Evaluation of Sexual Dysfunction in Patients Undergoing Hemodialysis Treatment

Aim

In this study. it was aimed to determine the prevalence of sexual dysfunction (SD) and the factors that may affect the occurrence of SD in patients receiving hemodialysis treatment.

Methods

The sample of the study consists of 49 patients (20 females. 29 males) receiving treatment in the hemodialysis unit of a university hospital. The data of the study were collected through a general information form including socio-demographic characteristics and risk factors. Female Sexual Function Index (FSFI). International Assessment Form for Erectile Function (IIEF) and Quality of Life Scale (SF-36).

Results

In our study. SD was detected in all patient groups. While the most affected area was seen to be orgasmic function and the least affected area was sexual desire in famales. the most affected area was found to be orgasmic function and the least affected area was erectile dysfunction in males. Such factors as age. profession. having a child. working status and duration of hemodialysis were found to affect occurrence of SD. There was a relationship between all sub-dimensions of sexual function and quality of life in male and female subjects.

Conclusion

In conclusion. sexual dysfunction is commonly encountered in patients undergoing hemodialysis treatment. In these patients. psychosocial factors as well as disease-related factors have an effect on SD. Therefore. SD should be evaluated together with disease-related factors as well as psychosocial factors in patients undergoing hemodialysis treatment.

     

Neurocognitive functions after aortic arch repair with right brachial artery perfusion

Background

Satisfactory neurologic outcome following aortic arch repair through right brachial artery perfusion is well established. However, how neurocognitive functions are affected following selective cerebral perfusion, still needs to be elucidated.

Methods

In a period between April 2002 and March 2003, 22 patients (19 male, 3 female, with a mean age of 46.8 ± 12; range: 26 to 70 years old), underwent aortic arch repair using right brachial artery low flow (8 to 10 mL · kg⁻¹ · min⁻¹) selective antegrade cerebral perfusion under moderate hypothermia (26°C). There were 6 Stanford type-A dissections and 16 ascending aortic aneurysms. All patients were evaluated preoperatively and postoperatively (at seventh day and second month) for neurocognitive functions.

Results

There was no operative mortality. The average cardiopulmonary bypass time was 115.0 ± 24.2 minutes and the average antegrade cerebral perfusion time was 29.8 ± 7.1 minutes (19 to 38 minutes). No major neurologic deficit was observed in the postoperative period. In terms of neurocognitive test results, between the preoperative and postoperative assessments for both hemispheric cognitive functions no deterioration was detected.

Conclusions

The low-flow selective antegrade cerebral perfusion technique through the right brachial artery may safely be used for the great majority of patients undergoing aortic arch repair without causing deteriorations in neurocognitive functions.     

A case of primary Sjögren’s syndrome with pulmonary-limited Wegener’s granulomatosis

A 60-year-old woman had a history of dyspnea for 5–6 weeks. The chest radiograph and computed tomography scans revealed bilateral patchy reticulonodular pattern. The patient had positive test results for antineutrophil cytoplasmic antibody against proteinase-3 (c-ANCA), antinuclear antibody and anti-Ro antibody. According to European Study Group on Classification Criteria for Sjögren’s Syndrome, the patient was diagnosed as primary Sjögren’s syndrome based on the presence of clinical features, positive findings on Schirmer’s test and parotis scintigraphy. Lung biopsy obtained by wedge resection showed granulomatous inflammation with extensive multinuclear giant cells involving the lung parenchyma and vascular structures. There was neither upper airway nor renal involvement. Thus, the patient was simultaneously diagnosed as pulmonary-limited Wegener’s granulomatosis. With this unique case, we would like to emphasize that the awareness of ANCA-associated vasculitis as a diagnostic possibility in primary Sjögren’s syndrome is important during the work-up of lung lesions.     

Reliability and validity of the Functional Living Index-Cancer in Turkish cancer patients

The objective of this study was to test the reliability and validity of the Turkish version of the Functional Living Index-Cancer in Turkey. The English version of the Functional Living Index-Cancer was translated into Turkish following the standard translation methodology. The questionnaire was administered to 110 cancer patients who had been receiving chemotherapy. Internal consistency reliability was in the acceptable range for this instrument. Among cancer patients, the Cronbach alpha reliability for the total scale was .88, and subscale alpha coefficients ranged from .60 to .83, which is similar to the alpha of .79 observed in the Functional Living Index-Cancer, English version. The results of the principle components analysis and varimax rotation resulted in 5-factor structure: physical functioning, psychological functioning, current well-being, social functioning, and gastrointestinal symptoms. The results of this study suggest that the Turkish version of the Functional Living Index-Cancer is a reliable and valid supplementary measure of the quality of life in cancer patients in Turkey, and it can be used in clinical trials and studies of outcome research in oncology.     

