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Objectives: Distal bolt-locking screw (DSBLS) tibial nailing offers an innovative method in which the nail is locked upon entering the screw. The current study compares the clinical, radiological, and functional outcomes of DSBLS tibial nails with conventional tibial nails. Patients and Methods: We retrospectively evaluated 38 tibial fractures of 37 patients treated with intramedullary nailing. In Group 21 fractures were treated with DSBLS nailing, while in Group 2, 17 fractures were treated with conventional nailing. Duration of surgery, time to weight-bearing, time to union, presence of deformity, return to work and sports, complications, American Orthopedic Foot and Ankle Society Score (AOFAS) and Olerud-Molander Ankle Score (OMAS) values were compared between the groups. Results: Group 1 patients had significantly shorter time to full weight-bearing than patients in Group 2 (P=0.032). There was no significant difference between the groups in functional comparisons according to the AOFAS. In contrast, the outcomes of Group 2 were better than those of Group 1 according to the OMAS (P=0.475 and P=0.037). The outcomes for the other variables were similar. Conclusion: In this method, patients can bear weight in a shorter time. The results of DSBLS nailing are as good as conventional nails, and it can be safely preferred in treating tibial fractures with intramedullary nailing. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate radiologically the effects of long-term luteinizing hormone-releasing hormone (LHRH) agonist therapy on extraocular muscle thickness, retrobulbar orbital fat (ROF), and the optic nerve (ON) in prostate cancer (PCa) patients. Methods: The retrospective study included patients with primary or recurrent PCa who received androgen deprivation therapy (ADT) for at least 12 months. Each patient underwent gallium-68 prostate-specific membrane antigen positron emission tomography-computed tomography both before and at the end of the 12-month treatment. Thickness of the ON, lateral rectus muscle, medial rectus muscle, superior rectus muscle, and inferior rectus muscle were measured by using the coronal CT sections in soft tissue window. ROF, ocular protrusion, and ON length were measured in sagittal and coronal planes. Changes in these anatomical structures induced by LHRH analogs were investigated by comparing pre- and post-treatment measurements. Results: A total of 57 patients were included in the study. Median PSA and TT values ​​of the patients before treatment were 36.5 (range, 19.6–51.2) ng/mL and 614.0 (range, 472.0–743.0) ng/dL, respectively, and these values ​​decreased significantly after the treatment (10.6 [range, 5.2–14.2] ng/mL and 36.5 [range, 19.6–51.2] ng/dL, respectively, p < 0.001 for both). After the treatment, there was a statistically significant decrease in the areas of inferior rectus muscle, superior rectus muscle, lateral rectus muscle, and medial rectus muscle (p < 0.001 for all), while significant increases were observed in ROF (11.9%, p < 0.001) and ON thickness (14.3%, p = 0.004). The amount of ocular protrusion also showed a significant increase of approximately 14% after the treatment (14.0 [range, 12.0–16.0] mm vs. 16.0 [range, 14.0–17.2] mm, p < 0.001). Discussion/Conclusion: Our findings, for the first time in the literature, indicated that ADT causes a decrease in extraocular muscle mass and an increase in ROF with ocular protrusion. It can be asserted that these changes are similar to the changes in skeletal muscle and fat mass in other body parts. Further studies with a higher level of evidence are needed to clinically evaluate the increase in ocular protrusion and ON enlargement, which are likely to be caused by the increase in ROF. [ABSTRACT FROM AUTHOR]

Introduction: The appearance of hematomas or hemorrhages after the implantation of a cardiac implantable electronic device (CIEDs) is a well‐known early complication, which can be associated with reinterventions, infections, readmissions, and longer hospital stays. Occasionally, these bleedings may correspond to arterial hemorrhages, which require early identification and specific treatment. We reviewed two clinical cases of inadvertent arterial bleeding after Pacemaker implantation that required a high clinical suspicion together with a multidisciplinary evaluation of cardiologists, radiologists and interventional medicine that allowed a fast and effective endovascular approach. [ABSTRACT FROM AUTHOR]

Factors including suburethral blood flow impairment, collagen deficiency, and the lack of tissue healing factors are known to play a role in stress urinary incontinence (SUI). Autologous fibrin (AF) appears to be a viable material for the treatment of SUI. The aim of this study was to present the initial clinical outcomes of a novel technique named "Demirtaş Erciyes-Mid Urethral Fibrin Fixation Technique (DE-MUFFT)" that involved the placement of AF material in the suburethral space instead of sling material (mesh). In this study, the clinical outcomes of five women with pure SUI who underwent the placement of AF material in the suburethral space were examined retrospectively. The complaint of urine leakage during physical exertion and patients' quality of life were assessed using Incontinence Quality of Life Scale (I-QoL), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), Incontinence Impact Questionnaire (IIQ-7), and 24-h pad test. Patient outcomes were evaluated preoperatively, at sixth week and third month postoperatively. Significant improvement was obtained in the quality-of-life tests and 24-h pad test. In all patients, the complaint of urine leakage disappeared almost completely. No adverse event or postoperative complication occurred in any of the patients. These results indicated that DE-MUFFT can be a promising procedure in the treatment of SUI due to its biocompatibility, minimally invasive nature, re-applicability, and cost-effectivity. [ABSTRACT FROM AUTHOR]

