Investigation of Enthesopathy with Ultrasonography and Comparison with Skin Findings in Asymptomatic Psoriatic Patients.

BACKGROUND: Joint involvement associated with psoriasis is referred to as psoriatic arthritis. A late diagnosis of psoriatic arthritis may cause a variety of morbidities; therefore, an early diagnosis and treatment of psoriatic arthritis are required. Asymptomatic psoriatic arthritis has been found in 8-70% of patients with psoriasis using imaging techniques. OBJECTIVE: To investigate joint and enthesis regions by ultrasonography in patients with psoriasis without inflammatory joint symptoms to detect subclinical psoriatic arthritis. METHODS: We included 50 psoriasis patients and 30 healthy control subjects without joint complaint in this study. Twelve joint regions of all subjects in each group were examined by ultrasonography. RESULTS: The presence of any pathological ultrasonography finding (30%) was higher but did not significantly differ in psoriasis patients compared with the control group (13.33%; p > 0.05). CONCLUSION: Although statistically not significant, the pathological ultrasonography findings were approximately twofold more common in patients with psoriasis compared with the control group. Therefore, the development of psoriatic arthritis in patients with psoriasis should be more closely followed.

Evaluation of Carotid Intima Media Thickness and Renal Artery Resistive Index in Patients With Pseudoexfoliation Syndrome: A Prospective Case-Control Study.

PURPOSE: To investigate the significance of renal artery resistance and carotid intima media thickness (CIMT) parameters in patients with pseudoexfoliation syndrome (PES). MATERIALS AND METHODS: In this prospective case-control study, 37 patients were involved and grouped as PES (n=19) and control groups (n=18). Ophthalmological evaluation included visual acuity, intraocular pressure, central corneal thickness measurement, and optic disc evaluation. In addition, renal artery resistive index and CIMT measurements were taken for all patients and compared between the groups. RESULTS: The 2 groups were similar with respect to age, sex, and family history of glaucoma. The mean CIMT in the PES group was found to be significantly higher compared with the control group (0.73±0.02 vs. 0.59±0.06 mm, P=0.003). Renal artery resistive indices were found to be higher in the PES group than in the control group, however, the difference was not significant (P=0.46). A moderate positive correlation between CIMT and renal artery resistive indices was detected (r=0.447, P=0.01). However, a higher correlation rate was detected when the analysis was made in the PES group only (r=0.603, P=0.01). CONCLUSIONS: CIMT increases in PES patients and also the renal artery resistance index has a tendency to increase. Patients with PES should be informed about potential systemic consequences of this syndrome.

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer.

BACKGROUND: PET-CT is important for evaluating the cancer stage preoperatively. In patients with locally advanced disease, who are candidates for curative treatment modalities following computed tomography (CT) and ultrasonography evaluation, PET-CT can show distant metastases and spare patients unnecessary surgical interventions. We aimed to evaluate the contribution of PET-CT scans compared to conventional imaging studies on the change of treatment plan in patients with locally advanced esophagogastric cancer from neoadjuvant to palliative setting. MATERIALS AND METHODS: In this study, 91 patients with histopathologically proven diagnosis of esophageal or gastric cancer in our clinic between the years 2010-2014 were included. Prior to PET-CT evaluation, all of the patients were evaluated with thorax and abdomen computed tomography. Seventy-six of these patients were further evaluated by PET-CT due to ambiguous findings on computed tomography and 15 of them for staging purposes. The patients, who were shown to have distant metastases on conventional radiological imaging, were excluded from the study population. RESULTS: Ninety-one patients were included in the study. Their median age was 57 (range 30-80) years and three-quarters of the patients were male. Most of the patients were evaluated by PET-CT due to suspicion of distant metastasis (83.5%). Primary sites of the tumors on PET-CT were: esophagus 38.5% and stomach 61.5%. Between CT and PET-CT tumor stage and pathological lymphadenopathy concordance rates were 75.8, and 69.2%, respectively. On PET-CT evaluation 47.3% of patients had distant metastasis. New metastases were detected in 34.1% of patients by PET-CT despite entering to scanning field of tomography. Following the PET-CT evaluation due to detected metastasis, 47.3% of patients' treatment plan was changed from neoadjuvant to palliative therapy. CONCLUSION: In the current study, 47.3% (n = 43) of patients had distant metastasis that were not detected by CT evaluation. These patients were spared unnecessary surgical interventions. Evaluating the locally advanced gastric and esophageal cancer patients for PET-CT new metastasis could be indicated when the treatment plan of these patients would be changed from curative to palliative.

Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia.

We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p < 0.05). The prostatic RI levels were found to be associated with fasting blood glucose and total prostate volume, and also with CVS risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors.

Effects of medical therapy or surgery on prostatic and bladder resistive indices in patients with benign prostatic hyperplasia.

