Consensus statement addressing controversies and guidelines on pediatric urolithiasis.

PURPOSE: We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. METHODS: Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literature, and prepare the initial survey. Data were collected through surveys and focus group discussions. Existing guidelines were reviewed, and a second survey was conducted using the Delphi method to validate findings and facilitate consensus. The primary outcome measures investigated controversial issues, integrating expert consensus and guideline reviews. RESULTS: Experts from 15 countries participated, including 20 with 16+ years of experience, 2 with 11-15 years, and 4 with 6-10 years. The initial survey identified nine main themes, emphasizing the need for standardized diagnostic and treatment protocols and tailored treatments. Inter-rater reliability was high, with controversies in treatment approaches (score 4.6, 92% agreement), follow-up protocols (score 4.8, 100% agreement), and diagnostic criteria (score 4.6, 92% agreement). The second survey underscored the critical need for consensus on identification, diagnostic criteria (score 4.6, 92% agreement), and standardized follow-up protocols (score 4.8, 100% agreement). CONCLUSION: The importance of personalized treatment in pediatric urolithiasis is clear. Prioritizing low-radiation diagnostic tools, effectively managing residual stone fragments, and standardized follow-up protocols are crucial for improving patient outcomes. Integrating new technologies while ensuring safety and reliability is also essential. Harmonizing guidelines across regions can provide consistent and effective management. Future efforts should focus on collaborative research, specialized training, and the integration of new technologies in treatment protocols.

Investigation of long-term COVID-19 patients' quality of life and affecting factors: Data from single COVID-19 follow-up center.

Background: Patients with COVID-19 experienced changes in their quality of life. However, far less is known about how quality of life changes in long-term COVID-19 follow-ups. Aim: This article aims to explore the relationship between quality of life change and long-term COVID-19 patient status in the COVID-19 follow-up center. Patients and Methods: This study was designed retrospectively with patients admitted to the COVID-19 follow-up center between January and May 2021. The single group consisted of 125 patients. Their status and 36-Item Short-Form Health Survey (SF-36) variables were compared at two different time intervals. The first admission indicates the first 3 months, and the second admission covers 3-6 months after being diagnosed with COVID-19. Results: Cough and chest pain increased in the second admission (P < 0.001). No significant differences were found in SF-36 change according to age. The general health subgroup scores were lower in females than males (P = 0.004). The SF-36 Form's subgroups for physical function, physical role, emotional role, bodily pain, energy, mental health, general health, and social function showed improvement (P = 0.001, P = 0.001, P = 0.026 P < 0.001, P = 0.007, P = 0.031, P <0.001, P <0.001, respectively). In addition, comparing with the SF-36 subgroups in terms of treatment places, a significant result was found between the inpatient and intensive care unit (ICU) in the general health subgroup (P = 0.044). Conclusions: The results show that quality of life may worsen during follow-up for COVID-19. In summary, these findings have significant implications for understanding long-term COVID-19 patients with a multidisciplinary approach and the necessity of follow-up centers to detect the unpredictable results of long-term COVID-19.

COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study.

BACKGROUND: Aim of this study is to investigate COVID-19 outcomes in patients with antiphospholipid syndrome (APS). METHODS: A retrospective cohort was formed from APS patients. Patients were screened for a record of positive SARS-CoV 2 PCR. In PCR­positive patients, clinical data and information regarding COVID-19 outcomes were collected from medical records. RESULTS: A positive PCR test was detected in 9/53 APS patients, while 66.7 %, 33.3 % and 11.1 % of APS patients with COVID-19 were under hydroxychloroquine, LMWH or warfarin, and acetylsalicylic acid, respectively. There were 3/9 patients found to be hospitalized and one died. No new thrombotic event was reported in any of the patients during COVID-19 infection. CONCLUSION: Baseline use of hydroxychloroquine, antiaggregants and anticoagulants may be associated with an absence of new thrombotic event (Tab. 2, Ref. 33).

Systemic inflammation in both open-angle and angle-closure glaucoma: role of platelet-to-lymphocyte ratio.

