Help-seeking interval in erectile dysfunction analysis of attitudes, beliefs, and factors affecting treatment-seeking interval in turkish men with previously untreated erectile dysfunction

In this study, we report data on attitudes, beliefs, and factors affecting the help-seeking interval among Turkish men with erectile dysfunction to determine whether they are different from those previously published in the literature. Out of 279 Turkish men complaining of erectile dysfunction attending our clinic between December 2006 and March 2008 without the need for referral, 202 were interviewed from a standardized questionnaire covering demographic details, relationships, help-seeking intervals, and attitudes and beliefs. Eleven patients interrupted the questionnaire and only 191 individuals who had never sought medical help for their erectile dysfunction completed the study. The mean age of the study population was 50.1 (20-80) years. Overall, 93.7% of participants had engaged in sexual intercourse during the year preceding the interview. The mean help-seeking interval and the mean estimated time elapsed since last satisfactory sexual intercourse were 24.5 (1-360) and 10.5 (1-180) months, respectively. Patients with low household income and education level had a relatively longer help-seeking interval than the remaining sample. No statistical correlation was seen between treatment-seeking interval and patient age, duration of marriage or continued relationship, and presence of premature ejaculation. Main reasons for delayed consultation included embarrassment (n = 63, 33%) and thinking of erectile dysfunction as a natural process of aging (n = 51, 26.7%). To enable earlier diagnosis and management of erectile dysfunction, emphasis should be put into the provision of affordable health care and wide public education about erectile dysfunction as an entity requiring prompt medical consultation

Effects of Topical Cova™, Tisseel® and Adcon®Gel application on the development of spinal peridural fibrosis: An experimental study in rats

AIm: Leptomeningeal adhesions and fibrosis in the spinal peridural space are the most common causes of post-laminectomy syndrome. Fibrin sealant agents and membrane barriers are commonly used for hemostasis and sealing purposes in spinal surgery. Peridural fibrosis may be a risk of the usage of these topical agents. In this study, we aimed to compare the effects of Cova™, Tisseel® and Adcon®Gel on the development of spinal peridural fibrosis in the experimental rat model. Mater Ial and Methods: Thirty-two Sprague Dawley female rats were randomly divided into 4 groups. Groups were constituted as group 1; Cova™ group (laminectomy+CovaTM), group 2; Tisseel® group (laminectomy+Tisseel®), group 3; Adcon®Gel group (laminectomy + Adcon®Gel), group 4; control group (laminectomy only). Six weeks after laminectomy, spinal columns were removed en bloc between L1 and L4 vertebrae. Peridural fibrosis was evaluated histologically and the results were compared statistically. Results: Statistically significant reduction of peridural fibrosis was achieved in groups 1, 2, and 3 when compared with the control group (p<0.05). Our data revealed a statistically significant difference between group 1 and group 3 (p<0.05). When we compared with group 2 and 3, the fibrosis grades were not different between these two groups (p>0.05). ConclusIon: Fibrin sealant agent Tisseel® and membrane barrier Cova™ do not enhance peridural fibrosis following laminectomy. Cova™ and Tisseel® may be appropriate for hemostasis and leakage prevention during the spinal surgery and it is safe to leave these materials on the operation surface

Recurrent and Massive Life Threatening Epistaxis due to Nasal Heroin Usage

Epistaxis, active bleeding from the nose, is a common ear nose and throat emergency, and can be severe or even fatal. We report a severe life threatening recurrent massive nasal bleeding caused by intranasal heroin use that has not hitherto been reported in the English literature. A 24-year-old male who took heroin several times nasally presented with massive nasal bleeding. A blood transfusion and an operation to halt nasal bleeding were required. The patient did not experience a bleeding attack 2 months following cessation of nasal heroin use

A child with a severe headache: Questions

A 12-year-old girl presented with complaint of severe headache lasting 10 days, nausea and vomiting for 1 day. The headache was localized in the right fronto-occipital region with spread to the neck and shoulders. In her medical history, tympanostomy tubes were inserted in her ears due to frequent otitis media with effusion before 2 years. She had recurrent reactive airway, asthma attacks, and allergic rhinitis. Before the definitive diagnosis could be established, she had received systemic antihistamine, nasal steroid, leukotriene antagonist, inhaler steroid, and salbutamol. She was treated with sefaclor per orally due to acute sinusitis for 5 days. The patient was admitted to our hospital with symptoms of severe headache. Physical examination showed that she was alert with an axillary temperature of 36.3 °C, weight of 60 (95th percentile) kg, height of 155 (65th percentile) cm, blood pressure of 150/100 mmHg (> 95th/> 95th percentile), and heart rate of 98 beats/min