INTRODUCTION: The effects of medical therapy or surgery on bladder and prostatic resistive indices (RIs) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) were evaluated in the present study. PATIENTS AND METHODS: A total of 124 consecutive LUTS/BPH patients who were candidates for medical therapy (alfuzosin 10 mg once daily, n=66) or surgery (transurethral prostatectomy (TUR-P), n=58) were prospectively included. Baseline assessment of patients was performed with the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and prostatic and bladder RIs measured using power Doppler imaging (PDI). All patients were re-evaluated 3 months after treatment measuring the same parameters. RESULTS: Following medical therapy, mean IPSS (17.2±5.1 vs. 8.3±5.3, p=0.0001), postvoiding residual (PVR) urine (80.0±80.5 vs. 40.3±38.6, p=0.0001), and prostatic RI (0.73±0.1 vs. 0.70±0.1, p=0.0001) were decreased, Qmax (13.7±4.2 vs. 16.9±5.9, p=0.0001) was increased, and bladder RI remained unchanged (0.70±0.1 vs. 0.70±0.1, p=0.68). Mean IPSS (25.3±5.6 vs. 6.0±4.5, p=0.0001), PVR urine volume (134.5±115.5 vs. 35.7±25.9, p=0.0001), and prostatic (0.78±0.1 vs. 0.67±0.04, p=0.0001) and bladder RIs (0.72±0.1 vs. 0.64±0.04, p=0.005) were decreased, and Qmax (8.0±4.5 vs. 17.2±8.2, p=0.0001) was increased after TUR-P. CONCLUSIONS: Our results demonstrated that TUR-P decreased both prostatic and bladder RIs, while α-blocker therapy did not change bladder RI in the early posttreatment period in LUTS/BPH patients.

Comparison of Histopathological and CT Findings in Experimental Rabbit Sinusitis.

The aim of this study was to investigate and compare histopathological and computerized tomographic (CT) findings of experimental acute sinusitis in an animal model. The noses of five healthy rabbits were inoculated with a gelatin sponge impregnated with a solution containing Staphylococcus aureus, and one healthy rabbit acted as the control. The animals were sacrificed on the tenth day, following the acquisition of paranasal CT scans. Specimens were obtained from the lateral nasal walls, and the ethmoid and maxillary sinuses of the animals for histopathological examination. Histopathological and CT findings were compared. Various degrees of epithelial disorganization, foci of ruptured epithelial cells, and inflammatory cell infiltration in the lamina propria were seen in the histopathological examinations of the five study rabbits, and mucosal thickening and soft tissue density were noted in their CTs. There was no correlation between the histopathological and CT findings. It was shown that CT did not reflect the acute changes in the sinus mucosa. Patients with chronic sinusitis must be evaluated for a chronic process. Computerized tomographic scans should not be obtained in acute sinusitis cases. In this way, both unnecessary radiation exposure and economic waste can be avoided.

Effect of transurethral resection of prostate on prostatic resistive index.

INTRODUCTION: In the present study, we evaluated the effect of transurethral resection of the prostate (TUR-P) on prostatic resistive index (RI) in patients with benign prostatic hyperplasia(BPH). PATIENTS AND METHODS: Forty BPH patients who were candidates for prostatectomy were prospectively included in the study. Prostatic RI was measured using power Doppler imaging (PDI) before TUR-P. In the postoperative follow-up, all patients were reevaluated with PDI, International Prostate Symptom Score (IPSS) and uroflowmetry. RESULTS: Mean age, IPSS and maximal urine flow rate (Q(max)) of the patients was 65.8 +/- 7.6 years, 24.6 +/- 7.1 and 7.7 +/- 3.8 ml/s, respectively. The mean prostatic RI of the patients before TUR-P was 0.79 +/- 0.02. Prostatic RI positively correlated with total prostate volume and IPSS (r = 0.57, p = 0.0001, and r = 0.42, p = 0.008, respectively) and negatively correlated with Q(max) (r = -0.37, p = 0.029) prior to treatment. After TUR-P, mean IPSS and prostatic RI significantly decreased (6.5 +/- 4.3 and 0.68 +/- 0.03, respectively; p < 0.05), whereas mean Q(max) was increased (15.7 +/- 5.7, p < 0.05). CONCLUSIONS: Our data demonstrated that prostatic RI of the patients with BPH significantly decreased after TUR-P. We believe that prostatic RI could be a useful parameter for the follow-up of patients who underwent TUR-P.

Cerebrovascular accident during cisplatin-based combination chemotherapy of testicular germ cell tumor: an unusual case report.

Even though testicular nonseminomatous germ cell tumors (NSGCTs) usually have a good prognosis and high curability rates, unpredicted complications owing to chemotherapy regimens might complicate the course. Modalities that are commonly used to cure NSGCTs have well-known side effects. Thromboembolism, which is infrequently associated with germ cell tumors and the vascular toxicity of chemotherapeutics, causes morbidity and mortality. We report a young testicular NSGCT patient, without any known underlying risk factor, who experienced an unpredicted cerebrovascular accident after he received cisplatin-based combination chemotherapy.