Adaptation of the Fears of Compassion Scale into Turkish: a reliability and validity study.

BACKGROUND: The concept of fear of compassion draws the interest of researchers in both clinical and scientific fields. The Fears of Compassion Scale (FCS) was developed in order to examine the fear of compassion for others, compassion from others and compassion for one's self. This study aims to adapt the FCS into the Turkish language. The Satisfaction with Life Scale and the Self-Compassion Scale were used to assess the criterion-related validity of the FCS. PARTICIPANTS AND PROCEDURE: In order to determine the construct validity of the scale, validity and reliability studies and factor analysis were carried out on 681 participants (Mage = 32.00, SD = 10.15; 64% female and 36% male). RESULTS: The results of the confirmatory factor analysis yielded the expected 3-factor solution (the fear of compassion for others, the fear of compassion from others and the fear of self-compassion), which consists of 35 items. The internal consistency validity coefficient of the whole scale was .92. Moreover, there were significant negative relationships between the Fears of Compassion Scale, the Satisfaction with Life Scale and Self-Compassion Scale, which are similar to those of the original scale. CONCLUSIONS: These significant findings reveal the Turkish adaptation of the FCS to be a valid and reliable measurement tool.

Self-Efficacy, Self-Love, and Fear of Compassion Mediate the Effect of Attachment Styles on Life Satisfaction: A Serial Mediation Analysis.

This study examined the effect of attachment styles on the life satisfaction of adults and the serial mediating effect of self-efficacy, self-love, and fear of compassion in this effect for the first time in the literature to the best of our knowledge. The study group consisted of a total of 639 adults. As a result of the study, it is seen that secure attachment affects life satisfaction positively. This process is mediated by the variables of high self-efficacy, high self-love, and low fear of compassion. However, avoidant attachment seems to negatively affect life satisfaction. This process is mediated by low self-efficacy, low self-love, and high fear of compassion variables. Apart from these results, it was observed that anxious-ambivalent attachment negatively affected life satisfaction, but this relationship was not mediated by self-efficacy, self-love, and fear of compassion. This result may be due to the fact that people with anxious-ambivalent attachment style perceive others positively despite seeing themselves as worthless and inadequate. These people may not want to show compassion for themselves because they have low self-worth, but they may show compassion for others because they find them valuable.

What is the best approach for pediatric kidney stones of moderate-sized between shock wave lithotripsy, ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery?

PURPOSE: This study aimed to compare the results of ultramini percutaneous nephrolithotomy (UMP), shock wave lithotripsy (SWL) and retrograde intrarenal surgery (RIRS) in pediatric patients with kidney stones 10-20 mm size. METHODS: The files of 159 pediatric patients (36 RIRS, 39 SWL, 84 UMP) with kidney stones were reviewed retrospectively. Preoperative age, sex, stone size and location were evaluated. The three methods were compared in terms of operation and fluoroscopy duration, complications with the modified Clavien grading system, and stone-free rate (SFR) in the postoperative first month. RESULTS: The stone burdens of the groups were similar (P = 0.102). At the end of the first month, SFR was higher in the RIRS and UMP groups compared to the SWL group (88.9%, 92.9% and 69.2%, respectively, P = 0.002). UMP had higher SFR for lower pole stones than the other two methods (P = 0.042). There was no difference in complications between the three methods (P = 0.758). CONCLUSION: SFR was similar for all three methods in all localizations, apart from lower pole stones. UMP had higher SFR for lower pole stones than the other two methods. There was no difference in terms of complications between the three methods.

Better outcomes with desmopressin melt than enuretic alarm therapy in children with nocturnal enuresis during coronavirus disease 2019 (COVID-19).

