Background/Aim: Cervical dysplasia is a well-recognized precursor to cervical cancer, and human papillomavirus (HPV) infection is the primary causative agent in its development. The intricate relationship between cervical and anal HPV infections remains understudied. There have been no established risk factors determined for anal HPV infection in women without a history of anal intercourse. This study aims to address this critical knowledge gap by evaluating the risk factors for anal HPV infection in a homogeneous population of heterosexual women with HPV-associated cervical dysplasia. Methods: This retrospective cohort study was carried out in a single tertiary center and comprised women between the ages of 30 and 65. Women diagnosed with either low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL) and without a history of anal intercourse were included in the analysis. Participants without a histological or colposcopic diagnosis were excluded from the analysis. Women with a history of prior cervical therapeutic intervention, previous cervical or genital dysplasia, known immunosuppressive disorders, current immunosuppressive medication use, a past cancer diagnosis, or a history of HPV vaccination were also excluded. Anal sampling was performed for HPV infection within the first year after the initial diagnosis of cervical dysplasia. Patient characteristics including smoking status were extracted from patient files. Results: Overall, 186 women who met the inclusion criteria were tested for active anal HPV infection of the anal canal. Active anal HPV infection was found in 96 (51.6%) of the patients. In women with active anal HPV infection, 31 (32.3%) were found to have only HPV 16/18 genotypes, and 22 had HPV16/18 along with other high-risk types. When risk factors were analyzed, only current smoking was found to be associated with anal HPV infection in this group of women. Overall, 40.6% of the women with active anal HPV infection were smokers; however, only 25.6% of the women without anal HPV infection were current smokers (P=0.029). Conclusion: Women had a high risk of active anal HPV infection during the diagnosis of cervical intraepithelial neoplasia. Current smoking was the only identifiable risk factor for anal HPV infection in women without anal intercourse history.
{"title":"Evaluation of risk factors for anal human papillomavirus infection in heterosexual women diagnosed with human papillomavirus associated cervical dysplasia","authors":"Utku Özgen","doi":"10.28982/josam.8000","DOIUrl":"https://doi.org/10.28982/josam.8000","url":null,"abstract":"Background/Aim: Cervical dysplasia is a well-recognized precursor to cervical cancer, and human papillomavirus (HPV) infection is the primary causative agent in its development. The intricate relationship between cervical and anal HPV infections remains understudied. There have been no established risk factors determined for anal HPV infection in women without a history of anal intercourse. This study aims to address this critical knowledge gap by evaluating the risk factors for anal HPV infection in a homogeneous population of heterosexual women with HPV-associated cervical dysplasia. Methods: This retrospective cohort study was carried out in a single tertiary center and comprised women between the ages of 30 and 65. Women diagnosed with either low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL) and without a history of anal intercourse were included in the analysis. Participants without a histological or colposcopic diagnosis were excluded from the analysis. Women with a history of prior cervical therapeutic intervention, previous cervical or genital dysplasia, known immunosuppressive disorders, current immunosuppressive medication use, a past cancer diagnosis, or a history of HPV vaccination were also excluded. Anal sampling was performed for HPV infection within the first year after the initial diagnosis of cervical dysplasia. Patient characteristics including smoking status were extracted from patient files. Results: Overall, 186 women who met the inclusion criteria were tested for active anal HPV infection of the anal canal. Active anal HPV infection was found in 96 (51.6%) of the patients. In women with active anal HPV infection, 31 (32.3%) were found to have only HPV 16/18 genotypes, and 22 had HPV16/18 along with other high-risk types. When risk factors were analyzed, only current smoking was found to be associated with anal HPV infection in this group of women. Overall, 40.6% of the women with active anal HPV infection were smokers; however, only 25.6% of the women without anal HPV infection were current smokers (P=0.029). Conclusion: Women had a high risk of active anal HPV infection during the diagnosis of cervical intraepithelial neoplasia. Current smoking was the only identifiable risk factor for anal HPV infection in women without anal intercourse history.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"BC-10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated, reliable, and feasible instrument used to evaluate nasal obstruction severity. We aimed to assess patient satisfaction using the NOSE score after revision rhinoplasty with free diced cartilage (fDC) grafts. Methods: In this cross-sectional study, 36 patients who underwent a revision rhinoplasty procedure completed the Turkish version of the NOSE questionnaire before and six months after rhinoplasty. Pre- and postoperative NOSE scores were compared using the Mann Whitney U test. Results: The pre- and postoperative total mean NOSE scores were 68.06 and 8.47, respectively. The NOSE score significantly decreased six months after rhinoplasty surgery (P<0.001). Adapting to exercise was the parameter with the highest improvement rate. Conclusion: The outcome of the NOSE questionnaires in patients with nasal deformities shows that a revision rhinoplasty surgery with the placement of fDC grafts contributes to the improvement of nasal functions. The Turkish version of the NOSE scale is a useful tool to assess patient satisfaction among the Turkish population.
