Search

OBJECTIVE: Sepsis remains a common cause of death. The cereblon (CRBN) protein, which is involved in important cellular processes, plays a role in sepsis. This cross-sectional study aimed to show the CRBN protein expression and its effects on patients in the intensive care unit. PATIENTS AND METHODS: Samples were taken by deep tracheal aspiration from patients. The presence of CRBN was pathologically investigated using immunohistochemical tests and polyclonal antibodies against CRBN. The relationship between gender, sepsis, steroid, survival and the presence of CRBN was examined. RESULTS: Respiratory and neurologic diseases were the most common reasons for admission. Acinetobacter was the most frequent microorganism. In patients with more than normal inflammatory cells, a negative correlation was observed between CRBN expression and leukocyte rate (p=0.031). In patients with CRBN, there was no correlation between steroid and mortality, APACHE/ Glasgow score, hospital stay length, and ICU. CONCLUSIONS: Although the prognosis for sepsis is better in CRBN-deficiency animals, the presence of CRBN in humans does not affect it. In our study, CRBN decreased as inflammatory cells increased in the patient’s aspiration material. The response to steroids, an immunomodulator, did not change with the presence of the immunomodulator target molecule, CRBN. Therefore, using immunomodulators in the treatment of sepsis should be reconsidered. [ABSTRACT FROM AUTHOR]

INTRODUCTION: To evaluate indications for intraoperative frozen section (IFS) during robot assisted laparoscopic radical prostatectomy (RALRP) in our series. PATIENTS AND METHODS: Prospectively documented 80 patients with prostate cancer (PCa) who underwent RALRP were evaluated between June 2010 and July 2012. Patients were divided into 2 groups according to whether systematically IFS was performed or not. Group 1 (n=66) consisted of patients on whom systematic IFS was performed, Group 2 (n=14) consisted of patients on whom IFS was not performed. All recorded data evaluated and statistical analyses were performed for determining indications and predictive factors for IFS during RALRP. All patients were operated by single surgeon and IFS, pathological assessments were performed by experienced uropathologist. Statistical significant p value was p < 0.05. RESULTS: Mean follow-up was 15±6 (25-4) months. Pre-operative prostate volume in trans-rectal ultrasonography (TRUS) was statistically higher in Group 1 than Group 2 (p = 0.037).The other parameters were statistically similar in both groups. According to outcomes of our study IFS was a dependent factor for positive surgical margin. Additionally, the cut off value of prostate volume in TRUS for IFS was 55.5 cc for IFS. CONCLUSIONS: Preoperative measured prostate volume in TRUS may be an indicator of IFS. Therefore, more accurate information may be given to patients with prostate cancer (Pca) before RALRP by using preoperative prostate volume in TRUS. [ABSTRACT FROM AUTHOR]

The article discusses a study on the effects of starch sources with various degradation rates on biochemical parameters in the blood of lactating Holstein dairy cows housed at the University of Uludag in India. Vacutainer blood collection tubes were used to take blood samples from vena jugularis external of the cows. The wheat and corn based diet (WCBD) group demonstrated lower values for total cholesterol compared with the CBD group. All groups failed to show significant difference for glucose.

