Alper Özorak

Sildenafil citrate as a phosphodiesterase inhibitor has an antioxidant effect in the blood of men

Background and objective:  Sildenafil citrate enhances the action of nitric oxide by preventing the hydrolysis of cGMP, and is widely used to treat erectile dysfunction. We investigated the effects of sildenafil citrate administration on lipid peroxidation and antioxidant redox enzymes in blood of healthy men.

Androgen deprivation therapy for prostate cancer: Effects on hand function

OBJECTIVES Prostate cancer is the most frequently diagnosed malignancy. Luteinizing hormone-releasing hormone (LH-RH) agonists are used in most patients with locally advanced and metastatic prostate cancer, and decrease testosterone production. We aimed to find out the effects of androgen deprivation therapy with LH-RH agonist on the hand function, quality of life, and mood of the patients with prostate cancer. SUBJECTS A total of 20 patients with locally advanced prostate cancer and 20 age-matched healthy men were included in the study as LH-RH and control groups, respectively. MAIN MEASURES Age, body mass index, occupation and dominant hand, physical activity level, Beck depression inventory scores, 15D quality of life questionnaire scores, and Duruoz hand index scores were recorded. Handgrip strength was tested in the dominant hand using the Jamar hand dynamometer (Sammons Preston, Inc., Bollingbrook, IL). The Grooved Pegboard Test was used to test manual dexterity. Serum concentrations of total and free testosterone, estradiol levels were measured. RESULTS There were no differences between the groups in body mass index, physical activity level, and age (P > 0.05). Serum total and free testosterone, estradiol level, and the mean grip strength score were statistically lower in the LH-RH group. Manual dexterity was diminished in the LH-RH group (P < 0.001). The Duruoz hand index, and Beck depression inventory and 15D quality of life questionnaire scores were statistically lower in the LH-RH group (P < 0.005). We found a correlation between handgrip strength, dexterity, Beck depression inventory scores, 15D quality of life questionnaire scores, and total and free testosterone. CONCLUSION Men with low testosterone levels caused by androgen deprivation therapy have worse grip strength, dexterity, 15D quality of life questionnaire scores, and depressive symptoms than age-matched men who have not received androgen deprivation therapy.

Management of symptomatic ureteral calculi complicating pregnancy.

OBJECTIVE To review our experiences with management of symptomatic ureteral calculi complicating pregnancy. METHODS Between January 2001 and December 2011, 57 pregnant women were treated for symptomatic ureteral stones. The medical records of these patients were reviewed retrospectively. RESULTS The mean patient age was 24 (range 17-37) years and gestational age at presentation was 26 weeks (range 12-38). Most of the cases (60%) occurred in the third trimester. Flank pain was the most common presenting symptom (90%). Ultrasonography was the initial test confirming diagnosis. With conservative management, spontaneous passing of stones was noted in 13 cases (22.8%). In 10 patients (17.5%), symptomatic relief occurred without spontaneous passing of stones until the end of pregnancy. Invasive management was required in 34 patients (59.6%) because of persistent pain and/or ureteral obstruction. In 29 patients, ureteral calculi were treated successfully by ureteroscopy. Stones were extracted by pneumatic lithotripsy or forceps. In 5 patients, only double-J stent was inserted during ureteroscopy as a result of unreached or migrated stone. The majority of patients (58.8%) had lower ureteric calculi. The mean size of the stones retrieved was 7 mm (range 4-13 mm). Minor complications like ureteric edema, mild ureteric laceration, or bleeding were seen in 5 patients. Three patients had a urinary tract infection and 3 complained of stent-induced bladder irritation; uterine contraction was observed after the procedure in 1 patient, but no serious obstetric or urologic complications were observed in any case. CONCLUSION When conservative treatment fails, ureteroscopy is an effective and safe therapeutic option in symptomatic ureteral calculi complicating pregnancy.