{"title":"Revision rhinoplasty with free diced cartilage grafts: Outcome evaluations with the Nasal Obstruction Symptom Evaluation (NOSE) scale","authors":"Hüseyin Kandulu","doi":"10.28982/josam.7726","DOIUrl":"https://doi.org/10.28982/josam.7726","url":null,"abstract":"Background/Aim: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated, reliable, and feasible instrument used to evaluate nasal obstruction severity. We aimed to assess patient satisfaction using the NOSE score after revision rhinoplasty with free diced cartilage (fDC) grafts. Methods: In this cross-sectional study, 36 patients who underwent a revision rhinoplasty procedure completed the Turkish version of the NOSE questionnaire before and six months after rhinoplasty. Pre- and postoperative NOSE scores were compared using the Mann Whitney U test. Results: The pre- and postoperative total mean NOSE scores were 68.06 and 8.47, respectively. The NOSE score significantly decreased six months after rhinoplasty surgery (P<0.001). Adapting to exercise was the parameter with the highest improvement rate. Conclusion: The outcome of the NOSE questionnaires in patients with nasal deformities shows that a revision rhinoplasty surgery with the placement of fDC grafts contributes to the improvement of nasal functions. The Turkish version of the NOSE scale is a useful tool to assess patient satisfaction among the Turkish population.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"13 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Advances in the therapeutic treatment of multiple myeloma have continuously led to better prognoses. However, longer lives for patients include complications due to both potential comorbidities and the possible severe side effects of specific treatments. These issues make caring for such patients exhausting. In this study, we investigated the most important factors that negatively affect the quality of life (QoL) of non-professional caregivers of patients with multiple myeloma (MM). Methods: This study was a cross-sectional study conducted between March 2023 and August 2023. The caregivers of 144 patients with MM were assessed for inclusion/exclusion. The demographics of caregivers, their familial relation to the patient, and their socioeconomic status (education, both marital and financial status, and occupations) were recorded. Additionally, data from MM patients were retrieved: (1) clinical and demographic data, (2) light and heavy chain types, (3) disease stage, (4) lytic lesions, and (5) treatment(s). The Caregiver Quality of Life Index-Cancer (CQOLC) questionnaire contains four sub-scores and a total score and was administered to all caregivers who volunteered to participate. Results: A total of 73 patients and their caregivers were included in the study. For patients, their mean age was 65.7 (11.4) years, 52% were female, and the mean value of the disease duration was 30.5 (16.0–66.5) months. For caregivers, their mean age was 47.2 (12.8) years, and 63% were females. Multivariable linear regression revealed that higher (>40 years) caregiver age was independently associated with a higher CQOLC Burden and Positive adaptation score. Being a female caregiver was independently associated with a higher CQOLC Disruptiveness score. Having university-level or higher education status was independently associated with a lower CQOLC Financial Concerns score. In terms of the overall score, we found that higher (>40 years) caregiver age and the gender of the caregiver (female) appear to be factors that are independently associated with higher CQOLC total scores, whereas being a second-degree relative to the patient independently lowered the total score. Conclusion: Among caregivers of MM patients, those who were older, female, and/or the first-degree relative of the patient (versus second-degree) with having lower education (versus university or higher) resulted in an improved caregiver QoL. The gender bias among caregivers is also a novel finding.
{"title":"Factors associated with quality of life in caregivers of patients with multiple myeloma","authors":"Esma Evrim Doğan, Naciye Demirel","doi":"10.28982/josam.8002","DOIUrl":"https://doi.org/10.28982/josam.8002","url":null,"abstract":"Background/Aim: Advances in the therapeutic treatment of multiple myeloma have continuously led to better prognoses. However, longer lives for patients include complications due to both potential comorbidities and the possible severe side effects of specific treatments. These issues make caring for such patients exhausting. In this study, we investigated the most important factors that negatively affect the quality of life (QoL) of non-professional caregivers of patients with multiple myeloma (MM). Methods: This study was a cross-sectional study conducted between March 2023 and August 2023. The caregivers of 144 patients with MM were assessed for inclusion/exclusion. The demographics of caregivers, their familial relation to the patient, and their socioeconomic status (education, both marital and financial status, and occupations) were recorded. Additionally, data from MM patients were retrieved: (1) clinical and demographic data, (2) light and heavy chain types, (3) disease stage, (4) lytic lesions, and (5) treatment(s). The Caregiver Quality of Life Index-Cancer (CQOLC) questionnaire contains four sub-scores and a total score and was administered to all caregivers who volunteered to participate. Results: A total of 73 patients and their caregivers were included in the study. For patients, their mean age was 65.7 (11.4) years, 52% were female, and the mean value of the disease duration was 30.5 (16.0–66.5) months. For caregivers, their mean age was 47.2 (12.8) years, and 63% were females. Multivariable linear regression revealed that higher (>40 years) caregiver age was independently associated with a higher CQOLC Burden and Positive adaptation score. Being a female caregiver was independently associated with a higher CQOLC Disruptiveness score. Having university-level or higher education status was independently associated with a lower CQOLC Financial Concerns score. In terms of the overall score, we found that higher (>40 years) caregiver age and the gender of the caregiver (female) appear to be factors that are independently associated with higher CQOLC total scores, whereas being a second-degree relative to the patient independently lowered the total score. Conclusion: Among caregivers of MM patients, those who were older, female, and/or the first-degree relative of the patient (versus second-degree) with having lower education (versus university or higher) resulted in an improved caregiver QoL. The gender bias among caregivers is also a novel finding.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeynep Caliskan, Canan Kucukgergin, Gulsan Aktan, Nurgul Bulut, Gul Ozdemirler
