Intratunical instillation of bupivacaine and methylprednısolone for relief of scrotal pain and swelling from tese or mesa

Objective: Scrotal pain and swelling due to surgical sperm retrieval procedures and peritesticular fibrosis, as a problem of late term, create significant morbidity in the postoperative life of patients and affect possible future sperm retrieval procedures. Methods: Thirty-one patients received NSAIDS postoperatively by IM (intramuscular) route without local anaesthetic agent and/or corticosteroid instillation around the testicles before closure of the tunica vaginalis-control group-. No NSAIDS were given to the remaining 34 patients in whom 2.5 ml of 0.5% bupivacaine combined with 10 mg/ml. methylprednisolone were introduced before closing of the tunica vaginalis. The mean pain scale scores and duration of painless period after surgery between the two groups were evaluated. Results: The mean pain score difference was not statistically significant just after surgery between the two groups (p>0.05), while the differences were significant for 2 and 4 hours after surgery (p<0.05 and p<0.01). The mean duration of pain free interval (hours) after the procedure was 47.8 ± 16.9 (12-72) hours in the intratunical instillated group patients, and 10 (29%) and 23 (67%) of them were completely free of pain and had no scrotal swelling, respectively. Meanwhile, in the control group, the mean painless period was 9.9 ± 3.6 (4-20) hours, after second NSAID, and 30 of them (97%) had scrotal swelling, postoperatively. Conclusion: This study confirms that direct intratunical Instillation of bupivacaine and methylprednisolone around the testis reduces postoperative pain, scrotal swelling and peritesticular fibrosis. Controlling of post surgical scrotal pain and edema results in more rapid return to daily activities and work

The impact of metabolic risk management on recurrence of urinary stones

Introduction: Urinary stone disease is a common urologic problem and recurrence in stone formation is a very familiar issue to urologists. Although recurrence in stone formation has been linked to metabolic abnormalities, it can be accessible by metabolic risk analysis studies.Methods: Herein, we present our experience in metabolic risk management on recurrence of urinary stones for 10 years in Akdeniz University School of Medicine department of Urology. We retrospectively analyzed Akdeniz University Urinary Stone Database between dates of January 2000 and December 2010. We found over 3500 patients who were managed by SWL (shock wave lithotripsy) or PCNL (percutaneus nephrolithotripsy) or URS (Ureterorenoscopic lithotripsy) or open surgery.Results: 525 patients’ metabolic risk analysis was ordered due to recurrent urinary stone disease. Only 134 (25.5 %) current metabolic analysis were returned. Mean patient age was 32.2 years (range: 19-82 years).Patients were 103 male and 31 female. Stone analysis results were CaOx monohydrate in 48 (35.8 %), CaOx dihydrate in 8 (5.9 %), CaOx mono and dihydrate in 70 (52.2 %), uric acid in 3, CaOx monohydrate and uricacid in 2, cystine in 2, and struvite in 1 patient, respectively. The  metabolic risk analysis showed some abnormality in 54 (40.2 %) patients.Conclusion: Although compliance to metabolic risk analysis studies is low among recurrent urinary stone formers, some significant metabolic abnormalities could be detected in those who are effectively screened.Recurrence of urinary stones in patients who are started on appropriate metabolic management can be prevented

The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Nephrolithotomy in 189 Patients with Solitary Kidneys

