A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate.

OBJECTIVES: To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer. MATERIALS AND METHODS: The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA1 and PSA2) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values. RESULTS: PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), P=.019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515-0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (P:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33-0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations. CONCLUSION: PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.

Valoración del impacto de la tasa libre de litiasis en los resultados de la evaluación metabólica / Is stone free status really necessary for metabolic evaluation following stone removal procedures?

Objetivo Evaluar si la tasa libre de litiasis afecta a los resultados del estudio metabólico en pacientes con alto riesgo de litiasis recidivante tras tratamiento completo mediante ureteroscopia. Pacientes y métodos Un total de 78 pacientes sometidos a cirugía retrógrada intrarrenal (CRIR) para el tratamiento de litiasis fueron incluidos en este estudio. Cuatro semanas después del tratamiento, los casos se dividieron en dos grupos en base a los resultados de la tomografía computarizada sin contraste (TCSC). Los casos del grupo 1 (n=54) presentaban una tasa libre de litiasis del 100% y los del grupo 2 (n=24) presentaban litiasis residuales en el riñón. Cuatro semanas después de la ureteroscopia flexible (URF) se realizó un análisis completo de orina de 24h a todos los pacientes de ambos grupos, para detectar los factores de riesgo implicados en la litogénesis. Los resultados del estudio metabólico (orina de 24h y suero) se compararon entre los dos grupos. Resultados La evaluación preoperatoria en orina y suero de los factores de riesgo asociados a la formación de cálculos no reveló diferencias estadísticas entre los dos grupos. El análisis comparativo de los factores de riesgo implicados en la formación de la litiasis mediante pruebas de orina de 24h tampoco reveló diferencias estadísticamente significativas entre los resultados preoperatorios y postoperatorios en los casos del grupo 2 con cálculos residuales. Tampoco se observaron diferencias significativas entre las medias de las variables séricas preoperatorias y postoperatorias de ambos grupos. Conclusiones Según nuestros resultados, y dada la similitud de los hallazgos obtenidos en los estudios metabólicos de los casos con y sin litiasis residual, la tasa libre de litiasis puede no constituir un factor imprescindible para la realización del estudio metabólico detallado (suero y orina de 24h) tras las intervenciones endourológicas para la extracción de los cálculos renales. (AU)

Objective To evaluate the impact of stone free status on the outcomes of metabolic evaluation in recurrent stone formers after ureteroscopic stone removal. Patients and methods A total of 78 patients undergoing retrograde intrarenal surgery (RIRS) for renal stones were included and cases were divided into two groups after 4 weeks based on the NCCT findings. While cases in the Group 1 (n=54) was completely stone free, cases in Group 2 (n=24) had residual fragments in the kidney. A full 24-hour urine analysis for relevant stone forming risk factors has been performed after 4 weeks following the fURS procedures in all patients of both groups. Outcomes of metabolic evaluation (24-hour urine and serum) have been comparatively evaluated in both groups. Results Evaluation of the preoperative serum and urine stone forming risk factors revelaed no statistical difference in both groups. Comparative evaluation of the 24-hour urinary stone forming risk factors also revealed no statistically significant difference between preoperative and postoperative findings in cases of Group 2 with residual stones. Last but not least, no significant difference was observed between the mean preoperative and postoperative serum variables between two groups. Conclusions Our results show that in the light of the similar metabolic evaluation outcomes obtained in cases with and without residual fragments, ‘stone free status’ may not be an essential factor to perform a detailed metabolic evaluation (24-hour urine analysis and serum parameters) after endourological stone removal procedures. (AU)

Is stone free status really necessary for metabolic evaluation following stone removal procedures?