Background: This study aimed to determine the tendency of older adults to present to the emergency department with pain complaints during the COVID-19 pandemic compared to the prepandemic period., Methods: A cross-sectional, retrospective study design was used. Data were collected from the electronic medical records of older people who presented to emergency departments with pain before (March 2019-March 2020) and during the COVID-19 pandemic (April 2020-July 2021). We identified 10 pain diagnosis groups using ICD-10 codes. Patient data were grouped and cleaned using SQL scripts on the Oracle database., Results: It was determined that 13.3% of 405,404 older people had presented to the emergency department with pain between March 2019 and July 2021. There was a 14.2% decrease in such admissions during the pandemic period. In the study, an increase was observed in the rates of older adults presenting to the emergency department with myalgia and joint pain. In contrast, the rates of those presenting with low back and neck pain, headache, eye pain, dysuria, and acute pain decreased during the pandemic. In the regression analysis, predictors for older adults' presentation to the emergency department with pain included age over 85 years (OR: 1.403), female gender (OR: 1.053), and myalgia (OR: 2.471)., Conclusions: During the COVID-19 pandemic, our study revealed fewer presentations to the emergency department for pain-related complaints. To prevent severe health problems from delayed care, we recommend expanding telemedicine, remote pain management, and home-based care. Further research is needed to examine the long-term effects of increased myalgia and joint pain., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Objectives: Cardiovascular surgery advancements have emerged with various minimally invasive approaches for treating multivessel coronary disease to improve outcomes and minimize the burden associated with conventional cardiac surgery. We present our clinical experience and minimally invasive coronary bypass techniques through minithoracotomy, which we apply without selection to patients who have decided to have elective surgery for multivessel isolated coronary artery disease., Methods: It consists of 230 consecutive patients operated by the same team with this method between July 2020 and September 2022. The patients were assigned to one of the two methods preoperatively to their accompanying comorbidities and operated on either with blood cardioplegia via 5 to 7 cm left anterior minithoracotomy, with on-pump clamped technique or without pump via left anterolateral minithoracotomy., Results: Mortality was observed in two of our patients (0.9%), but myocardial infarction was not observed in our patients in the early postoperative period. None of our patients required conversion to sternotomy (0%). Five patients' needed reoperation from the same incision due to postoperative bleeding (2.2%), and atrial fibrillation developed in 17 patients in the postoperative period (7.4%). The mean number of bypasses was found to be 3.0 ± 0.9., Conclusions: Minimally invasive coronary artery bypass surgery via minithoracotomy can be routinely reproduced safely. More long-term results and more multicenter studies are needed for more widespread acceptance of the technique.

Introduction Diabetic foot ulcers (DFU) are one of the most common complications of diabetes mellitus (DM). The use of platelet-rich plasma (PRP) in the treatment of DFU has been increasing in recent years. In the current study, we aimed to evaluate the factors affecting the success of PRP in the management of DFU. Methods The present study was planned in a prospective manner, and we enrolled patients with DFU in the study. Patients' characteristics, DFU properties, and treatment outcomes were recorded. Patients with DFU were classified into two groups according to PRP success: healed DFU patients in Group 1 and non-healed DFU patients in Group 2. Groups were compared according to patient characteristics and treatment outcomes, and multivariate regression analysis was performed to clarify factors that predicted PRP success. Results In total, 182 patients were enrolled in the study, and DFU in 141 (77.5%) patients healed with PRP treatment. The mean body mass index (BMI) was significantly higher in the non-healed patients (p= 0.005). The smoking rate was 58.5% in the non-healed group and 39.7% in the healed group (p= 0.016). The duration of DM (17.9 years vs. 22.5 years, p= 0.003) was significantly longer, and patients with glomerular filtration rate (GFR) < 60 (44.0% vs. 63.4, p= 0.028) were significantly more common in the non-healed group. Multivariate regression analysis demonstrated that BMI ≥30 kg/m 2  and duration of DM ≥20 years were predictive factors for PRP failure in patients with DFU (p= 0.019 and p= 0.005). Smoking and GFR <60 were significantly associated with PRP failure (p= 0.040 and p= 0.044). Conclusion In our study, it was found that PRP was an effective treatment that improved DFU in 141 out of 182 patients. Moreover, the present study demonstrated for the first time that higher BMI, longer duration of DM, smoking, and lower GFR were significantly related to PRP failure in patients with DFU., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kanber et al.)

