The protective effect of taurine on cyclophosphamide-induced testicular toxicity in rats.

This study aimed to evaluate the protective effect of taurine (TAU) with regard to antioxidant, anti inflammatory and antiapoptotic pathways on cyclophosphamide (CP)-induced testicular toxicity in rats. Forty Sprague-Dawley male rats were used in this experimental study. The CP group animals received a single dose of 200mg/kg CP on Day 8 intraperitoneally (i.p). The other groups were treated with TAU (75, 150 and 300mg/kg) orally for 14 days prior to and following a single i.p injection of CP. Morphometrical analysis and histological examination of testicular tissue were performed. Serum testosterone, LH and FSH levels were measured in serum using commercial ELISA kits. The testicular injury induced by CP was evaluated in terms of oxidative stress, inflammation and apoptosis with a significant inflammatory and apoptotic response and an insignificant oxidative stress. TAU treatment resulted in improvement in body weight gain, oxidative stress, inflammation and apoptosis, some of which were significant. The improvement was more pronounced for antiapoptotic effect of taurine in the testis of CP-treated animals. It was concluded that TAU may prevent and/or treat the testicular toxicity by ameloirating oxidative stress, inflammation and apoptosis.

Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines.

OBJECTIVE: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. METHODS: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were consid- ered most important and relevant to practices by using Google Forms. RESULTS: Total number of responses was 340. Respondents reported that they recorded a detailed patient's medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n=323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n=75) replied that they performed in >75% of cases. Participants (n=311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most pre- ferred drug for stuttering priapism (n=141, 41%). Participants (n=284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of par- ticipants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. CONCLUSION: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency.

The prevalence and topographic distribution of penile calcification in a large cohort: a retrospective cross-sectional study.

The prevalence of penile calcification in the population remains uncertain. This retrospective multicenter study aimed to determine the prevalence and characteristics of penile calcification in a large cohort of male patients undergoing non-contrast pelvic tomography. A total of 14 545 scans obtained from 19 participating centers between 2016 and 2022 were retrospectively analyzed within a 3-months period. Eligible scans (n = 12 709) were included in the analysis. Patient age, penile imaging status, presence of calcified plaque, and plaque measurements were recorded. Statistical analysis was performed to assess the relationships between calcified plaque, patient age, plaque characteristics, and plaque location. Among the analyzed scans, 767 (6.04%) patients were found to have at least one calcified plaque. Patients with calcified plaque had a significantly higher median age (64 years (IQR 56-72)) compared to those with normal penile evaluation (49 years (IQR 36-60) (p < 0.001). Of the patients with calcified plaque, 46.4% had only one plaque, while 53.6% had multiple plaques. There was a positive correlation between age and the number of plaques (r = 0.31, p < 0.001). The average dimensions of the calcified plaques were as follows: width: 3.9 ± 5 mm, length: 5.3 ± 5.2 mm, height: 3.5 ± 3.2 mm, with an average plaque area of 29 ± 165 mm² and mean plaque volume of 269 ± 3187 mm³. Plaques were predominantly located in the proximal and mid-penile regions (44.1% and 40.5%, respectively), with 77.7% located on the dorsal side of the penis. The hardness level of plaques, assessed by Hounsfield units, median of 362 (IQR 250-487) (range: 100-1400). Patients with multiple plaques had significantly higher Hounsfield unit values compared to those with a single plaque (p = 0.003). Our study revealed that patients with calcified plaques are older and have multiple plaques predominantly located on the dorsal and proximal side of the penis.

Ejaculation Disorders in Male Patients with Cancer: A Systematic Review and Meta-Analysis of Prevalence.