Neurocognitive functions after beating heart mitral valve replacement without cross-clamping the aorta

BACKGROUND AND AIM OF THE STUDY: Although neurologic outcome after cardiac surgery is well-established, neurocognitive functions after beating heart mitral valve replacement still needs to be elucidated. The aim of this study was to compare preoperative and postoperative neurocognitive functions in patients who underwent beating heart mitral valve replacement on cardiopulmonary bypass without cross-clamping the aorta. METHODS: The prospective study included 25 consecutive patients who underwent mitral valve replacement. The operations were carried out on a beating heart method using normothermic cardiopulmonary bypass without cross-clamping the aorta. All patients were evaluated preoperatively (E1) and postoperatively (at sixth day [E2] and second month [E3]) for neurocognitive functions. RESULTS: Neurologic deficit was not observed in the postoperative period. Comparison of the neurocognitive test results, between the preoperative and postoperative assessment for both hemispheric cognitive functions, demonstrated that no deterioration occurred. In the three subsets of left hemispheric cognitive function test evaluation, total verbal learning, delayed recall, and recognition, significant improvements were detected at the postoperative second month (E3) compared to the preoperative results (p = 0.005, 0.01, and 0.047, respectively). Immediate recall and retention were significantly improved within the first postoperative week (E2) when compared to the preoperative results (p = 0.05 and 0.05, respectively). CONCLUSIONS: The technique of mitral valve replacement with normothermic cardiopulmonary bypass without cross-clamping of the aorta may be safely used for majority of patients requiring mitral valve replacement without causing deterioration in neurocognitive functions.     

Psychopathology,health-related quality-of-life and parental attitudes in pediatric asthma

Objective: Considering that unknown psychopathology might play a role in the management of pediatric asthma, this study examines how self-esteem and psychosocial family environment (child-raising attitudes and parental coping strategies) influence the physical and psychosocial well-being of these children. Hence, this paper aims to predict psychosocial factors influencing health-related quality-of-life (HRQL) in children with asthma without a documented history of mental illness. Methods: 32 patients with asthma and 32 controls aged 8–18?years were included in the study. All participants were largely middle-income, Caucasian school-aged children. The child-raising attitudes examined were: dependency, egalitarianism/democratic attitude, rejection of the homemaking role, marital conflict, and strictness/authoritarianism. The parental coping strategies were; social support seeking, problem-solving attitude and avoidance. Results: Psychiatric comorbidity was present in 72% of asthma patients and 22% of the controls. The most common mental illness identified was generalized anxiety disorder; 32% vs 13%, respectively. Dependency was the only parental child-raising attitude that differed significantly between groups (47?±?8 vs 41?±?11, respectively. p?=?0.035). There was a negative correlation between the PARI dependency subscale and the total HRQL score according to the parents (r_p=??0.39, p?=?0.027). The most influential factors connected with the total HRQL score in asthma were Rosenberg self-esteem scale score, presence of psychopathology and dependency according to the child. Conclusions: Simple ways to overcome emotional dependency and fortify self-esteem (exercises promoting self-awareness, opportunities cultivating decision-making, and a considerable freedom-of-choice to experience consequences) worth recommending to parents of children with asthma. Patients with suspected mental illness must be referred for psychiatric evaluations.     

Identification of the synthetic cannabinoid <Emphasis Type="Italic">N</Emphasis>-(2-phenyl-propan-2-yl)-1-(4-cyanobutyl)-1<Emphasis Type="Italic">H</Emphasis>-indazole-3-carboxamide (CUMYL-4CN-BINACA) in a herbal mixture product

We were the first to detect N-(2-phenylpropan-2-yl)-1-(4-cyanobutyl)-1H-indazole-3-carboxamide (common name CUMYL-4CN-BINACA) as a new synthetic cannabinoid, on the illegal market in Bursa, Turkey. To elucidate the chemical structure, the dried herbal mixture was extracted with methanol. The extract was purified by column chromatography. Pure compound was analyzed by gas chromatography–mass spectrometry (GC–MS), attenuated total reflection Fourier-transform infrared spectroscopy (FT-IR), and one- and two-dimensional nuclear magnetic resonance (NMR) spectroscopy. The GC–MS, FT-IR and ¹H and ¹³C NMR spectra of the compound coincided well with the reference data. All protons and carbons were assigned by their couplings and correlations observed in ¹H-¹H correlation spectroscopy, ¹H-¹³C heteronuclear multiple bond correlation, and ¹H-¹³C heteronuclear single quantum coherence spectra. On the basis of the spectral data, the compound was identified as CUMYL-4CN-BINACA. Herewith, we report analytical characteristics of CUMYL-4CN-BINACA enabling its (and possible analogues thereof) determination in criminal seizures.     

Changes in expressions of ADAM9, 10, and 17 as well as α-secretase activity in renal cell carcinoma

Background

ADAM9, 10, and 17 are a class of disintegrins and metallproteinases with α-secretase activity. There are conflicting results regarding the role(s) of ADAM9, 10, and 17 in carcinogenesis, and only a few studies have examined their levels and cellular localization in renal cell carcinoma (RCC). Studies examining changes in α-secretase activity in RCC compared to enzymatic activity of the uninvolved kidney are lacking.