Objectives: This study aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of children with primary monosymptomatic nocturnal enuresis (MNE) with desmopressin melt versus an enuresis alarm. Materials and methods: This study included 56 children with primary MNE who were taking desmopressin melt or using an alarm. Their anxiety levels were evaluated using the Social Anxiety Scale for Children-Revised. For both treatment methods, data from a 3-month bedwetting diary between the third and sixth months of the pre-pandemic treatment were compared with those assessed during the same period during the pandemic. Results: Prior to the COVID-19 pandemic, the median 3-month mean frequency of MNE was 1 (0-7.67) in children using desmopressin melt versus 1.33 (0-6) in those using alarm treatment (p = 0.095). During the COVID-19 pandemic period, the median monthly mean frequency of MNE was 1.33 (0-7.33) in children using desmopressin melt versus 6 (1.33-13) in those using alarm treatment (p < 0.001). Conclusions: The COVID-19 pandemic and its accompanying psychological effects did not affect the treatment efficacy of desmopressin melt in children with primary MNE but did adversely affect that of enuresis alarms.

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study.

INTRODUCTION: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. METHODS: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. RESULTS: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates. CONCLUSIONS: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

Effect of freezing-thawing cycles on the strength and pollutant leachability of stabilized/solidified metallurgical waste.

Stabilized/solidified hazardous wastes may lose their structural integrity and stability when exposed to long-term extreme weather conditions, such as repeated wetting-drying and freezing-thawing (F-T). This situation causes wastes to become environmentally risky again even if they are stabilized and solidified. In this study, the effects of F-T cycles on the strength and pollutant leachability of stabilization/solidification (S/S) products of zinc extraction residue (ZER) stabilized/solidified by Portland cement (PC), fly ash (FA), and alkaline phosphate (AP) were comprehensively investigated. S/S efficiency and F-T resistance of the samples were determined by unconfined compressive strength (UCS), and leaching tests widely applied in the USA (TCLP), European Union (EN-12457/1-4 2020), and Turkey (TS-EN 12457/4). In addition, X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses and visual inspection were performed to examine the variations in mineralogical and morphological structures. S/S efficiency and F-T resistance changed depending on the type and amount of S/S reagent used and decreased in the order of PC+AP>PC>>FA. All applied S/S procedures, except for 10% PC addition, were found to be suitable for the S/S of ZER from the viewpoint of the achievement of the minimum required strength and pollutant leachability. F-T events did not change the mineralogical structures of the S/S products, but significantly reduced the UCS value by causing structural deformation. The pollutant concentrations released from the samples that lost their monolithic structure by crumbling after certain cycle increased with the increasing F-T cycle, causing a change in the storage criteria of the samples. Therefore, it is important to consider and apply the F-T cycle as a standard test in addition to the existing leaching and strength tests for S/S products of the wastes in terms of minimizing environmental risks.

The role of RENAL, PADUA and C-index scoring systems in predicting the results of partial nephrectomy without ischemia.

OBJECTIVE: To evaluate the feasibility and renoprotective effect of off-clamp partial nephrectomy (PN) by renal scoring systems. METHODS: After approval of the local ethics committee, the radiological and clinical data of patients with renal masses who underwent PN between January 2012 and January 2017 were evaluated in two university hospitals. Total 132 patients who underwent open surgery and off-clamp technique were included. All patients underwent contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) preoperatively. Preoperative demographic data, estimated glomerular filtration rate (e-GFR) and hematocrit changes, operation time, tumor volume and hospitalization time from patients were evaluated separately and statistically for each of the three scoring systems. RESULTS: Our study consisted of 132 patients with a mean age of 53.9 ± 13.9 with 69 male and 63 female. Statistically significant difference between the risk groups in RENAL and PADUA scoring were found according to tumor T stage and tumor volüme (p <0.005). Statistically significant difference was only found between risk groups of RENAL scoring system in e-GFR reduction (p<0.05). There was no statistically significant difference between the groups in the complications of all three classification systems (p > 0.005). CONCLUSIONS: In our study, all three scoring sytem successfully predicted the surgical complexity ve surgical outcomes and our results indicate that off-clamp PN has similar success and complications rates when compared to the literature. The off-clamp PN must be kept in mind to maintain postoperative renal functions eligible patients.

Small renal pelvis stones: Shock wave lithotripsy or flexible ureteroscopy? A match-pair analysis.

