The effect on the sensitivities of PSA and PSA-age volume score of IPSS and nocturia in predicting positive prostate biopsy findings

Objective: The PSA-age volume (PSA-AV) score was calculated by multiplying the age and prostate volume and then dividing the total by the prebiopsy PSA level. The aim of this study was to evaluate the effect on the sensitivities of PSA and PSA-AV score of International Prostate Symptom Score (I-PSS) and nocturia in predicting positive prostate biopsy findings.Subjects and methods: A total of 1302 biopsies data were divided into two groups according to presence/ absence of nocturia. Of these biopsies, 452 biopsies data with I-PSS were also divided into three groups according to severity of I-PSS. The sensitivities, specificities, positive and negative predictive values of the PSA-AV and PSA in all the groups were calculated separately.Results: Although the sensitivities of PSA and PSA-AV were similar in the patients with nocturia (94.1% and 95.8%, respectively), the sensitivity of PSA-AV (99.2%) was higher than PSA (91.8%) in the patients without nocturia. The sensitivities of PSA in mild, moderate and severe I-PSS group were found to be 100%, 92.9% and 95%, respectively (the sensitivities of PSA-AV were 100%, 94.4% and 88.2%, respectively). While severity of I-PSS was decreasing, although sensitivity of PSA-AV increased regularly, sensitivity of PSA was variable.Conclusions: All our data shows that if we remove most of the factors which effect PSA such as age, prostate volume, prostatitis and BPH, we may increase the sensitivity of PSA for predicting positive prostate biopsy. Further PSA formulas contain of result of some tests (I-PSS, uroflowmetry or postvoiding residue urine) as well as age and prostate volume should increase the sensitivity and specificity of PSA for detecting prostate cancer.Keywords: PSA; PSA-AV; Prostate biopsy; IPSS; Nocturi

Phosphorus recovery from anaerobically digested liquor of screenings

Phosphorus is a limited resource which is predicted to get exhausted at some point during the twenty-first century. However, it is present in wastewaters at concentrations that come close to supplying the nation’s annual requirements for fertiliser. Many papers have addressed the recovery of phosphorus as struvite (magnesium ammonium phosphate hexahydrate) from different types of waste while the most prominent usage of struvite is as a slow-release fertiliser, suitable as a replacement for chemical fertiliser, for agricultural application. In this study, screenings produced during the wastewater treatment process were anaerobically digested to obtain anaerobically digested liquor which was subsequently used for phosphorus recovery in the form of struvite. This was carried out at different concentrations of dry solids. The amount of struvite potential was calculated theoretically using molar ratio calculations of 1:1:1 (Mg:N:P). From the results, it was found that the digestate is high in phosphorus content and can be recovered up to 41%. For struvite yield, 0.27,kg of struvite can be recovered from each kg dry solids of screenings from 3% of dry solids. Screenings thus prove a valuable source of additional phosphorus which current disposal practices fail to exploit

Laparoscopic versus open radical cystectomy in the treatment of locally advanced t3 and t4 bladder cancer: Perioperative and mid-term oncological outcomes

Objective: In this study, we aim to compare the perioperative and midterm oncological outcomes in patients with advanced bladder cancer and those who had laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC). Material and methods: We retrospectively reviewed medical records of patients who underwent LRC or ORC in a single center between 2008 and 2014 with a pathological diagnosis of pT3 and pT4 bladder cancer. Thirty-five and 39 patients were included in the study as part of the LRC and ORC groups, respectively. Results: There was no statistically significant difference between the two groups in terms of disease-free survival (LRC, 39.8±4.86 months; ORC, 45.47±8.92 months, P=0.896). Average estimated blood loss and length of hospitalization were significantly less in the LRC group. The overall survival rates of patients at 1, 2, and 3 years were 73%, 46%, and 46% in the ORC group and 78%, 65%, and 40% in the LRC group, respectively, and there was no statistically significant difference between the two groups. One patient in the ORC group experienced rectal injury in the form of a serosal tear, which was repaired primarily without any postoperative sequelae. There were no conversions in the laparoscopic group. Similarly, in 1 patient, rectal serosal tear was repaired preoperatively. Conclusion: Our study showed that LRC provides midterm oncological outcomes similar to ORC in the treatment of locally advanced T3 and T4 bladder cancer. However, long-term oncological and functional outcomes are required. © 2020 by Turkish Association of Urology

