Objectives: To compare pain, quality of life(QoL), sexual function and lower urinary tract symptoms(LUTS) between rigid(RC) and flexible cystoscopy(FC). Methods: Forty-one patients who were planned control cystoscopies were enrolled the study. At the first cystoscopy, 20 patients(Group 1) and other 21 patients(Group 2) were performed by using flexible(15,5Fr) and rigid cystoscope(15,5Fr), respectively. At the second cystoscopies, the patients in group 1 and group 2 were performed by using rigid and flexible cystosacope, respectively. In all the patients, pain was measured with visual pain scale(VPS) shortly after cystoscopy. Also SF, QoL and LUTS were assessed by using IIEF, SF-36 and MLUTS forms, respectively. Results: While 22 of the patients preferred FC, the other 19 preferred RC(p>0,05). There were no statistically differences between VPS, IIEF, SF-36 and MLUTS scores of the two groups. In multivariate analysis regarding quality of life, although sexual function, pain and cystoscopy type did not affect QoL, voiding symptoms affected independently QoL. After the both cystoscopy type, IIEF, SF-36 and MLUTS scores did not change statistically. Conclusion: The results showed that the effects on pain, sexual function, QoL and LUTS of RC and FC were similar. In general, cystoscopy did not affect negatively on QoL, sexual function and LUTS of the patients.
Aim: To show if lower urinary tract symptoms (LUTS) could be symptoms of COVID-19 with validated questionnaires. Methods: The 96 COVID-19 patients who were hospitalized at a tertiary center were collected retrospectively. After the exclusion criteria, 46 patients were consisted as the study population. The male and female patients then fill formed the International Prostate Symptom Score and Urinary Symptom Profile respectively. All patients responded to these questions for the three period. Results: 27 female (58.6 %) and 19 male (41.4 %) COVID-19 patients answered the questions In the male patients, while there were no statistically significant differences in the total IPSS, the voiding IPSS score, and quality of life between the three periods (p=0.148; p=0.933, p=0.079, respectively), the storage IPSS scores had a significant difference between the three periods (p=0.05). In the female patients, low stream scores, were similar between the three periods (p=0.368). The scores of stress incontinence and an overactive bladder had a significant difference between the three periods (p=0.05 and p=0.05). Conclusion: LUTS, especially storage symptoms, might be one of the initial symptoms of COVID-19 and the clinicians should evaluate LUTS with other known symptoms of the virus when a patient is suspected of having COVID-19.
Purpose: To investigate the effect of mirabegron 50 mg/daily for JJ stent-related symptoms after ureteroscopic stone surgery. Methods: Medical records of 145 patients who were given a single daily oral dose of 50 mg of mirabegron for relieving stent-related symptoms were retrospectively analyzed. Demographic and clinical data and stone parameters were recorded. All participants completed the Turkish version of the Ureter Symptom Score Questionnaire (USSQ-T) on the postoperative seventh day, and again after at least three weeks, before JJ stent removal. The severity of stent-related symptoms was statistically compared before and after the mirabegron treatment. Results: The mean urinary symptoms score decreased significantly from 30.87 ± 9.43 to 22.61 ± 6.78 (p < 0.0001), mean body pain score decreased significantly from 21.82 ± 11.22 to 14.03 ± 7.52 (p < 0.0001), mean work performance score decreased from 10.50 ± 8.61 to 7.02 ± 6.51 (p < 0.0001), and mean general health score decreased significantly from 15.43 ± 6.50 to 11.12 ± 3.70 (p < 0.0001). The mean sexual matters score significantly decreased from 3.88 ± 3.40 to 2.48 ± 2.03 (p < 0.0001), the additional problem score decreased from 9.31 ± 4.61 to 6.51 ± 2.83 (p < 0.0001), and the overall quality of life (QoL) score decreased from 5.18 ± 1.94 to 4.23 ± 1.71 after mirabegron use (p < 0.0001). Conclusion: Daily use of 50g of mirabegron significantly improved stent-related symptoms, sexual matters, and quality of life.
