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Multicentric Screening of Local Antibiotic Resistance in Uncomplicated Urinary System Infections: 1850 Patients from 37 Centers
(Ankara Microbiology Soc, 2024) Cinislioglu, Ahmet Emre; Cinislioglu, Nazan; Öztürk, Metin İshak; Akkaş, Fatih; Aksakalli, Tugay; Atilla, Mustafa Kemal; Atış, Gökhan
study demonstrated that antibiotic resistance in the treatment of uncomplicated urinary tract infections varies by geographical region. We believe this comprehensive, national prospective study will provide valuable insights for clinicians planning empirical treatment for uncomplicated urinary tract infections.
Protective Effects Of Systemic Piracetam Treatment On Testicular Torsion/Detorsion Damage In Rats: A Dose-Response Study
(2017) Tuğlu, Devrim; Yuvanç, Ercan; Bal, Fatih; Yılmaz, Erdal; Atasoy, Pınar; Kısa, Üçler; Batislam, Ertan
Amaç: Çalışmamızda amacımız, testiste iskemi/reperfüsyon (I/R) etkisi ile oluşan oksidatif hasar üzerine pirasetamın koruyucu etkilerini araştırmaktır. Gereç ve Yöntemler: Ratlar rastgele 4 gruba ayrıldı. Grup 1= sham (kontrol), Grup 2=I/R (iskemi/reperfüsyon), Grup 3=I/R+pirasetam (250 mg/kg; i.p.) ve Grup 4=I/R+pirasetam (500 mg/kg; i.p.). Pirasetam intraperitoneal yolla testis torsiyonunu takiben 60. dakikada verilmiştir. Her 4 grupta işlemin başlangıcından 6 saat sonra ipsilateral sol testis ve kontralateral sağ testisler çıkarılmıştır. Bulgular: Pirasetam uygulaması total antioksidan kapasiteyi istatistiksel olarak anlamlı biçimde arttırırken, oksidatif stres indeks oranını da istatistiksel olarak anlamlı biçimde azaltmıştır. İpsilateral ve kontralateral testis grupları arasında Johnsen skorlama sistemine göre istatistiksel farklılık saptanmamıştır. Sonuç: Pirasetam uygulaması, testislerde iskemi reperfüzyon ile oluşan oksidatif hasarı antioksidan kapasiteyi arttırarak ve oksidatif stres skorlarını düşürerek azaltmıştır; ancak, histopatolojik incelemede ve spermatogenes skorlarında bir değişime neden olmamıştır.
Erişkin polikistik böbrek hastalığında (EPBH) hemospermi nedeni olan veziküloseminalis kistleri
(2003) Yılmaz, E.; Başar, M. M.; Tuğlu, D.; Başar, H.; Batislam, E.
Adult polikistik böbrek hastalığı ile takip edilen 42 yaşında erkek hasta hemospermi yakınması ile başvurdu. Transrektal Ultrasonografi (TRUS) ve spesifik, non-spesifik kültürleri içeren detaylı değerlendirme sonrası hastada vezikülo seminalis kistleri dışında herhangi bir hemospermi nedeni saptanmadı. Anti-inflamatuar ve antibiyotik tedavisi sonrası hastanın yakınmaları düzeldi ve 6 aylık takipte hemospermi tekrarlamadı.
