Lokal İleri Evre Prostat Kanserinde Maksimal Androjen Blokaj Tedavisinin Hematolojik, Biyokimyasal Ve Kemik Yoğunluğu Parametreleri Üzerine Etkileri

Aim: In the present study we aimed to check the impact of maximal androgen deprivation therapy (MADT) on cellular blood components such as hemoglobin (Hb) andhematocrit (Htc) fasting blood glucose (FBG), serum lipid values and bone mineraldensity (BMD) in locally advanced prostate cancer.Patients and Methods: Having been treated with maximal androgen blockade therapy, thirty-nine patients' initial values and at the twelfth month values of hemoglobin(Hb), hematocrit (Htc), FBG, total cholesterol (tChol), triglyceride (TG), high densitylipoprotein (HDL), low density lipoprotein (LDL) and spine BMD were recorded. Statistical comparisons of initial and at the twelfth month values were performed.Results: A statistically significant decrease was recorded in Hb and BMD valuesafter one year MADT. On the other hand, TG, tChol, LDL, HDL and FBG valuesshowed a statistically significant increase. Although Hb levels were significantly reduced, none of our patients developed symptoms of anemia. Fourteen of 37 patientswhose FBG levels were under 110 mg/dl before treatment, increased over 110 mg/dlat the twelfth month of treatment. Seven patients developed diabetes mellitus (DM)after treatment. Moreover, T score evaluation revealed newly developed osteoporosis in 4 patients. All of the patients with developed osteoporosis had osteopenicT score values before treatment. No bone fractures occurred in any of our patients.Conclusion: Our study points out the increase of FBG related to the treatment ofMADT. Decrease in BMD is higher in previously osteopenic patients. The lack of bonefracture and anemia symptoms might be considered as a result of evaluation of theearly data on MADT.Amaç: Bu çalışmanın amacı, lokal olarak ilerlemiş prostat kanserinde maksimal androjen blokajı tedavisinin (MABT) hemoglobin (Hb) ve hematokrit (Htc) değerleri ile açlık kan şekeri (AKŞ), serum lipid değerleri ve kemik mineral yoğunluğu (KMD) üzerindeki etkisini kontrol etmektir. Hastalar ve Yöntemler: MABT ile tedavi edilen 39 hastanın başlangıç ve onikinci aydaki hemoglobin, hematokrit, açlık kan şekeri, total kolesterol (tChol), trigliserit (TG), yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL) ve omurga KMD değerleri kaydedildi. İlk ve onikinci aydaki değerlerin istatistiksel karşılaştırmaları yapıldı. Bulgular: Bir yıllık MABT sonrası Hb ve KMD değerlerinde istatistiksel olarak anlamlı azalma kaydedildi. Öte yandan, TG, tChol, LDL, HDL ve AKŞ değerleri istatistiksel olarak anlamlı bir artış gösterdi. Hb düzeyleri önemli ölçüde azalmış olmasına rağmen, hastalarımızın hiçbirinde anemi belirtileri gelişmedi. Tedaviden önce FBG seviyeleri 110 mg / dl'nin altında olan 37 hastanın 14'ü tedavinin onikinci ayında 110 mg / dl'nin üzerine çıktı. Yedi hastada tedaviden sonra diyabetes mellitus (DM) gelişti. Dahası, T skoru değerlendirmesi 4 hastada yeni gelişen osteoporozu ortaya koymuştur. Osteoporoz gelişen tüm hastaların tedaviden önce osteopenik T skoru değerleri vardı. Hiç bir hastamızda kemik kırığı oluşmadı. Sonuç: Çalışmamız MABT bağlı AKŞ artışını göstermektedir. KMD değerindeki azalma, daha önce osteopenik olan hastalarda daha yüksektir. Kemik kırığı ve anemi semptomlarının olmaması, MABT ile ilgili erken verilerin değerlendirilmesinin bir sonucu olarak düşünülebilir

Diyabetik Hastalarda Tadalafi lin Koroid Kalınlığı ve Makula Parametreleri Üzerine Etkileri