PURPOSE: Ejaculatory dysfunction (EjD) and erectile dysfunction after cancer treatment are clinically important complications, but their exact prevalence by various kinds of cancer site and type of treatment is unknown. The aim of this systematic review and meta-analysis was to examine the available evidence and provide pooled estimates for prevalence of EjD and erectile dysfunction in relation to all cancer sites and identify characteristics associated with EjD in cancer patients. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of cross-sectional and case-control studies. We searched 4 electronic databases (Medline®, CINAHL, PsychInfo and Embase®) until July 22, 2020. All retrospective or prospective studies reporting the prevalence of EjD in male patients with cancer were included in this review. A random effects meta-analysis was conducted calculating prevalence proportions with 95% confidence intervals. Prevalence proportions were calculated for the incidences of EjD by cancer site and type of treatment. RESULTS: A total of 64 studies (a total of 10,057 participants) were included for analysis. The most common cancer sites were bladder, colon, testis and rectum. The prevalence rates of EjD after surgical intervention ranged from 14.5% (95% CI 2.2-56.3) in colon cancer to 53.0% (95% CI 23.3-80.7) in bladder cancer. The prevalence rates of erectile dysfunction ranged from 6.8% (95% CI 0.8-39.1) in bladder cancer to 68.7% (95% CI 55.2-79.6) in cancer of the rectum. CONCLUSIONS: In a large study-level meta-analysis, we looked at a high prevalence of EjD and erectile dysfunction at various cancer sites and across different treatment types. Prospective studies of EjD and erectile dysfunction after various kinds of cancer treatments are warranted.

Examination of the effect of COVID-19 on sexual dysfunction in women.

OBJECTIVE: To investigate the effect of COVID-19 on sexual dysfunction in women. MATERIAL AND METHODS: The women diagnosed with COVID-19 and hospitalised at a tertiary hospital were included. They completed the Introductory Data Form, the Female Sexual Function Index-(FSFI) and the Short Form-36 Quality of Life Scale (SF-36). RESULTS: Fifteen women between the ages of 19-49 who completed the treatment protocol, discharged at least 14 days before and who had not been diagnosed as sexual dysfunction; sexually active earlier were included in the study. It was detected that weekly sexual intercourse before and after COVID-19 significantly differed (P = .047). The frequency of relationships decreased statistically after COVID-19. The mean value of the FSFI satisfaction score differs from COVID-19 before and after diagnosis (P = .012). The mean satisfaction score before COVID-19 was 3.47, and after COVID-19 was 2.93. The score of the subgroups of FSFI did not differ from COVID-19 before and after diagnosis (P > .050). The median value of SF-36 pain differs from COVID-19 before and after diagnosis (P = .008). CONCLUSION: It was concluded that the frequency of sexual intercourse and sexual satisfaction in women decreased after COVID-19 disease, and the quality of life scores did not change in a statistically significant way.

Gabapentin add-on therapy for patients with spinal cord injury associated neurogenic overactive detrusors that are unresponsive to combined anticholinergic and beta-3 adrenergic therapy.

INTRODUCTION: Spinal cord injury is a major cause of lifelong morbidity and functional micturition problems. Some patients are refractory to the available therapeutics, even when used in combination. In this paper we report our results of using gabapentin as an add-on treatment in refractory overactive detrusor cases secondary to spinal cord injury. MATERIAL AND METHODS: A total of 27 patients who had a spinal cord injury between the levels of the second thoracic and fourth lumbar vertebrae and had an overactive detrusor in urodynamic studies were included in this retrospective study. The patients were selected due to the fact that they also had not responded to a combination of an anticholinergic and mirabegron and had neuropathic pain. Gabapentin treatment was added to the previous therapy. Demographics, previous treatments, chronic conditions, urodynamic findings, clinical and urodynamic responses are reported in this paper. RESULTS: We observed a response to treatment in the urodynamic studies of 11 patients (40.17%), in terms of decreased detrusor contractions, maximal detrusor pressure, and the number of incontinence episodes. Sixteen patients did not respond to the gabapentin add-on therapy and were referred for Botulinum toxin injections to the bladder. CONCLUSIONS: Gabapentin add-on therapy can be considered as a third or further option, before Botulinum toxin injection, for patients with neurogenic overactive detrusor who did not respond to the combination of anticholinergics and mirabegron. The approved usage of gabapentin for neurogenic pain justifies its usage in this area. In our selected patient group, who had not responded to the combination therapy, we observed a clinical benefit in one-third of the patients.

Could LUTS be early symptoms of COVID-19.