Purpose:  Phyllodes tumors (PTs) are uncommon fibroepithelial breast lesions that are classified as three different forms as benign phyllodes tumor (BPT), borderline phyllodes tumor (BoPT), and malignant phyllodes tumor (MPT). Conventional radiologic methods make only a limited contribution to exact diagnosis, and texture analysis data increase the diagnostic performance. In this study, we aimed to evaluate the contribution of texture analysis of US images (TAUI) of PTs in order to discriminate between BPTs and BoPTs-MPTs., Methods:  The number of patients was 63 (41 BPTs, 12 BoPTs, and 10 MPTs). Patients were divided into two groups (Group 1-BPT, Group 2-BoPT/MPT). TAUI with LIFEx software was performed retrospectively. An independent machine learning approach, MATLAB R2020a (Math- Works, Natick, Massachusetts) was used with the dataset with p < 0.004. Two machine learning approaches were used to build prediction models for differentiating between Group 1 and Group 2. Receiver operating characteristics (ROC) curve analyses were performed to evaluate the diagnostic performance of statistically significant texture data between phyllodes subgroups., Results:  In TAUI, 10 statistically significant second order texture values were identified as significant factors capable of differentiating among the two groups (p < 0.05). Both of the models of our dataset make a diagnostic contribution to the discrimination between BopTs-MPTs and BPTs., Conclusion:  In PTs, US is the main diagnostic method. Adding machine learning-based TAUI to conventional US findings can provide optimal diagnosis, thereby helping to choose the correct surgical method. Consequently, decreased local recurrence rates can be achieved., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Introduction: Music is widely used to reduce anxiety, and the beneficial effects of music on anxiety are well established. Maqams represent a system of melodic modes used in traditional Turkish music. Different maqams may have different effects on anxiety., Objective: The current study intended to investigate the effects of Hicaz and Huseyni maqams on anxiety and to evaluate whether a difference in effects exists., Design: The research team performed a preliminary, randomized controlled trial., Setting: The study took place in the Department of Family Medicine, Faculty of Medicine and the Department of Music, Faculty of Fine Arts, at Izmir Democracy University in Izmir, Turkey., Participants: The participants were 87 volunteers between the ages of 18 and 27, who were students studying at the university., Intervention: The participants were randomly divided into three groups, with 29 participants in each group. One intervention group listened to the music in the Hicaz maqam-the Hicaz group-and the second listed to the music in the Huseyni maqam-the Huseyni group-for 30 minutes a day for a week. The control group received no intervention., Outcome Measures: The Beck Anxiety Inventory (BAI) was used to measure participants' level of anxiety., Results: No significant differences existed between the three groups in the BAI scores at baseline (P = .97). For the Hicaz and Huseyni groups, a significant decrease was found in the mean BAI scores between baseline and postintervention (P < .001), but no statistically significant difference was found for the control group (P = .29). No statistically significant difference in the BAI scores existed postintervention between the Hicaz and the Huseyni groups (P = .66) or between the Hicaz group and the control group (P = .06), but a statistically significant difference did exist between the Huseyni and the control groups (P = .01)., Conclusions: Listening to music is an effective auxiliary method for reducing anxiety. The type of music to which an individual listens can affect this benefit, with some types having a greater positive effect than others.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.

Purpose: To determine how often os trigonum is accompanied by accessory navicular and os peroneum. A secondary aim of the study was to investigate the bone and related tendon pathologies that may develop in these three accessory bones., Materials and Methods: A total of 110 patients who were evaluated by ankle MRI and were determined with os trigonum between 2009-2015 were included in the study. The frequency was determined of os trigonum together with accessory navicular bone and os peroneum. MR images were also evaluated in respect of bone pathologies and related tendon pathologies of these 3 accessory bones., Results: Of 110 patients determined with os trigonum on MRI, 21 (19%) were also determined with accessory navicular bone and 5 (4.5%) with os peroneum.When bone pathologies were examined, the most frequently seen pathology was bone marrow edema.The most common pathology in the tendons related to the accessory bones was increased amount of synovial fluid within the tendon sheath. In cases with os trigonum, bone changes were observed more frequently than pathologies of the adjacent tendons, in the accessory navicular bone cases, tendon pathologies were observed more than bone changes and in the cases with os peroneum, bone and tendon pathologies were determined at equal rates.There was no significant difference in terms of FHL tendon pathology between patients with and without edema in os trigonum. However, TP tendon was significantly more pathological in patients with edema in accessory navicular bone., Conclusion: More than one accessory bone was determined in approximately one in four cases.The most common pathologies determined in these accessory bones was bone marrow edema and increased amount of synovial fluid within the tendon sheath.It is necessary to investigate and report all these findings on MRI as they play an important role in the explanation of clinical findings and treatment planning., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: Recently laparoscopic radical prostatectomy (LRP) is a minimally invasive surgical option for prostate cancer (PCa) treatment in the lack of robot. To eliminate numbers of trocars and to modify surgical technique can make the LRP procedure easier. We aimed to introduce our novel approach on LRP by using just only 3 trocars and to compare conventional extraperitoneal LRP (eLRP) with 3 trocars eLRP. METHODS: Of the 223 PCa patients undergone eLRP were divided into 2 groups as Group 1 (n=69) consisted of conventional eLRP, Group 2 (n=154) consisted of consecutive 3 trocars eLRP. Demographic, operative, postoperative, and short-term follow-up data including functional results were analysed. RESULTS: Mean follow-up was 10.9±5.1 months. Preoperative and demographic parameters were comparable between the groups. Mean operative time, intraoperative used carbon dioxide (CO2) gas, and hospital stay were significantly shorter in Group 2 (for all parameters p<0.001). Haemoglobin decrease was also less in Group 2 without statistical significance. Oncologic and functional results were similar. There was no major complication in Group 2. CONCLUSIONS: According to our results 3 trocars eLRP can be performed safely and effectively in experienced hands. Haemorrhage, operative time, CO2 usage, and hospital stay could be shortened with our novel approach.

