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2.
Turk J Obstet Gynecol ; 21(2): 98-103, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38853492

RESUMEN

Objective: Adenomyosis is a chronic inflammatory illness that depends on estrogen. In addition to its immune regulatory effects in chronic diseases, vitamin D also plays roles in regulating normal cell growth. In the present study, the purpose was to evaluate the possible relationships between serum 25-OH vitamin D levels and clinical and laboratory parameters in patients who were histopathologically diagnosed with adenomyosis. Materials and Methods: A total of 168 females with a history of hysterectomy between January 2019 and November 2022 who were histopathologically diagnosed with adenomyosis and 168 women who were not diagnosed with adenomyosis were retrospectively evaluated in the present study. Demographic, clinical, and laboratory data were recorded at the time of admission. Visual analogue scale (VAS) scores were calculated for each patient to evaluate the severity of dysmenorrhea. Results: There was a significant difference between the groups in terms of VAS: the adenomyosis group scored an average of 6, whereas the control group scored an average of 3 (p<0.001). The average platelet volume value of the patients was 8.6 fL in the adenomyosis group, and that of the control group was 7.2 fL, and it was detected to be significantly elevated in the adenomyosis group (p<0.001). The CA-125 value of the patients was 63.5 U/mL in the adenomyosis group, and that of the control group was 15.6 U/mL and it was detected to be significantly rised in the adenomyosis group (p<0.001). The 25-OH vitamin D level of the patients was 12.6 ng/mL in the adenomyosis group and that of the control group was 19.1 ng/mL and it was detected to be significantly elevated in the control group. Conclusion: The current investigation provides compelling evidence for the association between low vitamin D levels and adenomyosis, which agrees with other research in the field. The current study's findings agree with other research that suggests vitamin D regulates cellular and signaling networks, including those that control cytokines and gene expression during adenomyosis. However, further studies are needed because data assassing the therapeutic efficacy of vitamin D in adenomyosis are questionable.

3.
Rev Assoc Med Bras (1992) ; 70(5): e20231445, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38775533

RESUMEN

OBJECTIVE: We aimed to assess the impact of the coronavirus disease 2019 pandemic on the clinical presentation of tubal ectopic pregnancies. METHODS: This retrospective cohort study was conducted at a tertiary center and included 76 cases of tubal ectopic pregnancies. The study period was divided into two groups: the pre-coronavirus disease group (January 2018 to February 2020, Group 1; n=47, 61.8%) and the coronavirus disease group (March 2020 to February 2022, Group 2; n=29, 38.2%). Subgroup analysis was also performed for tubal ruptured ectopic pregnancies as Group 1 (n=15, 62.5%) and Group 2 (n=9, 37.5%). RESULTS: No statistically significant differences were observed between the pre-coronavirus disease and coronavirus disease groups in terms of demographic characteristics. Although the serum beta-human chorionic gonadotropin level was found to be higher in Group 2, the difference was not statistically significant (p=0.7). The groups appeared to be similar in treatment management, duration of hospitalization, and blood transfusion needs (p=0.3, p=0.6, and p=0.5, respectively). Additionally, no significant difference was observed between the groups in the evaluation of ruptured ectopic pregnancies (p=0.5). In the subgroup analysis of tubal ruptured ectopic pregnancies, no significant difference was observed. CONCLUSION: To the best of our knowledge, there are few studies evaluating the effect of the pandemic on tubal ectopic pregnancies in the literature. Although we did not report statistically significant differences between groups in our study, given the potential prolonged duration of the pandemic, healthcare professionals should actively prompt their patients to seek necessary medical assistance.


