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WOS: 000430115300010, PubMed ID: 29558755, Objectives: The clinicopathological characteristics, treatment modalities, and effects on the prognosis of pure squamous cell carcinoma (SqCC) and adenocarcinoma (AC) were evaluated. Materials and Methods: 86 patients with pure SqCC and AC bladder cancer were evaluated retrospectively. Results: Of the 86 patients, 51 had SqCC and 35 had AC. No differences in clinicopathological characteristics were observed between patients with AC and SqCC, except for the prevalence of T4 disease (28.6% vs. 51.0%, respectively). In multivariate analysis, older age, stage IV disease, and Eastern Cooperative Oncology Group (ECOG) performance status (> 2) were predictive of a poor overall survival (OS). The median OS was significantly longer for stage I-III patients (82.9 months) treated with surgery +/- chemotherapy (CT) +/- radiotherapy (RT) than for those treated with transurethral resection +/- CT +/- RT (24.3 months) (P = 0.007). The median OS of patients with SqCC and AC who were given platinum-based CT for metastasis was 7.7 and 30.3 months, respectively. Conclusions: Advanced age, stage IV disease, and poor ECOG performance status were factors associated with a poor prognosis. Surgery +/- CT +/- RT resulted in significantly better OS, except in stage IV disease. Patients with metastatic AC had better response rates with platinum- based CT. (c) 2018 S. Karger GmbH, Freiburg

Backgrounds: The serum leptin level (SLL) has been shown to increase in patients with nonsmall cell lung cancer (NSCLC). However, available data regarding the relation between SLL and tumor subtypes, survival, cachexia, and tumor respectability in NSCLC are still under debate. The aim of this study is to evaluate SLL in NSCLC patients with and without cachexia. Materials and Methods: A total of 71 patients with early stage NSCLC were enrolled in this prospective study. SLL was measured by enzyme-linked immunosorbent assay. The relationship between SLL and clinicopathological factors including histopathological subtypes, weight loss, overall survival, and tumor resectability were evaluated. Results: Of the 71 patients, 57 (81%) were male with a mean age of 63.3 ± 8.2 years. The rates of histological subtypes of NSCLC were as follows: Squamous cell carcinoma 60.5%, adenocarcinoma 32%, and others 7.2%. Mean SLL was 12.9 ± 38.4 pmol/mL. There was no distinctive difference between SLL, weight loss, and survival. However, when stratifying the groups according to the lung cancer histological subtypes, mean SLL was significantly higher in patients with adenocarcinoma than those with squamous cell subtype (26.9 ± 6.2 pmol/mL vs. 5.1 ± 9.1 pmol/mL, P = 0.004). Conclusions: SLL might be beneficial as a useful biomarker in preclinical setting of NSCLC to guide detecting the lung cancer subtypes as well as monitoring the patients.

It is well-known that tumor phenotype may change during the progression of breast cancer (BC). The purpose in this study was to compare the discordance in estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) between primary and recurrent/metastatic lesions (RML) and also to evaluate the prognostic significance of change in tumor phenotype on survival in patients with metastatic BC.The medical records of 6638 patients with BC from two breast centers treated between 1992 and 2015 were retrospectively analyzed. Of the 6638 patients, 549 cases in whom recurrence was histologically proven by biopsy or by surgical resection were enrolled into this study.Our presentation 13.5% of the patients had metastatic disease. Biopsy on recurrence was obtained from distant metastasis sites in 250 (63.6%) patients or from locoregional soft tissues/lymph-nodes in 143 (36.4%). Receptor discordance in ER, PgR and HER2 expressions between primary and RML were 27.2% (p=0.32), 38.6% (p0.001) and 14.4% (p=0.007), respectively. Subsequent gain of ER and PgR showed significantly higher overall survival (OS) and post-recurrence survival (PRS) compared to the corresponding concordant-negative patients (119 vs 57 months, p=0.001 and 56 vs 31 months, p=0.03 for ER, 148 vs 58 months, p=0.003 and 64 vs 31 months, p=0.01 for PgR, respectively), hormone receptor (HR) loss was associated with worse OS. Similarly, HER2-loss cases experienced poorer PRS and OS outcomes, compared with those having stable HER2 expression (median 26 vs 60 months, p=0.009 for PRS and median 60 vs 111 months, p=0.06 for OS, respectively).This study confirmed the receptor discordance in ER/PgR and HER2 receptor expressions between primary and RML in patients with metastatic BC. As the loss of receptor expression is the most responsible factor for the discordance, treatments of recurrent/metastatic tumors should be individualized on the basis of molecular and genomic properties.

