Can proliferative hypertrophic scars of the median sternotomy incision predict the occurrence and characteristics of urethral stricture?

Conclusion: A poorly healed median stemotomy incision scar can predict a poor wound healing in the urethra tissue. Further large scale, multi-center and prospective studies are needed to clarify this relationship

The cientificWorldJOURNAL Clinical Study Fasting Blood Glucose and Lipid Profile Alterations following Twelve-Month Androgen Deprivation Therapy in Men with Prostate Cancer

properly cited. Purpose. In this retrospective study, we aimed to investigate the effects of androgen deprivation therapy (ADT) on blood glucose and blood cholesterol levels over a 12-month period. Materials and Methods. Between January 2010 and June 2012, the data of 44 patients with prostate cancer who were receiving ADT were collected from a hospital database. Patients with additional malignancy or diabetes and those who had been prescribed and were currently taking cholesterol-lowering medication were excluded from the study. Data (including fasting blood glucose levels and a cholesterol profile) were collected and analysed statistically. A P value <0.05 was considered statistically significant. Results. Twelve months after the initiation of ADT, fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride (TG) levels changed. FBG, TC, LDL cholesterol, and TG increased significantly (P = 0.009, 0.000, 0.000, and 0.000, resp.), while HDL cholesterol decreased (P = 0.000). Conclusion. ADT may increase FBG, TC, LDL cholesterol, and TG but decrease HDL cholesterol by the end of a year of treatment. Therefore, close followup may be needed as a consequence of one-year ADT regarding metabolic alterations

Particularities regarding Clinical-biological and Evolutive Parameters of Immune-mediated Rheumatic Diseases in Patients with COVID-19 – systematic literature review

Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was a serious medical threat and was declared Global Pandemic, triggering fear, panic and uncertainty for people around the Globe. Among those individuals, there is a specific category of patients – the ones with immune-mediated rheumatic diseases (IMIDs) – whose mantra from the diagnosis was to avoid infections at all costs because of the additional negative impact on the immune sys-tem and overall reactivity. Objective: Considering the aforementioned, our objective is to understand the in-depth relation of the immune system of patients with IMIDs in the set-ting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the real bur-den of the disease and vaccination against COVID-19. Materials and Methods: In this res-pect, we have conducted a thoroughly systematic literature review according to the “Prefer-red Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” concept. Following its five-steps algorithm, we first selected 745 articles that were published in re-putable international medical databases, ISI-indexed, for the period 1 January, 2021–31 December, 2022. After consequent elimination of duplicates, of articles that were not En-glish-written and “open access” and then applying PEDro classification/scoring-inspired, only 58 articles were selected for in-depth full qualitative reading. In the last stage,20 arti-cles were “excluded with reasons”, because they didn’t offer significant information. The-refore, in our systematic literature review, 38 articles were included.Results: In the data gathered in this review we described the molecular pathways of activation of the immune system triggered by COVID-19, with significance on the clinical and paraclinical aspects of IMID patients infected with the new Coronavirus. Patients with IMIDs are at higher risk for hospitalization if diagnosed with SARS-CoV2 and more prone to severe outcomes and death. Risk factors associated with severe outcomes and death are: age, comorbidities, un-derlying disease activity, therapies used (“the good” being anti-tumor necrosis factor α, “the bad” – Methotrexate, Sulfasalazine, Azathioprine and “the ugly” – anti CD20 mono-clonal antibodies). There were several reports of flares and new-onset of IMIDs after CO-VID-19 and after vaccination against this disease, but data from larger studies and registri-es do not confirm higher incidence of flare-ups or new-onset IMIDs. Regarding vaccination, of mounting importance is the timing between immunomodulatory and immunosuppres-sive agents and the administration of the vaccine. And last but not the least, we discussed about Long COVID and the role of artificial intelligence in the pandemic and related-drug development. Discussion and Conclusion: The data in our systematic literature review is consistent with the expertise from our clinical practice. This article is the first part of the doctoral study that is centralized on the same topics, with the current objective of deepe-ning the knowledge about the intersection of COVID-19/SARS-CoV2 and immune-mediated rheumatic diseases and a future objective: to compare information we have synthetized here with our database of almost 170 Romanian patients with a IMID and COVID-19/SARS-CoV2. The next objective is to extend the study to a multicenter control one

Endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer and dextranomer/hyaluronic acid in adults

Purpose Aim of this study is to examine the effectiveness of dextranomer/hyaluronic acid copolymer and polyacrylate polyalcohol copolymer in endoscopic treatment of vesicoureteral reflux disease in adult patients with and without chronic renal failure. Materials and Methods Thirty two patients (12 female, 20 male) with a total of 50 renal units were treated for vesicoureteral reflux. There were 26 (81%) chronic renal failure patients. The success of treatment was evaluated by voiding cystouretrography at 3rd and 12th months after subureteric injection. The persistence of reflux was considered as failure. Patients were divided into two groups according to injected material. Age, sex, grade of reflux and treatment results were recorded and evaluated. Results Reflux was scored as grade 1 in seven (14%), grade 2 in 16 (32%), grade 3 in 21 (42%) and grade 4 in six (12%) renal units. There was not patient with grade 5 reflux. Fourteen renal units (28%) were treated with dextranomer/hyaluronic acid copolymer (group 1) and 36 renal units (72%) were treated with polyacrylate polyalcohol copolymer (group 2). The overall treatment success was achieved at 40 renal units (80%). The treatment was successful at 11 renal units (79%) in group 1 and 29 renal units (81%) in group 2 (p = 0.71). There was not statistically significant difference between two groups with patients with chronic renal failure in terms of treatment success (p = 1.00). Conclusions The effectiveness of two bulking agents was similar in treatment of vesicoureteral reflux disease in adult patients and patients with chronic renal failure

Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists

Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted kappa values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders

Progress of urban forests in Turkey and legal aspect

Aim of study: The level at which the concept of urban forest, which is constantly developing, has reached in Turkey and in the world has been researched. At the same time, it is aimed that the concept of urban forest in Turkey is considered from the legal aspect and the legal deficiencies in this point are examined and suggestions for solutions are made

Morphological and morphometric anatomy of the lesser occipital nerve and its possible clinical relevance

Abstract The lesser occipital nerve (LON) has one of the most variations among occipital nerves. We aimed to investigate morphological and morphometric features of LON. A total of 24 cadavers, 14 males (58%) and 10 females (42%), were dissected bilaterally. LON was classified into 3 types. The number of branches and the perpendicular distances of the point where LON emerged from the posterior border of sternocleidomastoid muscle to vertical and transverse lines passing through external occipital protuberance were determined. The shortest distance between LON and great auricular nerve (GAN), and linear distance of LON to its branching point were measured. The most common variant was Type 1 (30 sides, 62.5%), followed by Type 2 (12 sides, 25%) and Type 3 (6 sides, 12.5%), respectively. In males, Type 1 (22 sides, 78.6%) was the most common, while Type 1 (8 sides, 40%) and Type 2 (8 sides, 40%) were equally common and the most common in females. On 48 sides, 2–9 branches of LON were observed. The perpendicular distance of said point to vertical and transverse lines was meanly 63.69 ± 11.28 mm and 78.83 ± 17.21 mm, respectively. The shortest distance between LON and GAN was meanly 16.62 ± 10.59 mm. The linear distance of LON to its branching point was meanly 31.24 ± 15.95 mm. The findings reported in this paper may help clinicians in estimating the location of the nerve and/or its branches for block or decompression surgery as well as preservation of LON during related procedures

Energy use pattern and cost analysis of cotton agriculture: A case study for Sanliurfa, Turkey

This survey was conducted to determine the energy use pattern and economic analysis of cotton farming in the Southeastern Anatolia Project (SEAP) areas in Turkey. Data were obtained through a questionnaire sent to 40 cotton producers from the different villages of Sanliurfa, Turkey which is the most important cotton province of the SEAR Basic operational data were measured by using a computer-based data acquisition system. Total energy input, total energy output, output/input ratio and net energy ratio were 37.910, 95.800, 2.52 and 1.532 MJ ha(-1), respectively. The highest contribution to the total energy consumption came from fuel and oil energy input at 10.417 MJ ha(-1). However, the lowest contribution to total energy consumption came from bund making at 99,6 MJ ha(-1)

Do the values of prostate specific antigen obtained from fresh and dried urine reflect the serum measurements?

Aim: To investigate if free PSA (fPSA) and total PSA (tPSA) values obtained from simultaneously collected urine, fresh and dried on filter paper, reflect the serum free and total PSA. Materials and Methods : The sera and 20 cc first voided urine from 33 consecutive men aged between 40 and 84 (mean 61 ± 12), were collected in the morning and delivered to the laboratory. Three different aliquots of 100 microgram urine were taken with automatic pipette and dropped on 3 certain areas of a filter paper and allowed to dry for each patient. On each paper, borders of dried urine were marked. PSA values were obtained from the sera and fresh urine samples and recorded. Later on particular days dried urine samples were dissolved and eventually PSA values were derived and recorded again. The results were compared to each other. Correlations were evaluated by using an SPSS statistics program. Results: Serum PSA values correlated weakly (r 0.75) among PSA values of dried urine samples of 1-day, 7- and 28-days, were seen. Conclusions : We conclude that PSA values obtained from fresh and dried urine could not reflect serum PSA values. But, because dried urine on a filter paper can be stable for years, it could be used for forensic purposes

Teaching NeuroImages: A rare cause of trigeminal neuralgia Dysplastic venous aneurysm of dural arteriovenous fistula

A 56-year-old man presented with episodic intense facial pain. Trigeminal neuralgia was the presumed diagnosis. MRI revealed vascular compression of the root entry zone (REZ) of the trigeminal nerve (TN) (figure 1, A and B). A dural arteriovenous fistula was detected at the left side of the cerebellar tentorium on digital subtraction angiography (figure 2). A dysplastic venous aneurysm of the draining vein was determined to be the compressive vascular lesion seen on MRI. Trigeminal neuralgia is a common neuropathic disorder characterized by episodes of intense facial pain, most often because of a vascular compression of the REZ of the TN.(1,2</SUP