Asunto(s)
COVID-19 , Embarazo Tubario , Humanos , Femenino , Estudios Retrospectivos , COVID-19/epidemiología , Embarazo , Adulto , Embarazo Tubario/sangre , Embarazo Tubario/epidemiología , SARS-CoV-2 , Pandemias , Adulto Joven , Gonadotropina Coriónica Humana de Subunidad beta/sangre
4.
Am J Obstet Gynecol ; 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38570007
5.
J Obstet Gynaecol Res ; 50(6): 991-1001, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38575743

RESUMEN

AIM: Our aim is to investigate the effect of uterine lower segment involvement on prognosis of early-stage endometrial cancer cases diagnosed and treated in our clinic. MATERIALS AND METHODS: The file records of 316 cases reviewed retrospectively.Only stage I (a and b, n=209) cases were investigated, because they were more homogeneous group. RESULTS: The lymphovascular invasion rate was found to be higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Adjuvant treatment requirement was higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Among stage Ia cases, the recurrence rate between 1 and 3 years was found to be higher in cases with uterine lower segment involvement (p = 0.001). Among the stage Ib cases, lymphovascular invasion was found to be higher in cases with uterine lower segment involvement (p < 0.001). The recurrence rate between 1 and 3 years was found to be higher in stage Ib compared to Ia (p = 0.01). Uterine lower segment involvement was found to be associated with high lymphovascular invasion rate in all stage I cases (p < 0.001). It was determined that the need for adjuvant treatment was higher in cases with uterine lower segment involvement (p < 0.001). It was determined that the probability of recurrence between 1 and 3 years was higher in cases with uterine lower segment involvement (p = 0.007). CONCLUSION: Uterine lower segment involvement is associated with increased lymphovascular invasion even in the early stages. It is an important risk factor for systemic spread such as lymphovascular invasion, myometrial invasion, and lymph node involvement.


Asunto(s)
Neoplasias Endometriales , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Humanos , Femenino , Neoplasias Endometriales/patología , Neoplasias Endometriales/terapia , Persona de Mediana Edad , Estudios Retrospectivos , Pronóstico , Anciano , Adulto , Invasividad Neoplásica , Útero/patología
6.
8.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 70(5): e20231445, 2024. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1558914

RESUMEN

SUMMARY OBJECTIVE: We aimed to assess the impact of the coronavirus disease 2019 pandemic on the clinical presentation of tubal ectopic pregnancies. METHODS: This retrospective cohort study was conducted at a tertiary center and included 76 cases of tubal ectopic pregnancies. The study period was divided into two groups: the pre-coronavirus disease group (January 2018 to February 2020, Group 1; n=47, 61.8%) and the coronavirus disease group (March 2020 to February 2022, Group 2; n=29, 38.2%). Subgroup analysis was also performed for tubal ruptured ectopic pregnancies as Group 1 (n=15, 62.5%) and Group 2 (n=9, 37.5%). RESULTS: No statistically significant differences were observed between the pre-coronavirus disease and coronavirus disease groups in terms of demographic characteristics. Although the serum beta-human chorionic gonadotropin level was found to be higher in Group 2, the difference was not statistically significant (p=0.7). The groups appeared to be similar in treatment management, duration of hospitalization, and blood transfusion needs (p=0.3, p=0.6, and p=0.5, respectively). Additionally, no significant difference was observed between the groups in the evaluation of ruptured ectopic pregnancies (p=0.5). In the subgroup analysis of tubal ruptured ectopic pregnancies, no significant difference was observed. CONCLUSION: To the best of our knowledge, there are few studies evaluating the effect of the pandemic on tubal ectopic pregnancies in the literature. Although we did not report statistically significant differences between groups in our study, given the potential prolonged duration of the pandemic, healthcare professionals should actively prompt their patients to seek necessary medical assistance.

9.
Eur J Obstet Gynecol Reprod Biol ; 293: 125-131, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38157829

RESUMEN

OBJECTIVE: The aim of this study is to examine whether there is a synergistic relationship between the diaphragm and pelvic floor muscles (PFM) in pregnant women. MATERIAL AND METHODS: Our study was carried out as a cross-sectional study in primigravid pregnants in the second and third trimesters. Superficial electromyography (EMG), 2D/3D ultrasonography (USG), pulmonary function test (PFT), PERFECT, maximum expiratory pressure (MEP) and inspiratory pressure (MIP) measurements were used to evaluate pelvic floor and diaphragm muscle functions during pregnancy. Mann-Whitney U test was used to show the change in the second and third trimesters, and Spearman correlation was used to determine the relationship. RESULTS: No correlation was found between the EMG data of the PFM and diaphragm, or between the USG data of the PFM and diaphragm in all participants, in the second and third trimesters. In the third trimester of the study, diaphragmatic thickness and levator hiatal area (LHA) decreased and both diaphragm and PFM % MVC EMG parameters increased. In the third trimester, FVC, MIP, MEP decreased, and nonsignificant increase in FEV1, FEV1/FVC and peak ekspiratuar flow(PEF) were detected. A significant correlation was found between pelvic floor levator hiatal area USG and FEV1/FVC in both trimesters (r: 0,577p: 0,004). CONCLUSION: There may be a synergistic relationship between the diaphragm and PFM in pregnant women, the relationship may weaken as pregnancy progresses, and there may be no coactivation relationship between the two muscles. In order to prevent the occurrence of pelvic floor dysfunction during pregnancy and to increase the effect of rehabilitation programs, the relationship between the diaphragm and the PFM should be determined and more studies should be conducted.


