The best method for erection function in urethroplasty; is excision and primary anastomosis or buccal mucosal graft urethroplasty?

INTRODUCTION

The aim of this study is to evaluate and compare erection function (EF) after Excision and Primary Anastomosis Urethroplasty (EPAU) and Buccal Mucosal Graft Urethroplasty (BMGU) in bulbar urethral stricture.

METHODS

Patients who underwent urethroplasty were identified retrospectively. The criteria for inclusion in the study were determined as being over 18 years old and under 70 years old, being sexually active. Exclusion criteria are; preoperative severe erectile dysfunction, stricture outside the bulbar urethra, psychosocial incompatibility, urethral stricture related to pelvic fracture, follow-up time less than a year. As the primary endpoint, the International Index of Erectile Function-5 (IIEF-5) was determined as a comparison of EF in the preoperative and third, sixth and twelfth months after surgery. The secondary endpoint was the evaluation of the effects of demographic data, stricture and treatment characteristics on EF.

RESULTS

Fifty patients were identified considering the inclusion/exclusion criteria. It was observed that there were 30 patients who underwent EPAU and 20 patients who underwent BMGU. At the third month after surgery, EF showed a statistically significant decrease in the EPAU group. In both patient groups, it was observed that the early negative effects after the operation in EF started to improve in the sixth month and returned to the baseline level by the first year.

CONCLUSION

EPAU and BMGU techniques have a similar effect on EF in the medium and long term. Both methods can be used safely and effectively in the appropriate patient group.

Could Prognostic Nutritional Index be a new criteria for active surveillance of prostate cancer?

OBJECTIVE

To evaluate the importance of the Prognotic Nutritional Index(PNI) value for patient selection of active surveillance(AS) in prostate cancer.

METHODS

Between September 2020 and June 2022, the data of 125-patients who underwent Robot-Assisted-Laparoscopic-Prostatectomy(RALP) were retrospectively analyzed. All patients were suitable for AS preoperatively. Using the pathological results of RALP, patients have been divided two groups. Patients who met the criteria for AS were defined as the first group, others were defined second. Demographic datas, PNI values and hematological parameters of the groups were compared.

RESULTS

38% (n:48) patients were found suitable for the group1, and 62%(n:77) were found suitable for the group 2. Upgrading and upstaging were found at 76 patients (61%) and 26(21%), respectively. There is no significant difference between groups on age, BMI, PSA, PSA-density, prostate volume, and PIRADS. PNI value was found higher at first group. The value of 49.45 was calculated by ROC analysis as the ideal PNI cut-off value for predicting upgrading and upstaging of prostate cancer (P < ,001). According to the both univariate and multivariate regression analysis, PNI was found a predictor for exclusion from AS (P < ,001).

CONCLUSION

Upgrading and upstaging are detected at a higher rate in patients with low PNI values. The use of PNI value in the selection of patients to AS will increase the success rate of ideal patient selection.

Decreases in ganglion cell layer and inner plexiform layer volumes correlate better with disease severity in schizophrenia patients than retinal nerve fiber layer thickness: Findings from spectral optic coherence tomography

Background

Optic coherence tomography (OCT) is a new, contactless and fast neuroimaging method. Previous studies have observed thinning of the retinal nerve fibre layer (RNFL) in many neurodegenerative diseases, and researchers have suggested that correlations exist between the thinning of the RNFL and the neurodegeneration detected with other imaging methods or the severity of illness. More recently, OCT has been used in patients with schizophrenia. RNFL thinning has also been detected in these patients. With more sophisticated devices, segmentation of the retina and measurements of the ganglion cell layer (GCL) and internal plexiform layer (IPL) can be performed.

Methods

We measured the RNFL thickness and the GCL and IPL volumes in 40 treatment refractory patients with schizophrenia, 41 treatment responsive refractory patients and 41 controls using spectral-OCT, and we evaluated the correlations between the disease severity and OCT measurements.

Results

The global RNFL thickness and GCL and IPL volumes were decreased in the patients with schizophrenia compared with the controls. In addition, the GCL and IPL volumes were lower in the treatment refractory patients with schizophrenia compared to the treatment responsive patients. Using parameters such as the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scores, the disease duration and number of hospitalizations, correlations between the GCL and IPL volumes and disease severity were stronger than the correlations between the RNFL and the disease parameters.

Conclusion

Our findings suggest that OCT can be used to detect neurodegeneration in schizophrenia and that the GCL and IPL volumes can also be used to monitor the progression of neurodegeneration.

Evaluation of amalgam-related retinal neurotoxicity with optical coherence tomography findings

PURPOSE

To evaluate the neurotoxic effect of amalgam dental fillings on plasma mercury (Hg) levels and retino-choroidal layers measured by spectral domain optical coherence tomography (SD-OCT).

MATERIALS/METHODS

Study participants included 56 cases with amalgam dental fillings and 44 healthy controls. All participants were examined in terms of detailed ophthalmic examination, oral examination, and body mass index (BMI). The measurement of retinal layers and choroid was performed using SD-OCT. Venous blood samples were collected and blood Hg levels were measured using cold vapor atomic absorption spectrometric analysis. Correlations between SD-OCT measurement results and blood Hg levels were analyzed.

