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Objective: To evaluate the effect of pre-biopsy povidone-iodine rectal cleansing on post-biopsy hospitalization rates due to prostate biopsy-related infectious complications., Material and Methods: In this retrospective study, we reviewed 552 patients who underwent ultrasonography-guided transrectal prostate biopsy between 2014 and 2022. Group 1, 361 patients (January 2014-October 2020) were not applied povidone-iodine rectal cleansing, and group 2, 191 patients (November 2020-January 2022) were applied povidone-iodine rectal cleansing since we changed our biopsy protocol. All patients were given the same antibiotic prophylaxis, ciprofloxacin 500 mg, and ornidazole 500 mg twice daily starting 24 h before the biopsy and lasting a total of 5 days. Sodium phosphate enema was applied to all patients in the biopsy morning. The outcome was the hospitalization rates of patients because of infectious complications a month after the biopsy., Results: No patients were hospitalized in the povidone-iodine rectal cleansing group because of biopsy related complications. The hospitalization rate of group 1 was 3% and there was a statistical difference between groups., Conclusion: The povidone-iodine solution is cheap, safe and easy to apply. The povidone-iodine rectal cleansing method seems to decrease infectious complications related to prostate biopsy procedure, but we need a randomized controlled trial to confirm our study., Trial Registration: We got permission for this retrospective study from the Karabuk university ethics council with the number 2021/649 on 1 October 2021.

Background: Cardiovascular complications, including ventricular arrhythmias associated with abnormalities of ventricular repolarization, are the leading cause of morbidity and mortality in patients with acromegaly. Herein, we aimed to investigate ventricular repolarization using Tp-e interval, Tp-e interval/QT, and Tp-e interval/QTc ratios in acromegalic patients compared to healthy subjects., Methods: A total of 29 patients (aged 51.9 ± 11.2, 65.5% women) with acromegaly and 30 control subjects (aged 47.3 ± 14.4, 63.3% women) were enrolled in the study. Tp-e and QT interval, corrected QT (QTc), Tp-e/QT, and Tp-e/QTc ratios were calculated from the 12-lead electrocardiogram., Results: Tp-e interval (89.28 ± 12.16 vs. 75.97 ± 9.92 ms; p < 0.001), Tp-e/QT ratio (0.237 ± 0.045 vs. 0.212 ± 0.029; p = 0.019), and Tp-e/ QTc ratio (0.218 ± 0.031 vs. 0.195 ± 0.026; p = 0.003) were significantly higher in patients with acromegaly compared to control group. A positive correlation was determined between left atrial volume index (LAVI) and Tp-e interval (r = 0.272, p = 0.039)., Discussion: The current study is the first to have shown significantly increased Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in acromegalic patients. These results may be important for screening malignant arrhythmic events in acromegaly.

Background and Aim: This study aims to investigate the effects of chronic coffee consumption (>5 years) and type of coffee in non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver (NAFLD) and patients who have regular alcohol consumption., Materials and Methods: In this study, 158 healthy individuals and 101 patients with histologically proven NASH were enrolled. The daily amount of coffee intake, amount of alcohol use and type of coffee were calculated for all patients. The degree of steatosis and fibrosis was analyzed by transient elastography and liver ultrasound in non-NASH and by liver biopsy in NASH patients., Results: Patients with a history of coffee consumption (n=132) had lower liver enzyme levels compared to the non-coffee group (n=127) (p=0.001). Serum ALT level was significantly lower [ALT: 21.2±11.7 U/L vs. 56.4±15.6 U/L (p=0.004)], and the liver histopathology was significantly better for patients with a coffee consumption of daily for >5years (p=0.045 for fibrosis score for NASH, p=0.036 for LSM and p=0.015 for CAP measurements for the non-NASH patient)., Conclusion: Coffee seems to have a positive protective effect on liver histology and liver enzyme levels in healthy individuals, in patients with chronic alcohol consumption, NAFLD and NASH. These results are more prominent in patients who drink coffee on a regular daily base for more than five years., Competing Interests: The authors does mot have any conflict of interest., (© Copyright 2020 by Hepatology Forum.)

Background and Aim: Recent studies have reported that the widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULN<40U/L) is high for the healthy population. We aimed to find the correct ULN level for men and women in a presumed healthy liver population group., Materials and Methods: The data of 7410 healthy subjects visiting the check-up clinics were retrospectively analysed in this study. Patients were divided in to "healthy liver group" (n=2694) and "high-risk liver group" (n=4716) based on fatty liver on ultrasound, existing of chronic liver disease, ongoing significant alcohol consumption, diabetes mellitus and dyslipidaemia. Receiver operating characteristic (ROC) curves were generated and the area under the curve (AUC) was calculated at the 95 th percentiles for both men and women., Results: The AUC score of ALT for men was 0.92, and the ULN for the serum ALT in men was found as 32.10 U/L (sensitivity of 0.89, specificity 0.85). The AUC score of ALT for women was 0.90, and the ULN for serum ALT was found as 23.15 U/L (sensitivity of 0.90, the specificity of 0.88)., Conclusion: ULN for serum ALT level should be lowered and different cut-off values should be used for men (32.10 U/L) and women (23.15 U/L)., Competing Interests: The authors does mot have any conflict of interest., (© Copyright 2020 by Hepatology Forum.)