AIM: To show if lower urinary tract symptoms (LUTS) could be symptoms of COVID-19 with validated questionnaires. METHODS: The 96 COVID-19 patients who were hospitalised at a tertiary centre were collected retrospectively. After the exclusion criteria, 46 patients consisted the study population. All patients then fill formed the International Prostate Symptom Score and Urinary Symptom Profile respectively. All patients responded to these questions for the three period. RESULTS: Twenty-seven female (58.6%) and 19 male (41.4%) COVID-19 patients answered the questions. In the male patients, while there were no statistically significant differences in the total IPSS, the voiding IPSS score, and quality of life between the three periods (P = .148; P = .933, P = .079, respectively), the storage IPSS scores had a significant difference between the three periods (P = .05). In female patients, low stream scores were similar between the three periods (P = .368). The scores of stress incontinence and an overactive bladder had a significant difference between the three periods (P = .05 and P = .05). CONCLUSION: LUTS, especially storage symptoms, might be one of the initial symptoms of COVID-19 and the clinicians should evaluate LUTS with other known symptoms of the virus when a patient is suspected of having COVID-19.

HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia.

AIMS: To evaluate the diagnostic significance of the novel index combining preoperative haemoglobin, albumin levels, lymphocyte and platelet counts (HALP) in prostate cancer (PCa) patients. METHODS: Between 1 January 2015 to 31 December 2018 at the Hitit University Erol Olçok Education and Research Hospital 225 patients who had undergone transrectal ultrasound guided prostate biopsy or prostate surgery were analysed retrospectively. A total of patients, 155 had benign prostate hyperplasia (group 1) and 70 had PCa (group 2). The preoperative serum levels of haemoglobin, albumin, lymphocyte counts and platelet counts were recorded. The HALP scores and the sub-parameters of this index for each of the two groups were compared. RESULTS: The total Prostate-Specific Antigen (PSA), albumin and lymphocyte differences between the groups were statistically significant (P = 0.0002, P = 0.0001, P = 0.005). The median value of HALP scores in Group 1 and 2 were 49.43 and 51.2, respectively, and this was not statistically significant between groups (P =0 .737). The HALP score had the least Area Under Curve (AUC) value compared with the others (0.514). The AUC of Albumin was larger than PSA for diagnostic efficacy in PCa patients (0.696-0.656). However, albumin levels were statistically significant compared with platelet count and the HALP score (P = 0.0033, P = 0.0068), except PSA and lymphocyte (P = 0.4580, P =0 .1717). CONCLUSION: Further prospective clinical studies that include more patients from multiple centres are needed to show the diagnostic role of the HALP score and its compounds on the patients with PCa.

Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey.

OBJECTIVE: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. METHODOLOGY: The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. RESULTS: A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. CONCLUSIONS: Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.

YouTube as a source of premature ejaculation / YouTube como fuente de información sobre la eyaculación precoz

INTRODUCTION AND OBJECTIVES: To evaluate the quality of information in You Tube videos pertaining to premature ejaculation. MATERIALS AND METHODS: A search for "premature ejaculation" (PE) was performed on You Tube in August 2018. Two senior urologist viewers watched and categorized each video for their sources, suggestions and information contents (excellent, fair or poor). RESULTS: Of the three hundred videos viewed on You Tube, 155 videos were included and analyzed. Mean video length (mean±standard deviation) was 3.08±2.02min. The information content was excellent only in 17 (10.9%) of all videos while for a majority of them it was poor (57.4% n=89). Fair videos constituted 31.7% (n=49) of the videos. There was no relation between the trustworthiness of the videos' contents and either their viewings or ratings (p = 0.561, p = 0.0966, respectively). Videos uploaded by health professionals were more reliable than those uploaded by laypersons (p < 0.001). CONCLUSIONS: The study suggests that although some videos, especially those uploaded by healthcare professionals, are useful; the majority of them have misleading information. Therefore, they are not a reliable source of PE information for PATIENTS: It is incumbent on urologists to counsel patients for other available useful internet information sources on PE