HER2-amplified breast cancer (BC) has a poor prognosis. The combination of trastuzumab with chemotherapy in the adjuvant setting decreases recurrence and improves overall survival in HER2-positive BC. However, the role of adjuvant treatment in patients with HER2-amplified small BC without lymph node involvement is still under debate. The purpose of this study was to investigate the safety of adjuvant paclitaxel and trastuzumab (APT) in this group of patients.A total of 87 operated early BC patients without lymph node involvement (N0) were treated with APT for 12 weeks followed by trastuzumab alone for a total of 9 months. Clinicopathological features and adverse events were analyzed.The median patient age was 50 years (range 28- 82), and 51% of them were postmenopausal. The median tumor diameter was 2.4 cm (range 0.5-6), with 51% of the patients having tumor size between 2 and 3 cm. Eighty-one percent of patients had invasive ductal carcinoma (IDC), and 64% had grade 3 tumors. Adjuvant hormone therapy and adjuvant radiotherapy were administered to 65 and 54% of patients, respectively. At a median follow up of 13 months (range 6-38), one patient (1.1%, 95% CI 0-3.4) experienced an asymptomatic decrease in left ventricular ejection fraction (LVEF) and 3 patients (3.4%, 95% CI 0-6.9) experienced grade 3 neuropathy.APT appears to be a safe combination in early-stage, HER2-amplified and node-negative BC.

The risk of breast cancer (BC) increases in parallel with increasing age. Despite the increased disease burden in elderly patients, there is still a great uncertainty regarding "how to manage" BC in aging-population. The purpose of this study was to investigate the clinicopathological features and treatment approaches of patients with BC aged 70 years or over.The medical records of 4413 patients with BC followed between 1994-2015 were retrospectively analyzed. Of the 4413 patients, 238 with stage I to III disease aged 70 years or over at BC diagnosis were enrolled into this study. Patients were divided into 2 groups according to the age as group 1 (70-79 years, N=192) and group 2 (80 or over, N=46). Clinicopathological features of patients including tumor histology, grade, estrogen (ER) and progesterone receptor (PgR) status, human epidermal growth factor receptor 2 (HER2) status, tumor size, lymph node involvement (LNI), lymphovascular invasion (LVI), perineural invasion (PNI), clinical stage, type of surgery, treatments and comorbid diseases were evaluated.The median age was 74 for group 1 (range 70-79) and 82 for group 2 (range 80-92). Excluding tumor size and grade, no statictically significant difference was found between the two groups according to histopathological characteristics. Patients in group 2 had more commonly larger T stage (T4), and less frequently presented with grade I tumor (p=0.014 and p=0.044, respectively). Modified radical mastectomy and adjuvant chemotherapy were more commonly performed in group 1 (p=0.001 and p=0.001, respectively). In contrast, neoadjuvant treatment was more frequently applied in group 2 (p=0.003). There was no difference in disease-free survival (DFS) between the groups (p=0.012), however, median overall survival (OS) was significantly higher in group 1 (p=0.03).Excluding the tumor grade and tumor size, both groups had similar histopathological features. However, patients aged between 70-79 years were likely to receive more agressive treatments for BC, indicating that treatment choice in patients over the age of 80 years was likely to be based on age-related factors rather than tumor characteristics.

