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Background and Objectives : This study was performed for the purpose of assessing whether antiepileptic levetiracetam treatment produces a change in brain volumes in children with epilepsy. To that end, we compared the volumes of the basal ganglia (caudate nucleus, putamen, globus, hip-pocampus, and thalamus) at magnetic resonance imaging (MRI) before and after treatment (months 18-24) in pediatric epilepsy patients using levetiracetam. Materials and Methods : This retrospective study involved a volumetric comparison of patients presenting to the Balikesir University Medical Faculty pediatric neurology clinic between 01.08.2019 and 01.11.2023 and diagnosed with epilepsy, and who underwent cranial MRI before and 18-24 months after treatment at the radiology department. The demographic and clinical characteristics (age, sex, family history of epilepsy, type of epilepsy, and EEG features (normal, abnormal, epileptiform)) of the patients included in the study were recorded. Results: The comparison of basal ganglia volumes at cranial MRI before and at months 18-24 of treatment revealed significant differences in the left caudate nucleus, right putamen, left putamen, left globus pallidus, right thalamus, left thalamus, and right hippocampal regions. Conclusions: In conclusion, differing findings are encountered at cranial imaging in patients with epilepsy, depending on the seizure frequency, activity, and the type of antiepileptic drugs used. This study compared basal ganglia volumes on cranial MRIs taken before and 18-24 months after treatment in pediatric epilepsy patients using levetiracetam. A significant increase was observed in the volumes of basal ganglia (caudate nucleus, putamen, globus pallidus, hippocampus, and thalamus) on the MRIs of pediatric epilepsy patients using levetiracetam.

Introduction: The aim of this study was to determine the level of frailty in older hemodialysis patients and to examine the relationship between their functional capacity, depression, and laboratory variables., Method: This was a cross-sectional study, and the data were collected 243 dialysis patients aged 65 and over between May 2021 and May 2022., Results: The frailty rate was 49%. A statistically significant positive correlation was found between the frailty and age, hemodialysis vintage, and the number of hospitalizations. The frailty was negatively correlated with body mass index, Kt/V, Albumin, and parathyroid hormone. There was a statistically significant positive correlation between frailty and depression and a negative correlation between functional capacity., Conclusion: A relationship was found between frailty and depression, functional capacity, and laboratory variables. In addition, the variables affecting the level of frailty in geriatric dialysis patients included dialysis vintage, dialysis adequacy, number of hospitalizations, albumin level, and patient weight., (© 2024 International Society for Apheresis and Japanese Society for Apheresis.)

Aims: This study aimed to determine the peak hours of sleepiness and the factors affecting the sleepiness levels of nurses., Background: Sleepiness is commonly seen in individuals working night shifts. However, in case of nurses, this sleepiness can be a major threat to patient and staff safety., Method: This was a prospective cross-sectional study. Data were collected between July and September 2023, and a stratified sampling method was used according to the departments in which the nurses worked. Data were collected using the Personal Information Form and Visual Analog Scale. Nurses reported their sleepiness levels at the beginning of each hour between midnight and 8:00 am., Equator Checklist: The study adhered to the STROBE checklist for reporting., Results: The mean sleepiness levels of emergency department nurses, intensive care nurses, internal or surgical clinic nurses, and all nurses were 59.75 ± 15.50, 43.53 ± 20.49, 44.67 ± 18.88, and 49.15 ± 19.67, respectively. The highest sleepiness level of the nurses was at 05:00 am. A significant correlation was found between the variables of age, gender, marital status, sleep quality, number of patients cared, working style and satisfaction with working in the department, and sleepiness level (P < 0.05)., Conclusion: Nurses working night shifts experience sleepiness (highest at 5:00 am). In addition, the sleepiness levels of nurses are affected by some personal and clinical factors., Implications for Nursing and Nursing Policy: Based on the results, there is a need for necessary policies regarding nurses' working hours and working conditions. To protect patient and employee safety, necessary strategies should be devised regarding the hours when nurses experience the highest sleepiness and the factors affecting sleepiness levels., (© 2024 The Authors. International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.)

Objective: The autonomic nervous system (ANS) plays an important role in maintaining physiological regulation. It regulates the body's response to many variable situations. Orthostatic intolerance (OI) is one of the most important signs of autonomic dysfunction. Autonomic dysfunction is known to cause premature ejaculation (PE) by disturbing the balance in erection and ejaculation cycles. Considering that OI may develop due to autonomic dysfunction in patients with PE, we hypothesized that OI symptoms would increase in these patients. The aim of our study was to investigate the relationship between orthostatic intolerance and PE., Patients and Methods: This case-control study included a total of 39 patients with PE and 47 volunteers without PE. All subjects were assessed using the self-reported Orthostatic Grading Scale (OGS). In addition, the validated five-item Turkish version of the Premature Ejaculation Diagnostic Tool (PEDT) was used to evaluate PE. The PE group included patients with a PEDT score ≥ 11., Results: The mean ages of the PE and control groups were 38.2 ± 7.8 and 40.5 ± 9.1 years, respectively (p = 0.137). The mean PEDT scores of the PE and control groups were 13.9 ± 3.6 and 6.6 ± 2.9, respectively (p < 0.0001), and their mean OGS scores were 5.6 ± 2.4 and 1.6 ± 1.3, respectively (p < 0.0001). A statistically significant correlation was found between the PEDT and OGS scores (r: 0.686, p < 0.0001)., Conclusions: The orthostatic intolerance symptoms of patients with PE were higher than those of the control group. There was a correlation between the severity of PE and the severity of orthostatic intolerance. This is the first study in the literature to reveal a relationship between orthostatic intolerance and PE.

Background: Arteriovenous fistula-related self-care behaviors, self-care agency and health literacy are important for vascular access patency, which is vital in the continuation of hemodialysis treatment. The purpose of this study was to determine the arteriovenous fistula-related self-care behaviors of patients receiving chronic hemodialysis treatment and the relationship between these behaviors and their health literacy and self-care agency levels., Methods: In this descriptive correlational study, the data were collected from 216 chronic hemodialysis patients., Results: The rate of the patients who had good self-care behaviors levels was 83.96%. The sociodemographic variables that were significantly related to AVF-related self-care behaviors were education, employment status and age. It was found that the patients who had had AVF for a longer time had better self-care behaviors regarding their management of symptoms and findings ( p  < 0.05). As the self-care agency of the patients ( r  = 0.612, p  < 0.001) and their health literacy ( r  = 0.421, p  < 0.001) increased, their AVF-related self-care behaviors also increased., Conclusion: Age, education status, health literacy and self-care agency were identified to affect AVF-related self-care behaviors., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: In the study, it was aimed to evaluate the relationship between health literacy and successful aging in elderly individuals with type 2 diabetes., Methods: This descriptive study was conducted with the participation of 415 elderly patients with type 2 diabetes who presented to the diabetics outpatient clinic between April-September 2021. The study data were collected through Identifying Information Form, Health Literacy Scale, and Successful Aging Scale. In the analysis of the data, descriptive statistics, Pearson correlation analysis, One-Way ANOVA, and student's t test were used., Results: Health Literacy Scale total mean score of the elderly individuals was found as 55.50 ± 6.08, and their Successful Aging Scale total mean score was determined to be 38.91 ± 2.05. A positive correlation was found between Health Literacy Scale total mean score and Successful Aging Scale total mean score, while a negative relationship was determined between Successful Aging Scale mean score and HbA1c values (p < 0.001)., Conclusion: As a result of the study, it was concluded that elderly patients with type 2 diabetes who had high levels of health literacy had high levels of successful aging as well., Competing Interests: Declaration of Competing Interest The authors declared that there is no conflict of interest., (Copyright © 2023 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to determine the diabetes burden in elderly individuals along with successful ageing, which defines how well individual ages contribute to coping with the disease and diabetes management. This study also aimed to evaluate the relationship between diabetes burden and successful ageing in elderly individuals with type 2 diabetes., Methods: The data for this descriptive study were collected from 526 individuals who were 65 years old patients diagnosed with type 2 diabetes in the diabetes polyclinic of a research and training hospital between January and June 2021., Results: It was found that the Successful Ageing Scale score was higher in women, those who had regular diabetes control, and those who had easy access to health services. Elderly Diabetes Burden Scale scores were found to be higher in men, those whose diabetes treatment was insulin, and those with poor perceived health status. No statistically significant relationship was determined between the Elderly Diabetes Burden Scale total score and the Successful Ageing Scale total score (p>0.05)., Conclusion: Accordingly, by enabling the elderly to have easy access to healthcare services, preventing complications, and providing elderly healthcare services, it will be possible to reduce the diabetes burden in the elderly and enable them to age successfully.

