A Novel Score to Predict One-Year Mortality after Transcatheter Aortic Valve Replacement, Naples Prognostic Score.

Background and Objectives: Aortic stenosis (AS) is a widespread valvular disease in developed countries, primarily among the elderly. Transcatheter aortic valve replacement (TAVR) has become a viable alternative to aortic valve surgery for patients with severe AS who are deemed a high surgical risk or for whom the AS is found to be inoperable. Predicting outcomes after TAVR is essential. The Naples Prognostic Score (NPS) is a new scoring method that evaluates nutritional status and inflammation. Our study is aims to examine the relationship between the NPS and outcomes for patients receiving TAVR. Material and Methods: We conducted a retrospective study of 370 patients who underwent TAVR across three tertiary medical centres from March 2019 to March 2023. The patients were divided into two groups based on their NPS, namely, low (0, 1, and 2) and high (3 and 4). Our study is primarily aimed to determine the one-year mortality rate. Results: Within one year, the mortality rate for the entire group was 8.6%. Nonetheless, the low-NPS group had a rate of 5.0%, whereas the high-NPS group had a rate of 13%. The difference between the two groups was statistically significant, with a p-value of 0.06. Conclusions: Our results show that NPS is an independent predictor of one-year mortality in patients undergoing TAVR.

Mean Platelet Volume-A Predictive Factor for the Diagnosis of Nonsymptomatic Prostatitis: Results of Univariate and Multivariate Models.

Mean platelet volume (MPV) has been reported to be related to inflammation. Prostate-specific antigen (PSA) is a protein produced by the prostate, and this protein may be elevated for several reasons, including prostatitis, benign prostatic hyperplasia, and/or cancer. The aim of the current study was to investigate the predictive effect of MPV values on nonsymptomatic prostatitis diagnosis and the relation between MPV and PSA. A total of 275 patients, 89 affected by benign prostate hyperplasia, 94 by prostate adenocancer, and 92 by prostatitis were included in the current study. PSA, total blood count parameters, and urine analysis were investigated. Findings were compared with the groups. The correlation between MPV and the other parameters were analyzed. Univariate and multivariate logistic regression analysis was performed to determine independent predictors of nonsymptomatic prostatitis diagnosis. MPV was significantly higher in patients with nonsymptomatic prostatitis than the other groups. There were negative correlations between MPV and age, total PSA or free PSA ( r = -.123; p = .042, r = -.235; p < .001, r = -.184; p = .006, respectively). According to multivariate regression model, only MPV was identified as the predictive factor for nonsymptomatic prostatitis (odds ratio: 1.451, 95% confidence interval [1.116, 1.887], p = .005). MPV, in the absence of other reasons that increased the MPV level, was significantly increased in cases with nonsymptomatic prostatitis; this increase is significantly higher than elevated PSA level in nonsymptomatic prostatitis patients. MPV could have a predictive value for the diagnosis of nonsymptomatic prostatitis.

Etiology and prognosis of penetrating eye injuries in geriatric patients in the Southeastern region of Anatolia Turkey.

BACKGROUND: The purpose of this study was to evaluate the etiologic and prognostic factors of open eye injuries in geriatric patients in the Southeastern region of Anatolia. METHODS: Forty-five geriatric patients who underwent surgery for an open eye injury in our clinic between the years of 2008 and 2012 were evaluated retrospectively. Age, gender, cause and the mechanism of the trauma, visual acuity (VA), and the time between the trauma and the surgery were obtained from files and evaluated. RESULTS: The mean age of the patients was 70.4±8.2 (65-90) years. Thirty-four of the cases were male and 11 were female. The most frequent mechanism of trauma was a wood strike, while the second most common one was injury with a knife. Corneoscleral penetration was the most frequently observed trauma. The mean VA of the patients was 2.26±0.65 at admission, and was 1.53±0.99 logarithm of the minimum angle of resolution at the final evaluation. The most frequent complications of trauma were iris prolapse and hyphema. There was a significant correlation between the first and final VA. CONCLUSION: Penetrating ocular injuries are seen less frequently among geriatric patients, and their prognosis may be worse due to less-efficient wound site healing and differences in scleral rigidity. The most important factor affecting the final VA measurement was the VA of the patient at admission.

Caffeic acid phenethyl ester (CAPE) protects against acute urogenital injury following pneumoperitoneum in the rat.

