Biomedical subjects

Devrim Tuglu

Publications and source records attributed to Devrim Tuglu.

7 recordsLinked to original sources

PubMed2006

Effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate levels in patients with erectile dysfunction.

OBJECTIVES: To investigate the effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate (DHEAS) levels in patients with erectile dysfunction (ED). METHODS: A total of 124 men with a mean age of 45.9 years were included in the study. Group 1 consisted of 78 patients with ED, as determined by the Sexual Health Inventory of Male (SHIM) scale (score less than 21). Group 2 consisted of 46 healthy men with a SHIM score of 21 or greater. The 78 patients with ED took 100 mg sildenafil citrate at least eight times in 1 month. The SHIM scale was administered and serum DHEAS levels measured before and after treatment in the ED group. The serum DHEAS levels were also measured in the control group. The treatment response was defined as positive if the SHIM score was 21 or greater after sildenafil administration. RESULTS: At the end of sildenafil citrate treatment, the serum DHEAS levels and SHIM scores had increased significantly in the ED group (P = 0.013 and P = 0.001, respectively). In groups 1 and 2, the mean pretreatment serum DHEAS level of the men younger than 50 years old was 200.1 +/- 77.9 and 279.4 +/- 125.4 microg/dL, respectively (P = 0.013). The elevation of the serum DHEAS levels and SHIM scores was more significant in the sildenafil responders (P = 0.002 and P = 0.001), respectively. CONCLUSIONS: Serum DHEAS levels were significantly greater in the patients younger than 50 years old than in the older patients in the ED group. The serum DHEAS levels increased significantly after sildenafil citrate treatment in the ED group (especially in the younger men). Also, patient age was an important factor affecting the sildenafil citrate response.

Adult↗

PubMed2006

Can prilocaine infiltration alone be the most minimally invasive approach in terms of anesthesia during extracorporeal shock wave lithotripsy?

OBJECTIVES: To evaluate the analgesic effect and utility of prilocaine infiltration alone for minimal morbidity during extracorporeal shock wave lithotripsy. METHODS: A total of 114 patients with kidney stones, aged 18 to 69 years, were randomly separated into two groups. The 58 patients in group 1 received intramuscular diclophenac 30 minutes before extracorporeal shock wave lithotripsy, and the 56 patients in group 2 received prilocaine infiltration into the 30 cm2 area below the 12th rib right before the session. A visual analog scale (0 to 100 mm) was used to evaluate pain. RESULTS: The visual analog scale scores for group 2 were statistically lower at 1, 10, and 20 minutes compared with the scores for group 1 (P = 0.006, P = 0.005, and P = 0.006, respectively). However, no difference was detected at the end of the procedure. The requirement for additional analgesic was less in group 2 (P = 0.007). CONCLUSIONS: Prilocaine infiltration alone can be used for analgesic purposes efficiently and safely during extracorporeal shock wave lithotripsy with minimal morbidity.

Adolescent↗

PubMed2006

Window technique on circumcision.

OBJECTIVE: To remove the preputium by using a simple, quick and safe method without damaging glans, frenulum and urethra as well as with a good cosmetic result. PATIENTS AND METHODS: The procedure, remind the guillotine technique at first, but completely different from it. Basically, a long haemostat is applied onto preputium and skin and subdermal tissue were incised; a small window is opened at dorsal of preputial mucosa and it is excised, while observing glans and frenulum. RESULTS: The circumcisions were performed in a quick, safe and pretty bloodless way. There was no case with glans amputation, frenulum short cut or urethral damage, even if a clamp includes the foreskin with a part of glans or excess frenulum unnoticedly. CONCLUSION: This technique is simple, quick, relatively bloodless operation with cosmetically good result. Morever it is quite safe against to amputation of glans, frenular short cut or urethral fistula formation.

Circumcision, Male↗

PubMed2005

Optimal frequency in extracorporeal shock wave lithotripsy: prospective randomized study.

OBJECTIVES: To determine the optimal frequency of extracorporeal shock wave lithotripsy of urolithiasis, in terms of efficacy and duration, by comparing three different shock wave frequencies. METHODS: A total of 170 patients between the ages of 18 and 69 years with radiopaque kidney stones were included in the study. The patients were randomly separated into three groups. Group 1 (56 patients) received 120 shock waves per minute, group 2 (57 patients) received 90 shock waves per minute, and group 3 (57 patients) received 60 shock waves per minute. The duration, analgesic or sedative requirement, and complications were recorded for each treatment. All patients were evaluated in terms of successful treatment by radiography of the kidneys, ureters, and bladder and abdominal ultrasonography 10 days after the single-session therapy. RESULTS: No statistically significant difference was observed in patients according to age, sex, stone size, side, composition, location in the kidney, total energy level, or number of shocks. The successful therapy rate in groups 2 and 3 was prominently greater compared with that for group 1, and the difference was statistically significant (P = 0.032 between groups 1 and 2 and P = 0.015 between groups 1 and 3). The analgesic or sedative requirement in groups 2 and 3 was lower than that in group 1, and the difference was statistically significant (P = 0.003 between groups 1 and 2 and P = 0.001 between groups 1 and 3). The duration was longer in group 3 than in groups 1 and 2, and the difference was statistically significant (P = 0.000 between groups 1 and 3 and P = 0.009 between groups 2 and 3). CONCLUSIONS: The results of our study have shown that the optimal frequency during extracorporeal shock wave lithotripsy is 90 shock waves per minute in terms of duration, efficacy, and analgesic and sedative requirement at the same total energy level.

