Sibel Canbaz Kabay

Acute urodynamic effects of percutaneous posterior tibial nerve stimulation on neurogenic detrusor overactivity in patients with Parkinson's disease

Lower urinary tract dysfunction is often occurs in patients with Parkinsons disease (PD), that is primarily induced by neurogenic detrusor overactivity (NDO) and negatively effect the quality of the patients life. The aim of this study is to evaluate the acute effects of posterior tibial nerve stimulation (PTNS) on the urodynamic findings in the PD patients with NDO.

The clinical and urodynamic results of a 3-month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis-related neurogenic bladder dysfunction†‡

The aim of this study was to investigate the effect of PTNS after 12 weeks, on the urodynamic findings in the Multiple Sclerosis (MS) patients with neurogenic detrusor overactivity (NDO).

Efficiency of Posterior Tibial Nerve Stimulation in Category IIIB Chronic Prostatitis/Chronic Pelvic Pain: A Sham-Controlled Comparative Study

Objectives: To evaluate the efficacy of percutaneous posterior tibial nerve stimulation (PTNS) for treatment of the patients with category IIIB chronic non-bacterial prostatitis/chronic pelvic pain syndrome. Methods: A total of 89 patients with therapy-resistant pelvic pain were randomized to receive either nerve stimulation (n = 45) or sham treatment (n = 44). The National Institutes of Health Chronic Prostatitis Symptom Index and visual analogue scale were used to assess treatment success after 12 weeks of intervention. Objective success was defined as a minimum 50% decrease in the mean scores. A decrease of over 25% to below 50% was considered to be a partial response. Results: An objective response was observed with the pain and symptom scores after 12 weeks of PTNS in 18 (40%) and 30 (66.6%) of the patients, whereas a partial response was observed in 27 (60%) and 15 (33.3%) of the patients, respectively. Mean symptom scores and visual analogue scale scores for pain and urgency were significantly changed from 23.6 ± 6.3 at baseline to 10.2 ± 3.6, 7.6 ± 0.8 at baseline to 4.3 ± 0.6, 5.7 ± 0.8 at baseline to 3.4 ± 0.7, respectively. Scores for the symptoms, urgency and pain were not changed with sham treatment. Conclusions: These results have demonstrated that percutaneous PTNS may relieve pain in the patients with category IIIB chronic non-bacterial prostatitis/chronic pelvic pain syndrome.

The clinical evaluation of the oral status in Alzheimer-type dementia patients.

BACKGROUND To evaluate the oral health status in patients with Alzheimer dementia (AD), and the association of the disease severity with the oral findings. METHODS The study was conducted on the study group (31 AD patients) and the control group (47 healthy volunteers) from the Neurology Department of the Institute. Cognitive status was evaluated with the MMSE scoring system. Oral parameters, such as decaying, missing, filled teeth (DMFT) index and teeth present (PT) were evaluated in the patients. Oral hygiene status, denture status and mucosal lesions, including denture-induced stomatitis were also investigated. RESULTS The study was conducted on the study group (31 AD patients) and the control group (47 healthy volunteers). Tooth brushing and denture cleaning were irregular in 22 of 31 (70%) patients with AD. The ratio of the subjects who forgot to remove their denture during the night was significantly higher in the study group than in the control group (p < 0.001). In this study, decreased cognitive functions in AD patients have been demonstrated to result in a deterioration of denture care and increased denture-related mucosal lesions. CONCLUSIONS These findings were considered due to decreased denture care including the non-removal of the denture in the night in the patients with decreased cognitive functions.

The Clinical and Urodynamic Results of Percutaneous Posterior Tibial Nerve Stimulation on Neurogenic Detrusor Overactivity in Patients With Parkinson's Disease

OBJECTIVE To investigate the effect of percutaneous posterior tibial nerve stimulation (PTNS) treatment after 12 weeks on urodynamic and clinical findings in patients with Parkinsons disease (PD) with neurogenic detrusor overactivity. METHODS A total of 47 patients with PD with neurogenic detrusor overactivity were enrolled in the study. Urodynamic studies before and after 12-week PTNS treatment were performed. International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder Questionnaire (OAB-V8), and Overactive Bladder Questionnaire Short Form (OAB-q SF) have been assessed before and after PTNS treatment. RESULTS The mean first involuntary detrusor contraction volume (1st IDCV) on standard cystometry was 133.2 ± 48.1 (24-265) mL, whereas it was 237.3 ± 43.1 (145-390) mL after PTNS. The mean maximum cystometric capacity (MCC) on standard cystometry was 202.2 ± 36.5 (115-320) mL, whereas it was 292.1 ± 50.6 (195-395) mL after stimulation. The improvements in the first involuntary detrusor contraction volume and maximum cystometric capacity were statistically significant after stimulation. The mean Pdetmax at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, PdetQmax, Qmax, and post-void residual volume were statistically significant after 12-week stimulation. Mean parametric improvements at 12-week PTNS treatment from baseline included daytime frequency decreased by 5.6 voids daily, urge incontinence decreased by 3.1 episodes daily, urgency episodes decreased by 6.3 episodes daily, nocturia decreased by 2.7 voids, and voided volume improved by a mean of 92.6 mL. The change from baseline on the ICIQ-SF, OABv8, and OAB-q at 12-week PTNS treatment demonstrated statistically significant improvements. CONCLUSION These results have demonstrated that PTNS improves the lower urinary tract symptoms and urodynamic parameters in patients with PD.

