The protective effect of ischemic preconditioning on rat testis

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Reliability of venous diameter in the diagnosis of subclinical varicocele

Objective: The diameters of the veins in the pampiniform plexus have been used to diagnose subclinical varicocele. But there are many cutoff points and some controversies about the diagnosis. These cause difficulty in the evaluation of the results of epidemiological and clinical studies. Our aim is to establish the reliability of vein diameters in the pampiniform plexus in the diagnosis of subclinical varicocele. Methods: Physical examination, scrotal gray scale ultrasonography (SU) and color Doppler ultrasonography (CDU) were performed to assess varicocele in 100 infertile patients without clinical varicocele (group I), 100 infertile patients with clinical left varicocele (group II), and 50 fertile men without clinical varicocele (group III) as a control group. The diameter of the veins in the pampiniform plexus was measured with SU. According to various cutoff points of venous diameter and CDU criteria, the diagnosis of varicocele was made. The highest mean venous diameters were calculated with and without varicocele in men whose diagnoses had been made with CDU. The results were correlated with each other and the control group. Results: According to venous diameter cutoff points, the varicocele ratio did not correlate with the CDU results (p 0.05) except for the left side of group II patients. We did not find an exact relation between the highest venous diameter in the men who have and those who do not have subclinical varicocele with CDU. The highest mean diameter was 2.17 +/- 0.34 (SD) mm for men who have subclinical varicocele and 2.00 +/- 0.31 mm for men who do not have subdinical varicocele by CDU (p < 0.05). Conclusion: Our results indicate that venous diameters should not be used as diagnostic criteria for subdinical varicocele. Only the evaluation of venous diameter in varicocele should be used to document and quantify pathology, but it should not be used to establish the diagnosis. Copyright (C) 2003 S. Karger AG, Basel

Enuresis prevalence and accompanying factors in schoolchildren: A questionnaire study from Southeast Anatolia

Introduction: The aims of this study were to establish the prevalence of enuresis, to determine accompanying factors, and to identify common methods in the management of enuresis in Turkish children aged between 6 and 11 years living in eastern Anatolia. Methods: The parents of 3,527 schoolchildren aged between 6 and 11 years completed a self-administered questionnaire. The questionnaire asked about sociodemographic data, enuresis data, physical or psychological disorders, and family stressors. Descriptive statistics and chi(2) test were used for data analysis. Results: The response rate was 88%. The overall prevalence of reported enuresis was 12.96%, and the prevalence of marked enuresis ( at least weekly) was 9.8%. Enuresis was notably more common in boys ( male: female ratio 1.6), and the prevalence rates decreased by age without gender bias. Of all enuretic children, 21% had also daytime bed-wetting. The rate of a positive family history was 42% for siblings only and 66% for the other family members. Significantly more of the dry children woke up spontaneously at night to void as compared with the enuretic children ( p < 0.001). The parental concern level was not high, and only 15% of the children visited a physician for the management of enuresis. Low socioeconomic status, unfavorable perinatal or postnatal history, and unsatisfactory familial characteristics were significantly more frequent in the enuretic group (p < 0.05). The enuretic children had also higher rates of poor school performance and poor social adaptation as compared with nonenuretic children (p < 0.001). Conclusions: These results suggest that the prevalence of enuresis in eastern Anatolia is similar to that reported from western Anatolia and from most other countries. Turkish families did not report a high-level concern about enuresis, and the problem was managed primarily within the family. Copyright (C) 2004 S. Karger AG, Basel

Effectiveness of electro-acupuncture compared to sedo-analgesics in relieving pain during shockwave lithotripsy

The aim of this study was to compare the clinical efficacy of electro-acupuncture (EA) with the combination of tramadol+midazolam (TM) for pain relief during outpatient extracorporeal shockwave lithotripsy (ESWL). A total of 35 patients (20 men, 15 women) with stones located in the pelvicalyceal system of the kidney were randomized prospectively to undergo lithotripsy with a third generation lithotriptor (Stone Lith, smart PCK) after receiving either EA (n=17) or TM (n=18) for sedation and analgesia. EA treatment was applied to patients by the same licensed acupuncturist 30 min prior to ESWL in group EA. Tramadol (1.5 mg/kg) 30 min before the start of lithotripsy and midazolam (0.06 mg/kg) 5 min prior to ESWL were given as a sedo-analgesic intravenously to group TM. During ESWL, blood pressure, heart rate, pain and sedation levels were measured at baseline and every 15 min thereafter. The pain intensity perceived during lithotripsy was evaluated using a visual analog scale (VAS). There was no statistical differences in the diameters of the stones and age of the patients between groups (P=0.590; P=0.568, respectively). In the EA group, the median of maximum energy level achieved was 16.0 kV (range 10-23 kV), while it was 18.0 kV (range 10-20 kV) in the TM group. There was no statistically significant difference between the maximum energy levels applied to the patients during ESWL (P=0.613). The median numbers of shockwaves were 2,114 (range 1,100-3,800) and 2,200 (range 1,500-3,200) in the EA and TM groups, respectively. In the TM group, the numbers of shockwaves used were higher than in group EA during ESWL. However, this difference was not significant (P=0.732). VAS scores were consistently lower in the EA group compared with the TM group throughout the ESWL procedure. The median VAS score was 5.0 (range 1-10) in the EA group while it was 8.0 (range 2-10) in the TM group. The patients who underwent EA had lower median scores of VAS than patients who took only conservative treatment, but this difference was not significant (P=0.245). When both groups were compared for stone-free rates, no significant difference was found [82.3% (14/17) for group EA, 88.8% (16/18) for group TM] (P=0.658). Durations of ESWL procedures were similar in both groups [median 27.4 min (range 15.7-34.3) in group EA vs 27.1 min (range 16.1-33.6) in group TM] (P=0.517). No side effects was seen in any patient who received EA. Side effects such as mild orthostatic hypotension and dizziness occurred in patients given sedo-analgesia, but these were not severe enough to require any patient to be excluded from the study. Our study shows that EA is an effective method for inducing sedation with analgesia without any demonstrable side effects

Wound approximation with tissue glue in circumcision

Background: To assess the feasibility of using tissue glue in the approximation of circumcision wounds in children

An Unusual Presentation of Polyarteritis Nodosa: A Case Report

Polyarteritis nodosa with gallbladder involvement is a rare condition. Autosomal dominant polycystic kidney disease is also a rare condition and rarely complicated. We describe an extremely rare case of Polyarteritis nodosa, involving gallblader and ureter without obstruction, in a patient with autosomal dominant polycystic kidney disease. To the best of the authors’ knowledge, such a case has not been reported previously. "Una Manifestación poco usual de la Poliarteritis Nodosa Reporte de un Caso" La periarteritis nodosa con compromiso de la vesícula es una condición rara. La enfermedad poliquística renal autosómica dominante es también una condición rara y raramente complicada. Describimos un caso extremadamente raro de poliarteritis nodosa, con compromiso de la vesícula y el uréter sin obstrucción, en un caso de enfermedad poliquística renal autosómica dominante. Al leal saber y entender de los autores, no ha sido reportado antes un caso como éste