean CIMT>75th percentile according to age and sex were significantly higher in the rosacea group (p = 0.001). Rosacea patients with ocular involvement exhibited significantly higher hs-CRP values in comparison to those without ocular involvement (p = 0.008). No significant correlation was detected between disease duration, severity, subtype and the study parameters. CONCLUSIONS: This study results suggest that rosacea poses an independent risk for subclinical atherosclerosis regardless of its severity, duration, or subtype. Therefore, individuals diagnosed with rosacea should receive careful evaluation and monitoring to detect possible cardiovascular complications promptly. Furthermore, our study hints at a potential elevated risk of subclinical inflammation in rosacea patients with ocular involvement, warranting additional attention and further investigation.

Role of Lactate Dehydrogenase and Lymphocyte Count as Predictors of Poor Perinatal Outcomes in COVID-19-Infected Pregnancies Requiring Hospitalization and Delivery: A Retrospective Cohort Study.

INTRODUCTION: Physiological, hormonal, or biochemical changes may be related to the increased morbidity of COVID-19 during pregnancy. Our knowledge remains limited about which pregnant women will worsen and develop complications. The aim was to evaluate the maternal, fetal, and neonatal outcomes in hospitalized pregnant women who delivered while infected with acute COVID-19 and to investigate the possible predictors of poor prognosis in a tertiary pandemic center. METHODS: A retrospective cohort study was conducted on pregnant women who required termination or delivery during a COVID-19 infection in a tertiary hospital. Serum markers were analyzed to determine any possible association and the predictive value of these markers to show poor maternal, fetal, and/or neonatal outcomes. RESULTS: Out of 45 patients, 12 had maternal complications (Group 1) and 33 had no maternal complications (Group 2). The mean lymphocyte at hospital admission was measured as 1,175.83 ± 362.0 and 1,735.30 ± 746.1 in Groups 1 and 2, respectively (p=0.02). The lymphocyte count measured at hospital admission showed significance in predicting poor maternal outcome, with an area under the curve (AUC) of 0.737 (95% CI:0.578 to 0.897) and a cut-off value of 1,110 mcL with 82% sensitivity and 67% specificity. Nineteen of the 45 women had fetal complications. Receiver operating characteristic analysis showed maternal lactate dehydrogenase as a significant predictor for poor fetal outcome with a cut-off value of 213 U/L (AUC:0.719; 95% CI:0.566 to 0.872) with 85% sensitivity and 60% specificity. CONCLUSION: The lymphocyte count can be used as a predictor of poor maternal outcome and lactate dehydrogenase demonstrates poor fetal outcome during hospitalization.

Nerve Root Compression Due to Contralateral Compensatory Hypertrophy: A Rare Case of Vertebral Artery Thrombosis.

In the patient who complained of dizziness, thrombus was observed in the right vertebral artery. Compression was detected in the nerve root due to compensatory hypertrophy in the left vertebral artery. In conclusion, in cases of unilateral vertebral artery thrombosis, should be aware of the pathologies that may develop in adjacent structures due to compensatory hypertrophy. Teaching Point: An occluded vertebral artery (VA) can cause contralateral VA hypertrophy, which can cause various pathologies including nerve root compression.

Isolated Intracranial Extramedullary Hematopoiesis in an Adult Patient.

This article describes the case of a 56-year-old male patient who presented with a headache and swelling on the left side of his head. Medical examinations, including non-contrast computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI), revealed the presence of an expansile soft tissue lesion in the frontoparietal bone structures, causing compression of the brain tissue. Further immunohistochemical analysis confirmed the diagnosis of extramedullary hematopoiesis (EMH) in the bone lesion, with predominant involvement of the myeloid series. EMH is a compensatory mechanism of the body to meet the demand for erythropoiesis. While EMH is commonly associated with thalassemia in children and myelofibrosis in adults, it can occur in various tissues throughout the body, including the intracranial region, although it is rare. The imaging findings of EMH on MRI typically show iso-hypointense signals on T1-weighted images and hypointense signals on T2-weighted images due to the presence of hemosiderin. However, in this case, the lesions appeared hyperintense on T2-weighted images, which posed a challenge in the differential diagnosis. The article highlights the importance of clinical evaluation and imaging findings in diagnosing EMH, as these lesions can resemble other conditions such as metastases, angiomatous meningioma, chloroma, or epidural hematoma. Teaching Point: Isolated cases of intracranial EMH should be considered as a differential diagnosis in adult patients as they may be radiologically confused with malignant conditions such as metastases, angiomatous meningioma, chloroma or epidural hematoma.

