Semih Aki

Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence.

We investigated the effectiveness of pelvic floor muscle (PFM) exercises or biofeedback for the treatment of urinary stress incontinence (USI). Fifty patients with USI were included in this randomized, controlled, prospective study. Twenty patients were taught PFM exercises via digital palpation and instructed to perform regularly as home program. The second group of 20 patients had PFM exercises via biofeedback three times a week for 2 months. The third group of 10 patients did not have any exercises. The patients were evaluated via pad test, perineometry, digital palpation based PFM strength, incontinence frequency, and visual analog scale based social activity index prior to and 8 weeks after the treatment. The first two groups had significant improvement in USI with respect to the control group (p < 0.001). The rise in PFM strength with perineometry of the biofeedback group was higher than in the digital palpation group after treatment (p < 0.001). PFM exercises are effective for the treatment of USI; the biofeedback method revealed better PFM strength results with respect to digital palpation.

Insulin resistance and body composition in preterm born children during prepubertal ages.

Background  Premature born children may show insulin resistance in childhood which may be due to intrauterine or postnatal adverse environmental factors.

Insulin, adiponectin, IGFBP‐1 levels and body composition in small for gestational age born non‐obese children during prepubertal ages

Background  Being small for gestational age (SGA) at birth and postnatal growth pattern may have an impact on insulin resistance and body composition in later life. Adiponectin is a strong determinant of insulin sensitivity.

Adiponectin is an indicator of insulin resistance in non‐obese prepubertal children born large for gestational age (LGA) and is affected by birth weight

Background and objective  Being born as large for gestational age (LGA) has an increased risk of developing insulin resistance. Hypoadiponectinaemia is associated with insulin resistance. The aim of this study was to evaluate adiponectin levels and insulin resistance in association with body composition in LGA born non‐obese children at prepubertal ages.

Effect of alendronate on bone density and bone markers in postmenopausal osteoporosis

The aim of this randomized, controlled study was to evalaute effects of 12 months alendronate therapy on bone mineral density (BMD) and markers of bone formation and resorption in women with postmenopausal osteoporosis. Study enrolled women with BMD at least 2 SD below adult, premenopausal BMD mean. Patients to be treated were randomized into two groups. Patients in the control group received 500 mg elemental calcium tablet daily and treatment group received 10 mg/day alendronate and 500 mg elemental calcium tablet for twelve months. Pretreatment characteristics of patients in both groups were similar. A significant increase in BMD of the treatment group patients compared to control group was observed at 12 months ( p< 0.001). Markers of bone formation and resorption in the treatment group reduced significantly at 6 and 12 months of therapy compared to control group ( p< 0.001). In conclusion, we found that 12 months alendronate therapy (10 mg/day) significantly increased BMD in all sites of measurement compared to control group and also significantly reduced markers of bone formation and resorption at all time points (at 6 and 12 months) in postmenopausal women with osteoporosis compared to control group. It is fact that bone density clearly improved by alendronate therapy and the biochemical markers were shown as valid tools for monitoring and prediction of treatment effect of alendronate therapy.

İNMELİ HASTALARDA OTONOMİK FONKSİYONLAR: VASKÜLER TUTULUMUN YERİ İLE KARŞILAŞTIRMA

Amac: Calismamizin amaci; inmeli hastalarin sempatik ve parasempatik sistem fonksiyonlarini arastirmak ve vaskuler tutulumun yeri ile iliskisini incelemekti. Gerec ve yontem: Her iki ust ekstremitenin sempatik deri yaniti (SSR) ve RR interval varyasyonlari (RRIV) inmeli 56 hasta ve 42 saglikli gonullude istirahat ve derin nefes sirasinda kayit edildi. Bulgular: Inmeli hastalarin her iki (etkilenen ve etkilenmeyen) tarafinin ortalama SSR latanslari kontrollerinki ile karsilastirildiginda anlamli olarak uzamisti (p < 0,05). Inmeli hastalarin her iki ekstremitesinden elde edilen ortalama amplitudler (0,8±0,6 mV etkilenen, 0,9±0,8 mV etkilenmeyen) kontrollerden anlamli olarak daha kucuktu (1,4 ±0,9 mV) (p < 0,001, p < 0,01). Hastalarda istirahatte RRIV’ler kontrollerle karsilastirildiginda 30,97± 27,99 karsi 16,5±5,1 ve derin nefes alma ile 34,2±25,2 karsi 19,9±8,6 idi (p < 0,05). Infarkt lokalizasyonuna gore lezyonlar hemisferik (n=46) ve beyin sapi olarak siniflandi (n=10). Hemisferik lezyonlu hastalarin kontroller ile karsilastirildiginda anlamli olarak artmis latanslari vardi (p < 0,05) ve amplitudleri dusuktu (p < 0,001), istirahat (p < 0,001) ve hiperventilasyon sirasinda (p < 0,001) RRIV artmisti. Istirahat ve derin nefes ile RRIV’nin her ikisi sag taraf kortikal lezyonlarinda sol taraf kortikal lezyonlarindan daha yuksekti (p < 0,05, p < 0,01). Beyin sapi lezyonlarinin etkilenen ellerinden artmis SSR latanslari ve etkilenmeyen ellerinden azalmis amplitudleri kontrollere gore kayit edilmistir (p < 0,05). Sonuc: Sonuc olarak beyin damar tutulumlarinda esas olarak sag taraf kortikal lezyonlari sempatik ve parasempatik fonksiyonlari etkilendi. Beyin sapi vaskuler lezyonlari sadece sempatik refleks aktivitenin tutulumu ile karakterize idi.