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Objective: The aim of this study is to assess the effectiveness and safety of purely endonasal endoscopic resection of extracranial trigeminal schwannomas (TGSs), with assessment of surgical and clinical outcomes in order to identify optimal candidates for an endonasal endoscopic approach (EEA)., Methods: A retrospective review of patient's records operated for TGSs between 2008 and 2021 was conducted. Patients operated with a purely EEA were included in this study. Pictures from a frozen fresh cadaver head dissection were used to demonstrate the surgical approach and to show anatomic relationships, complexity of the surgical area and safe corridors for surgery., Results: A total of 5 patients (4 females and 1 male) were operated for TGS. All patients had facial numbness (100%) as a presenting symptom, followed by facial pain in 2 patients (40%), and orbital pain in 1 (20%). Also, 3 patients (60%) had a tumor originating at the level of the foramen ovale and 2 (40%) at the foramen rotundum. The mean tumor diameter was 3,7 ± 2 cm. Gross total resection were achieved in all cases. Postoperatively, 1 patient had severe mastication problems, 1 had blurred vision, and in the long-term follow-up, 1 had frontal sinusitis. The mean follow up was 106.6 (min:49, max:132, SD: 29.82) months. No recurrences were detected., Conclusions: In cases with the extradural TGS having limited extension into Posterior Cranial Fossa, or located in the Middle Cranial Fossa, a purely EEA is possible even for tumors bigger in size. Unilateral endonasal corridors are adequate for resection in most cases., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

Aim: To examine all skin changes in peritoneal dialysis (PD) patients followed up in our unit., Methods: Patients on PD program for at least three months without any known chronic skin disease were included in the study. Patients with already diagnosed skin disease, those who have systemic diseases that may cause skin lesions, patients with malignancies and those who did not give informed consent were excluded from the study. All patients were examined by the same predetermined dermatologist with all findings recorded. The demographic, clinical and laboratory data including measures of dialysis adequacy of patients were recorded also. Statistical Package for Social Sciences (SPSS) for Windows 16.0 standard version was used for statistical analysis., Results: Among the patients followed up in our PD unit, those without exclusion criteria who gave informed consent, 38 patients were included in the study with male/female ratio and mean age of 26/12 and 50.3 ± 13.7 years, respectively. The duration of CKD was 7.86 ± 4.16 years and the mean PD duration was 47.1 ± 29.6 mo. Primary kidney disease was diabetic nephropathy in 11, nephrosclerosis in six, uropathologies in four, chronic glomerulonephritis in three, chronic pyelonephritis in three, autosomal dominant polycystic kidney disease in three patients while cause was unknown in eight patients. All patients except for one patient had at least one skin lesion. Loss of lunula, onychomycosis and tinea pedis are the most frequent skin disorders recorded in the study group. Diabetic patients had tinea pedis more frequently (P = 0.045). No relationship of skin findings was detected with primary renal diseases, comorbidities and medications that the patients were using., Conclusion: Skin abnormalities are common in in PD patients. The most frequent skin pathologies are onychomycosis and tinea pedis which must not be overlooked.

Peritoneal dialysis (PD) offers the opportunity of a better quality of life for patients as long as they are able to perform dialysis according to the set procedures. Our aim in this study was to assess the change in PD patients' knowledge about their treatment and practice through repeated home visits. This study was based on the findings of a previous study. Fifteen patients participated and received two visits post training. During the visits, a questionnaire was completed, and the answers were analysed. Data were analysed by percentage statistics and assessed for differences between the two visits. The correct number of answers given during the first visit was 25.5 +/- 3.2/31 and was 27.8 +/- 4.0/31.8 at the second visit. The mean infection section and medication scores had increased from the original study findings. The personal hygiene section was the least correctly answered section. Consecutive home visits revealed that as the time on PD increased, knowledge and practice regarding infections and medication increased. Personal hygiene scores did not improve. This study confirmed the importance of home visits in detecting the weakest point of PD practice.

Training provided by dialysis nurses to the patients is of great importance in peritoneal dialysis (PD). This study aimed to examine how PD patients continue with the training and practice taught in this unit and correlate these data with the incidence of peritonitis. Home visits were paid to 32 patients. A form including questions about 'knowledge and skill' and dialysis environment was filled in for each patient. Answers were graded out of 100 points and were reported as average, percentage and minimum-maximum values. The mean 'knowledge and skill' criterion scoring was 79.8 +/-14.0, and the mean score for the dialysis environment was 87.7 +/-10.9. There was a significant correlation between the 'knowledge and skill' and environmental scores. Meaningful correlations were detected between the 'knowledge and skill' score as well as the environmental score with the rate of peritonitis. Training is of vital importance in PD practice, but results show that the dialysis environment is as important as the patient's knowledge or skill in exchanges.

The relation of various demographic, clinical and biochemical parameters of peritoneal dialysis patients with peritonitis and other infections was evaluated. The age, gender, peritoneal dialysis (PD) period, educational status, peritonitis, exit site score, serum albumin, C-reactive protein (CRP), and triglyceride levels at the beginning and the last visit were recorded. Mean age of 32 patients was 45.1 years; PD period was 13.1 months. Albumin level was inversely proportional to the frequency of peritonitis. Patients with peritonitis had albumin levels that were lower at the last visit, and were independent of the CRP values at the start of PD and during follow-up. Significant correlation was detected between females and exit site scores. There was significant correlation between educational status and peritonitis. Albumin level at first visit was a factor that reduced the likelihood of peritonitis, and low levels obtained during follow-up constituted a risk for peritonitis. It was also shown that peritonitis risk tended to decrease inversely with education level.