Background/Aim: Sperm quality has experienced a decline in recent years, with this issue being particularly pronounced in industrialized nations, suggesting a potential link to occupational exposures. Evaluating sperm DNA fragmentation can yield valuable insights into male fertility, although its association with occupational exposures remains less well-established. Our study aimed to investigate the relationship between self-reported occupational exposures and sperm DNA fragmentation in infertile men. Methods: This retrospective cohort study involved 391 infertile men who sought fertility treatment at a university clinic between 2017 and 2020. A brief questionnaire was administered to collect data on patients’ demographic characteristics, medical history, occupation, and exposure types. In this comparative study, patients were categorized into two groups based on their occupational exposures (the unexposed and exposed groups). The exposed group was further sub-grouped according to their specific exposure types, which included cement, solvents, metals, pesticides, mechanical vibration, and heat. The primary outcome in this study was assessed using the terminal deoxynucleotidyl transferase-mediated nick end-labeling test (TUNEL), with results expressed as the sperm DNA fragmentation index (DFI). Results: Patients in the exposed group exhibited a significantly higher sperm DFI compared to those in the unexposed group (14 [17] vs. 8 [9], P<0.001). After accounting for potential confounding factors, our results demonstrated that several occupational exposure factors significantly increased the risk of elevated sperm DFI (>15%) levels, including solvents (odds ratio (OR)=8.2, 95% confidence interval (CI)=3.6–18.5, P<0.001), metals (OR=2.2, 95% CI=1.0–4.7, P=0.048), pesticides (OR=14.6, 95% CI=1.6–130.7, P=0.016), mechanical vibration (OR=2.6, 95% CI=1.5–4.6, P<0.001), and heat (OR=6.4, 95% CI=1.7–23.5, P=0.005). Conclusion: The findings of our study corroborate earlier research suggesting that occupational exposures may have adverse effects on sperm DNA fragmentation in men. The identification and management of such exposures as part of routine clinical practice could offer a complementary approach to enhancing infertility treatment outcomes.
{"title":"Self-reported occupational exposure and its association with sperm DNA fragmentation in infertile men","authors":"Zeynep Caliskan, Canan Kucukgergin, Gulsan Aktan, Nurgul Bulut, Gul Ozdemirler","doi":"10.28982/josam.7978","DOIUrl":"https://doi.org/10.28982/josam.7978","url":null,"abstract":"Background/Aim: Sperm quality has experienced a decline in recent years, with this issue being particularly pronounced in industrialized nations, suggesting a potential link to occupational exposures. Evaluating sperm DNA fragmentation can yield valuable insights into male fertility, although its association with occupational exposures remains less well-established. Our study aimed to investigate the relationship between self-reported occupational exposures and sperm DNA fragmentation in infertile men. Methods: This retrospective cohort study involved 391 infertile men who sought fertility treatment at a university clinic between 2017 and 2020. A brief questionnaire was administered to collect data on patients’ demographic characteristics, medical history, occupation, and exposure types. In this comparative study, patients were categorized into two groups based on their occupational exposures (the unexposed and exposed groups). The exposed group was further sub-grouped according to their specific exposure types, which included cement, solvents, metals, pesticides, mechanical vibration, and heat. The primary outcome in this study was assessed using the terminal deoxynucleotidyl transferase-mediated nick end-labeling test (TUNEL), with results expressed as the sperm DNA fragmentation index (DFI). Results: Patients in the exposed group exhibited a significantly higher sperm DFI compared to those in the unexposed group (14 [17] vs. 8 [9], P<0.001). After accounting for potential confounding factors, our results demonstrated that several occupational exposure factors significantly increased the risk of elevated sperm DFI (>15%) levels, including solvents (odds ratio (OR)=8.2, 95% confidence interval (CI)=3.6–18.5, P<0.001), metals (OR=2.2, 95% CI=1.0–4.7, P=0.048), pesticides (OR=14.6, 95% CI=1.6–130.7, P=0.016), mechanical vibration (OR=2.6, 95% CI=1.5–4.6, P<0.001), and heat (OR=6.4, 95% CI=1.7–23.5, P=0.005). Conclusion: The findings of our study corroborate earlier research suggesting that occupational exposures may have adverse effects on sperm DNA fragmentation in men. The identification and management of such exposures as part of routine clinical practice could offer a complementary approach to enhancing infertility treatment outcomes.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"31 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135268371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Intraductal papillomas (IDP) of the breast, though benign, share an association with the duct epithelium, similar to some breast malignancies. Percutaneous biopsies often fail to fully characterize these lesions. The decision to perform surgical excision for IDP of the breast is frequently based on the presence of atypia observed during percutaneous biopsy. However, consensus remains lacking regarding the management of IDP of the breast without atypia. This study was undertaken to share findings on IDP, contributing to a better understanding of their nature and guiding treatment approaches. Methods: We conducted a retrospective evaluation of data from 42 female patients diagnosed with intraductal papilloma through percutaneous biopsy, who subsequently underwent surgical excision between January 1, 2015, and August 25, 2023. Patients not diagnosed with intraductal papilloma, those with prior breast malignancy diagnoses, and those identified incidentally during other surgical procedures were excluded from the study. Data recorded included patient ages, the largest lesion diameters measured by ultrasonography, the percutaneous biopsy method (Fine needle aspiration biopsy [FNAB] or Core needle biopsy [CNB]), atypia status observed during percutaneous biopsy, histopathological features observed during surgical excision, and lesion diameter in cases where malignancy was upgraded. If ductal carcinoma in situ (DCIS) or invasive cancer was identified in the surgical excision specimen, it was classified as an upgrade. Results: The median age of the patients was 48.5 years (range: 12.9 years). FNAB was performed in ten cases (23.8%), while CNB was used in 32 cases (76.2%). There was no significant difference in the detection of atypia when comparing FNAB and CNB (P=0.57). Eight patients (19%) were diagnosed with atypical intraductal papilloma. Among them, three patients with atypia and two patients without atypia exhibited an upgrade to malignancy. The study revealed a malignancy upgrade rate of 37.5% for IDP with atypia and 5.9% for those without atypia. Furthermore, the average age of patients with malignancy upgrades was higher than that of patients with benign lesions (P=0.02). Conclusion: In light of the malignancies detected in cases of breast IDP, even in the absence of atypia, opting for surgical excision, particularly in older patients, can help prevent the oversight of these cancers.