The concomitant use of USP28 and p53 to predict the progression of urothelial carcinoma of the bladder
(ELSEVIER GMBH, 2020) Devrim, Tuba; Atac, Fatih; Devrim, Alparslan Kadir; Balci, Mahi
The Ubiquitin Specific Peptidase 28 (USP28) is a deubiquitinase involved in the DNA damage pathway. Recently, USP28 protein is reported to play roles in the mechanism of p53 action and could be a possible prognostic marker for bladder cancer (BCa). This study aims to explore the relation of USP28 with tumor growth and invasion, and also to investigate the interplay between USP28 and p53 in BCa. Expression levels of USP28 and p53 in human BCa (invasive and non-invasive, n = 43) and control tissues (n = 8) were evaluated by immunohistochemistry and quantitative real-time polymerase chain reaction (qPCR) profiling. The relationship between protein and gene expression levels, clinicopathologic features and prognosis were evaluated. Significant positive correlations were found between BCa tumor progression and the USP28 expression, and also between the USP28 and p53 scores (p all < 0.05). Immunohistochemistry staining percentages were strongly correlated between USP28 and p53, and also positive correlations between tumor progression and p53 expressions were determined (p all < 0.001). Interestingly, USP28 and p53 were highly expressed and correlated in BCa. Consequently, the immunohistochemistry and qPCR results reported in our study suggested the idea that USP28 in coordination with p53 could serve as a marker in BCa progression.
Do Anesthesia Methods in Retrograde Intrarenal Surgery Make Difference Regarding the Success of Ureteral Access and Surgical Outcomes?
(MARY ANN LIEBERT, INC, 2020) Öztekin, Ünal; Caniklioğlu, Mehmet; Selmi, Volkan; Kantekin, Çiğdem Ünal; Ataç, Fatih; Gürel, Abdullah; Sarı, Sercan
Background: Retrograde intrarenal surgery (RIRS) is a safe and minimally invasive method for the endoscopic treatment of upper urinary system stones especially sized <2 cm. Ureteral entrance is an important stage of RIRS. General anesthesia (GA) is usually used for RIRS. There is not enough data about the effect of anesthesia methods on the success of ureteral entrance and RIRS. We aimed to evaluate the effects of anesthesia methods (spinal anesthesia [SA], epidural anesthesia [EA], and GA) on the ureteral access and RIRS outcomes in primary surgery. Methods: After local ethical approval, 105 patients were prospectively randomized into three groups according to the anesthesia methods. GA, SA, and EA were defined as Group 1, 2, and 3, respectively. Results: Stone density was statistically significantly different between three groups (P = .008). Lithotripsy and operation time were significantly lower in Group 3 (P = .001). Dilatation and stone access time were significantly lower in Group 1. There was no statistically significant difference for scopy time, success, Visual Analog Scale score at 8th and 24th hours, and intraoperative and postoperative complications. Conclusions: GA may be recommended to decrease manipulations for the success of first ureteral access and time to reach the stone if there is not any contraindication.
Effect of synbiotics in the treatment of smokers and non-smokers with gingivitis: randomized controlled trial
(WILEY, 2020) Ercan, N.; Olgun, E.; Kisa, U.; Yalim, M.
Background To evaluate the efficacy of synbiotic tablets on the clinical and biochemical parameters of smokers and non-smokers with gingivitis. Methods Eighty patients with gingivitis [40 smokers (+), 40 non-smokers (-)] were randomly assigned to test (T) or control (C) groups. Four groups were defined: T(+), T(-), C(+) and C(-). The subjects daily chewed a synbiotic or placebo tablet for 30 days. The gingival crevicular fluid levels of interleukin (IL)-6, IL-8 and IL-10 were determined as the primary outcome variables. Results The clinical and biochemical parameters for all groups significantly reduced compared with the baseline (P < 0.05). While there were no significant differences between the groups for gingival index, the plaque index was significantly higher in both smoker groups than that in the T(-) group during the second month (P < 0.05). IL-8 levels in C(-) and IL-6 levels in both control groups were significantly higher than those in the T(+) group. The IL-10 levels in both control groups were significantly higher than those in the T(-) group during the second month (P < 0.05). Conclusions Adjunctive synbiotic tablets significantly reduce subclinical therapeutic outcomes for both smokers and non-smokers compared with placebo according to the biochemical parameters.
Comparison of Safety and Efficiency of General, Spinal and Epidural Anesthesia Methods Used for the Endoscopic Surgical Treatment of Ureteral Stones: Which One is Better To Access The Ureter and Reach The Stone?