Many factors are considered to affect vascular physiology. It is known that one of the reasons for many diseases is a pathology at the microvascular level. Therefore, the relationship between endothelial dysfunction and many diseases is currently being investigated. The clinical evaluations of arterial stiffness have made it possible to perform necessary risk assessment regarding cardiovascular diseases. In this way, protective measures can be taken against microvascular pathologies in many organs. In this paper, we present a review of studies investigating the relationship between urological conditions and the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. As with erectile dysfunction, some studies have shown that conditions such as lower urinary tract symptoms, overactive bladder, and chronic kidney disease are also associated with an elevated CAVI. The association of erectile dysfunction and chronic kidney disease with vascular pathologies has been clearly demonstrated. In addition, lower urinary tract symptoms may be the first sign of silent vascular dysfunction. Assessing arterial stiffness with CAVI can help prevent future cardiovascular events in these patients., Competing Interests: The authors report no conflicts of interest concerning this work., (© 2023 Bulbul et al.)

Purpose: In this study, we aimed to compare the results of split-cuff nipple and modified Lich-Gregoir ureteroneocystostomy, which are the most commonly used techniques in stage ≥ 3 iatrogenic distal ureteral injuries., Methods: The files of patients who were treated for iatrogenic distal ureteral injuries in our clinic between January 2013 and January 2019 were retrospectively reviewed. A total of 60 patients who underwent either intra-vesical split-cuff nipple ureteroneocystostomy (Group A) or extra-vesical modified Lich-Gregoir ureteroneocystostomy (Group B) operations were included in the study. The success of ureteroneocystostomy was defined as no additional surgery requirement, no progression of hydronephrosis on imaging, and normal contrast transition on imaging., Results: Thirty-four patients underwent split-cuff nipple and 26 patients underwent modified Lich-Gregoir ureteroneocystostomy. The treatment was successful in 53 (88.3%) patients and failed in seven (11.7%). Complications occurred in 19 (31.7%) patients, of whom 14 (23.3%) had minor and five (8.3%) had major complications. The rate of postoperative complications was significantly higher in Group A than in Group B (p = 0.019). There was no significant difference between Group A and Group B in terms of the success ratio (p = 1), rate of major complications (p = 0.372), and postoperative hospitalization times (p = 0.254)., Conclusion: In this study, a higher complication rate was found in patients with iatrogenic ureteral injuries who underwent ureteroneocystostomy with the split-cuff ureteral nipple technique compared to those who underwent this operation with the modified Lich-Gregoir technique. However, no significant difference was observed between these two techniques in terms of treatment success and major complications., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To examine the parameters affecting the need for additional procedures in the primary ureteroscopy treatment in patients with ureteral stones above the iliac crest level., Methods: Seventy-one patients were included in the study who were ≥ 18 years old and had undergone ureteroscopy (URS) for ureteral stones above the iliac crest level between 2018-2020 and had a non-contrast-enhanced abdominal computed tomography before the procedures were included in the study. Patients and stone characteristics were prospectively collected. The results were evaluated six weeks after URS. The absence of any residual fragment was thought to indicate stone-free status. The patients with failure were referred for the additional procedures., Results: The median patient age was 51 years [interquartile range (IQR): 18-66]. The median transverse stone diameter was 9.5 mm (IQR: 7.1-11.4), and the median ureteral wall thickness (UWT) was 5.8 mm (IQR: 4.3-6.5). In the univariate analysis, UWT (p < 0.001), presence of multiple stones (p = 0.008), and stone length (p = 0.022) affected stone-free status. The multivariate analysis revealed UWT as the only independent factor affecting the need for additional procedures after URS (p = 0.028). In the receiver operating characteristic curve analysis, the best threshold value for UWT according to the outcomes was identified as 5.8 mm., Conclusion: Ureteral wall thickness was the only independent parameter determining the need for additional procedures and affecting the treatment outcomes after the URS procedure., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objectives: To compare the efficacy of in-vivo and in-vitro stone attenuation in the prediction of stone composition using non-contrast-enhanced abdominal computed tomography (NCCT)., Methods: This study included a total of 104 patients with renal stones who received percutaneous nephrolithotomy treatment for renal stones between December 2016 and December 2019 and underwent NCCT before the procedure. Preoperative (in-vivo) and postoperative (in-vitro) kidney stone attenuations were compared using the NCCT images of the patients. Renal stone fragments were analysed with the infrared spectrophotometer method., Results: The mean age of the 104 patients was 49.5 (interquartile range: 37-61) years. According to the receiver operating characteristics analysis, the cut-off values for the prediction of uric acid stones were determined to be 556 HU for the in-vivo and 774 HU for the in-vitro attenuation measurement. Sensitivity and specificity were 100% and 96.6%, respectively, for the in-vivo and 90.9 and 91%, respectively, for the in-vitro images. The cut-off values for the prediction of calcium stones were determined to be 824 HU and 1065 HU for the in-vivo and in-vitro attenuation measurements, respectively. Sensitivity and specificity were 97.3 and 96% for the in-vivo and 96 and 96% for the in-vitro images., Conclusions: In-vivo stone attenuation measurement in NCCT was slightly superior to in-vitro measurement due to the reduction in the composition and size of the stone. Our findings show that NCCT in-vivo stone attenuation might differentiate uric acid and calcium stones from the other stone types., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: To search whether there is a correlation between middle hepatic venous indices (HVIs) obtained by pulsed waved doppler ultrasonography (PW-DUS) and the main pulmonary artery (mPA) diameter, calculated by computed tomography (CT)., Study Design: A descriptive cross-sectional study., Place and Duration of Study: Department of Radiology, Balikesir University School of Medicine, Turkey, from February to December 2020., Methodology: After excluding the cases with suspected COVID-19 from the cases sent to the Radiology Department for chest CT exams with the mPA included in the cross-sections, the volunteers were evaluated with PW-DUS. The study group consisted of 66 cases. Two radiologists measured the velocity values of the A, S, and D waves in the recorded PW Doppler spectra. HVIs (A/S, A/S+D, A/A+S+D) were calculated. The mPA diameter was calculated in the axial plane from the pulmonary trunk, 1cm proximally to the bifurcation manually on the workstation. The correlation between the HIVs and mPA diameter was evaluated. Interoperator reliability was also analysed., Results: Thirty-nine males (59%) and 27 (41%) females were included in the study group. The mean HVI values were 0.50 ±0.20, 0.28 ±0.12, and 0.21 ±0.07 for A/S, A/A+S, and A/A+S+D, respectively. The mean mPA diameter was 24.0 ±3.3 mm. Correlation analysis determined that the HVIs were positively correlated with mPA diameter (r=0.730-0.765-0.751, p<0.001). Inter-observer correlation coefficients were found to be compatible between two radiologists., Conclusion: A significant and strong correlation was found between HVIs and mPA diameter. The mPA diameter that reflects the pulmonary artery systolic pressure (PAP) increased as the HVIs increased. Therefore, PW-DUS may be helpful to evaluate PAP as a quantitative method that is cost-effective, easily accessible and radiation-free., Key Words: Hepatic veins, Pulmonary artery, Multidetector computed tomography, Pulmonary hypertension, Pulsed doppler ultrasonography.