{"title":"Rates of upgrade to malignancy in surgical excision of intraductal papillomas of the breast: A retrospective cohort study","authors":"Zehra Ünal Özdemir","doi":"10.28982/josam.7994","DOIUrl":"https://doi.org/10.28982/josam.7994","url":null,"abstract":"Background/Aim: Intraductal papillomas (IDP) of the breast, though benign, share an association with the duct epithelium, similar to some breast malignancies. Percutaneous biopsies often fail to fully characterize these lesions. The decision to perform surgical excision for IDP of the breast is frequently based on the presence of atypia observed during percutaneous biopsy. However, consensus remains lacking regarding the management of IDP of the breast without atypia. This study was undertaken to share findings on IDP, contributing to a better understanding of their nature and guiding treatment approaches. Methods: We conducted a retrospective evaluation of data from 42 female patients diagnosed with intraductal papilloma through percutaneous biopsy, who subsequently underwent surgical excision between January 1, 2015, and August 25, 2023. Patients not diagnosed with intraductal papilloma, those with prior breast malignancy diagnoses, and those identified incidentally during other surgical procedures were excluded from the study. Data recorded included patient ages, the largest lesion diameters measured by ultrasonography, the percutaneous biopsy method (Fine needle aspiration biopsy [FNAB] or Core needle biopsy [CNB]), atypia status observed during percutaneous biopsy, histopathological features observed during surgical excision, and lesion diameter in cases where malignancy was upgraded. If ductal carcinoma in situ (DCIS) or invasive cancer was identified in the surgical excision specimen, it was classified as an upgrade. Results: The median age of the patients was 48.5 years (range: 12.9 years). FNAB was performed in ten cases (23.8%), while CNB was used in 32 cases (76.2%). There was no significant difference in the detection of atypia when comparing FNAB and CNB (P=0.57). Eight patients (19%) were diagnosed with atypical intraductal papilloma. Among them, three patients with atypia and two patients without atypia exhibited an upgrade to malignancy. The study revealed a malignancy upgrade rate of 37.5% for IDP with atypia and 5.9% for those without atypia. Furthermore, the average age of patients with malignancy upgrades was higher than that of patients with benign lesions (P=0.02). Conclusion: In light of the malignancies detected in cases of breast IDP, even in the absence of atypia, opting for surgical excision, particularly in older patients, can help prevent the oversight of these cancers.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135729122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: The three-dimensional (3D) display system can solve essential problems in conventional laparoscopic radical prostatectomy (LRP), like depth perception and spatial orientation. Several studies reported initial comparisons of LRP with 2D and 3D vision systems in terms of operative outcomes, with 3D systems coming out on top. However, there are few published comparison studies on the long-term outcomes of LRP with 2D and 3D vision systems. In this regard, we aimed to compare operative and long-term functional results of 3D-High definition (HD) LRP with conventional two-dimensional (2D)-HD display systems. Methods: A total of 115 cases that underwent LRP between October 2010 and December 2016 were prospectively evaluated, and a prospective cohort study was conducted. Inclusion criteria at baseline were as follows: age at surgery <75 yr, prostate-specific antigen (PSA) concentration <20 ng/ml, clinical tumor stage
{"title":"Two-dimensional vs. three-dimensional vision during the laparoscopic radical prostatectomy: A matched comparison of operative and long-term functional outcomes","authors":"Yavuz Baştuğ, Serdar Aykan","doi":"10.28982/josam.7965","DOIUrl":"https://doi.org/10.28982/josam.7965","url":null,"abstract":"Background/Aim: The three-dimensional (3D) display system can solve essential problems in conventional laparoscopic radical prostatectomy (LRP), like depth perception and spatial orientation. Several studies reported initial comparisons of LRP with 2D and 3D vision systems in terms of operative outcomes, with 3D systems coming out on top. However, there are few published comparison studies on the long-term outcomes of LRP with 2D and 3D vision systems. In this regard, we aimed to compare operative and long-term functional results of 3D-High definition (HD) LRP with conventional two-dimensional (2D)-HD display systems. Methods: A total of 115 cases that underwent LRP between October 2010 and December 2016 were prospectively evaluated, and a prospective cohort study was conducted. Inclusion criteria at baseline were as follows: age at surgery <75 yr, prostate-specific antigen (PSA) concentration <20 ng/ml, clinical tumor stage <T4, no diagnosis of metastatic disease, and informed consent to participate in the study. Patients who underwent salvage treatments after LRP and patients with incomplete follow-up were excluded. The patients were divided into groups, Group 1 (n=72) and Group 2 (n=43), according to the display systems used, 2D-HD vs. 3D-HD during LRP. Demographic data, operative and postoperative, and long-term follow-up outcomes were recorded. Additionally, urinary continence