Comparison of Preoperative and Postoperative Sexual Dysfunction in Male Patients with Lumbar Disc Herniation.

AIM: To compare preoperative and postoperative sexual dysfunction in male patients diagnosed with lumbar disc herniation (LDH). MATERIAL AND METHODS: This study was conducted in a single group with a pretest?posttest design. The sample included 32 male patients with LDH admitted to the neurosurgery outpatient clinic of a state hospital between August 1, 2019 and November 1, 2020 and who were about to undergo operation. The data were collected using a questionnaire form developed by the researchers, the Golombok?Rust Inventory of Sexual Satisfaction (GRISS), and the Visual Analogue Scale (VAS). Descriptive statistical methods, Mann?Whitney U test, Wilcoxon test, and Spearman correlation analysis were used to evaluate the data. Significance was evaluated at the level of p < 0.05. RESULTS: Before LDH surgery, male patients had problems with sub-dimensions of sexual function, such as frequency, communication, avoidance, touching, impotence, and premature ejaculation. A significant improvement was achieved after the operation in the communication sub-dimension and pain levels. The mean preoperative and postoperative VAS scores of the patients were 8.18 ± 1.20 and 1.28 ± 1.08, respectively. CONCLUSION: Lumbar disc surgery has a positive effect on sexual function and reduces pain levels. Since there is a strong relationship between LDH and sexual dysfunction, taking sexual history from patients should be part of routine medical history, and psychiatric care and consultation should be offered if necessary.

Rapid titration protocol - Experiences with a dynamic novel titration regime for vagus nerve stimulation in a group of depressive patients.

Vagus nerve stimulation (VNS) is an established tool in the psychiatric armamentarium for patients with therapy-resistant depression (TRD) with response rates of approximately 60%. So far, VNS is titrated slowly during ambulatory in-office visits. Thus, antidepressive effects can be expected after approximately six months. We report our experiences with a rapid dosing regime (RDR) with titration start shortly after VNS-implantation. We retrospectively analysed data of six patients with TRD who received VNS. Stimulation parameters were evaluated with regard to clinical side effects, heart rates (HR) and blood pressures (BP). Depressive symptoms were measured by Montgomery-Asberg Depression Rating Scale (MADRS) one week before and three months after implantation of the VNS. All patients received first stimulation between one and four days after surgery. We elevated output current using 0.25 mA titration steps. We increased output current between one and four days after the last titration. All patients received 1.0 mA output current after eight to 14 days post-surgery. HR and BP remained stable in all patients. All side effects were mild and temporary. MADRS scores were significantly lower three months after VNS-implantation (24 ±â€¯8) than one week before VNS-implantation (42 ±â€¯4; p = 0.028). The therapeutic range of VNS-parameters for antidepressive effect was reached quicker without finding increased numbers of side effects. Consequently, by using RDR the antidepressive effect of VNS-therapy for patients with TRD could be reached earlier than using slow titration. Our presented RDR might be able to significantly shorten the "clinical effect gap" due to the neurobiological and titration-related latency.

Could interleukin-33 and its suppressor of tumorigenicity 2 (ST2) receptor have a role in cervical human papillomavirus (HPV) infections?

Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPV-positive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre- and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections.

Role of Ozone Therapy in Preventing Testicular Damage in an Experimental Cryptorchid Rat Model.

BACKGROUND Cryptorchidism is the most common developmental abnormality of the male reproductive system. If left untreated, it results with infertility and testicular cancer. According to current evidence, surgery is the mainstay of treatment, and hormonal therapy approaches are still under investigation. For the protection of testicular functions, antioxidants have emerged as novel options. This study aimed to evaluate the protective properties of ozone, a strong antioxidant, on testicular tissue. MATERIAL AND METHODS Thirty-five male Wistar-albino rats, 1-month-old, were used for the study. Groups were formed as follows: 1) control, 2) sham surgery (cryptorchidism), 3) cryptorchidism plus ozone, 4) cryptorchidism plus human chorionic gonadotropin (hCG), and 5) ozone plus hCG. Surgical procedures were performed on all rats except the control group. All rats except the control group were used to create an experimental cryptorchidism model, and left testes of animals were surgically placed into the abdomen. After 1 month of surgery, groups 3, 4, and 5 were given corresponding treatments intraperitoneally for 4 weeks. At the end of the study period, testicular atrophy index (TAI) and testicular sperm motility (TSM) were assessed and biochemical, histopathological, and immunohistochemical tests were performed. RESULTS TAI and TSM were higher in the ozone, hCG, and ozone plus hCG groups than in the sham surgery group (p=0.001). TSM in the ozone group was significantly higher than in the hCG and ozone plus hCG groups. In biochemical analyses, the parameters of oxidative stress (GPx1, MDA, CAT, GSH, SOD) indicated increased oxidative activity in cryptorchidism, which was resolved by applying ozone and hCG (p=0.001). In addition, apoptotic markers, Caspase 3 and bcl-2 were significantly decreased by applying ozone and hCG (p=0.001). CONCLUSIONS Results of this study suggest that ozone therapy, either as a single agent or in combination with hCG, is a promising approach for protection of testicular functions.