This study aims to investigate the long-term relationship between gold prices per ounce and crude oil prices and Borsa İstanbul 100 Index. To this end, data of 3703 days between the years of 1997 and 2014 has been studied. “Augmented Dickey-Fuller and Philips Perron Unit Root Tests” revealed that the variables were stationary at first difference, yet it was found through “Johansen Cointegration” analysis that there exists an vector showing a long term relationship between the variables. However, the coefficient of the vector error correction term reflecting on the long-term relationship between the variables provided above was statistically insignificant and the variables did not have the long-term balance relationship. These findings support the fact that, as a means of investment, gold is used as an alternative to shares

Companies should understand the events correctly and produce appropriate solutions within the framework of a good plan to protect and develop their current situation. For companies, the possibility of surviving is parallel with the accuracy of these predictions in increasing competition environment. According to this idea, demand forecast has vital importance for all companies. The purpose of the forecast is to predict situations companies may face in the future, using different data and techniques and take action in advance. Demand forecasting is to determine the demand level of a product or some products of a company for a specific time in the future. There are many methods used to forecast demand which are critical for companies. İn this study, explained demand forecasting methods and made literature survey.

Aim of the study: We compared stone size, localization, complaint at the time of applying, comorbidity, treatment and complications between older (60 years of age and older) and younger patients with urolithiasis (59 years of age and younger). Materials and Methods: We retrospectively reviewed the records of 950 consecutive patients who presented to our clinic and underwent surgery for urolithiasis from January 2007 to March 2012. The patients were divided into two groups: patients ≥ 60 years an patients < 60 years. Results: There were 174 men and 61 women in elderly group, 528 men and 187 women in younger group. Ureteral stones were found more often in the younger group compared to elderly patients (p < 0.05). Conversely, bladder stone was more frequent in the elderly group. In the elderly group comorbidities are more frequent (diabetes mellitus, hypertension, ischemic heart disease, congestive heart disease, osteoarthritis and chronic obstructive lung). Patients ≥ 60 years significantly had larger kidney and bladder stones compared the younger, but ureteral stone sizes were not statistically different between the two groups. Older patients had a higher postoperative complication rate than younger patients (16% versus 3%, p < 0.05) although postoperative complications (e.g. urinary retention, cardiac dysrythmia, fever, constipation) were not serious and resolved with medical treatment. The average length of stay in hospital was longer in the elderly group, but the difference was not statistically significant. Conclusions: Elderly patients with urolithiasis usually have larger and more complex stone disease, more comorbidities and atypical presentation.

Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. As we know that obesity is a risk factor for stress urinary incontinence (SUI), in this study we compared the VAI levels between the women with SUI and without SUI. Two hundred and twenty-nine women were included in the study: 125 women with SUI and 104 women without SUI (control). All women were evaluated for SUI. We accessed the women for SUI at gynecologic position, and we performed cough stress test. In the calculations, continence was defined as no incontinence at all. Mean age was 52.1 (29–73) in women who have SUI and 50.8 (31–65) in control women. The women with SUI had higher BMI, TG levels, higher WC and lower HDL-C levels. Mean VAI level was 5.21 ± 2.61 in study group and 3.49 ± 1.78 in control group, respectively. VAI levels were statistically higher in women with SUI (p

Endothelial dysfunction and microvascular damage play a crucial role in the pathogenesis of erectile dysfunction (ED). Lp-PLA2 is a calcium-independent member of the phospholipase A2 family and hydrolyses oxidised phospholipids on low-density lipoprotein (LDL) particles that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between Lp-PLA2 levels and ED in patients without known coronary artery disease (CAD). All patients were evaluated for ED and divided into two groups: 88 patients suffering from ED for >1 year were enrolled as an experimental group and 88 patients without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of Lp-PLA2 were measured in serum by colorimetric assay. The relationship between Lp-PLA2 levels and ED in patients was evaluated statistically. The mean age of patients with ED group was 59.4 ± 11.32 and 55.8 ± 9.67 in the control group. Plasma Lp-PLA2 levels were significantly higher in ED than in the control group (220.3 ± 66.90 and 174.8 ± 58.83 pg ml(-1) , respectively, P < 0.001). The Lp-PLA2 levels were negatively correlated with score of ED (r = -0.482, P < 0.05). In logistic regression analysis, enhanced plasma Lp-PLA2 levels result in approximately 1.2-fold increase in ED [1.22 (1.25-2.76)]. In this study, serum Lp-PLA2 levels were found to be associated with endothelial dysfunction predictive of ED. Serum Lp-PLA2 level appears to be a specific predictor of ED, and it may be used in early prediction of ED in the male population.