Aim: The neutrophil-lymphocyte ratio (NLR) is a parameter that has been shown to be effective as a prognostic marker in many solid tumors. It is aimed to investigate NLR and the systemic immune-inflammation index (SII) in predicting the overall survival and lymph node positivity in bladder cancer (BC). Methods: The retrospective study included patients that underwent radical cystoprostatectomy/radical cystectomy (RC) due to muscle- invasive bladder cancer (MIBC), high-grade T1 BC, or carcinoma in situ in our clinic between January 2010 and March 2020. All the patients had no history of preoperative metastasis, lymph nodes, chemotherapy, hematological malignancies, and preoperative urinary tract infection. Data on neutrophil, lymphocyte, platelet, and hemoglobin levels and total white blood cell counts were retrieved from clinical records and data on disease stage and lymph node positivity were retrieved from pathology reports. Follow-up times and survival times were recorded. Results: The 213 patients comprised 196 (92%) men and 17 (8%) women with a mean age of 63.17±11.25 years. Lymph node positivity was detected in 49 (23%) patients. The mean overall survival time was 75.04, 63.77, and 84.4 months in all patients, patients with lymph node positivity, and patients with lymph node negativity, respectively. No significant difference was found between patients with lymph node positivity and negativity with regard to NLR and SII values (p=0.975 and p=0.745, respectively). In the receiver operating characteristics (ROC) analysis NLR and SII had no significant effect in predicting lymph node positivity [Area under the ROC curve (AUC) 0.499 (95% confidence interval (CI): 0.403-0.594) and AUC 0.485 (95% CI: 0.394-0.575), respectively] and in predicting overall survival [AUC 0.423 (95% CI: 0.346-0.501, p=0.056) and AUC 0.435 (95% CI: 0.357-0.514, p=0.107), respectively]. Conclusion: The results indicated that SII and NLR are not sufficient to predict lymph node positivity and survival in patients with organ-confined BC. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Post-prostatectomy stress incontinence (PPI) is an important health problem for patients with radical prostatectomy history. Duloxetine is a common drug, used in PPI with the out of indications in most countries. In this study, we aimed to evaluate the prophylactic effect of duloxetine administration in PPI during the early postoperative period in patients undergoing laparoscopic radical prostatectomy (LRP). The retrospective study included 209 patients who underwent LRP. Patients were divided into two groups: Group I (n=96) was initiated on pelvic floor exercises (PFE) + duloxetine in the early postoperative period and continued this regimen for a total of 12 weeks and Group II (n=113) only performed PFE for 12 weeks after surgery. Exclusion criteria were as follows: a history of neuromuscular dysfunction of bladder, post-prostatectomy urge incontinence, receiving adjuvant radiotherapy during the 12-week period, prior anti-incontinence surgery, and post-voiding urine>100 ml. The prevalence rates of urinary incontinence measured at the time of urinary catheter removal (baseline) and at weeks 3, 6, and 12 after surgery and the number of wet pads per day were compared. The study included 209 patients with a mean age of 60.68 ± 7.16 years. Baseline urinary continence rates were similar in Group I and Group II (29.2% vs. 35.4%, p=0.338). At 12 weeks, although PPI rates have decreased in both groups, there was no difference between Group I and Group II (15.6% vs. 24.8%, p=0.103). Administration of prophylactic duloxetine in the early postoperative period, which started without regard to the positivity of PPI, is not significantly effective to early postoperative urinary continence recovery. [ABSTRACT FROM AUTHOR]

Aim: It is known that the Coronavirus disease-2019 (COVID-19) does not only affect the respiratory system in the body, but also affects many vital systems. In this study, we aimed to investigate polymerase chain reaction (PCR) positivity rates in urine samples of patients with COVID-19 infection and to evaluate the effectiveness of positron emission tomography/computed tomography (PET/CT) in demonstrating renal involvement in patients with urinary system involvement findings. Methods: Patients who had positive COVID-19 PCR test and were hospitalized in Erciyes University pandemic wards due to COVID-19 infection between June 2020 and December 2020 were included in this prospective study. A urine PCR test was applied to all patients. In addition, PET/CT was performed in patients with no known malignancy, clean urine culture, but suspected COVID-19 urinary system involvement. Results: A total of 66 patients with a mean age of 45.4±9.1 years were included in the study. PET/CT was performed at the same time in 6 of these patients with suspected urinary system involvement. Only 1 (1.5%) of 66 patients had a positive urine PCR test. No abnormal genitourinary PET/CT findings were found in any of the patients. Conclusion: Urine PCR positivity is very rare in patients with COVID-19 infection. In addition, according to our results, it can be said that PET/CT is not an effective imaging method to show COVID-19 urinary system involvement. [ABSTRACT FROM AUTHOR]

