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    Bladder cancer invasion predictability based on preoperative neutrophil-lymphocyte ratio
    (SAGE PUBLICATIONS LTD, 2014) Kaynar, Mehmet; Yildirim, Mehmet Erol; Badem, Huseyin; Cavis, Mucahit; Tekinarslan, Erdem; Istanbulluoglu, Mustafa Okan; Karatas, Omer Faruk
    An increased pretreatment neutrophil-lymphocyte ratio (NLR) is associated with poor prognosis in colorectal, gastric, and ovarian cancer; malignant mesothelioma; and renal cell carcinoma. The present study aims to define the predictive value of preoperative peripheral blood count NLR in non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease (MIBC) patients. There were in total 291 patients, 241 males and 50 females. Out of these, 156 male and 36 female patients were in the NMIBC group and 85 male and 14 female patients in the MIBC group. In the NMIBC group, 172 patients had low-grade and 20 high-grade papillary urothelial carcinoma. The mean age of the patients in the NMIBC group was 64 +/- 13, ranging from 27 to 97. The mean age of the patients in MIBC group was 70.5 +/- 10, ranging from 27 to 95. A statistically significant relation between patient ages and tumor invasiveness was determined (p = 0.023, 95 % confidence interval (CI) 63.3-66.7). The mean tumor size of the NMIBC group was 2.1 +/- 1.09 (cm) (range 0.5-8), and of MIBC group 3.6 +/- 1.5 (cm) (range 0.8-9). There was a statistically significant relation between the tumor size and invasiveness (p = 0.002, 95 % CI 2.8-4.4). In the NIMBC group, 149 (77.6 %) of them have NLR a parts per thousand currency signaEuro parts per thousand 2.5 and 43 (22.4 %) have NLR > 2.5. Also, in MIBC, 67 (67.7 %) of them have NLR a parts per thousand currency signaEuro parts per thousand 2.5 and 32 (32.3 %) have NLR > 2.5. The mean NLR in the NMIBC group was 2.4 +/- 0.1 (range 0.08-6.49, 95 % CI 1.52-2.71) and in the MIBC 2.9 +/- 0.2 (range 0.08-16.72, 95 % CI 1.67-2.97). In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.028). Platelet-lymphocyte ratio (PLR) of the two groups was also analyzed. The PLR of the NMIBC group was 12.8 +/- 15.1 (range 3.38-19.1) and of the MIBC 13.6 +/- 8.78 (range 0.18-63), yet there was not any statistically significant difference (p = 0.810, 95 % CI 11.4-14.8) (Table 1). The correlation tests revealed a positive correlation between the age (r = 0.144, p = 0.024), tumor size (r = 0.193, p = 0.02), and tumor invasiveness NLR (r = 0.138, p = 0.031). NLR can be used to determine tumor invasiveness as a cost-effective, common, and simple biomarker in bladder cancer (BC).
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    Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic
    (W B SAUNDERS CO-ELSEVIER INC, 2015) Kaynar, Mehmet; Koyuncu, Ferudun; Buldu, Ibrahim; Tekinarslan, Erdem; Tepeler, Abdulkadir; Karatag, Tuna; Istanbulluoglu, Mustafa Okan
    Objective: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief. Methods: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes. Results: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P=.001). After 60 minutes, mean VAS scores of groups I and III (P=.753) were similar. The mean VAS score of group III was lower than that of group II (P=.013). After 120 minutes, the difference in the VAS scores was (P=.000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P=.488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS. Conclusions: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality. (C) 2015 Elsevier Inc. All rights reserved.
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    Does the presence of hydronephrosis have effects on micropercutaneous nephrolithotomy?
    (SPRINGER, 2015) Karatag, Tuna; Buldu, Ibrahim; Kaynar, Mehmet; Inan, Ramazan; Istanbulluoglu, Mustafa Okan
    To evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery. A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system. A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 +/- A 93.06 vs. 143.70 +/- A 70.77 mm(2), p = 0.856 and 27.6 +/- A 4.2 vs. 26.7 +/- A 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5 %, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 +/- A 23.62 min and 105.3 +/- A 47 s, it was 38.8 +/- A 26.4 min and 112.53 +/- A 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 +/- A 0.47 in Group 1 and 1.76 +/- A 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis. The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.
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    Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy
    (POLISH UROLOGICAL ASSOC, 2015) Kaynar, Mehmet; Tekinarslan, Erdem; Keskin, Suat; Buldu, Ibrahim; Soenmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa Okan
    Introduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.