Objectives To evaluate the relationship between varicocele and benign prostatic hyperplasia/lower urinary tract symptoms in patients over the age of 40 years. Methods A total of 1040 patients with benign prostatic hyperplasia/lower urinary tract symptoms were evaluated for prostate volume, testicular volume, testicular consistency, total testosterone, total prostate-specific antigen and body mass index. A questionnaire including International Prostate Symptom Score and a uroflow test were also carried out. The presence and grade of varicocele was determined in each patient by physical examination. Results Varicocele was found bilaterally in 22.3% and unilaterally in 25.7% of the patients. There was no difference in terms of age and body mass index distribution between subgroups. When grouping patients for varicocele laterality, total testosterone (P = 0.04), prostate volume (P = 0.009) and total prostate-specific antigen (P = 0.02) level were significantly different. Similarly, these parameters were significant between patients with grade 1, 2 and 3 varicocele. Total testosterone level (P = 0.02) and prostate volume (P = 0.035) were found to be significantly different when patients were grouped according to testicular size. A positive correlation was found between testosterone level and prostate volume (P = 0.004; r2 = 0.084). Conclusions Bilateral and/or higher-grade varicocele is associated with lower prostate volume and testosterone levels, as well as lower prostate-specific antigen levels. However, it is not associated with dynamic components of benign prostatic hyperplasia/lower urinary tract symptoms in patients over the age of 40 years.

Background: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. Results: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p

We evaluated the potential protective effect of hydrogen sulfide (H2S) against GEN-induced nephrotoxicity in rats.Twenty-four rats were randomly divided into four groups, each consisting of six animals as follows: (1) the rats were control, (2) intraperitoneally injected with GEN 14 consecutive days (100 mg/kg/day), (3) treated with GEN plus %0.9 saline intraperitoneally for 14 days and (4) treated with GEN plus sodium hydrogen sulfide (NaHS)-exogenous H2S donor (56 µmol/kg/day) for 14 days. After 15 days, rats were sacrificed and their kidneys were taken and blood analysis was performed. Twenty-four hours urine collections were obtained in standard metabolic cages a day before the rats were sacrificed. Tubular necrosis and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH) levels were determined in the other part of kidneys. Statistical analyses were made by the chi-squared test and one-way analysis of variance.Serum urea and creatinine levels were significantly higher in rats treated with GEN alone, than the rats in control and GEN + NaHS groups. The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of NaHS to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and NaHS had significantly lower MDA and NO levels in kidney cortex tissue than those that was given GEN alone. In rats treated with GEN + NaHS, despite the presence of mild tubular degeneration and tubular necrosis are less severe, and glomeruli maintained a better morphology when compared with GEN group.We can say that H2S prevent kidney damage with antioxidant and anti-inflammatory effect.

Pirpose: The aim of this study to analyze the association between history of diabetes mellitus (DM) with risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. Materials and Methods: 50 patients with DM and 50 patients without DM who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ≥7 were considered high grade and

In the present study, we prospectively collected data from pre- to postmenopausal women with or without metabolic syndrome (MetS) and evaluated the impact of MetS on stress urinary incontinence (SUI) in women. The women divided into four equal groups: premenopausal with and without MetS; postmenopausal with and without MetS. There were 100 women in each group. We assessed the women for SUI at gynecologic position and we determined cough stress test. MetS was defined according to the criteria established in 2005 by the NCEP/ATP III. Mean age was 48.52 ± 8.16 in women with MetS and 48.81 ± 8.31 in women without MetS. SUI was found more often in both pre- and postmenopausal women with MetS (p = 0.001 and p

Diskapi Education & Research Hospital, Department of Medical Oncology, Ankara, Turkey *Author for correspondence: Tel.: +90 312 596 2854; Fax: +90 312 318 6690; m_f_karatas@hotmail.com

Purpose: To compare histopathologic findings of patients who underwent transurethral resection of a bladder tumor (TUR-B) between groups with and without the metabolic syndrome. Materials and Methods: We retrospectively analyzed data of 535 patients who underwent TUR-B in our department between October 2005 and March 2011. All patients had primary urethelial cell carcinoma (UCB). Histologic stage, grade, the presence of hypertension, diabetes mellitus, body mass index (BMI), waist circumference, HDL and trigliseride levels were evaluated. The TNM classification was used, with Ta tumor accepted as lower stage and T1 and T2 tumors as higher stage bladder cancers. Also, the pathological grading adopted by the 2004 World Health Organization grading system were applied. Non-invasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. Results: Among the total of 509 patients analyzed in our study, there were 439 males (86.2%) and 70 females (13.8%). Metabolic syndrome was significantly associated with high histologic grade, and high pathologic stage (p