Objectives: To compare the surgical outcomes of open and laparoscopic ureterolysis procedures in patients requiring surgical treatment for ureteral obstruction caused by retroperitoneal fibrosis (RPF). Materials: This study was designed retrospectively. The clinical records of patients who underwent ureterolysis between January 2005 and April 2019 because of ureteral obstruction caused by RPF were examined. According to the type of surgery, the patients were divided into two groups as Group 1 (open ureterolysis) and Group 2 (laparoscopic ureterolysis). Demographic features, preoperative-postoperative renal functions, duration of follow-up with ureteral stents, and perioperative-postoperative complications were examined. The requirement of ureteral stent placement during the follow-up period was accepted as unsuccessful ureterolysis. Results: Ureterolysis was performed in 13 patients and 23 renal units. Eleven of these patients were men and two were women. The median age of the patients was 54 (44-68) years. There were six patients and 12 renal units in Group 1 and seven patients and 11 renal units in Group 2. Postoperatively, a total of four patients (30%) had minor complications (Clavien-Dindo 1-2) and one patient had a major complication (Clavien-Dindo 3a). Ureterolysis was determined to be effective in 21 of the renal units (91%) [11/12 (92%) in Group 1 vs 10/11 (91%) in Group 2]. No statistically significant difference was found between the groups in terms of the success and complication rates ( p  = 1 and p  = 0.529, respectively). Postoperative hospitalization length and recovery time to return to normal preoperative activities were significantly shorter in Group 2 than in Group 1 ( p  = 0.011 and p  = 0.041, respectively). Conclusions: The success and complication rates were similar between the open and laparoscopic methods for ureterolysis. Laparoscopic approach was advantageous over open approach in terms of postoperative hospitalization length and recovery time to return to normal preoperative activities.

Aim and Objective: This study was conducted to assess whether there is an association between alexithymia in patients with diabetes and the levels of perceived social support and glycaemic control., Background: In the literature, whether inadequate perceived social support is a cause or effect of alexithymia has also not been clearly explained. It is stated that it is difficult to determine from where these contradictions arise, and there is a need for more studies on this topic., Method: This cross-sectional and correlational study included 537 patients with type I and type 2 diabetes. The data were collected using a Patient Information Form including the patient's HbA1c value that reflected their glycaemic control level, the Toronto Alexithymia Scale and the Multidimensional Scale of Perceived Social Support. The study was reported according to the STROBE Declaration., Results: Among the patients with diabetes, 63.9% showed signs of alexithymia. Alexithymia had a negative relationship with perceived social support and a positive relationship with HbA1c. Additionally, it was determined that the patients who showed signs of alexithymia had lower levels of perceived social support in comparison with those who did not show such signs, whereas the HbA1c levels of the former were also higher than those of the latter. Moreover, it was found that the duration of the disease, HbA1c levels and levels of perceived social support from family and a significant other explained 30% of the total variance in the level of alexithymia., Conclusion: Alexithymia was seen prevalently among the patients with diabetes, and it was associated with a reduced level of perceived social support and weak glycaemic control., Relevance to Clinical Practice: It is recommended to provide patients with psychosocial support in the scope of holistic care and include the individuals who provide care for and support the patient in the patient's management of the disease., (© 2021 John Wiley & Sons Ltd.)

Objective: To examine the relation between burnout levels and caring behaviours in intensive care nurses in Turkey, and the affecting factors., Research Methodology/design: The research was conducted as a descriptive, cross-sectional and multi-centred study., Setting: In this study, an online questionnaire was applied in April and May 2021, using Google Form. A total of 460 intensive vare nurses responded to the questionnaire., Main Outcome Measures: Burnout was assessed with the Maslach Burnout Inventory, and care behaviours with the Caring Behaviours Inventory-24., Results: The nurses reported a high level of emotional exhaustion (73.9%) and depersonalization (52.2%), and a medium level of personal accomplishment (40%). The nurses' levels of perception of care quality were high (5.4 ± 0.6). It was found that their highest score on the subdimensions was on knowledge and skills (5.6 ± 0.5), and the lowest was on connectedness (5.2 ± 0.7). There was a very weak, respectively weak correlation, between nurses' emotional exhaustion (r = -0.1), respectively depersonalization (r = -0.2), and poor care behaviours. There was a strong correlation between low personal accomplishment scores and poor care behaviours (r = 0.8). It was found that the mean scores of the nurses' exhaustion and care behaviours varied according to many descriptive characteristics, such as education, age, professional experience, the unit where they worked, communication difficulties, living conditions and whether they had chosen nursing willingly., Conclusions: It appears that the level of personal accomplishment, is the only subscale reflecting risk of burnout, that strongly correlates with care behaviour., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Introduction: This study was conducted to determine the constipation-related quality of life, bowel habits, and comfort levels of constipated hemodialysis patients. It is known that the prevalence of constipation is high in hemodialysis patients., Methods: This was a cross-sectional and correlational study. The study included 164 hemodialysis patients who were determined to have constipation by examining the constipation statuses of 385 patients based on the Rome-IV criteria. The study was reported according to the STrengthening the Reporting of OBservational studies in Epidemiology Declaration., Findings: It was determined that as the constipation-related quality of life of the patients increased, their comfort levels also increased. Constipation-related quality of life increased in parallel with an increasing Bristol Stool Scale (BSS) score and an increasing number of bowel movements. The BSS scores of the patients were found to have a significant positive correlation with the patients' bowel movement frequencies and a significant negative correlation with their constipation frequencies. There was a negative correlation between years of dialysis and bowel movement frequencies. The presence of a previous gastrointestinal system complaint, the presence of an impact of constipation on the patient's dialysis session, and comfort levels were determined to be significant predictors of constipation-related quality of life that explained 26.3% of the total variance in constipation-related quality of life., Discussion: In patients receiving hemodialysis treatment, constipation is an important and frequently encountered problem. Constipation leads to a reduction in quality of life and hemodialysis-related comfort., (© 2022 International Society for Hemodialysis.)