Objective: To compare the efficacy between motorized articulating instruments (AI) and rigid conventional laparoscopic instruments (CI) in chancing visualizing systems, respectively two-dimension (2D) and three-dimension (3D)., Methods: Sixty physicians were divided into three groups according to their previous experience as medical students (Group 1), residents (Group 2), and expert surgeons (Group 3). Four experimental sets were created, respectively CI-2D visualizing system (CI-2D), CI-3D visualizing system (CI-3D), AI-2D visualizing system (AI-2D), and AI-3D visualizing system (AI-3D) platforms. European training in basic laparoscopic urological skills (E-BLUS) and anastomosis tasks (ın total five tasks) was used. All participants were randomly required to perform tasks in each one of the technical platforms, except anastomosis exercises that were performed as the last exercises. Duration of tasks were measured, and predefined errors were counted. All these were recorded, and completion quality samples were evaluated. Significant p was p < 0.05., Results: Significant time reduction and improvement in quality of tasks were observed in favor of Group 3, in all sets for all tasks (p < 0.001). Quality of the tasks was significantly improved in AI-3D in Group 1 and Group 2 for all tasks. Task 5 was the most difficult one and needed more experience to be completed with quality. Even, Group 3 was the experienced group; AI with 3D display enabled Group 3 to improve performance with increased quality without statistical significance., Conclusion: The AI-3D visualizing system can provide more successful completion in E-BLUS tasks than CI-2D, AI-2D, and CI-3D visualizing systems for the beginners in urologic laparoscopy, not for experts. Besides, AI with 3D display enable surgeons to improve their performance with increased quality of tasks, in anastomosis.

Objectives: To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients., Materials and Methods: Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alphablockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p<0.05., Results: In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p<0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1st and 6th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p<0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS., Conclusions: MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS., (Copyright® by the International Brazilian Journal of Urology.)

Purpose: To investigate relationship between overactive bladder (OAB) and metabolic syndrome (MtS) by using neck circumference (NC)., Methods: In retrospective view of prospective collected data, 204 women with or without OAB were enrolled into study, between August 2012 and December 2013. All patients were administered OAB validated questionnaires (OAB-V8) and whose score was > 8 were accepted as OAB. Patients were divided into two groups and group 1 consisted of patients with OAB, group 2 consisted of patients without OAB. Demographic data with anthropometric measurements and blood analyses were recorded. Statistical analyses including receiver operating characteristic (ROC) curves were performed; statistically significant p was < 0.05., Results: Mean age was 41.06 ± 9.78 years. There were 115 (56.4 %) patients in group 1, and 89 (43.6 %) patients in group 2. OAB-V8 scores were significant higher in group 1 than group 2 (p < 0.001). Waist circumference (WC) and NC measurements were statistical significant longer in group 1 than group 2 (p < 0.001). In multivariate logistic regression analyses age, body mass index, MtS, WC, and NC were statistical significant associated with OAB. In ROC curves, area under the curve (AUC) was 0.72 cm 2 for relationship between OAB and WC (p < 0.001), and AUC was 0.73 cm 2 for relationship between OAB and NC (p = 0.004). Cut-off NC and WC values for OAB were determined as 35.25 cm and 98.5 cm, respectively., Conclusions: OAB with metabolic syndrome seems like more common in women than in those without. NC may be a novel indicator for OAB in selected female patients with MtS.