Abstract Objective: To evaluate whether smoking cessation has an effect on female sexual function and quality of life. Methodology: After approval by the local ethics committee, smoking and non-smoking female participants were included in the study and all participants filled the female sexual function index (FSFI) and the short form 36 (SF-36). The same questionnaires were filled again at the 9th month control after smoking cessation. The scores of these questionnaires were compared between the groups. In addition, the FSFI and SF-36 scores of the participants in the smoking group were also compared with the scores at the 9th month after smoking cessation. Results: The rate of FSD was significantly higher in the smoking group when compared with control group (86.0% vs 32.5%; p<0,001). The FSFI total and sub domains score was significantly lower in the smoking group when compared control group [21.5 (min:14.4-max:28.69) and 28.9 (min:17.7-max:32.8); p<0.001 respectively]. The rate of FSD was significantly decreased after nine months smoking cessation (86% to 35.1%; p<0.001). After smoking cessation significant improvements on FSFI total and sub-domain scores and SF-36 sub-domain scores were determined. Conclusion: In this study, it was shown that smoking negatively affected FSD and QOL when compared to healthy non-smoking women, and smoking cessation caused significant improvements in FSFI and SF-36 scores in these women after 9 months. Keywords: female sexual dysfunction, female sexual function index, smoking cessation, the Short Form 36, quality of life.
Objectives To investigate the operation time (OT) and the ureteral access sheath (UAS) usage with the infection rates and to determine a cut-off value for OT Methods We retrospectively analyzed the data of the patients who underwent FURS for renal stones larger than 20 mm between 2010 and 2019. The investigated parameters were OT, UAS using, and infection status. The data were analyzed by forming two groups according to whether the OT was less than 60 minutes and more, whether the UAS was used and whether an infection occurred. In addition, independent risk factors that may affect postoperative urinary infection development were also investigated by logistic regression analysis. And, a ROC curve analysis was applied to determine a cut-off value in OT terms, where infection rates increase more. Results A total of 575 patients were enrolled in the study. The rates of the usage UAS and infection were greater statistically in the group for longer than 60 minutes. OT was longer statistically in the infection group than in the group without infection ( 94.1±14.2 and 68.01±23.1, for groups 1 and 2, respectively, p<0.05, Table 2). OT was statistically longer in the UAS group than unused one ( 79.3±24.4 and 66.7±22.4, for groups 1 and 2, respectively, p<0.05, Table 3). ROC analyses revealed a cut-off point of 87.5min for OT in terms of infection rate Conclusion While the infection risk increases when OT exceeds 60 minutes, FURS can be safely performed up to 87.5 minutes with 89% sensitivity and 69% specificity infection risk.
Abstract Objective: Since technological devices used for communication affect communication between people, Nomophobia is a disorder of a new age. In this study, we discuss the relationship between nomophobia and smoking addiction and the factors affecting them. Methods: The Demographic Information Form and Nomophobia Scale (NMP-Q), ıf they were smoking we applied the Fagerström Test for Nicotine Dependence (FTND) Scales were directed among students (N = 641) at Süleyman Demirel University studying Medicine, Dental, Nursing, and Physiotherapy departments in the 1st and 4th grades. Mann-Whitney U, Kruskal Wallis test to compare the scores of the variables with more groups. Correlation analysis was performed between the NMP-Q and Fagerström Test for Nicotine Dependence scores by Spearman correlation. Bonferroni test applied as Post Hoc test for multiple comparisons of groups. Results: In our study, 267 (42,6%) of participants who had nomophobia refuse to be dependent and smartphone addiction level was found to be 99.69 for all students.Responses were received from 73,2% (n=469) female and 26,8% (n=172) male participants. There is no significant difference between smokers in terms of factors in nomophobia (p>0.05). Total score of the questionnaire (p<0.01*) by gender and averages scores of women were higher in all mentioned sub-dimensions and total scores. Conclusions: In our study, there was no correlation between nomophobia and cigarette addiction due to the low number of smokers participating in our survey. Therefore, new conflicts with wider audiences are needed to examine the relationship between these two addictions Keywords: Nomophobia, Smartphone Addiction, Cigarette, Addiction What’s Already Known About This Topic? All addictions trigger each other. Here, we examined the effects of these two addictions on each other. ’What does this article add? There are not many studies on the effects of nomophobia and smoking addiction on each other. People should be careful about these two addictions.
