Investigation of the Relationship between Prostate Weight and Clinical Outcomes in Retzius- Sparing Robot-Assisted Radical Prostatectomy

Objective: To examine the relationship between prostate weight and oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). Materials and Methods: Data of the patients who underwent RS-RARP in our clinic between December 2018 and December 2020 were evaluated retrospectively. A total of 106 patients with 12-month postoperative follow-up data were included in the study. The patients were separated into 2 groups according to the weights of the pathology specimens as Group 1 (n=53, prostate weight less than 50 g), and Group 2 (n=53, prostate weight more than 50 g). Postoperative oncological and functional data were analyzed. At the end of the 12th month, continence was regarded as requirement of no pad or 1 pad per day. Potency was considered as the ability to have sexual intercourse. Prostate-specific antigen (PSA) above 0.2 ng/ml in the follow-up period was considered as biochemical recurrence. Results: Preoperative PSA levels were comparable between groups (9.78+7.84 ng/ml vs. 11.87+8.38 ng/ml). There was no difference in clinical cancer stages and The International Society of Urological Pathology (ISUP) scores between the groups. Median vesicourethral anastomosis time (30 minvs.33 min) and median operative time (240 min vs. 240 min) were comparable in both groups (p>0.05). There was no difference in localized disease and locally advanced disease rates between the groups (pT2: 58.5% vs. 67.9%, pT3: 41.5% vs. 32.0%). Respective surgical margin positivity (SMP) ([16.9% (n=9) vs 9.4% (n=5]), and 12th month biochemical recurrence rates (11.32% vs 3.77%) for Groups 1 and Group 2, were as indicated (p>0.05). Postoperative urinary continence rates at 12 months were 89% and 90% in Groups 1 and 2, respectively (p>0.05). Continence status was not different between the groups. Potency rates at 12 months were comparable between the groups. Conclusion: RS-RARP can be applied in patients with any size of prostates with comparable functional and oncological outcomes

Persistent Left Superior Vena Cava and Partial Anomalous Pulmonary Venous Return in an Old Asymptomatic Female Patient

Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography. The diagnosis can be made when injection of contrast in left antecubital vein results in enhancement of the dilated coronary sinus before right atrium. MRI, CT-scan and catheterisation can be used to confirm the diagnosis

Isolated Subclavian Vein Injury: A Rare and High Mortality Case

Isolated subclavian vein injuries are rarely seen without concomitant arterial injury, bone fracture, damage to brachial plexus, and thoracal traumas. Our case was brought to the emergency service 6 hours after he had been shot at the shoulder with a firearm. After detection of extravasation from the left axillary and subclavian vein on arteriographic and venographic examinations, he was operated on. An autogenous saphenous vein graft was interposed between subclavian and axillary veins. Cardiac arrest developed twice because of hypovolemia, which was resolved with medical therapy. Subclavian vein injuries have a more mortal course when compared with the injuries to the subclavian arteries. Its most important reason is excessive blood loss and air embolism because of delayed arrival to hospital. As is the case in all vascular injuries, angiography is the most important diagnostic examination. If the general health state of the patient permits, arteriography and venography should be performed in patients potentially exposed to vascular injuries. In patients with extreme blood loss and deteriorated health state, direct surgical exploration of the injury site, containment of the bleeding, and venous repair are life-saving approaches

PREVALENCE OF ANXIETY AND RELATIONSHIP OF ANXIETY WITH COPING STYLES AND RELATED FACTORS IN HEALTHCARE WORKERS DURING COVID-19 PANDEMIC

Background: The aim is to investigate anxiety prevalence among the healthcare workers during COVID-19 pandemic and the Subjects and methods: An online questionnaire was performed to evaluate the anxiety responses of 544 healthcare workers, the adopted coping styles and the related factors during COVID-19 pandemic. The questionnaire included the subsections of sociodemographic data, other clinical data and the items on exposure to social media, Generalized Anxiety Disorder-7 (GAD-7) Scale and Coping Styles Scale Brief Form. Results: Minimal, mild, moderate and severe anxiety were present in 214 (39.3%), 191 (35.1%), 95 (17.5%) and 44 (8.1%) participants, respectively. GAD-linical COVID-19, concern about infect COVID-19 to relatives, unwillingness to work, frequency of social media use about COVID-19, sleep l ed that higher adoption of using emotional social support, one of the emotional focused coping styles and behavioral disengagement, one of the ineffektive focused coping styles are considered to be predictor of significant clinical anxiety. Whereas, positive reinterpretation, one of the emotional focused coping styles was a predictor in reduction of significant clinical anxiety. Also more frequent exposure to social media and sleep disturbances were the predictors of significant clinical anxiety in the healthcare staff. Conclusion: Our results have emphasized the factors that should be taken into account and application of coping styles that may be functional in protecting mental health of the healthcare workers in their struggle against a huge disaster affecting worldwide societies

