Comparison of Diagnostic Performance of PI-RADS V2 and V2.1 and Interobserver Agreement in Both Versions

Objective: To compare the diagnostic performance for the detection of clinically significant prostate cancers and interobserver agreement between PI-RADS v2 and v2.1 Material and Method: The mpMRI images of 258 patients and 394 nodüles included in this retrospective study were obtained on 3T MR and evaluated by two radiologists according to PI-RADS v2 and v2.1. Sensitivity and specificity between v2 and v2.1 compared. Detection rates for clinically significant prostate cancers of upgraded and downgraded lesions in the use of v2.1 from v2 were assessed. Interobserver agreement was assessed using κ statistics. Results: PI-RADS v2.1 and v2 showed higher sensitivity and lower specificity (100%, 52.38%) in peripheral zone and showed higher sensitivity and specificity (92.86%, 98.79%) in transition zone for category ≥4 lesions in the detection of csPCa, not significantly difference was found between the two versions. Interobserver agreement was statistically significant and very weak in the transition zone (κ=0.383, κ=0.279, respectively), very strong in the peripheral zone (κ=0.869) according to both classifications and they were similar. Conclusion: The diagnostic performance of PI-RADS v2 and v2.1 were found similar in detecting clinically significant cancers and all cancers in both zones. The clinically significant cancer detection rate in category 2+1 lesions in the transition zone was higher than in category 2 lesions but it wasn’t statistically significant. Interobserver agreement was low in the transition zone and very strong in the peripheral zone in both versions

Comparison of Post Biopsy Pathology and Post Radical Prostatectomy Pathology in Patients with Prostate Cancer Detected After Fusion Biopsy

Aims: To compare the post-radical prostatectomy (RP) final pathologies and post-biopsy pathologies of the patients diagnosed with prostate cancer (PCa) after fusion biopsy according to the International Society of Urological Pathology (ISUP) grading system. Material and Methods: In this retrospective study, data of 182 patients who underwent fusion biopsy and concomitant systematic biopsy between January 2020 and August 2022 was reviewed. All these patients were biopsy naive with PIRADS-3 lesions according to the multiparametric MRI (mp-MRI) imaging. A total of 89 patients with PCa detected by biopsy were included in the study. Age, PSA, PSA density, and lesion grades according to PI-RADS were analysed. The post-biopsy (fusion and systematic biopsy) pathology results of 60 patients who underwent RP were compared with the final pathology results after RP. Results: Pathological results after fusion biopsy and RP were compared. The individual agreement between RP and fusion biopsy for each ISUP grade was moderate to almost excellent (0.558 to 0.848). When the overall agreement between RP and fusion biopsy was evaluated, the weighted kappa was calculated as 0.721 (95% CI: 0.577 to 0.865), which was determined as substantial significant agreement. On the other hand, the overall agreement between systematic biopsy and pathology results after RP was calculated as weighted kappa 0.544 (95% CI: 0.405 to 0.683) and this agreement was determined as moderate agreement. Conclusion: Our study showed that the concordance between the pathology result after fusion biopsy and the final pathology after RP was higher than the standard TRUS prostate biopsy. We think this compliance is crucial in the regulation and follow-up of the treatment of the patients