INTRODUCCIÓN Y OBJETIVOS: Evaluar la calidad de la información de los vídeos de YouTube relacionados con la eyaculación precoz (EP). MATERIALES Y MÉTODOS: Se realizó una búsqueda en YouTube sobre EP en agosto de 2018. Dos urólogos con experiencia vieron y clasificaron cada vídeo por sus fuentes, sugerencias y contenido científico (excelente, aceptable o deficiente). RESULTADOS: De los 300 vídeos vistos en YouTube, se incluyeron y analizaron 155 vídeos. La duración media del vídeo (media±desviación estándar) fue de 3,08±2,02min. El contenido científico fue excelente solo en 17 (10,9%) de todos los vídeos, mientras que en la mayoría de ellos esta fue deficiente (57,4%; n=89). Los vídeos aceptables constituyeron el 31,7% (n=49). No hubo relación entre la fiabilidad de los contenidos de los vídeos y el número de visualizaciones o las valoraciones de los usuarios (p = 0,561; p = 0,0966, respectivamente). Los vídeos subidos por profesionales sanitarios fueron más fiables que los subidos por profanos (p < 0,001). CONCLUSIONES: El estudio sugiere que, aunque algunos vídeos, especialmente aquellos publicados por profesionales sanitarios, son útiles, la mayoría de ellos contienen información engañosa. Por tanto, no son una fuente fiable de información sobre la EP para los pacientes. Les corresponde a los urólogos aconsejar a los pacientes sobre otras fuentes de información disponibles en Internet que resulten útiles

The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes.

BACKGROUND: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate. METHODS: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group. RESULTS: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05). CONCLUSION: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.

The effect of modifiable lifestyle factors on semen quality.

INTRODUCTION AND OBJECTIVES: To examine the association between lifestyle factors (body mass index, smoking, alcohol consumption, coffee intake, physical activity, sauna and cell phone usage, wearing tight-fitting underwear), and conventional semen parameters. MATERIALS AND METHODS: 1311 participants who attended the Andrology Clinic were included in the study. All participants were separated into two groups as men with normozoospermia and dysspermia. All participants answered a questionnaire which contains questions about the modifiable lifestyle factors. The total risk scores were calculated after all the positive lifestyle factors had been counted. RESULTS: Men with normozoospermia and dysspermia consisted of 852 (65.0%) and 459 (35.0%) participants respectively. A negative relationship between the wearing of tight underwear and having normal semen parameters was detected between the two groups (p=0.004). While going to a sauna regularly was negatively related to semen concentration, wearing tight underwear was also related to both lower motility, normal morphology as well as semen concentration (p<0.05). While the total score of all participants was 5.22±1.34 point, there were no statistical differences between the two groups (p=0.332). It was found that having 3 more or fewer points was not related to any type of semen parameters and results of a spermiogram. CONCLUSION: The clinicians should give advice to infertile male patients about changing their risky lifestyle, for infertility, to a healthy lifestyle for fertility. Better designed studies, with larger sample sizes using conventional semen analysis with sperm DNA analysis methods, should be planned to identify the possible effects of lifestyle factors on semen quality.

YouTube as a source of premature ejaculation.

INTRODUCTION AND OBJECTIVES: To evaluate the quality of information in You Tube videos pertaining to premature ejaculation. MATERIALS AND METHODS: A search for "premature ejaculation" (PE) was performed on You Tube in August 2018. Two senior urologist viewers watched and categorized each video for their sources, suggestions and information contents (excellent, fair or poor). RESULTS: Of the three hundred videos viewed on You Tube, 155 videos were included and analyzed. Mean video length (mean±standard deviation) was 3.08±2.02min. The information content was excellent only in 17 (10.9%) of all videos while for a majority of them it was poor (57.4% n=89). Fair videos constituted 31.7% (n=49) of the videos. There was no relation between the trustworthiness of the videos' contents and either their viewings or ratings (p=0.561, p=0.0966, respectively). Videos uploaded by health professionals were more reliable than those uploaded by laypersons (p<0.001). CONCLUSIONS: The study suggests that although some videos, especially those uploaded by healthcare professionals, are useful; the majority of them have misleading information. Therefore, they are not a reliable source of PE information for patients. It is incumbent on urologists to counsel patients for other available useful internet information sources on PE.

The therapeutic potential of amifostine on cyclophosphamide-induced testicular dysfunction in rats: An experimental study.