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, neutrophile lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence free survival (RFS) and progression free survival (PFS). The prognostic ability of the SII for progression was analyzed 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. A 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=0.003) and a higher SII increased the progression one-fold. A tumor 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 randomized controlled studies with large patient groups.
Objective: The aim of this study is to find out the potential risk factors including Charlson Comorbidity index (CCI) score associated with death in COVID-19 cases hospitalized due to pneumonia and try to find a novel COVID-19 mortality score for daily use. Methods: All patients diagnosed as confirmed or probable COVID-19 pneumonia whom hospitalized in our Chest Diseases Education and Research Hospital between March 11, 2020 and May 15,2020 were enrolled. The optimal cut-off values, sensitivity and specificity values and odds ratios to be used in mortality prediction of the novel scoring system created from these parameters were calculated by ROC analysis according to the area under the curve and Youden index. Results: Over 383 patients (n:33 deceased, n:350 survivors) univariate and multivariate regression analysis showed that CCI and lymphocyte ratio were prognostic factors for COVID-19 related mortality. Using this analysis, a novel scoring model CoLACD (CoVID-19 Lymphocyte ratio, Age, CCI score, Dyspnea) was established. The cut-off value of this scoring system, which determines the mortality risk in patients, was 2.5 points with 82% sensitivity and 73% specificity (AUC = 0.802, 95% CI 0.777-0.886, p <0.001). The risk of mortality was 11.8 times higher in patients with a CoLACD mortality score higher than 2.5 points than patients with a score lower than 2.5 (OR = 11.8 95% CI 4.7-29.3 p <0.001). Conclusion: This study showed that by using the CoLACD mortality score, clinicians may achieve a prediction of mortality in COVID-19 patients hospitalized for pneumonia.
Background: We studied whether significant differences in care gaps exist between specialists and PCPs. Methods: GOAL Canada enrolled patients with CVD or familial hypercholesterolemia (FH) and LDL-C > 2.0 mmol/L despite maximally tolerated statin therapy. During follow-up, physicians received online reminders of treatment recommendations based on Canadian Guidelines. Results: A total of 177 physicians (58% PCPs) enrolled 2009 patients; approximately half of the patients were enrolled by each physician group. Patients enrolled by specialists were slightly older (mean age 63 years vs. 62), female (45% vs. 40%), Caucasian (77% vs. 65%), and had a slightly higher systolic pressure and lower heart rate. Patients enrolled by specialists had less frequent history of familial hypercholesterolemia, diabetes, hypertension, chronic kidney disease and liver disease but more frequent history of coronary artery disease, atrial fibrillation and premature family history of CVD. There was no significant baseline difference in LDL-C, HDL-C, or non-HDL-c, although total cholesterol and triglycerides were slightly higher in patients managed by PCPs. At baseline, PCPs were more likely to use statins (80% vs.73%, p=0.0002) and other therapies such as niacin or fibrate (10% vs. 6%, p=0.0006) but similar use of ezetimibe (24% vs. 27%, p=0.15). At the end of follow up, specialists used less statins (70% vs. 77%, p=0.0005) and other therapies (6% vs. 10%, p=0.007) but more ezetimibe (45% vs. 38%, p=0.01) and the same frequency of PCSK9i (28% vs. 27%, p=0.65). The proportion of patients achieving the recommended LDL-C level of 2.0 mmol/L or below (primary endpoint) was similar at last available visit between specialists and PCPs (44% vs. 42%, p=0.32). Conclusion: Despite minor differences in the clinical profile of their patients, both PCPs and specialists actively participate in the management of lipid lowering therapy in high risk CVD patients and experience similar challenges and care gaps.