N-acetyl cysteine attenuates diazinon exposure-induced oxidative stress in rat testis

The aim of this study was to investigate the gonadotoxic effects of diazinon and its mechanism of action with special reference to its possible reactive oxygen species generating potential in rat testis and the protective effect of N‐Acetyl Cysteine (NAC) on the exposure of diazinon. The vehicle was given orally to the control group and NAC, diazinon, combination of NAC and diazinon were given to three treatment groups for 4 weeks. Testis lipid peroxidation levels were higher in diazinon group than in control although lipid peroxidation levels were lower in diazinon + NAC group than in diazinon group. The reduced glutathione (GSH) levels were lower in diazinon group than in control and NAC group although its levels were higher in diazinon + NAC group than in diazinon group. Vitamin C, Vitamin E and β‐carotene concentrations were also lower in diazinon group than in control and NAC groups. Vitamin E and β‐carotene concentrations were higher in diazinon + NAC group than diazinon group. Glutathione peroxidase activity and vitamin A concentrations in the testis did not show any difference between the four groups. In conclusion, we observed that NAC treatment modulated diazinon‐induced oxidative injury in the rat testis. These findings suggest that NAC supplementation can be useful in testis oxidative injury caused by the organophosphate insecticides.

Correlation between BMD and bone scintigraphy in patients with prostate cancer

OBJECTIVE Bone metastasis is a major cause of morbidity in prostatic cancer. Therefore, detecting and monitoring bone lesions are crucial for treatment of prostatic carcinoma. We aimed to evaluate total body bone mineral density and regional bone mineral density in patients with prostate cancer with and without metastases, and to compare them with bone scintigraphy. METHODS Fifty-four patients with prostatic carcinoma and 20 healthy subjects were investigated with bone scintigraphy and dual-energy X-ray absorptiometry. The bone scintigraphic findings were classified as normal (score 0: n = 22), abnormal but not typical for metastases (score 1: n = 18), and typical pattern of metastases (score 2: n = 14). RESULTS The patients with bone metastases prostate cancer had significantly higher total bone mineral density and regional bone mineral density of trunk and pelvis than healthy controls and prostate cancer patients without bone metastases. There was a significant positive correlation between bone scan score and total bone mineral density and regional bone mineral density of trunk and pelvis (r = 0.328, P < 0.05, r = 0.60, P < 0.001, r = 0.480, P < 0.001, respectively). CONCLUSION Our results show that patients of prostate cancer with bone metastases have increased bone mineral density (BMD) in the pelvis and trunk, possibly because of a predominance of osteoblastic over osteolytic metastases demonstrated by Tc-99m MDP bone scan.

Acute Prostatitis Due to Brucellosis; Report of Two Cases

DOI: 10.4328/JCAM.3758 Received: 14.07.2015 Accepted: 31.07.2015 Publihed Online: 02.08.2015 Corresponding Author: Ibrahim Koc, Pulmonary Medicine, Viransehir State Hospital, Sanliurfa, Turkey. GSM: +905453142502 E-Mail: Ibrahimkoc1981@gmail.com Ozet Pulmoner emboli vucudun baska bir yerinden kaynaklanan bir olusumla ile pulmoner arterlerin tikanmasi ve erken teshis ve tedavi edilmedigi takdirde yuksek olum oranina sahip bir hastaliktir. Tuberkuloz Mycobacterium tuberculosis’in neden oldugu genellikle akcigerleri etkileyen bir hastalik olup vucudun diger organlari da etkilenebilmektedir. Burada nefes darligi, kilo kaybi ve gece terlemeleri, nefes darligi sikayetleri ile klinigimize basvuran altmis uc yasinda bir kadin hasta sunulmaktadir. Ileri yasta kilo kaybi ve gece terlemesi, bir maligniteyi dusundurmus olmakla beraber tumor belirtecleri negatif saptandi. Sigara icmeyen daha onceden saglikli olan bir bireyde dusuk oksijen saturasyonu pulmoner emboliden suphelendirmistir. Akcigerin bilgisayarli tomografi anjiyografisinde lenfadenopati ve pulmoner emboli saptandi. Servikal lenf nodu eksizyonunun patolojik degerlendirmesinde kazeifikasyon nekrozu saptandi. Sonuc olarak pulmoner emboli tanili olan hastalarda kilo kaybi ve oksijen saturasyonunda dusme varsa maligniteyle beraber tuberkulozun da ekarte edilmesi gerekmektedir.

