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1.
JMIR Med Inform ; 12: e59258, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39230947

RESUMEN

BACKGROUND: Reading medical papers is a challenging and time-consuming task for doctors, especially when the papers are long and complex. A tool that can help doctors efficiently process and understand medical papers is needed. OBJECTIVE: This study aims to critically assess and compare the comprehension capabilities of large language models (LLMs) in accurately and efficiently understanding medical research papers using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist, which provides a standardized framework for evaluating key elements of observational study. METHODS: The study is a methodological type of research. The study aims to evaluate the understanding capabilities of new generative artificial intelligence tools in medical papers. A novel benchmark pipeline processed 50 medical research papers from PubMed, comparing the answers of 6 LLMs (GPT-3.5-Turbo, GPT-4-0613, GPT-4-1106, PaLM 2, Claude v1, and Gemini Pro) to the benchmark established by expert medical professors. Fifteen questions, derived from the STROBE checklist, assessed LLMs' understanding of different sections of a research paper. RESULTS: LLMs exhibited varying performance, with GPT-3.5-Turbo achieving the highest percentage of correct answers (n=3916, 66.9%), followed by GPT-4-1106 (n=3837, 65.6%), PaLM 2 (n=3632, 62.1%), Claude v1 (n=2887, 58.3%), Gemini Pro (n=2878, 49.2%), and GPT-4-0613 (n=2580, 44.1%). Statistical analysis revealed statistically significant differences between LLMs (P<.001), with older models showing inconsistent performance compared to newer versions. LLMs showcased distinct performances for each question across different parts of a scholarly paper-with certain models like PaLM 2 and GPT-3.5 showing remarkable versatility and depth in understanding. CONCLUSIONS: This study is the first to evaluate the performance of different LLMs in understanding medical papers using the retrieval augmented generation method. The findings highlight the potential of LLMs to enhance medical research by improving efficiency and facilitating evidence-based decision-making. Further research is needed to address limitations such as the influence of question formats, potential biases, and the rapid evolution of LLM models.

2.
Fr J Urol ; 34(9): 102707, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39067524

RESUMEN

OBJECTIVES: To investigate the association between pain and sleep quality, anxiety, depression, body perception, and biological rhythm in chronic scrotal pain (CSP). MATERIAL AND METHODS: This cross-sectional study of 140 CSP patients was conducted between January and October 2023. The patients were separated into groups according to the Visual Analogue Scale (VAS) score as group 1 (score<3, n=27), group 2 (score: 3-6, n=84), and group 3 (score>6, n=29). In addition to demographic data, the points were recorded from the Body Image Scale (BIS), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The median (IQR) age of patients was 33 (20) years and the median (IQR) duration of pain was 5 (9) months. Group 3 patients had more anxiety (24.1% vs. group 1: 22.2%; group 2: 8.3%; P=0.03) and depression (55.2% vs. group 1: 40.7%; group 2: 29.8%; P=0.04) symptoms. No statistical differences were determined between the groups according to the BIS (P=0.54). The median (IQR) total BRIAN score was higher in group 3 than group 1 [37 (11) vs. 33 (13), P=0.03]. Higher rates of poor sleep quality were determined in group 3 patients according to the PSQI (75.9% vs. group 1: 48.1%; group 2: 51.2%; P=0.04). The VAS score was found to be positively associated with pain duration, total BRIAN score and PSQI score (r=0.31, P<0.001; r=0.17, P=0.04; r=0.23, P=0.006, respectively). The PSQI score was found to be an independent predictor for a higher VAS score (HR: 1.14, P=0.01). CONCLUSION: The results of this study suggest that poor sleep quality may influence the perceived intensity of pain. LEVEL OF EVIDENCE: II.