OBJECTIVE: Kidney stones in renal pelvis may be treated using various methods. For larger stones, percutaneous nephrolitotomy (PNL) is the first choice of option; where for smaller stones, shock wave lithotripsy (SWL) or flexible ureteroscopy (F-URS) could be more suitable options. In this article we aimed to compare the outcomes of F-URS and SWL on the treatment of renal pelvis stones <10 mm. MATERIAL AND METHODS: Files of patients treated with SWL and F-URS for renal pelvis stones <10 mm between March 2013 and May 2016 in our clinic were analyzed. For comparison, a match-pair analysis was designed. Complete stone removal was considered success. RESULTS: Forty patients were treated using F-URS (Group 1) and 40 patients underwent SWL (Group 2). Patients were assessed the day after the last session of the procedure. The early stone-free rates were 70% (28/40) in Group 1, and 15% in Group 2 (p<0.05). The same analysis was performed after three months. Stone-free rates were 100% and 92.5% in Groups 1 and 2, respectively (p=0.079). Three patients in Group 2 were not stone free after 3 sessions of SWL and considered unsuccessful. They were all successfully treated by F-URS. CONCLUSION: Even though there is no statistical difference among groups, our data may be interpreted as having better outcomes and tolerability with F-URS than SWL. We believe F-URS may have a great treatment prospect in this particular patient group.

Recurrent Pilonidal Sinus Cyst on Penis.

Pilonidal sinus, including one or more sinus canals and hairs, is a disease with a chronic course showing acute attacks which is often encountered in the general population, usually affecting young adults, at a rate in males twice that of females. Pilonidal sinus on the penis is so rare that very few cases have been reported in literature. A 20-year-old male presented to the urology outpatient clinic with the complaint of a suppurative lesion with discharge on the skin of the penis which had been ongoing for approximately three months. Clinical examination revealed an indurated, erythematous, ulcerative lesion, 3 cm x 2 cm in size, in the middle of the ventral aspect of the penile shaft. We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.

Diagnostic value of platelet indices in acute appendicitis and comparison with histopathology.

BACKGROUND: Acute appendicitis is one of the most common surgical emergencies. An early and accurate diagnosis of acute appendicitis is vital. Evidence for a link between platelets indices and inflammation disease comes from recent studies. We aimed to evaluate preoperative diagnostic values of platelet indices (Mean platelet volume-MPV, Platelet Distribution Width-PDW, Plateletcrit-PCT) and leukocyte count (WBC) in comparison with post-operative histopathology results in patients who underwent appendectomy. METHODS: The 165 patients who underwent appendectomy, were evaluated retrospectively. Patients' demographic characteristics, imaging findings, preoperative laboratory markers and postoperative histopathology results were recorded. The patients were divided into three groups based on the histopathologic findings; perforated appendicitis, acute appendicitis without perforation and negative appendectomy group. The specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of the laboratory markers were measured. Additionally potential correlation among laboratory markers analysed. RESULTS: The negative appendectomy rate was 15.1% in 165 patients. The leukocyte count was statistically higher in acute appendicitis (14.9×103/µL) group than negative appendectomy (6.9×103/µL) group. There was also statistically significant difference between groups according to the PCT levels. The leukocyte count achieved sensitivity, specificity, PPV, and NPV of 95.9, 24, 99.1, and 92.7% respectively. A significant positive correlation between WBC and PCT were obtained. Inflammatory markers were not directly related to the severity of the disease. CONCLUSIONS: Elevated leukocyte count and PCT levels support diagnosis of acute appendicitis in correlation with pathological findings. Thereby combination of the inflammatory markers, positive clinical and radiological findings would improve diagnostic accuracy in acute appendicitis. KEY WORDS: Acute appendicitis, Inflammatory markers, Platelet indices.

Conservative/surgical treatment predictors of maternal hydronephrosis: results of a single-center retrospective non-randomized non-controlled observational study.

