Molecular and serological evidence of Anaplasma phagocytophilum infection of farm animals in the Black Sea Region of Turkey

This study was designed to determine the presence and the prevalence of Anaplasma phagocytophilum infection in sheep and cattle in the Middle and Eastern Black Sea Regions of Turkey in which the potential vector, Ixodes ricinus , is widespread. Blood samples were collected from 720 sheep and 720 cattle from 6 provinces of the region, and used for detecting antibodies to A. phagocytophilum by indirect immunofluorescent antibody test (IFAT) and specific nucleic acids by a nested polymerase chain reaction (PCR). Blood smears were also prepared and examined microscopically for the presence of A. phagocytophilum -like organisms in polymorphonuclear cells. Of the animals examined, antibodies were detected in 110 (15.27%) cattle and 107 (14.86%) sheep and A. phagocytophilum -like organisms were detected in the blood of 73 (10.13%) cattle and 71 (9.86%) sheep. In addition, specific DNA was detected in the blood of 27 (14.75%) cattle and 22 (12.35%) sheep. The results obtained constitute the first molecular and serological evidence of A. phagocytophilum infection in sheep and cattle in the Black Sea Region of Turkey

Robot assisted heminephrectomy for duplicated renal collecting system: Technique and outcomes

Background: The aim of this study was to describe experience with robotic assisted hemi-nephrectomy (RAHN) for the management of duplicated renal collecting system. Methods: The authors' institutional database was queried to identify patients who underwent RAHN from 2007 to 2013 for the management of a duplicated system. Patient demographics, indications and surgical outcomes were reviewed and analyzed. Results: Five patients were identified with a duplicated system of which all had a history of pain and recurrent infection. Three patients underwent hemi-nephrectomy for a poorly functioning lower pole and two for an abnormal upper pole moiety. All operations were completed successfully using a robotic approach. There were only two minor (Clavien grade 1-2) complications. Conclusions: RAHN is a viable option for the surgical treatment of an atrophic, chronically infected duplicated system. The unique features of robotic technology offer enhanced dexterity and vision facilitating the management of complex vascular and ureteral anatomy

Laparoscopic vs Percutaneous Cryoablation for the Small Renal Mass: 15-Year Experience at a Single Center

Objective To analyze our 15-year experience with small renal masses ablation and present oncologic and functional outcomes of laparoscopic cryoablation (LCA) and percutaneous cryoablation (PCA). Materials and Methods We identified patients who underwent LCA (n = 275) or PCA (n = 137) for small renal masses between 1997 and 2012. Differences in overall survival (OS) and recurrence-free survival (RFS) were analyzed using a log-rank test. Cox proportional hazard ratios model was used to determine factors that predicted OS. Fit proportional hazard risk ratios were also calculated to determine if there were any factors that affected tumor recurrence. Results Tumor sizes were equal between the 2 groups; however, tumors in the PCA group were more complex. The overall (7.27% and 7.29%) and major complications (0.7% and 3.6%) were similar. The estimated probability of 5-year OS for LCA and PCA was 89% and 82%, respectively. The estimated probability of the 5-year RFS for LCA and PCA was 79% and 80%, respectively. Heart disease (hazard ratio, 2.15; 95% confidence interval, 1.35-3.41; P =.001) and history of disease recurrence (hazard ratio, 2.49; 95% confidence interval, 1.60-3.86; P =.001; P <.0001) were predictors of death. The median follow-up time for the LCA group (4.41 years [1.67-6.91 years]) was longer than the PCA group (3.15 years [1.37-4.08 years]; P =.0001). Conclusion We found no significant difference in OS or RFS at 5 years between the 2 groups. Tumor size and anterior location affected local recurrence rates, and these factors should be taken into consideration when choosing the appropriate treatment plan. RENAL nephrometry score or type of cryoablation was not associated with tumor recurrence