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Background: Indications and appropriateness of aspirin use have not been well investigated in Turkey. Aims: To investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. Study Design: Cross-sectional study. Methods: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) is a cross-sectional and multicenter study that included 5007 consecutive patients aged 18 or over who presented to 30 different cardiology outpatient clinics from 14 cities throughout Turkey. Only patients using aspirin (80-325 mg) were included. The study population was divided into 2 groups regarding the use of aspirin: primary prevention (PP) group and secondary prevention (SP) group. The indication of aspirin use was evaluated following the 2016 European Society of Cardiology (ESC) and the 2016 United States Preventative Services Task Force (USPTF) guidelines in the PP group. Results: A total of 5007 patients (mean age 62.15 ± 11.05, 39% female) were enrolled. The PP group included 1132 (22.6%) patients, and the SP group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71% of the patients according to the USPTF guidelines. Multivariate logistic regression analysis showed age OR: 0.98 CI (0.97-0.99) P = .037, smoking OR: 0.60 CI (0.44-0.82) P = .001, heart failure OR: 2.11 CI (1.14-3.92) P = .017, hypertension OR: 0.51 CI (0.36-0.74) P < .001, diabetes mellitus OR: 0.34 CI (0.25-0.47) P < .001, oral anticoagulant use OR: 3.01 CI (1.10-8.25) P = .032, and female sex OR: 2.73 CI (1.96-3.80) P < .001 were independent predictors of inappropriate aspirin use in PP patients. Conclusion: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in PP, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines. Besides, heart failure, oral anticoagulant use, and the female sex of the patients were independent predictors of inappropriate use of aspirin. INSET: 183. [ABSTRACT FROM AUTHOR]

Objective: Bacillus Calmette-Guérin (BCG) limited availability, cost, and allergic response in some patients limit its use, leading to the search for alternative agents. We aimed to present the outcomes of intermediate- and high-risk non-muscle invasive bladder cancers treated with bladder wall thermochemotherapy (BWT) system via a single-arm prospective study. Materials and Methods: Overall, 44 patients were enrolled and subjected to a treatment with mitomycin-C and BWT for 6 weeks, followed by a monthly maintenance for up to 1 year. The recurrence rate, progression rate, recurrence-free survival, progression-free survival, and side effects were evaluated. Results: In the intermediate- and high-risk groups, the median follow-up duration was 14 and 17 months; recurrence rates were 28.6% and 23.3%; progression rates were 7.1% and 23.3%; the recurrence free survival at the 24th month were 78.6% and 80.0% and the progression free survival at the 24th month were 92.6% and 76.7%, respectively. All the patients suffered from dysuria lasting for 2-3 days; five of the 442 BWT application developed allergic reactions requiring treatments with oral agents. Conclusion: BWT showed comparable recurrence and progression rates, but seemed safer than BCG when our findings were compared to those of published studies. It could be an alternative for individuals who are not suitable for BCG or in a case of BCG unavailability. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Urological Surgery is the property of Galenos Yayinevi Tic. LTD. STI 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: Falls are a significant cause of morbidity and mortality, particularly in hospitalized patients. In this study, we aimed to evaluate the risk of falls in the patients hospitalized in a urology clinic. Materials and Methods: The study included patients that were hospitalized in a urology clinic between November and December 2018. All the patients were administered both Itaki Fall Risk scale (IFS) and Morse Fall scale (MFS). Demographic and clinical characteristics, history of falls within the past six months, type of surgery, primary diagnosis (urooncological vs non-urooncological), and the department/unit from which the patients were referred [outpatient clinic vs emergency service/intensive care unit (ICU)] were recorded. Results: The risk of falls was significantly higher in the patients with urooncological diseases compared to the patients with non-urooncological diseases (p<0.001) and in the patients referred from emergency service/ICU compared to the patients referred from outpatient clinics (p<0.001). Moreover, the patients with a history of falls within the past six months were found to be at higher risk of falls compared to the patients with no history of falls both on IFS and MFS (p=0.002, p=0.01, respectively). Conclusion: Hospitalized patients should be closely followed due to the risk of falls, particularly the cancer patients and the patients referred from the emergency service or ICU. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Urological Surgery is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Purpose: We aimed to present our clinical experience with percutaneous antegrade ureteral stent placement in a single center.Methods: Electronic records of patients who underwent percutaneous image-guided ureteral stent placement between September 2005 and April 2017 were reviewed. A total of 461 patients (322 males, 139 females; age range, 19-94 years; mean age, 61.4±15 years) were included in the study. Patients were classified into two main groups: those with neoplastic disease and those with non-neoplastic disease. Failure was defined as persistence of high level of serum creatinine or an inability to place stents percutaneously. Postprocedural complications were grouped as percutaneous nephrostomy and stent placement related complications.Results: A total of 727 procedures in 461 patients were included in the study: 654 procedures (90%) in 407 patients (88.3%) were in the neoplastic group and 73 procedures (10%) in 54 patients (11.7%) were in the non-neoplastic group. Our technical success rates were 97.7% and 100% and complication rates were 3.1% and 4.1% in neoplastic and non-neoplastic groups, respectively. Seven stents retrievals and 112 balloon dilatations were performed successfully.Conclusion: Percutaneous antegrade ureteral stent placement is a safe and effective method for management of ureteral injuries and obstructions due to both malignant and benign causes when the retrograde approach has failed. [ABSTRACT FROM AUTHOR]

