The effect of games and physical activities class on the development of motoric features of elementary school students

Bu çalışmanın amacı, temel hareket becerileri eğitimi programlarının, ilkokul öğrencilerinin motorik özelliklerinin gelişimi üzerinde etkilerini araştırmaktır. Araştırmaya ilkokul 4. Sınıf , 9-10 yaş grubu öğrencilerinden Beykoz İlçesi Güzelcehisar İlkokul öğrencileri (n=29) boy uzunluğu 136,78±6,62 cm., vücut ağırlığı 36,02±9,41 kg. deney grubunu, Üsküdar İlçesi Çengelköy İlkokulu öğrencileri (n=23) boy uzunluğu 141,87±5,66 cm., vücut ağırlığı 35,54±6,38 kg. kontrol grubunu oluşturulmuştur. Bu çalışmada deney grubuna "Oyun ve Fiziki Etkinlikler" dersleri için hazırlanmış olan Fiziksel Etkinlik Kartları (FEK) ndan Sarı Kart grubundaki, Temel Hareket Becerileri alanı olan programı haftada 1 ders saati olmak üzere 6 hafta süresince uygulanmıştır. Her iki gruba "Flamingo Denge Testi", "Durarak Uzun Atlama Testi (DUA)", "Illionis Çeviklik Testi", "30 m. Sprint Testi" “Mekik Testi”, “Esneklik Testi” çalışmanın döneminin başında ön test ve sonunda son test olarak uygulanmıştır. Elde edilen veriler, tanımlayıcı istatistikler olarak belirlenmiş ve Wilcoxon işaretli sıralar toplamı testi sonucuna göre de öğrencileri deney grubunun DUA (p<0.05), Esneklik (p<0.05), Mekik (p<0.01) özelliklerinin ön ve son test puanları arasında istatistiksel açıdan anlamlı bir fark olduğu ve bu özelliklerin olumlu yönde geliştiği, kontrol grubu öğrencilerinin Esneklik (p<0.05), Mekik (p<0.01) özelliklerinin ön ve son test puanları arasında istatistiksel açıdan anlamlı bir fark olduğu ve bu özelliklerde bir gerileme olduğu saptanmıştır. Elde edilen verilere göre Oyun ve Fiziki Etkinlikler Dersinin Temel Hareket Beceri uygulamalarının 4. Sınıf grubu ilkokul öğrencilerinin özellikle kuvvet ve esneklik gelişimleri üzerine etkili olabileceği değerlendirilmişti

Ureteral Jet Flow Dynamics Can Provide Information About the Mechanism of Stone Formation

Ureteral jet dynamics, which have been shown in recent studies to indicate stone formation mechanism in adults and children, provide information about ureteral peristaltism. The dynamics were measured with Doppler ultrasonography and included ureteral jet flows and ureteral jet patterns. In this paper, we present radiographic images of a non-obstructive lower pole stone in the right kidney and a non-obstructive upper pole stone in the left kidney measuring <1 cm and ureteral jet dynamics in a 26-year-old male patient. Our opinion is that the dynamics can provide information about stone formation mechanism

Comparison of Efficacy and Complications of Holmium Laser and Pneumatic Lithotripters Used in the Ureterorenoscopic Treatment of Proximal Ureter Stones, a Multi-Center Study of Society of Urological Surgery Aegean Study Group

Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones.Materials and Methods:Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared.Results:The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2.Conclusion:If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases

Effect of the Anesthetic Method on the Outcomes of Ureteroscopy for Proximal Ureteral Stones: A Multi-center Study of the Society of Urological Surgery Aegean Study Group

Objective:To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones.Materials and Methods:Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients’ demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner.Results:There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041).Conclusion:URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient’s comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes

Disrupted epithelial permeability as a predictor of severe COVID-19 development

BackgroundAn impaired epithelial barrier integrity in the gastrointestinal tract is important to the pathogenesis of many inflammatory diseases. Accordingly, we assessed the potential of biomarkers of epithelial barrier dysfunction as predictive of severe COVID‐19.MethodsLevels of bacterial DNA and zonulin family peptides (ZFP) as markers of bacterial translocation and intestinal permeability and a total of 180 immune and inflammatory proteins were analyzed from the sera of 328 COVID‐19 patients and 49 healthy controls.ResultsSignificantly high levels of circulating bacterial DNA were detected in severe COVID‐19 cases. In mild COVID‐19 cases, serum bacterial DNA levels were significantly lower than in healthy controls suggesting epithelial barrier tightness as a predictor of a mild disease course. COVID‐19 patients were characterized by significantly elevated levels of circulating ZFP. We identified 36 proteins as potential early biomarkers of COVID‐19, and six of them (AREG, AXIN1, CLEC4C, CXCL10, CXCL11, and TRANCE) correlated strongly with bacterial translocation and can be used to predict and discriminate severe cases from healthy controls and mild cases (area under the curve (AUC): 1 and 0.88, respectively). Proteomic analysis of the serum of 21 patients with moderate disease at admission which progressed to severe disease revealed 10 proteins associated with disease progression and mortality (AUC: 0.88), including CLEC7A, EIF4EBP1, TRANCE, CXCL10, HGF, KRT19, LAMP3, CKAP4, CXADR, and ITGB6.ConclusionOur results demonstrate that biomarkers of intact or defective epithelial barriers are associated with disease severity and can provide early information on the prediction at the time of hospital admission