Aim: To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing conventional 12-core TRUS-Bx at radical prostatectomy specimens (RP). Methods: Consecutive patients diagnosed prostate cancer (127 with combination of both targeted biopsy (TBx) plus systematic biopsies (SBx) and separate patient cohort of 330 conventional TRUS-Bx without mpMRI) with a PSA level of <20 ng/ml prior to RP were included. The primary end point was the grade group concordance between biopsy and RP pathology according to biopsy technique. Results: Clinically significant prostate cancer detection was 51.2 % for TRUS-Bx, 49.5 % for SBx, 67% for TBx and 75.7% for TBx+SBx . Upgrading and downgrading of at least one Gleason Grade Group (GGG) was recorded in 43.3% / 6.7% patients of the TRUS-Bx, and in 20.5% / 22 % of the TBX+SBx group, respectively (all p<0.001). Concordance level was detected to be significantly higher for ISUP 1 in combined TBx + SBx method compared to conventional TRUS-Bx (61.3% vs 37.9%, p=0.014). In ISUP 1 exclusively, significant upgrading was seen in TRUS-Bx (62.1%) when compared to TBx (41.4%) and TBx+SBx (38.7%). Conclusions: MRI-targeted biopsies detected more significant PCa than TRUS-Bx but, superiority in significant cancer detection appears as a result of inadvertant selective sampling of small higher grade areas. within an otherwise low grade cancer and does not reflect accurate GGG final surgical pathology. TBx+SBx has the greatest concordance in ISUP Grade 1 with less upgrading which is utmost important for active surveillance.
COVID-19 pandemic continues to spread across the world in late September 2020. To date, total cases of COVID-19 exceed 33 million including 996.342 deaths according to the WHO data. Although hydroxychloroquine, oseltamivir, remdesivir, favipiravir have been reported as an anti-SARS-CoV-2 effect, it is still unclear the fully effective protective drug and treatment. Herein, we report a woman under Tenofovir diphosphate who live and close contact with his COVID-19 positive husband. Although she had close contact with his husband without measure in the home she did not show any symptoms and signs of COVID-19 and her PCR test along with antibody test negative. Given the high reproduction number of SARS-CoV-2 and long-term close contact of the case, it can be speculated that Tenofovir could interfere with the transmission of COVID-19.
Conspiracy theories, omnipresent in traditional and modern societies , span demographic strata and political differences  and have fascinated people for ages . While many conspiracy theories are harmless and may even be entertaining, the ones related to medical and public health topics can be particularly dangerous for the individual and collective well-being . This second category includes misinformation and conspiracy theories related to COVID-19, which is likely one the most significant pandemics of our lifetime. Compounding the challenges that it opened for the economy, social and political sciences, and biomedical, translational, and clinical research, COVID-19 also propelled discussions about conspiracy theories and media health literacy to the forefront of public health in ways that were nearly impossible to predict.Situations of crisis, fear, and uncertainty increase the likelihood of conspiratorial thinking . A key difference between COVID-19 and the 1918 flu pandemic, which is sometimes used as a reference, is that a highly interconnected world, to a great extent on social media, is setting the stage for distributing information and misinformation about COVID-19 . In the short time since the beginning of the pandemic, the number of COVID-19-related conspiracy theories increased and propagated on social media. According to some metrics, online sensationalist and conspiratorial sites and articles generate more user engagement than more reputable sources such as the World Health Organization and the US Centers for Disease Control and Prevention  or mainstream news media such as the BBC and New York Times .An important way in which misinformation related to COVID-19 differs from misinformation that impacts other health-related topics is its multi-layered nature, in the sense that it concomitantly targets multiple facets of the pandemic. These include misinformation and conspiracies casting doubt on the very existence of the virus, minimizing the value of long-proven preventive strategies, and questioning the safety, efficacy, and potential ulterior motives of a vaccine that is not even available yet, and not sure it will ever be. In the wake of COVID-19, an ocean of misinformation  that spans all these domains has accumulated faster than for many other health-related topics. As a result, mutually incompatible and contradictory conspiracy theories were sometimes being endorsed and circulated together . Misinformation and disinformation during the pandemic contributed to the demonization of health care workers . As patients avoided hospitals or had difficulties making appointments in the wake of the pandemic, they experienced delays in accessing healthcare for various medical conditions [11-14]. An increased mortality from acute heart disease was reported in several countries . In this context, ambiguous messages about the pandemic endanger the delivery of healthcare in virtually all clinical areas and can place patients at a heightened risk of complications.Some