The effect on the sensitivities of PSA and PSA-age volume score of IPSS and nocturia in predicting positive prostate biopsy findings

Objective The PSA-age volume (PSA-AV) score was calculated by multiplying the age and prostate volume and then dividing the total by the prebiopsy PSA level. The aim of this study was to evaluate the effect on the sensitivities of PSA and PSA-AV score of International Prostate Symptom Score (I-PSS) and nocturia in predicting positive prostate biopsy findings. Subjects and methods A total of 1302 biopsies data were divided into two groups according to presence/absence of nocturia. Of these biopsies, 452 biopsies data with I-PSS were also divided into three groups according to severity of I-PSS. The sensitivities, specificities, positive and negative predictive values of the PSA-AV and PSA in all the groups were calculated separately. Results Although the sensitivities of PSA and PSA-AV were similar in the patients with nocturia (94.1% and 95.8%, respectively), the sensitivity of PSA-AV (99.2%) was higher than PSA (91.8%) in the patients without nocturia. The sensitivities of PSA in mild, moderate and severe I-PSS group were found to be 100%, 92.9% and 95%, respectively (the sensitivities of PSA-AV were 100%, 94.4% and 88.2%, respectively). While severity of I-PSS was decreasing, although sensitivity of PSA-AV increased regularly, sensitivity of PSA was variable. Conclusions All our data shows that if we remove most of the factors which effect PSA such as age, prostate volume, prostatitis and BPH, we may increase the sensitivity of PSA for predicting positive prostate biopsy. Further PSA formulas contain of result of some tests (I-PSS, uroflowmetry or postvoiding residue urine) as well as age and prostate volume should increase the sensitivity and specificity of PSA for detecting prostate cancer. © 2016 Pan African Urological Surgeons’ Associatio

The prevalence and epidemiological characteristics of hepatitis B virus and hepatitis C virus coinfection in Turkey [Türkiye'de hepatit B virüs ve hepatit C virus koenfeksiyonu prevalansi{dotless} ve epidemiyolojik özellikleri]

We aimed to determine prevalence and epidemiological characteristics of cases coinfected with hepatitis B virus (HBV)/hepatitis C virus (HCV) in Turkey. Material and Methods: The data for this study was obtained from Turk-Hepatitis Registry (HEP-NET) Project, which includes real-life cohort of hepatitis patients from 15 centers in Turkey, and is supported by Viral Hepatitis Society. In the project, 10,165 hepatitis cases were evaluated in 10 hospitals. Results: According to initial visit results, HBV/HCV coinfection was detected in 99 patients. The ratio was 974/100 000. The mean age of the cases was 40.9+21.7 years, 56.6% of them were males and 43.4% were females,. The major risk factors were dental therapy, any surgical procedure, hemodialysis and blood transfusion. The mean alanine aminotransferase (ALT) levels were 70.9±49.1 IU/L in coinfected patients. In 12% of cases HBeAg was positive. The median HCV RNA level was found 0 IU/mL (minimum: 50-maximum: 2.18x107 IU/mL), and the median HBV DNA level was found 2.50x102 IU/mL (minimum: 12-maximum: 1.70x108 IU/mL). In 8.1% of the patients both HCV RNA and HBV DNA were positive, and in 87.5% of cases HCV infection was dominant. The most important risk factor was hemodialysis (25%) in this group. Conclusion: This is the most detailed study which evaluates the prevalence of HBV/HCV coinfection in Turkey. HBV/HCV coinfection prevalence was not higher than HBV or HCV monoinfections. In cases where both HCV RNA and HBV DNA were positive, HCV was predominant. © 2013 by Türkiye Klinikleri

Assessment of Proportion of Hidden Patients Having Symptoms of Overactive Bladder and Why Has It Been Hidden in Female Outpatients Admitted to Hospital.

PURPOSE: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. METHODS: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score≥8 were defined as having OAB symptoms. RESULTS: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: "I did not think I had a disease" and "The symptoms did not bother me," with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P<0.001). CONCLUSIONS: This is the first study to demonstrate a significant proportion of women with undetected OAB symptoms. The main reasons the women did not admit themselves to a hospital were their unawareness of the disease and because the LUTS were not bothersome. Public awareness programs on this disease may resolve this problem