RESUMEN

BACKGROUND: Understanding the knowledge and attitudes of university students regarding organ transplantation and donation is crucial, as these students can significantly influence public opinion and behavior. This study aims to assess the knowledge and attitudes of North Cyprus University students towards organ transplantation and donation. METHODS: A cross-sectional study was conducted with 400 students from Northern Cyprus University, divided into medical and social science faculties. A structured questionnaire was utilized to assess their knowledge and attitudes towards organ transplantation and donation. Descriptive statistics, Chi-square tests, and effect size calculations were employed for data analysis. RESULTS: Among the 400 students, 27% demonstrated sufficient knowledge of organ transplantation, and 62.7% had positive views on organ donation. Willingness to donate was expressed by 37% as living donors and 64% as deceased donors. There were no significant differences in knowledge and attitudes between medical and social science students. Factors such as sex, marital status, faculty, and contact with individuals with end-stage organ failure did not significantly influence the knowledge and attitudes. CONCLUSIONS: This study highlights the necessity for educational interventions and awareness campaigns to improve understanding and attitudes towards organ donation among Northern Cyprus University students. Incorporating organ donation education into university curricula, providing accurate online information, addressing misconceptions, and promoting awareness of donation centers and transplant hospitals are essential steps to mitigate organ shortages. Public engagement should be encouraged to foster a supportive environment for organ donation.

Asunto(s)

RESUMEN

This retrospective study assessed the efficacy of low-intensity extracorporeal shockwave therapy (Li-ESWT) in the treatment of erectile dysfunction (ED) in patients unresponsive to phosphodiesterase inhibitors (PDE5is). Between May 2020 and December 2022, we retrospectively analyzed the records of 126 ED patients who underwent Li-ESWT post unsuccessful PDE5is trials, defined as inadequate response following at least 6 consistent trials with correct dosage (preference given to 20 mg tadalafil). Patients with neurogenic disorders were excluded. Patients' ED severity was determined using the IIEF-5 score and further categorized into 2 groups. The Li-ESWT treatment protocol consisted of 12 weeks. Data was analyzed using descriptive statistics and paired t-tests. In the cohort of 126 patients, the mean age was 50.5 ±â€…12.4 years, with a BMI of 29.18 ±â€…3.49. Notably, 74.6% had ED for more than 12 months. Before Li-ESWT, 55.6% used sildenafil and 44.4% used tadalafil. Post 3 months of Li-ESWT, the average IIEF score rose significantly from 10.19 ±â€…7.71 to 14.29 ±â€…0.92 (P < .01). Particularly, Group 2 exhibited a significant improvement in their mean IIEF score from 13.78 ±â€…1.38 pretreatment to 21 ±â€…2.31 post-treatment. However, Group 1 (with higher diabetes prevalence) showed a marginal rise from 5.8 ±â€…1.47 to 6.1 ±â€…3.2 (P = .14). Similarly, the overall EHS score progressed significantly from 1.34 ±â€…0.8 to 2.3 ±â€…1.17 post-treatment. Post-treatment, while Group 1 showed no changes in successful vaginal penetration, Group 2 reported a dramatic increase in successes, from 16 before treatment to 68 after. This study demonstrated the efficacy of Li-ESWT for PDE5is-refractory ED, particularly in patients with moderate to mild ED. However, patients with severe ED and comorbidities did not show significant improvement. Further research with larger sample sizes, control groups, longer follow-up periods, and standardized protocols is required to confirm the effectiveness and limitations of Li-ESWT in ED treatment.

Asunto(s)

RESUMEN

Peritoneal dialysis is a reliable and effective treatment for end-stage kidney disease. However, inadequate catheter insertion can lead to mechanical dysfunction, which remains an unresolved problem. In this study, we present the initial results of a modified laparoscopic approach. This study included 38 patients who underwent peritoneal dialysis using a modified laparoscopic approach. During the procedure, a single laparoscopic trocar was employed, and peritoneal entry was performed using a percutaneous pull-apart sheath/dilator. To minimize the risk of complications, the free catheter portion was kept short in the peritoneum. The modified method was guided by proven recommendations of the standard laparoscopic technique. The mean operation time was recorded as 24.28 ±â€…15.5. The mean hospitalization was found to be 1.20 ±â€…0.72 days. The postoperative morbidity was 26.3%. The mechanical dysfunction rate was 5.26%. The median follow-up time was 20.4 ±â€…17.14 months. The median peritoneal dialysis catheter-free survival was 25.96 ±â€…4.02 months. The catheter-free survival rate was 92.11%. The modified laparoscopic approach has been demonstrated to be a safe and effective option, and initial studies have indicated that it offers several benefits over traditional methods, including a straightforward procedure with a brief duration, minimal complications, and brief hospital stay.