A child with a severe headache: Answers

1) What is your suspected diagnosis of acute severe headache in this patient? We report here an adolescent girl who presented with severe headache while receiving acute sinusitis treatment and was found to have bilateral papilledema, anemia, hepatosplenomegaly, and hypertension. In addition, our patient also manifested the symptoms and signs suggesting increased intracranial pressure as intractable headache, nausea, vomiting, and bilateral papilledema

Rasyonlarda yem katkı maddesi olarak iki Deniz yosununun (Ulva lactuca, Enteremorpha linza) gökkuşağı alabalığının (Oncorhynchus mykiss) büyüme performansı, yem değerlendirme ve vücut kompozisyonu üzerine etkileri

Bu çalışmada, iki deniz yosunu (Ulva lactuca, Enteremorpha linza) içeren rasyonun gökkuşağı alabalığının büyüme performansı, yem değerlendirmesi ve vücut kompozisyonu üzerine etkisinin belirlenmesi amaçlanmıştır. İki deneme rasyonu % 10 U. lactuca ve %10 E. linza unu içerecek düzeyde formülüze edilmiş, kontrol grubuna ise hiçbir deniz yosunu ilave edilmemiştir. Her bir deneme grubu üç tekerrürden oluşmuş, her bir tekerrürde ortalama ağırlığı 32.960.29 g olan 14 balık yer almıştır. Balıklar günde üç kez elle yemlenmiş ve çalışma 60 gün sürmüştür. Deniz yosunu içermeyen Kontol grubu ile U. lactuca ve E. linza unu ihtiva eden gruplar arasında ağırlık artışı, spesifik büyüme oranı, nispi büyüme oranı ve yemden yararlanma yönünden farklılık istatistiki olarak önemli bulunmuştur (P0.05). % 10 E. linza unu içeren grupta, yem değerlendirmenin en düşük olduğu tespit edilmiştir (P0.05). Yaşama oranı tüm deneme gruplarında % 96’dan %98’e değişim göstermiştir. Görünür net protein alımı, protein etkinlik oranı, günlük yem ve toplam yem alımı U. lactuca ve E. linza içerikli rasyonlarda kontrol grubuna nazaran nispeten daha düşük bulunmuştur (P0.05). Deneme sonunda, balıketinde yapılan ham protein, ham yağ ve ham kül oranı deneme başıyla karşılaştırıldığında tüm deneme gruplarında daha yüksek bulunmuştur (P0.05). Bu çalışma sonuçları, gökkuşağı alabalığı rasyonlarında %10 seviyesinde U. lactuca ve E. linza kullanmanın kontrol grubuna göre, balıkların daha düşük bir büyüme ve yem değerlendirmesine neden olduğunu ortaya çıkarmıştır. Bu yüzden, alabalık rasyonlarında bu deniz yosunlarının, optimum kullanımı için daha fazla araştırma yapmaya gerek vardır.In the present study, it was aimed to determine the effects of diet containing two seaweed species, Ulva lactuca and Enteromorpha linza, on the growth performance, feed utilization and body composition of rainbow trout. Two experimental diets were formulated with the usage of 10% U. lactuca meal and 10% E. linza meal in feed and control group had no seaweed ingredients. Each experiment was triplicate and each group had fourteen fish specimens with an average weight of 32.96&plusmn;0.29 g. Fish were hand fed three times per day for 60 days. Significant differences were determined in weight gain, specific growth rate, relative growth rate and feed utilization between experimental and control groups (P&lt;0.05). Fish fed with the diet containing 10% E. linza meal had the poorest feed utilization. The survival rate ranged from 96% to 98% in all groups during trial period. Apparent net protein retention, protein efficiency rate, daily dry feed intake and total feed intake were significantly lower in fish groups which fed with the diet containing U. lactuca and E. linza than control group (P&lt;0.05). The final levels of crude protein, crude lipid and crude ash were in higher rates in the body composition all the groups compared when compared to the initial level (P&lt;0.05). The results of the experiment revealed that a diet with U. lactuca and E. linza inclusion at 10% levels resulted in a poorer growth and feed utilization for rainbow trout when compared to those of control group. Hence, more defined experiments seem to be necessary in order to determine the optimum dietary inclusion level of these seaweeds in rainbow trout diets

Rutin tonsil ve adenoid spesimenlerinin histopatolojik incelemesi: Gerekli bir yaklaşım mı?

