Unusual case of urothelial carcinoma disguised as xanthogranulomatous pyelonephritis and causing reno-colic fistula: Case report and review of literature

Xanthogranulomatous pyelonephritis is a rare and aggressive form of chronic pyelonephritis, it can occur at all age groups but is more common in women than in men, supposedly relating to the increased incidence of urinary tract infections and chronic nephrolithiasis in woman. Computed tomography (CT) findings are very helpful in making the correct diagnosis, but the definitive diagnosis is still based on histology, as there are many differential diagnoses such as renal cell carcinoma and renal tuberculosis. The complications of this type of pyelonephritis are due to the involvement of adjacent organs. The most frequent ones are Psoas abscess, perinephric abscess, and sepsis. Nephrocutaneous and renocolic fistulas are less common. We report a case of a 61-year-old male, who presented to emergency for left-sided lumbar pain for whom radiological investigations confirmed a renocolic fistula complicating xanthogranulomatous pyelonephritis. The diagnosis of XGP was proven by histopathological examination of the nephrectomy specimen slides, but there was also association with an underlying malignant squamous differentiation consistent with urothelial carcinoma, which was not evident on CT. XGP is a rare variant of chronic pyelonephritis with known imaging features. The treatment of choice is nephrectomy and histopathological examination is required for final diagnosis, as there may be associated renal malignancy.     

Pain induced by phacoemulsification performed by residents using topical anesthesia.

BACKGROUND AND OBJECTIVE: To evaluate patient-reported pain induced by phacoemulsification performed by residents using topical anesthesia. PATIENTS AND METHODS: This prospective study comprised 81 eyes of 76 consecutive patients having phacoemulsification under topical anesthesia. Surgery was performed by an experienced surgeon (group 1; n=41 eyes) or by two residents (group 2; n=40 eyes). No sedation or intracameral anesthesia was used in either group. Eighty eyes had clear corneal phacoemulsification with foldable acrylic posterior chamber intraocular lens implantation. Patients were asked postoperatively to grade the pain they experienced during the procedure using a visual analog pain scale from 0 to 10. RESULTS: The median pain score for the overall pain was 1.59 +/- 1.43 (range: 0 to 6) in group 1 and 1.95 +/- 1.64 (range: 0 to 7) in group 2 (P = .291). The mean pain score for the maximum pain perceived was 2.39 +/- 1.86 (range: 0 to 7) in group 1 and 2.53 +/- 1.67 (range: 0 to 7) in group 2 (P = .734). There was no significant correlation between the duration of surgery and the overall pain score (r = 0.102, P = .365). CONCLUSION: Topical anesthesia had sufficient analgesic effects in selected patients undergoing phacoemulsification cataract surgery by resident surgeons. The pain felt during the operation was low and tolerable.     

Associations between Poor Sleep Quality,Obesity, and the Anthropometric Measurements of Women in Turkey

Recent studies have shown that poor sleep quality is significantly associated with obesity. The aim of this study is to examine the association of sleep quality with obesity and specific anthropometric measurements. A total of 105 women aged 20–55 years with no chronic diseases participated in this study. They filled out the Pittsburgh Sleep Quality Index (PSQI), their anthropometric measurements were taken, and their dietary data were collected with a food frequency questionnaire (FFQ). There was no significant relationship between sleep quality and BMI, waist circumference, triceps skinfold thicknesses, body fat ratio (%), and body fat mass (p > .05), but high bread consumption was significantly associated with poor sleep quality (p < .05). The women with poor sleep quality consumed significantly more bread, but not other foods, than the women with good sleep quality. Sleep quality can thus be related to eating habits.     

Effects of Kinesio tape application to trunk isokinetic strength in female participants

ABSTRACT

The purpose of this study is to analyse the effects of KT on trunk strength with respect to different angular speeds when applied to the trunks of healthy women. Forty healthy female participants were randomly distributed into two groups: the placebo group (PG) in which placebo KT was applied and the experimental group (EG). Participants’ trunk concentric flexion and extension muscle strength were measured using an isokinetic dynamometer in two different angular speeds (60°/s ? 180°/s). In both PG and EG groups, there was no significant difference measured immediately after taping at the two angular speed values. In the measurements taken 48 h later, as regards PG trunk flexion, extension muscle strength increased significantly (p = 0.0001) at 60°/sc. angular speed while, for the EG only, the strength of trunk extension muscle increased significantly (p = 0.002). It was observed, that to ensure an increase in strength, waiting for a certain length of time was required. Lower angular speeds and short-term applied KT improved the strength of the trunk extension muscle.     