Asunto(s)
Ansiedad , Dolor Crónico , Depresión , Dimensión del Dolor , Escroto , Calidad del Sueño , Humanos , Masculino , Estudios Transversales , Adulto , Dolor Crónico/psicología , Dolor Crónico/fisiopatología , Ansiedad/epidemiología , Ansiedad/psicología , Ansiedad/diagnóstico , Depresión/epidemiología , Depresión/psicología , Depresión/fisiopatología , Depresión/diagnóstico , Dimensión del Dolor/métodos , Persona de Mediana Edad , Imagen Corporal/psicología , Adulto Joven
3.
Urologia ; : 3915603241246669, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600722

RESUMEN

OBJECTIVE: To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language. MATERIAL AND METHODS: The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method. RESULTS: The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 (p < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores (r: 0.63, p < 0.001; r = 0.32, p < 0.001; r = 0.56, p < 0.001; r = 0.59, p < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score. CONCLUSION: The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP.

4.
Int Urol Nephrol ; 55(6): 1421-1426, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37115457

RESUMEN

AIM: To determine the effect of heparin administered during the early post urethral trauma period on inflammation and spongiofibrosis in rats. MATERIALS AND METHODS: The study included 24 male rats that were randomized into 3 groups of 8 each. The urethra was traumatized using a 24-G needle sheath in all rats. Group 1 (control group) received intraurethral saline 0.9% injected b.i.d. for 27 days, group 2 received intraurethral Na-heparin (liquemine-Roche) 1500 IU kg-1 injected b.i.d. for 27 days, and group 3 received intraurethral Na-heparin 1500 IU kg-1 injected b.i.d and saline 0.9% s.i.d. for 27 days. On day 28 the rats' penises were degloved and penectomy was performed. Inflammation, spongiofibrosis, and congestion in the urethra were investigated in each group. RESULTS: A statistically significant difference was found between the three groups (control, heparin, and heparin + saline) in the histopathological status of spongiofibrosis, inflammation, and congestion, respectively (P = 0.0001, P = 0.002, P = 0.0001). Severe spongiofibrosis was observed in six (75%) of the rats in group 1 (control group), whereas severe spongiofibrosis was not observed in group 2 (heparin) or group 3 (heparin + saline). CONCLUSION: We observed that intraurethral Na-heparin 1500 IU kg-1 injectioned during the early posturethral trauma period in rats significantly decreased inflammation, spongiofibrosis, and congestion.


Asunto(s)
Heparina , Uretra , Ratas , Masculino , Animales , Uretra/lesiones , Heparina/farmacología , Pene , Inflamación/tratamiento farmacológico , Inflamación/etiología
5.
Neurourol Urodyn ; 42(4): 814-821, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36751884

RESUMEN

PURPOSE: To evaluate pelvic floor and sexual dysfunction, and anxiety and depression symptoms in females with different urinary incontinence (UI) types. MATERIALS AND METHODS: A cross sectional evaluation was made of 73 patients diagnosed with UI in the Urology Clinic between December 2021 and November 2022. In addition to demographic data, the points were recorded from the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory-20 (PFDI-20). RESULTS: The mean age of the patients was 38.3 ± 3.7 years. Incontinence types of the patients were determined as 42% urgency urinary incontinence (UUI), 30.1% stress urgency incontinence (SUI), and 27.4% mixed type urinary incontinence (MUI). Anxiety symptoms were determined in 20.5% and depression symptoms in 41.1% of all the patients. The median ICIQ-FLUTS score was determined to be significantly higher in the MUI patients than in the other types [25.5 (MUI) vs. 17 (SUI), p = 0.007; 16 (UUI), p = 0.001]. The median FSFI and HADS scores were seen to be similar in all the UI types (p = 0.1). The median PFDI-20 score was found to be higher in the MUI group than in the UUI group (126.5 vs. 88.5, p = 0.02). CONCLUSION: The sexual dysfunction and psychological symptoms were found to be similar in the patients according to UI type. The MUI patients were seen to have more incontinence symptoms compared to the other types and experienced more pelvic floor dysfunction than patients with UUI.