Asunto(s)
Diafragma Pélvico , Mujeres Embarazadas , Femenino , Embarazo , Humanos , Contracción Muscular/fisiología , Diafragma/diagnóstico por imagen , Estudios Transversales , Electromiografía , Número de Embarazos
10.
Urol Res Pract ; 49(4): 253-258, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37877827

RESUMEN

OBJECTIVE: The immune system has an essential role in the development of cancer by showing both anti-tumor and pro-tumor activities. Understanding the immune func- tion of patients with malignancy is of clinical importance for the evaluation, treatment, and prognosis of the disease. We aimed to evaluate lymphocyte subtypes in peripheral blood samples of prostate cancer patients and their relationship with clinicopathologi- cal features and prognosis. METHODS: One hundred thirty-seven patients who underwent open radical prosta- tectomy were included in our study. The percentages of CD3+T lymphocyte, CD19+ B lymphocyte, CD16/56 natural killer cells, CD4+ helper T lymphocyte, CD8+ cytotoxic T lymphocyte, and CD45 total lymphocyte were evaluated for each patient using the blood sample taken into a hemogram tube before surgery. RESULTS: The pathological stage was T2 for 64 of the cases and T3 for 73. The mean follow-up period of the patients was 12.81 ± 6.20 months. The CD3+/CD4+ counts of the patients with pathological stage T2 were found to be statistically significantly higher than stage T3. There was a statistically significant negative correlation between the prostate-specific antigen levels and CD3+/CD4+ percentages of the patients. There was no statistical significance between the percentages of lymphocyte subtypes and the presence of surgical margin, biochemical recurrence, adjuvant therapy, and cancer upgrade. CONCLUSION: We consider that the increase in the pathological stage and prostate-spe- cific antigen value and the decrease in the number of CD4+ T lymphocyte subtypes may be prognostic markers in prostate cancer patients.

11.
Int J Impot Res ; 2023 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-37660216

RESUMEN

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.

12.
BMC Med Educ ; 23(1): 698, 2023 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-37752458

RESUMEN

BACKGROUND: There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. METHODS: A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach's alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. RESULTS: A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach's alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. CONCLUSION: The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. TRIAL REGISTRATION: 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital.


Asunto(s)
Instituciones de Atención Ambulatoria , Profesionalismo , Humanos , Reproducibilidad de los Resultados , Escolaridad , Canadá
13.
Int Urogynecol J ; 34(11): 2725-2736, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37417993

RESUMEN

INTRODUCTION AND HYPOTHESIS: The aim of our study is to examine the changes in core muscle functions during pregnancy. METHODS: Our study was carried out in 67 primigravida pregnant women. Superficial electromyography (EMG) and non-invasive 2D/3D ultrasonography (USG) were used to evaluate core muscle (diaphragm, transversus abdominus [TA], internal oblique [IO]-external oblique [EO] muscles, pelvic floor muscles, multifidus) function during pregnancy. Pelvic floor muscle strength was also measured by a digital palpation method (PERFECT system). USG was used to measure expected fetal weight and the diastasis recti (DR) distance. Mann-Whitney U test was used to show changes in trimesters in the core muscles, and Spearman correlation analysis was used to determine the relationship. RESULTS: In the third trimester, an nonsignificant increase in EMG parameters was observed in all of the core muscles. Although a statistically significant decrease was observed in muscle thickness values measured by EO and IO USG in the third trimester, DR was found to increase at all levels (p < 0.005). When we evaluated both trimesters and all pregnant women together, no relationship was found between all core muscles and pelvic floor muscles in the data evaluated by EMG and USG. We found a negative correlation in USG values between fetal weight and IO and the upper part of the rectus abdominus muscle, and a positive correlation between the EMG data of the EO and rectus abdominus muscles. CONCLUSIONS: In women, the coactivation relationship between the core muscles may disappear during pregnancy. As the trimesters progress during pregnancy, a decrease in thickness and an increase in muscle activity can be observed in the core muscles. Pregnant women can be given exercise training for core muscles for protection in both the prenatal and postnatal periods. But more research needs to be done.