Adolescent↗

PubMed2005

Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy.

BACKGROUND AND PURPOSE: To investigate the effect and usefulness of Eutectic Mixture of Local Anesthetic (EMLA) applied with an occlusive dressing and used simultaneously with a low dose of fentanyl during shockwave lithotripsy (SWL). PATIENTS AND METHODS: One hundred sixty patients with kidney stones, aged between 19 and 68 years, were randomly divided into seven groups that were treated as follows: group 1: fentanyl 1 microg/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 microg/kg; group 3: occlusive dressing and IV fentanyl 0.25 microg/kg; group 4: placebo cream and IV fentanyl 0.25 microg/kg; group 5: EMLA cream and IV fentanyl 0.25 microg/kg; group 6: placebo cream and IV fentanyl 0.25 microg/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 microg/kg with an occlusive dressing. The mean arterial pressure (MAP), heart rate, ventilatory rate, and oxygen saturation (SpO(2)) were recorded on all patients. A visual analog scale 0-100 mm (VAS) was used for the evaluation of pain. The skin integrity was inspected to detect any lesions after SWL. RESULTS: The SpO(2) in group 1 was lower statistically than in the other groups. The VAS score in group 7 was clearly lower than in the others in the first, tenth, and twentieth minutes and at the end of SWL. In groups 6 and 7, additional fentanyl doses were lower than in the other groups, but only in group 7 was the total fentanyl dosage low. Skin lesions were not seen only in groups 3, 6, and 7. CONCLUSION: Use of EMLA and an occlusive dressing with low doses of fentanyl during SWL provides appropriate analgesia with minimal morbidity.

Administration, Topical↗

PubMed2005

The comparison and efficacy of 3 different alpha1-adrenergic blockers for distal ureteral stones.

PURPOSE: alpha1-Adrenergic blockers have recently been shown to increase the rate of spontaneous passage of distal ureteral stones. We compared efficacy of 3 different alpha1-adrenergic blockers for this purpose. MATERIALS AND METHODS: A total of 114 patients between 18 and 65 years old who had lower ureteral stones were included in the study. Patients were randomly divided into 4 groups. Group 1 consisted of 28 patients and acted as the control group. Group 2 comprised 29 patients who received tamsulosin, group 3 was 28 patients receiving terazosin and group 4 was 29 patients receiving doxazosin. These agents were given for up to a month and hydration was also recommended simultaneously. Every week patients were controlled with x-rays of the kidneys, ureters, bladder and urinary ultrasonography. Meanwhile the number of pain episodes, analgesic dosage and the number of days for spontaneous passage of the calculi through the ureter were also recorded. RESULTS: There were no differences between the groups with respect to age, weight, height, sex and stone size. The calculi passed through the ureter spontaneously in 15 patients in group 1 (53.57%), in 23 patients in group 2 (79.31%), in 22 patients in group 3 (78.57%), and in 22 patients in group 4 (75.86%). In groups 2 to 4 the number of pain episodes, expulsion time and analgesic dosage were found to be lower compared with those in group 1. CONCLUSIONS: alpha1-Adrenergic blockers increase the frequency of spontaneous passage of the distal ureteral calculi. All 3 agents tested were equally efficacious.

Adrenergic alpha-1 Receptor Antagonists↗

PubMed2003

C-reactive protein in early detection of bacteriemia and bacteriuria after extracorporeal shock wave lithotripsy.

OBJECTIVES: To evaluate the value of plasma C-reactive protein (CRP) levels in early detection of bacteriuria and bacteriemia after extracorporeal shock wave lithotripsy (ESWL) of calcium and infection stones. METHODS: A total of 75 patients who had infection stones (n = 27) and calcium stones (n = 48) were included in the study. All patients had sterile urine before ESWL. The mean age was 41.6 +/- 4.85 and male/female ratio was 2.12. Blood cultures were obtained within 1 hour post-ESWL period. Urine cultures were obtained 3 times just after and on the first and seventh day of ESWL. RESULTS: Post-ESWL evaluations showed 3 positive blood cultures with 2 (2.66%) patients in infection stone and 1 (1.33%) patient in calcium stone groups, whereas urine cultures revealed 6 (8%) positive results in infection stones and 4 (5.33%) in calcium stones. The patients who had positive cultures also had elevated plasma CRP levels when compared to the levels in patients with negative cultures (p = 0.000). CONCLUSIONS: Bacteriuria and bacteriemia after ESWL have been well-identified entities and may be responsible from some of the post-ESWL complications. CRP can be useful for early detection of such complications.

Adult↗