Asunto(s)

RESUMEN

Graft and surgery-related complications still pose a problem in kidney transplant surgery. Vascular complications due to surgery can be severe, threatening both graft and recipient life. Various treatment approaches have been described in the literature for vascular complications diagnosed peri-operatively and post-operatively. However, studies that provide long-term results on which approach will be applied in which period and in which conditions are limited. In this case report, we share our 6-year patient follow-up experience and repair of external iliac artery dissection related to renal transplantation with internal iliac artery transposition.

Asunto(s)

RESUMEN

BACKGROUND: This retrospective research endeavored to conduct a comparative evaluation of the Pediatric Lower Urinary Tract Symptoms Scoring (PLUTSS) system and the Voiding Diary (VD). The correlation between these diagnostic tools, their prognostic value for treatment outcomes in pediatric Lower Urinary Tract Dysfunction (LUTD), and their relationship with patients' sociodemographic characteristics were also explored. METHODOLOGY: The study data for the cohort established between December 2005 and September 2006 were obtained from a specialized thesis, while the subsequent expansion from 2022 to 2023 involved a prospective approach, including an additional 73 patients, resulting in a total of 113 pediatric patients (79 females and 34 males). Comprehensive diagnostic evaluations, such as urinalysis, urine culture, renal function tests, urinary tract ultrasound, uroflowmetry-electromyography (EMG), and post-voiding residual urine measurement (PVR), were conducted. The patient's symptoms were assessed using the Pediatric Lower Urinary Tract Symptom Score (PLUTSS) and a two-day-three-night voiding diary. RESULTS: The correlation between the PLUTSS and VD was not absolute but substantial concerning daytime frequency and incontinence. Notably, PLUTSS emerged as the primary predictor of treatment outcomes. No significant association was discerned between sociodemographic characteristics, such as socioeconomic status, sibling count, toilet training, school performance, patient personality, and LUTD diagnosis or prognosis. CONCLUSION: The findings underscore the prognostic value of PLUTSS for treatment outcomes in pediatric LUTD. Although a significant correlation was observed between PLUTSS and VD, they are not interchangeable. As a result, concurrent utilization of both tools is endorsed for comprehensive diagnosis, follow-up, and treatment planning in pediatric LUTD.

RESUMEN

Kidney transplantation provides a higher quality of life, a longer life expectancy for end-stage renal disease patients, and a lower cost than other treatments. Unfortunately, organ shortage for kidney transplantation is a major obstacle for countries with long waiting lists. Approaches to solving organ shortages with laws and regulations differ between countries. The reasons for these differences are evaluated by considering many factors, such as religious beliefs, sociocultural differences, and distrust in health systems. Until another evidence-based treatment becomes available, efforts to increase dead donor transplants are the main solution to reducing waiting lists. In a retrospective study conducted in our region, we investigated the prevalence and potential correlation of deceased organ transplantation based on family refusal and other issues.

Asunto(s)

RESUMEN

Introduction Increasing deceased organ transplantation rates is an important strategy to overcome the organ shortage. Prior to the pandemic in Northern Cyprus, there were more transplants from deceased donors than from living donors. However, after the pandemic, living donor organ transplants were almost equal to cadaveric organ transplants. The purpose of this study was to explore the knowledge, attitudes, and experiences of hospital-based clinicians involved in the diagnosis of brain death and donor care in order to raise the deceased organ transplantation rate. Methods The study population consisted of three departments: physicians' anesthesiology, neurology, and neurosurgeons, who signed off on the brain death report. The demographic information of the participants was recorded. A total of 31 questions in the questionnaire were about personal experiences, attitudes toward brain death, organ donation, and donor care, and the level of knowledge and expertise required for the identification and care of potential organ donors. The answers are "agree," "indecisive," and "disagree." Results A total of 29 physicians, seven (24.1%) neurologists, six (20.7%) neurosurgeons, and 16 (55.2%) anesthesiologists answered the questionnaire. Although all of the participants stated that brain death is a definite death, it was determined that they did not agree on how the process should proceed for non-donors after the diagnosis of brain death. Conclusion Physicians' attitudes towards deceased organ transplantation are positive. It is pointed out that society's insensitivity and indifference to the decrease in organ donation rates. Multidisciplinary work motivation may increase deceased organ transplant rates.