Objective: Periprostatic nerve block (PPNB) and intrarectal local anesthesia (IRLA) are two of the most commonly used methods for pain control in the transrectal ultrasonography (TRUS)-guided prostate needle biopsy procedure, which is the standard method for the diagnosis of prostate cancer. This study compared the efficacy of IRLA alone and with PPNB using lidocaine or prilocaine. Materials and Methods: A total of 64 patients with suspicious rectal examination symptoms and/or serum prostate-specific antigen (PSA) elevation underwent standard 12-core TRUS-guided prostate needle biopsy. The patients were divided into 3 groups: IRLA with lidocaine gel only (group 1), IRLA with lidocaine gel plus PPSB with 2% lidocaine injection (group 2), and IRLA with lidocaine gel plus PPSB with 2% prilocaine injection (group 3). Patients' pain levels were assessed by visual analog scale (VAS) immediately (VAS-1) and at 45 minutes (VAS-2) after prostate biopsy. In addition, serum PSA levels, age, body mass index (BMI), prostate volume, and cancer detection rates of the patients were recorded. Results: There were no statistical differences between the groups in terms of total PSA, age, BMI, prostate volume, or cancer detection rates. According to VAS-1 score, group 1 had more severe pain compared to the other groups, while there was no significant difference between groups 2 and 3. When VAS-2 score was examined, group 1 experienced the most severe pain, while group 3 was the least painful group. When asked which biopsy step was the most painful, all groups reported that introduction of ultrasound probe into the rectum was the most painful. Conclusion: The combination of IRLA and PPNB seems to be a more effective method than IRLA alone for pain control during TRUS-guided prostate biopsy. Prilocaine and lidocaine have comparable onset but the effect of prilocaine lasts longer. Therefore, prilocaine is a preferable agent for prostate biopsy under TRUS guidance. [ABSTRACT FROM AUTHOR]

The aim of our study is to investigate change in the impact of Turkish Orthopedics and Traumatology on the international scientific literature by examining the success of the Acta Orthopaedica et Traumatologica Turcica (AOTT) journal. All clinical research articles published in the AOTT between 2006 and 2015 were included in the study. The number of citations and the factors (number of centers participating in the study, the origin of study (domestic-foreign), design, level of evidence, type and subtype of studies) that may affect the number of citations were evaluated. A total of 517 clinical research articles were evaluated. There has been an increase in the citation rate over the last five years (p=0.046). The majority of the articles were multi-center (54.9%) and domestic-origin (85.1%). In the last five years, there has been an increase foreign-origin articles (p=0.01). The majority of the articles was level 4 (76.2%) and designed retrospectively (95.9%). In the last five years, there has been an increase in the evidence levels of the articles and prospectively design studies (p=0.07, p=0.157, respectively). The majority of the articles were related to treatment of the diseases (74%). In the last five years, there has been an increase in the studies related to economic and decision analysis (p=0.055). Articles were mostly related to trauma (26.5%). In the last five years, there has been an increase in the number of articles related to arthroplasty, and a decrease in those associated with foot-ankle and pediatric orthopedics (p=0.022, p=0.036, p=0.007, respectively). As a result; it was seen that Turkish Orthopedics and Traumatology increased its influence on the international scientific literature between the years 2011-2015. [ABSTRACT FROM AUTHOR]

Copyright of Istanbul Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Copyright of Istanbul Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI 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: To examine the relationship of neutrophil counts, lymphocyte count and neutrophil-to-lymphocyte ratio (NLR) with postoperative fever in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: A total of 519 patients aged over 18 years, who underwent PCNL between January 2005 and January 2013 and had a preoperative white blood cell count between 4000-12,000/µL, were included in this study. Conditions that could lead to postoperative fever or impact blood parameters constituted the exclusion criteria. At the postoperative period, the patients were divided into two groups based on the presence of fever. Age, gender, Body Mass index, stone size, number of percutaneous access, duration of operation, preoperative white blood cell count, neutrophils, lymphocytes, and NLR were compared. The relationship of these parameters with fever was evaluated with univariate and multivariate analyses. Results: The group with fever included 50 patients and the group without fever, 469 patients. The difference between the two groups was statistically significant in terms of neutrophil and lymphocyte counts, and NLR. Univariate analysis revealed that preoperative thrombocyte count, lymphocyte count, neutrophil count, and NLR were the parameterss significantly related with fever, yet, in multivariate analysis, the only statistically significant parameters related with post-PCNL fever were age, thrombocyte count, and white blood cell count. Conclusion: When risk factors for fever are excluded, lymphocyte count and NLR appear to be easy-to-use and affordable diagnostic markers to predict postoperative fever in patients undergoing PCNL. [ABSTRACT FROM AUTHOR]