The neuroprotective effect of acute moderate alcohol consumption on caspase-3 mediated neuroapoptosis in traumatic brain injury: The role of lysosomal cathepsin L and nitric oxide

Our aim in this study was to investigate the effect of moderate acute alcohol administration on cysteine protease mediated neuronal apoptosis and nitric oxide production in the traumatic brain injury. A total of 29 adult Sprague-Dawley male rats weighing 250-300 g were used. The rats were allocated into four groups. The first group was the control (sham-operated) group in which only a craniotomy was performed, the others were alcohol, trauma and trauma+alcohol groups. Caspase-3 enzyme activity in the trauma group increased significantly in comparison with the control group. The alcohol given group showed a decreased caspase-3 enzyme activity compared to the trauma group. The level of caspase-3 enzyme activity in the alcohol+trauma group decreased in comparison to the trauma group. SF/FEL ratio of cathepsin-L enzyme activity in the trauma group was significantly higher than in the control group. Our results indicate that moderate alcohol consumption may have protective effects on apoptotic cell death after traumatic brain injury. Protective effects of moderate ethanol consumption might be related to inhibition of lysosomal protease release and nitric oxide production.

Erythropoietin prevents nitric oxide and cathepsin-mediated neuronal death in focal brain ischemia.

We examined the preventive effect of human recombinant erythropoietin (HrEPO) on nitric oxide (NO)-mediated toxicity to neurons and cysteine protease release into cytoplasm, which is attributed to neuronal death in brain ischemia. Focal cerebral ischemia was induced by permanent occlusion of middle cerebral artery in two sets of rat. The first set was used to monitor NO concentration and cathepsin activity, while the second was used for histological examination with hematoxylin and eosin, and TUNEL staining. A group in both set was administered human recombinant erythropoietin (HrEPO). NO content, cathepsins B and L activity increased significantly in the post-ischemic cerebral tissue (p<0.05). HrEPO treatment reduced NO concentration and cathepsin activity to control level (p>0.05). A significant increase in the number of necrotic and apoptotic neurons was observed in the post-ischemic cerebral cortex (p<0.05). HrEPO treatment was markedly lowered both of these (p<0.05). It is concluded that HrEPO prevents neuronal death by protecting neuronal liposomes from NO-mediated toxicity and suppressing the release of cathepsins.

Long term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12-months results

The aim of this study is to determine the sustained therapeutic efficacy and treatment intervals for PTNS in NOAB with MS, offering periodic additional treatments during 1 year in patients who completed an initial course of 12 consecutive weekly sessions.

The effects of levetiracetam on urinary 15f-2t-isoprostane levels in epileptic patients

PURPOSE We aimed to investigate the effects of levetiracetam on oxidative stress which is one of the new antiepileptic drugs in epileptic patients. METHODS The study consisted of 21 patients with cryptogenic partial epilepsy. We determined the urinary 15F-2t-isoprostane levels of the 30 patients which is a marker of oxidative stress. Morning urine samples were collected from the patients before beginning LEV and after 3 months treatment. Of these patients 9 were excluded from the study that had seizure history in the last 1 month. Urinary levels of 15-F2t-isoprostane determined by ELISA initially and after 3 months treatment for each patient. RESULTS Mean age of the 21 patients was 29.6, of these 11 were females and 10 males. Mean urinary 15F-2t-isoprostane level of the patients was 876 ± 447 ng/mg Cr before the treatment of LEV. After 3 months treatment the mean 15F-2t-isoprostane level of the patients was 1560 ± 630. The patients had significantly higher levels of urinary 15F-2t-isoprostane when compared with initial levels (p = 0.025). CONCLUSION Our results showed the increase of urinary 15F-2t-isoprostane levels in epileptic patients whom were treated with LEV which may indicate that LEV induces the oxidative stress in epileptic patients.

Evaluation of the Size and Area of the Corpus Callosum with the Osiris Method in Alzheimer’s Disease

Background/Objective: Significant corpus callosum (CC) atrophy has been demonstrated in patients with Alzheimer’s disease (AD). The aim of this study is to evaluate the size and the area of the CC with the Osiris method. The correlation between the CC measurements and Mini-Mental Status Examination (MMSE) scores in AD patients was also investigated. Methods: The results of the topographic measurements included the cross-sectional area of entire CC, body, rostral portion of the genu and splenium from a midsagittal magnetic resonance imaging section. The results of the topographic measurements of CC on MRI with the Osiris method were compared between AD (n = 29) and control subjects (n = 27). Results: In AD patients the mean value of the splenium was 9.2 ± 1.5 mm, the width of the CC body was 3.9 ± 0.2 mm, the rostral portion of the genu was 7.9 ± 0.2 mm, and the total CC area was 47.2 ± 0.9 mm2. In the control group the mean values were 12.2 ± 2.1 mm, 5.9 ± 0.2 mm, 11.2 ± 0.2 mm and 56.1 ± 0.6 mm2, respectively. Significant reduction was detected in the splenium, the CC body and the rostral part of the genu and CC area in AD patients. The MMSE score was 18.9 ± 4.5 in the AD patients and 29.1 ± 0.9 in the control subjects. A significant positive correlation between the MMSE scores and each CC measurement was seen in the AD patients. Conclusion: The results of this study suggest that callosal atrophy in AD may suggest the severity of the disease. The Osiris method for CC measurements may be used as an easy and reliable technique to assess the severity of the disease.