Evaluation of the effectiveness of colorectal cancer screening intervention.

PURPOSE: The effectiveness of the Colorectal Cancer (CRC) screening program is assessed based on the reduction in CRC mortality and incidence rates over time. To accurately estimate the long-term impact, it is advisable to monitor additional indicators such as age and stage-specific incidence rates. Our objective is to evaluate the effectiveness of the National CRC Screening Program in Turkey and analyze its influence on disease stage at diagnosis and survival rates. METHODS: The National CRC Screening Program was considered an intervention and the distribution of local, regional, and distant diseases, and survival estimates were assessed before and after the intervention to evaluate the effectiveness of the intervention. RESULTS: 518 patients were included in the study. At the time of diagnosis, localized, regional, and distant disease in pre-intervention were 31.3%, 42.9%, 25.8%, while post-intervention were 42.8%, 33.3%, 23.9%, respectively (p = 0.020). The relative effectiveness of the intervention in males, females, and 50-70 ages were calculated as 1.2[95% CI 0.95-1.73], 1.5[95% CI 1.04-2.18], and 1.6[95% CI 1.21-2.28] in localized disease, 0.8[95% CI 0.67-1.18], 0.6[95% CI 0.43-0.90], and 0.6[95% CI 0.46-0.81] in regional diseases, 0.8[95% CI 0.57-1.20], 1.1[95% CI 0.66-1.84], and 1.0[95% CI 0.70-1.57] in distant disease, respectively. CONCLUSION: A noticeable shift in the disease stage at the time of diagnosis was observed; however, this shift varied among gender and age groups. To effectively evaluate the impact of a cancer screening program on reducing the incidence and mortality rates of the disease, it is essential to monitor and analyze these indicators alongside 5-10-year survival estimates and stage changes at the time of diagnosis.

Knowledge and attitude evaluation of physicians and nurses on COVID-19.

OBJECTIVE: This study aims to evaluate the knowledge, perceptions, and attitudes of physician faculty members, nurses, and medical students who work in a hospital in Istanbul regarding COVID-19. METHODS: This cross-sectional study was conducted in a tertiary hospital from March 2 to March 10, 2020. The research data were collected through a survey consisting of 22 questions about their demographics and their level of knowledge, sources of information, actions, attitudes, and thoughts about COVID-19. The collected data were analyzed using SPSS 22.0. RESULTS: Out of 1.460 people, 614 (42%) participated in this study. More than 60% of the participants correctly answered the information questions about COVID-19. 72.6% of the participants stated that the situation that would stress them out the most in case of a COVID-19 outbreak in Turkey would be the diagnosis of one of their family members with COVID-19. Social media (66.4%) was the primary source of information in this process. CONCLUSION: The findings obtained in this study showed that right before the outbreak, healthcare professionals were concerned and stressed about the inadequacy of protective measures and the possibility of transmission, although they were ready for the outbreak in the professional sense.

Comparison of melatonin and ozone in the prevention of reperfusion injury following unilateral testicular torsion in rats.

OBJECTIVE: To compare the efficacy of ozone with melatonin, shown as the most powerful antioxidant in attenuation of testicular ischemia/reperfusion injury, in an experimental rat model of testicular torsion/detorsion. METHODS: Twenty-four male Wistar rats were divided into 4 groups: sham-operated, torsion/detorsion, torsion/detorsion plus melatonin, and torsion/detorsion plus ozone. Melatonin (10 mg/kg) and ozone (4 mg/kg) were intraperitoneally injected daily beginning 15 minutes before detorsion for the following 7 days. At the seventh day, blood and tissue samples were obtained. Johnsen score, malondialdehyde, inhibin B, glutathione plasma total sulfhydryl group (RSH) levels, and total nitric oxide were studied. RESULTS: Torsion/detorsion caused increase in tissue malondialdehyde and total nitric oxide along with a decrease in Johnsen score, tissue and plasma inhibin B, RSH, and glutathione levels. Melatonin prevented the rise in malondialdehyde and total nitric oxide levels and improved Johnsen score, tissue and plasma inhibin B, and tissue glutathione levels, along with a decrease in plasma RSH level. Ozone showed similar results except for the total nitric oxide level. Concomitantly, in contralateral testis, melatonin and ozone induced similar changes for Johnsen score, malondialdehyde, and inhibin B (not significant) and in glutathione (significant). Melatonin decreased the total nitric oxide level in both testes and ozone increased the same parameter. CONCLUSION: On different pathways, ozone was comparable with melatonin in the amelioration of ischemia/reperfusion injury. Protective effects of ozone were associated with nitrous oxide. The potential for ozone as a treatment for torsion/detorsion therefore deserves to be further elucidated.