PURPOSE: To determine the parameters that may help the clinicians decide the best suitable treatment method for the pregnant women with symptomatic hydronephrosis which will be based on the easily accessible laboratory tests, monitoring methods and clinical symptoms. METHODS: Digital data and documents of 246 pregnant women with symptomatic hydronephrosis who were hospitalized in our clinic between the dates of January 2011 and January 2016 were retrospectively evaluated. All patients were statistically evaluated in terms of age, symptomatic maximal anterior-posterior diameter of the renal pelvis (MADP), parity, C-reactive protein (CRP) level, white blood cell count (WBC), presence of pyuria, growth of urine culture, fever, serum urine and creatinine levels, visual analog scale (VAS) score of pre- and post-therapy and threatened preterm labor. RESULTS: The study includes a total of 211 pregnant women with symptomatic hydronephrosis. In the second and third trimester groups, the surgical treatment group statistically provided higher levels of CRP, WBC and VAS. Mean MADP in the second trimester of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.67 ± 4.67 and 28.68 ± 7.70 mm, respectively. Mean MADP in the third trimester group of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.96 ± 5.96 and 28.85 ± 7.64 mm, respectively. CONCLUSIONS: In patients with symptomatic pregnancy hydronephrosis, the likelihood of surgical treatment for CRP levels, WBC counts and VAS is high.

The Comparison of Lichtenstein Procedure with and without Mesh-Fixation for Inguinal Hernia Repair.

Aim. Although inguinal hernia repair is the most frequently performed surgical procedure in the world, the best repair method has not gained acceptance yet. The ideal repair must be safe, simple, and easy to perform and require minimal dissection which provides enough exploration, maintain patient's comfort in the early stage, and also be cost-effective, reducing operation costs, labor loss, hospital stay, and recurrence. Materials and Methods. There were eighty-five patients between the ages of 18 and 75, diagnosed with inguinal hernia in our clinic. Lichtenstein procedure for hernia repair was performed under spinal anesthesia in all patients. Forty-two patients had the standard procedure and, in 43 patients, the polypropylene mesh was used without fixation. All patients were examined and questioned on the 7th day of the operation in terms of pain, scrotal edema, and the presence of seroma and later on in the 6th postoperative month in terms of paresthesia, neuropraxia, and recurrence by a single physician. Results. Operative time and pain scores in the nonfixation group were significantly lower, without any increase in rates of recurrence. Conclusion. Based on these findings, in Lichtenstein hernia repair method, nonfixation technique can be used safely with better results.

Laparoscopic Roux-en-Y gastric bypass with ileal transposition - an alternative surgical treatment for type 2 diabetes mellitus and gastroesophageal reflux.

Currently, type 2 diabetes mellitus (T2DM) is considered as a gastrointestinal disease. Numerous studies have demonstrated that bariatric operations ameliorate T2DM significantly. The laparoscopic Roux-en-Y gastric bypass (L-RYGB) is considered as the gold standard procedure. We aimed to evaluate the feasibility and impact of L-RYGB with ileal transposition (or interposition) on diabetes resolution in a patient who has not benefited from any medical therapy, with its additional effect on the amelioration of gastroesophageal reflux disease. The patient was a 38-year-old diabetic woman with uncontrolled blood glucose despite medical treatment, with additional gastroesophageal reflux disease. Following the procedure, her biochemical parameters and reflux symptoms improved significantly within 10 months. We think that L-RYGB with ileal transposition may be easily employed to gain a maximum effect in diabetics with adverse prognosis. This technique may be an alternative in the treatment of type 2 diabetic patients with gastroesophageal reflux.

A Rare Cause of Acute Abdomen: Perforation of Double Meckel's Diverticulum.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel's diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel's diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel's diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel's diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

Diagnostic and therapeutic value of ERCP in acute cholangitis.

Cholangitis, with a clinical spectrum between acute ascending cholangitis and acute fulminant cholangitis, the mildest and the most severe forms, respectively, is the infection of bile ducts with a potential of serious mortality and morbidity. Obstruction of the bile ducts followed by infection, with E. coli being the most commonly isolated agent, is common to all forms of cholangitis. Biliary obstruction is caused by choledocholithiasis mostly. "Choledochal pressure" is the most important factor, determining morbidity. If the pressure exceeds 25 cm H2O, which is the critical value, immune dysfunction ensues. Sepsis is common if the infection of biliary ducts is suppurative. Mortality and morbidity are inevitable if left untreated or drained late. The objective of this study is, in the stand point of the current literature, to analyse the diagnostic, therapeutic success and complication rates of ERCP (Endoscopic retrograde cholangiopancreatography) in patients with a diagnosis of acute purulent cholangitis with no response to medical treatment.