AIM: To analyse the effect of systemic inflammatory status in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) by calculating platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). METHODS: This retrospective case-control study included 200 patients with POAG, 22 patients with PACG and 100 healthy subjects. The participants' white-blood-cell, lymphocyte, neutrophil, and platelet counts were recorded from previous blood assays. NLR and PLR were calculated manually. Results were compared among the groups. RESULTS: Both the POAG and PACG groups had higher platelet counts and PLR values than the control group (p=0.001 and p=0.001; respectively). The difference in NLR between POAG, PACG and control groups was not statistically significant (p=0.076). The POAG group had higher NLR values than the control (p=0.035). CONCLUSION: Both the POAG and the PACG groups exhibited higher platelet and PLR levels than the control. These results indicate a potential role of systemic inflammation in the pathogenesis of POAG and PACG (Tab. 4, Fig. 1, Ref. 35).

The relationship between teamwork attitudes and caring behaviors among nurses working in surgical clinics: A correlational descriptive study.

AIM: This study was planned and carried out to determine how teamwork attitudes of nurses working in surgical clinics affect their caring behaviors. MATERIALS AND METHODS: The research was conducted as a relational descriptive study. The research population consisted of 126 nurses working in the surgical clinics of a state hospital. A total of 116 nurses who agreed to participate in the study were admitted to the study. Data were collected using the Descriptive Characteristics Question Form, the Teamwork Attitudes Questionnaire (TAQ), and the Caring Behaviors Inventory-24 (CBI-24). Data were analyzed using counts, percentage distributions, Mann-Whitney U test, and Kruskal-Wallis tests, Games-Howell post hoc test, and Spearman's correlation. RESULTS: The nurses participating in the study were found to have a mean score of 112.11 ± 17.86 for the TAQ and a mean score of 4.95 ± 0.54 for the CBI. There was a statistically positive correlation between the nurses' teamwork attitudes and caring behaviors (P < 0.05). CONCLUSION: It can be said that the teamwork attitudes of the nurses had a positive effect on their caring behaviors. It may be suggested to plan relevant research studies examining especially observational behavioral assessments.

Evaluation of mental foramen location in the 10-70 years age range using cone-beam computed tomography.

INTRODUCTION: Mental foramen (MF) locations were determined according to gender and age in terms of the vertical distance from the surrounding anatomical structures and the vertical and horizontal size of the MF. MATERIALS AND METHODS: One hundred-seven male and 103 female patients in the age group between 10 and 70 years were included in our retrospective study and were examined using cone-beam computed tomography (CBCT). The right and the left MF locations were determined from panoramic and cross-sectional images. On the cross-sectional CBCT images, the distance of the MF upper limit from the alveolar crest edge, the distance of the MF lower limit from the lower edge of the mandible, and vertical size of the MF were measured. RESULTS: MF location differed in males and females (P < 0.001); it was generally located at the first and second premolar in females, and at the level of the second premolar in males. However, the MF location was not different on the right and left sides (P = 0.436). The distance of the MF from the surrounding anatomic structures were found to be lower in females than in males in all measurements (P < 0.001). The horizontal size of the MF was found to be less on the left side (P < 0.001). CONCLUSIONS: Knowing both the position and the distance of the MF from the surrounding anatomical structures is not only useful information for surgery, but will also help avoid complications such as paresthesia.

Laparoscopic temporary clipping of uterine and ovarian arteries for the treatment of interstitial ectopic pregnancy.

PURPOSE OF INVESTIGATION: To assess the effect of laparoscopic temporary clipping of uterine and ovarian arteries for the treatment of interstitial ectopic pregnancy. MATERIALS AND METHODS: A 29-year-old woman with vaginal bleeding and pelvic pain was admitted to the current clinic. She had secondary amenorrhea for nine weeks. Transvaginal ultrasonography revealed normal empty uterus and right interstitial ectopic pregnancy with viable embryo. Laparoscopic temporary clipping of uterine and ovarian arteries, interstitial pregnancy resection, and primary myometrial suturing was performed. RESULTS: Following dissection Latzko pararectal space for the visualization of both uterine arteries, four vascular clips were placed (two to uterine arteries, two to infundibulopelvic ligaments). Excision of interstitial pregnancy and primary myometrial suturing was performed with minimal blood loss. The patient was discharged from the hospital after one day without any remarkable complications. CONCLUSIONS: To the best of the authors' knowledge, this is the first case of interstitial pregnancy that was successfully treated by temporary laparoscopic clipping of uterine and ovarian vessels prior to interstitial ectopic pregnancy resection.