İDRAR KAÇIRAN KADIN HASTALARDA İDRAR YOLU ENFEKSİYONU GÖRÜLME SIKLIĞI VE RİSK FAKTÖRLERİ

Uluslararası Kontinans Derneği tarafından sosyal ve/veya hijyenik sorun haline gelen istemsiz idrar kaybı olarak tanımlanan idrar kaçırma, dünya çapında yılda yaklasık 200 milyon kisiyi etkileyen büyük bir sağlık problemidir. Yasam kalitesini belirgin ölçüde etkileyerek psikolojik ve medikal morbiditeye neden olmaktadır. Đdrar yolu enfeksiyonları da birçok nedene bağlı gelisen zaman zaman ciddi morbiditelere neden olabilen ve ülkelerin sağlık harcamalarında önemli yer tutan bir hastalık grubudur. Tüm dünyada çok yaygın olarak görülen bu iki önemli hastalık kendi aralarında da iliskili gibi gözükmektedir. Çalısmamızda idrar kaçıran kadın hastalarda ĐYE’ye yatkınlık olusturabilecek risk faktörlerinin ve bu faktörlerden özellikle ĐK’nın ĐYE üzerine etkisinin değerlendirilmesi amaçlanmıstır. Gazi Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı Kadın Ürolojisi Biriminde, Eylül 2002-Ocak 2010 tarihleri arasında değerlendirilmis ve kayıtları tutulmus, 1069 kadın hastanın dosyaları incelenerek idrar kaçırması olan 979 hasta çalısmaya alınmıstır. Đdrar kültüründe üreme olan 72 hasta üriner enfeksiyon grubu kabul edilmis ve Grup A olarak isimlendirilmis, idrar kültüründe üreme olmayan 907 hasta Grup B olarak tanımlanmıstır. Hastaların dosyalarından yas, stres tip idrar kaçırma, sıkısma tip idrar kaçırma, karısık tip idrar kaçırma, doğum sayısı, doğum tipi, zorlu doğum varlığı, geçirilmis histerektomi, konstipasyon varlığı, postmenopozal semptomların varlığı, obstrüktif üriner semptomların varlığı, idrar yolu enfeksiyonu öyküsü, sistemik hastalık durumu; diabetes mellitus, nörolojik hastalık varlığı ve sigara kullanımına ait bilgiler elde edilmistir. Ayrıca hastaların ürogenital sistem muayenesine ait beden kitle indeksi değeri, vajinal-üretral atrofi varlığı, Q tipi, sistosel ve rektosel bulguları değerlendilmistir. Bu çalısmada idrar kaçıran kadınlarda idrar yolu enfeksiyonu riskini arttıran faktörler olarak tekli değisken analizlerinde yaslanma, artmıs mesanede kalan idrar miktarı, düsük Qmax değeri, postmenapozal semptom varlığı, diabetes mellitus, nörolojik hastalık olması, vajinal-üretral atrofi ve üroflow grafiğinin anormal olması bulunurken, çoklu analizlerin ise sadece diabetes mellitus istatistiksel olarak anlamlı bulunmustur.Urinary incontinance which is defined as an urinating without will that becomes a social and/or health problem by the International Continence Society. It is a big health problem that affects approximately 200 billion people a year worldwide. It causes psychological and medical morbidity by affecting life quality. Urinary tract infection includes the disease groups that are commonly seen worldwide which causes serious morbidities sometime and takes big places in the health costs of the countries. These two common diseases are seem to be related between each other. In this study we aimed to evaluate the risk factors especially urinary incontinance that lead to urinary tract infection. Medical records of 1060 female patients who applied to the Women Urology section of the Gazi University School of Medicine Urology Department between September 2002 - January 2010 were examined and 979 patients with urinary incontinence included to the study. 72 patients who have positive urine culture are accepted as group A and 907 patients who don’t have bacteria in the urine culture are accepted as Group B. Data’s about age, stress urinary incontinence, urge urinary incontinance, mixed urinary incontinance, parity, type of delivery, hard delivery history, hysterectomy history, constipation, postmenauposal symptom, obstructive urinary symptoms, urinary tract infection history, systemic illnesses such as diabetes mellitus, neurologic disorders, smoking history were obtained from the medical records of the patients. In addition, the information that obtained from the urogenital examination which includes body mass index, vaginal- urethra atrophy, Q type, cystocele and rectocele grade were evaluated. In this study in the monovariate analysis getting older, higher post void residual urine, smaller Qmax, postmenauposal symptoms, diabetes mellitus, neurologic disorders, vaginal-urethral atrophy and the abnormality of the uroflow graphic are found as the risk factors for the urinary tract infection. In multivariate analysis only diabetes mellitus is found to be statistically meaningful as a risk factor for developing urinary tract infection

Transcriptomic expression levels of the VHL, TIMP-3, and RASSF1A genes in renal tumors