Abstract Background and Purpose: The study compared characteristics and outcomes in patients with solitary and bilateral kidneys who were treated with percutaneous nephrolithotomy (PCNL) in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study. Patients and Methods: Data from consecutively treated patients from 96 centers worldwide were collated after a 1-year period. The following variables in patients undergoing PCNL with solitary or bilateral kidneys were compared: Prevalence, patient characteristics, intraoperative differences and outcomes, including bleeding and transfusion rates, renal function, and stone-free rates. Results: Data from 5803 patients were collated; 189 (3.3%) with solitary and 5556 (96.7%) with bilateral kidneys. Patient characteristics were well matched generally with the exception of cardiovascular disease and American Society of Anesthesiologists (ASA) risk scores, which were significantly greater in patients with solitary than with bilateral kidneys (P<0.0001 and P=0.004, respectively). Patients with solitary kidneys had also undergone significantly more procedures to remove calculi before this survey than bilateral patients (P= 00.049 ?<0.0001). Levels of renal impairment were significantly greater (P<0.0001) and stone-free rates were significantly lower (P=0.001) post-PCNL in solitary than bilateral kidney patients. Although bleeding rates were the same in both groups, transfusion rates were significantly greater in solitary kidney patients (P=0.014). Conclusions: Patients with a solitary kidney had a higher cardiovascular risk and ASA score. Outcomes related to morbidity and stone-free rate were less favorable for solitary kidneys.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98444/1/end%2E2011%2E0169.pd

Palliative care in the home: a case study of secondary histiocytic sarcoma in a 3-year-old child

This article describes the medical, psychological, and social challenges encountered during home-based, family-centred palliative care of a 3-year-old female with secondary histiocytic sarcoma diagnosed during treatment for T-cell acute lymphoblastic leukaemia. Histiocytic sarcoma is an exceedingly rare cancer in adults, but even less frequent and highly aggressive when presenting as a secondary cancer in children. Comprehensive, multidisciplinary paediatric hospice care services are not widely available across Slovakia,thus limiting the number of patients and families offered such highly specialized end-of-life care. This case study illustrates the primary benefits for the child and family of such a program as well as the impact on the medical and nursing professionals working in the fi eld of paediatric haematology-oncology

The impact of metabolic risk management on recurrence of urinary stones

Introduction: Urinary stone disease is a common urologic problem and recurrence in stone formation is a very familiar issue to urologists. Although recurrence in stone formation has been linked to metabolic abnormalities, it can be accessible by metabolic risk analysis studies.Methods: Herein, we present our experience in metabolic risk management on recurrence of urinary stones for 10 years in Akdeniz University School of Medicine department of Urology. We retrospectively analyzed Akdeniz University Urinary Stone Database between dates of January 2000 and December 2010. We found over 3500 patients who were managed by SWL (shock wave lithotripsy) or PCNL (percutaneus nephrolithotripsy) or URS (Ureterorenoscopic lithotripsy) or open surgery.Results: 525 patients’ metabolic risk analysis was ordered due to recurrent urinary stone disease. Only 134 (25.5 %) current metabolic analysis were returned. Mean patient age was 32.2 years (range: 19-82 years).Patients were 103 male and 31 female. Stone analysis results were CaOx monohydrate in 48 (35.8 %), CaOx dihydrate in 8 (5.9 %), CaOx mono and dihydrate in 70 (52.2 %), uric acid in 3, CaOx monohydrate and uricacid in 2, cystine in 2, and struvite in 1 patient, respectively. The  metabolic risk analysis showed some abnormality in 54 (40.2 %) patients.Conclusion: Although compliance to metabolic risk analysis studies is low among recurrent urinary stone formers, some significant metabolic abnormalities could be detected in those who are effectively screened.Recurrence of urinary stones in patients who are started on appropriate metabolic management can be prevented

The effect of mineral radon water applied in the form of full baths on blood pressure in patients with hypertension