PURPOSE: Our aim is to determine the biochemical and histologic changes induced in the kidneys, testis and prostate on possible ischemia and reperfusion (I/R) injury caused by pneumoperitoneum (PNP) in a rat model and to evaluate the ability of protective effects of caffeic acid phenethyl ester (CAPE). METHODS: Twenty-eight adult male Wistar albino rats were randomly divided to one of three treatment groups, with seven animals in each group. Sham, laparoscopy (L), and laparoscopy plus CAPE (L + C) group were subjected to 60 min of PNP with 15 mmHg one hour before the desufflation period. Total oxidant status (TOS) and total antioxidant status (TAS) levels were determined in kidney, testis, and prostate. Kidney and testis tissues were removed to obtain a histologic score. Also, Johnsen scoring system was used for testicular tissue analysis. RESULTS: L group had significantly higher TOS and lower TAS levels on kidney and testis compared to the other groups. In prostate biochemical analysis, there was not any difference between groups. No difference was found between groups according to kidney and testis tissues' histologic evaluation. In evaluation of Johnsen scoring, L group showed significant lower score compared to the other two groups. CONCLUSIONS: Increased intraabdominal pressure (IAP) had an oxidative effect on kidney and testis but not on prostate in rats. Moreover, it could affect the testicular Johnsen score. All these adverse effects of IAP on both kidney and testis could be prevented by CAPE administration.

The investigation of total PSA, free PSA, and free/total PSA ratio in patients with liver cirrhosis patients according to Child-Pugh score.

OBJECTIVE: To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency. METHODS: Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters. RESULTS: The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score. CONCLUSION: The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA.

Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia.

OBJECTIVE: There are limited data on whether there is an association between nocturia, benign prostatic hyperplasia (BPH) and endothelial dysfunction. The aim of the present study was to evaluate whether there is an association between nocturia and endothelial dysfunction in patients with BPH. MATERIAL AND METHODS: Forty-two men with a diagnosis of BPH and 42 age-matched controls were enrolled. All patients were assessed for frequency and duration of nocturia, and prostate volume, completed the International Prostate Symptom Score (IPSS) questionnaire, and underwent brachial flow-mediated dilatation (FMD) evaluation. RESULTS: There was a negative correlation between FMD and frequency of nocturia (r = -0.879, p < 0.0001). Moreover, there was a negative correlation between duration of nocturia and FMD (r = -0.890, p < 0.0001). In addition, FMD was significantly decreased in the BPH group compared with the control group (6.0 ± 0.09 to 7.8 ± 0.10%) (p = 0.0001). CONCLUSION: In patients with BPH, nocturia is associated with endothelial dysfunction and may be an insidious risk factor for cardiovascular disease.

Corneal perforation during Nd:YAG laser capsulotomy: a case report.

We report a case where corneal perforation developed during Nd:YAG laser capsulotomy. We present a 20-year-old male with the complaint of impaired vision in the right eye. Leukoma consistent with the incision line in the cornea and opacity in the posterior capsule were observed.

Effects of sildenafil citrate, isoniazid, and streptomycin on testicular tissue and epididymal semen quality in rats.

OBJECTIVE: To evaluate the effects of isoniazid (INH) and streptomycin (STR) on epididymal semen quality and testicular tissue, and to evaluate the protective effect of sildenafil citrate (SC) on possible testicular toxicity induced by STR and INH in rats. METHODS: Eighty adult male Sprague-Dawley rats were divided randomly into 8 groups including control, SC, INH, STR, STR+INH, SC+INH, SC+STR, and SC+INH+STR. After 45 days of treatment, the reproductive organ weights, epididymal semen quality, testicular histopathological findings, levels of serum nitric oxide, testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were investigated. RESULTS: SC significantly increased the epididymal sperm motility and concentration, and the levels of FSH, LH, and testosterone. The STR group had a significantly higher percentage of sperm head defect than the control group (P < .05). The INH group had lower Johnsen Testicular Biopsy Score than the control group (P < .001). Although SC and INH treatment alone did not affect the epididymal semen quality negatively, the SC+INH group had significantly higher spermatozoon tail and total morphologic defect ratios than the control group (P < .05). CONCLUSION: It has been concluded from this study that (1) SC has positive effects on spermatogenesis, sperm production, and semen quality; (2) STR affected the testicular biopsy score and spermatozoon head morphology negatively, but positively affected the other spermatologic traits; (3) INH did not effect the epididymal semen quality negatively, but decreased testicular biopsy score; and (4) SC can prevent the spermatozoon head defects induced by STR and can decrease the testicular toxicity induced by INH.