Measuring the resistance of different substructure materials by sticking them to dentine with two different resin cements in vitro.

INTRODUCTION: The resistance of three different substructure materials - metal (Cr-Co), zirconium (Zr), and ceramics (IPS Empress II) - was measured by sticking them to dentine with two different resin cements, a dual-cure resin cement (Panavia F 2.0 Light) and a self-adhesive resin cement (BisCem). MATERIALS AND METHODS: In an in vitro study, 72 central upper front teeth were selected with no decay or apparent breakage and with complete development, removed for periodontal reasons. Labial and incisal surfaces of all teeth were prepared. Molds were obtained to prepare metal (Co-Cr), Zr, and ceramic (IPS Empress II) blocks for use in the study. The compressive strengths of the obtained material infrastructures were examined after thermal cycle processing by performing cementation to the teeth with two different cements. The data obtained were analyzed statistically. The Mann-Whitney U-test was used for comparisons of the groups with two options, and Kruskal-Wallis variance analysis was used to compare more than two groups. P<0.05 were considered statistically significant. RESULTS: While the highest result between samples was 117.86 ± 47.94 N in the dual-cure (Panavia)-ceramic group, the lowest value was observed at 6.53 ± 3.12 N in the self-adhesive (BisCem)-metal group. There was a significant difference between dual-cure (Panavia) and self-adhesive (BisCem) groups. CONCLUSION: In this study, we measured the bond strength; our most durable resistance groups were found to be, in order, Panavia-ceramics >Panavia-metal >Panavia-Zr >self-adhesive-ceramics >self-adhesive-Zr >and self-adhesive-metal.

Amniotic fluid lamellar body count as a novel biochemical marker for timing elective caesarean delivery.

The aim of this study is to evaluate the performance of amniotic fluid lamellar body count (LBC) on the timing of elective caesarean delivery (CS) at ≥ 39 weeks. After allocating the study group (group I, transient tachypnoea of newborn (TTN), n = 14), an age-matched control group (group II, no TTN, n = 79) was selected for amniotic fluid LBC analysis. The median amniotic fluid LBC levels in group I were significantly lower than in the control group. Furthermore, the median values of mean lamellar body volume, median lamellar body distribution width and lamellar bodycrit in group I were also significantly lower than in group II. The best amniotic fluid LBC value to predict TTN was 40.15 × 10(3)/µl, with 82.3% sensitivity and 64.3% specificity. The favourable sensitivity and specificity values to predict the TTN for amniotic fluid LBC may suggest using it as an elective caesarean delivery-time scheduling marker.

Nine-year Follow-up of a Patient with Thoracic Outlet Syndrome and Paget-Schroetter Syndrome.

Thoracic outlet syndrome (TOS) is a challenging clinical condition with regards to its diagnosis and treatment. Its management may turn out to be challenging a case when an adverse complication such as Paget-Schroetter syndrome (PSS) also co-exists. Herein, we report a nine-year follow-up of a patient with TOS (a 41-year old cardiovascular surgeon) who had suffered multiple PSS episodes and repeat TOS surgeries. In essence, we want to highlight the diverse clinical indings of TOS and discuss its management in light of the relevant literature.

Macular injury resulting from a high-powered tank laser telemetry device.

A high-powered laser is an essential part of a modern military rangefinder; however, this paper presents three cases with macular injury resulting from a high-powered tank laser telemetry device. All injuries occurred when another user deliberately pointed the telemetry target unit at the patient's eyes. The devastating effect of this high-powered laser resulted in a permanent foveal scar in the second patient and a macular hole formation in the third patient. This report emphasises that education plays a primary role in preventing accidental laser injuries. Using general guidelines and safety regulations will prevent accidental macular injuries.

Fetal nasal bone length at 11(+0) - 13(+6) weeks of gestation: an evaluation of 554 consecutive cases.