<strong>Introduction:</strong> Due to patients’ safety, increased blood pressure often restricts wider use of mineral water for therapeutic purposes in rehabilitation practice. The aim of this study was to examine the effect of radon mineral water applied in the form of full baths on blood pressure in people with hypertension.<br /><strong>Methods: </strong>A total of 27 patients, average age 58.10 years with hypertension were included in the study. Balneotherapy was applied in the form of full baths with mineral radon water of neutral temperature. Values of systolic and diastolic blood pressure were measured before and after twenty minutes therapy on the first and fifth day of treatment.<br /><strong>Results:</strong> On the first day of treatment there was no significant change in blood pressure after the application of full baths with mineral radon water of neutral temperature (systolic pressure t = 0.697, not significant; diastolic pressure t = 0.505, not significant). On the fi fth day of treatment there was no significant changes in blood pressure after the application of medical baths with mineral radon water of neutral temperature (systolic pressure t = 1.372, not significant; diastolic pressure t = 1.372, not significant).<br /><strong>Conclusion:</strong> The significant increase of blood pressure in patients with mild and moderate hypertension is not expected when Fojnica water (radioactive mineral water) is being used in the form of full baths of neutral temperature, which allows a broader application of this balneo procedure in rehabilitation practice

Is there any relationship between PSA and increased peripheral CD4+CD25highFOX3+ Treg in prostate cancer patients?

Introduction: The aims of this study were fi rst, to determine whether peripheral levels of CD4+CD25highFoxp3+ regulatory T cells (Treg) are elevated in Prostate Cancer (PCa) patients, and second, to determine the direct correlation between peripheral Treg and total serum Prostate Specifi c Antigen (PSA) levels in these patients. Methods: Peripheral Blood Mononuclear Cells from 56 subjects undergoing diagnostic prostate biopsies (PSA ≥ 2.5 ng/ml) were analyzed for Treg numbers. The association between the peripheral Treg and serum PSA values was fi rst determined in the entire population, including people with no prostate pathology and PCa and Benign Prostate Hyperplasia (BPH) patients, and second, in nine PCa patients before and after curative prostatectomy. Results: This project was performed in Akdeniz University immunology laboratory and urology out patient clinic from 2008 to 2010. Peripheral Treg frequencies were signifi cantly increased in PCa patients (n = 19, 3.23 ± 1.59) compared with BPH patients (n = 27, 1.66 ± 0.80) and healthy subjects (n = 10, 1.08 ± 0.43) (p < 0.01). The percentage of Treg in BPH patients was also signifi cantly higher than that of healthy subjects (p < 0.01). Importantly, the increase in BPH and PCa patients paralleled the elevation in total serum PSA levels, demonstrating a strong positive correlation (r = 0.75; p < 0.01). Conclusion: These results demonstrate that peripheral Treg densities are correlated with PSA in BPH and PCa patients, suggesting that PSA may have a role in Treg induction and/or maintenance in Treg in these people

The impact of metabolic risk management on recurrence of urinary stones

Introduction: Urinary stone disease is a common urologic problem and recurrence in stone formation is a very familiar issue to urologists. Although recurrence in stone formation has been linked to metabolic abnormalities, it can be accessible by metabolic risk analysis studies. Methods: Herein, we present our experience in metabolic risk management on recurrence of urinary stones for 10 years in Akdeniz University School of Medicine department of Urology. We retrospectively analyzed Akdeniz University Urinary Stone Database between dates of January 2000 and December 2010. We found over 3500 patients who were managed by SWL (shock wave lithotripsy) or PCNL (percutaneus nephrolithotripsy) or URS (Ureterorenoscopic lithotripsy) or open surgery. Results: 525 patients’ metabolic risk analysis was ordered due to recurrent urinary stone disease. Only 134 (25.5 %) current metabolic analysis were returned. Mean patient age was 32.2 years (range: 19-82 years). Patients were 103 male and 31 female. Stone analysis results were CaOx monohydrate in 48 (35.8 %), CaOx dihydrate in 8 (5.9 %), CaOx mono and dihydrate in 70 (52.2 %), uric acid in 3, CaOx monohydrate and uric acid in 2, cystine in 2, and struvite in 1 patient, respectively. The  metabolic risk analysis showed some abnormality in 54 (40.2 %) patients. Conclusion: Although compliance to metabolic risk analysis studies is low among recurrent urinary stone formers, some significant metabolic abnormalities could be detected in those who are effectively screened. Recurrence of urinary stones in patients who are started on appropriate metabolic management can be prevented