Objectives: To evaluate the emergency management of obstructing ureteral calculi with two different techniques (SWL and URS) with an emphasis on patients life quality. Methods: A total of 80 patients presenting with acute colic pain due to a single obstructing ureteral stone were treated within 24 hours following the onset of pain with two different approaches in a randomized manner. Patients requiring DJ stent placement and/or auxiliary measures after both procedures were excluded and the remaining 65 patients were evaluated [Group1: ESWL (n = 34); Group 2: URS (n = 31)]. Patients were followed during 4-weeks period with respect to the analgesic requirement, number of renal colic attacks and emergency department visits along with the HRQOL scores. Results: While 26 patients treated with URS (83.9%) were stone-free, 24 cases in SWL were stone-free (70.6%) after 4 weeks. Evaluation of the cases during this follow-up period demonstrated that cases undergoing SWL required significantly higher amount of analgesics when compared with URS group (p < 0.001). In addition to the lower mean number of renal colic attacks and emergency department visits in URS group; both the mean HRQOL in terms of EQ-5D index and mean EQ-5D VAS values were also significantly higher in these cases when compared with the cases tretaed with SWL. Conclusions: Due to the negative impact of stone related events after emergency SWL on patients HRQOL, emergency URS may be applied more effectively with the advantages of prompt fragmentation of the calculi along with the immediate relief of obstruction and pain.

Objectives: Patients with chronic renal failure who are treated with hemodialysis need a patent arteriovenous fistula (AVF). This study was an analysis to determine the best approach to prevent complications and provide treatment. Methods: In this retrospective study, a total of 437 AVF patients’ medical records and postoperative epicrisis with 4 years of clinical follow-up were evaluated. The preferred method of anastomosis surgery was the end-to-side technique. Complications were divided into categories of early (seen within 48 hours), and late (after 48 hours). Results: Of 437 patients, 288 (65.9%) were men, and the remaining 149 (34.1%) were women. The mean age was 46 years (range: 20-72 years). The locations of fistulas were snuffbox (n=42; 8.5%), radiocephalic (n=298; 60.9%), brachiocephalic (n=126; 25.6%), and brachiobasilic (n=25; 5%). Early complications were thrombosis (n=57; 69.5%), bleeding (n=14; 17%), and hematoma (n=11; 13.4%). Late complications observed were thrombosis/stenosis (n=25; 39.6%), venous hypertension (n=4; 6.3%), aneurysmatic dilatation (n=12; 19%), infection (n=6; 9.5%), bleeding/hematoma (n=7; 11.1%), arterial steal syndrome (n=4; 6.3%), congestive heart failure (n=1; 1.5%), seroma (n=2; 3.1%), and neuropathy (n=2; 3.1%). The most frequent of 145 total complications observed during the follow-up period was thrombosis (n=82; 16.7%). Conclusion: The benefits of ultrasound assistance in both the control and treatment of bleeding was also a supportive measure for the management of complications, such as steal syndrome, as it can be used to develop the best treatment strategy by considering flow velocities, or in the case of venous hypertension, to detect central stenosis. Embelectomy with re-operation may be preferred in a case of thrombosis, rather than embelectomy alone, as it is a time-consuming procedure and was reported in our clinic to be less effective when a standalone procedure.

Background: Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients. Objectives: Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure. Patients and Methods: This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high), and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1). Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42), state-trait anxiety inventory scale (STAI-I), and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies). The association between education levels (primary- secondary, high school and postgraduate) and the number of biopsies (1 and more than 1) with the level of anxiety and stress were evaluated using the above-mentioned scales. Results: Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients with neck biopsy had the highest anxiety score. Conclusion: We believe that active briefing of patients who need to undergo neck and bone biopsies and have high anxiety score by healthcare personnel is an effective method to control psychological mood and increase the efficiency of treatment. Keywords: Stress; Radiogic Biopsy; Anxiety; Depression

Objective: This study aimed to compare the pulmonary embolism (PE) location and clot burden on computed tomography pulmonary angiography (CTPA), the degree of right ventricular dysfunction (RVD), D-dimer, and cardiac troponin I (cTnI) levels, and the presence of a lower extremity deep venous thrombosis (DVT) in patients with and without cancer diagnosed with a non high risk pulmonary embolism (PE). Method: We calculated Miller score for each patient for clot burden. The location of PE was also evaluated at CTPA. D-dimer and cardiac cTnI levels were measured. Patients had echocardiography for RVD and lower extremity color flow Doppler ultrasonography for DVT. Results: The study included 71 patients with PE. The patients were divided into two groups according to the presence of cancer. There was no statistically significant difference for D-dimer levels (P=0.15), PE location (p=0.67), clot burden (P=0.34), RVD (P=0.28) and DVT (P=0.33) between groups (P=0.15). Cancer patients diagnosed as PE had statistically significantly higher levels of cTnI than those who were diagnosed as PE without cancer (P=0.03). Conclusion: There was no significant difference between patients diagnosed as PE with and without cancer in terms of D-dimer levels, clot burden and emboli location, RVD and DVT. cTnI levels were higher in non-high risk PE patients with cancer than these patients without cancer.