Background: It has been reported that there is a relationship between erectile dysfunction and endothelial dysfunction. However, a practical and non-invasive method to clinically evaluate this relationship has not yet been determined. The cardio-ankle vascular index is a marker of arteriosclerosis that develops as a result of endothelial dysfunction., Objective: To investigate the correlation between the cardio-ankle vascular index and the presence and severity of erectile dysfunction., Materials/methods: This was a case-control study including 74 patients that presented to the urology department of our institution with erectile dysfunction (without cardiovascular risk factors) and 86 healthy individuals of similar age. The patients with erectile dysfunction and the control group were evaluated using the five-item version of the International Index of Erectile Function (IIEF-5). Cardio-ankle vascular index and ankle-brachial pressure index measurements were performed using the VaSera VS-1000 (Fukuda-Denshi Company, Ltd, Tokyo, Japan) device., Results: The mean age was 59.8 ± 1.3 years for the erectile dysfunction group and 57.9 ± 1.1 years for the control group. The mean right (R)-cardio-ankle vascular index values of the erectile dysfunction and control groups were 9.20 ± 2.6 and 8.11 ± 1.8, respectively (p = 0.014), and their mean left (L)-cardio-ankle vascular index values were 9.08 ± 2.7 and 7.96 ± 1.2, respectively (p = 0.008). The mean International Index of Erectile Function score of the patients with erectile dysfunction was 10.1 ± 3.6. An inverse correlation was found between the R-cardio-ankle vascular index and L-cardio-ankle vascular index and the International Index of Erectile Function score (r = -0.411, p = 0.011, and r = -0.454, p < 0.001, respectively)., Discussion and Conclusion: According to our findings, the cardio-ankle vascular index was higher in patients with erectile dysfunction than in healthy individuals., (© 2022 American Society of Andrology and European Academy of Andrology.)

In this cross-sectional, descriptive study, the arteriovenous fistulas (AVF) of HD patients were evaluated by physical examination and factors associated with AVF function and longevity were investigated. Data were collected using a patient information form and the Arteriovenous Fistula Assessment Scale (AVF-AS). The study population included 279 patients under chronic HD treatment. Their mean age was 61.14 ± 14.00 years and 58.6% were men. Age, AVF location, and number of AVFs created were identified as factors associated with AVF needle entry site and flow problems, stenosis, and risk of developing ischemic complications (p = 0.005, p = 0.000, p = 0.006, respectively). AVF dysfunction adversely affected HD pump speed (p = 0.000) and HD adequacy (p = 0.000). It was determined that gender, AVF location, last AVF duration, and total number of previous AVF were identified as the risk of AVF complications. The results of this study revealed that regular follow-up and evaluation are needed to minimize the risk of dysfunction and failure due to AVF complications., (© 2021 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.)

Background: In the literature, there is not sufficient data on factors affecting the development of complications in patients with penile fracture after early surgical intervention., Objectives: To investigate the predictors of long-term complications in patients who underwent immediate surgical repair for penile fracture., Materials/methods: This clinical study included a total of 31 cases of penile fracture in which surgical treatment was performed within the first 24 h and penile fracture was confirmed during the operation. The patients with and without late complications were compared in terms of parameters such as age, tear size of the tunica albuginea of the penis, bilateral involvement of the corpora cavernosa involvement, urethral injuries, and duration from penile fracture to surgery., Results: The median age of the patients was 42 years (interquartile range: 34-51 years). The median time from penile fracture to surgery was 13 h (8-18 h). The median tear size was 16 mm (11-21 mm). Late complications were seen in 13 (41.9%) patients in the post-operative period. Erectile dysfunction developed in five (16.1%) patients in the post-operative period. There was no statistically significant relationship between age, tear size, time from penile fracture to surgery, and bilateral corporeal involvement in terms of erectile dysfunction development. Painful erections, penile deviations, urethral strictures, tunical scars, and re-fracture were the other late complications. There was a significant relationship between the development of any complication and time from penile fracture to surgery (p = 0.028) and tear size (p = 0.031). In the receiver operating characteristic analysis of complication development, the cut-off value for the time from penile fracture to surgery was 13.5 h., Discussion and Conclusion: We found that the longer time interval between penile fracture and surgery worsened the patient outcomes. In addition, tear size was determined to be a predictor for long-term complications. In our opinion, early treatment of penile fracture can prevent severe complications in these cases., (© 2021 American Society of Andrology and European Academy of Andrology.)

Background: Patients receiving hemodialysis treatment are among the risk groups during the COVID-19 pandemic. They must cope with many factors simultaneously like anxiety about being ill, social isolation, inadequate information about protective precautions, and the need to attend regular treatment., Objectives: This study was performed with the aim of determining problems experienced by individuals receiving hemodialysis treatment during the pandemic., Design: This was a descriptive and cross-sectional type study., Participants: The research included 234 patients receiving chronic hemodialysis treatment., Measurements: For collection of data in the research, a patient descriptive information form and COVID-19 phobia scale (CP19-S) scale were used., Results: Patients receiving hemodialysis treatment were determined to have high levels of compliance with individual precautions required during the pandemic. Of patients, 87.6% were determined to experience concern about bringing infection from the dialysis unit to family members. The mean total points for CP19-S were 59.80 ± 14.49. Patients who were female, had low educational level, were not employed, had heart disease in addition to kidney failure, with hemodialysis age from 6 to 8 years, who did not want to go to the dialysis center and had not received education about the pandemic (p < 0.001) were identified to have high phobia at statistically significant levels., Conclusions: Changes occurring in normal life and to hemodialysis treatment during the pandemic cause concern and anxiety in many patients. In this process, providing patients with education about the pandemic and protective methods is very important., (© 2021 International Society for Hemodialysis.)

Introduction: The exact definition of small-for-gestational-age (SGA) infant is still controversial among clinicians. In this study, we aimed to understand which definition is better in terms of establishing both early postnatal problems and growth. In this way, we compared early neonatal problems and infancy growth of term infants with birth weight (BW) < -2 SDS and with BW between 10th percentile (-1.28 SDS) and -2 SDS. Methods: A single center retrospective cohort study was conducted. Preterm infants, multiple gestations and newborns with any congenital anomalies were excluded from the study. Study group was defined as Group 1 ( n = 37), infants BW < -2.00 SDS; Group 2 ( n = 129), between -1.28 and -2.00 SDS; and Group 3 ( n = 137), randomly selected newborns with optimal-for-gestational-age (BW between -0.67 and +0.67 SDS) as a control group. Results: The incidence of severe hypoglycemia was highest in Group 1 (%10.8) and Group 2 and 3 had similar rates of severe hypoglycemia (0.8 and 0.7%, respectively). The incidence of polycythemia was 5.4% in Group 1 and was significantly higher than Group 3 (0.0%) while it was 2.3% in Group 2. Short stature (length < -2 SDS) ratio at the age of 1 and 2 years were similar in each group. Overweight/obesity ratio at the age of 1 were 9.5, 20.8 and 16.7% in each group, respectively ( p = 0.509). Conclusion: This study was planned as a pilot study to determine potential differences in the problems of hypoglycemia, polycythemia, and growth according to the differences in definition. Short term disturbances such as hypoglycemia and polycythemia are found to be higher in infants with a BW SDS below -2. From this point of view, of course, it will not be possible to change the routine applications immediately, however this study will be an initiative for discussions by making long-term studies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Abali, Beken, Albayrak, Inamlik, Bulum, Bulbul, Eksi, Ay, Karabay, Kaya, Halici, Semiz and Korkmaz.)