Endocrine therapy-induced hair loss (ETIHL) associated with aromatase inhibitors and tamoxifen treatment is currently mostly reported but remained an unresolved therapeutic issue in patients with breast cancer (BC) since the number of studies regarding the management is limited in literature. Herein we investigated the possible causes of this clinical problem and its relation with endocrine therapies widely used for BC survivors and made some modest practical recommendations in light of the literature review in order to provide an optimal management. On the basis of literature findings, common causes of hair loss apart from endocrine therapies should be investigated with an initial evaluation workup and then should be corrected, if observed. Treatment with topical 5-alpha reductase inhibitors and supplementation of Vitamin C and omega-3 fatty acids are likely appeared to be the most appropriate treatment agents for ETIHL without causing an adverse effect on BC prognosis. However, more prospective, randomised, placebo-controlled studied are required in order to confirm our results and also identify the clinical effects of this problem on patients with BC.

e13100Background: Body mass index (BMI) is defined as a poor prognostic factor in patients with breast cancer (BC). However, there are controversial results regarding the various effects of BMI on ...

e12062Background: Tumor phenotype may alter during the progression of breast cancer (BC). Our aim in this study is to compare the discordance in estrogen receptor (ER) / progesterone receptor (PR) ...

Aromatase inhibitors (AIs) are standard of care in the adjuvant setting of postmenopausal women with hormone receptor positive breast cancer. Despite their beneficial effects on survival outcomes in breast cancer, AIs-induced arthralgia (AIA) is a common side effect which may lead to drug discontinuation and decreased AIs adherence among patients. So far, the exact pathophysiology of AIA is still an unclarified condition that explains why the optimal treatment in its management has not yet been established. Moreover, studies regarding the alternative treatment options for AIA are limited due to small sample size. Herein, we report a summary of current treatment options and their effectiveness in AIA with a practical algorithm in light of the relevant literature.

Heart metastasis of renal cell carcinoma (RCC) without vena cava inferior involvement is exceptionally rare. Here, we presented a case of RCC presenting with the right ventricle metastasis without inferior vena caval and right atrial involvement.

Chronic lymphocytic leukemia (CLL) is the most common leukemia worldwide. Skin lesions associated with CLL mostly develop on the bases of infectious or a hemorrhagic origin with an estimated incidence of 25% of all the cases. Kaposi sarcoma (KS)-associated with human herpes virus-8 infection is a spindle-cell, malignant, low-grade tumor originating from vascular and lymphatic endothelium. KS mostly presents with skin lesions as the initial presentation. The relation between these two pathologies has not yet been clarified up to date. Herein, we report a case of KS along with CLL to illustrate the possible relation between these two pathologies.

Background Extrapulmonary small cell carcinoma (SmCC), also known as oat cell carcinoma or small cell neuroendocrine carcinoma, is characterized by an aggressive clinical course with early metastasis pattern and a short life expectancy. So far, there is no prospective, data-based case-control study due to its low incidence. The purpose of this paper is to discuss the epidemiology, morphopathology, clinical characteristics, differential diagnosis and treatment of bladder SmCC in the light of the literature. Scope PubMed and American Society of Clinical Oncology Meeting abstracts were searched according to the following keywords: 'extrapulmonary SmCC', 'bladder cancer', and 'therapeutic approach'. The last search was performed on 1 October 2015. Some additional papers were determined by reviewing references of the appropriate articles. Most of the data regarding small cell carcinoma of the urinary bladder (SmCCB) were found to be based on the retrospective trials. Findings Bladder SmCC is more frequent in men and usually appears in the seventh to eighth decades. Macroscopic hematuria is the most common clinical symptom. The diagnosis of SmCCB is performed based on the same criteria determined by the WHO classification for the diagnosis of small cell lung carcinoma (SCLC). Prognosis is closely correlated with the stage at presentation. Although the prognosis of the disease is poor, a long survival can be achieved particularly by radical surgery following neoadjuvant chemotherapy in patients with early stage tumors. Cystectomy is still the current standard local treatment. However, cystectomy alone is not sufficient. Chemotherapy and definitive radiotherapy should be preferred for limited disease in patients who are not candidate for surgery. Conclusion Considering the poor prognosis of the disease, further studies are needed to determine the optimal treatment options and new molecular markers in the way of early diagnosis and favorable outcomes. Prospective, multicenter, randomized studies are required to evaluate the role of neoadjuvant chemotherapy followed either by surgery or radiotherapy.