Asunto(s)
Síntomas del Sistema Urinario Inferior , Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Humanos , Femenino , Adulto , Depresión , Diafragma Pélvico , Estudios Transversales , Calidad de Vida , Incontinencia Urinaria de Urgencia , Encuestas y Cuestionarios , Ansiedad
6.
Urologia ; 90(1): 109-115, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35445621

RESUMEN

PURPOSE: If not treated on time with proper management options, urolithiasis cause serious morphologic and functional alterations in the involved renal units. Like many other pathologies, the diagnosis, treatment, and follow-up principles of patients with urinary stones have been negatively affected by the unestimated changes in the healthcare systems dealing intensively with COVID-19 patients. In this present study, we aimed to evaluate and present the possible effects of COVID-19 infection on the ureterorenoscopic stone treatment. MATERIALS AND METHODS: Clinical and procedural characteristics of 96 patients undergoing flexible and/or rigid ureterorenoscopy because of urolithiasis between March 2020 and January 2021 were evaluated in a retrospective manner. Obtained data were evaluated after match-pair analysis in a comparative manner between cases with a positive medical history of COVID-19 infection (Group 1, n: 48) and those without any COVID-19 infection (Group 2, n: 48). RESULTS: There was no statistically significant difference between the two groups of cases with respect to age, gender, associated comorbidities, and stone characteristics (p > 0.05). The mean serum creatinine level was determined to be higher in Group 1 than in Group 2 (1.15 ± 0.59 mg/dl, 0.83 ± 0.21 mg/dl, p = 0.007, respectively). Evaluation of the operative parameters revealed longer mean time from diagnosis to surgery (33.5 ± 14.27 vs 12.12 ± 6.33 days, p = 0.001), operating time, median length of stay in hospital along with higher additional intervention rates, and Clavien-Dindo complication scores again in Group 1 (p < 0.05). CONCLUSION: Our results indicate that the presence of COVID-19 infection anamnesis may affect the clinical and operative parameters of ureteroscopic stone management in cases with urolithiasis due to the possible effects of renal units damage and longer waiting time. Urologists may be aware of these unestimated problems during and after the intervention to take necessary measures for a safe and successful ureteroscopic stone removal.


Asunto(s)
COVID-19 , Cálculos Renales , Litotricia , Cálculos Ureterales , Urolitiasis , Humanos , Cálculos Ureterales/cirugía , Estudios Retrospectivos , COVID-19/epidemiología , Litotricia/métodos , Ureteroscopía/métodos , Urolitiasis/terapia , Resultado del Tratamiento , Cálculos Renales/cirugía , Cálculos Renales/etiología
7.
Andrology ; 11(3): 425-432, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36417491

RESUMEN

BACKGROUND: Premature ejaculation (PE) is the most common ejaculatory function disorder. To date, four types of PE have been identified depending on the severity, onset, and course of the problem. OBJECTIVES: The aim of this study was to investigate whether or not there is a difference between these types in respect of anxiety, perceived stress, insomnia severity, and sleep chronotype. MATERIALS AND METHODS: The study included 112 patients diagnosed with PE in our clinic between October 2021 and May 2022. The patients were separated into groups according to PE types of lifelong (LPE, n = 39), acquired (APE, n = 45), variable (VPE, n = 10), and subjective (SPE, n = 18). In addition to the demographic and clinical data, the scores were recorded of all participants in the International Index of Erectile Function-5, Hospital Anxiety and Depression Scale, Premature Ejaculation Diagnostic Tool (PEDT), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Morningness Eveningness Questionnaire (MEQ). RESULTS: SPE was determined more in university graduate patients (42.1% vs. LPE, 21.1%; APE, 36.8%; VPE, 0%; p = 0.01). In patients with APE, erectile dysfunction was more severe (80.0% vs. LPE, 8.0%; SPE, 12.0%; VPE, 0%; p < 0.001). The median (IQR) PEDT score was determined to be higher in APE than in LPE and SPE (16(5), 13(7), 11(5), p = 0.001, respectively). Patients with APE were determined to have higher median (IQR) ISI (21(9) vs. LPE, 8(7); SPE, 5(8); VPE 8(4), p < 0.001) and PSS scores (35(12) vs. LPE, 22 (7); SPE,22(5); VPE 21(6), p < 0.001), the sleep chronotype was more eveningness according to the MEQ (80.8% vs. LPE, 19.2%; VPE, 0%; SPE, 0%; p < 0.001), and there were seen be more anxiety symptoms (75.5% vs. LPE,12.2%; VPE, 0%; SPE, 12.2%; p < 0.001). CONCLUSION: Psychological status and sleep health were concluded to be important factors for PE patients, and the patients with acquired PE were the group most affected by these factors.