Asunto(s)
Diástasis Muscular , Peso Fetal , Humanos , Femenino , Embarazo , Músculos Abdominales/fisiología , Electromiografía , Ejercicio Físico/fisiología , Terapia por Ejercicio/métodos
14.
Sisli Etfal Hastan Tip Bul ; 57(1): 92-98, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37064857

RESUMEN

Objectives: As an effective and minimally invasive technique, ureteroscopy has some potential intraoperative complications. Ureteral avulsion is among these complications, although rare. This study aimed to determine factors predicting nephrectomy by considering ureteral avulsion from a medicolegal perspective for the 1st time in the literature. Methods: A total of 33 patients with ureteral avulsion during ureteroscopic surgery, who presented to various hospitals in Turkey between September 2004 and April 2019 and whose cases were being reviewed at the Institution of Forensic Medicine with regard to malpractice, were evaluated retrospectively. The patients who underwent nephrectomy after ureteral avulsion were evaluated as Group 1, and those who underwent reconstructive surgery as Group 2. Results: The mean age of the patients was 39.5±12.1 years. Seventeen (51.5%) patients had partial and 16 (48.4%) had complete ureteral avulsion. Nephrectomy was performed in 14 (42.4%) patients, and ureteral reconstruction in 19 (57.5%) patients. It was determined that the patients in Group 1 had more proximal stones and a higher degree of hydronephrosis compared to Group 2. Complete avulsion developed in 71.4% of the patients in Group 1 and in 31.6% of those in Group 2. After avulsion, 78.6% of the patients in Group 1 were treated in a state hospital, and 63.2% of those in Group 2 were treated in a tertiary referral hospital. The increase in the degree of hydronephrosis, presence of complete avulsion, and intervention at a state hospital were determined as independent predictive factors for nephrectomy. Conclusion: This is the first study with the largest cohort in the literature to medicolegally evaluate ureteral avulsion and determine predictive factors for nephrectomy. Although each patient should be treated with different methods in the presence of ureteral avulsion, our study aimed to provide a common approach to this catastrophic complication.

15.
Int Urogynecol J ; 34(9): 2067-2080, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-36951973

RESUMEN

INTRODUCTION AND HYPOTHESIS: A multiple-component intensive pelvic floor muscle training (MCI-PFMT) protocol was developed as a neurophysiological-based rehabilitation model to improve neuroplasticity. This study aimed to investigate the effects of the MCI-PFMT protocol on muscle fatigue and symptoms in women with urinary incontinence. METHODS: This randomized controlled trial included 49 female patients with mixed urinary incontinence. Participants were divided into the MCI-PFMT group and the control group. The MCI-PFMT group performed supervised intensive pelvic floor muscle training, while the control group received bladder training and standard pelvic floor muscle training as a home program. Both training sessions were conducted 5 days a week for a single week. Participants' symptoms were evaluated with questionnaires, bladder diary, and pad tests. Superficial electromyography, ultrasonography, and the PERFECT scale were used to evaluate pelvic floor and abdominal muscle functions. RESULTS: In the post-treatment evaluation, symptoms were decreased in both groups, with a significant decrease in the MCI-PFMT group (p < 0.05). While average and peak work values of pelvic floor muscles, transversus abdominus, and internal oblique muscles increased in both groups, maximum voluntary contraction values of these muscles decreased (p < 0.05). A 12.7% decrease was observed in the maximum voluntary contraction values of pelvic floor muscles in the control group, while a 9.6% decrease was observed in the MCI-PFMT group. CONCLUSIONS: The MCI-PFMT protocol can lead to pelvic floor and abdominal muscle fatigue. However, it may be effective at decreasing symptoms in women with urinary incontinence. Additional studies on this issue are needed.


