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    ASSESSMENT OF HEADACHE IN MEN TAKING PHOSPHODIESTERASE-5 INHIBITOR (TADALAFIL) FOR ERECTILE DYSFUNCTION
    (Carbone Editore, 2014) Okuyucu, E. Esra; Guven, Oguz; Ucar, Edip; Duman, Taskin
    Aims: Tadalafil, a selective inhibitor of the cyclic guanosine monophosphate (cGMP) degrading phosphodiesterase 5 (PDE5), is known to cause headache as a secondary effect. This study was undertaken to assess the frequency, clinical characteristics of headache prospectively in a group of erectile dysfunction patients taking tadalafil as a PDE inhibitor. Materials and methods: As the first step of study, the question about having ever headache in last year was asked. Of the 31 patients, 16 patients (51.6%) had yes as an answer for the presence of headache. A questionnaire was given to the patients who had experienced headache whether recurrent or not. When patients were at headache-free period, tadalafil (20 mg) was administrated to each patient. The question about having headache was asked 5 hours and 48 hours later. According to the answer of this question, second questionnaire was conducted. The analysis of questionnaires was made separately. International Classification of Headache Disorders (ICHD) has been used for the case definition criteria. Results: A statistical significant difference was observed for the occurrence of headache between the baseline, 5th and 48th hours (p=0.001, cochrans Q test). However, we found no significant difference in headache occurrence between fifth hour and 48th hour of tadalafil 20 mg administration (p=0.687, Mc Nemar test). Conclusion: So from this study, it can be concluded that tadalafil can trigger headache attacks within the half-life of the drug.
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    Assessment of headache in men taking phosphodiesterase-5 inhibitor (tadalafil) for erectile dysfunction
    (Acta Medica Mediterranea, 2014) Esra Okuyucu, E.; Guven, Oguz; Ucar, Edip; Duman, Taskin
    Aims: Tadalafil , a selective inhibitor of the cyclic guanosine monophosphate (cGMP) degrading phosphodiesterase 5 (PDE5), is known to cause headache as a secondary effect. This study was undertaken to assess the frequency, clinical characteristics of headache prospectively in a group of erectile dysfunction patients taking tadalafil as a PDE inhibitor. Materials and methods: As the first step of study, the question about "having ever headache in last year" was asked. Of the 31 patients, 16 patients (51.6%) had "yes" as an answer for the presence of headache. A questionnaire was given to the patients who had experienced headache whether recurrent or not. When patients were at headache-free period, tadalafil (20 mg) was administrated to each patient. The question about "having headache" was asked 5 hours and 48 hours later. According to the answer of this question, second questionnaire was conducted. The analysis of questionnaires was made separately. International Classification of Headache Disorders (ICHD) has been used for the case definition criteria. Results: A statistical significant difference was observed for the occurrence of headache between the baseline, 5th and 48th hours (p= 0.001, cochran's Q test). However, we found no significant difference in headache occurrence between fifth hour and 48th hour of tadalafil 20 mg administration (p= 0.687, Mc Nemar test). Conclusion: So from this study, it can be concluded that tadalafil can trigger headache attacks within the half-life of the drug.
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    Coronary Artery Disease Risk Factors in Patients on Continuous Ambulatory Peritoneal Dialysis
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Pocan, Bekir; Ucar, Edip; Kuvandik, Guven; Borazan, Ali; Guven, Oguz; Gursurer, Metin; Camizci, Rale
    Aim: We aimed to investigate especially early stage non traditional cardiovascular risk factors in end stage renal failure patients who were in Continued Ambulatory Peritoneal Dialysis (CAPD) programme in our center. Methods: In this study 21 CAPD patients and 21 sex and age matched controls were enrolled. The clinical history and demographic parameters were obtained and than for physical evaluation blood samples were drawn for 12 hours fasting glucose, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, apoA, apoB, total protein, albumin, calcium, phosphorus, parathormon (PTH), hemoglobin (Hb), Lp(a), C-reactive protein (CRP), homocysteine (tHcy), anticardiolipin antibody (ACLA), fibrinogen. Results: While age, sex, Body Mass Index (BMI), smoking status and hereditary factors were comparable between the groups, diabetes mellitus and hypertension were significantly higher in CAPD patients. There was no statistical significance between the groups considering mean serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, PTH, Lp(a), tHcy, ACLA Ig M and ACLA Ig G levels. In the present study mean apoA level was significantly lower in the study group, while apoB and phosphorus were higher (p=0.003). Also mean total protein, albumin, calcium, and Hb level were significantly lower, while mean CRP and fibrinogen were higher in the study group (p=0.0003). Conclusion: Because of the high rates of increased risk factors for coronary artery disease in CAPD patients at early stages, these patients should be closely followed for coronary artery disease.