Aim: To determine clinical risk factors in patients with PI‐RADS 3 lesions and prostate‐specific antigen (PSA) < 10 ng/mL. Methods: In this prospective study, all patients underwent multiparametric magnetic resonance imaging. Following the 2‐5 core fusion‐targeted biopsy, standard 12‐core prostate biopsy was performed in each patient (combined biopsy). The cutoff values were calculated with receiver‐operating characteristic analysis. First, univariate logistic regression analysis was used to evaluate the relationship between total eight parameters and prostate cancer. Subsequently, multiple logistic regression analysis was performed to the parameters associated with prostate cancer. Results: Two hundred and eighty‐eight patients were included in the study. Some clinical parameters are determined to be significant in univariate and multiple logistic regression analyses, including PSA, free/total PSA ratio, PSA density (PSA/total prostate volume), positive family history of PCa, and PI‐RADS 3 lesion diameter. Patients were classified between 0 and 5 according to the number of risk factors. While the risk of cancer was 7.1% in patients with one or less risk factors, the PCA rate was 45.2% among patients with all risk factors. Conclusion: In patients with PI‐RADS 3 lesion and PSA < 10 ng/mL, histopathological results of biopsy can be estimated with higher accuracy using some clinical parameters. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of four different techniques used in the treatment of ureteral stones on patients' daily physical functioning (PF) and quality of life (QoL). Materials and Methods: Patients who underwent ureterorenoscopy (URS)—with or without Double-J stenting (DJS)—and extracorporeal shock wave lithotripsy (SWL) were divided into four groups: Group I: SWL (n = 29), Group II: URS (n = 43), Group III: URS +4.8F DJS (n = 39), Group IV: URS +6F DJS (n = 42), and Group V: Control (n = 30). Short Form-36 (SF-36) was administered to each participant both preoperatively and 14 days after operation. Based on the SF-36 results, the changes in patients' PF and QoL were evaluated. Results: Ureteral stone treatment was performed in 202 patients. Of these, 153 patients who underwent an effective SWL or URS procedure in the first attempt were included in the study. Success rates in the first session were 53.7% (29/54) and 83.8% (124/148) for SWL and URS, respectively (p < 0.001). All the four groups were similar with regard to age, gender, body mass index, stone size, preoperative PF, and QoL. However, although postoperative PF, role limitations due to physical health, and energy/fatigue scores were similar in Group I, III, and IV, they were significantly higher in Group II. No major complication associated with SWL or URS occurred in any patient. However, in Group 2, DJS was inserted in three (7.7%) patients in the early postoperative period (within the first 48 hours) due to renal colic attacks secondary to ureterovesical junction mucosal edema. Conclusion: URS without DJS seems to be the most advantageous technique in the treatment of ureteral stones in terms of daily PF and QoL. However, it should be noted that patients undergoing URS may require postoperative emergency stenting, although rarely. [ABSTRACT FROM AUTHOR]

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Bleeding is one of the most important causes of mortality in patients with acute coronary syndrome (ACS). This study therefore aimed to investigate bleeding risk in patients with ACS who were scheduled to receive dual antiplatelet therapy (DAPT) in Turkey. Methods: This was a multicentre, observational, cross‐sectional cohort study. The study population included 963 patients with ACS from 12 centres in Turkey. We used the Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE‐DAPT) score to predict the bleeding risk for all the patients. The patients were divided into high (≥25) or low (˂25) bleeding risk groups based on their PRECISE‐DAPT scores. Results: The mean PRECISE‐DAPT score was 21.9. Overall, 32.2% of the patients had high PRECISE‐DAPT scores (≥25). Compared with the male patients, the female patients had higher PRECISE‐DAPT scores (28.2 ± 15.7 vs 18.4 ± 13.6, P ˂.001). Among the females, the rate of patients with a PRECISE‐DAPT score ≥25 was 53%, while among the male patients, the score occurred at a rate of 22%. The female patients had lower haemoglobin (Hb) levels than the male patients (12.1 ± 1.7 vs 13.8 ± 1.9, P ˂.001) and lower creatinine clearance (70.7 ± 27.5 vs 88.7 ± 26.3, P ˂.001). The in‐hospital bleeding rates were higher among the patients with high PRECISE‐DAPT scores than among those who did not have high scores. Furthermore, the patients with high PRECISE‐DAPT scores had a higher in‐hospital mortality rate compared with those with low PRECISE‐DAPT scores (1% vs 0%, P =.11). Conclusions: The mean PRECISE‐DAPT score was high among the patients with ACS in this study, indicating that the bleeding tendency was high. This study showed that the PRECISE‐DAPT score may help physicians determine the type and duration of DAPT, especially in patients with ACS in Turkey. [ABSTRACT FROM AUTHOR]