conspiratorial claims include assertions that COVID-19 is a hoax, arguments that the virus was created artificially [16, 17] and spread on purpose  as a bioweapon , or allegations that governments are using the emergency situation to pursue their anti-democratic goals . As early as in January 2020, social media stories contained claims that 5G technologies either caused or accelerated the spread of the pandemic [21, 22]. Other conspiracies argued that people in power are taking advantage of the pandemic as a plan to inject microchip quantum-dot spy software and monitor people . Videos or articles perpetuating these theories were viewed by millions of people on social media platforms. Another conspiracy theory, circulating in several languages, claimed that the swab test reaches the back of the nasopharynx and damages the blood brain barrier, and urged people to refuse testing [23, 24]. Yet another conspiracy theory, spread thousands of times on social media, claimed that testing itself infects people with the coronavirus and urged them to refuse testing .The use of face masks has become a passionately debated topic [25, 26], even though many studies support their benefit against SARS-CoV, SARS-CoV-2, MERS-CoV, [27, 28], flu, and seasonal coronaviruses . Some people wearing masks have faced alienation or discrimination . Claims on social media that the virus crosses the masks, and therefore the mask is useless, have been circulating together with claims that the virus persists on the surface of the mask and wearing a mask would, therefore, infect people, or that the mask could “activate the virus” . Other social media claims include warnings that masks may cause fungal or bacterial pneumonia  or oxygen deprivation and carbon dioxide poisoning , an especially worrisome complication for children and pregnant women, despite evidence that no differences exist in heart rate and oxygen saturation between pregnant and non-pregnant women wearing N95 respirators for a short period of time .Most recently, warnings on social media advised people of the dangers of having their temperature checked upon entering closed spaces, based on the false claim that infrared light damages their pineal gland, when in reality infrared thermometers detect radiation emitted by the body [35, 36]. Other pseudoscientific claims advanced unproven therapies, including homeopathic arsenic-based products or colloidal silver solutions , advocated for prophylactic vitamin megadoses , promoted vitamin C and garlic as miracle remedies , and recommended ginger, hot pepper, and lemon to limit the impact of the pandemic .A vaccine is highly anticipated but not yet available, and it is uncertain which of the several vaccines that are currently pursued will succeed, if any. As of late July 2020, ~200 vaccine candidates were under active development and 15 were in human clinical trials . Prior to the widespread use of social media and crowdsourcing to obtain medical information and advice, the spread of infectious disease outbreaks was usually limited to confined geographic locations; now, the availability of misinformation widens the footprint of its harm. Vaccine-related misinformation on social media is rampant. In late April 2020, a false story that circulated claimed that one of the first volunteers in the UK during a COVID-19 vaccine trial died from complications . Another conspiracy theory claimed that the vaccine will be used to establish a global surveillance network . Additionally, various social media posts are already providing advice on how to avoid the vaccine. A WebMD poll in late July 2020 found that if a COVID-19 vaccine was available, fewer than one-third of the respondents would take it in the first 90 days, and fewer than one-half of the people would take it in the first year .Each of these conspiracy theories may be destructive in itself. While it is challenging to demonstrate the direct influence of any given conspiracy theory on an individual’s behavior, there are some suggestive trends. In the wake of the misinformation linking 5G technologies to the pandemic, attacks were perpetrated against telecommunication masts on several continents, and engineers were subjected to verbal and physical abuse . Between April 2-6, 2020, it was estimated that at least 20 phone masts were damaged in the UK. This included a hospital in Birmingham, UK, whose phone mast was set on fire . There are previous examples to illustrate the heavy price of denial and misinformation in the wake of an infectious disease crisis. During the HIV/AIDS pandemic, claims that the virus does not exist or that it does not cause AIDS were incredibly harmful . When the South African government, in its widely criticized denialist approach , withheld lifesaving drugs and promoted non-tested alternative solutions instead , the public health damage was incalculable and estimated to have claimed >330,000 lives [47-49].Anti-vaccination rhetoric and conspiracies are not new. They existed since Edward Jenner’s time, when some rumors claimed that vaccination will make people grow horns [50, 51]. The themes have been strikingly similar across time, and include distrust of the medical establishment or governments mandating vaccination; revulsion at the idea of introducing unknown substances into the body; accusations that the ingredients are harmful; or suspicion that the real motives