BACKGROUND: Cyclophosphamide (CP) is a well-known alkylating anticancer agent used in the treatment of various malignant and non-malignant tumors. CP may also cause a variety of adverse effects, including reproductive toxicity. Amifostine is known as a cytoprotective drug having antioxidant properties. OBJECTIVE: To evaluate the possible beneficial effects of amifostine on testicular toxicity induced by CP in rats. MATERIALS AND METHODS: A total of 35 Sprague-Dawley rats were used in this experimental study. The CP group animals received a single dose of 200 mg/kg CP on Day 8 by intraperitoneal injection and were left untreated for the following seven days. The two remaining groups of animals were treated with 200 mg/kg/day amifostine (AMF 200) and 400 mg/kg/day amifostine (AMF 400) for seven days prior to and following a single intraperitoneal injection of CP. Morphometrical analysis and histological examination of testicular tissue were performed. Serum testosterone, luteinizing hormone, and follicle-stimulating hormone levels were measured in serum using commercial ELISA kits. The epidydimal sperm count was determined. RESULTS: The tubular epithelial height in the testis was significantly higher in the AMF400 group compared to other groups (p < 0.001). Animals in the AMF400 group showed minimal debris in the tubules, no Sertoli cell damage, and the Johnsen scores were slightly higher in the AMF400 group. The epididymal sperm count was significantly lower in the CP-administered animals compared to the control animals and was significantly higher in the AMF200 and AMF400 groups compared to the CP group (p = 0.006, and p = 0.019 respectively). CONCLUSION: Amifostine, at a dose of 400 mg/kg, may have a protective effect on testicular damage induced by CP in rats.

Is there any role of epithelial to mesenchymal transition in the pathogenesis of contrast nephropathy?

AIM: Contrast medium-induced nephropathy is one of the major complications of intravenous contrast medium use. But its pathogenesis is unclear. Epithelial mesenchymal transition (EMT) is defined as the transformation of the primer epithelial cells to mesenchymal cells. EMT in tubular cells might cause tubulointerstitial damage. In this study, we investigated whether or not EMT has a role in radiocontrast-induced nephropathy. Radiocontrast medium might be triggering reversible EMT via serum and glucocorticoid-regulated kinase 1 (SGK 1). We investigated the effect of different concentrations of the contrast agent iopromide on human proximal tubule cell (HK-2) culture by measuring the level of SGK1, snail family zinc finger 1 (SNAIL1), connective tissue growth factor (CTGF), and collagen type I alpha 1 (COL1A1). METHODS: We conducted a scratch assay and qPCR. HK-2 cells were cultured in the petri dishes/flasks and starved with serum-free medium. The 40, 20, and 10 mg/mL doses of iopromide were administrated to cells. The scratches were photographed immediately and again at the 20th hour. The levels of gene expression of SGK1, SNAIL1, CTGF, and COL1A1 were measured using the real-time qPCR system at the end of the 24th hour. RESULTS: Iopromide caused the breaking of intercellular connections, the disappearance of the cobblestone appearance of cells, and the migration of cells at the 20th hour in the scratch assay. It also increased the expression of SGK1, SNAIL1, CTGF, and COL1A1 genes. CONCLUSION: Our study concluded that certain important markers of EMT increase in different concentrations of the contrast agent. High osmolality might trigger EMT. The relationship between contrast agent and EMT has not been defined before. Further in vivo and in vitro studies are required.

Effect of Work-Related Factors on Lower Urinary Tract Symptoms in Nurses and Secretaries.

OBJECTIVE: The objective of the present study was to examine the relationship between work-related factors and lower urinary tract symptoms (LUTS) and to emphasize the vicious circle between symptoms and work conditions. METHODS: The Turkish version of the Nurse Bladder Survey was used to estimate the prevalence of LUTS and to assess the relationship between individual characteristics, personal habits and work-related factors in nurses and secretaries who were working in Eskisehir Osmangazi University Hospital. The Turkish version of the Short Form 36 Health Survey was used to assess the nurses' and secretaries' health-related quality of life (HRQL). RESULTS: Of the 281 women who participated in the study, 218 (77.5%) and 63 (22.5%) were nurses and secretaries, respectively. There were no significant differences in personal habits and work-related factors between the nurses and secretaries. Of the study participants, 121 (43.1%) experienced at least one type of LUTS. There were no significant differences in the prevalence of any type of LUTS between the two groups. Only the mean scores of social functioning were significantly different for nurses and secretaries on the other aspects of HRQL in the SF-36. When the nurses with LUTS and the secretaries with LUTS were compared, the secretaries had a greater score on the general health domain than nurses. CONCLUSION: There is a vicious circle between symptoms and work conditions. To prevent the working women from harmful effects of this circle, the employers should be aware of this health problem; working conditions should be improved; educational programs for LUTS should be organized and the working women should be encouraged to go to the health providers to seek treatment when the symptoms occurred.