RESULTS

There were no differences between groups in terms of age, sex, or BMI. The mean blood Hg level was 2.76 ± 1.21 µg/L in the amalgam group and 2.06 ± 1.15 µg/L in the control group ( p = 0.04). The Hg/BMI ratio was 0.12 ± 0.06 kg/m² in the amalgam group and 0.09 ± 0.05 kg/m² in the control group ( p = 0.01). Reduced volumes of ganglion cell layer and inner plexiform layer were observed in the amalgam group when compared with the control group ( p < 0.05).

CONCLUSION

Amalgam dental fillings can cause retinal neurotoxicity. SD-OCT can be useful for evaluating amalgam-related retinal neurotoxicity.

Decreases in ganglion cell layer and inner plexiform layer volumes correlate better with disease severity in schizophrenia patients than retinal nerve fiber layer thickness: Findings from spectral optic coherence tomography

BACKGROUND

Optic coherence tomography (OCT) is a new, contactless and fast neuroimaging method. Previous studies have observed thinning of the retinal nerve fibre layer (RNFL) in many neurodegenerative diseases, and researchers have suggested that correlations exist between the thinning of the RNFL and the neurodegeneration detected with other imaging methods or the severity of illness. More recently, OCT has been used in patients with schizophrenia. RNFL thinning has also been detected in these patients. With more sophisticated devices, segmentation of the retina and measurements of the ganglion cell layer (GCL) and internal plexiform layer (IPL) can be performed.

METHODS

We measured the RNFL thickness and the GCL and IPL volumes in 40 treatment refractory patients with schizophrenia, 41 treatment responsive refractory patients and 41 controls using spectral-OCT, and we evaluated the correlations between the disease severity and OCT measurements.

RESULTS

The global RNFL thickness and GCL and IPL volumes were decreased in the patients with schizophrenia compared with the controls. In addition, the GCL and IPL volumes were lower in the treatment refractory patients with schizophrenia compared to the treatment responsive patients. Using parameters such as the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scores, the disease duration and number of hospitalizations, correlations between the GCL and IPL volumes and disease severity were stronger than the correlations between the RNFL and the disease parameters.

CONCLUSION

Our findings suggest that OCT can be used to detect neurodegeneration in schizophrenia and that the GCL and IPL volumes can also be used to monitor the progression of neurodegeneration.

Impact of Added Encapsulated Phosphate Level on Lipid Oxidation Inhibition during the Storage of Cooked Ground Meat

The effect of levels (0.1%, 0.2%, 0.3%, 0.4%, 0.5%) of added encapsulated (e) phosphate (sodium tripolyphosphate, STP; sodium hexametaphosphate, HMP; sodium pyrophosphate, SPP) on lipid oxidation inhibition during storage (0, 1, and 7 d) of ground meat (chicken, beef) was evaluated. The use of eSTP and eSPP resulted in lower and higher cooking loss (CL) compared to eHMP, respectively (P < 0.05). Increasing encapsulated phosphate level (PL) enhanced the impact of phosphates on CL in both chicken and beef samples (P < 0.05). Encapsulated STP increased pH, whereas eSPP decreased pH (P < 0.05). pH was not affected by PL. The highest orthophosphate (OP) was obtained with eSTP, followed by eSPP and eHMP (P < 0.05). The level of OP determined in both chicken and beef samples increased (P < 0.05) during storage. Increasing PL caused an increase in OP (P < 0.05). The highest reduction rate in the formation of thiobarbituric acid reactive substances (TBARS) and LPO for both meat species were obtained with eSPP, followed by eSTP and eHMP (P < 0.05). Increasing PL resulted in lower TBARS and LPO (P < 0.05). Findings suggest that encapsulated phosphates can be a strategy to inhibit lipid oxidation for the meat industry and the efficiency of encapsulated phosphates on lipid oxidation inhibition can be enhanced by increasing PL.

Effects of Different End-Point Cooking Temperatures on the Efficiency of Encapsulated Phosphates on Lipid Oxidation Inhibition in Ground Meat

Effects of 0.5% encapsulated (e) phosphates (sodium tripolyphosphate, STP; sodium hexametaphosphate, HMP; sodium pyrophosphate, SPP) on lipid oxidation during storage (0, 1, and 7 d) of ground meat (chicken, beef) after being cooked to 3 end-point cooking temperatures (EPCT; 71, 74, and 77 °C) were evaluated. The use of STP or eSTP resulted in lower (P < 0.05) cooking loss (CL) compared to encapsulated or unencapsulated forms of HMP and SPP. Increasing EPCT led to a significant increase in CL (P < 0.05). Both STP and eSTP increased pH, whereas SPP and eSPP decreased pH (P < 0.05). The higher orthophosphate (OP) was obtained with STP or SPP compared to their encapsulated counterparts (P < 0.05). The lowest OP was determined in samples with HMP or eHMP (P < 0.05). A 77 °C EPCT resulted in lower OP in chicken compared to 74 and 71 °C (P < 0.05), dissimilar to beef, where EPCT did not affect OP. In encapsulated or unencapsulated form, using STP and SPP enhanced reduction in TBARS and lipid hydroperoxides (LPO) compared with HMP (P < 0.05). Regardless of the phosphate type, more effective lipid oxidation inhibition was achieved by the use of encapsulated forms (P < 0.05). Increasing EPCT resulted in lower TBARS in beef and higher LPO values in both beef and chicken samples (P < 0.05). Findings suggest that encapsulated phosphates can be a strategy to inhibit lipid oxidation for meat industry and the efficiency of encapsulated phosphates on lipid oxidation inhibition can be enhanced by lowering EPCT.