behind vaccines are to make people sick or to control the population. Like many conspiracy theories, some worries over history have been rooted in a kernel of truth. Such examples include the Tuskegee Syphilis Study, where the government and the medical establishment have abused their power at the cost of people’s health [52-54]; the rare cases when contaminated vaccines caused harm [55-57]; or instances when vaccination was used as a cover for intelligence operations . During the Zika virus epidemic, some of the conspiracy theories claimed that the disease was caused by vaccines, and an Australian anti-vaccination Facebook group emphasized that the vaccine used to prevent diphtheria, tetanus, and pertussis in pregnant women was introduced in Brazil only months before the Zika outbreak [59-61]. This makes it understandable, to a certain extent, why some people continue to view vaccines with suspicion.A paradox in the vaccination debate seems to be the fact that even though vaccines have well-known and widely-reported adverse effects [62-64], most conspiratorial discussions focus on false claims about adverse effects that were never linked to vaccines, while the actual adverse effects, that scientists and regulators are attempting to address and avoid, are rarely discussed, if ever. What makes the COVID-19 vaccine refusal so different is that the debates are directed against a vaccine that was not even manufactured yet. Amidst these multiple layers of misinformation and conspiratorial discourse, the potential for damage is unpredictable, poignant, and difficult to manage, and the challenges associated with bringing the pandemic under control adopt a new, amplified, and more acute perspective.On the bright side, overall, social media harbors a larger volume of accurate information than misinformation . The sobering news is that misinformation seems to be more popular , become more prevalent over time , and spread faster, farther, and deeper [67, 68]—though whether this is true of health emergencies is less clear . Several studies found that COVID-19 conspiracy beliefs negatively correlate with COVID-19 health-protective behaviors [70, 71], and individuals who support COVID-19 conspiracy theories are less likely to accept the advice of public health experts .Even though social media made it easier to disseminate misinformation, it is not clear to what extent it causes more people to believe in them. Surveys of public opinion around conspiratorial beliefs, particularly during an ongoing global event such as the current pandemic, should be interpreted with caution. The responses to such surveys depend on the questions asked. As noted, conspiracy theories often make a multitude of specific, sometimes mutually contradictory claims; COVID-19 conspiracy theories are no exception. As a result, it is difficult for a single survey to cover all variants of any given conspiracy theory. While research suggests that endorsement of one conspiracy theory predicts the endorsement of others, general conspiratorial ideation has been found to be relatively weakly predictive of general conspiracy claims about COVID-19, and even more weakly predictive of a plethora of specific claims . Even more basic aspects of survey design such as the wording of available response options can have a substantial influence on responses . The extent to which such surveys over- or underestimate true engagement with conspiracy theories is therefore unknown. It must also be noted that misinformation constitutes only a small fraction of people’s news consumption, and that news consumption itself is only a small fraction of people’s overall information diet . The nuances of public opinion around conspiracy claims should receive increased attention in the years to come, as they have the potential to directly impact public health.Even though initial surveys indicate that many people would hesitate to adopt a coronavirus vaccine, it is important not to over-extrapolate, as responses to hypothetical questions may reflect many unstated assumptions and variables. However, the link merits increased focus over the coming months and years. We also need to recognize that hesitancy does not necessarily suggest that someone is a conspiracy theorist, or that they won’t actually seek vaccination should it become a reality with demonstrated safety and efficacy. A lot remains to be understood about people’s attitudes towards vaccines, and we should support this topic to further develop in the years to come.As we are exploring the best way forward during the COVID-19 pandemic, an ongoing challenge and a critical task will be to understand how to limit the rapid spread of misinformation, for which the term “infodemic” was coined to reflect its amplitude and extent [75-77]. Prompt, effective, and targeted interventions that seek to delegitimize misinformation emerge as an important strategy to reduce its impact. It was suggested that social media users should take advantage of the mechanisms available to report misinformation on the respective platforms . More extensive efforts need to be dedicated to advance and promote media and social media literacy, and to interrogate the impact of misinformation, disinformation, and conspiratorial thinking on the different facets of this pandemic and of other public health emergencies. For sure, the road ahead will be long and tortuous.
