Peripheral blood monocytes in multiple sclerosis exacerbations

Objectives: Monocytes (MO), macrophages, and microglia have a central role in the central nervous system inflammation of multiple sclerosis (MS). During clinical activity in MS, MO activation markers increase and some interleukins and tumor necrosis factor-alpha levels are elevated. Our aim was to determine levels of absolute MO count and percentage in peripheral blood of MS patients during the attacks. Methodology: We assessed the percentage of MO by examining the blood smears in 28 patients with definite MS, in 20 patients with acute cerebrovascular disease (CVD) and in 20 healthy control subjects. Results: The mean value of absolute MO count in MS patients, CVD and control groups were as 606.67± 170.52, 746.50±414.76 and 360.00±109.54 respectively. The mean values of MO percentage in MS patients, CVD and control group were 8.34±2.61%, 5.56±2.48% and 5.36±1.50% respectively. The mean percentage of MO was significantly elevated in MS patients compared with the both groups of CVD and control (P<0.001). Conclusion: Our results suggest a possible role of an increase in MO activation in the acute exacerbations of Multiple Sclerosis

Cardiac involvement in Sydenham's chorea: clinical and Doppler echocardiographic findings

Sydenham's chorea is often encountered in pure form, but it may also occur in association with carditis. Recently, it has been reported that silent, mild valvular regurgitation has been encountered in patients with rheumatic fever manifested by isolated polyarthritis and pure chorea. We studied 22 children with Sydenham's chorea to determine clinical and subclinical heart involvement at the time of the initial diagnosis. Ages of the patients ranged from 6-19 y (mean 13.14 +/- 3.0), and the female/male ratio was 3.4:1. All patients were evaluated by clinical and echocardiographic examination with respect to heart involvement. Carditis was detected in only 5 of 22 patients (23%) by auscultation. Clinical valvular involvement was determined. mitral regurgitation in three and combined mitral and aortic regurgitation in two. The frequency of valvular involvement increased significantly to 63% (14/22) after adding silent mitral regurgitation detected by colour Doppler echocardiography (chi(2) = 7.50, p = 0.0062). We found that clinically inaudible, but echocardiographically significant, mild valvular regurgitation was frequent in patients with pure chorea. It is concluded that colour Doppler echocardiography may be useful in detecting silent valvular regurgitation and in deciding the duration of prophylaxis

Is Tadalafil an Effective Treatment Option for Interstitial Cystitis/Painful Bladder Syndrome? A Report of a Challenging Case

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pelvic pain (CPP) syndrome that is frequently seen in female patients. Since its molecular mechanism and etiopathogenesis are not clearly elucidated, its treatment options are limited. Phosphodiesterase-5 (PDE-5) inhibitors act on nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) and are an effective treatment option in some CPP syndromes. We discuss the case of a 44-year-old female patient who presented to our clinic with a two-year history of frequent urination and pain in the pelvic area. The cystoscopy of the patient, who did not benefit from first- and second-line treatments, was normal. With the diagnosis of IC/PBS, she was started on tadalafil (oral) 5 mg/day. At the end of a total of 12 months of follow-up, it was observed that the patient's symptoms significantly regressed

Impaired heart rate variability as a marker of cardiovascular autonomic dysfunction in multiple sclerosis

Multiple sclerosis (MS) can cause alterations in autonomic cardiovascular functions. We aimed to investigate the correlation of disease activity and disability with heart rate variability (HRV) of cardiovascular autonomic dysfunction (CAD) demonstrated by 24-h Holter monitorization. Thirty-four patients with clinically active relapsing-remitting MS, age 33.8 ± 7.6 years, were studied. Twenty healthy volunteers served as controls. The time domain long-term HRV parameters were recorded by a digicorder recorder calculated by ambulatory electrocardiograms.Variabilities in time domain were lower in the MS patients: SDNN (standard deviation of all R-R intervals, p = 0,019), SDANN (standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recordings, p = 0,040), RMSSD (the square root of the mean of the sum of the squares of differences between adjacent R-R intervals, p = 0,026), HRVM (mean of the SDNN in all the 5-minute intervals, p = 0,029), HRVSD (standard deviation of the SDNN in all the 5-minute, p = 0,043). These results suggest that MS causes CAD manifesting as long-term HRV abnormalities. This illness seems to cause a dysfunction in parasympathetic cardiovascular tone. Depressed HRV parameters are independent from the clinical findings, but the illness progression partially seems to provoke a decrease in such parameters

Demirtas' early renal vascular control technique (DERVACT): A novel technique for open partial nephrectomy

© 2022 Ondokuz Mayis Universitesi. All rights reserved."Demirtas' Early Renal Vascular Control Technique (DERVACT)" is a novel technique for renal pedicle control that aims to achieve rapid and direct access to the renal artery through the retroperitoneal space and then the superior-dorso-lateral aspect of the kidney. In this study, we aimed to introduce DERVACT and to present the initial outcomes of this technique. This retrospective-observational study compared two groups of patients that were operatively treated by the same surgical team using two different nephron sparing surgery (NSS) procedures. Group I (n=95) underwent standard open NSS and Group II (n=92) underwent open NSS with the DERVACT between Jan 2015 and July 2020. Mean age was 56.42 ± 13.27 years. No significant difference was found between the two groups with regard to age, gender, Body mass index, mass laterality and size, and the Padua and c-index scores (p=0.087, p=0.354, p=0.642, p=0.957, p=0.200, p=0.101, p=0.361, respectively). Similarly, no significant difference was found between the DERVACT group and the other group with regard to ischemia duration (20.0 [15.0-30.0] min vs. 18.5 [11.0- 27.0] min, respectively, p=0.060) and intraoperative vascular complication rate (6.3% vs. 1.1%, respectively. p=0.059). However, non-ischemic operative time was significantly shorter in the DERVACT group than in the standard partial nephrectomy group (64.0 [50.0-75.0] vs. 84.0 [61.0- 105.0], p<0.001). As a conclusion, DERVACT is a simple, time-saving, and safe procedure for NSS that can be used in clinics with no opportunities for robotic-laparoscopic partial nephrectomy or in open partial nephrectomy

Diagnostic efficiency of systemic immune-inflammation index in fusion prostate biopsy

Objective: To investigate the diagnostic efficiency of systemic immune response (SII) in prostate cancer (PCa) in patients with PSA < 10 ng/ml undergoing fusion prostate biopsy