Analysis of orthostatic intolerance symptoms in patients with premature ejaculation.

OBJECTIVE: The autonomic nervous system (ANS) plays an important role in maintaining physiological regulation. It regulates the body's response to many variable situations. Orthostatic intolerance (OI) is one of the most important signs of autonomic dysfunction. Autonomic dysfunction is known to cause premature ejaculation (PE) by disturbing the balance in erection and ejaculation cycles. Considering that OI may develop due to autonomic dysfunction in patients with PE, we hypothesized that OI symptoms would increase in these patients. The aim of our study was to investigate the relationship between orthostatic intolerance and PE. PATIENTS AND METHODS: This case-control study included a total of 39 patients with PE and 47 volunteers without PE. All subjects were assessed using the self-reported Orthostatic Grading Scale (OGS). In addition, the validated five-item Turkish version of the Premature Ejaculation Diagnostic Tool (PEDT) was used to evaluate PE. The PE group included patients with a PEDT score ≥ 11. RESULTS: The mean ages of the PE and control groups were 38.2 ± 7.8 and 40.5 ± 9.1 years, respectively (p = 0.137). The mean PEDT scores of the PE and control groups were 13.9 ± 3.6 and 6.6 ± 2.9, respectively (p < 0.0001), and their mean OGS scores were 5.6 ± 2.4 and 1.6 ± 1.3, respectively (p < 0.0001). A statistically significant correlation was found between the PEDT and OGS scores (r: 0.686, p < 0.0001). CONCLUSIONS: The orthostatic intolerance symptoms of patients with PE were higher than those of the control group. There was a correlation between the severity of PE and the severity of orthostatic intolerance. This is the first study in the literature to reveal a relationship between orthostatic intolerance and PE.

The relationship among plasma copeptin, carboxyhemoglobin, and lactate levels in carbon monoxide poisoning.

OBJECTIVE: The aim of our study is to determine whether there is a change in the plasma levels of copeptin and there is a relationship among the plasma levels of carboxyhemoglobin (COHb), lactate, and copeptin levels in patients presenting to the emergency department with carbon monoxide (CO) poisoning. METHODS: Fifty-seven patients admitted to the emergency department with CO poisoning were included in the study. The blood samples of the patients were collected on arrival 0th, 6th, and 12th hours for copeptin, lactate, and COHb levels. Data were analyzed using SPSS-17 statistical software. RESULTS: Arrival serum copeptin levels of the patients were compared to copeptin levels of healthy individuals and a statistically significant difference was found between them (p = 0.008). There was a statistically significant difference between the arrival levels of copeptin and 6th-hour (p = 0.006) and 12th-hour (p = 0.001) levels of copeptin. There was no significant difference between 6th-hour and 12th-hour copeptin levels (p = 0.51). In terms of serum lactate levels, there was a significant difference between arrival and 6th h (p < 0.001), arrival and 12th h (p < 0.001), and 6th and 12th h (p < 0.001). Likewise, in terms of serum COHb levels, there was a significant difference between arrival and 6th h (p < 0.001), arrival and 12th h (p < 0.001), and 6th and 12th h (p < 0.001). There was a positive correlation between COHb and lactate levels on arrival (r = 0.52; p = 0.001). CONCLUSION: Copeptin as a stress hormone can be used in the diagnosis and monitoring of patients with CO poisoning. However, the copeptin level was not superior to COHb and lactate levels.

The prevalence and morphometric features of mastoid emissary vein on multidetector computed tomography.