(UROL & NEPHROL RES CTR-UNRC, 2020) Oztekin, Unal; Caniklioglu, Mehmet; Atac, Fatih; Kantekin, Cigdem Unal; Gurel, Abdullah; Isikay, Levent
Purpose: The aim of this study is to evaluate the effects of anesthesia methods on the success of urethral access and stone access achievement in endoscopic treatment of urolithiasis. Materials and Methods: In this prospective randomized study, 105 patients who underwent primary ureterorenoscopy (URS) procedure for ureteral stones were evaluated. The patients were randomized into three groups by permuted block randomization according to the applied anesthesia method: General anesthesia (GA): 33 patients, Spinal anesthesia (SA): 31 patients, and Epidural anesthesia (EA): 31 patients. Ten patients, whose ureteral access was not successful, were dropped out. The success of the three anesthesia methods on the success of the ureter access and its effects on surgical outcomes were compared. Results: There was no statistically significant difference among the three groups in terms of the demographic values and preoperative features except the American Society of Anesthesiologists (ASA) status. Dilatation and the access time to stone were statistically significantly longer in SA and EA group compared to the GA group. There was no statistically significant difference among the groups in terms of operation, lithotripsy time, stone-free rate (SFR), and complication rates. The Visual Analog Scale (VAS) scores in the 8th and 24th hours were statistically significantly higher in the GA group. Conclusion: In patients who decided to undergo primary ureterorenoscopy procedure, it can be suggested to treat with GA to provide a better relaxation of the ureter if there are no contraindications.
The effect of ureterorenoscopy and retrograde intrarenal surgery procedures on renovascular hemodynamics
(BAYRAKOL MEDICAL PUBLISHER, 2020) Oztekin, Unal; Erkoc, Fatih; Sari, Sercan; Selmi, Volkan; Gurel, Abdullah; Atac, Fatih
Aim: The aim of this prospective clinical study was to evaluate the preoperative and postoperative intrarenal vascular parameters of the kidneys undergoing URS and RIRS operations and compare the outcomes with the results of the normal contralateral kidneys. Materials and Methods: A total of 89 patients were included in the study. There were 42 and 47 patients in RIRS and URS groups respectively. The ureteral tract with stone formation was named as operated side, and the contralateral side was named as non-operated side. Preoperative gray-scale and CDUS measurements were obtained 24 h before and 8 h after the operations. The RI measurements were calculated from the upper pole, middle area, and the lower pole of the kidney and averaged. Results: There was no statistically significant difference in the demographic and peroperative features between the two groups except for irrigation fluid volume. Preoperative mean RI values were higher than the contralateral non-operated side kidney but not statistically significant (p=0,346). The.RI values were higher on the operated side in RIRS group compared with URS according to the selected surgery method (p=0,041). Discussion: Endoscopic stone surgery procedures increase renal vascular resistance by increasing intrarenal pressure. Therefore, we recommend reducing the use of irrigation fluids as much as possible during surgical applications.
Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized controlled clinical study
(BMC, 2020) Yaman, Ferda; Tuglu, Devrim
Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
Rare Plasmacytoid Urothelial Carcinoma of the Bladder: Two Case Reports
(Urol & Nephrol Res Ctr-Unrc, 2019) Devrim, Tuba; Atac, Fatih; Altunkaya, Canan; Ozbek, Aye; Ozdemir, Gulhan; Eryol, Merve
Plasmacytoid urothelial carcinoma is a rare and aggressive form of urothelial carcinoma characterized with delayed presentation and poor prognosis. Very few cases of this carcinoma have been reported in the literature. Here, we report and discuss two cases of bladder plasmacytoid urothelial carcinoma of a 57-year-old male presented with renal colic, and a 33-year-old female presented with macroscopic hematuria. Pathologic examinations of the transurethral biopsies revealed urothelial carcinoma with plasmacytoid appearance. Subsequently, immunohistochemical evaluation showed positive expression of epithelial markers and CD138. Additionally, losing of the membranous expression of E-cadherin verified the diagnosis of plasmacytoid urothelial carcinoma.
