Effect of mirabegron on overactive bladder symptoms in patients with myasthenia gravis disease

Aim: Overactive bladder (OAB) is a chronic, bothersome disease that decreases the quality of life and can be treated with antimuscarinic or β(3)-adrenergic agonist drugs, such as mirabegron. Myasthenia gravis (MG) is an autoimmune disease, in which neurotransmission is blocked by antibodies. Mirabegron is recommended as the first-line medical treatment for OAB compared with antimuscarinic drugs, which have several severe side effects. In this study, we assessed the efficacy of mirabegron in patients with MG and OAB. Methods: A total of 57 MG patients with OAB were included in this study. The participants received 50 mg mirabegron once daily and were followed up for 4 weeks. Subsequently, patients were evaluated using the International Consultation on Incontinence-Short Form and the "Overactive Bladder Symptom Score" (OABSS) and tasked to complete a 3-day micturition diary. Results: According to the 4-week follow-up results, the decrease in the OABSS scores following mirabegron administration was statistically significant (p<0.001). In addition, the frequency of daily micturition, nocturia, and need for a daily pad decreased dramatically (p=0.001, p=0.002, and p<0.001, respectively). In contrast, the average voiding volume increased significantly (p=0.001). Conclusions: Although they induce several side effects, antimuscarinic drugs are commonly used for OAB treatment. However, only a few autoimmune response-inducing drugs, with minimal side effects, are favored in MG comorbidity treatments. Thus, mirabegron is a promising candidate drug for the treatment of this type of comorbidity

CD10 expression in urothelial carcinoma of the bladder

Background. CD10 antigen is a 100-kDa-cell surface zinc metalloendopeptidase and it is expressed in a variety of normal and neoplastic lymphoid and nonlymphoid tissues. The aim of this study was to evaluate CD10 expression in urothelial carcinoma of the urinary bladder and to determine the correlation between immunohistochemical (IHC) CD10 expression and histopathologic parameters including grade and stage. Methods. 371 cases of urothelial bladder carcinomas, all from transurethral resections, were included in this study. Hematoxylin-eosin (HE) stained sections from each case were reevaluated histopathologically according to WHO 2004 grading system. The TNM system was used for pathologic staging. Selected slides were also studied by IHC and a semiquantitative scoring for CD10 expression based on the percentage of positive cells was performed. Results. 157 cases (42.3%) showed immunostaining while 214 cases (57.7%) were negative for CD10. 1+ staining was seen in 65 CD10 positive cases (41.4%), and 2+ in 92 cases (58.6%). Overall CD10 expression as well as 2+ immunostaining was significantly correlated with high histologic grade. Overall CD10 expression was also significantly higher in invasive pT1 and pT2-3 tumors compared to noninvasive pTa tumors. pT1 and pT2-3 tumors were also significantly correlated with 2+ immunostaining. Conclusion. To date, only a few comparative IHC studies have assessed CD10 expression in urothelial carcinoma of the urinary bladder and this study represents the largest series. Our findings indicate that CD10 expression is strongly correlated with high tumor grade and stage in urothelial carcinoma of the bladder, and that CD10 may be associated with tumor progression in bladder cancer pathogenesis. © 2009 Bahadir et al; licensee BioMed Central Ltd

Clinicopathological significance of fascin and CD44v6 expression in endometrioid carcinoma

BACKGROUND: Fascin and CD44v6 may have significant roles as biomarkers in tumour progression and metastasis. In endometrioid carcinomas, the fascin expression profile is less defined, and the significance of CD44v6 is uncertain. We aimed to investigate the expressions of both fascin and CD44v6 in endometrioid carcinomas and to evaluate their inter-relation with clinicopathological parameters. METHODS: Fascin and CD44v6 expressions were evaluated, individually and in combination, in a series of 47 endometrioid carcinomas and 10 proliferative endometrium samples. The staining extent and intensity of both markers in tumour cells were scored semiquantitatively. The relationship between immunoexpressions and clinicopathological variables was assessed. RESULTS: The expression rates of fascin and CD44v6 in endometrioid carcinoma were 72.34% and 46.80%, respectively. Although these expression rates were higher than those in proliferative endometrial samples, fascin expression showed a statistically significant difference from the normal group (p = 0.02), but CD44v6 did not differ (p = 0.54). Fascin expression was significantly correlated with tumour grade (p = 0.003) and neural invasion (p = 0.036) in a univariate analysis. In contrast, no significant correlation was found between CD44v6 and any of the clinicopathological parameters. CONCLUSIONS: Our findings suggest that fascin might be an independent prognostic indicator in the different steps of extracellular matrix invasion. On the other hand, CD44v6 was not a predictive factor in endometrioid cancer. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8511594927206899

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

Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study

Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors. Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p &lt; 0.05. Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores. Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey

Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study

Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors. Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p < 0.05. Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores. Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey

A parametric study to improve suitability of micro-deval test to assess unbound base course aggregates

Micro-deval test provides a measure of resistance and durability of aggregates submerged in water through the actions of aggregate particles and abrasion from steel balls. The presence of water in the test chamber provides a more realistic assessment of field conditions when compared with Los Angeles (LA) abrasion test. Currently there is only one testing procedure in the United States (U.S.) to evaluate the coarse aggregates using micro-deval tests. Previous studies indicate that there has been significant interest in utilizing micro-deval test to assess the suitability coarse aggregates to be used in asphalt concrete and their field performance. However the studies related to evaluating coarse aggregates with microdeval test for base course applications are very limited. This study attempts to address how the microdeval testing procedure may be revised to better assess the performance of aggregates considered for the base course. Aggregates with seven different geological compositions were used in the study. Total of 250 micro-deval tests were performed and the results confirmed the repeatability and the suitability of the proposed method to all of the tested aggregates. As part of this study, a threshold is determined for the optimum amount of abrasive charge that should be used in the tests to obtain maximum material loss regardless of the geological make-up of the aggregate. If this approach is followed, a strong relationship between the number of revolutions and percent material loss is achieved. This relationship provides an opportunity to shorten the micro-deval tests and also an approach to assess durability of aggregates at number of revolutions significantly larger than what is prescribed in the existing micro-deval testing procedure. This ability may be used in the future to more realistically relate the long-term durability prediction of aggregates as it relates to field performance of base course. (C) 2017 Elsevier Ltd. All rights reserved

The effect of fly ash and limestone fillers on the viscosity and compressive strength of self-compacting repair mortars

Today, self-compacting mortars are preferred for repair purposes due to the application easiness and mechanical advantages. However, for self-compactability, the paste phase must meet some certain criteria at fresh state. The cement as well as the ingredients of the paste, powders with cementitious, pozzolanic or inert nature and plasticizing chemical admixtures should be carefully chosen in order to obtain a suitable paste composition to enrich the granular skeleton of the mix. The physical properties of powders (shape, surface morphology, fineness, particle size distribution, particle packing) and physico-chemical (time-dependent hydration reactions, zeta potentials) interactions between cement powder and plasticizer should be taken into consideration. All these parameters affect the performance of fresh paste in different manners. There is no universally accepted agreement on the effect of these factors due to the complexity of combined action; thus, it is hard to make a generalization