Student Centered Education Scale: A Validity and Reliability Study

The purpose of the study is to develop a valid and reliable scale to measure the teachers’ levels of student-centered education practices. The Exploratory Factor Analysis sample included a total of 426 teachers and the Confirmatory Factor Analysis of the scale was conducted on a total of 160 teachers working in the province of Duzce during the spring term of 2014-2015 education year. Exploratory Factor Analysis was performed to test the construct validity of the scale and the model was tested through the Confirmatory Factor Analysis. For the reliability, Cronbach’s Alpha internal coefficient was calculated and item analysis was performed based on the corrected item total correlation. The final form of the scale included 32 items and one dimension. These 32 items explained 40.04% of the total variance. The results of the item total correlation analysis indicated that none of the item was below 0.30 and the lowest item correlation coefficient was 0.51. Cronbach’s Alpha was found to be 0.95 for the internal consistency of the scale. The reliability and validity results for the Student-Centered Education Scale suggest that this scale is a reliable and valid tool to measure the levels of student-centered educational practices among teachers

Heart Rate Variability in Children with Tricyclic Antidepressant Intoxication

The aim of this study was to evaluate HRV in children requiring intensive care unit stays due to TCA poisoning between March 2009 and July 2010. In the time-domain nonspectral evaluation, the SDNN (P<0.001), SDNNi (P<0.05), RMSDD (P<0.01), and pNN50 (P<0.01) were found to be significantly lower in the TCA intoxication group. The spectral analysis of the data recorded during the first 5 minutes after intensive care unit admission showed that the values of the nLF (P<0.05) and the LF/HF ratio (P=0.001) were significantly higher in the TCA intoxication group, while the nHF (P=0.001) values were significantly lower. The frequency-domain spectral analysis of the data recorded during the last 5 minutes showed a lower nHF (P=0.001) in the TCA intoxication group than in the controls, and the LF/HF ratio was significantly higher (P<0.05) in the intoxication group. The LF/HF ratio was higher in the seven children with seizures (P<0.001). These findings provided us with a starting point for the value of HRV analysis in determining the risk of arrhythmia and convulsion in TCA poisoning patients. HRV can be used as a noninvasive testing method in determining the treatment and prognosis of TCA poisoning patients

New Pulmonary Valvuloplasty Technique by Use of an Hourglass-Shaped Balloon in 3 Adults with Severe Pulmonary Valve Stenosis

Percutaneous balloon pulmonary valvuloplasty is the preferred therapy for pulmonary valve stenosis. However, the designs of the cylindrical balloons historically used for valvuloplasty have limitations, especially in patients who have large pulmonary annular diameters. The hourglass-shaped V8 Aortic Valvuloplasty Balloon may prove to be an effective alternative. The balloon has 2 large bulbous segments that are separated by a narrowed waist. The geometric shape is maintained throughout inflation, improving fixation and enabling broader leaflet opening. We present our first experience with the V8 balloon in 3 adults who had severe, symptomatic pulmonary valve stenosis. In addition to describing their cases, we detail our sizing technique for pulmonary valvuloplasty with the V8 balloon. Our successful results suggest that the V8 balloon is efficient and safe for balloon pulmonary valvuloplasty in adults with severe pulmonary valve stenosis

3D printed Artificial Cornea for Corneal Stromal Transplantation

The aim of this study is to understand the optical, biocompatible, and mechanical properties of chitosan (CS) and polyvinyl-alcohol (PVA) based corneal stroma constructs using 3D printing process. Corneal stroma is tested for biocompatibility with human adipose tissue-derived mesenchymal stem cells (hASCs). Physico-chemical and chemical characterization of the construct was performed using scanning electron microscopy (SEM), fourier transforms infrared spectroscopy (FTIR). Optical transmittance was analyzed using UV-Spectrophotometer. Results showed fabricated constructs have required shape and size. SEM images showed construct has thickness of 400 µm. The FTIR spectra demonstrated the presence of various predicted peaks. The swelling and degradation studies of 13%(wt)PVA and 13%(wt)PVA/(1, 3, 5)%(wt)CS showed to have high swelling ratios of 7 days and degradation times of 30 days, respectively. The light transmittance values of the fabricated cornea constructs decreased with CS addition slightly. Tensile strength values decreased with increasing CS ratio, but we found to support intraocular pressure (IOP) which ranges from 12 to 22 mm-Hg. Preliminary biostability studies showed that composite constructs were compatible with hASCs even after 30 days’ of degradation, showing potential for these cells to be differentiated to stroma layer in future. This study has implications for the rapid and custom fabrication of various cornea constructs for clinical applications