The Effects of Nocturnal Blood Pressure Patterns and Autonomic Alterations on Erectile Functions in Patients with Hypertension
(Urol & Nephrol Res Ctr-Unrc, 2019) Yuvanc, Ercan; Dogru, Mehmet Tolga; Simsek, Vedat; Kandemir, Huseyin; Tuglu, Devrim
Purpose: Hypertension (HT) is known to be of the main risk factors for erectile dysfunction (ED). But non-dipping (<%10 drop in the night) of HT is not investigated truly. The aim of this study was to test the hypothesis that the non-dipper hypertensive patients are more prone to develop erectile dysfunction. Materials and Methods: This was a cross-sectional clinical study. 70 HT patients diagnosed by Ambulatory blood pressure monitoring (ABPM) were classified into 3 groups (No ED, mild to moderate and severe) according to their International Index of Erectile Function (IIEF) scores. All three groups were compared for their dipping status by ABPM, heart rate variability (HRV) by holter monitoring. Results: In our study non-dipper hypertensives had statistically more erectile dysfunction (P = 0.004). Also severe ED patients with non-dipping pattern had decreased dipping blood pressure levels then those of ED(-) patients with non-dipping HT (P = .003) Conclusion: Autonomic dysfunction especially sympathetic overactivity is associated with both non dipping pattern of HT and erectile dysfunction as a common pathologic pathway, besides there might be an association between ED and non dipping HT.
The effect of coenzyme Q and selenium on kidney in rats with partial unilateral ureteral obstruction
(Aves, 2019) Kirdag, Mustafa Koray; Tuglu, Devrim; Yuvanc, Ercan; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, Erdal
Objective: In this study, we aimed to investigate the antioxidant effects of selenium and coenzyme Q on renal damage in a partial unilateral ureteral obstruction (PUUO) in a rat model. Material and methods: A total of 24 Sprague-Dawley rats were divided into four groups as Group 1 Control Group, Group 2, PUUO Group, Group 3 PUUO + coenzyme Q group, Group 4 PUUO + selenium group. Paraoxonase (PON), total antioxidant capacity (TAC), and total oxidant levels (TOS) were analyzed biochemically from tissue and blood samples. Tissue samples were examined histopathologically. Results: The TAC in the tissues was found to be statistically significantly increased in Groups 3 and 4, compared to Group 2. Tissue TOS was found to be significantly reduced in Groups 3 and 4, compared to Group 2. Serum PON levels were significantly increased in Group 3 and 4, compared to Group 1 and 2. Histopathological examination showed that interstitial inflammation and congestion were lesser in the coenzyme Q and selenium groups than in the PUUO group. A more significant decrease was found in the selenium group than in the coenzyme Q group. Conclusion: Our study results showed that coenzyme Q and selenium reduced the oxidation and the damage in tissue in PUUO in rats.
Investigation of the antioxidant effects of pheniramine maleate and nebivolol on testicular damage in rats with experimentally induced testis torsion
(Acta Cirurgica Brasileira, 2018) Yuvanc, Ercan; Tuglu, Devrim; Ozan, Tunc; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, Erdal
Purpose: To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol. Methods: Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples. Results: The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant. Conclusions: Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.
Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas
(Springer Japan Kk, 2018) Devrim, Tuba; Atasoy, Pinar; Tuglu, Devrim
Xanthogranulomatous pyelonephritis (XGP) is a rare benign condition with unknown aetiology and chronic infection of kidney. Commonly, most cases are related with urinary tract obstruction, nephrolithiasis, infection, diabetes, and/or immune compromise. XGP is associated with destruction of the renal parenchyma and granulomatous inflammation with foamy lipid-laden macrophages resulting from obstructive uropathy. It closely mimics a malignancy, exhibiting local tissue invasion and destruction. Adjacent organs especially duodenum as well as very rarely pancreas or spleen may be involved. Additionally, XGP is known as notorious for fistulisations, such as pyelocutaneous and ureterocutaneous fistulae, which have been reported as well described. XGP may be indistinguishable from renal cell carcinoma by radiographic and clinic consultation so it must be diagnosed based on the histopathologic examinations. Furthermore, macroscopic appearance of XGP is a mass of yellow tissue with focal haemorrhage besides necrosis and in this regard, it grossly resembles renal cell carcinoma. Here, we report the case of a 32-year-old female, preoperatively diagnosed as malignancy by clinical examination. Our further pathological evaluations revealed very rarely adhesion of XGP to pancreas tissue.
Audiometry Results and TEOAE and DPOAE Amplitudes in Men Taking a Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction
(Sage Publications Inc, 2017) Ontepeli, Sertan; Muluk, Nuray Bayar; Tuglu, Devrim; Sipal, Timucin
We conducted a prospective study of transient evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in men who were taking an oral phosphodiesterase type 5 (PDE5) inhibitor for erectile dysfunction. Our study group was made up of 30 men (60 ears), aged 34 to 60 years (mean: 50.9). They were randomly divided into three groups; 10 men were given sildenafil (Viagra) at 50 mg twice a week, 10 were given tadalafil (Cialis) at 20 mg twice a week, and 10 were given vardenafil (Levitra) at 20 mg twice a week. All patients took their drug for 3 weeks, for a total of 6 tablets for each patient. Audiometric tests and TEOAE and DPOAE measurements were performed before and after treatment. Post-treatment audiometry demonstrated improvement in hearing in all three groups. However, post-treatment TEOAE amplitudes and DPOAE amplitudes differed among the three groups; they were significantly higher in the sildenafil group at 1.0 kHz and the same in the tadalafil group; in the vardenafil group, the DPOAE amplitude was significantly lower at 3.0 kHz while there was no change in the TEOAE amplitude. We speculate that the possible mechanism for these findings is that PDE5 inhibitors block degradation of cyclic guanosine monophosphate (cGMP) and induce dilation of the cochlear microcirculation, resulting in an increase in cochlear blood flow. We also believe that the decrease in DPOAE amplitudes at 3.0 kHz seen in the vardenafil group may be related to an accumulation of nitric oxide/cGMP complex, which is toxic to the cochlea; however, since there was no change in TEOAE amplitude in the vardenafil group, this influence may be minimal. Further studies are needed to obtain a more comprehensive assessment of the effects of PDE5 inhibitors on hearing with the use of higher doses and longer durations of therapy.
Protective effects of udenafil citrate, piracetam and dexmedetomidine treatment on testicular torsion/detorsion- induced ischaemia/reperfusion injury in rats
(Wiley-Blackwell, 2016) Tuglu, D.; Yuvanc, E.; Ozan, T.; Bal, F.; Yilmaz, E.; Atasoy, P.; Batislam, E.
The aim of this study was to investigate the antioxidant properties of udenafil citrate (1.4 mg kg(-1)-2.8 mg kg(-1)), dexmedetomidine 25 mu g kg(-1) and piracetam 200 mg kg(-1) administered on ipsilateral/contralateral testes after ischaemia in a rat model of testicular torsion/detorsion (T/D) and define its protective effect histologically. Fifty-six Wistar albino rats were included and randomly assigned into 6 groups. No intervention was performed in control group (Group 1, n = 8) and in torsion/detorsion group, (Group 2, n = 8). Udenafil 1.4 mg kg(-1) was given to torsion/detorsion group (Group 3, n = 10), udenafil 2.8 mg kg(-1) was given to torsion/detorsion group (Group 4, n = 10), piracetam 200 mg kg(-1) was given to torsion/detorsion group (Group 5, n = 10) and dexmedetomidine 25 mu g kg(-1) was given to torsion/detorsion group (Group 6, n = 10) intraperitoneally after 60 mins of testicular torsion. Biochemical and histopathological testicular injury were evaluated. When the tissue was examined by TOS values, Group 3, Group 4 and Group 5 were significantly lower than Group 2. In contrary Group 6 values were significantly higher than Group 2. The increasing doses of udenafil demonstrated antioxidant properties on the testis tissue and histopathological that protects the testicles.