BACKGROUND: The aim of the study was to evaluate the prevalence and morphometric features of mastoid emissary vein (MEV) on multidetector computed tomography (MDCT) scans, emphasize its clinical significance and review its surgical implications. MATERIALS AND METHODS: Cranial and temporal bone MDCTs of 248 patients (496 sides) were analysed by 2 radiologists. Mastoid foramen (MF) was defined on the 3 dimensional volume rendered (3DVR) images. The MF and mastoid emissary canal (MEC) were investigated in axial thin slices and the diameters of the largest MF and MEC were measured. Mean diameters of MF and MEC were determined. The number of the mastoid foramina was noted. Differences in MF prevalence by sex and side were evaluated. RESULTS: The overall prevalence of MEC was 92.3%. It was observed in 91.5% of women and 93.3% of men. MEC was present on the right side in 84.7% and on the left side in 82.3% of temporal bones. The mean diameter of MF was 1.92 ± ± 1.02 mm on the right and 1.84 ± 0.98 mm on the left. In both sides the number of the MF's changed from absent to triple. The mean diameter of MEC was 1.58 ± 0.86 mm on the right and 1.48 ± 0.79 mm on the left side. The mean diameter of MEC was significantly larger in men. No significant correlation was detected between age and the MEC diameter. CONCLUSIONS: The preoperative detection of mastoid emissary veins is necessary. The radiologists should be familiar with their clinical significance and variant appearances and report them accurately. Knowledge of their morphology and surgical implications by the surgeons will make them aware to avoid unexpected and fatal complications while operating in the suboccipital and mastoid area. MDCT is a reliable diagnostic tool for imaging the MEC and MF.

Transvaginal low anterior resection for rectal cancer.

Adenocarcinoma of the lower rectum can be resected with a sphincter-sparing procedure but exposure of the lower pelvis may be difficult and sphincter function may be compromised. We have performed a low anterior resection for rectal cancer in a 69-year-old woman with mobilisation of the tumour and anastomosis performed transvaginally without a covering stoma. This way we could get good exposure of the lower rectum and anal sphincters. The patient made an uneventful recovery and was fully continent after surgery. Transvaginal low anterior resection is an alternative route which may be useful in cases of difficult exposure of low rectal cancer.

Effects of long-term cyclosporine A therapy on renal functions in Behçet's disease.

Cyclosporin A (CsA), one of the most extensively investigated immunomodulatory agents, is widely used today in the treatment of various immunologically triggered dermatologic disorders. The immunologic basis for the therapeutic action of CsA depends on the suppression of lymphokine production by T cells. Due to its immunologic effects, this drug is also commonly preferred in Behcet's disease, especially with neurologic and ocular involvement. Since the course of this chronic disease presents remissions and exacerbations, drug therapy should be long term. Studies on the safety of long-term use of CsA in dermatologic diseases are limited. In this study, we aimed to evaluate the long-term use of CsA in Beh,et's disease without renal involvement. A total of 19 patients with ocular Beh,et's disease receiving CsA therapy for at least 1 year were included in this retrospective study. Changes in the parameters of renal function (creatinine clearance, creatinine level in serum), other adverse effects and their relation with cumulative CsA dosage were evaluated. The duration of CsA therapy and total dosage were not found to have a significant effect on the parameters of renal function, but, depending on clinical observations, the adverse effects seem to increase in the long term. We conclude that our results on renal function should be supported by renal biopsies.

Prevention of nickel-induced allergic contact reactions with pentoxifylline.

In this study, we investigated the effect of pentoxifylline, an inhibitor of TNF-alpha, on the contact sensitivity response induced by nickel. For induction, open epicutaneous sensitization by NiSO4. 6 H2O (25% aq.) solution was applied on the backs of 38 albino guinea pigs 5 days a week for 4 weeks. NaCl (0.9%) solution was applied epicutaneously to 10 albino guinea pigs as a control group. 19 were sensitized by nickel and developed positive patch test reactions. Patch tests were repeated after 10 of the sensitized pigs were given pentoxifylline 20 mg/kg/day orally. At the end of this study, only 2 positive patch test reactions were observed in the pentoxifylline-treated group, while 7/9 of the untreated guinea pigs developed positive reactions. These results suggest that pentoxifylline inhibits the contact sensitivity response induced by nickel only during drug administration.