WOS: 000499705600020PubMed: 31773698OBJECTIVE: In this study, we aimed to investigate the relation between the mRNA expression levels of VHL, TIMP-3 and RASSF1A genes, and the histopathological and clinical characteristics of patients with renal tumors. PATIENTS AND METHODS: Radical nephrectomy specimens of cases presented without neoadjuvant treatment were confirmed to be cancerous, non-cancerous, benign, and healthy after removal from separate localizations. A total of 69 patients with kidney tumors (138 tissue samples) were included in the study group. RNA isolation, reverse transcriptase PCR (RT-PCR), and quantitative real time PCR (qPCR) were performed, and the GAPDH gene was used to normalize mRNA levels. RESULTS: In the RCC cancerous tissue. TIMP-3 levels increased 1.3 times and RASSF1A levels increased 1.4 times compared to the corresponding levels in non-cancerous tissues, and there was no statistically significant difference in these values. On the other hand, VHL gene expression levels in cancerous tissue were 2.8 times higher than in matched adjacent non-cancerous tissues (p < 0.05). In the case of oncocytomas, TIMP-3 levels were found to be 3.2 times higher, RASSF1A levels 3.8 times higher, and VHL levels 2.2 times lower than the corresponding levels in healthy tissues (p < 0.05). CONCLUSIONS: The roles of VHL, TIMP-3, and RASSF1A mRNA expression in contributing to the development of renal tumors could not be clearly established. Further studies are therefore required to elucidate the mechanisms underlying renal tumors.Gazi University Research FundGazi University [01/2010-25]This study was conducted with financial support from the Gazi University Research Fund with the project code number 01/2010-25

Retrograt intrarenal cerrahi geriatrik erkek hastalarda böbrek taşı tedavisinde etkin ve güvenilir bir seçenek midir?

Amaç Bu çalışmada böbrek taşı tedavisi için kliniğimizde retrograt intrarenal cerrahi(RİRC) uygulanılan geriatrik yaş grubu erkek hastaların etkinlik ve güvenlik sonuçlarının, daha genç yaş hasta grubu ile karşılaştırılarak sunulması amaçlanmıştır. Gereç ve Yöntem Kliniğimizde böbrek taşı nedeniyle RİRC uygulanmış olan, 40 yaş üzeri erkek hastaların verileri retrospektif olarak değerlendirildi. Hastalar yaşlarına göre iki gruba ayrıldı: 40-64 yaş (Grup 1) ve 65 yaş ve üzeri (Grup 2). Komorbidite değerlendirilmesi için anestezi risk skoru (ASA) ve modifiye Charlson komorbidite indeksi (MCKİ) kullanıldı. Hastanenin kayıt sisteminden ve hastaların dosyalarından genel bilgiler, komplikasyon bilgileri, renal anormallik varlığı, taşın bulunduğu böbrek ve lokalizasyonu, taşın dansitesi, taşın boyutu, taş sayısı verileri ve postoperatif taş temizlenme verileri elde edildi. Bulgular Çalışmaya 233 tanesi Grup 1 (40-64 yaş) ve 61 tanesi Grup 2 (65 yaş ve üstü) olmak üzere toplam 294 hasta alınmıştır. ASA ve MCKİ skorları bakımından Grup 2’de yer alan hastaların skorları Grup 1’e göre istatistiksel olarak anlamlı olarak daha yüksek olarak bulunmuştur (sırasıyla p=.000, p=.000). Gruplar arasında taş dansitesi, taş boyutu, taş hacmi, operasyon süresi, hastanede yatış süreleri ve postoperatif taşsızlık oranları bakımından fark bulunmamıştır. Grup 1’de toplam 25 (%10.7) hastada ve Grup 2’de toplam 10 (%16.4) hastada komplikasyon geliştiği tespit edilmiştir ve gruplar arasında genel komplikasyon oranları açısından istatistiki fark bulunmamıştır (p=.265). Sonuç Dünya nüfusunun giderek yaşlanması ile beraber bu hasta grubunun hastalıklarının da en uygun tedavi metodlarıyla tedavi edilmesinin önemi artmıştır. Çalışmamızda RİRC yöntemi ile böbrek taşı tedavisi yaşlı hasta grubunda da güvenli ve etkili olarak çıkmıştır

How did the COVID-19 pandemic affect audience's attitudes in webinars?

Introduction Following the COVID-19 pandemic, the face-to-face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID-19 pandemic era