RESUMEN

Wunderlich syndrome (WS) is defined as a rare spontaneous renal hemorrhage. It mostly occurs with concomitant diseases without trauma. It usually presents with the Lenk triad and is diagnosed in emergency departments with the effective use of advanced imaging modalities such as ultrasonography, computerized tomography, or magnetic resonance imaging scanning. In the management of WS, conservative treatment, interventional radiology, or surgical procedures are decided according to the patient's condition and treated appropriately. Conservative follow-up and treatment should be considered in patients whose diagnosis is stable. If diagnosed late, the progression can be life-threatening. As an interesting case of WS, a 19-year-old patient was presented with hydronephrosis due to ure-teropelvic junction obstruction. Spontaneous renal hemorrhage without a history of trauma is presented. The patient, who presented to the emergency department with the sudden onset of flank pain, vomiting, and macroscopic hematuria was imaged by computed tomography. The patient could be followed and treated conservatively for the first 3 days, and on the 4th day, his general condition deteriorated, and he underwent selective angioembolization and then laparoscopic nephrectomy. WS is a serious, life-threatening emer-gency, even in young patients with benign conditions. Early diagnosis is mandatory. Delays in diagnosis and non-energetic approaches can lead to life-threatening situations. In hemodynamically unstable non-malignant cases, the decision for immediate treatment, such as angioembolization and surgery, should be taken without hesitation.

Asunto(s)

RESUMEN

Fordyce angiokeratoma is a benign lesion commonly developing on the scrotal skin. The incidence increases with age. About half of these lesions may be symptomatic and frequently cause itching and bleeding. Although the treatment is not always considered necessary, several treatment methods are used for symptomatic cases, especially for cosmetic purposes. Treatment options include surgical excision, laser ablation, electrocoagulation, cryotherapy, and sclerotherapy. The most widely used methods are electrocoagulation and cryotherapy. Although these two methods are similarly effective and safe, there are differences in means of patient comfort and cosmetic outcomes. Patient comfort can be defined as pain management during the procedure and the healing period. Bleeding and wound infection are other parameters that may decrease patient comfort. Patients would prefer treatment methods with less or no pain and shorter recovery periods, healthcare providers, and insurance. The cosmetic result is another critical issue, especially for patients with multiple lesions. Treatment methods avoiding genital scars are more likely to meet the aesthetic demands of the patients.

RESUMEN

Penile paraffinoma is an uncommon entity produced by penile paraffin injections for the purpose of penile enlargement by a nonmedical person. Although it is not a current method of penile enlargement procedures, in our opinion dermatologists and urology specialist should be have knowledge of this entity about diagnosis and management. It will be an aim to share our experiences and views in this paper.

RESUMEN

Pure testicular choriocarcinoma with metastasis to the skin is a very rarely seen phenomenon. Choriocarcinoma has a distinct propensity for early hematogenous spread to distant sites. We present the case of a 42-year-old white male with testicular choriocarcinoma with skin metastasis.

Asunto(s)

RESUMEN

BACKGROUND: Aluminum has recently been recognized as a causative agent in dialysis encephalopathy, osteodystrophy, and microcytic anemia occurring in patients with chronic renal failure who undergo long-term hemodialysis. Only a small amount of Al(III) in dialysis solutions may give rise to these disorders. METHODS: Magnetic poly(2-hydroxyethyl methacrylate) (mPHEMA) beads in the size range of 80-120 microm were produced by free radical co-polymerization of HEMA and ethylene dimethacrylate (EDMA) in the presence of magnetite particles (Fe3O4). Then, metal complexing ligand alizarin yellow was covalently attached onto mPHEMA beads. Alizarin yellow loading was 208 micromol/g. These beads were used for the removal of Al(III) ions from tap and dialysis water in a magnetically stabilized fluidized bed. RESULTS: Al(III) adsorption capacity of the beads decreased with an increase in the flow-rate. The maximum Al(III) adsorption was observed at pH 5.0. Comparison of batch and magnetically stabilized fluidized bed (MSFB) maximum capacities determined using Langmuir isotherms showed that dynamic capacity (17.5 mg/g) was somewhat higher than the batch capacity (11.8 mg/g). The dissociation constants for Al(III) were determined using the Langmuir isotherm equation to be 27.3 mM (MSFB) and 6.7 mM (batch system), indicating medium affinity, which was typical for pseudospecific affinity ligands. Al(III) ions could be repeatedly adsorbed and desorbed with these beads without noticeable loss in their Al(III) adsorption capacity. CONCLUSIONS: Adsorption of Al(III) demonstrate the affinity of magnetic dye-affinity beads. The MSFB experiments allowed us to conclude that this inexpensive sorbent system may be an important alternative to the existing adsorbents in the removal of aluminium.