Re: A Randomized Double-Blind Placebo-Controlled Phase 2 Dose-Ranging Study of OnabotulinumtoxinA in Men with Benign Prostatic Hyperplasia

Botulinum toxin is a neurotoxin inhibiting the release of acetylcholine and is used in various fields of medicine. Recently, it has been proposed as an alternative minimally invasive treatment modality for patients unresponsive to oral therapies. The present study is the largest prospective, randomized and placebo-controlled study investigating the efficacy and safety of different onabotulinumtoxinA (BTX-A) doses in men with moderate to severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). 100 U, 200 U and 300 U BTX-A doses via transperineal or transrectal route were injected within the transition zone of each lateral lobe. 69.7% of patients (115 of 380) completed the 72-week study. The authors reported significant improvement for all treatment arms including placebo from weeks 2 through 72 including the primary time point of week 12. There were no statistically significant differences between BTX-A groups and placebo in terms of treatment efficacy described as International Prostate Symptom Score (IPSS) reduction, improvement of peak urinary flow rate (Qmax) and post-void residual volume (PVR) and prostate volume reduction at any time point throughout the study. Only in a subgroup of patients, including previous alpha-blocker users, 200 U BTX-A worked better than placebo in terms of IPSS reduction. Adverse event rates were similar between all treatment arms. The unexpected pronounced placebo response in the present study raises question marks in minds regarding the use of BTX-A as an alternative treatment option. These conflicting results suggest that intraprostatic BTX-A injection is still experimental and further trials are required

Re: Renal and Adrenal Minilaparoscopy: A Prospective Multicentric Study

EDITORIAL COMMENT The authors evaluated the role of minilaparoscopy (ML) in renal and adrenal surgery in 6 laparoscopic surgical centers by collecting data with a common database in a prospective manner. One-hundred ten patients (73 males and 37 females) were included during the study period consisting of 59 nephrectomy (40 radical nephrectomy, 12 simple nephrectomy, 7 living donor nephrectomy), 20 partial nephrectomy, 9 nephroureterectomy, 13 pyeloplasty, 3 pyelolithotomy, and 6 adrenalectomy. Standard approach was defined as 3 to 4 3-mm trocars with a 3-mm laparoscope and 3-mm instruments. Overall mean operative time was 180±64 minutes, with estimated blood loss of 120±50 mL. Eleven cases required an additional 5-10 mm port, one case of conversion to 5-mm trocars and a single case conversion to open surgery. Intraoperative complication rate was 5.4% (n=6) and postoperative complication rate was 28% (n=31) which are similar to standard laparoscopy series. With regard to the Clavien-Dindo classification, 71% was grade 1, 6% - grade 2, 20% - grade 3 and a single case was grade 4. No mortality was reported. Average hospitalization time was 5±2.2 days and transfusion rate was 5.4%. Considering the role of ML in most urological surgical procedures, the present study provides valuable data for the feasibility and reproducibility of this evolving technique. Further prospective randomized studies will better help for standardization of this technique for everyday clinical practice

Re: Multicenter External Validation and Comparison of Stone Scoring Systems in Predicting Outcomes after Percutaneous Nephrolithotomy

There was no stone scoring system for preoperative patient counseling and standardization until Guy’s stone score was developed in 2011. S.T.O.N.E Nephrolithometry and Clinical Research Office of Endourological Society nomogram have been developed, respectively. The present study is the largest multicenter cohort study including 586 patients, retrospectively evaluating and comparing these three scoring systems at four academic institutions. The authors reported similar results regarding estimation of stone-free rates (SFR) with all the three scoring systems after a single session percutaneous nephrolitotomy (PCNL). They also noted that none of these scoring systems have significantly added predictive accuracy over stone size alone as a predictor of SFR. The patients were stratified into low-, intermediate-, high- and very high-risk groups for relative risk for residual stone for all scoring systems and it was seen that residual stone risk after PCNL surgery increases with increased risk group stratification. With regard to complications, none of the scoring systems strongly predicted complications. Only S.T.O.N.E score was found to be an independent predictor of operation time. As a result, all the three scoring systems are useful and equally effective in prediction of SFR despite specific limitations. Urological surgeons may benefit from these scoring systems for estimating case complexity and preoperative patient counseling. Further researches on scoring systems are mandatory especially for prediction of complications