Amaç: Bu çalışmada adenoidektomi veya tonsilektomi spesimenlerinin rutin histopatolojik incelemesinin gerekli olup olmadığı araştırıldı. Hastalar ve Yöntemler: Retrospektif ve çok merkezli bu çalışmaya adenoidektomi veya tonsilektomi ameliyatı olan 1021 çocuk ve erişkin hasta (557 erkek 464 kadın; ortanca yaş 8 yıl; dağılım 5-13 yıl) dahil edildi. Toplam hastaların 809’u (%79.3) çocuk, 212’si (%20.7) erişkin idi. Hastaların yaş, cinsiyet, histopatolojik tanıları ile malign tanı konulan hastalarda malignite açısından risk faktörleri mevcut hasta kayıtları kullanılarak incelendi. Bulgular: Hastaların 396’sına (%38.8) adenotonsilektomi, 266’sına (%26) tonsilektomi, 359’una (%35.2) adenoidektomi yapıldı. Histopatolojik tanı 1021 hastanın 1011’inde (% 99) bening, 11’inde (%1) malign idi. Yalnızca erişkin hastalarda malign tanı mevcuttu. Malign tanı konulan hastaların tümünde cerrahi öncesinde malignite açısından bir veya daha fazla risk faktörü vardı. Cerrahi öncesi risk faktörü taşımayan hiçbir hastada beklenmedik malignite görülmedi. Sonuç: Adenotonsilektomi ameliyatı sonrası, özellikle çocuk hastalar başta olmak üzere, risk faktörü taşımayan hastalarda rutin histopatolojik incelemenin gerekli olmadığı sonucuna varıldı.Objectives: This study aims to investigate whether it is necessary to perform histopathologic examination of the specimens of tonsillectomy and/or adenoidectomy. Patients and Methods: In this retrospective and multicenter study, 1021 pediatric and adult patients (557 males, 464 females; median age 8 years; range 5 to 13 years) who underwent adenoidectomy and/or tonsillectomy were included. Of the patients, 809 (79.3%) were pediatrics, while 212 (20.7%) were adult. Age, gender, histopathologic diagnosis and risk for malignancy in the patients with malignant diagnosis were reviewed using present patient records. Results: Adenotonsillectomy was performed on 396 patients (38.8%), tonsillectomy on 266 patients (26%) and adenoidectomy on 359 patients (35.2%). Of the 1021 patients, 1011 (99%) received a benign histopathologic diagnosis, while 11 (1%) receieved malignant diagnosis. Malignant diagnosis was present only in adult patients. All patients diagnosed with a malignancy had one or more preoperative risk factors. No unexpected malignant diagnosis was found in any of the patients without preoperative risk factors. Conclusion: We concluded that histopathologic diagnosis may not be required for the patients without preoperative risk factors, particularly pediatric patients

Radyonlarda Yem Katkı Maddesi Olarak İki Deniz Yosununun (Ulva lactuca, Enteremorpha linza) Gökkuşağı Alabalığının (Oncorhynchus mykiss) Büyüme Performansı, Yem Değerlendirme ve Vücut Kompozisyonu Üzerine Etkileri