Asunto(s)
Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Femenino , Humanos , Diafragma Pélvico , Fatiga Muscular , Terapia por Ejercicio/métodos , Incontinencia Urinaria/terapia , Resultado del Tratamiento
16.
Prague Med Rep ; 124(1): 40-51, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36763830

RESUMEN

To investigate the relationship between lesion size determined using multiparametric magnetic resonance imaging (mpMRI) and histopathological findings of specimens obtained after mpMRI fusion biopsy and radical prostatectomy (RP). We retrospectively analysed 290 patients with PCa who underwent an MRI fusion biopsy. We measured the diameter of suspicious tumour lesions on diffusion-weighted mpMRI and stratified the cohort into two groups. Group A included patients with a suspicious tumour lesion 10 mm and Group B included those with a suspicious tumour lesion > 10 mm. In Group B, the PI-RADS score determined in mpMRI was higher than Group A, and there was a statistically significant difference between the two groups in terms of clinical T-stage. The PCa detection rate and the number of positive cores were statistically significantly higher in Group B than in Group A. In addition, there was a statistically significant difference between the two groups in relation to the biopsy, the International Society of Urological Pathology (ISUP) grade values, and the presence of clinically significant PCa. In Group B, pathological T-stage and extraprostatic extension (EPE) and surgical margin (SM) positivity were found to be higher among the patients who underwent RP. In the multivariate analysis, the mpMRI lesion size being > 10 mm was found to be an independent predictive factor for SM and EPE positivity. The clinical results of this study support the modification of the lesion size threshold as 10 mm for use in the differentiation of PI-RADS scores 4 and 5.


Asunto(s)
Imagen por Resonancia Magnética , Neoplasias de la Próstata , Masculino , Humanos , Imagen por Resonancia Magnética/métodos , Estudios Retrospectivos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/cirugía , Imagen de Difusión por Resonancia Magnética , Biopsia Guiada por Imagen/métodos
17.
J Manipulative Physiol Ther ; 46(4): 201-211, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-38520441

RESUMEN

OBJECTIVE: This study aimed to investigate the synergy between the diaphragm and pelvic floor muscles (PFM) according to different exercise positions in women with pelvic floor dysfunction. Our secondary aim was to determine the short-term effects of single-week pelvic floor muscle training (PFMT) program on diaphragmatic function. METHODS: The cross-sectional study included 64 women with pelvic floor dysfunction. The participants' diaphragm and abdominal muscle functions during voluntary PFM contraction and relaxation were assessed by surface electromyography and ultrasonography. The surface electromyography assessments were performed in supine (P1), crawling (P2) and sitting (P3) positions. A single week-PFMT was conducted on women who agreed to determine the short-term responses of the diaphragm function. The muscle functions according to exercise positions were compared with Friedman Analysis of Variance, and the short-term effects of single-week PFMT on diaphragm function was analyzed with Wilcoxon Signed-Ranks Test. RESULTS: The diaphragm activity during voluntary PFM contraction was highest in P2 before and after single-week PFMT (P < .001). Positive significant correlations were found between the activities diaphragm and abdominal muscles in different exercise positions (P < .05). After single-week PFMT, diaphragm thickness increased (P = .030) in P1, but diaphragm activity did not change in all 3 exercise positions (P > .05). CONCLUSION: The synergy between the diaphragm and PFM was greater in the crawling position in women with pelvic floor dysfunction. The abdominal muscles seemed to contribute to maintaining this synergy. Therefore, PFMT combined with diaphragmatic breathing exercises in the crawling position should be considered. In addition, single-week PFMT may positively affect diaphragm function in the short-term.


Asunto(s)
Diafragma , Electromiografía , Terapia por Ejercicio , Trastornos del Suelo Pélvico , Diafragma Pélvico , Humanos , Femenino , Estudios Transversales , Diafragma/fisiopatología , Diafragma/diagnóstico por imagen , Adulto , Diafragma Pélvico/fisiopatología , Trastornos del Suelo Pélvico/fisiopatología , Trastornos del Suelo Pélvico/terapia , Terapia por Ejercicio/métodos , Persona de Mediana Edad , Contracción Muscular/fisiología , Músculos Abdominales/fisiopatología , Músculos Abdominales/diagnóstico por imagen , Músculos Abdominales/fisiología
18.
Pediatr Surg Int ; 38(9): 1327-1334, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35849174

RESUMEN

OBJECTIVE: To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population. METHODS: 47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared. RESULTS: We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS. CONCLUSIONS: Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.


