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The effect of the presence of multiple arteries on living renal donor selection

Aim: Donor kidneys with multiple renal arteries induce a challenge for transplant surgeons in association with the processes of living donor nephrectomy and graft implantation. Assessment of the selection criteria in regard to the number of the renal arteries was aimed in the present study. 

Materials and Methods: Between February 2015 and October 2018, 279 renal donors underwent laparoscopic donor nephrectomy. Data were collected retrospectively. The patients were separated into two groups up to the number of the renal arteries (Group A: single artery, Group B: ≥2 arteries). Two groups were compared according to warm/cold ischemia time and complications. Besides, the right-sided and single artery donors were compared with left-sided and multiple arteries donors in accordance with the same criteria.

Results: Single artery was present in 224 donors as group A (80,2%) and fifty donors had double arteries (18%) and there were three arteries in five donors (1,8%). In brief, there were 55 donors in Group B (19,8%).  Groups were similar in terms of age, gender, and BMI. Warm ischemia time has shown no statistical difference between groups. However, cold ischemia time was significant long in Group B (p < 0.005). The vascular complication rates were similar in both groups. 

Discussion: The presence of multiple renal arteries poses any challenge for the selection of donor renal graft. Although the grafts with multiple arteries cause longer cold ischemia time, there is no effect on primary graft function.

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Effects of nutrient deficiencies on the development of restless leg syndrome in pediatric patients with primary malnutrition

Aim: Although it is emphasized in the literature that conditions such as celiac disease, obesity, and iron deficiency cause an increase in Restless legs syndrome (RLS) incidence, there are not enough studies evaluating the effects of primary malnutrition on the development of RLS. Therefore, in this study, we aimed to evaluate the effects of vitamin and mineral deficiencies on the risk of developing RLS in pediatric patients with primary malnutrition.

Materials and Methods: A This study included a total of 100 patients aged 11-18 years who presented to Pediatric Gastroenterology, Hepatology, and Nutrition outpatient clinic and who were diagnosed with malnutrition due to low oral intake between July 2017 and July 2018 and 70 control subjects.

Results: The RLS was detected in 18 (18%) in the primary malnutrition group and in four patients (5.7%) in the control group. Anemia, hypoferritinemia, vitamin D deficiency, vitamin D deficiency, folic acid deficiency were significantly more common in the RLS group (P <0.05). When potential risk factors for RLS development are evaluated according to logistic regression analysis, 30,222 times in patients with anemia; 27,692 times in patients with hypoferritinemia; 29,951 times in patients with vitamin D deficiency; 10.08 times in patients with vitamin D deficiency; 10,615 times in patients with multivitamin deficiency; we detected 3.622 times higher risk of developing RLS in malnourished patients (Table 4). Moderately weak and severe stunting increased the risk of developing RLS 2,971 and 4,670 times, respectively, while severe weak, moderate stunting did not pose a significant risk for the development of RLS.

Discussion: Our study shows that malnutrition, anemia, vitamin and mineral deficiencies increase the risk of developing RLS.

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An epiglottic vallecular cyst incidentally discovered during cervical spinal magnetic resonance imaging

Laryngeal cyst is a rare entity that constitutes only 4.3-6% of all benign laryngeal tumors and epiglottic vallecular cyst (EVC) is a variant of laryngeal cysts. As EVCs mostly remain asymptomatic in adulthood, they are only followed-up without any intervention. However, recent studies have shown that EVCs are not as innocuous as they have previously been regarded. Therefore, the detection of these lesions is of clinical importance. The majority of the EVCs are unintentionally discovered by otolaryngologists, anesthesiologists or endoscopists. But they may also be incidentally detected by radiologists during imaging studies performed for another purpose. Here, we present a 41-year-old lady who admitted with complaints regarding her neck and left upper limb and an EVC was detected in her left vallecula during the cervical spinal magnetic resonance imaging study.

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