Objective: To evaluate the effects of thiocolchicoside during endoscopic treatment of ureteral calculus., Material and Methods: Between May 2014 and December 2014, 498 consecutive patients were enrolled. Exclusion criteria were operations under general anaesthesia, chancing laser lithotripter settings, and urinary tract infection. All patients were divided into three groups: Group 1 consisted of patients who were not administered thiocolchicoside, group 2 consisted of patients who were administered 5 mg thiocolchicoside, and group 3 consisted of patients who were administered 10 mg thiocolchicoside. Demographic, perioperative, and postoperative data were recorded. Complications were noted according to Clavien-Dindo classifications. A p value of p ≤ 0.05 was considered statistically significant., Results: A total of 427 patients (319 male and 108 female) with full data were investigated. Mean age was 43.3 ± 13.3 years. There were 157 patients in group 1, 141 patients in group 2, and 129 patients in group 3. Stone migration and operation time were significantly lower in groups 2 and 3 than in group 1 (respectively; p < 0.001, p = 0.03). However, usage of jj stents was significantly lower in group 3 than in the other groups (p < 0.001)., Conclusion: Stone migration can be decreased by using locally administered thiocolchicoside in irrigation solution during endoscopic treatment of ureteral calculus. Additional doses may decrease usage of jj stents and operation time.

Objectives: The objective of the present study was to evaluate anti-inflammatory effects of hydroxyfasudil in a protamine sulfate (PS) induced cystitis rat model. Additionally, we investigated prevention of bladder overactivity (BO), and tissue damage in these experiments., Methods: Animals were divided into four groups. In Groups 1 and 2, chemical induced cystitis model was created by administrating intravesical PS with PE50 catheter by the transurethral route. In Group 1, Rho-kinase inhibitor hydroxyfasudil was administered intaperitoneally, and in Group 2, subjects were administered a corresponding volume of saline in the same way. In Group 3, vehicle was administered intravesically and hydroxyfasudil was administrated intraperitoneally. Group 4 was a control Group, and the vehicle was administered intravesically and intraperitoneally. Micturition frequencies were recorded. Biochemical analyses were performed for oxidative stress, and pathological evaluations were investigated. In vitro contractions of bladder tissue strips were measured in tissue-bath., Results: There were significantly lower Lipid peroxidase levels and higher levels of Glutathione in Group 1 than Group 2 (P = 0.016, P = 0.001, respectively). There was generally more inflammation in Group 2 than the other groups as determined by microscopy. There were significantly higher frequencies of micturition, lower volume, and mean voided maximum urine output after PS administration in Groups 1 and 2. In vitro contraction responses of bladder strips to potassium chloride and acetylcholine were statistically higher in Group 2 than Groups 1 and 3., Conclusions: Significant reduction of inflammation by affecting the anti-oxidant defense systems was provided by hydroxyfasudil. Decreased in vitro responses to contractions of bladder smooth muscle strips were obtained. Hydroxyfasudil may be a potential new therapeutic option for inflammation and BO, in rat bladder., (© 2014 Wiley Publishing Asia Pty Ltd.)

Objective: The aim of this study was to investigate endoscopic treatment in children with primary vesicoureteral reflux (VUR) and conduct a multivariate analysis of factors for failure., Material and Methods: Between August 2006 and January 2012, 216 children (32 boys and 184 girls) with primary VUR (grades I-IV) who underwent endoscopic treatment were analysed. Patients with grade V VUR were excluded. Hydrodistension tests and intraureteral injection techniques were performed, if applicable. Urinary ultrasound and voiding cystourethrography were studied 3-6 months after surgery. Univariate and multivariate logistic regression were used for statistical analyses., Results: In total, 172 children (21 boys and 151 girls) were enrolled, and 280 ureters were treated (108 bilateral, 64 unilateral; three with grade I, 34 with grade II, 214 with grade III and 29 with grade IV VUR). The median (± SD) age was 7.8 ± 3.1 years (boys 7 ± 3.1 years, girls 7.9 ± 3.1 years). The mean (± SD) follow-up was 24.4 ± 4.1 months (boys 28.2 ± 8.1 months, girls 21.4 ± 4.1 months). Mean injected volume per ureter was 1.8 ± 0.5 ml. A single injection resolved the reflux in 79.6% and a second injection resolved it in 90.4% of ureters. Eight children (4.6%) had postoperative febrile urinary tract infections (fUTIs). Postoperative fUTIs were significantly associated with failures in injection (p < 0.001). Renal scars were significantly associated with postoperative fUTI (p = 0.006). Haematuria occurred in three children (minor complication); a non-functional kidney was observed in one child (major complication) and a laparoscopic nephrectomy was performed. Fourteen children underwent ureteroneocystostomy owing to unsuccessful VUR treatment., Conclusions: Endoscopic injection of small-diameter microsphere (80-120 μm) non-animal dextranomer-hyaluronic acid copolymer seems to be an effective treatment for VUR. Only postoperative fUTI and the presence of a renal scar were correlated with failed endoscopic treatment of VUR.