Asunto(s)
Disfunción Eréctil , Hominidae , Eyaculación Prematura , Trastornos del Inicio y del Mantenimiento del Sueño , Masculino , Humanos , Animales , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Ansiedad/complicaciones , Ansiedad/epidemiología , Ansiedad/psicología , Síndrome , Estrés Psicológico/complicaciones , Eyaculación
8.
Urol J ; 16(2): 157-161, 2019 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-30345497

RESUMEN

AIM: The complaints of lower urinary tract symptoms (LUTS) in cases with Prostate carcinoma (Pca) depend on coexisting benign prostate hyperplasia (BPH) or aging bladder. We aimed to investigate and compare the effect of goserelin acetate with leuprolide acetate on total prostate volume (TPV), post voiding residue (PVR), International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) reduction on cases of advanced Pca. METHODS: Patients with advanced Pca were treated with goserelin acetate (10.8 mg/3 months) or leuprolide acetate (22.5 mg/3 months) for 6 months. Changes in Prostate specific antigen (PSA), testesterone level, TPV, IPSS, PVR, and Qmax were assessed every 3 months. RESULTS: Fifty-one patients analyzed in this study. Mean percent decrease in PSA and testesterone from baseline to 6th month was not significantly difference between two groups (respectively; p = 0.9, p = 0.15) but TPV was reduced by -20.2 % ± 4.8 and -15.6 % ± 1.04,  the median total IPSS score was decreased by -34.77 % ± 8.8 and -19.77 % ± 6.1, median Qmax increased by 45.34 % ± 10.16 and 23.21 % ± 6.93, median PVR decreased by -31.54 % ± 8.4 and -19.23 % ± 5.5, respectively for two groups (all parameters (p < 0.05))Conclusion. In this study, we observed that the improvement of voiding parameters goserelin acetate was beter than leuprolide acetate. Especially it was detected the superiority of goserelin acetate group on the reduction of TPV, PVR and IPSS. Oncological outcomes were not different in both groups.


Asunto(s)
Antineoplásicos Hormonales/uso terapéutico , Goserelina/uso terapéutico , Leuprolida/uso terapéutico , Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Neoplasias de la Próstata/tratamiento farmacológico , Trastornos Urinarios/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Antineoplásicos Hormonales/farmacología , Goserelina/farmacología , Humanos , Leuprolida/farmacología , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/complicaciones , Estudios Retrospectivos , Carga Tumoral/efectos de los fármacos , Trastornos Urinarios/etiología
9.
Int Neurourol J ; 19(3): 164-70, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26620898

RESUMEN

PURPOSE: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. METHODS: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. RESULTS: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). CONCLUSIONS: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.

10.
Int Urol Nephrol ; 47(11): 1773-7, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26377497

RESUMEN

INTRODUCTION: Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. MATERIALS AND METHODS: Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. RESULTS: Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). CONCLUSION: The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.


Asunto(s)
Ansiedad/prevención & control , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/efectos adversos , Hipnosis , Dolor/prevención & control , Próstata/patología , Anciano , Ansiedad/etiología , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/psicología , Humanos , Masculino , Persona de Mediana Edad , Dolor/etiología , Dimensión del Dolor , Cuidados Preoperatorios , Escalas de Valoración Psiquiátrica
11.
Turk J Urol ; 41(2): 57-60, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26328202