Background: In our study, we aimed to evaluate left ventricular global longitudinal strain (LV‐GLS) value in patients with premature ventricular contractions (PVCs) and reduced LV ejection fraction (LVEF) and to determine the effect of radiofrequency catheter ablation (RFA) procedure on LV‐GLS. Methods: In this cross‐sectional study, 150 patients who underwent three‐dimensional RFA with the diagnosis of PVCs were included. LV‐GLS was measured with strain echocardiography in all patients before RFA and in the sixth‐month control. Patients included in the study were grouped as LVEF <50% (Group I) and LVEF ≥50% (Group II) according to baseline LVEF, and patients within Group I were grouped as LVEF <50% (Group A) and LVEF ≥50% (Group B) according to the sixth‐month LVEF. Results: There were 39 patients (26%) with baseline LVEF <50%. In 14 (36%) of these patients, LVEF <50% was observed to continue during the sixth‐month controls. Both the baseline and sixth‐month LV‐GLS values were significantly lower in Group I patients (<0.01). RFA treatment significantly increased both LVEF and LV‐GLS (<0.01). It was found that age, N‐terminal pro‐brain natriuretic peptide, LV diameters, and baseline LVEF were higher, and baseline LV‐GLS level was lower in Group A patients (P <.01). Baseline LVEF and LV‐GLS values were found to independently determine the patients in Group A (P <.01). In receiver operator characteristic analysis, when the limit value is accepted as 40% for baseline LVEF and 18% for baseline LV‐GLS, it can determine Group A with acceptable sensitivity and specificity. Conclusions: LV‐GLS decreases significantly in patients with reduced LVEF and PVCs. In these patients, RFA treatment significantly increases both LVEF and LV‐GLS. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the association of atrial fibrillation (AF) recurrence with left atrial (LA) strain in nonvalvular paroxysmal AF patients after cryoablation.Methods: We included 190 patients who underwent successful cryoablation due to paroxysmal AF. In addition to classical echocardiographic data, LA apical 2-chamber (A2C) strain, LA apical 4-chamber (A4C) strain, and LA global longitudinal strain (LA-GLS) values were calculated by speckle tracking echocardiography. Forty-eight-hour Holter monitoring was performed to all patients no later than 6 months after ablation.Results: AF recurrence was detected in 42 patients (22.1%). End-systolic diameter, LA end-systolic diameter, LA-volume, LA-volume index, interatrial septum thickness, coronary sinus diameter, epicardial fat thickness (EFT), and septal E/E` ratio were significantly higher, LV-EF, IVRT, septal S and A` wave, lateral S wave, LA-A2C strain, LA-A4C strain, and LA-GLS were significantly lower in patients with AF recurrence. LA-GLS, LA-volume index, and EFT were found to be independent parameters for predicting AF recurrence.Conclusions: LA-GLS and LAVI should be included in routine evaluations to determine long-term AF recurrence preoperatively. [ABSTRACT FROM AUTHOR]

Introduction: There is not enough data on the effects of primary hyperparathyroidism (pHPT) on morning blood pressure surge (MBPS) in the literature. We aimed to determine whether there was any change in MBPS value in patients with hypertensive pHPT and to determine the parameters related to MBPS. Method: 80 patients with newly diagnosed pHPT with hypertension (HT) and 80 controls with newly diagnosed hypertension were included. Routine laboratory examinations and ambulatory blood pressure monitoring (ABPM) were performed in all patients. Results: In patients with pHPT, blood urea nitrogen (BUN), triglyceride, hs-CRP, uric acid, serum calcium (Ca), parathormone (PTH), daytime SBP and MBPS levels are higher than others (p < 0.05). Body mass index (BMI) and Ca level were independently associated with MBPS. In patients with MBPS ≥ 25 mmHg, BMI, BUN, creatinine, uric acid, Ca and PTH levels were found to be higher than others. BMI values and Ca levels determine the patients with MBPS ≥ 25 mmHg (p < 0.05) independently. According to this analysis, increase in BMI (for each 1 unit) and Ca level (for each 0.1 mg/dL) was found to increase the probability of MBPS ≥ 25 mmHg by 17.8% and 7.7%, respectively. When the cut-off value for Ca was taken as 10 mg/dL, the patients with MBPS ≥ 25 mmHg were determined with 73.5% sensitivity and 73.1% specificity. Conclusion: MBPS significantly increases in patients with newly diagnosed hypertensive pHPT. This increase in MBPS is closely associated with increased Ca levels. In patients with pHPT, lowering the Ca level below 10 mg/dL may have clinical implications. [ABSTRACT FROM AUTHOR]