Objective: To evaluate the correction rate of urinary flow rate after posterior urethral valve (PUV) resection for predicting success after operation., Methods: This retrospective study was performed between March 2006 and February 2013 at the Department of Pediatric Urology, Akdeniz University School of Medicine, Antalya, Turkey. Of the 67 patients with PUV, 52 patients were enrolled. Physical examinations, urine and blood analyses, uroflowmetry (UFM) including maximum flow rate (Qmax) and average flow rate (Qavg), and post voiding residual urine volume (PVR) were recoded. The UFM, PVR, voiding cystourethrography, serum creatinine levels were recorded in clinical visits. Additional operations were performed if there were symptoms of urinary obstruction. Statistical analyses were carried out., Results: The mean age was 9+/-2.9 years. The mean follow-up was 10.6+/-4.2 months. There was a significant difference between preoperative and postoperative serum creatinine (p=0.028), Qmax (p=0.001), Qavg (p=0.002), and PVR (p=0.001). Postoperative serum creatinine was significantly positively correlated with postoperative PVR (p=0.024). In logistic regression analysis, success on PUV resection was associated with preoperative Qavg (p=0.016) and PVR (p=0.004), and postoperative Qavg (p=0.039) and PVR (p=0.030). Of the 42 (80.7%) patients, significant improvements in UFM, PVR, and serum creatinine levels were obtained after first operation. In 10 patients, re-operations were performed., Conclusion: Short-term effectiveness of PUV resection may be predicted by changes in UFM and PVR parameters in selected patients.

Introduction: Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide. It is an important health problem especially in women of reproductive age. IDA may cause anxiety, which is the major factor for female sexual dysfunction (FSD)., Aim: The aim of the present study was to determine the impact of IDA on FSD in women of reproductive age., Methods: In total, 207 women were enrolled. Women with IDA who were admitted in an outpatient clinic of family medicine were asked to complete Beck Anxiety Inventory (BAI), Female Sexual Function Index (FSFI), and Quality of Life (QoL) questionnaires. Questionnaires were completed before and after IDA treatments. Blood samples were obtained for measurements of hemoglobin, hematocrit, levels of serum iron, and iron-binding capacity., Main Outcome Measures: Outcomes of blood samples were used for diagnosing of IDA. BAI, FSFI, and QoL scores were evaluated. Paired samples t-tests and Pearson correlation analyses were used to assess relationship between findings of IDA treatments and other parameters., Results: The mean age was 33.6 ± 8.4 years. There were statistical significant differences between pre- and posttreatment in terms of hemoglobin, hematocrit, serum iron, and serum iron-binding capacity. BAI scores were decreased and FSFI scores, which were statistically significant, increased after IDA treatments (P < 0.001). However, QoL scores were developed without statistical significance., Conclusion: There is a risk for anxiety as well as FSD in IDA women of reproductive age. Treatment of IDA can significantly improve sexual functions and QoL in these women population in short term., (© 2014 International Society for Sexual Medicine.)

Purpose: To compare renal injury and vascular resistance between standard and tubeless percutaneous nephrolithotomy (PCNL) in patients who had undergone procedures for kidney stone by using colored Doppler ultrasonography (CDUS)., Patients and Methods: All consecutive PCNLs were evaluated between 2009 and 2011. Patients in whom access was in the lower pole, and who regularly visited our outpatient clinic were enrolled in the study. Patients who underwent standard PCNL were included in group 1, and patients who underwent tubeless PCNL were included in group 2. All data were collected from patients' files. CDUS was performed to evaluate the resistive index (RI), parenchymal thickness, and parenchymal echogenicity before the operation, in the early postoperative period (7 days after catheter removal in group 1 and 7 days postoperatively in group 2), and during the midterm period (6 months postoperatively). Statistical significance was accepted at P<0.05., Results: The mean patient age was 47.54±13.26 years. There were 33 patients in group 1 and 28 patients in group 2. The mean follow-up duration was 10.71±1.2 months. There were no significant differences in demographic data between the two groups. The hospital stay was longer in group 1 than in group 2 (P=0.038). The mean operative time was shorter in group 2 than in group 1 (P=0.001). An increase in RI and a decrease in parenchymal thickness in the midterm follow-up period were noted when compared with the preoperative RI kidneys that had undergone operations in the lower pole., Conclusions: Although tubeless PCNL was successful and was associated with a shorter hospital stay and less kidney damage in the short-term period compared with standard PCNL, both procedures may cause an almost equal degree of damage in the midterm.