OBJECTIVE: To evaluate the impact of stone free status on the outcomes of metabolic evaluation in recurrent stone formers after ureteroscopic stone removal. PATIENTS AND METHODS: A total of 78 patients undergoing retrograde intrarenal surgery (RIRS) for renal stones were included and cases were divided into two groups after 4 weeks based on the NCCT findings. While cases in the Group 1 (n = 54) was completely stone free, cases in Group 2 (n = 24) had residual fragments in the kidney. A full 24-h urine analysis for relevant stone forming risk factors has been performed after 4 weeks following the fURS procedures in all patients of both groups. Outcomes of metabolic evaluation (24-h urine and serum) have been comparatively evaluated in both groups. RESULTS: Evaluation of the preoperative serum and urine stone forming risk factors revelaed no statistical difference in both groups. Comparative evaluation of the 24-h urinary stone forming risk factors also revealed no statistically significant difference between preoperative and postoperative findings in cases of Group 2 with residual stones. Last but not least, no significant difference was observed between the mean preoperative and postoperative serum variables between two groups. CONCLUSIONS: Our results show that in the light of the similar metabolic evaluation outcomes obtained in cases with and without residual fragments, 'stone free status' may not be an essential factor to perform a detailed metabolic evaluation (24-h urine analysis and serum parameters) after endourological stone removal procedures.

The comparison of the effects of three types of piezoelectric ultrasonic tips and air polishing system on the filling materials: an in vitro study.

AIM: The aim of this study was to evaluate the effect of air polishing and different ultrasonic scaler inserts on dental fillings, such as amalgam, composite and porcelain. MATERIALS AND METHODS: This study was performed on amalgam, composite and porcelain samples. The surfaces of the samples were exposed to different type of piezoelectric ultrasonic scaler inserts and air-abrasive unit. The scaler inserts were Instrument A, Instrument PS and PI. The roughness of the surfaces of each sample were measured with a profilometer and observed by stereomicroscope. RESULTS: The stereomicroscopic images and profilometric values showed that Instrument A and PS resulted in rough surfaces, such as chips, nicks and scratches on the amalgam, composite and porcelain surfaces. The Instrument PI roughened the amalgam surface, but it did not roughen the porcelain or composite surfaces. The profilometric measurements (Ra) showed that the roughness of the surfaces depending on air polishing was less than the ultrasonically scaled surfaces. CONCLUSION: The wrong tip applications during dental scaling procedure cause roughness, such as scratches, nicks or chips, not only on the teeth surfaces but also on the filling materials. Thus, dental scaling procedure on the restorations should be performed carefully and the roughness sites on the restorations have to be re-polished after scaling to prevent plaque accumulation.

Sonic and ultrasonic scalers in periodontal treatment: a review.

Periodontal therapy aims at arresting periodontal infection and maintaining a healthy periodontium. The periodic mechanical removal of subgingival microbial biofilms is essential for controlling inflammatory periodontal disease. Mechanical periodontal therapy consists of scaling, root planing and gingival curettage. The sonic and ultrasonic scalers are valuable tools in the prevention of periodontal disease. The vibration of scaler tips is the main effect to remove the deposits from the dental surface, such as bacterial plaque, calculus and endotoxin. However, constant flushing activity of the lavage used to cool the tips and cavitational activity result in disruption of the weak and unattached subgingival plaque. The aim of the study was to review the safety, efficacy, role and deleterious side-effects of sonic and ultrasonic scalers in mechanical periodontal therapy.

Reactive oxygen species and human inflammatory periodontal diseases.

Reactive oxygen species (ROS) have emerged as important signaling molecules in the regulation of various cellular processes. They can be generated by the mitochondrial electron transport chain in mitochondria and activation of polymorphonuclear leukocytes (PMN) during inflammatory conditions. Excessive generation of ROS may result in attack of and damage to most intracellular and extracellular components in a living organism. Moreover, ROS can directly induce and/or regulate apoptotic and necrotic cell death. Periodontal pathologies are inflammatory and degenerative diseases. Several forms of periodontal diseases are associated with activated PMN. Damage of tissues in inflammatory periodontal pathologies can be mediated by ROS resulting from the physiological activity of PMN during the phagocytosis of periodontopathic bacteria.