Background: To investigate the relationship between ureteral wall thickness (UWT) and other variables of patients who underwent extracorporeal shock wave lithotripsy (SWL) in the primary treatment of the ureteral stone above the iliac crest level., Material and Methods: A total of 147 patients aged 18 years and older, who underwent SWL in our clinic between December 2016 and December 2019 for the treatment of ureteral stones above the iliac crest level and had non-contrast enhanced abdominal computed tomography scans before the procedure were included in the clinical study. The results were evaluated at 3 months after SWL. The absence of residual fragments was considered as stone-free status, and the existence of any size residual fragment was considered as treatment failure., Results: In our study, the mean age of the patients was 42.4 ± 12.8 years, and the stone-free rate was 92.5%. The median transverse stone size was 7.5 mm (min 2.8-max 15), and the median UWT was 4.2 mm (1-8.7). In the multivariate analysis, UWT (P = .002) and multiple stone presence (P = .027) were found to be independent factors affecting stone-free status. In the receiver operating characteristic curve analysis, the optimal threshold value for UWT was determined as 5.25 mm., Conclusions: We found that UWT was the most important independent variable associated with increased failure in SWL treatment. The presence of multiple stones was another independent factor that increased the failure rates. Using SWL technology through experience accumulated with the mechanical hardware of the machine, we can select patients who are more suitable for this treatment and improve treatment outcomes., (© 2021 John Wiley & Sons Ltd.)

Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated. Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups. Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine ( p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants ( p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels ( p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels ( p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown. Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Beken, Abali, Yildirim Saral, Guner, Dinc, Albayrak, Ersoy, Kilercik, Halici, Bulbul, Kaya, Karabay, Ay, Eksi, Benli Aksungar, Korkmaz and Serteser.)

Aim: This methodological study was conducted to develop a reliable instrument for the assessment of the arteriovenous fistula in patients under hemodialysis therapy. The purpose of the scale is to evaluate risk of developing arteriovenous fistula complications in patients receiving hemodialysis treatment., Methods: An item pool was created in accordance with data obtained from our literature review and expert opinions. Validity of the scale was evaluated using construct and content validity analyses. Cronbach's alpha coefficient, test-retest, and split-half reliability were used to assess reliability., Results: The final 3-point Likert-type Arteriovenous Fistula Assessment Scale developed in this study consists of 18 items in three subdimensions: arteriovenous fistula flow, stenosis and ischemia, and needle entry site. The scale-level Content Validity Ratio was 0.90. Explanatory factor analysis revealed a three-factor structure with factor loadings of 0.622-0.800, 0.361-0.891, and 0.431-0.954, respectively, explaining 55.51% of the total variance. The Cronbach's alpha values for the subdimensions were 0.72, 0.71, and 0.83, respectively, and 0.82 for the scale overall., Conclusion: The Arteriovenous Fistula Assessment Scale is a valid and reliable instrument that can be used to monitor arteriovenous fistulas in hemodialysis patients.

Objective: The aim of our study is to determine whether there is a change in the plasma levels of copeptin and there is a relationship among the plasma levels of carboxyhemoglobin (COHb), lactate, and copeptin levels in patients presenting to the emergency department with carbon monoxide (CO) poisoning., Methods: Fifty-seven patients admitted to the emergency department with CO poisoning were included in the study. The blood samples of the patients were collected on arrival 0th, 6th, and 12th hours for copeptin, lactate, and COHb levels. Data were analyzed using SPSS-17 statistical software., Results: Arrival serum copeptin levels of the patients were compared to copeptin levels of healthy individuals and a statistically significant difference was found between them ( p = 0.008). There was a statistically significant difference between the arrival levels of copeptin and 6th-hour ( p = 0.006) and 12th-hour ( p = 0.001) levels of copeptin. There was no significant difference between 6th-hour and 12th-hour copeptin levels ( p = 0.51). In terms of serum lactate levels, there was a significant difference between arrival and 6th h ( p < 0.001), arrival and 12th h ( p < 0.001), and 6th and 12th h ( p < 0.001). Likewise, in terms of serum COHb levels, there was a significant difference between arrival and 6th h ( p < 0.001), arrival and 12th h ( p < 0.001), and 6th and 12th h ( p < 0.001). There was a positive correlation between COHb and lactate levels on arrival ( r = 0.52; p = 0.001)., Conclusion: Copeptin as a stress hormone can be used in the diagnosis and monitoring of patients with CO poisoning. However, the copeptin level was not superior to COHb and lactate levels.

In this study, one of the most promising methods of tailoring a composite scaffold material in nano sized diameters, electrospinning method were used to produce Polycaprolactone (PCL)/Graphene Oxide (GO)/Iron(II, III) Oxide (Fe 3 O 4 ) nanocomposite fibers as biocompatible scaffolds for biomedical applications. Products were analyzed by scanning electron microscopy (SEM) for morphological analysis of the electrospun nanocomposites and Fourier Transform Infrared Spectroscopy (FTIR) was used to determine functional groups of the PCL, GO, and Fe 3 O 4 materials in the electrospun nanocomposites. For physical properties, viscosity, density, permittivity, dielectric loss and liquid and solid state alternating current conductivity, measurements were done for each nanocomposite fibers. Effects of concentration percentage of GO on permittivity, dielectric loss and AC conductivity have been analyzed by using measured and calculated data. Trend lines have been drawn for permittivity, dielectric loss and conductivity via concentration percentage of GO. The relation between ac conductivity and frequency have been studied for each concentration percentage of GO and interpretations have been done by using the obtained results., (Copyright © 2018 Elsevier B.V. All rights reserved.)

To search for giant X-ray pulses correlated with the giant radio pulses (GRPs) from the Crab pulsar, we performed a simultaneous observation of the Crab pulsar with the X-ray satellite Hitomi in the 2 - 300 keV band and the Kashima NICT radio observatory in the 1.4 - 1.7 GHz band with a net exposure of about 2 ks on 25 March 2016, just before the loss of the Hitomi mission. The timing performance of the Hitomi instruments was confirmed to meet the timing requirement and about 1,000 and 100 GRPs were simultaneously observed at the main and inter-pulse phases, respectively, and we found no apparent correlation between the giant radio pulses and the X-ray emission in either the main or inter-pulse phases. All variations are within the 2 sigma fluctuations of the X-ray fluxes at the pulse peaks, and the 3 sigma upper limits of variations of main- or inter-pulse GRPs are 22% or 80% of the peak flux in a 0.20 phase width, respectively, in the 2 - 300 keV band. The values become 25% or 110% for main or inter-pulse GRPs, respectively, when the phase width is restricted into the 0.03 phase. Among the upper limits from the Hitomi satellite, those in the 4.5-10 keV and the 70-300 keV are obtained for the first time, and those in other bands are consistent with previous reports. Numerically, the upper limits of main- and inter-pulse GRPs in the 0.20 phase width are about (2.4 and 9.3) ×10 -11 erg cm -2 , respectively. No significant variability in pulse profiles implies that the GRPs originated from a local place within the magnetosphere and the number of photon-emitting particles temporally increases. However, the results do not statistically rule out variations correlated with the GRPs, because the possible X-ray enhancement may appear due to a > 0.02% brightening of the pulse-peak flux under such conditions.