RESUMEN

OBJECTIVE: Renal neoplasms have a predilection to occur in older patients and they are often malignant. They may have different structural characteristics according to age groups. In our study, we have investigated age-related demographic characteristics of the patients who were operated because of suspected malignant renal masses. MATERIALS AND METHODS: Between 2010 and 2014, 129 patients were treated surgically for suspected malignant renal masses at our institution. These cases had undergone open radical, open partial, and laparoscopic radical nephrectomies. Patients were divided into two groups based on their ages and evaluated accordingly as Group 1 (≤50 years) and Group 2 (>50 years). Groups were compared based on their clinical and pathological features. RESULTS: Group 1 and Group 2 consisted of 29 (22.4%) and 91 (77.6%) patients, respectively. The mean age of younger patients was 43.1 years (23-49 years), with a male to female ratio of 19/10, while the average tumor size was 57.6 mm (20-120 mm). Twenty-four patients (83%) had a malignant pathology and five patients (17%) had a benign pathology. Clear cell carcinoma was diagnosed in 67% of the patients in both groups. There was no significant difference with respect to age and tumor size of male and female patients in the younger age group, while younger female adults tended to have a more benign pathology than their male counterparts (40% and 5%, respectively, p<0.05). CONCLUSION: There was no significant difference with respect to gender, tumor size, laterality, and surgical and pathologic features between younger and older patients. An organ- sparing approach should be strongly considered when treatment for renal tumors in young females is performed because of a potentially higher incidence of a benign pathology of renal masses.

12.
J Pediatr Surg ; 50(4): 651-4, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25840081

RESUMEN

PURPOSE: To evaluate the differential diagnosis of testicular torsion and acute epididymo-orchitis by measuring the acute increase in plasma d-dimer levels in an experimental rat model. METHODS: Thirty male Wistar rats were randomly divided into 5 groups, 1--sham operated group (acute term; 4 hours), 2--early torsion group (acute term; 4 hours), 3--late torsion group (long-term; 72 hours), 4--control of epididymitis group (vehicle injected; 0.1 ml physiologic saline injected into the left ductus deferens) (long term; 72 hours), 5--epididymitis group (0.1 ml Escherichia coli injected into the left ductus deferens), (n=6 for each group). RESULTS: Serum d-dimer levels were significantly higher compared with the sham operated group with early torsion (p=0.002). This elevation remained mildly in the late torsion group compared with the control group (p<0.001), but there was no difference between 4 and 72 hours of the testis torsions (p=0.794). On the other hand, d-dimer levels were significantly higher in the torsion groups compared to the epididymitis group (p=0.042). CONCLUSIONS: The present study demonstrated that testicular damage that occurs following testicular torsion shows a higher increase in d-dimer levels than epididymitis, suggesting that d-dimer level can be used as a diagnostic marker of testicular torsion.


Asunto(s)
Diagnóstico Precoz , Epididimitis/diagnóstico , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Torsión del Cordón Espermático/diagnóstico , Animales , Biomarcadores/sangre , Diagnóstico Diferencial , Modelos Animales de Enfermedad , Epididimitis/sangre , Masculino , Ratas , Ratas Wistar , Torsión del Cordón Espermático/sangre
13.
Urol J ; 12(1): 2014-9, 2015 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-25703911

RESUMEN

PURPOSE: To investigate the efficacy of a novel anesthetic technique called iliohypogastric nerve block (INB) for pain control in patients undergoing prostate biopsy. MATERIALS AND METHODS: A total of 59 consecutive patients who underwent transrectal ultrasound guided prostates biopsies were included in the study. Patients were randomized into four groups: (1) control, no method of anesthesia was administered, (2) intrarectal prilocaine-lidocaine cream application, (3) INB and (4) INB + intrarectal prilocaine-lidocaine cream application (combined group). Patients were asked to use a scale of 0-10 in a Visual Analogue Scale (VAS) questionnaire about pain during probe insertion (VAS 1) and prostate biopsy (VAS 2). RESULTS: The mean VAS 1 and VAS 2 scores were 0.7 and 4.9 for controls, 0.5 and 1.8 for INB, 0.5 and 2.6 for the intrarectal cream group, and 0.4 and 1.8 for the combined group. The mean VAS 1 scores were not different between groups. However, the mean VAS 2 scores were significantly lower in INB, prilocaine-lidocaine cream and combined groups compared to the control group (P < .001). In addition, the INB group had significantly lower VAS 2 scores compared to the cream application group (P = .03). On the other hand, there was no difference between the INB and combined groups (P = .8). CONCLUSION: Any form of anesthesia was superior to none. However, INB alone seemed to be superior to prilocaine-lidocaine cream application in patients undergoing prostate biopsy. Addition of prilocaine-lidocaine cream application to INB may not provide better analgesia. 