Can occult cystobiliary fistulas in hepatic hydatid disease be predicted before surgery?

BACKGROUND: Biliary fistulas because of the cystobiliary communication is the most frequent and undesirable postoperative complication of hepatic hydatid surgery. We aimed to identify the predicting factors of the occult cystobiliary communication in this study. METHODS: The patients who underwent surgical treatment for hepatic hydatid disease between 2003 and 2008 were reviewed retrospectively. The patients who had jaundice history, preoperative high total bilirubin and direct bilirubin levels, dilated bile duct in preoperative radiologic imagings were not included the study. Patients were divided into two groups: group A; without postoperative biliary fistula, group B; with biliary fistula. The two groups were compared according to preoperative descriptive findings, cystic specialties, and laboratory findings. RESULTS: There were 53 patients and 15 patients in groupA and groupB, respectively. The 20 (37.7%) of 53 patients were male in group A and the 10 (66.7%) patients were male in group B (p<0.05). The age, number of cysts, Garbi scores of cysts, the rate of recurrent cysts, the level of preoperative bilirubin, alkalene phosphatase, and transaminases were similar in both groups (p>0.05). GGT was significantly different between two groups (p<0.05). The cystotomy + drainage, cystotomy + omentopexy, and intracystic biliary suture rates were similar in both groups. Postoperative non biliary complications were determined in 4 (7.5%) patients in group A and 7 patients (46.7%) in group B (p<0.05). Hospital stay was longer in group B significantly (p<0.05). CONCLUSIONS: In conclusion, GGT as a laboratory [corrected] test for predicting occult CBC preoperatively have been shown to be useful in the clinical practice. However, larger prospective studies are needed on this subject. Occult cysto-biliary fistulas can only be exposed during surgery when suspected by a surgeon. If occult CBC is found, the opening in the biliary system should be sutured with absorbable material, with or without cystic duct drainage. If no biliary opening is found, cystic duct drainage may be performed if preoperative factors predict the presence of CBC. As the development of external biliary fistulas increases the morbidity and the hospitalization period, novel surgical methods to prevent the development of bile fistulas are required in such patients.

The value of serum biomarkers (Bc1, Bc2, Bc3) in the diagnosis of early breast cancer.

BACKGROUND: Surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF) is an approach to biomarker discovery that combines chromatography and mass spectrometry. We aimed to consider the efficacy of Bc1, Bc2, and Bc3 serum biomarkers on early detection of breast cancer (BC) in this study. STUDY DESIGN: In this prospective study, 91 patients who were admitted to our hospital between January 2007 and July 2008 were included. Serum samples from 91 women were stored at -80 °C until use. The cancer group included 27 cases of BC. The benign breast disease group included 24 women with benign breast diseases and control group 37 age-matched apparently healthy women. The data obtained for these three groups of patients was worked out for each serum biomarker (Bc1, Bc2, and Bc3) by using SELDI-TOF individually and compared with each other separately and evaluated statistically. RESULTS: Bc2 possesses the highest individual diagnostic power. Bc2 was statistically significant in comparison between the malignant disease group, control group and benign disease group. Bc1 was statistically significant in the malignant disease group compared to control group as well as in the benign disease group compared to control group. Thus Bc1, rather than showing malignant progression, it shows tumoral progression or inflammatory process. Bc3 was found upregulated in all malignant cases; however, it was not statistically significant compared to the benign disease group or the control group. CONCLUSIONS: It has been shown that Bc2 profiles might be useful in clinical practice to improve BC diagnosis. However none of the proteomics reach reasonable AUC values for the discrimination of the BC. Additional confirmation in larger and similarly-designed prospective studies is needed to consider of the efficacy of Bc1 and Bc2 in early diagnosis of the BC.