Background and Aims: Endothelial nitric oxide synthase gene polymorphisms play a role in some pathophysiological processes. In this study, the possible effects of endothelial nitric oxide synthase gene polymorphisms on ureteral stone disease in patients who were admitted to the emergency department with severe pain due to renal colic are examined., Materials and Methods: The study groups were designed as controls and patients. The control group was formed from the healthy volunteers who applied to the blood center next to the emergency service. The patient group comprised patients who were diagnosed with ureteral stone disease with severe pain. All of the genetic studies were based on extracted peripheral blood samples using the necessary procedures from the Genome and Stem Cell Center at Erciyes University (GENKOK). The data were analyzed with SPSS (IBM, ver 20, United Sate)., Results: The study group comprised 62 females and 138 males, and the control group comprised 64 females and 136 males. All of the stones that caused renal colic were found to be localized in the ureters and the ureterovesical junction. The genotypes of the intron 4 polymorphism were found to be as follows: 4a/4a in 10 people, 4b/4a in 115, and 4b/4b in 275 people. The GG genotype of the eNOS-G894T polymorphism was found in 108 patients in the study group and in117 of the healthy individuals. There was no statistically significant difference between the two groups regarding these data., Conclusion: Although this study is the first in the literature to examine the relationship between renal colic and endothelial nitric oxide synthase gene polymorphisms, our study demonstrated that no relation was found., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Introduction: Multidetector Computed Tomography (MDCT) is a widespread method for evaluating paranasal sinuses and nasal cavity in daily practice. The maxillary teeth are in field of view in a paranasal sinus CT scan and it is possible to detect dental pathologies with CT., Aim: To determine the incidence of maxillary teeth pathologies in routine paranasal sinus CT scans., Materials and Methods: A retrospective study was conducted. Consecutive 395 paranasal sinus CT scans were evaluated. All CT images were obtained with a 64 detector-CT. Patients with previous facial trauma, operation, invasive tumors and repeated exams were excluded. Detected findings were classified as "tooth loss, dental restorations or procedures and dental pathologies (carious lesions, dental developmental anomalies, periapical lesions and periodontal diseases). The proportion of findings was reported as simple percentiles., Results: Three hundred and eighty-four CT scans were included in the study. Dental restorations or procedures were determined in 129 (33.5%) patients. A total of 34 (8.8%) patients had normal teeth count and morphology. A total of 264 (64.3%) patients had at least one tooth loss. A total of 195 (51%) patients had at least one or more dental pathology. Number of dental carious lesions, dental developmental anomalies, periapical lesions and periodontal disease were 104 (27.0%), 78 (14.3%), 46 (11.9%), 44 (11.4%), respectively., Conclusion: Dental pathologies were encountered in more than half of the patients. Detecting dental pathologies may prevent tooth loss and improve oral health. The radiologist should keep in mind dental pathologies while evaluating paranasal sinus CT in daily practice.

Laser-treated Ti6Al4V surfaces were coated by the single-layer hydroxyapatite (HA) and double-layer hydroxyapatite reinforced by the reduced nano-graphene oxide (rGO) using the sol-gel method. The effects of rGO reinforcement at different ratios and sintering temperatures on surface morphology and adhesion strength of the single and double layer coatings (rGO/HA) were analysed. As the initial treatment process, a laser texturing was patterned on the alloy and then, prepared samples were coated. The coated laser-modified HA and HA/rGO-coated Ti6Al4V surfaces were characterized by Raman spectroscopy, X-ray diffraction (XRD), Field Emission Scanning Electron Microscope (FESEM) and the adhesion strength between the coat and substrates were determined by the standard adhesion tests. The conducted analyses indicated that the substitution of rGO into HA matrix revealed a homogeneous morphology and relatively crack-free coatings on the laser-treated Ti substrate surfaces. Adhesion tests showed that, the HA + rGO (1.0 wt. %) biocomposites exhibited a significant increase in adhesion strength compared to untreated surfaces and to the single HA-coated Ti6Al4V substrates.

Objective: The bony nasolacrimal duct (BNLD) morphology as a contributory factor in primary acquired nasolacrimal duct obstruction (PANDO) is still controversial. The objectives of this study were to evaluate the morphometric differences of BNLDs in unilateral PANDO patients between PANDO and non-PANDO sides, as compared with the control group using multidetector computed tomography (CT)., Materials and Methods: Bilateral BNLDs in 39 unilateral PANDO patients and 36 control subjects were retrospectively reviewed. CT images with 0.5-mm thickness were obtained with a 64-slice scanner. The length, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were assessed. The entrance, minimum and distal end transverse diameters (TD) of BNLD was investigated., Results: The mean minimum and distal end BNLD TDs measurements were significantly narrower in PANDO patients, both in PANDO and non-PANDO sides, as compared with the control group (p < 0.001 and p = 0.040, respectively); however, there were no significant differences between PANDO and non-PANDO sides within PANDO patients. The length, entrance TD, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were not significantly different between PANDO patients and control subjects, as well as between PANDO and non-PANDO sides within PANDO patients., Conclusion: The narrow mean minimum and distal end BNLD TD in PANDO patients, in both PANDO and non-PANDO sides, may be associated with PANDO development. The lack of difference between PANDO and non-PANDO sides within PANDO patients and some overlap between PANDO patients and control subjects suggest that narrow BNLD is not the sole factor.

Introduction: Computed tomography (CT) is a widespread method for evaluating head and neck pathologies. The lacrimal glands (LGs) are usually visible in routine head and neck CT scans. LG pathologies usually manifests with changes in gland sizes, so it is important to know the normal values of the LG dimensions and volume. The LG sizes may change with age, gender and race. The normal values of LG dimensions and volume in Turkish population was not reported before., Aim: The aim of this study was to evaluate the dimensions and volumes of the LGs by CT in a Turkish population., Materials and Methods: Two hundred seventeen consecutive paranasal CT scans of subjects evaluated retrospectively. Measurements of LG dimensions were performed in axial and coronal paranasal CT images. The LG volume was calculated with Aquarius software by outlining the gland in all consecutive axial images., Results: Four hundred orbits of 200 subjects were included to the study. The mean axial LG length in right and left orbits were 16.2±2.0 mm and 16.0±2.0 mm and the mean axial width of the right and left orbits were 4.1±0.7 mm and 4.0±0.7 mm. The right and left LG mean values for coronal length and width were equal 18.3 ±2.2 mm and 4.1±0.7mm respectively. The mean LG volume was 0.617±0.210 cm(3) in right and 0.597±0.197 cm(3) in the left orbits. There were statistically significant differences in the axial width and volume of the LG according to sides, however there was no significant difference according to gender. Age and LG measurements were negatively correlated., Conclusion: Our study may serve as a guide to determine the average values of the LG measurements in Turkish population and find out the orbital pathologies that involves the LG.