The Coexistence of the Fibromyalgia Syndrome and the Overactive Bladder Syndrome

Objectives: Overactive bladder syndrome [OBS] and fibromyalgia syndrome [FMS] have similar etiopathological factors such as serotonine, endoteline-1, noradrenaline, etc. The aim of this study was to investigate the relation between OBS and FMS. Methods: This was a prospective study. Patients with OBS and healthy normal control subjects were included in this study. The diagnosis of FMS was based on the 1990 criteria of American College Rheumatology and the diagnosis of OBS was based on urgency and urge incontinence symptoms. All participants completed a questionnaire to gather information including demographic features, medical history such as presence of headache, poor sleep, and urological symptoms, and the Beck depression scale. Patients with OBS were divided into two subgroups according to coexistence of FMS [OBS or OBS + FMS.] Results: Forty patients with OBS and 40 healthy normal control subjects were included in this study. All of the subjects with FMS were female. The FMS was present in 30 percent of OBS subjects and five percent of healthy normal controls [P < 0.05]. Urge incontinence was more common in the OBS than the OBS +FMS subgroup [P< 0.05]. There was not any significant difference with respect to headache, poor sleep, and Beck depression scale score [P > 0.05]. There was a positive correlation between the duration of OBS and FMS [r = 0.614, P < 0.05]. Conclusion: Our findings suggest that there is an association between OBS and FMS, especially in female patients. This may be due to altered serotonin function.

Protective effect of theophylline on renal functions in experimental pneumoperitoneum model

Abstract Our objective in this experimental study is to research the effect of the intra-abdominal pressure which rises following pneumoperitoneum and whether Theophylline has a possible protective activity on this situation. In our study, 24 Wistar Albino rats were used. Rats were divided into two groups. The first group was set for only pneumoperitoneum model. The second group was given 15 mg/kg of Theophylline intraperitoneally before setting pneumoperitoneum model. Then urea, creatinine, cystatin-C, tissue and serum total antioxidant capacity, total oxidant capacity and oxidative stress index in two groups were measured and compared with each other. Apoptosis and histopathological conditions in the renal tissues were examined. The differences between the groups were analyzed with the Mann–Whitney U test. Results were considered significant at p < 0.05. No statistically significant difference was determined between tissue and serum averages in two groups in terms of TAS, TOS and OSI values (p > 0.05). The mean value of urea were similar in pneumoperitoneum and pneumoperitoneum + theophylline groups (p = 0.12). The mean cystatin-C value was 2.2 ± 0.3 µg/mL in pneumoperitoneum, 1.74 ± 0.33 µg/mL in pneumoperitoneum + theophylline (p = 0.002). According to our study, lower cystatin-C levels in the group, where Theophylline was given, are suggestive of lower renal injury in this group. However, this opinion is interrogated as there is no difference in terms of tissue and serum TAS, TOS, OSI and urea values between the groups.

Cancer detection rates of different prostate biopsy regimens in patients with renal failure

Abstract We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

Where Do Patients Go for Treatment of Urethritis

Background: Urethritis is characterized by urethral inflammation, and it can result from both infectious and noninfectious conditions. Physicians and other health care providers play a critical role in preventing and treating urethritis. Objectives: The aim of this study was to describe and identify predictors of health care seeking behavior among men with urethritis. Patients and Methods: In total, 98 male patients aged between 16 to 52 years-of-age (mean 30.9 ± 8.0 years), who attended our clinic with symptoms of urethritis, were included in the study. We conducted face-to-face interviews with the patients using a 9-item survey questionnaire. Patients were divided into three groups according to their level of education as follows: group I (n = 44), elementary school; group II (n = 38), high school; and group III (n = 16), university. Results: Among the 98 patients evaluated, the source of treatment was physicians in 44 patients (44.9%), drugstores in 38 cases (38.77%), and friends in 16 patients (16.32%). There was a statistically significant difference found between the groups according to the source of treatment (P < 0.001). The most common factors associated with seeking care from other sources, rather than physicians, were economic reasons in 19 patients (35.18%), confidentiality concerns in 24 (44.4%), and ease of access in 11 patients (20.37%). Conclusions: A substantial proportion of patients with urethritis sought help from other sources, rather than physicians. The results of our study show that the patients with higher levels of education were more likely to seek help from health care services. It is important to promote the public’s knowledge through informative studies and educational materials in order to encourage patients to seek rapid and effective treatment from proper sources.