Sir, Insulin glargine (LANTUS® SOLOSTAR®; Sanofi Aventis, Deutschland) – relatively a new medication in the treatment of diabetes mellitus – is a long-acting insulin for meeting the basal insulin requirement with an ongoing effect up to 24 h.[1,2] In literature, there are small number of cases regarding with overdose use of insulin glargine. One of these cases with regard to insulin glargine overdose was by Lu and Inboriboon, who had reported a case of suicide attempt with 2700 units of insulin glargine resulting 96 h of hypoglycemia.[3] Herein, we report another case of insulin glargine overdose resulting 120 h of hypoglycemia in a diabetic patient who had attempted suicide with 3600 units of insulin glargine. To our knowledge, this is the highest reported insulin glargine dose ever. In this present case, a 45-year-old-male patient with type-2 diabetes mellitus and major depression was admitted to emergency department with the loss of consciousness after self-administered 3600 units of insulin glargine. Patient's laboratory findings on admission were as follows: Blood glucose level - 20 mg/dl, potassium - 2,8 mmol/L, serum level of sulfonylurea - 0,0 mg/μL, C-peptide - 0.0956 (0.51–2.7 ng/mL normally), and serum insulin value - 216 mU/L (2.6–25 normally). Patient treated with continuous intravenous dextrose infusion and 1 mg of glucagon hydrochloride. On follow-up, the patient needed 120 h of intravenous glucose infusion for the recurrent hypoglycemic episodes. At the end of the 5th day, no hypoglycemia attack was observed. The patient discharged without any permanent complications on the 6th day of hospitalization. Then, he referred to a psychiatry clinic. Hypoglycemia is the most frequent side effect of insulin glargine. The timing of hypoglycemia and its duration differs according to the insulin formulations. Insulin glargine is known to have no peak effect. The plasma concentration versus time profile of insulin glargine is relatively more stable with no peak in 24 h compared to conventional human insulin.[4,5] This allows once-daily administration as basal therapy. However, overdose use of insulin glargine may rarely present with prolonged hypoglycemia attacks.[3] As a result, we aimed to emphasize in this letter that emergency and intensive care physicians should be aware of overdose use of insulin glargine present with prolonged hypoglycemia attacks. In these cases, intensive care physicians should immediately initiate continuous dextrose infusions, and the patients should be monitored closely with frequent blood glucose samples to prevent the risk of prolonged hypoglycemia episodes. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Poor sleep quality (SQ) is increasingly recognized as giving rise to decreased quality of life, and raising pain perception. Our aim is to evaluate the SQ in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor alpha (anti-TNF-α) therapy. This was a prospective observational and open-label study of RA patients. A total of 35 patients with RA were enrolled in this study. Of the 35 patients, 22 had high disease activity (DA), and 13 were in remission. High DA group was initiated an anti TNF-α therapy. Clinical and objective parameters of SQ were assessed by using the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG). The total PSQI score and the frequency of poor SQ were high in 60 % of the RA patients. The median PSQI score was significantly higher in the high DA group than in the remission group (P = 0.026). Following an anti-TNF-α therapy initiation, significant improvements were observed in the high DA group by PSQI test (P = 0.012). However, no statistically significant difference was found by PSG (P > 0.05). Although an improvement in DA with anti-TNF-alpha therapy did not provide an amelioration in laboratory parameters, we found a significant improvement in SQ by subjective PSQI test. These findings may support that sleep disorders in RA are likely to be associated with a complex pathophysiology.

