Objective: This article aims to evaluate the efficacy of multiparametric magnetic resonance imaging before
standard tru-cut biopsy in making prostate cancer diagnosis.
Materials and Methods: A total of 160 patients with prostate biopsy indications were prospectively evaluated between May 2017 and October 2018. Multiparametric magnetic resonance imaging was taken after
obtaining a written informed consent from all patients. Cognitive transrectal ultrasound-guided biopsy was
performed based on multiparametric magnetic resonance imaging results. Standard tru-cut biopsy was
included to reduce false-negative rate. Statistical analysis was performed using the Statistical Package for
Social Sciences version 20.0 software.
Results: The mean age of the patients was 65.94 ± 7.90 (48-84) years. Around 19.37% of the patients had a
specificity in the digital rectal exam. The mean prostate-specific antigen value of the patients with adenocarcinoma was 42.1 ng/mL and it was 10.2 ng/mL in patients with benign prostate hyperplasia. It was observed
that the prostate-specific antigen values in prostatic adenocarcinomas were significantly higher than those
in benign prostate hyperplasia (P < .001). The results of multiparametric magnetic resonance imaging and
the biopsy were 100% similar in terms of zones in patients with adenocarcinoma. All of the biopsy results
of the patients who were evaluated to have normal prostate tissue in multiparametric magnetic resonance
imaging were evaluated as benign prostate hyperplasia; on the other hand, 13.6% of PI-RADS 2 lesions, 14%
of PI-RADS 3 lesions, 31.8% of PI-RADS 4 lesions, and 85.7% of PI-RADS 5 lesions were determined to be
adenocarcinoma. It was observed that the prevalence of adenocarcinoma increased as the risk elevated in
multiparametric magnetic resonance imaging (P < .001).
Conclusion: Multiparametric magnetic resonance imaging evaluated by experienced radiologists may be
instructive of urologists and reduce the need for unnecessary biopsies.
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Objective: The location of arterial occlusions can be predictive in the prognosis and endovascular treatment
of acute stroke patients. We aimed to determine if the location of the stent retriever being on the superior
or inferior division of the middle cerebral artery has an effect on the success and clinical outcomes of recanalization in middle cerebral artery M1 occlusion.
Materials and Methods: Data were generated for the period from May 2015 to January 2019. Divisions
of middle cerebral artery were assigned to the 2 groups as superior and inferior divisions according to the
anatomical classification. The dominant trunk of the artery was assessed on the last angiogram image.
Results: We eventually included 81/90 patients (mean age: 62 ± 13.5; 63% [51/81] female; mean National
Institutes of Health Stroke Scale rating: 16.3 ± 3.6) treated with thrombectomy. The branches of the middle
cerebral artery were as follows: 40 (49.4%) co-dominant, 22 (27.2%) inferior, and 19 (23.5%) superior
division dominant. The stent retriever was placed in the dominant trunk in 22/41(53.7%) cases at first pass.
When stent retriever was placed in the dominant middle cerebral artery trunk, the rate of successful recanalization was very high with the first pass of thrombectomy (P < .001).
Conclusion: Stent retriever placement within the superior or inferior middle cerebral artery trunk does
not have an effect on the success rate of recanalization; however, its placement in the dominant trunk can
increase the chance of complete recanalization to be early.
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Objective: The clinical presentation of coronavirus disease 2019 may be more severe in individuals with
diagnoses such as neurodegenerative diseases and cerebrovascular disease, which may occur at an advanced
age, among the underlying chronic neurological disorders. In this study, we analyzed the incidence of underlying neurological disorders, the clinical process, the effects on prognosis, duration of hospitalization, and
clinical parameters such as mortality and the incidence of neurological manifestations that occurred in the
study group after being infected and their relationship with the prognosis in patients hospitalized due to
coronavirus disease 2019.
Materials and Methods: This is a retrospective and single-centered study. Individuals aged 65 years and older
whose diagnosis of coronavirus disease 2019 was confirmed and who were hospitalized for treatment were
included in the study.
Results: A total of 282 individuals were included in the study. Neurological manifestaitons were observed
in 217 (77.0%) patients, and 131 (46.5%) patients had a neurological disorders in their medical history. Of
the 58 patients in intensive care, 36 (12.8%) had a positive history of neurological disorders (P=.006). The
incidences of diseases common in advanced age were 22 (7.8%) for dementia, 37 (13.1%) for cerebrovascular disease, and 4 (1.4%) for movement disorders. The most common symptom were myalgia in 67 (23.8%)
patients.
Conclusion: The clinical presentation was more severe and the risk of being treated in the intensive care
unit was higher in individuals with a history of neurological disorders and neurological manifestations.
Furthermore, patients who developed neurological manifestations had a greater risk of mortality and longer
periods of hospitalization.
