Purpose: To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples. Materials and Methods: Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated. Results: This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4 %) and histological prostatitis (n=304; 34.8 %). Intra-and intergroup comparative evaluations were performed.White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p<0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p<0.05) but not lymphocyte count (p>0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p<0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p>0.05, respectively). Conclusions: Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.
Aims This study aims to analyse the novel Coronavirus disease‐ (COVID‐19) related testicular pain in hospitalised patients because of COVID‐19 and to review as an aetiological factor for epididymitis, orchitis or both. Methods A total of 91 patients were included in the study. A questionnaire was formed for the questioning of testicular pain or epididymo‐orchitis in patients with COVID‐19. Demographics and past medical history was also recorded. Patients’ neutrophil and lymphocyte counts, neutrophil‐lymphocyte ratios (NLR), C‐reactive protein (CRP) levels and D‐dimer values were recorded. Patients with COVID‐19 were divided into two groups according to absence or presence of testicular pain or epididymo‐orchitis as group 1 and group 2. All results were compared for both groups. Results The median age of patients was similar in both groups. Testicular pain was occurred in 10.98% of the patients. Clinical presentation of epididymo‐orchitis was diagnosed in only one patient. No statistically significant difference was reported in terms of patients’ age, levels of CRP and D‐Dimer or NLR and results of questionnaire form queries between the two groups (P > .05). Conclusion Testicular pain was observed more frequently in hospitalised COVID‐19 cases. While no inflammation marker which is related to predict of testicular pain or epididymo‐orchitis was found in patients with COVID‐19.
Aim We aimed to investigate the predictor role of the systemic immune‐inflammation index (SII) on Bacille Calmette‐Guerin (BCG) response in patients with high‐risk non‐muscle invasive bladder cancer (NMIBC). Methods A total of 96 patients with high‐risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence‐free survival (RFS) and progression‐free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models. Results The mean follow‐up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut‐off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds. Conclusions The SII might be a successful, non‐invasive and low‐cost parameter for prediction of BCG failure in patients with high‐risk NMIBC. The cut‐off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.
Diabetes insipidus (DI) is a condition with heterogeneous clinical symptoms characterized by polyuria (urine output >4 mL/kg/hr) and polydipsia (water intake >2 L/m 2 /d). In children, acquired nephrogenic DI (NDI) is more common than central DI (CDI). Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. A water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI from CDI and diagnose their incomplete forms. Neonates and young infants are better managed with hydration therapy alone. Older children with CDI are treated with desmopressin (1-deamino-8-D-arginine vasopressin, dDAVP). Its oral form is safe, highly effective and has dosing flexibility. We report a case of an 8-year-old male patient with CDI with severe bilateral non-obstructive hydronephrosis and megaureter. Dramatic clinical and radiological responses to dDAVP treatment were achieved and therapy reduced urine volume and led to marked radiological improvement in hydronephrosis.
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