Acoustic Radiation Force Impulse (ARFI) Elastography in Evaluation of Supraspinatus Tendinopathy.

BACKGROUND: The most common etiology of shoulder pain in adults is rotator cuff tear. Elastography is an imaging method that can report the strain and elastic modulus of the biological tissue. We think acoustic radiation force impulse (ARFI) elastography can effectively assess rotator cuff tendinopathy. PURPOSE: This study aimed to investigate the usefulness of ARFI elastography in evaluating supraspinatus tendinopathy. MATERIALS AND METHODS: We included 44 patients (22 men, 22 women, median age, 47 years; range, 20-69 years) with unilateral supraspinatus tendinopathy diagnosed with magnetic resonance imaging (MRI) in this prospective study. The normal tendons and tendinopathies, including supraspinatus tendinosis, partial-thickness, and full-thickness supraspinatus tears, were evaluated with ultrasound and ARFI elastography. The ARFI elastography values were compared between healthy and tendinopathy groups, and the gender was compared between elastography values of the normal tendons and tendinopathies using the Mann-Whitney U test. RESULTS: The values of ARFI elastography correlated with tendinopathy. (P = 0.001). The gender differed between the elastography values of the normal tendons (P = 0.002) and tendinopathies (P = 0.001). CONCLUSION: ARFI elastography is a non-invasive and feasible method for quantitatively assessing supraspinatus tendinopathy. It can be an alternative method to MRI in diagnosing supraspinatus tendinopathy.

A New Insight Into Pathophysiological Mechanism of Abdominal Aortic Aneurysm With Novel Parameters Salusin-ß and Arterial Stiffness.

BACKGROUND: Abdominal aortic aneurysm (AAA) has risk factors similar to those of atherosclerosis. Salusin-ß and arterial stiffness are novel parameters that have been shown to predict atherosclerosis and related cardiovascular disorders. However, their predictive value for detecting AAA remains unclear. METHODS: Forty-eight patients with AAA and 47 age- and sex-matched participants without AAA were enrolled in the study. Arterial stiffness parameters were obtained via an oscillometric Mobil-O-Graph PWA Monitor device (IEM GmbH) with integrated ARCSolver software (Australian Institute of Technology). Plasma salusin-ß levels were analyzed using an enzyme-linked immunosorbent assay reagent kit (Abbkine, Inc). The measured salusin-ß levels and arterial stiffness parameters of the AAA and control groups were compared. RESULTS: Salusin-ß levels were significantly lower in patients with AAA (P = .014). There was a significant negative correlation between salusin-ß levels and abdominal aorta diameter. No significant difference was detected between AAA and control groups in terms of arterial stiffness parameters (P > .05). In backward multiple regression analysis, the presence of AAA, platelet count, and augmentation index were found to be independent predictors of salusin-ß levels (P = .006 and P = .023, respectively). CONCLUSION: Arterial stiffness parameters were not found to be associated with AAA. Contrary to previous results regarding atherosclerosis and related cardiovascular disorders, salusin-ß levels were found to be lower in patients with AAA. Although AAA is thought to have similar risk factors as atherosclerosis, the exact pathophysiologic mechanism remains unclear.

Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results.

PURPOSE We aimed to investigate the accuracy of Vesical Imaging - Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system. METHODS A prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist. RESULTS Using the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]). CONCLUSION The mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system.

The effect of perirenal fat stranding on infectious complications after ureterorenoscopy in patients with ureteral calculi.

Objective: Perirenal fat stranding (PFS) is linear areas of soft-tissue attenuation in the perirenal space on non-contrast computed tomography. The present study aimed to investigate whether PFS is associated with infectious complications after ureterorenoscopy (URS) in patients with ureteral calculi in any location. Methods: The data of 602 patients with ureteral stones who underwent URS were analyzed retrospectively. The patients were divided into two groups as Group 1 (PFS not detected) and Group 2 (PFS detected). Gender, and age of patients, size, side, and location of the stone, operation time, double-J stent insertion status, perioperative ureter injury, postoperative infection after URS and related complications, and duration of hospital stay were compared. Results: While PFS was not detected in 530 patients, PFS was detected in 72 patients. The mean age, male/female ratio, side and localization of the stones, operation time, and perioperative insertion of the double-J after lithotripsy were statistically similar (p>0.05). The median stone diameter was smaller in Group 2 (9 mm vs. 8 mm) (p=0.033). Fever was observed in 30 and 38 patients in Group 1 and Group 2, respectively (p=0.0001). Urinary tract infection was detected in 24 and 27 patients in Group 1 and Group 2, respectively (p=0.0001). The urosepsis did not occur in any patients in Group 1, whereas 8 (11.1%) patients in Group 2 experienced urosepsis (p=0.0001). Conclusion: According to the results of the present study, patients with ureteral stones accompanied by PFS are much more prone to ureteral injuries and infectious complications such as urinary tract infection, fever, and sepsis after URS.