Aims: This study aims to analyze the novel Coronavirus disease (COVID-19) related testicular pain in hospitalized patients due to COVID-19 and to review as an etiological 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. Demophrahics 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 occured 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>0.05). Conclusion: Testicular pain was observed more frequently in hospitalized 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.
COVID-19 and late-onset hypertension with hyporeninaemic hypoaldosteronismAmit K J Manda, MB, FRCP(Ed), FRCP, FACP1Jason Kho MBBCh, BAO1Sofia Metaxa, MD, PhD 1Constantinos G Missouris, MD, FRCP, FACP1,21Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK2University of Cyprus Medical School, Nicosia, Cyprus
Background: Renal carcinoma and associated venous thrombosis cause-specific perioperative and postoperative challenges. We aimed to evaluate the factors affecting clinical outcomes in patients undergoing radical surgery due to renal carcinoma and associated venous thrombosis. Materials and methods: Hospital records were retrospectively reviewed to identify patients with renal carcinoma and associated venous thrombosis treated with radical surgery between 2006 and 2019. Preoperative, perioperative, and postoperative findings were analyzed to determine the associations between clinical and survival outcomes. Overall and disease-free survival was analyzed by the Kaplan-Meier method. Other associated prognostic variables were assessed using univariate and multivariate Cox regression analyses. Results: Thirty-three patients with renal carcinoma and associated venous thrombosis were enrolled for this study. There were 15 (45.4%) patients with level I, five (15.2%) with level II, eight (24.2%) with level III, and five (15.2%) with level IV venous thrombosis according to the Mayo Clinic classification system. The median follow-up was 35.6 months. In the univariate analysis, increased tumor size was associated with poor overall and disease-free survival. Preoperative clinic M1 disease was associated with poor overall survival. A high Mayo Clinic thrombus level was associated with poor disease-free survival. In the multivariate analysis, only tumor size and clinic M1 disease were independently correlated with poor overall survival. No independent statistically significant association was detected between thrombus level and survival outcomes. Conclusions: Although the thrombus level was not associated with overall and disease-free survival, tumor size and clinic M1 disease were found to have an independent prognostic impact on overall survival.
Objectives: A significant proportion of COVID-19 patients may have cardiac involvement including arrhythmias. Although arrhythmia characterization and possible predictors were previously reported, there are conflicting data regarding the exact prevalence of arrhythmias. Clinically applicable algorithms to classify COVID patients’ arrhythmic risk are still lacking, and are the aim of our study. Methods: We describe a single center cohort of hospitalized patients with a positive nasopharyngeal swab for COVID-19 during the initial Israeli outbreak between 1/2/2020 –30/5/2020. The study’s outcome was any documented arrhythmia during hospitalization, based on daily physical examination, routine ECG’s, periodic 24-hour Holter, and continuous monitoring. Multivariate analysis was used to find predictors for new arrhythmias and create classification trees for discriminating patients with high and low arrhythmic risk. Results: Out of 390 COVID-19 patients included, 28 (7.2%) had documented arrhythmias during hospitalization, including: 23 atrial tachyarrhythmias, combined atrial fibrillation (AF) and ventricular fibrillation, ventricular tachycardia storm, and 3 bradyarrhythmias. Only 7/28 patients had previous arrhythmias. Our study showed significant correlation between disease severity and arrhythmia prevalence (p<0.001) with a low arrhythmic prevalence among mild disease patients (2%). Multivariate analysis revealed background heart failure (CHF) and disease severity are independently associated with overall arrhythmia while age, CHF, disease severity, and arrhythmic symptoms are associated with tachyarrhythmias. A novel decision tree using age, disease severity, CHF, and troponin levels was created to stratify patients into high and low risk for developing arrhythmia. Conclusions: Dominant arrhythmia among COVID-19 patients is AF. Arrhythmia prevalence is dependent on age, disease severity, CHF, and troponin levels. A novel simple Classification tree, based on these parameters, can discriminate between high and low arrhythmic risk patients.
Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology: The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results: A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared to normal life. Conclusions: Covid-19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.