In the present study, it was aimed to determine to effects of diet containing two seaweed species, Ulva lactucaand Enteromorpha linza , on the growth performance, feed utilization and body composition of rainbow trout. Two experimental diets were formulated with the usage of 10% U. lactuca meal and 10% E. linza meal in feed and control group had no seaweed ingredients. Each experiment was triplicate and each group had fourteen fish specimens with an average weight of 32.96±0.29 g. Fish were hand fed three times per day for 60 days. Significant differences were determined in weight gain, specific growth rate, relative growth rate and feed utilization between experimental and control groups (P<0.05). Fish fed with the diet containing 10% E. linza meal had the poorest feed utilization. The survival rate ranged from 96% to 98% in all groups during trial period. Apparent net protein retention, protein efficiency rate, daily dry feed intake and total feed intake were significantly lower in fish groups which fed with the diet containing U. lactuca and E. linza than control group (P<0.05). The final levels of crude protein, crude lipid and crude ash were in higher rates in the body composition all the groups compared when compared to the initial level (P<0.05). The results of the experiment revealed that a diet with U. lactuca and E. linza inclusion at 10% levels resulted in a poorer growth and feed utilization for rainbow trout when compared to those of control group. Hence, more defined experiments seem to be necessary in order to determine the optimum dietary inclusion level of these seaweeds in rainbow trout diets.Bu çalışmada, iki deniz yosunu ( Ulva lactuca and Enteromorpha linza) içeren rasyonun gökkuşağı alabalığının büyüme performansı, yem değerlendirmesi ve vücut kompozisyonu üzerine etkisinin belirlenmesi amaçlanmıştır. İki deneme rasyonu % 10 U. lactuca ve %10 E. linza unu içerecek düzeyde formülüze edilmiş, kontrol grubuna ise hiçbir deniz yosunu ilave edilmemiştir. Her bir deneme grubu üç tekerrürden oluşmuş, her bir tekerrürde ortalama ağırlığı 32.96±0.29 g olan 14 balık yer almıştır. Balıklar günde üç kez elle yemlenmiş ve çalışma 60 gün sürmüştür. Deniz yosunu içermeyen Kontol grubu ile U. lactuca ve E. linza unu ihtiva eden gruplar arasında ağırlık artışı, spesifik büyüme oranı, nispi büyüme oranı ve yemden yararlanma yönünden farklılık istatistiki olarak önemli bulunmuştur (P<0.05). % 10 E. linza unu içeren grupta, yem değerlendirmenin en düşük olduğu tespit edilmiştir (P<0.05). Yaşama oranı tüm deneme gruplarında % 96’dan %98’e değişim göstermiştir. Görünür net protein alımı, protein etkinlik oranı, günlük yem ve toplam yem alımı U. lactuca ve E. linza içerikli rasyonlarda kontrol grubuna nazaran nispeten daha düşük bulunmuştur (P<0.05). Deneme sonunda, balıketinde yapılan ham protein, ham yağ ve ham kül oranı deneme başıyla karşılaştırıldığında tüm deneme gruplarında daha yüksek bulunmuştur (P<0.05). Bu çalışma sonuçları, gökkuşağı alabalığı rasyonlarında %10 seviyesinde U. lactuca ve E. linza kullanmanın kontrol grubuna göre, balıkların daha düşük bir büyüme ve yem değerlendirmesine neden olduğunu ortaya çıkarmıştır. Bu yüzden, alabalık rasyonlarında bu deniz yosunlarının,optimum kullanımı için daha fazla araştırma yapmaya gerek vardır

Prostatic diseases and male voiding dysfunction

OBJECTIVES To evaluate, in a retrospective, single-center trial, our open prostatectomy outcomes andcomplications in the past 12 years to emphasize the feasibility of open prostatectomy for largeprostates.METHODS A total of 1193 patients underwent open prostatectomy from 1995 to 2007. We retrospectivelyanalyzed the data from 664 patients who had preoperative, operative, and postoperative dataavailable.RESULTS The mean patient age was 67.5 years (range 52–86). The mean preoperative prostate-specificantigen value was 9.6 ng/mL (range 1.65– 45.6). The mean prostatic weight was 88.7 g (range45–324) and was significantly different for the 1995–2001 and 2002–2007 groups (73.6 vs 98.2 g,respectively). Of the 664 patients, 208 (31%) had had an indwelling catheter before surgery. Theaverage International Prostate Symptom Score was 21.7 (range 13–32) preoperatively and 10.6(range 8–18) postoperatively (P .005). The average hospitalization was 6.74 days (range4–14). Blood transfusion was required in 12.7% of the patients either intraoperatively orpostoperatively. Postoperatively, 82 patients (12.3%) had urinary tract infections, 22 (3.2%) hadbladder neck obstruction, 5 (0.7%) had urinary incontinence, and 15 (2.3%) had a ureteralmeatus stricture.CONCLUSIONS Open prostatectomy is a feasible treatment option for patients with a large prostate and also forpatients with additional bladder pathologic findings such as bladder calculi or diverticula forwhom endoscopic treatment modalities are not appropriate. Consequently, open prostatectomyis still the primary option for patients with a prostate greater than 100 cm3 and preserves itsimportance in urology practice, even in the presence of endoscopic innovations