Management Of Fournier's Gangrene Secondary To Traumatic Urethral Catheterisation

Fournier's gangrene (FG) is a rare aggressive necrotising fasciitis of the genitalia. We present one FG case following traumatic urethral catheterization in spinal cord injury patient with suspected bladder cancer. We want to emphaze that bedside cystoscopy can be needed for deciding what we will do when the FG patient has concomitant suspected bladder cancer and urethral catheterisation should be performed by expert hands

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Optimal screening value of vitamin D deficiency for distal symmetric polyneuropathy in patients with diabetes

Abstract Aim: The cut-off value of serum 25-hydroxy-vitamin D level for bone-skeletal and cardiovascular diseases are well defined. However, there is no current study defining the optimal cut-off value of serum 25(OH)D levels for preventing diabetic distal symmetric polyneuropathy (DSP). We aimed to evaluate the relationship between the 25(OH)D levels and the parameters of electrophysiology and Toronto Clinical Scoring System (TCSS) to obtain a cut-off value of serum 25(OH)D levels in diabetic DSP patients. Materials and Methods: This is a case-control study included 90 diabetic patients with or without diagnosed DSP who were visiting the outpatient Physical Therapy and Rehabilitation Clinic. The patients’ demographic data and vitamin D levels were recorded. The patients were classified according to serum 25(OH)D levels as having optimal, insufficiency, and deficiency. The electrophysiological study was conducted for the diagnosis and staging of polyneuropathy. TCSS was used to evaluate the patients’ neuropathic symptoms. Results: From the results of this study conducted on the 90 patients that were diagnosed with diabetes, it was found that the electrophysiological study and TCSS were significantly different in the three vitamin D groups. Regression analysis test demonstrated that 25 (OH) D level with 0.845 odds ratio is the only risk factor for the development of DSP. The serum levels of 25(OH)D below 15 ng/mL is associated with DSP. Conclusion: This study indicate that vitamin D deficiency is a risk factor for the development of DSP, and serum 25(OH)D level ≤ 15 ng/ml is crucial in assessing the severity of neuropathic symptoms

Association between diabetes mellitus and disability in hand osteoarthritis

Aims: Osteoarthritis (OA) and diabetes mellitus (DM) may coexist frequently. The increase in overall OA incidence is correlated with poor glycemic control and disease duration in patients with DM. However, the association between a DM diagnosis and specifically hand OA has not been explicitly determined. We assessed the association between DM and severity of disability in hand OA. Methods: This single-center, case-control study prospectively enrolled outpatients with hand OA who visited a physical therapy and rehabilitation clinic. The patients were grouped according to the presence of DM diagnosis. Pain, hand function, grip strength, and quality of life were evaluated and compared between the two groups. Results: The study included 100 participants [Age: 62.7±10.7 years (33-92); female: 78%]. The mean Australian/Canadian OA hand index of patients with OA with (n=50) and without DM (n=50) was 30.7±10.1 vs. 19.9±9.6, respectively (p0.001). The mean lateral grip strength of the dominant hand of patients with and without DM was 4.5±2.1 vs. 5.9±2.1, respectively (p=0.002). Lateral grip strength of the non-dominant hand showed a negative correlation with DM duration among women (r=-0.387, p=0.018) and a positive correlation with hemoglobin A1c level among men (r=0.609, p=0.027). Conclusions: This study showed an association between DM diagnosis and severity of hand disability in patients with hand OA, with different patterns among women and men. Nevertheless, the results were unadjusted for relevant confounders © Copyright 2022 by the University of Health Sciences Türkiye, Gülhane Faculty of Medicine / Gülhane Medical Journal published by Galenos Publishing Hous

Penile Reconstruction After Radiator Fluid Burn

Chemical burns are among the leading causes of mortality and morbidity. While radiator fluids used in the cooling systems of vehicle radiators contain ethylene glycol and other organic chemical agents, ethylene glycol, because of its high boiling point, can lead to serious burns even in brief contact. In total or partial penis losses, regardless of etiology, the desired aesthetic and functional results can be achieved by using free composite tissue reconstruction. However, presence of extensive scar tissue on the donor site and the recipient vessels that are located in the zone of injury are restricting factors for using free flaps in burn reconstruction. In this report, a case with subtotal penis loss due to a scald burn that occurred from car radiator fluid in a traffic accident and our reconstructive treatment approach with free osteocutaneous fibular flap is presented