Background: The aim of the study was to evaluate the prevalence and morphometric features of mastoid emissary vein (MEV) on multidetector computed tomography (MDCT) scans, emphasize its clinical significance and review its surgical implications., Materials and Methods: Cranial and temporal bone MDCTs of 248 patients (496 sides) were analysed by 2 radiologists. Mastoid foramen (MF) was defined on the 3 dimensional volume rendered (3DVR) images. The MF and mastoid emissary canal (MEC) were investigated in axial thin slices and the diameters of the largest MF and MEC were measured. Mean diameters of MF and MEC were determined. The number of the mastoid foramina was noted. Differences in MF prevalence by sex and side were evaluated., Results: The overall prevalence of MEC was 92.3%. It was observed in 91.5% of women and 93.3% of men. MEC was present on the right side in 84.7% and on the left side in 82.3% of temporal bones. The mean diameter of MF was 1.92 ± ± 1.02 mm on the right and 1.84 ± 0.98 mm on the left. In both sides the number of the MF's changed from absent to triple. The mean diameter of MEC was 1.58 ± 0.86 mm on the right and 1.48 ± 0.79 mm on the left side. The mean diameter of MEC was significantly larger in men. No significant correlation was detected between age and the MEC diameter., Conclusions: The preoperative detection of mastoid emissary veins is necessary. The radiologists should be familiar with their clinical significance and variant appearances and report them accurately. Knowledge of their morphology and surgical implications by the surgeons will make them aware to avoid unexpected and fatal complications while operating in the suboccipital and mastoid area. MDCT is a reliable diagnostic tool for imaging the MEC and MF.

An extraordinary cerebral venous drainage pathway and dilated vein at the left posterior cervical region were detected with routine contrast-enhanced neck computed tomography exam. The left sigmoid sinus was drained by dilated mastoid emissary vein (MEV). The MEV continued as posterior auricular and posterior external jugular veins (PEJVs). The left PEJV directly drained into subclavian vein. Atretic right transverse sinus, left facial vein forming the external jugular vein, atresia and hypoplasia of upper internal jugular veins at the right and left sides, respectively, were the other uncommon findings in our case. Detecting venous variations may prevent complications during surgical and interventional procedures, so the radiologists should examine the superficial cervical veins closely.

Liposarcoma (LPS) of vulva is a rare entity. We present the ultrasonographic (US) and color Doppler ultrasonographic (CDUS) findings of a vulvar myxoid LPS. Although LPS cases have been reported in the extremities and trunk, the US or CDUS findings of LPS in vulva have not been described previously. On US the mass appeared as a well-defined, homogeneous hypoechoic structure and on CDUS it was quite hypervascular.

Purpose: To investigate whether there is an association between primary acquired nasolacrimal duct obstruction and paranasal computed tomography (CT) findings., Materials and Methods: The study cohort consisted of paranasal CT images from 40 patients being treated for unilateral primary nasolacrimal duct obstruction (PANDO) and the reformatted coronal temporal CT images of 71 control subjects who attended the ENT clinic with the complaint of vertigo and tinnitus. A radiologist masked to the clinical situation of participants, investigated the paranasal CT findings of the PANDO and control patients retrospectively. The side, localization, and angle of the septal deviation as well as the thickness and lateralization angle of the inferior turbinate's were recorded. Additionally maxillary and ethmoid sinusitis, concha bullosa, Agger nasi cell formation, and osteomeatal complex status were evaluated., Results: No significant difference was found between the paranasal abnormality incidence in the PANDO and non-PANDO sides of the patients or the control group. Only the side of the septal deviation correlated with the side of the PANDO (p = 0.008)., Conclusions: The incidence of PANDO may not be directly related to paranasal abnormalities. Further large-scale studies should be performed to clarify the relationship between paranasal abnormalities and PANDO.

Purpose: To investigate whether unilateral primary acquired nasolacrimal duct obstruction (PANDO) causes Schirmer score and lacrimal gland volume changes in the contralateral non-PANDO eye., Methods: Sixteen unilateral female PANDO and 16 female controls were enrolled in the study. Exclusion criteria were orbital trauma, inflammation, infection, tumor involvement or infiltrative diseases, history of ocular surgery, ocular surface disorder, systemic drug use that interferes with tear secretion, and chronic use of topical eye drops. Bilateral lacrimal gland volumes were measured in computed tomography (CT) images of the participants. A Schirmer test without anesthesia was also performed on each participant., Results: As there was no significant difference between the right and left eye values for Schirmer and gland size (P > 0.05), both eyes of the control group were enrolled in the study. The groups were age matched and the mean lacrimal gland was 0.479 cm3 in the PANDO as well as the contralateral non-PANDO side, which was statistically smaller compared to the control eyes (0.580 cm3) (P = 0.04). The mean Schirmer scores in the same order were 18.5 ± 7.1 mm, 13.2 ± 8.9 mm, and 21.3 ± 10.5 mm, respectively. Non-PANDO side Schirmer scores were lower compared to the other two groups, but statistical significance was present for the control group (P = 0.04)., Conclusions: Compared to the control group, lacrimal gland volumes were bilaterally smaller in unilateral PANDO patients. Schirmer scores were statistically lower in the contralateral non-PANDO side compared to the controls.

Objective: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies, affecting 5-8% of reproductive-age women. It is associated with insulin resistance, central obesity, type 2 diabetes mellitus, dyslipidemia, and cardiovascular diseases. The current study was undertaken to evaluate serum copeptin and obestatin levels, carotid artery intima-media thickness, and brachial artery flow mediated dilatation in obese and nonobese women with PCOS and age-matched healthy controls and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters and cardiovascular risk factors., Method: In the study population, we analyzed 60 patients with PCOS and 30 age-matched healthy women as controls. The patients with PCOS were divided into two groups based on body mass index (BMI): obese group (BMI>30kg/m(2), n=30) or nonobese group (BMI<30kg/m(2), n=30). History was obtained and a physical examination, peripheral venous blood sampling, and carotid and brachial artery ultrasonography were performed. Serum copeptin and obestatin levels, total testosterone, C-reactive protein (CRP), glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, homeostasis model assessment for insulin resistance (HOMA-IR), carotid artery intima-media thickness (CIMT), and brachial artery flow-mediated vasodilation (FMD) were determined and compared among the groups., Results: Women with PCOS, especially obese ones, had higher triglycerides, HOMA-IR, total testosterone, CRP, systolic and diastolic blood pressure, and waist-to-hip ratio (WHR), and lower HDL. Serum obestatin levels were significantly lower in the obese PCOS group than they were in the nonobese and control groups (p<0.001). Serum copeptin levels were significantly higher in the obese PCOS group than they were in the nonobese PCOS and control groups (p<0.001). CIMT values were similar among the groups (p>0.05). Brachial artery FMD was lower in the PCOS groups than it was in the control group (p<0.001). Obestatin and FMD values were negatively correlated with cardiovascular risk factors, whereas copeptin was positively correlated. A significant positive correlation was found between copeptin, BMI, WHR, hirsutism score, total testosterone, and HOMA-IR. There was no correlation between CIMT, copeptin, obestatin, and FMD. A positive correlation was seen between CIMT, BMI, triglycerides, and HOMA-IR., Conclusion: Copeptin and obestatin may provide useful information regarding future cardiovascular risk in PCOS patients as copeptin was positively correlated and obestatin was negatively correlated with cardiovascular risk factors., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

Objective: We aimed to investigate the relationship between allergic rhinitis, which is an important reason of nasal obstruction, and maxillary sinus aeration., Patients and Methods: Three hundred fifteen patients who have a complaint of nasal obstruction and scheduled to undergo skin prick test (SPT) with a suspicion of allergic rhinitis (AR) were enrolled for this study. Thirty-two patients with positive SPT result and 30 patients with a negative SPT result were determined as group 1 and 2 (control group), respectively. A 3-dimensional reconstruction of computed tomography images of the 62 patients was used to assess and calculate maxillary sinus volumes (MSVs)., Results: Total maxillary sinus volumes were measured as 21.87 cm(3) and 30.15 cm(3) in group 1 and group 2, respectively. A statistically significant difference was observed between the MSVs of the groups (P < 0.001)., Conclusion: Total maxillary sinus volumes were found to be significantly smaller for patients with a positive SPT compared to patients with a negative SPT. Thus, we may conclude that AR has a negative impact on maxillary sinus aeration.