Association of increased levels of omentin-1 and carotid intima-media thickness with early signs of cardiovascular risk in patients with polycystic ovary syndrome: A prospective case control study.

AIM: Omentin-1, an adipokine primarily secreted from visceral adipose tissue, regulates metabolic homeostasis, whereas carotid intima-media thickness (CIMT) is a valid marker for early diagnosis of atherosclerosis. We aimed to investigate whether polycystic ovary syndrome (PCOS) is related to levels of omentin-1 and CIMT and demonstrate the association with cardiovascular risk. METHODS: A prospective case-control study was performed on 47 PCOS patients and 35 healthy subjects. Hormonal and metabolic parameters, levels of serum omentin-1, and CIMT were evaluated in the two groups. RESULTS: The right, left, total CIMT, and levels of serum omentin-1 were significantly higher in the PCOS group than in the healthy controls (p = 0.015, p = 0.009, p = 0.021, and p = 0.002, respectively). Using multiple linear and backward elimination regression analyses, serum omentin-1 was found to be independently associated with age and Ln-transformed homeostasis model assessment of insulin resistance, and cardiovascular parameters were independently associated with body mass index (BMI). In the PCOS group, the means of right, left, and total CIMT were significantly higher in the subgroup with BMI levels ≥25 kg/m2 compared to the subgroup with BMI levels <25 kg/m2 (p < 0.001 for all comparisons). CONCLUSION: A significant increase in CIMT is associated with cardiovascular risk in patients with PCOS. Levels of serum omentin-1 were found to be significantly higher in early PCOS cases at a younger age, acting as a protective acute-phase reactant.

Can Variable Plasma Volume Alterations Affect the Efficiency of the First Trimester Screening Test?

BACKGROUND: The aim of this study was to assess the effect of plasma volume alteration determined by hematocrit on biochemical parameters of the first trimester screening test. METHODS: Enrolled in this study were 1,424 pregnant women in their first trimester who underwent a first trimester screening test. Fetal Nuchal Trancluciency measurement was obtained by ultrasonographic evaluation. Blood samples were taken for complete blood count, serum free ß-HCG, and PAPP-A between 11 and 14 weeks of gestation. The effect of plasma volume alteration on the screening test was evaluated. Mean corpuscular volume was used to rule out possible iron deficiency anemia. RESULTS: There were 59 women with combined risk > 1/270. Of these 59 women, there were 21 false positive results (1.5%). Serum Htc significantly predicted the false positive cases (AUC: 0.839, p < 0.001). The optimal cutoff value was obtained at a value of 30.2% with 85% sensitivity and 75% specificity. CONCLUSIONS: Our study suggests that the degree of plasma alterations may affect the serum levels of the biochemical components of the first trimester screening test for aneuploidy, thereby leading to false positive test results.

Factors associated with urinoma accompanied by ureteral calculi.

OBJECTIVE: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. MATERIAL AND METHODS: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. RESULTS: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). CONCLUSIONS: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.

Relationship between Response to PDE5 Inhibitors and Penile Duplex Doppler Ultrasound in Erectile Dysfunction.

The relationship between the results of penile duplex Doppler ultrasound (PDDU) and response to vardenafil was investigated in patients diagnosed with erectile dysfunction (ED). Data from 148 patients with ED were analyzed retrospectively. Patients who did not respond to therapy were classified in to Group I (n = 32), those who responded partially were classified into Group II (n = 40), and complete responders were classified into Group III (n = 76). Age, comorbidities, and vascular and penile pathologies were compared among the three groups. While diabetes mellitus (DM) and dyslipidemia positivity adversely affected the response to treatment, the presence of hypertension (HT), Peyronie's disease and priapism increased the therapeutic response to the treatment (p < 0.05). Arterial insufficiency was present in 20 (30.3%), 25 (37.9%) and 21 (31.8%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). Venous insufficiency was observed in three (14.3%) patients in Group I and in eight (85.7%) patients in Group III (p = 0.001). Arterial/venous insufficiency was seen in 9 (30%), 14 (46.7%) and 7 (23.3%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). The response rate to treatment was highest in normal patients according to PDDU, followed by patients with venous insufficiency. In addition, it was found that DM decreased the response to treatment, whereas the response increased in cases with HT, priapism and Peyronie's disease.