Introduction: There is no study evaluating the Tp-e/QT and Tp-e/QTc ratios with T wave peak to end interval (Tp-e interval) used for evaluation of cardiac arrhythmia risk and ventricular repolarization changes in patients with primary aldosteronism (PA). We aimed to investigate whether there was a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with PA. Method: Thirty patients with newly diagnosed hypertension (HT) and PA and 30 patients with primary HT were included. Twelve-lead electrocardiography (ECG) was performed in all patients. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured in addition to routine measurements in ECG. Results: Sodium, potassium, and plasma renin activity (PRA) were significantly lower in patients with PA; systolic and diastolic blood pressure, plasma aldosterone, plasma aldosterone/PRA were significantly higher in patients with PA (p <.05 for each one). When ventricular repolarization parameters were examined; while QT and QTc interval were similar between two groups, Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were significantly higher in patients with PA (p <.05 for each one). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were positively correlated with the serum calcium, aldosterone, and aldosterone/PRA levels and negatively correlated with serum sodium, potassium, renin levels (p <.05 for each one). In linear regression analyses, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were independently associated with the aldosterone/PRA ratio. Conclusion: Tp-e interval, Tp-e/QT and Tp-e/QTc were increased in hypertensive patients with PA and were independently associated with aldosterone/PRA levels. This may be related to the changing neuroendocrine state in patients with PA. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the relationship between right atrial pressure (RAP) and liver stiffness (LS) determined by liver elastography (LE) during cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and conventional pacemaker (PM) implantation in patients without HF. Methods: 60 patients with HF who underwent CRT and 60 patients without HF who underwent PM were enrolled. Routine echocardiography and laboratory examinations were performed. Systolic, diastolic, and mean RAP measurements were performed inversely during PM implantation and LS measurement with ElastPQ technique. Results: Systolic, diastolic, and mean RAP, left ventricular (LV) systolic-diastolic, right ventricular (RV) diastolic and left atrial diameters, tricuspid regurgitation pressure gradient, and RV-myocardial performance index (MPI) values were significantly higher in patients with HF (p < 0.05 each-one). LV ejection fraction and tricuspid annular plane systolic excursion values were significantly lower in patients with HF group (p < 0.05 each-one). LS values and inspiratory (Ins) and expiratory inferior vena cava (IVC) diameters were significantly higher in the patients with HF (p < 0.05 each-one). Mean RAP was found to be closely related to LS value, Ins-IVC diameter, RV-MPI, and NT-proBNP levels. LS value and Ins-IVC diameter were found to determine patients with mean RAP > 5 mmHg and > 10 mmHg. When the cut-off value of LS was taken as 7 kPa, it was found that the mean RAP > 10 mmHg with 89.6% sensitivity and 87.5% specificity. Conclusions: The non-invasive LS value determined by LE independently determines the mean RAP in patients with and without HF. According to our study results, > 7 kPa value for LS determined in liver US may be predictive for increased mean RAP. [ABSTRACT FROM AUTHOR]

Purpose: Decrease in the blood glucose level may trigger the tachycardia or bradycardia because it has an arrhythmogenic effect on the heart. Our purpose in this study was to investigate whether the blood glucose level has an effect on patients who attended to the hospital with nocturnal supraventricular tachycardia (SVT).Methods: We included 151 patients in our study who have SVT history. Plasma glucose levels which were taken during night hours, electrolytes, and 12 lead electrocardiography were evaluated.Results: There were 105 patients without nocturnal SVT attack and 46 patients with nocturnal SVT attack. Patients with nocturnal SVT attack, blood glucose level, potassium, calcium, and hemoglobin levels were significantly lower, hs-CRP was significantly higher, basal cycle length (BCL) was significantly short, and QT interval was significantly longer. It was found that blood glucose (O.R. = 0.904, 95% GA 0.828-0.986, p = 0.023) and potassium levels (O.R. = 0.128, 95% GA 0.029-0.561, p = 0.006) and basal cycle length (BCL) (O.R. 0.988, 95% GA, 0.980-0.996, p = 0.005) values were in independently correlated with nocturnal SVT attacks.Conclusion: The decrease in blood glucose level of the patients who are being followed with SVT diagnosis might trigger the nocturnal SVT attacks. [ABSTRACT FROM AUTHOR]

