The SPARE score reliably predicts the conversion from open partial to radical nephrectomy

Aim To assess the power of nephrometry scores to predict the intraoperative conversion from partial nephrectomy (PN) to radical nephrectomy (RN). Methods We identified all the patients at our institution who were scheduled for PN between April 2012 and December 2017. Patients who underwent robotic or laparoscopic surgery were excluded. A total of 149 patients (94 men) who underwent open surgery and had complete data were included. The power of the R.E.N.A.L., PADUA, SPARE, and DAP scores to predict the conversion to RN, and the threshold values were assessed. In the multivariate analysis, the predictive power of the nephrometry scores was tested by separately including them in different models. Results The median age was 57 (48-67) years, while the median follow-up was 15 (7-29.5) months. The overall conversion rate was 10.7%. The optimal cut-off values for the R.E.N.A.L., PADUA, SPARE, and DAP scores were 7.5, 9.5, 5.5 and 7.5, respectively. The SPARE score had the highest area under the curve (AUC=0.807, P<0.001). In the multivariate analysis, the SPARE score had the highest odds ratio (OR 12.561; confidence interval 3.456-45.534, P<0.001]. Conclusion A high SPARE score was significantly associated with the conversion to RN in patients who underwent open PN

Prostatic Adenosquamous Carcinoma Metastasizing to Testis

Adenosquamous carcinoma of the prostate is an unusual tumor with poor prognosis. Most arise after hormonal or radiotherapy of conventional prostatic adenocarcinoma. Sarcomatous transformation in them has been reported in only a few cases. Here, we present a unique case of “de novo prostatic adenosquamous carcinoma with focal sarcomatoid areas” that showed testicular metastasis, detected after scrotal orchiectomy.PubMedWoSScopu

Adding stewed apricot juice to senna improves quality of colon cleansing in preparation for colonoscopy

Background: To achieve optimal colonoscopic examination, the bowel must be sufficiently cleansed. However, none of the currently available colonoscopy preparation regimens is safe, efficient, and comfortable. The aim of this study was to determine whether adding stewed apricot juice to senna increased patient comfort and improved bowel cleansing during colonoscopy preparation. Methods: Outpatients of both genders who were over 18 years old and were referred for elective colonoscopy were randomly allocated to drink stewed apricot juice with senna or senna by itself. The quality of the colon cleansing was evaluated using the Ottawa scale. Patient tolerance and adverse events were evaluated through the completion of a questionnaire. Results: The study included a total of 128 patients in the randomization procedure. A significantly greater cleansing effect was observed using stewed apricot juice plus senna in the right and transverse colon (p = 0.038, p = 0.037 respectively). It was also determined that in the stewed apricot juice plus senna group, overall cleansing was superior (p < 0.001), total colonoscopy (17.6 min vs. 22.8 min, p = 0.048) and cecal intubation (7.4 min vs. 11.2 min, p = 0.042) times were shorter, and the colonoscopy procedure was easier (79.4% vs. 49.2%, p < 0.001). No differences were observed between the groups with respect to patient acceptance, compliance, and adverse events. In the stewed apricot juice plus senna group, 91.2% of patients stated their willingness to receive the same regimen in the future compared to 80% of the patients in the senna alone group (p = 0.037). Conclusion: The addition of natural, stewed apricot juice to senna significantly improves cleansing outcomes without additional adverse effects