Lack of evidence of HPV etiology of prostate cancer following radical surgery and higher frequency of the Arg/Pro genotype in turkish men with prostate cancer

ABSTRACT Objectives The aim of this study was to assess the possible role of HPV in the development of prostate cancer (PCa) and investigate the distribution of the p53 codon 72 polymorphism in PCa in a Turkish population. Materials and methods A total of 96 tissues, which had been obtained using a radical surgery method, formalin-fixed and parafin-embedded, were used in this study. The study group consisted of 60 PCa tissues (open radical prostatectomy) and the control group contained 36 benign prostatic hyperplasia tissues (BPH) (transvesical open prostatectomy). The presence of HPV and the p53 codon 72 polymorphism was investigated in both groups using real-time PCR and pyrosequencing. Results The results of the real-time PCR showed no HPV DNA in any of the 36 BPH tissue samples. HPV-DNA was positive in only 1 of the 60 PCa samples (1.7%). The HPV type of this sample was identified as HPV-57. The distribution of the three genotypes, Arg/Arg, Arg/Pro and Pro/Pro was found to be 45.6, 45.6, and 8.8% in the PCa group and 57.1%, 34.3% and 8.6% in the control group, respectively. Compared with the control group, patients with PCa had a higher frequency of the Arg/Pro genotype and Proline allele (odds ratio (OR)=1.67, 95% confidence interval (CI)=0.68-4.09, p=0.044; OR=1.13, 95% CI=0.76-1.68, p=0.021, respectively). Conclusions The results of the study do not support the hyphothesis that prostate cancer is associated with HPV infection but indicated that Proline allele can be a risk factor in the development of PCa in the Turkish population.

Metalloproteinases and Their Inhibitors in Patients with Inguinal Hernia.

AIM: The aim of this prospective study is to investigate if there is a relationship between inguinal hernia, matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs). MATERIALS AND METHODS: This case control study was performed on patients admitted to the general surgery department of Erzincan University Hospital. Four groups were created: control, indirect hernia, direct hernia, and bilateral hernia. All groups were comprised of 11 patients. Serum and tissue levels of MMP-1, MMP-2, MMP-9, MMP-13, TIMP-1, TIMP-2, TIMP-3, and hydroxyproline were evaluated. RESULTS: MMPs values were significantly high at hernia groups, especially at bilateral hernia group (p < 0.05), whereas TIMPs values were significantly low at bilateral hernia group (p < 0.05). MMPs values were increasing at hernia groups in an order as control, indirect, direct, and bilateral. TIMPs values were decreasing at hernia groups in an order as control, indirect, direct, and bilateral. CONCLUSION: Increased levels of MMP-1-2-9-13 and decreased levels of TIMP-1-2-3 may have played role in the formation of inguinal hernia. Hernia is not only a local defect, but a reflection of systemic disease. This is even more significant for bilateral hernias.

Lack of evidence of HPV etiology of prostate cancer following radical surgery and higher frequency of the Arg/Pro genotype in Turkish men with prostate cancer.

OBJECTIVES: The aim of this study was to assess the possible role of HPV in the development of prostate cancer (PCa) and investigate the distribution of the p53 codon 72 polymorphism in PCa in a Turkish population. MATERIALS AND METHODS: A total of 96 tissues, which had been obtained using a radical surgery method, formalin-fixed and parafin-embedded, were used in this study. The study group consisted of 60 PCa tissues (open radical prostatectomy) and the control group contained 36 benign prostatic hyperplasia tissues (BPH) (transvesical open prostatectomy). The presence of HPV and the p53 codon 72 polymorphism was investigated in both groups using real-time PCR and pyrosequencing. RESULTS: The results of the real-time PCR showed no HPV DNA in any of the 36 BPH tissue samples. HPV-DNA was positive in only 1 of the 60 PCa samples (1.7%). The HPV type of this sample was identified as HPV-57. The distribution of the three genotypes, Arg/Arg, Arg/Pro and Pro/Pro was found to be 45.6, 45.6, and 8.8% in the PCa group and 57.1%, 34.3% and 8.6% in the control group, respectively. Compared with the control group, patients with PCa had a higher frequency of the Arg/Pro genotype and Proline allele (odds ratio (OR)=1.67, 95% confidence interval (CI)=0.68-4.09, p=0.044; OR=1.13, 95% CI=0.76-1.68, p=0.021, respectively). CONCLUSIONS: The results of the study do not support the hyphothesis that prostate cancer is associated with HPV infection but indicated that Proline allele can be a risk factor in the development of PCa in the Turkish population.

Neural effects of methylphenidate and nicotine during smooth pursuit eye movements.