Introduction: Atrial fibrillation (AF) attacks can be silent, symptomatic, or emerge with its complications in pacemaker-implanted patient groups. P-wave duration index (PWDI), a novel parameter, is calculated by dividing the P-wave duration (PWD) by the PR interval. This study aimed to investigate the relation between PWDI and silent AF development in cardiac resynchronisation therapy defibrillator (CRT-D)-applied patients. Material and methods: The study population consisted of 181 CRT-D device-implanted patients. Atrial fibrillation attacks that last at least 30 s with no symptoms were accepted as silent AF. Results: Patients were separated into two groups: "with silent AF" and "without silent AF". The without silent AF group comprised 121 patients (mean age: 62.9 ±8.7 years, 62% male). The with silent AF group included 60 patients (mean age: 67.9 ±9.7 years, 60% male). The silent AF group had significantly higher mean age (p = 0.001). PR duration was significantly higher in the without silent AF group (p = 0.001). Patients with first-degree IAB and PWDI values were significantly higher in the with silent AF group (p-values were 0.001 and < 0.001, respectively). Age (OR = 1.073, 95% CI: 1.028-1.119, p = 0.001) and PWDI (OR = 1.053, 95% CI: 1.028-1.078, p < 0.001) were detected as independent predictors for silent AF in the binomial logistic regression analysis. In the ROC analysis, a PWDI cut-off value of 0.67 determined silent AF with 81.7% sensitivity and 51.4% specificity (AUC = 0.701, p < 0.001). Conclusions: P-wave duration index was significantly associated with silent AF in patients with CRT-D. [ABSTRACT FROM AUTHOR]

In conclusion, this study has shown that substantial portions of the patients still feel severe pain during the prostate biopsy, and we believe that mpMRI technology should be used as a standard before biopsy for the detection of patients with high-pain risk. In this current study, which included a total of 108 patients, standard prostate biopsy plus target biopsy was applied as a combined method and an average of 14.6 cores were sampled per patient. [Extracted from the article]

Aims: To investigate the efficacy and safety of intradetrusor onabotulinumtoxinA (onaBoNT‐A) injection in patients with overactive bladder (OAB) refractory to antimuscarinic treatment. Methods: A total of 80 patients with OAB symptoms were enrolled in this prospective multicenter study and received 100 U intradetrusor onaBoNT‐A injection.The changes from baseline in the frequency of voiding, urge urinary incontinence (UI) and urge episodes, mean and maximum bladder capacities, uroflowmetry, post‐void residual urine volume (PVR), quality of life score, and treatment benefit scale score were assessed. The need for a second injection,and treatment‐related adverse events were also examined postoperatively. Results: OnaBoNT‐A injection significantly decreased the UI episodes(P = 0.0001), the mean voiding frequency (P = 0.0001), and the urgency episodes (P = 0.0001) in the third month compared to baseline. Similarly, the mean bladder capacity, and maximal bladder capacity were increased (P < 0,05). The quality of life scores improved by 57.1% compared to the pre‐treatment rate (P = 0,0001). No significant change was observed in the PVR or maximum flow rate. Urinary retention developed in 3 (3.75%) patients and urinary infection and transient hematuria were observed in five patients (6.25%) each. The UI episodes, voiding frequency and urgency episodes were significantly lower at the 9th month than at baseline (all P = 0.0001). Overall 67% of the patients continued to experience benefits from the injection. Sixteen patients (20%) required a second injection in the third month. Eight patients were lost to follow‐up at the last visit in the 9th month, and 34 of the remaining 56 patients required a second injection at the 9th month. Cumulatively, 50 (63%) patients needed re‐injections. Conclusions: Our results demonstrated that the onaBoNT‐A injection produced significant improvement in all OAB symptoms with a low incidence of treatment related adverse events. [ABSTRACT FROM AUTHOR]

We report the case of a 23-year-old male with thalassemia major who developed long QT and continuous ventricular tachycardia (VT). Electrocardiography, echocardiography, and cardiac magnetic resonance imaging (MRI) were used for diagnosis and risk stratification. VT causes and treatments are presented and discussed. Ventricular arrhythmia can be treated by normalizing QT interval with high-dose beta-blocker therapy. However, MRI-compatible internal cardiac defibrillator implantation was performed due to the high risk in this patient. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine the plain radiographic signs that can be indicative of meniscal injuries in Schatzker type II tibial plateau fractures. Methods: The lateral plateau depression and lateral plateau widening were measured on anteroposterior knee radiographs in 20 patients with Schatzker type II tibial plateau fracture. Meniscal injury was present in 12 patients (three, meniscal tears; nine, peripheral meniscal detachments). The lateral plateau depression and lateral plateau widening measurements were compared between those who had meniscal injury (Group 1) and those who did not (Group 2). Results: In Group 1, the median lateral plateau depression was 20 mm (IQR: 14-25) and the median lateral plateau widening was 12 mm (IQR: 10-14). In Group 2, the respective values were 10 mm (IQR: 5-17) and 6 mm (IQR: 2-10). There was a statistically significant difference in both parameters when the two groups were compared ( p = 0.001). Conclusions: A plain anteroposterior radiograph depicting a lateral plateau depression ≥14 mm and/or a lateral plateau widening ≥10 mm is associated with a significantly increased risk of meniscal injury in Schatzker type II tibial plateau fractures. These parameters can be used to predict the probable presence of lateral meniscal injury in such patients in routine clinical practice. Level of evidence: Retrospective comparative study, Level III. [ABSTRACT FROM AUTHOR]