Endothelial dysfunction and microvascular damage play a crurical role in the pathogenesis of erectile dysfunction (ED). Insulin-like growth factor-1 (IGF-1) is one of the growth factors that have a wide range of biologic effects. IGF-1 is an important mediator of cell growth, differentiation and transformation in various tissues. The purpose of the current study was to determine the association between IGF-1 levels and ED.All men were evaluated for ED and divided into two groups: 80 patients suffering from ED for 1 year and 80 subjects without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. IGF-1 levels were measured in serum by an automated chemiluminescence immunoassay. The relationship between IGF-1 levels and ED scores in patients was statistically evaluated.The mean age of patients in ED group was 60.4 ± 11.3 years and 55.4 ± 9.6 in control group. The plasma IGF-1 levels were significantly lower in ED than in control group (96.5 ± 38.3 and 132.5 ± 53.3 ng/ mL, respectively, P 0.001). The IGF-1 levels were positively correlated with ED score (r = 0.623, P 0.01).In this study serum IGF-1 levels were found to be associated with endothelial dysfunction that predicts ED. Serum IGF-1 level appears to be a specific predictor of ED, and it might be used in early prediction of ED in male population.La dysfonction endothéliale et les altérations vasculaires jouent un rôle crucial dans la pathogenèse de la dysfonction érectile (DE). L’Insulin-like Growth Factor-1 (IGF-1) est l’un des facteurs de croissance qui ont un vaste champ d’effets biologiques. IGF-1 est un médiateur important de la croissance, différentiation et transformation cellulaires dans différents tissus. Le but de la présente étude était de rechercher une association entre les taux d’IGF-1 et la dysfonction érectile.La dysfonction érectile a été évaluée chez tous les hommes, constitués en 2 groupes : 80 patients souffrant de DE depuis plus d’un an, et 80 sujets sans DE recrutés comme groupe témoin dans l’étude. Le diagnostic de DE était basé sur le score 5 de l’Index International de la Fonction Erectile. Les taux d’IGF-1 ont été mesurés par immunodosage automatisé par chemiluminescence. La relation entre les taux d’IGF-1 et le score de la DE a été statistiquement évaluée.L’âge moyen des patients du groupe DE était de 60.4±11.3 ans et de 55.4±9.6 dans le groupe témoin. Les taux plasmatiques d’IGF-1 étaient significativement plus bas dans le groupe DE que chez les témoins (respectivement 96.5±38.3 et 132.5±53.3 ng/mL, P0.001). Les taux d’IGF-1 étaient positivement corrélés au score de la DE (r = 0.623, P0.01).Nos résultats indiquent que les taux sériques d’IGF-1 sont associés à une dysfonction endothéliale qui prédit la DE. L’IGF-1 sérique apparaît être un prédicteur spécifique de la DE, et il pourrait être utilisé pour une prédiction précoce de la DE dans la population masculine.

Introduction/Objective: Ureteral obstruction is a common pathology and causes kidney fibrosis and dysfunction at late period. In this present study, we investigated the antifibrotic and antiinflammatory effects of hydrogen sulfide on kidney damage after unilateral ureteral obstruction (UUO) in rats. Materials and Methods: 24 rats were divided into four groups. Group 1 was control, group 2 was sham, group 3 included rats with UUO and group 4 rats with UUO which were given sodium hydrogen sulfide (NaHS)-exogenous donor of hydrogen sulfide (intraperitoneally 56μmoL/kg/day). After 14 days, rats were killed and their kidneys were taken and blood analysis was performed. Tubular necrosis, mononuclear cell infiltration and interstitial fibrosis were determined histopathologically in a part of the kidneys; nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH) levels were determined in the other part of the kidneys. Urea-creatinine levels were investigated by blood analysis. Statistical analyses were made by the Chi-square test and one-way analysis of variance (ANOVA). Results: There was no significantly difference for urea-creatinine levels among groups. Pathologically, there was serious tubular necrosis and fibrosis in group 3 and there was significantly decreasing of tubular necrosis and fibrosis in group 4 (p

Background: Calcium-sensing receptor gene (CaSR) might be a strong component of the complex genetic background regulating calcium excretion and stone formation in kidney. The polymorphisms in different parts of the gene could be associated with calcium stone formation. Objective: The individual studies indicate a correlation between CaSR gene polymorphisms and urolithiasis but not sufficient to draw a precise result. We aimed to search literature to come to a reliable conclusion through a systematic review. Materials and methods: We have serached individiual studies regarding the issue and high quality reviews. We assessed all the studies to draw a conclusion. Conclusion: The genetic background of the neprolithiasis is an interesting issue deserving to be disscussed on. Regading genes of which, CaSR gene polymorphisms is the leading one, are studied in many individual studies but they are not sufficient to have a precise conclusion. Well-oriented and documented, phenotypically homogenous large coh...

Purpose: The aim of this study was to analyze any association between the metabolic syndrome (MetS) and risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. Materials and Methods: 50 patients with MetS and 50 patients without MetS who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ≥7 were considered high grade and

Background: Relationships between smoking and bladder neoplasms, one of the common malignancies, are well-known. Different smoking-related malignancies may occur together. In this study, we evaluated the stage and grade of bladder neoplasms in patients also featuring lung or larynx cancer. Materials and Methods: From January 2006 to February 2012, patients who underwent surgery for bladder neoplasms in our clinic were screened retrospectively. In the evaluation, 5 patients had larynx cancer and 20 patients have lung cancer in addition, all having been smoking for a long time. The bladder tumor stage and grade were investigated in these 25 cases. Results: Mean age of patients was 66.8 (49-78). In the evaulation, all of 5 patients who had larnyx cancer also had high grade urothelial cancer. One had T2 urothelial, and 3 T1 urothelial cancer. In the same way, all of the 20 patients with lung cancer also have high grade urothelial cancer, three T2, and 13 T1. Bladder cancer stage and grade were determined to be significantly increased in patients with concomitant bladder and lung or larynx cancer. Conclusions: In the patients who have smoking releated second malignancy, bladder cancer prognosis appears more aggressive. We now need a larger series and multi-center studies for understanding relevant pathophysiology.

WOS: 000353402400009 PubMed ID: 24824329 Female sexual dysfunction is a prevalent and multidimensional disorder related to many biological, psychological, and social determinants. The authors assessed the effect of one of the many factors affect sexual function-metabolic syndrome-on female sexual function. They equally divided 400 women participants among 4 groups: (a) premenopausal with metabolic syndrome, (b) premenopausal without metabolic syndrome, (c) postmenopausal with metabolic syndrome, and (d) postmenopausal without metabolic syndrome. The authors used the Female Sexual Function Index to assess women's sexual function. Female sexual dysfunction was found more often in both pre- and postmenopausal women with metabolic syndrome (p =.001). Overall Female Sexual Function Index score and satisfaction, pain, and desire domain scores independently of the menopause status showed statistically significant differences across women with metabolic syndrome in comparison with participants with no metabolic syndrome (p

INTRODUCTION AND OBJECTIVES: Magnetic resonance imaging (MRI) is a diagnostic imaging method that can be used to assess indeterminate renal masses on computed tomography (CT). However, the diagnostic accuracy of MRI differs depending on the type of the benign tumor. In addition, the ability of MRI to distinguish between renal cell carcinoma (RCC) and benign renal masses has not been fully evaluated. Therefore, we evaluated the diagnostic accuracy of magnetic resonance imaging (MRI) in distinguishing renal cell carcinoma (RCC) from indeterminate renal masses on computed tomography (CT) and investigated the impact of MRI on clinical decision making. METHODS: A retrospective study was conducted in 120 patients who performed MRI to distinguish RCC from indeterminate renal mass on CT. The diagnostic accuracy of CT and MRI was compared, and factors associated with a final diagnosis of RCC were evaluated using multivariate logistic regression analysis. RESULTS: Of the 120 patients, 47 (39.2%) had benign masses, including 32 (26.7%) AMLs, five (4.2%) oncocytomas and 10 (8.3%) complicated cysts. The specificity of MRI was significantly superior to that of CT in diagnosing RCC (68.1% vs. 27.7%, p1⁄40.001), whereas the sensitivity was equivalent (91.8% vs. 94.5%, p1⁄40.754). Multivariate analysis showed that, female gender (odds ratio [OR]; 0.11, p