INTRODUCTION: Nicotine and methylphenidate are putative cognitive enhancers in healthy and patient populations. Although they stimulate different neurotransmitter systems, they have been shown to enhance performance on overlapping measures of attention. So far, there has been no direct comparison of the effects of these two stimulants on behavioural performance or brain function in healthy humans. Here, we directly compare the two compounds using a well-established oculomotor biomarker in order to explore common and distinct behavioural and neural effects. METHODS: Eighty-two healthy male non-smokers performed a smooth pursuit eye movement task while lying in an fMRI scanner. In a between-subjects, double-blind design, subjects either received placebo (placebo patch and capsule), nicotine (7mg nicotine patch and placebo capsule), or methylphenidate (placebo patch and 40mg methylphenidate capsule). RESULTS: There were no significant drug effects on behavioural measures. At the neural level, methylphenidate elicited higher activation in left frontal eye field compared to nicotine, with an intermediate response under placebo. DISCUSSION: The reduced activation of task-related regions under nicotine could be associated with more efficient neural processing, while increased hemodynamic response under methylphenidate is interpretable as enhanced processing of task-relevant networks. Together, these findings suggest dissociable neural effects of these putative cognitive enhancers.

Use of Ozone to Treat Ileostomy Dermatitis in an Experimental Rat Model.

BACKGROUND: Dermatitis associated with ileostomy is an important problem that affects many people, especially children. The aim of this study was to investigate the therapeutic effects of ozone on dermatitis due to ileostomy, and to develop an alternative treatment option. MATERIAL/METHODS: A total of 28 rats were divided into 4 groups: control, ileostomy, ozone, and zinc oxide. Ileostomy was performed in all rats except the control group. After a 1-week waiting time, the ozone group was administered ozone therapy and the zinc oxide group was administered zinc oxide cream locally once a day for a total of 7 days. All rats were sacrificed at the end of this period. The efficacy of treatment was examined by biochemical, histopathological, and immunohistochemical parameters. The levels of malondialdehyde (MDA), total glutathione (tGSH), total antioxidant capacity (TAC), and total oxidant status (TOS) were measured from tissue. Vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) were examined immunohistochemically. RESULTS: Dermatitis occurred pathologically in all rats that underwent ileostomy surgery. The lowest dermatitis score was in the ozone treatment group (p<0.05). Ileostomy dermatitis caused increased levels of MDA and TOS. Ozone treatment resulted in reduced MDA and TOS levels, while the levels of tGSH and TAC were increased (p<0.05). Both VEGF and PCNA immunostaining were augmented in the ozone treatment group (p<0.05). CONCLUSIONS: Local ozone application may be a good alternative compared to the conventional treatment methods for the prevention of skin lesions that develop after ileostomy.

[Determination of anti-echinococcus IgG antibodies by ELISA in patients with suspected hydatid cyst]. / Kist Hidatik Süpheli Hastalarda Anti-Echinococcus IgG Seropozitifliginin ELISA Yöntemiyle Belirlenmesi.

OBJECTIVE: Cystic echinococcosis (hydatid cyst) is one of the most important parasitic zoonoses that affect both humans and animals and has been known since prehistoric times. The cystic echinoccosis is a major health problem in our country as well as in many countries worldwide, and serological methods, in addition to imaging techniques, are used in the diagnosis of hydatid cyst. In the present study, anti- Echinococcus antibodies were investigated by ELISA in patient's serum samples, which were routinely delivered to the Medical Microbiology Laboratory of Gazi University Faculty of Medicine due to suspected hydatid cyst. METHODS: A total of 186 patients with suspected hydatid cysts from several outpatient clinics and departments of Gazi University Hospital were included in the present study. IgG antibodies in serum samples of patients with anti-Echinococcus were investigated by ELISA (Novalisa Echinococcus IgG, NovaTec, Germany). RESULTS: Anti-Echinococcus IgG seropositivity was determined as 35.5% in patients with suspected hydatid cyst. There are no statistical differences in ELISA positive results relating to gender, adult/child age group and associated clinics. CONCLUSION: Hydatid cyst seropositivity was higher among patients admitted to our hospital.

Yeast vaginitis during pregnancy: susceptibility testing of 13 antifungal drugs and boric acid and the detection of four virulence factors.

A higher prevalence of vulvovaginal candidiasis (VVC) is seen in pregnant women compared with those who are not pregnant. Recurrence is also more common in pregnant women, and therapeutic responses are reduced. In this investigation, 207 vaginal yeast isolates recovered from pregnant women were tested for susceptibility to 13 antifungal drugs and boric acid and through these studies four virulence factors were also determined. The isolates were recovered from vaginal samples of patients with acute VVC [AVVC, (n = 73)], symptomatic recurrent VVC [RVVC, (n = 89)], asymptomatic RVVC (n = 27), and those without signs and symptoms (n = 18). Candida albicans was the most common species found (59.9%), followed by C. glabrata (19.8%), other Candida spp., (19.8%), and Saccharomyces cerevisiae (0.5%). Antifungal susceptibility testing was performed as described in CLSI document M27-A3. Additionally, we examined phospholipase and proteinase production, adhesion to vaginal epithelial cells and hemolytic activity. Notably, the MIC values of Candida spp. isolates derived from patients with VVC were no different from those of the controls (P > 0.05). In addition, Candida isolates derived from patients with AVVC or RVVC produced significantly higher amounts of phospholipase and proteinase compared with the controls (P < 0.05). Antifungal testing and the determination of virulence factors may lead to the effective and prompt treatment of VVC, particularly in pregnant women.