Asunto(s)
Anestesia Local , Anestésicos Locales , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/efectos adversos , Bloqueo Nervioso/métodos , Dolor/prevención & control , Próstata/patología , Administración Rectal , Administración Tópica , Humanos , Lidocaína , Masculino , Dimensión del Dolor , Prilocaína
14.
Urolithiasis ; 43(2): 155-61, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25249328

RESUMEN

To compare the outcomes in patients who have been treated with flexible ureterorenoscopy (f-URS) and percutaneous nephrolithotomy (PNL) in managing stone-bearing caliceal diverticula. Between April 2007 and October 2013, we performed a retrospective analysis of 54 evaluable patients (28 women and 26 men) with symptomatic stone-bearing caliceal diverticula, who underwent PNL (n = 29) or F-URS (n = 25) in four referral hospitals in Turkey. The groups were compared with respect to demographics, stone location/size, success rate, stone-free status, symptom-free status, complication rates, and hospital stay. The average stone burden preoperatively was significantly larger in patients who were treated with PNL, with the average size for f-URS being 154 ± 77 mm(2) and that for PNL being 211 ± 97 mm(2) (p = 0.023). Symptom-free rates, success rates, stone-free rates and clinically insignificant residual fragments were similar between the groups (p = 0.880 vs. p = 0.537 vs. p = 0.539, and p = 0.877, respectively). There was no statistical difference between the groups for minor complications (p = 0.521) but no major complication (Clavien III-V) occured in the f-URS group; although there were three major complications (10.3 %) (Clavien III) in the PNL group (p < 0.001). Hospitalization time per patient was 1.04 ± 0.20 days in the f-URS group, while it was 3.86 ± 1.94 days in the PNL group (p < 0.001). Even though this study clearly shows that both techniques have high overall success and symptom-free rates with similar complication rates for stone-bearing calyceal diverticulum, major complication rates may suggest consideration of the invasiveness of PNL. The f-URS procedure is advantageous with respect to a shorter hospital stay and absence of major complications. Therefore, it should be emphasized that the location of the stone and diverticula is an important factor for the selection of the procedure.


Asunto(s)
Divertículo/complicaciones , Cálculos Renales/complicaciones , Cálculos Renales/cirugía , Cálices Renales , Enfermedades Renales/complicaciones , Nefrostomía Percutánea , Ureteroscopía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
16.
Arch Med Sci ; 10(2): 396-400, 2014 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-24904678

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the efficacy of Hypericum perforatum for prevention of adhesion formation in rats. MATERIAL AND METHODS: Twenty-four female wistar rats underwent left uterine horn adhesion model. Rats were randomised into 4 groups. Group 1 (Control): Closure of abdominal incision without any agent administration. Group 2: Closure of incision after administration of intraperitoneal (i.p.) Ringer's lactate solution. Group 3: Closure of incision after administration of i.p. olive oil (diluent of H. perforatum). Group 4: Hypericum perforatum extract (Ecodab(®)) was administered i.p. before the closure of incision. Fourteen days later, relaparatomy was performed and surgical adhesion scores, inflammation and fibrosis scores were noted. Groups were compared according to these scores. RESULTS: There was statistical significant difference between ringer's lactate group and olive oil group according to surgical adhesion score (p = 0.009). However, groups were not different according to inflammation and fibrosis scores (p > 0.05). CONCLUSIONS: Despite antiinflammatory, antioxidants and antimicrobial properties of H. perforatum, our results revealed no positive effect of H. perforatum on the prevention of intraperitoneal adhesion formation.

17.
Case Rep Urol ; 2014: 762630, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24883222

RESUMEN

Granulocytic sarcomas are rare tumors composed of neoplastic blood cells, typically occurring during the course of acute nonlymphoblastic leukemia or before its onset. We present a case of a 23-year-old young adult man with metachronous granulocytic sarcoma of the testis without hematologic manifestations who was diagnosed with granulocytic sarcoma (GS). The patient was treated with right orchiectomy but relapsed with a left testicular mass 16 months later when a left orchiectomy was performed. The patient has been free of disease for 13 months following the left orchiectomy. This case highlights a rare hematologic cancer that urologists and pathologists should be aware of since it can present as a testicular mass. Only 3 cases of testicular GS without an associated hematologic disorder have been described. To the best of our knowledge, our patient is the first reported case in the English literature of metachronous GS of the testis with no evidence of hematologic disorder.

