Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy in the Treatment of 2-3 cm Multicalyceal Kidney Stones

Objective:To demonstrate the feasibility of retrograde intrarenal surgery (RIRS) in the treatment of 2-3 cm multicalyceal kidney stones considering the possible complications and unsuitable situations. Multiple kidney stones are observed among 20-25% of patients seen in urology clinics. Percutaneous nephrolithotomy (PNL) is the primary method for treating kidney stones larger than 2 cm. Despite the high success rate achieved, life-threatening complications associated with PNL may arise. Multiple accesses may be required for multiple stones. RIRS has become increasingly widely used. In our study, we aimed to compare these two methods in the treatment of 2-3 cm multicalyceal stones.Materials and Methods:We retrospectively evaluated data of patients who presented with multicalyceal kidney stones measuring 2-3 cm between 2012 and 2016. A total of 64 patients who underwent surgery (36 RIRS, 28 PNL) were included in the study.Results:Major complications were more common, operative time, fluoroscopy time and length of hospital stay time were longer in PNL group than in RIRS group. The number of stones was statistically higher in RIRS group. There was no statistically significant difference in other parameters. No statistically significant difference was found between the two groups in operation success rates.Conclusion:In the literature, the primary treatment option for 2-3 cm multicalyceal stones has been reported to be PNL. RIRS should be used in appropriate patients who have risks of complications related to anesthesia, bleeding disorder and patients with anatomic abnormalities who are not suitable for PNL. This method is also used to reduce the potential complications and it is more reliable

Türkiye - Suriye ilişkilerinin yakın geçmişi

Suriye'nin 1946 yılından sonra bağımsızlığını kazanması ile Türkiye arasındaki ilk ciddi sorun 1957'de olmuştur. Suriye'de 1960'ların Haziranından itibaren yönetim de etkili olmaya başlayan Baas Partisi, Hatay'ın Suriye'nin toprağı olduğunu iddia etmiş ve bu konuda hem kendi kamuoyunda hem de Arap dünyasında propagandalar yapmıştır. Türkiye'nin Güneydoğu Anadolu Projesi'ne başlamasından sonra su sorununu gündeme taşıyan Suriye, Türkiye'yi su emperyalizmiyle suçlamış ve Arap ülkelerini Türkiye aleyhine kışkırtmıştır. Arap ülkelerinden, Suriye, Yunanistan ve Güney Kıbrıs Rum Yönetimi'nden tehdit algılayan Türkiye, İsrail ile stratejik işbirliği içine girmiştir. Güneydoğu Anadolu Projesini engellemek için Türkiye'ye karşı olan terörist örgütlere destek veren Suriye, Türkiye'ye 1984'ten bu yana ciddi zararlar veren PKK Terör Örgütü'ne 1998 yılına kadar yardım etmiştir. Türkiye'nin İsrail ile işbirliğine gitmesi Suriye'nin kendini bir anda çevrelenmiş hissetmesine yol açmıştır. 16 Eylül 1998'de Orgeneral Atilla Ateş ile başlayan Suriye'ye uyarı ve tehdit mesajları Ekim ayında Türkiye ile Suriye'yi savaşın eşiğine kadar getirmiştir. Özellikle Mısır'ın arabuluculuğu ve diğer Arap ülkelerinin desteğiyle imzalanan Adana Mutabakatı sonrası Suriye, PKK'ya olan desteğini kesmiş ve PKK'nın elebaşı Abdullah Öcalan'ı sınır dışı etmiştir. Adana Mutabakatından sonra ilişkiler yumuşamaya başlamıştır. 2000 yılında Suriye'de iktidarı devralan Beşar Esad, Türkiye ile olan ilişkilere önem vermeye başlamıştır. ABD'nin Orta Doğu'daki emperyalist tutumu Suriye ve Türkiye'yi 2002'den sonra yakınlaştırmıştır. 2002 yılında Türkiye de hükümet değişmiş , 2 ülke arasında 2011 Nisan ayına kadar birçok anlaşmalar yapılmış fakat bu tarihle beraber Suriye de yaşanan iç karışıklıklar nedeniyle Türkiye , Başbakanlık Afet ve Acil Durum Yönetimi Başkanlığı (AFAD) tarafından 4 ilimizde kurulan kamplarda Suriye de yaşanan bu iç karışıklıklara Akparti Hükümetinin tutumu ; Suriye'de yaşanan trajedi sadece Türkiye'nin sorunu değildir. Başta Müslüman dünya olmak üzere, vicdan sahibi her ülke bu sorunu, kanı, gözyaşını dindirmek için elinden geleni yapmak zorundadır. Her ne kadar Türkiye üzerine düşen sorumluluktan kaçmayacak olsa da bu sorunu tek başına Türkiye'nin çözmeye kalkmasının en son tercih olduğu da ortadadır. ifadeleriyle parti tüzüğüne yer etmiştir. Türkiye ile Suriye ye olan bakış açısı haliyle değişmiş , gün geçtikçe de değişmeye meyilli bir hal almaktadır

Malfunctioned and Fractured Penile Prosthesis Caused by Cross Placement: Case Report

Penile prosthesis is a functional option for patients who have erectile dysfunction after failed medical and intracavernosal treatments. Malleable penile prosthesis is a good alternative. Penile prosthesis implantation is a surgical process. Seldomly complications occur. In this study we presented a 61 y old man who has malfunctioned and broken penile prosthesis due to cross implantation

Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. Methods: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The sociodemographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. Results: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 ± 52.6 days, 39.0 ± 52.7 days for radiologic staging, and 74.9 ± 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of patients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. Conclusion: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer

Large-scale cross-societal examination of real- and minimal-group biases

Biases in favor of culturally prevalent social ingroups are ubiquitous, but random assignment to arbitrary experimentally created social groups is also sufficient to create ingroup biases (i.e., the minimal group effect; MGE). The extent to which ingroup bias arises from specific social contexts versus more general psychological tendencies remains unclear. This registered report focuses on three questions. First, how culturally prevalent is the MGE? Second, how do critical cultural and individual factors moderate its strength? Third, does the MGE meaningfully relate to culturally salient real-world ingroup biases? We compare the MGE to bias in favor of a family member (first cousin) and a national ingroup member. We propose to recruit a sample of > 200 participants in each of > 50 nations to examine these questions and advance our understanding of the psychological foundations and cultural prevalence of ingroup bias