Relationship between Twinkle Artefacts and in vivo Biochemical Composition of Kidney Stones.

INTRODUCTION: Our aim was to predict the chemical composition of kidney stones according to their twinkle artefact (TA) features obtained by in vivo color Doppler ultrasonography and to determine the potential factors affecting the formation and intensity of TAs. MATERIALS AND METHODS: A total of 101 patients who met the inclusion criteria were included in the study. All patients were evaluated for TAs using color Doppler ultrasonography. All stones were subjected to chemical analysis. The relationships between the TA and the size and chemical composition of the stone, presence of hydronephrosis and body mass index (BMI) were evaluated statistically. RESULTS: According to the results of the chemical analysis, 66 (65.3%) were calcium oxalate stones. It was found that the in vivo TA intensity did not predict cystine and calcium oxalate monohydrate stones (p > 0.05) and the intensity of TAs increases with increasing BMI (p = 0.002). CONCLUSION: The present study is the first to show that TAs may not be reliable in overweight patients. The TAs could not predict the chemical composition of stones; so future comprehensive in vivo studies will clarify the role of TAs in the prediction of the stone type preoperatively.

Effects of nasal continuous positive airway pressure therapy on partners' sexual lives.

To assess sexual functioning in male and female partners before and after nasal continuous positive airway pressure (CPAP) therapy in men with obstructive sleep apnea (OSA). Twenty-one male patients with moderate to severe OSA and erectile dysfunction, and their female partner, were recruited into this prospective study. Males diagnosed with OSA were treated with nasal CPAP therapy for 12 weeks. Women were assessed for sexual functioning using the Female Sexual Function Index (FSFI), and for mood status using the Beck Depression Inventory (BDI), before and after their male partner underwent nasal CPAP therapy. Sexual functioning was assessed in men using the International Index of Erectile Function (IIEF), before and after nasal CPAP therapy. After nasal CPAP therapy for OSA in men, IIEF scores were significantly higher than pre-treatment scores. Total pre- and post-treatment IIEF scores (mean ± standard deviation) were 50.28 ± 15.88 and 65.42 ± 7.47, respectively, P < 0.01. Pre- and post-treatment FSFI scores in women were 21.54 ± 6.62 and 29.94 ± 3.76, respectively, P < 0.01. Pre- and post-treatment BDI scores in women were 14.61 ± 9.69 and 12.42 ± 8.92, respectively, P < 0.01. Following treatment of men with OSA, our data indicate benefits for nasal CPAP therapy on sexual functioning in both the male and female partners. Moreover, our findings indicate that improved sexual function in women after their male partner underwent nasal CPAP also had psychological benefits.

Association between colchicine resistance and vitamin D in familial Mediterranean fever.

Although colchicines are the only effective treatment of familial Mediterranean fever (FMF), resistance to colchicines (CR) which is observed in up to 30% of the patients is still a problem. Clinically, resistance to colchicine is defined as three or more attacks within the last 6 months period while using ≥2 mg/day colchicine. Previous studies have shown decreased vitamin D levels in FMF patients compared with healthy controls. The aim of this study is to evaluate whether vitamin D levels differ between CR and non-CR FMF patients. This study included 64 FMF patients who were being followed in Nephrology Clinic of Samsun Research and Education Hospital for at least 1 year. FMF was diagnosed according to the criteria defined by Livneh et al. Serum 25-hydroxy vitamin D (25-OHD) concentration (ng/mL) was detected in all FMF patients who were not in an acute attack period. From 64 patients 29 were accepted as CR. Mean 25-OHD level was 9.39 ± 1.00 ng/mL in CR patients and 18.48 ± 1.09 ng/mL in colchicine responsive patients (p < 0.001). Plasma vitamin D levels were significantly lower in colchicine resistant patients. Vitamin D deficiency may be a factor in etiopathogenesis of CR. Studies in larger patient samples that particularly evaluate the response to vitamin D replacement in CR FMF patients are needed.