This study compares the results of the locking compression plate (LCP) and the dynamic compression plate (DCP) in the treatment of diaphyseal forearm fractures in adults and defines the indications for the use of the LCP. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the differences in body mass index (BMI), levels of cholesterol, and levels of triglycerides (TGs) among urolithiasis patients with different stone compositions. Materials and methods: Forty-nine patients who had a diagnosis of nephrolithiasis and had undergone open surgery or percutaneous surgery were included, and patients without urolithiasis were randomly selected as controls. Urinary stones were collected and analyzed using infrared spectroscopy. Data relating to patient's age, BMI at diagnosis, serum total cholesterol (TC), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) were collected. The stone groups including calcium oxalate monohydrate-calcium oxalate dihydrate (COM-COD), COM, and uric acid were compared with one another and with the control group. In addition, the stone formers group (COM-COD, COM, uric acid, calcium phosphate, and mixed-type stones) was compared to the control group. Results: BMI, TC, and TG levels were significantly higher in stone formers compared with the control group; this association of BMI and TC with stone formation was more prominent in uric acid and COM-COD stone formers, but there was no such prominence for COM stones. LDL-C levels in COM-COD stone formers were significantly higher when compared with COM stone formers. Conclusion: Elevated BMI, hypercholesterolemia, and hyperlipidemia, which are leading components of metabolic syndrome, may be associated with different types of urinary stone formation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: • To evaluate the effects of three phosphodiesterase type 5 (PDE5) inhibitors on the ejaculation process in men with lifelong premature ejaculation using a double-blind laboratory setting. PATIENTS AND METHODS: • Eighty men with lifelong premature ejaculation, 20 in each group, received placebo, vardenafil (10 mg), sildenafil (50 mg) or tadalafil (20 mg) in a doubleblind study design. Placebo or PDE5 inhibitor was ingested after at least 2 h fasting and non-smoking. The subjects were placed in a silent room immediately and real-time penile rigidity and tumescence was monitored. • Subjects read some magazines or newspapers without any sexually stimulating material for 1.5 h. At the end of this period audiovisual sexual stimulation began with a video film and after the 8th minute the subject began vibratory stimulation to the frenular area. • At the beginning of ejaculation the patient stopped stimulation. When the patient began and stopped stimulation, the light near the observer turned on and off and the observer calculated the ejaculation period with a chronometer. The elapsed time was the ejaculation latency time (ELT) in seconds. • There was no interaction between subjects and observer during the test. The ELT, and the qualities of base and tip rigidities during ELT and after ejaculation were calculated. RESULTS: • Median age of patients was 29 (range 22– 39) years and median duration of premature ejaculation was 60 (range 7–180) months and there was no significant difference between groups. Median duration of vibratory stimulation (ELT) of subjects who received placebo was 48.5 s: 53.5 s for sildenafil, 70.0 s for tadalafil and 82.5 s for vardenafil. Compared with the placebo group, ELT was significantly longer only in subjects receiving vardenafil ( P = 0.019). • In the post-ejaculatory refractory period, times to last recorded base rigidities were significantly longer than placebo in vardenafil and sildenafil groups with better erection quality ( P <0.01 for each). CONCLUSIONS:• The PDE5 inhibitors seem to prolong ELT and the quality of penile rigidity is better with PDE5 inhibitors in post-ejaculatory period. • These findings suggest that PDE5 inhibitors might have some beneficial effects in men with lifelong premature ejaculation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the effects of phosphodiesterase type 5 (PDE5) inhibitors on erectile variables during a period with no sexual stimulation in a laboratory setting double-blind study. PATIENTS AND METHODS: In all, 80 men without erectile dysfunction (ED) but with lifelong premature ejaculation (PE) were included in the study. The men were divided equally in to four groups and received either placebo, vardenafil (10 mg), sildenafil (50 mg) or tadalafil (20 mg) in a double-blind study design. The men attended the laboratory following 3 days of sexual abstinence and placebo or one of the PDE5 inhibitors was ingested after = 2 h of fasting and non-smoking. The men were then immediately placed in a silent room and real-time penile rigidity and tumescence monitoring with Rigiscan Plus (Rigiscan Plus® System, Osbon Medical Systems, Augusta, GA, USA) began. The men read some magazines or newspapers that contained no sexually stimulating material for 1.5 h. There was no interaction between the men and observer during the test period. Times to first measured and total durations of base and tip rigidities, and also total and per minute rigidity were evaluated. RESULTS:The recorded base and/or tip rigidity ratios were 40% (eight of 20), 71% (12/17), 47% (nine of 19) and 70% (14/20) in men who took placebo, sildenafil, tadalafil and vardenafil, respectively ( P = 0.126). The ratio of men who could obtain = 60% base and/or tip rigidities were 10% (two of 20), 41% (seven of 17), 26% (five of 19) and 55% (11/20) in placebo, sildenafil, tadalafil and vardenafil groups, respectively ( P < 0.05). The median time to first measured base rigidity was 58.0, 21.5, 54.5 and 57 min with placebo, sildenafil, tadalafil and vardenafil, respectively ( P = 0032). The median total duration of recorded base rigidity was 4.0, 27.5, 10.0 and 11.5 min in men who took placebo, sildenafil, tadalafil and vardenafil, respectively ( P = 0.013). The median total base rigidity (area under the curve) was 72.8, 699.0, 360.5 and 553.0 with placebo, sildenafil, tadalafil and vardenafil, respectively ( P = 0.016). CONCLUSIONS: Significant penile rigidities were obtained with PDE5 inhibitors during the short test period, with no sexual stimulation, in laboratory conditions. This finding might support the use of PDE5 inhibitors in men who need penile rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose. Assessment of effects of zoledronic acid therapy on bone metabolic indicators in hormone-resistant prostate cancer patients with bone metastasis. Material and Methods. Hormone-resistant prostate cancer patients who were identified to have metastases in their bone scintigraphy were taken to trial group. Before administration of zoledronic acid, routine tests for serum calcium, total alkalen phosphates were studied. Sample sera for bone metabolic indicators BALP, PINP, and ICTP were collected. Bone pain was assessed via visual analogue scale and performance via Karnofsky performance scale. Four mg zoledronic acid was administered intravenously once a month. Results. When serum levels of bone forming indicators PINP; BALP were compared before and after therapy, there were insignificant decreases (P = .33, P = .21, resp.). Serum levels of bone destruction indicator ICTP was compared, and there was a significant decrease after zoledronic acid therapy (P = .04). When performances of the patients were compared during therapy period, performances decreased significantly due to progress of illness (P = .01). All patients had ostalgia caused by bone metastases at various degrees. Significant decrease in pain scores was observed (P < .01). Conclusion. Zoledronic acid therapy decreased bone destruction and was effective in palliation of pain in patient with bone metastasis. Using bone metabolic indicators during followup of zoledronic acid therapy might be useful. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to measure the ejaculation latency time (ELT) and to evaluate the effects of vardenafil on ELT and rigidity parameters of patients with lifelong premature ejaculation (PE) in a laboratory setting. Materials and methods: Double-blind, placebo-controlled, cross-over laboratory study was performed with 40 males with lifelong PE. As the subject ingested the placebo or vardenafil, real-time penile tumescence and rigidity monitoring began. Audiovisual sexual stimulation (AVSS) was performed 45 min later. The patient began vibratory stimulation to the frenular area at 8th minute of AVSS till ejaculation. A button has been placed under the cover where the patient presses to operate the vibrator. ELT was calculated in seconds with a chronometer. Following ejaculation, AVSS was stopped. The test was repeated with second medication in 7-15 days. Results: Among 40 patients, the results of 17 could be evaluated. When the patient took placebo and vardenafil, mean ELTs were 62.7 and 189.5 s, respectively. When compared with placebo, vardenafil improved ELT significantly ( P = 0.04). After the beginning of AVSS, time to first recorded base or tip rigidities was shorter and time to last recorded tip or base rigidities following ejaculation was longer than placebo; however, these differences were not significant ( P > 0.05 for each). Conclusions: This laboratory design might be used to evaluate the effects of drugs on patients with ejaculation disorders. In this laboratory setting study, vardenafil exerted a threefold increase in ejaculation delay outside the vagina in patients with lifelong PE. [ABSTRACT FROM AUTHOR]