PURPOSE OF INVESTIGATION: To develop a nomogram for estimating nasal bone length (NBL) at 11(+0) - 13(+6) weeks of gestation in 554 consecutive cases and to determine the value of NBL measurement in screening for chromosomal abnormalities. MATERIALS AND METHODS: NBL and crown-rump length (CRL) were examined in 554 fetuses at 11(+0) - 13(+6) weeks' gestation. A nomogram for NBL was developed with data from 479 healthy fetuses in which fetal profile examination was possible. Reference values, including percentiles, weie calculated for each gestational age. RESULT: A linear correlation was noted between CRL and NBL in healthy fetuses at 11(+0) - 11(+6), 12(+0) - 12(+6) and 13(+0) - 13(+6) weeks of gestation. Mean NBL was 2.18 +/- 0.53 mm, 2.46 +/- 0.45 mm, and 2.91 +/- 0.55 mm in healthy fetuses, for these time frames, respectively. NBL increased significantly with CRL from respective means of 2.26 +/- 0.43, 2.60 +/- 0.48, 2.77 +/- 0.43, and 3.16 +/- 0.52 mm at 45 - 54.9, 55 - 64.9, 65 +/- 74.9, and 75 - 84 mm. CONCLUSION: The authors developed a NBL nomogram with data from normal, healthy Turkish fetuses at 11(+0) - 13(+6) weeks of gestation. These reference ranges may prove useful in prenatal screening and diagnosis of syndromes known to be associated with nasal hypoplasia.

Serum levels of androgens and prostate-specific antigen in endometriosis.

OBJECTIVE: The aim of the present study was to evaluate the levels of serum androgens and prostate-specific antigen (PSA) levels in patients with endometriosis. MATERIALS AND METHODS: Patients with Stage III/IV (advanced stage) endometriosis were compared to controls with respect to basal serum levels of total testosterone (T), free testosterone (fT), androstenedion (A), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulphate (DHEA-S), and PSA in the early follicular phase of menstrual cycle for this prospective case control study. RESULTS: Level of T, fT, A, DHEA, and DHEA-S were higher in patients with endometriosis when compared to control subjects, but the difference was not statistically significant. The mean PSA level was 0.0074 +/- 0.0120 ng/ml in patients with endometriosis and 0.0059 +/- 0.0056 ng/ml in control group and there was no statistically significant difference between groups (p = 0.58). CONCLUSION: Serum basal androgens and PSA levels are higher in endometriosis group with respect to control but the differences are not statistically significant.

Protective effects of growth hormone on bacterial translocation and intestinal damage in rats with partial intestinal obstruction.

OBJECTIVE: One of the reasons of bacterial translocation (BT) is the complete or partial intestinal obstructions (PIO) of the gastrointestinal system. In this study, we aimed to investigate the effects of recombinant human Growth Hormone (rhGH) on BT in rats with partial intestinal obstruction (PIO). MATERIAL AND METHODS: The rats were randomly divided into the 4 groups: Group I: Sham-operated (SO) (n = 12), Group II control PIO (n = 12), Group III: PIO with rhGH treatment for 5 days (n = 12), Group IV: PIO with rhGH treatment 5 days before PIO and 5 days after PIO (a total of 10 days) (n = 12). In the groups III and IV, the effects of 5 and 10 days administered rhGH were examined. RESULTS: The level of serum and of intestinal fluid IgA was significantly higher in the Group IV compared to the Group I, Group II and Group III. In the Group IV, the number of small intestinal goblet and colonic goblet cells, and the lengths of intestinal mucosal villi and crypt depths were statistically significantly higher than in Groups II and III. The rate of bacterial translocation was higher in the Group II: 100 % in MLNs, 41.6 % in blood culture and 50.8 % in the liver cultures, it was significantly higher compared to the other groups (p < 0.01). CONCLUSIONS: The study results demonstrated that administration of rhGH to the rats with PIO for at least 10 days decreased bacterial translocation (Fig. 3, Ref. 25).