Asunto(s)
Laparoscopía , Procedimientos Quirúrgicos Robotizados , Obstrucción Ureteral , Niño , Cicatriz , Estudios de Cohortes , Humanos , Pelvis Renal/cirugía , Laparoscopía/métodos , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados/métodos , Resultado del Tratamiento , Obstrucción Ureteral/cirugía , Procedimientos Quirúrgicos Urológicos/métodos
19.
Gynecol Endocrinol ; 38(7): 592-597, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35670515

RESUMEN

OBJECTIVE: High sympathetic nerve activity, is thought to be a cardiovascular risk factor, has been shown to correlate with circulating high testosterone levels. However its role on the pathophysiology of the polycystic ovarian syndrome has not been clearly established. The aim of our study is to compare the sympathetic nerve activity between polycystic ovarian syndrome and control group and to determine whether the use of oral contraceptives for contraception has any effect on this activity. MATERIALS AND METHODS: Our study has designed as a prospective, case-control study including patients diagnosed with polycystic ovarian syndrome. Antropometric measurements were calculated, hormone levels were measured and sympathetic skin response and heart rate variability measurements were performed in the laboratory to assess sympathetic activity before starting oral contraceptive pill therapy and at the end of 1 month follow up. RESULTS: In the baseline condition LH/FSH ratio, LH, DHEAS, and total testosterone levels were significantly higher in women with PCOS. After 1 month of treatment, reductions in Ferriman-Gallwey score, ovarian volumes, number of follicles, LH/FSH ratio, LH, and androgen hormone levels were statistically significant. The mean values of sympathetic skin response amplitude and R-R analysis-Valsalva test were higher in PCOS group as compared to the control group. However, these differences were not statistically significant. Similarly, no statistically significant difference in SSR latency and R-R analysis-standup test were demonstrated between PCOS and control groups. CONCLUSION: In conclusion, our study supports the increased sympatovagal activity in patients with polycystic ovarian syndrome.


Asunto(s)
Síndrome del Ovario Poliquístico , Estudios de Casos y Controles , Anticonceptivos Orales Combinados , Femenino , Hormona Folículo Estimulante , Humanos , Estudios Prospectivos , Testosterona
20.
Cent European J Urol ; 75(1): 96-101, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35591960

RESUMEN

Introduction: In this study, we aimed to measure the change in penile stiffness by evaluating corpus cavernosum (CC) with shear wave elastography (SWE) in patients with chronic obstructive pulmonary disease (COPD). Material and methods: Seventy outpatient patients aged 50-80 years who were diagnosed with COPD were evaluated using SWE. Patients were divided into 2 groups according to the International Index of Erectile Function-5 (IIEF-5) questionnaire (IIEF-5 >17: Group A, IIEF-5 <17: Group B). The measurements were made in both transverse and longitudinal sections. Results: The mean age of the patients was 60 ±7.9 years. The duration of COPD was significantly higher in Group B than in Group A (p = 0.003). The mean SWE values of right transverse mid-portion of corpus penis (RTM) and left transverse mid-portion of corpus penis (LTM) in Group B (21.1 ±5.6 kPa and 20.8 ±4.8 kPa, respectively) were significantly higher than in Group A (15.2 ±2.3 kPa and 15.8 ±2.7 kPa, respectively); (p <0.001 and p <0.001, respectively). There was a significant negative correlation between IIEF-5 scores and the duration of COPD (p <0.05). There was a significant negative correlation between IIEF values and RTM and LTM values of the patients (p <0.05 and p <0.05, respectively). There was a significant positive correlation between the duration of COPD and both RTM and LTM values (p <0.05 and p <0.05, respectively). Conclusions: In our study, according to the SWE findings, we showed the effect of systemic changes created by COPD on penile tissue and the negative effect of this on erectile function in patients.

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