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Everolimus-associated cytomegalovirus colitis is very rare in cancer patients. We present a case of cytomegalovirus colitis that occurred on using everolimus in a 64-year-old male with metastatic renal cell carcinoma
who received pazopanib, nivolumab, and everolimus treatments, respectively. Although an increasing number
of nivolumab-related cytomegalovirus colitis cases are reported recently, its mechanism of development is
still unknown. Our study highlights that clinicians should remember cytomegalovirus reactivation in the presence of diarrhea or colitis in patients receiving everolimus and/or nivolumab. Further studies are needed
to elucidate the relationship between immune checkpoint inhibitors and cytomegalovirus reactivation, and
these will also be a guide to prevent other possible viral infections.
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We describe a rare case of complete rupture of the flexor carpi radialis in a distal radius malunion. Though
the tendon was not repaired, the functional result was acceptable. The coronavirus disease-19 epidemic
highlights delayed treatment for routine orthopedic trauma and its complications. Decision-making as to
repair or reconstruction should rely on patient characteristics, fracture age, and geometry, as well as the
need for other repairs and grafting.
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Although esophageal perforation is rare, it is a life-threatening condition. The esophagus is very sensitive to
rupture and perforation due to the absence of a serosal layer. More than half of the esophageal perforations are iatrogenic and most occur during endoscopy. Around 55% of esophageal injuries occur in the
intrathoracic region, 25% in the cervical region, and 20% in the abdominal region. Clinical manifestations
and mortality are related to various components such as the etiology, localization, type of injury, severity
of contamination, injury to adjacent mediastinal structures, and time from perforation to treatment. When
perforation occurs in the esophagus, saliva, stomach contents, bile fluid, and other secretions may pass into
the mediastinum causing mediastinal emphysema, inflammation followed by mediastinal necrosis, and chemical mediastinitis. Early clinical suspicion and imaging are essential for successful treatment. Despite advances
in technology and treatment, the morbidity and mortality rate due to esophageal perforation is still higher
than 20% according to the reported studies. Until now, the main treatment of esophageal perforation was
the surgical approach. Nowadays, endoluminal procedures such as endoscopic vacuum therapy, endoscopic
stent placement, endoscopic clip closure, endoscopic suturing, and tissue adhesives have started to be applied
more. In this review, the minimally invasive and endoscopic approach methods suitable for esophageal perforation according to the characteristics of the patients and the structure of the perforation were examined.
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Objective: Postcircumcision pain in children can cause restlessness, crying and bleeding due to trauma.
However, there are various methods to prevent postoperative pain, caudal and penile blocks are in the
foreground. The primary objective of this study is to evaluate the effectiveness of CB and PB for the relief of
postcircumcision pain. The secondary aim is to evaluate the postoperative additional analgesic requirement
and side effects of these blocks.
Materials and Methods: A total of 148 children between the ages of 2 and 10 who underwent circumcision
surgery were randomly assigned to two groups in terms of postoperative analgesia. 1) A group of caudal
block (0,5 ml/kg %0.25 levobupivacaine) and 2) A group of penile block (0,3 ml/kg %0,25 levobupivacaine).
Premedication and sedoanalgesia were standardized. The pain (FLACC Pain Score), analgesic consumption,
motor block (Bromage Scale) and side effects (vomiting, hematoma, urinary retention) were assessed postoperatively for 4 hours.
Results: Postoperative FLACC scores were lower for caudale block group in the 1st, 3rd and 4th hours.
There was no significant difference in postoperative analgesic consumption between the groups. The most
common postoperative side effect was vomiting in both groups.
Conclusion: Caudal block provided more effective analgesia than penile block in postcircumcision pain control.
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Objective: Diabetic retinopathy is a leading cause of blindness. Diabetic retinopathy is not only
seen in diabetic patients with the clinical diagnosis but also in prediabetic patients. The aim of this
study is to evaluate the RNFL thickness in prediabetic patients.
Materials and Methods: In this study, 50 prediabetic patients and 50 healthy individuals were
included. RNFL measurements were performed with SD-OCT in patients with prediabetes and
healthy controls.
Results: The mean RNFL thickness for the prediabetic group was 94.7 ± 6.3 μm, inferior quadrant (120 ± 11.6), superior quadrant (112.3 ± 14.13), nasal quadrant (71 ± 12.9), and temporal
quadrant (65.3 ± 9.2 μm). The mean RNFL thickness for the control group was 98.9 ± 7.5 μm,
inferior quadrant (128 ± 14.7), superior quadrant (116.3 ± 15.12), nasal quadrant (77 ± 15.8),
and temporal quadrant (71.2 ± 10.3 μm). Variance analysis demonstrated that the RNFL thickness difference between the groups was significant in all quadrants (P < .001).
Conclusion: RNLF thinning can be seen in prediabetic patients before obvious vascular damage
has occurred, and it may present in prediabetic patients not only in the temporal quadrant but
also in all quadrants. The early retinal neural changes shown in this study in prediabetic patients
may help to better understand the process leading to diabetic overt retinopathy.
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