rate determined with a patient questionnaire and erectile functions determined with the International Index of Erectile Function (IIEF) questionnaire were recorded. All obtained parameters were compared between the groups using the independent t-test and the chi-square test. Differences were considered significant at two-sided P <0.05 and 95% confidence interval. Results: All patients completed a 24-month follow-up procedure. The groups were similar in age, serum PSA level, prostate volume, preoperative Gleason score, and cancer-positive core number. There were significantly better results in group 2 than in group 1 for operative parameters, catheterization time, and hospital stay (P<0.001, for all parameters). At long-term follow-up, the urinary continence rate was significantly higher in group 2 than in group 1 (P=0.023). Similarly, significantly higher IIEF scores were determined in the group 2 (P<0.001). Conclusion: Our results suggest that using a 3D-HD display system during LRP provides much better long-term functional and operative outcomes and may provide a cheap and equal alternative to the RARP procedure.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135858726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Patients with bipolar disorder often experience praxia deficits, which might impede their functionality and quality of life. This study sought to delve into praxis defects in these patients, contrasting their praxia performance with healthy controls and illuminating the interrelation between praxia performance, functionality, and quality of life. Methods: In this cross-sectional study conducted from February to July 2023, we enrolled 203 patients diagnosed with bipolar disorder 1. Participants were recruited from the Ibni Sina and Sifa Community Mental Health Centers, both of which are affiliated with the Istanbul Tuzla State Hospital. Additionally, 201 healthy controls (HC) were recruited, primarily from the friends and relatives of the hospital staff. Patients diagnosed with bipolar disorder 1, between 18 and 65 years of age, were included based on their diagnosis as determined by the Structured Clinical Interview for DSM-5 Clinical Version (SCID-5-CV). Their right-handedness was ascertained via the Edinburgh Handedness Inventory. To minimize the confounding effects of acute mood episodes on praxia deficits, patients were required to score below 5 on the Young Mania Rating Scale (YMRS) and 7 or lower on the 17-item Hamilton Depression Rating Scale (HDRS). This criterion ensured the exclusion of individuals experiencing an active mood episode. Additionally, participants needed to have been in remission for at least six months. Healthy controls, aged 18-65 and confirmed as right-handed, were included, provided they had no personal or familial history of psychiatric conditions. A detailed interview using SCID-5-CV confirmed that the healthy controls had no history or suspicion of bipolar disorder (BD) or any other psychiatric disorder and no relatives with a psychiatric disorder. All participants (203 bipolar disorder patients and 201 healthy controls) underwent evaluations using the Test for Upper Limb Apraxia (TULIA), while the bipolar cohort received the Global Functioning Assessment-Functioning (GAF-F) and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). Statistical analyses were conducted using SPSS 22.0. Results: We identified a critical TULIA score threshold of 217, which differentiates bipolar patients from healthy individuals with a sensitivity of 79.3% and a specificity of 77.1% (area under the curve (AUC) 0.799, P<0.001). TULIA scores in bipolar patients were significantly positively correlated with functionality (GAF-F; r=0.502, P<0.001) and quality of life-general health (WHOQOL; r=0.389, P<0.001). TULIA pantomime subscores (OR=0.92, 95% CI 0.86-0.99, P=0.022) and CPZ use of more than 250mg per day (OR=2.24, 95% CI 1.19-4.21, P=0.012) were independent predictors of impairment in functioning in bipolar patients. Conclusion: Praxia deficits in bipolar disorder patients may be intricately tied to specific clinical features that influence both their functionality and life quality. Comprehensive pr
背景/目的:双相情感障碍患者经常经历失用障碍，这可能会影响他们的功能和生活质量。本研究旨在深入研究这些患者的实践缺陷，将他们的实践表现与健康对照进行比较，并阐明实践表现、功能和生活质量之间的相互关系。方法:在这项于2023年2月至7月进行的横断面研究中，我们招募了203名诊断为双相情感障碍的患者。参与者是从Ibni Sina和Sifa社区精神卫生中心招募的，这两个中心都隶属于伊斯坦布尔图兹拉州立医院。此外，还招募了201名健康对照(HC)，主要来自医院工作人员的朋友和亲属。诊断为双相情感障碍1的患者，年龄在18至65岁之间，根据DSM-5临床版结构化临床访谈(SCID-5-CV)确定的诊断纳入研究。他们的右利手性是通过爱丁堡利手性量表确定的。为了尽量减少急性情绪发作对失用症的混杂影响，要求患者在青年躁狂症评定量表(YMRS)上得分低于5分，在17项汉密尔顿抑郁评定量表(HDRS)上得分低于7分。这一标准确保排除了经历活跃情绪发作的个体。此外，参与者需要缓解至少6个月。健康对照组，年龄在18-65岁之间，确认为右撇子，前提是他们没有个人或家族精神病史。使用SCID-5-CV的详细访谈证实，健康对照者没有双相情感障碍(BD)或任何其他精神障碍病史或怀疑，也没有亲属患有精神障碍。所有参与者(203名双相情感障碍患者和201名健康对照者)使用上肢失用症测试(TULIA)进行评估，而双相情感障碍队列接受全球功能评估-功能(GAF-F)和世界卫生组织生命质量简短版本(WHOQOL-BREF)。采用SPSS 22.0进行统计学分析。结果:我们确定了一个临界TULIA评分阈值为217，该阈值将双相情感障碍患者与健康个体区分开来，灵敏度为79.3%，特异性为77.1%(曲线下面积(AUC) 0.799, P<0.001)。双相情感障碍患者的TULIA评分与功能显著正相关(GAF-F;r=0.502, P<0.001)和生活质量(WHOQOL;r = 0.389,术中;0.001)。TULIA哑剧评分(OR=0.92, 95% CI 0.86-0.99, P=0.022)和CPZ每天使用超过250mg (OR=2.24, 95% CI 1.19-4.21, P=0.012)是双相情感障碍患者功能障碍的独立预测因子。结论:双相情感障碍患者的失用障碍可能与影响其功能和生活质量的特定临床特征复杂相关。全面的失动症评估可以为设计量身定制的干预措施铺平道路，增强失动症，进而提高双相患者的生活质量。
{"title":"Exploring praxia deficits in bipolar disorder: A cross-sectional analysis of functionality and quality of life","authors":"İpek Özönder Ünal","doi":"10.28982/josam.7967","DOIUrl":"https://doi.org/10.28982/josam.7967","url":null,"abstract":"Background/Aim: Patients with bipolar disorder often experience praxia deficits, which might impede their functionality and quality of life. This study sought to delve into praxis defects in these patients, contrasting their praxia performance with healthy controls and illuminating the interrelation between praxia performance, functionality, and quality of life. Methods: In this cross-sectional study conducted from February to July 2023, we enrolled 203 patients diagnosed with bipolar disorder 1. Participants were recruited from the Ibni Sina and Sifa Community Mental Health Centers, both of which are affiliated with the Istanbul Tuzla State Hospital. Additionally, 201 healthy controls (HC) were recruited, primarily from the friends and relatives of the hospital staff. Patients diagnosed with bipolar disorder 1, between 18 and 65 years of age, were included based on their diagnosis as determined by the Structured Clinical Interview for DSM-5 Clinical Version (SCID-5-CV). Their right-handedness was ascertained via the Edinburgh Handedness Inventory. To minimize the confounding effects of acute mood episodes on praxia deficits, patients were required to score below 5 on the Young Mania Rating Scale (YMRS) and 7 or lower on the 17-item Hamilton Depression Rating Scale (HDRS). This criterion ensured the exclusion of individuals experiencing an active mood episode. Additionally, participants needed to have been in remission for at least six months. Healthy controls, aged 18-65 and confirmed as right-handed, were included, provided they had no personal or familial history of psychiatric conditions. A detailed interview using SCID-5-CV confirmed that the healthy controls had no history or suspicion of bipolar disorder (BD) or any other psychiatric disorder and no relatives with a psychiatric disorder. All participants (203 bipolar disorder patients and 201 healthy controls) underwent evaluations using the Test for Upper Limb Apraxia (TULIA), while the bipolar cohort received the Global Functioning Assessment-Functioning (GAF-F) and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). Statistical analyses were conducted using SPSS 22.0. Results: We identified a critical TULIA score threshold of 217, which differentiates bipolar patients from healthy individuals with a sensitivity of 79.3% and a specificity of 77.1% (area under the curve (AUC) 0.799, P<0.001). TULIA scores in bipolar patients were significantly positively correlated with functionality (GAF-F; r=0.502, P<0.001) and quality of life-general health (WHOQOL; r=0.389, P<0.001). TULIA pantomime subscores (OR=0.92, 95% CI 0.86-0.99, P=0.022) and CPZ use of more than 250mg per day (OR=2.24, 95% CI 1.19-4.21, P=0.012) were independent predictors of impairment in functioning in bipolar patients. Conclusion: Praxia deficits in bipolar disorder patients may be intricately tied to specific clinical features that influence both their functionality and life quality. Comprehensive pr","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"256 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135858673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: It has been reported that both the internal carotid artery (ICA) and the common carotid artery (CCA) are associated with hypoxia, also observed in late-onset fetal growth restriction (FGR). However, it has not yet been investigated whether these Doppler measurements differ in cases of late-onset FGR. This study evaluated the ICA and the CCA Doppler parameters in late-onset FGR fetuses and compared these measurements with those of healthy fetuses. Methods: This cross-sectional observational study comprised 75 singleton pregnancies diagnosed with late-onset FGR between the 32nd and 37th weeks of gestation, alongside 75 healthy fetuses paired 1:1 based on obstetric history and gestational age between June 2022 and May 2023. The Delphi consensus of 2016 was used for the definition of late-onset FGR. The exclusion criteria were congenital anomalies, presence of any additional disease, maternal body mass index over 35 kg/m2, abdominal scars hindering ultrasound visualization, use of medications such as antenatal steroids, sympathomimetics, and indomethacin that affect vascular function, drug use, smoking during pregnancy, concurrent preeclampsia, and multiple pregnancies. Upon the patients' admission to the hospital, their demographic characteristics were documented, and ultrasonographic examinations and Doppler measurements were subsequently performed. The Doppler velocimetry of the umbilical artery (UA) encompassed measurements of the systolic to diastolic ratio (S/D), pulsatility index (PI), and peak systolic velocity (PSV). The carotid artery Doppler velocimetry of the middle cerebral artery (MCA), ICA, and CCA encompassed measurements of the PI, resistance index (RI), and PSV. We assessed the diagnostic performance of Doppler measurements for late-onset FGR through receiver operating characteristic (ROC) analysis. Results: In the late-onset FGR group, the mean UA-SD was higher (2.7 [0.6] vs. 2.5 [0.5], P=0.006), and the mean UA-PI (0.8 [0.2] vs. 0.9 [0.2], P=0.011) and mean PSV (35.6 [8.2] vs. 41.1 [7.1], P<0.001) were lower compared to the control group. In the late-onset FGR group, carotid Doppler measurements were more pronounced than UA Doppler measurements. Moreover, ICA Doppler measurements exhibited superior diagnostic performance in predicting late-onset FGR compared to other Doppler measurements (Area under the curve [AUC]=0.777, P<0.001 for ICA-PI; AUC=0.751, P<0.001 for ICA-RI; AUC=0.749, P<0.001 for ICA-PSV). Conclusion: In fetuses with late-onset FGR, UA Doppler measurements showed minimal differences compared to healthy fetuses, but differences in carotid Doppler measurements, especially in the ICA, were more pronounced. Therefore, in the management of fetuses suspected of having late-onset FGR, a more detailed Doppler examination might be required.