Multiple urethral anomalies: Parameatal urethral cyst, penile curvature, incomplete hypospadiac anterior duplication of the urethra and distal hipospadias
(Canadian Urological Association, 2015) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Gur, Serhan; Batislam, Ertan
The male genitourinary system is quite complex. There are numerous known anomalies of the male urethra either as isolated cases or in combination with other disorders. An improved understanding of the embryology and anatomy of the normal male urethral development might help explain the causes of the various urethral abnormalities. We contribute to the etiology of congenital anomalies with this multiple urethral anomalies case.
The antioxidant effect of dexmedetomidine on testicular ischemia-reperfusion injury
(Acta Cirurgica Brasileira, 2015) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Gencay, Isin Yazici; Atasoy, Pinar; Kisa, Ucler; Batislam, Ertan
PURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 mu g/kg Dex (group 3) and 100 mu g/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 mu g/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 mu g/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides.
Ways in which SWL affects oxidant/antioxidant balance
(Springer, 2013) Yılmaz, Erdal; Haciislamoğlu, Ahmet; Kısa, Üçler; Doğan, Özlem; Yuvanç, Ercan; Batislam, Ertan
Many damages can occur in the kidneys following extracorporeal shock wave lithotripsy (SWL) and some of these damages are thought to emerge as a result of oxidative stress. The objective of this study is to evaluate the impact of SWL application on kidneys in stone patients on oxidative stress parameters in 24-h urine. The study included 20 patients scheduled for SWL. total antioxidant capacity (TAC) and total oxidant status (TOS) measurements were made on 24-h urines of the patients before and after SWL. The oxidative stress index (OSI) was calculated based on these values. Following SWL, while TOS increased in 24-h urine (p = 0.006), TAC remained unchanged (p = 0.312). OSI increased following the procedure (p = 0.004). SWL application disrupts the oxidant/antioxidant balance in favor of oxidants, which leads to oxidative stress. TOS, TAC and OSI may be useful in the determination of the existence of oxidative stress following SWL.
Serum homocysteine levels and sildenafil 50 mg response in young-adult male patients without vascular risk factors
(Natl Inst Science Communication-Niscair, 2013) Basar, M. Murad; Ozkan, Yesim; Kisa, Ucler; Simsek, Bolkan
The aim of the present study was to investigate serum homocysteine levels in patients with erectile dysfunction and to evaluate the relationship between serum homocysteine levels and response to the standard 50 mg phosphodiesterase 5 inhibitor treatment. Twenty-eight erectile dysfunction patients having normal vascular parameter according to Penile Doppler Ultrasonography and twenty healthy subjects were enrolled in the study. All subjects filled The International Index of Erectile Function (IIEF) questionnaire. A total of 4-6 doses of phosphodiesterase 5 inhibitor (sildenafil 50 mg) were given to patients. Later, they were divided into two groups as sildenafil responder and non-responder. Serum homocysteine levels were compared in groups based on sildenafil response: Compared with healthy subject, higher homocysteine levels were observed in patients with erectile dysfunction (p = 0.005), especially in sildenafil non-responder group (p = 0.005). There was significant negative correlation between homocysteine and TIFF scores in group responder to sildenafil treatment (r = -0.698, p = 0.008). Mean IIEF scores of patients with non-responder to sildenafil 50 mg were lower than those of controls (p = 0.0001), but mean IIEF scores of patients with responders approached values observed in control subjects (p = 0.002). The results indicated that measurement of serum homocysteine levels could be used as a marker for the evaluation of efficacy of phosphodiesterase 5 inhibitor and the selection of efficacious alternative therapies.

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