Objective: To investigate the effects of tadalafi l on macular parameters and choroidal thickness in diabetic patients with erectile dysfunction(ED).Materials and methods: Total 37 diabetic patients with ED were included in this single-centred, open-label prospective study. The treatmentwas initiated with 5 mg tadalafi l hydrochloride daily for 3 months. Choroidal thickness, central macular thickness (CMT), and total macularvolume (TMV) measurements were performed using spectral domain optical coherence tomography (SD-OCT). SD-OCT and visual acuity(VA) measurements were repeated during all visits. Fundus fl uorescein angiography (FFA) was also performed at baseline and at the 12 th week.Results: There was a statistically signifi cant increase in the choroidal thickness compared to that at baseline at all visits except at the fi rst visit(mean central foveal choroidal thickness, baseline; 248.7 21.5, 1 st day; 247.4 23.2, 4 th week; 275.9 21.3, and 12 th week; 275.1 24.4, ?m,p 0.001). There was no statistically signifi cant change in the mean VA (baseline; 0.21 0.07, 12 th week; 0.22 0.06, logMar), mean CMT(baseline; 236.7 32.4, 12 th week; 234.8 32.8, ?m), mean TMV (baseline; 9.88 1.21, 12 th week; 9.83 1.26, mm 3 ), and FFA compared tothe baseline values (p 0.05).Conclusions: Choroidal thickness safely increases in response to systemic tadalafi l administration. The long-term use of systemic tadalafi l doesnot cause any adverse effects on the retina and the macula in diabetic patients with ED.Amaç: Erektil disfonksiyonlu(ED) diyabetik hastalarda tadalafi lin koroid kalınlığı ve maküla parametreleri üzerine etkilerini araştırmak.Materyal ve Metod: Bu tek merkezli açık etiketli prospektif çalışmaya ED tanılı diyabetik 37 hasta dahil edildi. Bu hastalara 3 ay boyuncagünlük 5 mg Tadalafi l hidroklorür başlandı. Koroidal kalınlık, santral makuler kalınlık(SMK) ve total makuler volüm(TMV) spectral optikkohorens tomografi (SD-OKT) kullanılarak değerlendirildi. tüm vizitlerde tekrarlandı. Tüm kontrollerde SD-OKT ve görme keskinliği(GK)ölçümleri tekrarlandı. Ayrıca başlangıçta ve 12. haftada tüm hastalara fundus fl oresein anjiografi (FFA) uygulandı.Sonuçlar: İlk visit hariç diğer tüm kontrollerde başlangıca gore koroid kalınlığında istatistiksel olarak anlamlı düzeyde artış olduğugörüldü(ortalama santral foveal koroidal kalınlık, başlangıç; 248.7 21.5, 1. gün; 247.4 23.2, 4. hafta; 275.9 21.3, ve 12. hafta; 275.1 24.4,?m, p0.001). GK (başlangıç; 0.21 0.07, 12. Hafta; 0.22 0.06, logMar), ortalama SMK (başlangıç; 236.7 32.4, 12.hafta; 234.8 32.8,?m), ortalama TMV (başlangıç; 9.88 1.21, 12. hafta; 9.83 1.26, mm 3 ) ve FFA’ da istatistiksel açıdan anlamlı fark tespit edilmedi(p0.05).Tartışma: Uzun süreli, düşük doz sistemik tadalafi l kullanımı diyabetik hastalarda güvenli bir şekilde koroid kalınlığını artırmaktadır. Ayrıcaretina ve maküla üzerinde yan etkiye sebep olmamaktadır

Which Criteria are More Valuable in Defining Hemodynamic Significance of Patent Ductus Arteriosus in Premature Infants? Respiratory or Echocardiographic?

Aim: Patent ductus arteriosus (PDA) is a frequent health problem in premature infants. Pharmacologic closure is recommended only for hemodynamically significant PDA (hsPDA) that is defined according to the clinical and echocardiographic criteria. The aim of this study was to explore the value of commonly used criteria in defining hsPDA and predicting the required number of courses of ibuprofen treatment to close PDA in premature infants. Methods: Sixty premature infants with a gestational age of ≤33 weeks were evaluated prospectively. Clinical and echocardiographic criteria [O2 requirement, ductus diameter (DD) and left atrial-to-aortic root diameter ratio (LA:Ao)] were used to define hsPDA. Clinical improvement after pharmacologic closure of PDA and association between the criteria and required number of ibuprofen courses were investigated. Results: O2 requirement decreased by PDA closure but was not different between patients with hsPDA and the others with PDA. Also, O2 requirement was not found to be associated with required number of ibuprofen courses. DD and LA:Ao were greater in patients with hsPDA. DD was found to be associated with required number of courses of ibuprofen treatment. Conclusion: Although there was an improvement in O2 requirement with PDA closure, echocardiographic criteria were found to be more valuable in defining hsPDA. DD should also be used to estimate the duration of treatment

Early neonatal outcomes of very-low-birth-weight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323WOS: 000534242500056PubMed: 31851725Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.Turkish Neonatal Society [2-2016]; Turkish Neonatal SocietyThis study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript