Endoscopic treatment of multiple prostatic calculi causing urinary retention

Although prostatic calculi are relatively common, the etiology of these stones is not clear. We report a case with multiple prostatic calculi causing urinary obstruction and a concomitant bladder stone. We treated these stones endoscopically. We found a lot of different sized stones endoscopically, some protruding into the urethra, some filling different cavities on the prostate. So these cavities suggest prostatic calculi may occur related to intraprostatic reflux in the congenital or acquired diverticulum of the prostatic tissue. In addition, the stone composition of the bladder and prostatic stones was the same. All of these results show that the origin of bladder and prostatic stones can be the same. This case also supports a theory of intraprostatic reflux and urine stasis.     

Localized crossed hyperhidrosis and the coexistence of thyroid gland disease

Hyperhidrosis is the most common type of sweat gland disorder. It may be localized or generalized. The localized type usually occurs in a symmetrical fashion over the palms, soles and armpits as a response to emotional stimuli. Another form of the localized type is idiopathic localized unilateral hyperhidrosis which is very rare and the etiopathogenesis remains unclear. Here, we report a female patient who had localized crossed hyperhidrotic areas on her body (on the left side of the scalp, face and the shoulder and on the right side of the trunk) and also had thyroid gland disease. We herein discuss this extremely rare presentation of the disease and its association with thyroid gland disease.     

Color Doppler sonography examination of partially obstructed kidneys associated with ureteropelvic junction stone before and after percutaneous nephrolithotripsy: Preliminary report

AIM: To evaluate resistive index (RI) changes before and after unilateral percutaneous nephrolithotripsy in chronic partially obstructed kidneys due to ureteropelvic junction (UPJ) stones. METHODS: Intrarenal RI of obstructed and contralateral normal kidneys of 18 patients were recorded immediately before the operations and at postoperative days 1, 7 and 30. Postoperative RI measurements were compared with baseline values for all patients without grouping and separately for different groups according to the preoperative RI value of the obstructed kidney. RESULTS: Mean age and symptom duration were 27.5 years and 43.8 weeks, respectively. Preoperatively and at all postoperative controls, kidney diameters and renal parenchyma thicknesses were normal in all patients. Mean RI of obstructed kidneys decreased from 0.68 to 0.63 for all patients (P=0.032), from 0.64 to 0.63 for those with preoperative RI<0.70 (P=0.850) and from 0.73 to 0.62 for those with preoperative RI>or=0.70 (P=0.001). In patients with preoperative RI>or=0.70 in obstructed kidney, significant RI decreases were recorded at postoperative day 7 and RI differences between obstructed and contralateral kidneys disappeared after then. No difference was present pre- and postoperatively between the mean RI of obstructed and contralateral kidneys of the patients with RI<0.70. Mean RI of contralateral kidneys were normal preoperatively and showed no significant change postoperatively. CONCLUSIONS: Preoperative RI levels may indirectly reflect the presence of functionally significant obstruction in chronic obstructed kidneys related to UPJ stones. Patients with RI>or=0.70 may have a good indication for a surgical approach. Normalization of high RI occurs rapidly after percutaneous nephrolithotripsy.     

Prevalence of hypertension among schoolchildren aged 13-18 years in Gemlik, Turkey

Arterial hypertension is the permanent elevation of blood pressure(BP). Previous studies have documented that hypertension maybegin in adolescence, perhaps even in childhood. The purposeof this study was to determine the prevalence of hypertensionamong adolescents in the Gemlik Research and Training Area,Turkey. Between January and March 1994, all secondary and highschool students aged 13–18 years were included in thisstudy. An elevated BP was defined according to the Report ofthe Second Task Force on Blood Pressure Control in Children.Of the 3,641 students screened, 262 (7.2%) had elevated systolicand/or diastolic BP, 161 (4.4%) students had significant hypertensionand 101 (2.8%) students had severe hypertension. We found thatsystolic and diastolic BP increased with age, height and weight.BP measurements should be included in physical examinationsas part of the continuing care of the child.     

Evaluation of shigellosis in a Turkish children''s hospital

BACKGROUND: The aim of the present study was to evaluate cases of Shigella and determine the pattern of antimicrobial resistance of shigella species in central Turkey. METHODS AND RESULTS: One hundred and ninety-eight patients with shigella gastroenteritis presenting to Sami Ulus Children's Hospital from June 2002 to December 2002 were included in the study. The clinical and laboratory data of the patients with shigellosis were collected by chart review. Male/female ratio was 1.35 and mean age was 4.83 +/- 3.2 years (range: 1-16 years). Shigella sonnei (83.3%) was the most common serogroup. This was followed by S. flexneri (10.1%), then S. dysenteria (5.1%), and S. boydii (1.5%). The antibiotic susceptibility of the shigella strains was determined. Most strains of Shigella species were resistant to trimethoprim-sulfamethoxazole (90.4%). All strains were found to be sensitive to ciprofloxacin (100%). Ampicillin susceptibility was 86.4% and cefotaxim (and/or ceftriaxon) susceptibility was 98%. CONCLUSION: Ampicillin is the drug of choice in the treatment of shigella infection in this region of Turkey. Cefotaxim or ceftriaxon was the second choice of antibiotics. Thus, Shigella is an important etiologic agent of diarrhea in Turkey. To determine the antibiotic susceptibility of the Shigella strains and appropriate empiric antibiotic treatment in Turkey, further studies will be needed.     

Comparison of a Safety Strategy Using Transradial Access and Dual‐Axis Rotational Coronary Angiography with Transfemoral Access and Standard Coronary Angiography

Objectives

We sought to investigate the radiation exposure and contrast utilization associated with using a strategy of transradial access and rotational angiography (radial‐DARCA) compared to the traditional approach of transfemoral access and standard angiography (femoral‐SA).

Background

There is an increased focus on optimizing patient safety during cardiac catheterization procedures. Professional guidelines have highlighted physician responsibility to minimize radiation doses and contrast volume. Dual axis rotational coronary angiography (DARCA) is the most recently investigated type of rotational angiography. This new technique permits complete visualization of the left or right coronary tree with a single injection, and is felt to reduce contrast and radiation exposure.

Methods

A total of 56 consecutive patients who underwent radial‐DARCA were identified. From the same time period, an age‐ and gender‐matched group of 61 patients who had femoral‐SA were selected for comparison. Total volume of contrast agent used, fluoroscopy time, and 2 measures of radiation dose (dose area product and air kerma) were recorded for each group.

Results

Mean contrast agent use and patient radiation exposure of the radial‐DARCA group were significantly less than that of the femoral‐SA group. There was no significant difference in fluoroscopy time between the 2 groups.

Conclusions

Physicians can successfully employ an innovative safety strategy of transradial access combined with DARCA that is feasible and is associated with lower radiation doses and contrast volume than femoral artery access and traditional coronary angiography approach. (J Interven Cardiol 2013;26:524‐529)

     

P-Wave Duration and Dispersion in Patients with Metabolic Syndrome

Background: Metabolic syndrome (MS) has been reported to be associated with an increased risk of atrial fibrillation (AF). The aim of this study was to investigate P-wave dispersion (PWD) in patients with MS.
Methods: The study population included 66 patients with MS (21 men, 45 women; mean age, 49.7 ± 9.1 years) and 63 control subjects without MS (26 men, 37 women; mean age, 47.0 ± 10.6 years). The diagnosis of MS was based on the National Cholesterol Education Program Adult Treatment Panel III criteria. A 12-lead electrocardiogram was recorded for each subject. The difference between maximum and minimum P-wave duration was calculated and defined as PWD. An echocardiographic examination was also performed for each subject.
Results: Maximum P-wave duration and PWD were found to be significantly higher in patients with MS compared with the control subjects (Maximum P-wave duration: 113.5 ± 9.7 ms vs 101.0 ± 8.1 ms, PWD: 37.8 ± 7.6 vs 23.3 ± 5.9, respectively, P < 0.001 for both). However, there was no statistically significant difference between two groups regarding minimum P-wave duration (75.6 ± 6.9 ms vs 77.6 ± 7.8 ms, respectively, P = 0.18). In addition, PWD was positively correlated with age, body mass index, waist circumference, systolic and diastolic blood pressure, triglyceride level, deceleration time, isovolumetric relaxation time and negatively correlated with high-density lipoprotein cholesterol level and early-to-late diastolic velocity ratio .
Conclusion: We have shown that patients with MS have higher PWD, indicating increased risk for AF, compared to the control subjects without MS.