{"title":"Evaluation of carotid artery Doppler measurements in late-onset fetal growth restriction: a cross-sectional study","authors":"Gokce Naz Kucukbas, Yasemin Doğan","doi":"10.28982/josam.7953","DOIUrl":"https://doi.org/10.28982/josam.7953","url":null,"abstract":"Background/Aim: It has been reported that both the internal carotid artery (ICA) and the common carotid artery (CCA) are associated with hypoxia, also observed in late-onset fetal growth restriction (FGR). However, it has not yet been investigated whether these Doppler measurements differ in cases of late-onset FGR. This study evaluated the ICA and the CCA Doppler parameters in late-onset FGR fetuses and compared these measurements with those of healthy fetuses. Methods: This cross-sectional observational study comprised 75 singleton pregnancies diagnosed with late-onset FGR between the 32nd and 37th weeks of gestation, alongside 75 healthy fetuses paired 1:1 based on obstetric history and gestational age between June 2022 and May 2023. The Delphi consensus of 2016 was used for the definition of late-onset FGR. The exclusion criteria were congenital anomalies, presence of any additional disease, maternal body mass index over 35 kg/m2, abdominal scars hindering ultrasound visualization, use of medications such as antenatal steroids, sympathomimetics, and indomethacin that affect vascular function, drug use, smoking during pregnancy, concurrent preeclampsia, and multiple pregnancies. Upon the patients' admission to the hospital, their demographic characteristics were documented, and ultrasonographic examinations and Doppler measurements were subsequently performed. The Doppler velocimetry of the umbilical artery (UA) encompassed measurements of the systolic to diastolic ratio (S/D), pulsatility index (PI), and peak systolic velocity (PSV). The carotid artery Doppler velocimetry of the middle cerebral artery (MCA), ICA, and CCA encompassed measurements of the PI, resistance index (RI), and PSV. We assessed the diagnostic performance of Doppler measurements for late-onset FGR through receiver operating characteristic (ROC) analysis. Results: In the late-onset FGR group, the mean UA-SD was higher (2.7 [0.6] vs. 2.5 [0.5], P=0.006), and the mean UA-PI (0.8 [0.2] vs. 0.9 [0.2], P=0.011) and mean PSV (35.6 [8.2] vs. 41.1 [7.1], P<0.001) were lower compared to the control group. In the late-onset FGR group, carotid Doppler measurements were more pronounced than UA Doppler measurements. Moreover, ICA Doppler measurements exhibited superior diagnostic performance in predicting late-onset FGR compared to other Doppler measurements (Area under the curve [AUC]=0.777, P<0.001 for ICA-PI; AUC=0.751, P<0.001 for ICA-RI; AUC=0.749, P<0.001 for ICA-PSV). Conclusion: In fetuses with late-onset FGR, UA Doppler measurements showed minimal differences compared to healthy fetuses, but differences in carotid Doppler measurements, especially in the ICA, were more pronounced. Therefore, in the management of fetuses suspected of having late-onset FGR, a more detailed Doppler examination might be required.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136012914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gül Bayram, Tugce Simsek, Selin Hazir, Fatma Zeynep Ozen, Mehmet Mustafa Erdogan, Sinan Seyhan, Hasan Kazaz, Erkan Tezcan
Background/Aim: The prevalence of human papillomavirus (HPV) in non-malignant tonsils can vary according to geographical location, age group, and risk factors. Some studies have found a relatively low prevalence of HPV, while other studies have found higher rates in non-malignant tonsils. The presence of HPV in non-malignant tonsils may be associated with precursor lesions that have the potential to develop into cancer. The aim of the current study was to detect the prevalence of HPV and p16 (one of the HPV types) in non-malignant tonsils and determine the existence of HPV in tonsil tissue using molecular and histological techniques. Methods: One hundred-three samples from non-malignant tonsils and one sample from squamous cell carcinoma of the tonsils were analyzed for the prevalence of HPV using molecular and histological methods. Real-time polymerase chain reaction (qPCR) was performed to detect HPV in the tissue samples. Results: HPV was not found in any tissue specimens based on histopathological and p16 immunohistochemical evaluations. HPV was not detected in all tissue samples using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). Conclusions: In our study of one hundred and four patients, HPV and p16 were not genetically detected in the tonsils that underwent surgery for reasons other than cancer. Hence, more comprehensive studies can contribute to evaluating the relationship between benign tonsil tissue and HPV infection, potentially leading to improved diagnostic and preventative measures.