Background: Premature ejaculation (PE) is the most common sexual disorder in men and studies reported prevalence up to 30% (1, 2). PE is not a life-threatening medical condition but it influences the quality of life (QoL)., Objectives: The aim of this study was to compare the efficiency, and safety of alpha blocker drugs in the treatment of patients with premature ejaculation (PE). Additionally we investigated the quality of life (QoL) in patients with PE who were treated with alpha blocker drugs., Materials and Methods: This study was a pilot clinical trial. Prospectively documented 108 patients with PE were treated and were followed-up in urology outpatient clinic. All patients were divided into 5 groups according to used alpha blocker agents which were determined by simple randomization. Silodosin 4mg (Group 1, n = 21), tamsulosin hydrochloride 0.4mg (Group 2, n = 23), alfuzosin 10mg (Group 3, n = 22), terazosin 5mg (Group 4, n = 21), doksazosin mesylate 4mg (Group5, n = 21), were used for treatment. The demographic parameters of patients, pre and post treatment intravaginal ejaculation latency time (IELT), PE Profile (PEP), and QoL index were recorded and evaluated. Effectiveness of treatment was evaluated by measuring IELT. Additionally, side effects of drugs were recorded. P < 0.05 was considered statistically significant., Results: All alpha blocker drugs were statistically effective for preventing PE. Notably, silodosin seemed to be more effective for preventing PE than other alpha blockers (P < 0.05). However all alpha blockers provided development in QoL scores, silodosin was a little better than other drugs in statistical analyses. Furthermore statistical increase in IELT and decrease in PEP were provided more in Group 1 than other groups (P < 0.05)., Conclusions: Silodosin seems to be able to even more prevent PE. Silodosin may provide development in QoL than other alpha blocker agents. Additionally, lower systemic adverse events and more effectivity are the prominent features of silodosin in PE.This study was a pilot clinical trial. Prospectively documented 108 patients with PE were treated and were followed-up in urology outpatient clinic. All patients were divided into 5 groups according to used alpha blocker agents which were determined by simple randomization. Silodosin 4mg (Group 1, n = 21), tamsulosin hydrochloride 0.4mg (Group 2, n = 23), alfuzosin 10mg (Group 3, n = 22), terazosin 5mg (Group 4, n = 21), doksazosin mesylate 4mg (Group5, n = 21), were used for treatment. The demographic parameters of patients, pre and post treatment intravaginal ejaculation latency time (IELT), PE Profile (PEP), and QoL index were recorded and evaluated. Effectiveness of treatment was evaluated by measuring IELT. Additionally, side effects of drugs were recorded. P < 0.05 was considered statistically significant.

Purpose: To investigate if effects of the first single dose of tamsulosin 0.4 mg on uroflowmetry parameters would predict treatment response at the third month., Methods: Men over 40 years old with complaints of lower urinary tract symptoms associated with benign prostatic hyperplasia were studied with physical examination, urine and blood analysis, uroflowmetry (UFM), post-voiding residual urine volume (PVR), international prostate symptom score (IPSS), quality-of-life (QoL) index and transrectal prostate ultrasonography (TRUS), and patients with prostate cancer suspicion, past urinary surgery, urinary tract infection and neurologic diseases were excluded. UFM, PVR, IPSS, QoL were repeated at 6th hour of the first day, first month and third month of oral tamsulosin 0.4 mg treatment. All parameters were recorded as baseline, and changes in the UFM parameters, PVR, IPSS and QoL were evaluated in clinical visits., Results: As a total, 48 men (mean 60.17 ± 1.18 years) were recruited. There was a significant increase in maximum urine flow rate (Q (max)) and average urine flow rate (Q (ave)) and decrease in PVR from baseline with the first dose of tamsulosin as well as first and third month of treatment (p < 0.05). IPSS and QoL scores significantly improved at the first month in correlation with UFM parameters. Tamsulosin treatment was effective in 33 (68.7 %) patients at the first administration and 35 (72.9 %) at the third month. Positive predictive value and negative predictive value of Q (max) change at first dose for the third month response rate were 90.9 and 66.6 %, respectively., Conclusions: The mid-term effectiveness of tamsulosin may be predicted by changes in UFM parameters achieved with its first dose.