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    EEG abnormalities during treatment with tadalafil, a phosphodiesterase type 5 inhibitor
    (Taylor & Francis Ltd, 2009) Okuyucu, Esra E.; Guven, Oguz; Duman, Taskin; Gorur, Sadik; Melek, Ismet M.; Akcin, Soner; Yilmazer, Serkan
    Objective: Tadalafil is a selective phosphodiesterase type 5 (PDE-5) inhibitor approved for the treatment of erectile dysfunction. Less is known about the electroencephalography (EEG) effects of PDE-5 inhibitors, and the present study, therefore, examined the risk of EEG abnormalities associated with tadalafil. Method: EEG recordings from 35 erectile dysfunction patients taking tadalafil (20 mg) were graded for severity of EEG abnormalities (at admission, 2 and 48 hours after tadalafil administration). Results: At admission, there were no EEG abnormalities. At second EEG, abnormalities occurred in 12 (34.3%) of the 35 patients. Eight (22.9%) patients had mild and four (11.4%) patients had moderate EEG abnormalities. At third EEG, one (2.9%) patient had mild and one (2.9%) patient had moderate EEG abnormalities. Conclusion: PDE-5 inhibitors may produce EEG abnormalities. Although the exact role of PDE in altering susceptibility to seizure remains unclear, epileptic seizures may occur during treatment with PDE inhibitors. [Neurol Res 2009; 31: 313-315]
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    Frequency of Metabolic Syndrome among Hemodialysis Patients According to NCEP-ATP III and IDF Definitions
    (Taylor & Francis Ltd, 2009) Ucar, Edip; Huzmeli, Can; Guven, Oguz; Savas, Nazan; Gullu, Murat; Asilyoruk, Sema; Kuvandik, Ceren
    Objective. Patients with chronic renal failure (CRF) have an increased risk of death from cardiovascular diseases. The metabolic syndrome is a common risk factor for cardiovascular diseases. In the present study, it was aimed to evaluate the frequency of metabolic syndrome using the National Cholesterol Education Program Adults Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF) definitions in patients with end-stage CRF undergoing hemodialysis (HD). Materials and Methods. A total of 222 cases undergoing HD were enrolled in the study. After obtaining medical history and physical examination, blood samples were collected from each patient for the measurements of fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. Results. Among HD patients evaluated according to both IDF and NCEP-ATP III definitions, the diagnosis of metabolic syndrome was confirmed by IDF in 56.5% of those fulfilling the criteria for NCEP-ATP III. Similarly, 86% of the undiagnosed patients according to NCEP-ATP III were confirmed by IDF definitions. The sensitivity and positive predictive value of NCEP-ATP III for metabolic syndrome were 81.25% and 64.8%, respectively. The area under the Receiver Operating Characteristic (ROC) curve for NECP-ATP III and IDF was 0.730. False-positive rate and probability ratio for NECP-ATP III were 0.352 and 2.49, respectively. In other words, among the patients who were diagnosed with metabolic syndrome according to NCEP-ATP III definitions, the proportion of subjects whose diagnosis was confirmed by IDF definitions was 2.49-fold higher than those with unconfirmed diagnosis. Conclusion. It is logical to evaluate patients with CRF for metabolic syndrome and cardiovascular risk factors at the time of diagnosis and regularly thereafter due to the high ratio of metabolic syndrome in this population.
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    Is Type 2 Diabetes Mellitus a Predictive Factor for Incontinence After Laparoscopic Radical Prostatectomy? A Matched Pair and Multivariate Analysis
    (Elsevier Science Inc, 2010) Teber, Dogu; Sofikerim, Mustafa; Ates, Mutlu; Goezen, Ali Serdar; Guven, Oguz; Sanli, Oener; Rassweiler, Jens
    Purpose: We evaluated the effect of diabetes mellitus on incontinence after laparoscopic radical prostatectomy. Materials and Methods: From a series of 2,071 patients 135 with type 2 diabetes mellitus undergoing laparoscopic radical prostatectomy without radiotherapy and with a minimum followup of 24 months were identified. These patients were randomly matched with 135 nondiabetic controls for age, body mass index, preoperative prostate specific antigen, clinical stage, neoadjuvant hormonal therapy, prostate volume, previous surgery, surgeon skills, surgical approach, presence of bladder neck sparing, lymphadenectomy, technique of urethrovesical anastomosis and attempted nerve sparing surgery. Results: Using multivariate analysis age, diabetes mellitus and duration of diabetes mellitus were independent factors for post-prostatectomy incontinence in the whole group. Early continence (0 to 3 months) was observed in 43.7% of patients with diabetes and in 57.8% of nondiabetic controls which was statistically significant (p = 0.02). The rates of continence in patients with diabetes mellitus for 5 or more years at 3, 12 and 24-month evaluations were less than those in patients with diabetes mellitus for less than 5 years, and the difference was statistically significant (36% vs 50%, p = 0.001; 63.9% vs 82.4%, p = 0.02; 91.8% vs 98.6%, p = 0.03, respectively). Conclusions: Patients with type 2 diabetes mellitus need longer to recover continence than nondiabetics after laparoscopic radical prostatectomy. However, type II diabetes mellitus did not affect overall return to continence. Patients with diabetes mellitus for 5 or more years have an almost 5 times increased risk of post-prostatectomy incontinence compared to those with diabetes mellitus for less than 5 years. Diabetic patients should be counseled for the potential negative impact of diabetes mellitus on the recovery of continence after laparoscopic radical prostatectomy.