{"title":"High-risk human papillomavirus infection prevalence in non-malignant tonsillar tissue: A single-center cross-sectional study","authors":"Gül Bayram, Tugce Simsek, Selin Hazir, Fatma Zeynep Ozen, Mehmet Mustafa Erdogan, Sinan Seyhan, Hasan Kazaz, Erkan Tezcan","doi":"10.28982/josam.7983","DOIUrl":"https://doi.org/10.28982/josam.7983","url":null,"abstract":"Background/Aim: The prevalence of human papillomavirus (HPV) in non-malignant tonsils can vary according to geographical location, age group, and risk factors. Some studies have found a relatively low prevalence of HPV, while other studies have found higher rates in non-malignant tonsils. The presence of HPV in non-malignant tonsils may be associated with precursor lesions that have the potential to develop into cancer. The aim of the current study was to detect the prevalence of HPV and p16 (one of the HPV types) in non-malignant tonsils and determine the existence of HPV in tonsil tissue using molecular and histological techniques. Methods: One hundred-three samples from non-malignant tonsils and one sample from squamous cell carcinoma of the tonsils were analyzed for the prevalence of HPV using molecular and histological methods. Real-time polymerase chain reaction (qPCR) was performed to detect HPV in the tissue samples. Results: HPV was not found in any tissue specimens based on histopathological and p16 immunohistochemical evaluations. HPV was not detected in all tissue samples using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). Conclusions: In our study of one hundred and four patients, HPV and p16 were not genetically detected in the tonsils that underwent surgery for reasons other than cancer. Hence, more comprehensive studies can contribute to evaluating the relationship between benign tonsil tissue and HPV infection, potentially leading to improved diagnostic and preventative measures.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136063727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sinem Kocagil, Ali Rıza Keklikci, Yusuf Aydemir, Oğuz Çilingir, Sabri Aynacı, Ebru Erzurumluoğlu Gökalp, Beyhan Durak Aras, Sevilhan Artan
Cockayne syndrome (CS, OMIM #216400 and OMIM #133540) is a rare, progressive, multisystemic disorder that results in premature aging and cachectic dwarfism. It is an autosomal recessive disorder with a prevalence of 2-2.5 per million. Pathogenic variants detected in the ERCC excision repair 6 (ERCC6) and ERCC excision repair 8 (ERCC8) genes are responsible for molecular pathogenesis. In this case report, an 11-year-old boy with severe microcephaly, growth retardation, loss of subcutaneous fat tissue, neuromotor developmental delay, bilateral cataracts, and facial dysmorphism but without dermal photosensitivity, who had a novel missense variant in trans configuration with a nonsense variant is presented.
{"title":"ERCC8 related Cockayne syndrome type-1: A rare entity diagnosed in a Turkish boy","authors":"Sinem Kocagil, Ali Rıza Keklikci, Yusuf Aydemir, Oğuz Çilingir, Sabri Aynacı, Ebru Erzurumluoğlu Gökalp, Beyhan Durak Aras, Sevilhan Artan","doi":"10.28982/josam.7380","DOIUrl":"https://doi.org/10.28982/josam.7380","url":null,"abstract":"Cockayne syndrome (CS, OMIM #216400 and OMIM #133540) is a rare, progressive, multisystemic disorder that results in premature aging and cachectic dwarfism. It is an autosomal recessive disorder with a prevalence of 2-2.5 per million. Pathogenic variants detected in the ERCC excision repair 6 (ERCC6) and ERCC excision repair 8 (ERCC8) genes are responsible for molecular pathogenesis. In this case report, an 11-year-old boy with severe microcephaly, growth retardation, loss of subcutaneous fat tissue, neuromotor developmental delay, bilateral cataracts, and facial dysmorphism but without dermal photosensitivity, who had a novel missense variant in trans configuration with a nonsense variant is presented.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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