Recurrent Breast Cancer with Cutaneous Metastasis in the Late Term

Breast cancer, which is a common cause of cutaneous metastasis, has substantially high mortality and morbidity rates in women. Skin metastasis of breast cancer usually occurs at the adjacent anterior chest wall, and scalp metastasis is very rare. Due to these rates, the preliminary diagnosis of the skin metastasis of breast cancer can be overlooked in case of a scalp mass, and this can result in inadequate or extra surgery. In this paper, we present the rare case of a patient who presented to our clinic with a scalp mass, and was operated with a preliminary diagnosis of a pyogenic granuloma; however, the patient’s histologic assessment revealed a diagnosis of late-term scalp metastasis of a breast mucinous carcinoma

Rare but lethal disease of childhood: metastatic, muscle invasive bladder cancer

Bladder cancer is the most common malignancy of urinary tract and the seventh most common cancer in men with the peak incidence in the sixth decade of life. Our knowledge about bladder tumors in pediatric age group mainly relies on case series. The reported cases are mostly low grade and non-muscle invasive. We herein present a case of a 17- year-old male with metastatic high-grade muscle-invasive bladder cancer who was presented with macroscopic hematuria and flank pain

Are There Relationships between Seminal Parameters and the Neutrophil-to-Lymphocyte Ratio or the Platelet-to-Lymphocyte Ratio?

Purpose: The aim of this study was to evaluate the relationship of seminal parameters with the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), which are inflammatory markers, in men with an abnormal semen analysis and men with normozoospermia. Materials and Methods: Fifty-seven men with abnormal semen analyses and 59 men with normozoospermia were included in this cross-sectional study. A complete blood count was recorded, and the NLR and PLR were calculated from the hematologic parameters. Results: The NLR was 1.84±0.78 in the normozoospermic group and 1.80±0.75 in the abnormal semen analysis group. The PLR was 95.32±35.47 in the normozoospermic group and 93.57±28.09 in the abnormal semen analysis group. No significant differences were found between the normozoospermic and the abnormal semen analysis group in the NLR (p=0.828) or the PLR (p=0.768). In addition, no seminal parameters were correlated with the NLR or the PLR (p＞0.05). Conclusions: We do not recommend using the NLR or the PLR as markers to screen for abnormal semen parameters or male infertility

Relationship between neck circumference and overactive bladder in women with metabolic syndrome: a preliminary study

WOS: 000391829500006PubMed: 25854906To investigate relationship between overactive bladder (OAB) and metabolic syndrome (MtS) by using neck circumference (NC). In retrospective view of prospective collected data, 204 women with or without OAB were enrolled into study, between August 2012 and December 2013. All patients were administered OAB validated questionnaires (OAB-V8) and whose score was > 8 were accepted as OAB. Patients were divided into two groups and group 1 consisted of patients with OAB, group 2 consisted of patients without OAB. Demographic data with anthropometric measurements and blood analyses were recorded. Statistical analyses including receiver operating characteristic (ROC) curves were performed; statistically significant p was < 0.05. Mean age was 41.06 +/- 9.78 years. There were 115 (56.4 %) patients in group 1, and 89 (43.6 %) patients in group 2. OAB-V8 scores were significant higher in group 1 than group 2 (p < 0.001). Waist circumference (WC) and NC measurements were statistical significant longer in group 1 than group 2 (p < 0.001). In multivariate logistic regression analyses age, body mass index, MtS, WC, and NC were statistical significant associated with OAB. In ROC curves, area under the curve (AUC) was 0.72 cm(2) for relationship between OAB and WC (p < 0.001), and AUC was 0.73 cm(2) for relationship between OAB and NC (p = 0.004). Cut-off NC and WC values for OAB were determined as 35.25 cm and 98.5 cm, respectively. OAB with metabolic syndrome seems like more common in women than in those without. NC may be a novel indicator for OAB in selected female patients with MtS