18.
J Reprod Med ; 58(3-4): 161-6, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23539886

RESUMEN

OBJECTIVE: To determine the role of human amniotic fluid (HAF) in preventing or reducing postoperative adhesions. STUDY DESIGN: Uterine horn adhesion model was carried out in 24 female Wistar rats. The animals were randomized into 4 groups: (1) control, (2) Ringer's lactate, (3) whole HAF, and (4) HAF depleted from cells and proteins. Adhesion grade and histologic findings of adhesion-carrying tissues were evaluated and groups were compared according to these parameters. RESULTS: Rats treated with whole HAF had less adhesion grade when compared to the control group, but the difference was not statistically significant. On the other hand, centrifuged amniotic fluid treatment significantly reduced peritoneal adhesion grade, fibrosis and inflammation (p < 0.05). CONCLUSION: Whole HAF seems to have no beneficial effect on peritoneal adhesion formation, but HAF depleted of protein and cells does have a positive effect on reducing adhesion formation.


Asunto(s)
Líquido Amniótico , Peritoneo/patología , Peritoneo/cirugía , Complicaciones Posoperatorias/prevención & control , Adherencias Tisulares/prevención & control , Animales , Terapia Biológica , Modelos Animales de Enfermedad , Femenino , Fibrosis/complicaciones , Fibrosis/prevención & control , Inflamación/complicaciones , Inflamación/prevención & control , Complicaciones Posoperatorias/patología , Ratas , Ratas Wistar , Adherencias Tisulares/complicaciones , Adherencias Tisulares/patología
19.
J Reprod Med ; 58(11-12): 511-6, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24568046

RESUMEN

OBJECTIVE: To determine the role of vitamin D for preventing or reducing postoperative adhesions. STUDY DESIGN: The uterine horn adhesion model was carried out in 24 female Wistar rats. The animals were randomized into 4 groups: (1) control, (2) Ringer's lactate, (3) olive oil, and (4) vitamin D. Adhesion grade and histologic findings of adhesion-carrying tissues were evaluated, and groups were compared according to these parameters. RESULTS: Rats treated with vitamin D had less adhesion and lower inflammation grade when compared to the control and Ringer's lactate groups, and the results were statistically significant (p < 0.05). On the other hand, no difference was detected between the groups according to the fibrosis score. CONCLUSION: Vitamin D decreased postsurgical adhesion scores by both visual scores and histologic analyses in a rat model. Further experimental and clinical trials are required to confirm these results.


Asunto(s)
Adherencias Tisulares/prevención & control , Enfermedades Uterinas/prevención & control , Vitamina D/administración & dosificación , Animales , Modelos Animales de Enfermedad , Femenino , Fibrosis/patología , Inflamación/patología , Soluciones Isotónicas/administración & dosificación , Aceite de Oliva , Aceites de Plantas/administración & dosificación , Ratas , Ratas Wistar , Lactato de Ringer , Adherencias Tisulares/patología , Enfermedades Uterinas/patología , Útero/patología , Útero/cirugía
20.
J Pediatr Urol ; 9(1): e76-7, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23044375

RESUMEN

Congenital scrotal agenesis is the rarest anomaly of scrotal development disorder and is characterized by the absence of scrotal rugae in the perineum between the penis and anus. We report here a case of hemiscrotal agenesis in a 2-year-old boy. To the best of our knowledge, our patient is the second reported case of hemiscrotal agenesis in the English literature.


Asunto(s)
Enfermedades de los Genitales Masculinos/patología , Hernia Inguinal/patología , Perineo/anomalías , Escroto/anomalías , Preescolar , Enfermedades de los Genitales Masculinos/complicaciones , Enfermedades de los Genitales Masculinos/congénito , Hernia Inguinal/etiología , Humanos , Masculino
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