Lab-scale experiments were conducted to investigate the effects of ferrous iron on nutrient removal performance and variations in the microbial community inside aerobic granular sludge for 408 days. Two reactors were simultaneously operated, one without added ferrous iron (SBR1), and one with 10 mg Fe 2+  L -1 of added ferrous iron (SBR2). A total of 1 mg Fe 2+  L -1 of added ferrous iron was applied to SBR1 starting from the 191st day to observe the resulting variations in the nutrient removal performance and the microbial community. The results show that ammonia-oxidizing bacteria (AOB) could not oxidize ammonia due to a lack of iron compounds, but they could survive in the aerobic granular sludge. Limited ferrous iron addition encouraged nitrification. Enhanced biological phosphorus removal (EBPR) from both reactors could not be maintained regardless of the amount of ferrous iron that was applied. EBPR was established in both reactors when the concentration of mixed liquor suspended solid (MLSS) and the percentage of Accumulibacteria increased. A total of 10 mg Fe 2+  L -1 of added ferrous iron had a relatively adverse effect on the growth of AOB species compared to 1 mg Fe 2+  L -1 of added ferrous iron, but it encouraged the growth of Nitrospira sp. and Accumulibacteria, which requires further study. It could be said that the compact and stable structure of aerobic granular sludge preserved AOB and NOB from Fe-deficient conditions, and wash-out during the disintegration period. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:716-725, 2017., (© 2017 American Institute of Chemical Engineers.)

Objective: To determine whether urea and creatinine measurements in vaginal fluid could be used to diagnose preterm premature rupture of membranes (PPROM) and predict delivery interval after PPROM., Methods: A prospective study conducted with 100 pregnant women with PPROM and 100 healthy pregnant women between 24 + 0 and 36 + 6 gestational weeks. All patients underwent sampling for urea and creatinine concentrations in vaginal fluid at the time of admission. Receiver operator curve analysis was used to determine the cutoff values for the presence of PPROM and delivery within 48 h after PPROM., Results: In multivariate logistic regression analysis, vaginal fluid urea and creatinine levels were found to be significant predictors of PPROM (p < 0.001 and p < 0.001, respectively) and delivery within 48 h after PPROM (p = 0.012 and p = 0.017, respectively). The optimal cutoff values for the diagnosis of PPROM were >6.7 mg/dl for urea and >0.12 mg/dl for creatinine. The optimal cutoff values for the detection of delivery within 48 h were >19.4 mg/dl for urea and >0.23 mg/dl for creatinine., Conclusion: Measurement of urea and creatinine levels in vaginal fluid is a rapid and reliable test for diagnosing and also for predicting delivery interval after PPROM.

Aerobic granulation is a promising technology for wastewater treatment, but problems regarding its formation and stability need to be solved. Divalent metal ions, especially Ca 2+ , Mg 2+ and Mn 2+ , have been demonstrated to play an important role in the process of aerobic granulation. Here, we studied whether iron ions can affect aerobic granulation. Granular sludge formed without iron ion addition (<0.02 mg Fe 2+ L -1 ) was fluffy and had a finger-type structure and filamentous out-growth. The addition of iron ions to concentrations of 1 and 10 mg Fe 2+ L -1 repressed the finger-type structure and filamentous out-growth. The results show that chemical precipitation in the granules with iron ion addition was higher than that in the granules without ferrous addition. The amount of precipitates was higher inside the granules than outside. This study demonstrates that iron ions (Fe 2+ /Fe 3+ ) increase the size and stability of aerobic granular sludge but do not affect the granulation time, which is the time that the first granular sludge is observed. The study shows that aerobic granular sludge technology can be confidently applied to actual wastewater containing a high concentration of iron compounds.

Aim: To evaluate the treatment of endometrial hyperplasia (EH) with different progestins., Methods: Eighty-two women with simple EH without atypia were included. Patients were offered oral progestagens and were randomized to one of three options for 3 months: medroxyprogesterone acetate (MPA, 10 mg/day), lynestrenol (LYN, 15 mg/day) and norethisterone (NET, 15 mg/day) for 10 days per cycle. Patients were reevaluated after treatment. Women diagnosed with proliferative and nonatypical EH at the second curettage were offered the same progestins for another 3 months. The primary outcome of the study was the proportion of women requiring further treatment., Results: Of the 82 women, 46 (56.1%) received MPA (23.2%), LYN (13.4%) and NET (19.5%) therapy for another 3 months at the end of the first 3 months of treatment. The patients receiving MPA showed resolution in 36.7% of the cases versus 37% in the NET group. The highest resolution rate (56%) was observed in the LYN group, although there was no statistically significant difference between progestins regarding the proportion of women requiring further treatment (χ(2) = 2.608; p = 0.271)., Conclusion: It seems that the efficacies of oral progestins are similar at these dosages in simple EH without atypia., (Copyright © 2011 S. Karger AG, Basel.)