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Background: The red cell distribution width (RDW) is a numerical measurement of variability in the size of red blood cells. Many studies have shown that high-density lipoprotein cholesterol (HDL-C), has an anti-inflammatory effect. The aim of this study was to investigate the relationship between the serum HDL-C level and RDW in patients with coronary artery disease (CAD). Methods: Patients who underwent coronary angiography were reviewed. Patients who had moderate or severe heart failure, moderate or severe renal failure, significant systemic disease, anemia, a blood transfusion within the last 3 months, or a hematologic disease, as well as those who were taking lipid-lowering medication, were excluded from the study. The Gensini scoring system was used to determine the severity of CAD. Biochemical and hematological parameters were measured from venous blood samples taken after the patient fasted for at least 8 h. The RDW was routinely obtained from a hemogram. Results: In total, 328 patients were included in the study. The patients were categorized according to quartiles. There were 80 patients in Quartile 1 (RDW < 13.2), 84 patients in Quartile 2 (13.2 ≥ RDW < 14.15), 81 patients in Quartile 3 (14.15 ≥ RDW < 16), and 83 patients in Quartile 4 (RDW ≥ 16). There was a significant and inverse relationship between the serum HDL level and RDW. Regression analysis showed that the HDL-C, hemoglobin, and hs-CRP levels and Gensini score were predictors for the RDW. Conclusion: We found an inverse and gradual association between the serum HDL-C level and RDW, and the serum HDL-C level was an independent predictor for the RDW. [ABSTRACT FROM AUTHOR]