Objective: To date the anatomy of the popliteal artery variations using multidetector-row computed tomography angiography (MD CTA) was not assessed. The objective of this study is to establish 3D CT anatomy of the popliteal artery variations., Materials and Methods: A total of 126 lower limbs that underwent CTA using 64-detector MDCT were retrospectively reviewed. The anatomical variations of the distal popliteal artery branching were assessed., Results: Ninety-seven lower limbs (83.6%) had the usual branching pattern (type 1 A) with tibialis anterior artery (TA) arising first followed by the tibial-peroneal trunk, which then gives rise to the tibialis posterior artery (TP) and peroneal artery. Variations in popliteal branching pattern were seen in 19 (16.4%) limbs. The commonest variation was first branch of the TP in 5 (4.4%) of the limbs (type 1 C) or high origin with anterior course of popliteus muscle of the TA in 5 (4.4%) limbs (type 2 A II)., Conclusion: Many variations exist in the running patterns of the branching pattern of the popliteal artery. Knowledge of the branching pattern of the popliteal artery will be beneficial to radiologist for the evaluation of CT angiograms and interventional vascular procedures, and to vascular surgeons for various surgical approaches. MD CTA provides noninvasive means of assessing distal popliteal artery variations.

Introduction: Accessory Spleen (AS) is a very rare entity and usually near the spleen's hilum and in the tail of the pancreas. Pelvis reported as an atypical and a rare localization. AS may be formed during embryonic life, they rise from the left side of the dorsal mesogastrium as a result of imperfect fusion of separate splenic masses., Presentation of Case: We report a case of an AS presenting as an left adnexal mass in a middle-aged woman. Transvaginal ultrasonography and magnetic resonance imaging (MRI) revealed a left adnexial mass. Laparatomy was performed, and histological examination revealed that resected mass was splenic tissue., Discussion: An AS is an incidental finding of no clinical significance in most patients. AS are generally determined during radiological investigations or during open or laparoscopic surgeries. When, the AS settle in the adnexal area; the differential diagnosis could include the causes of adnexal masses like enlarged lymph nodes, subserous fibroid, ovarian tumors, organized hematoma, tuboovarian abscess., Conclusion: Althought pelvic accessory spleen is a rare condition, should be considered in the differential diagnosis of adnexal masses., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: To evaluate the effects of selective α1A-adrenoceptor antagonist tamsulosin hydrochloride on choroidal thickness using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT)., Methods: This is a prospective observational study including 29 eyes of 29 patients with newly diagnosed benign prostatic hyperplasia. Choroidal thickness and retrobulbar ocular blood flow measurements were performed at baseline and after 3 months of treatment. Results were analyzed by the masked observer., Results: The mean subfoveal choroidal thickness (275.8-291.9 µm) and thicknesses 750 µm nasal (257.9-270.4 µm) and 750 µm temporal (262.4-277.0 µm) to the fovea were significantly increased after 3 months of treatment (p < 0.001). No statistically significant change was found in retrobulbar ocular blood flow., Conclusions: Tamsulosin causes a significant increase in EDI-OCT-based choroidal thickness measurements. This increase might be associated with choroidal vasodilation in consequence of blockade of sympathetic α1A-adrenoceptors, which is critical for the maintenance of vascular tone and resistance in the choroidal vascular architecture. This should be kept in mind when choroidal disease and its response to treatment are followed by EDI-OCT imaging.

Background: Tumor necrosis factor-alpha (TNF-α) antagonist treatment is associated with 1.6 to 27 times higher risk of tuberculosis (TB)., Objective: To find TB incidence of psoriasis patients treated with TNF- α antagonists and define risk factors related with this condition in a country with moderately high risk of TB., Methods: Three hundred seventy psoriasis patients treated by anti-TNF agents in four referral centers were included. The data on the characteristics of the patients, TB history, tuberculosis skin test results, anti-TNF agent type and exposure time, localization of TB, and isoniazide prophylaxis state were analyzed., Results: Four patients (1.08%) developed TB, three pulmonary and one gastrointestinal, 2-23 months after initiating anti-TNF agents. Other than the patient with gastrointestinal TB, who was using methotrexate and corticosteroid concomitantly, none had contributing risk factors for TB. Two patients developed pulmonary TB in spite of chemoprophylaxis. Three patients with pulmonary TB completely recovered following antiTB treatment whereas patients with gastroinrestinal TB developed renal failure., Limitations: The major limitation of the study is the lack of a diseased control group, which enables us to compare the risk of psoriatics with that of patients having other inflammatory diseases., Conclusion: Tuberculosis is a rare but a severe complication of anti-TNF treatment and may develop in spite of chemoprophylaxis. The risk of TB in psoriasis patients in the present study is comparable to literature mostly based on rheumatology patients., (© 2015 The International Society of Dermatology.)

We conducted a prospective study to compare the effectiveness of conventional computed tomography (CT) and puffed-cheek CT in detecting the presence and extension of oral cavity malignant tumors. We enrolled 11 patients--5 men and 6 women, aged 32 to 85 years--who had a primary squamous cell carcinoma of the oral cavity. These tumors were located in the floor of the mouth in 4 patients, in the buccal mucosa in 4, in both the buccal mucosa and retromolar trigone in 2, and in the retromolar trigone only in 1. First, conventional contrast-enhanced axial CT was obtained through the oral cavity and neck in each patient. Next, axial imaging was obtained through the oral cavity while patients inflated their cheeks, pursed their lips, and held their breath. We found that the puffed-cheek CTs provided more information regarding the size and extent of the squamous cell carcinomas than did the conventional CTs. For example, in 8 patients, conventional CT could not differentiate the tumor from the normal mucosal surface, but puffed-cheek images clearly showed the surface of the tumor as distinct from the normal mucosa. More disconcerting was the fact that in the other 3 patients, conventional CTs were evaluated as normal, even though puffed-cheek imaging clearly showed the mass in each case. We conclude that puffed-cheek CT is superior to conventional CT for evaluating the mucosal surfaces of the oral cavity. It provides a clearer and more detailed picture with no downside.

Cyclosporin A (CsA), one of the most extensively investigated immunomodulatory agents, is widely used today in the treatment of various immunologically triggered dermatologic disorders. The immunologic basis for the therapeutic action of CsA depends on the suppression of lymphokine production by T cells. Due to its immunologic effects, this drug is also commonly preferred in Behcet's disease, especially with neurologic and ocular involvement. Since the course of this chronic disease presents remissions and exacerbations, drug therapy should be long term. Studies on the safety of long-term use of CsA in dermatologic diseases are limited. In this study, we aimed to evaluate the long-term use of CsA in Beh,et's disease without renal involvement. A total of 19 patients with ocular Beh,et's disease receiving CsA therapy for at least 1 year were included in this retrospective study. Changes in the parameters of renal function (creatinine clearance, creatinine level in serum), other adverse effects and their relation with cumulative CsA dosage were evaluated. The duration of CsA therapy and total dosage were not found to have a significant effect on the parameters of renal function, but, depending on clinical observations, the adverse effects seem to increase in the long term. We conclude that our results on renal function should be supported by renal biopsies.