Postoperative outcomes of plasmakinetic transurethral resection of the prostate compared to monopolar transurethral resection of the prostate in patients with comorbidities.

OBJECTIVE: To compare the 12-month postoperative clinical data in patients with comorbidities undergoing plasmakinetic enucleation of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for symptomatic benign prostatic hyperplasia (BPH). METHODS: The data of 165 patients undergoing either PK-TURP or M-TURP from September 2006 to December 2010 were retrospectively evaluated in terms of erectile function. Decrease in Hb level at 24-hour follow-up, variations in serum Na(+) at 2-hour follow-up, and 12 month postoperative International Prostate Symptom Score (IPSS), Q(max.), postoperative International Index of Erectile Function (IIEF) scores and urethral stricture rates were evaluated. RESULTS: A total of 85 patients underwent M-TURP and 80 patients PK-TURP. In all, 62 patients in M-TURP group and 71 patients in PK-TURP group had one or more comorbidities (P = .01). The operative times were 59.8 ± 17.8 versus 60.3 ± 23.8 (P = 0.539). The postoperative 12-month IIEF scores of PK-TURP patients were significantly higher than those of M-TURP patients (M-TURP; 14.5 ± 6.9, PK-TURP; 17.4 ± 8.9, P = .04). IPSS and Q(max.) were similar in both the M-TURP and PK-TURP treatment arms (10.9 ± 8.1 versus 9 ± 7.9, P = .187 and 18.9 ± 4.8 versus 18.8 ± 6.4, P = .905). Urethral stricture rate was 3/62 in M-TURP versus 8/71 in PK-TURP treatment arm, P = .171). CONCLUSION: Both modalities yielded similar results with respect to IPSS and Q(max.). The postoperative IIEF in BPH patients with comorbidities appeared to be significantly higher in the PK-TURP group. Although urethral stricture rates seemed higher in the PK-TURP arm, the difference was not statistically significant.

Fluoroquinolone-resistant acute prostatitis requiring hospitalization after transrectal prostate biopsy: effect of previous fluoroquinolone use as prophylaxis or long-term treatment.

OBJECTIVES: This study aims to scrutinize the hospitalized patients with the diagnosis of acute prostatitis after transrectal ultrasound-guided biopsy of the prostate (TRUSBP) focusing their history of previous antibiotic use, clinical pictures, microbiologic features, and resistance patterns of the isolates. PATIENTS AND METHODS: A retrospective evaluation of the records between 2005 and 2010 revealed 13 patients. All patients received ciprofloxacin 500 mg twice a day starting from the day before TRUSBP for 5 days. RESULTS: Positive 13 urine and 7 blood samples (Escherichia coli in 12 patients, Enterococcus species in one) were evaluated for resistance patterns. All were resistant to fluoroquinolones. Extended spectrum beta-lactamase producing E. coli isolated in 4 patients were treated with carbapenems. Empirical ceftriaxone was shifted to carbapenem (4 patients), vancomycin (1 patient). Empirical carbapenem was maintained in 5 patients. Seven patients with elevated PSA received fluoroquinolones for 4 weeks before TRUSBP on the assumption that they had subclinical infectious prostatitis. Previous exposure to fluoroquinolones did not lead to important differences in respect to the studied parameters. CONCLUSIONS: The prompt initiation of effective treatment is essential to decrease morbidity and mortality. Empirical treatment would be a second or third generation cephalosporins, or carbapenems according to clinical severity of patients.