Studies have shown that healthcare professionals struggling with epidemics develop symptoms of post‐traumatic stress disorder. The aim of this study is to show how often and severely erectile dysfunction, one of the components of post‐traumatic stress disorder, is seen among healthcare professionals during COVID‐19 outbreak. The Impact of Event Scale‐Revised (IES‐R) and the Index of Erectile Function‐5 (IIEF‐5) were applied to 159 male healthcare professionals working in COVID‐19 units and a control group of 200 people. Healthcare professional group was divided into subgroups according to occupation (physician, nurse), age‐group (18–25, 26–30, >30), marital status and unit of work (Suspected Patient Area, Diagnosed Patient Area). Both stress disorder and erectile dysfunction were seen at higher rates in healthcare professionals group (p < .001). The median IIEF‐5 scores of nurses, married subjects and those working in the Diagnosed Patient Area, were found to be higher (p < .001, p = .014, p = .011 respectively). During the COVID‐19 outbreak, healthcare professionals are exposed to psychological trauma and their sexual function may be negatively affected. The measures to be taken are important to estimate which groups are more affected.
Purpose:To investigate the prognostic role of preoperative albumin/globulin ratio (AGR) in predicting disease-free survival (DFS) and overall survival (OS) in localized and locally advanced clear cell renal cell carcinoma (RCC) patients.Patients and Methods:162 patients who met the criteria specified were included in the study. The DFS and OS ratios were determined using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors affecting DFS and OS.Results:Median follow-up period was 27.5 (6-89) months. There was a statistically significant relationship between low AGR and high pathological tumor (pT) stage, presence of collecting system invasion, presence of tumor necrosis, and a high platelet count (p = 0.012, p = 0.01, p = 0.001, and p = 0.004, respectively). According to the Kaplan-Meier survival analysis, both OS and DFS were found to be significantly lower in the low AGR group (p = 0.006 and p = 0.012). In the multivariate Cox regression analysis, collecting system invasion and tumor necrosis were found to be independent prognostic factors in predicting OS and pT stage was found to be an independent prognostic factor in predicting DFS (HR: 4.08, p = 0.043; HR: 8.64, p = 0.003 and HR: 7.78, p = 0.041, respectively).Conclusion:In our study, low AGR was found to be associated with increased mortality and disease recurrence in localized and locally advanced RCC.
Twenty-two simple renal cysts of 16 patients were aspirated under guidance of ultrasound, with a 20-gauge needle with stylet. Sixteen of those cysts were treated with 96% alcohol. All cysts that were not treated with alcohol recurred within 10 weeks. Treatment with alcohol revealed no recurrences in 3 months follow-up for 12 patients and 6 months follow-up for 4 patients. No major complications were encountered.
Objectives
To investigate the predictors of acute kidney injury (AKI) after partial nephrectomy and the impact of AKI stage on long‐term kidney function.
Methods
Data of 1055 patients who underwent partial nephrectomy between January 2008 and January 2018 at seven separate tertiary centres were analysed. AKI was defined according to AKI Network criteria. The association between pre‐operative and perioperative factors and AKI was evaluated using logistic regression analysis. Recovery of at least 90% of baseline glomerular filtration rate 1 year after partial nephrectomy, change of 1 year glomerular filtration rate compared with baseline glomerular filtration rate and stage ≥3 chronic kidney disease (CKD) progression were assessed according to the stage of AKI.
Results
AKI was recorded in 281 (26.7%) of 1055 patients after partial nephrectomy, and of these patients, 197 (70.1%) had stage 1, 77 (27.4%) had stage 2 and 7 (2.5%) had stage 3. Higher tumour complexity and baseline glomerular filtration rate were independent predictors for AKI. The proportion of recovering 90% of baseline glomerular filtration rate at 1 year for any patient who had stage ≤1 vs stage 2‐3 of AKI was 78.2% (95% CI: 73.2%‐83.7%) and 23.8% (95% CI: 14.7%‐38.7%), respectively (P < .001). The risk of stage ≥3 CKD progression for any patient who had stage ≤1 vs stage 2‐3 of AKI was 6.2% (95% CI: 4.1%‐9.2%) and 63.1% (95% CI: 52.5%‐75.6%), respectively (P < .001).
Conclusions
AKI adversely affects renal function in the long‐term after partial nephrectomy and stage 2‐3 significantly increases the risk of CKD in the long term.
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