Avaliação de Padrões Pressóricos Dipper e Não-Dipper e Qualidade de Vida entre Pacientes com Doença Pulmonar Obstrutiva Crônica

BackgroundNon-dipper blood pressure is defined by less than a 10% reduction in nighttime blood pressure, and it is associated with cardiovascular disease. Inflammation is thought to play a role in the pathogenesis of both chronic obstructive pulmonary disease (COPD) and non-dipper blood pressure pattern, and both diseases are associated with lower quality of life.ObjectiveThe aim of this study was to investigate the effects of non-dipper blood pressure pattern in patients with COPD.MethodsA cross-sectional study was carried out with 142 patients with COPD. The Saint George Respiratory Questionnaire and the Euro Quality of Life Scale were used to collect data. To understand arterial stiffness, the augmentation index and pulse wave velocity were measured, and 24-hour ambulatory blood pressure monitoring was subsequently performed. A multivariable logistic regression model was used to understand the relationship between different independent variables and blood pressure pattern. P values lower than 0.05 were considered statistically significant.ResultsAs a result, 76.1% (n = 108) of the patients had non-dipper blood pressure pattern. Non-dipper patients had higher C-reactive protein (OR:1.123; 95% CI:1.016;1.242), augmentation index (OR: 1.057; 95% CI: 1.011;1.105) and Saint George Respiratory Questionnaire total score (OR: 1.021; 95% CI: 1.001;1.042) than dipper patients. Also, as the number of people living at home increased, non-dipper blood pressure pattern was found to be more frequent (OR: 1.339; 95% CI: 1.009;1.777).ConclusionNon-dipper blood pressure pattern may increase cardiovascular risk by triggering inflammation and may adversely affect the prognosis of COPD by lowering the disease-related quality of life. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)     

Is there any relationship between adverse pregnancy outcome and first trimester nuchal translucency measurements in normal karyotype fetuses?

Aim: This study aims to research whether there is a relationship between first trimester nuchal translucency (NT) measurements and pregnancy complications such as gestational diabetes mellitus (GDM), gestational hypertension (GHT), intrauterine growth restriction (IUGR) and oligohydramnios.

Method: This study included 225 singleton pregnancies attending Canakkale Onsekiz Mart University Obstetrics and Gynecology clinic for all monitoring and examinations, and gave birth at our clinic between January 2011 and December 2012. Data sources were clinical records and the hospital's automation system, and the study was planned as retrospective cohort. NT measurement was made between 10 weeks 3 days and 13 weeks 6 days gestation. For data analysis, the chi-square, Mann–Whitney U test and Spearman correlation were used.

Results: Of pregnancies, in the study, 5 (2.2%) developed GDM, 6 (2.6%) developed GHT, 2 (0.89%) developed IUGR and 10 (4.4%) developed oligohydramnios. There was no correlation identified between NT measurements and development of GDM, GHT, IUGR and oligohydramnios.

Conclusion: There was no relationship found between first trimester NT measurements and complications that could develop in pregnancy. For the first time in the literature, NT and oligohydramnios were studied and no relationship was observed.     

The Effect of Different Audio Distraction Methods on Children's Postoperative Pain and Anxiety

PurposeThe aim of the study was to determine the effect of different auditory methods of attention distraction on postoperative pain and anxiety in children.DesignThe study was conducted as a pretest–posttest experimental study to determine the effect of classical music, Turkish music, and audiobook on the reduction of postoperative pain and anxiety in children.MethodsThe patient population of the study comprised children who had undergone a surgical operation in the pediatric surgery clinics. A total of 90 children were included in the sample of the study. The data were collected using the Visual Analog Scale, the Wong-Baker Faces Pain Scale, and the State-Trait Anxiety Inventory for children, in addition to the sociodemographic data form of the child and the parent.FindingsClassical music, Turkish music, and audiobook methods played an effective role in decreasing postoperative pain and the anxiety state in children. Classical music listening was the most effective method in reducing the pain in children in the postoperative period in the three groups in the study.ConclusionsWe demonstrated that different auditory attention distraction methods had a decreasing effect on postoperative pain and anxiety in children.     

Pattern of primary tumors and tumor-like lesions of bone in children: retrospective survey of biopsy results

Background: Although primary bone tumors are relatively uncommon, they constitute the most important tumors in patients less than 20 years. We aimed to determine the frequencies of primary bone tumors and tumor-like lesions of bone and the anatomical sites of their occurrence. Methods: A retrospective review of histopathology reports of all bone specimens received in a private pathology laboratory in Istanbul between 2009 and 2015. Results: A total of 57 patients (aged 5 to 18 years) with a mean of 13.12 years were studied. Thirty five patients (61.4%) were males and 22 (38.6%) were females. Fifty five (94.4%) of the tumors were benign. Osteochondroma was the commonest tumor accounting for 31 cases (54.3%) followed by osteoid osteoma, 9 cases (15.7%). Chondrosarcoma observed in two patients and Ewing sarcoma in one patient as malignant tumors. Of the 57 bone tumors 13 (22.8%) occurred in the upper extremities, while 44 (77.2%) were in the lower extremities. Proximal humerus was the most commonly involved site in upper extremity tumors, with osteochondromas representing the most frequent type of tumor (4 patients; 7%). In the lower extremities again osteochondromas were the most common type of tumor (8 cases, 14%), with the femur being the most common site of involvement (18 patients, 31.5%). Of the patients with tumor-like lesions; four patients had fibrous dysplasia, 4 patients had non-ossified fibromas, 4 patients had simple bone cysts and 3 had aneurismal bone cyst. Conclusion: This study showed that primary bone tumors were mainly benign, settled predominantly in the lower extremities mostly in the femur with a male preponderance. Osteochondroma was the most common benign bone tumor. We didn’t observed osteosarcoma, which is the most frequent malignant bone tumor.