Obstructive sleep apnea syndrome and its association with vitamin D deficiency.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent, partial or complete episodes of apnea due to upper airway tract obstruction during sleeping period. Deficiency of vitamin D has roles in development of many diseases. Association between presence and severity of OSAS and vitamin D has recently gained research interest. AIM: The aim of our study was to investigate the association between serum 25-hydroxy [25 (OH)] vitamin D levels and severity of disease in patients with OSAS. MATERIAL AND METHODS: One hundred and fifty OSAS patients (50 patients with mild, 50 with moderate, 50 with severe OSAS) who were diagnosed by polysomnography (PSG) and 32 non-OSAS controls who were referred to the Health Ministry Ankara Numune Training and Research Hospital, Endocrinology and Metabolism Department, from January 2010 to May 2011 were included in the study. Serum 25(OH)D, PTH, calcium and phosphorus levels were evaluated in all the patients who were recruited to the study. RESULTS: There was no statistically significant difference in serum 25(OH)D levels between OSAS and controls (p>0.05). However, in subgroup analysis of OSAS, we found that the patients with severe OSAS had significantly lower levels of 25(OH)D as compared with other groups (p=0.003). Also, the number of patients with serum 25(OH)D deficiency (<10 µg/dl) were higher in OSAS group than in controls (p<0.05). CONCLUSIONS: We found that when the severity of OSAS increases, 25(OH)D deficiency becomes more pronounced.

Frequency of respiratory function disorders among dental laboratory technicians working under conditions of high dust concentration.

BACKGROUND AND OBJECTIVES: Dental laboratory technicians (DLTs) have much exposure to mineralogical dust that may have adverse effects on their lung health. The aim of our study was to investigate occupational dust exposure, and to determine the frequency of respiratory function disorders and radiologic abnormalities among DLTs. MATERIALS AND METHODS: The study enrolled 94 DLTs who were exposed to dust in dental laboratories and 94 control subjects. Dust concentrations in the workplaces were measured. RESULTS: The mean age of DLTs was 30.70 ± 9.84 years. No significant difference was found between the DLTs and the control groups for age or smoking status (p > 0.05). Spirometric values for the DLTs were found to be lower than the control group (p < 0.05). The mean working period for DLTs was 9.19±5.9 years. The pulmonary function test results for the DLTs showed that 65.9% had a normal pattern, 22.4% were restrictive, and 11.7% showed obstructive type pulmonary function disorder. Negative correlations were found between the working period time and Forced Expiratory Volume in 1 second in the DLTs (R = -0.675 p = 0.000). Negative correlations were also found between working period time and Forced Vital Capacity in the DLTs (R = -0.720 p = 0.000). All DLTs had chest X-rays and 16 (17%) of them showed radiological pneumoconiosis. CONCLUSIONS: This study showed a negative association between level of respiratory function and working period in DLTs.

The effect of chronic pelvic pain scoring on pre-term delivery rate.

A total of 57 pregnant women, who were admitted to the outpatient clinic having high visual analogue scale (VAS) and a history of chronic pelvic pain before pregnancy, were evaluated with the international pelvic pain assessment form (IPPAF). Gynaecological disorders, pain at ovulation, dysmenorrhoea, level of cramps with period and suspicion of endometriosis were determined to be higher in the pre-term group (p < 0.05). Regarding urological disorders, pain when the bladder was full, pain with urination, a positive answer to the question, 'Does your urgency bother you?' and suspicion of interstitial cystitis were also determined to be higher in the pre-term group (p < 0.05). Thus, the total IPPAF scores were significantly higher in the pre-term group (p < 0.05). The pregnant women with a higher total IPPAF score before pregnancy may thus have a higher probability of pre-term labour.

The effects of hormone therapy on ischemia modified albumin and soluble CD40 ligand levels in obese surgical menopausal women.

PURPOSE: To determine the effects of hormone therapy (HT) on ischemia modified albumin (IMA) and soluble (s)CD40 ligand in obese surgical menopausal women. MATERIALS AND METHODS: A total of 52 obese surgical menopausal women with a body mass index (BMI) > 30 kg/m2 were admitted to the study. Twenty-seven women received estradiol hemihydrate two mg and 25 did not receive any menopausal therapy. At baseline and after three and six months of treatment, IMA and sCD40 ligand levels were measured. RESULTS: There were no significant differences among the groups for any variables at baseline. No difference in change in the serum sCD40L levels was found in obese surgical menopausal women after three and six months of HT. Serum IMA levels were statistically lowered in obese women with HT after six months of treatment. CONCLUSION: HT may have a beneficial reduction in IMA levels in obese surgical menopausal women.