Ankara Üniversitesi Tıp Fakültesi mecmuası, Feb 1, 2013
Amac: 2002-2003 Egitim Ogretim yilinda Ankara Universitesi Tip Fakultesi, yeterlige-dayali profes... more Amac: 2002-2003 Egitim Ogretim yilinda Ankara Universitesi Tip Fakultesi, yeterlige-dayali profesyonel becerilerin ve probleme dayali ogrenme oturumlarinin oldugu, entegre, ogrenci merkezli bir mufredata gecmiștir. Bundan onceki yillarda disipline-dayali, geleneksel mufredat ile egitim verilmiștir. Bu nedenle her iki mufredat, paralel olarak geleneksel mufredatla egitim goren ogrenciler 2007 yilinda mezun olana kadar devam etmiștir. Bu calișmanin amaci, Ankara Universitesi Tip Fakultesinde yurutulmekte olan iki farkli egitim sistemi ile (klasik ve entegre) egitim goren Donem 5 ogrencilerinin, empati beceri duzeylerini karșilaștirmaktir. Metot: Calișma grubunu 2005-2006 Egitim-Ogretim Yilinda klasik sistemle egitim goren 194 Donem 5 ogrencisi ve 2006-2007 Egitim-Ogretim Yilinda entegre sistemle egitim goren 127 Donem 5 ogrencisi olușturmaktadir. 321 ogrencinin verileri, her biri 7 dereceli 20 maddeden olușan “Jefferson Empati Skalasi” ile toplanmiștir. Donem 5 ogrencilerinin empati skorlarinin farklilik gosterip gostermedigini test etmek icin t-testi kullanilmiștir. Bulgular: Bulgular, Donem 5 ogrencilerinin empati skorlarinda iki farkli egitim sistemine gore anlamli bir farklilik oldugunu gostermiștir. Sonuc: Bu calișma, ogrenci merkezli mufredatin ogrencilerin empati skorlari uzerindeki etkisini gosteren bir on calișma niteligindedir. Yazarlar, yeni mufredatin ogrencilerin empati duzeylerini arttirmada etkili olabilecegini one surmektedirler. Fakat calișmanin sinirliliklari goz onunde bulundurularak sonuclarin genelleme yapmadan once dikkatle yorumlanmasi gerekir. Bunun icin daha iyi organize edilmiș calișmalara gerek vardir.
Calismaya 2005 ? 2007 yillari arasinda A.U.T.F. Kadin Hastaliklari ve Dogum AnabilimDali Poliklin... more Calismaya 2005 ? 2007 yillari arasinda A.U.T.F. Kadin Hastaliklari ve Dogum AnabilimDali Polikliniginde muayene olan nullipar gebeler dahil edilmistir. Her iki gruptaki gebelerinuretra rotasyon acilari perineal ultrason ile Kadin Hastaliklari ve Dogum Anabilim Dalinda,perineometri ise Fiziksel TIP ve Rehabilitasyon Anabilim Dalinda yapilarak pelvik taban kaskuvveti olculmustur.Calisma sonucunda hem egzersiz grubunda hem de kontrol grubunda anlamli sonuclar eldeedilmistir. Yas, dogum agirliklari ve BM? gibi parametrelerde her iki grupta anlamli farkcikmamasina ragmen, uretra rotasyon acisinda, pelvik taban kas kuvvetinde, P?SQ-12, UD?-6ve ??Q-7 skorlamalarindaki sonuclar hem gebelik trimesterler arasi hem de postpartumdonemde anlamli olarak degerlendirilmistir. Her iki grupta pelvik taban kas kuvvetinde artis,UD?-6 skorlamasinda anlamli azalma tespit edilsede, uretra rotasyon acisi gibi onemliparametrede kontrol grubunda her hangi bir degisiklik izlenmemistir. Egzersiz grubunda iseuretra rotasyon acisindaki azalma sadece postpartum donemde degil hem de gebeliktrimesterleri arasinda anlamli fark gostermistir. Her iki grup arasindaki diger onemli farkpelvik taban kas kuvvetindeki artisin ve UD?-6 skorlamalarinda anlamli azalmanin kontrolgrubunda gebelik trimesterler arasi gorulmemesidir. Buda gebelikte yapilan egzersizlerin alturiner semptom acisindan bir daha onemini ortaya koymaktadir.Ozet olarak bizde buradan yola cikarak nullipar gebelerde egzersizin alt uriner sistemsemptomlarina,pelvik taban kas kuvvetine etkisini arastirmak icin bu calismayi yaptik. Hastasayisinin az olmasi verilerin optimum ihtimalini dusurse de, daha kapsamli calismalarin dahaiyi sonuclar verecegini dusundurmektedir.Buna ragmen vaka grubundaki parametrelerdeUD?-6 anket skorlarinda ve uretra rotasyon acisindaki azalma egzersizin onemini bir dahaortaya koymaktadir. Gunumuzde bu calismanin devamini getirmek ve objektif bulgular eldeetmek icin daha genis serilerde calismalara ihtiyac oldugu dusuncesindeyiz.AbstractNulliparous pregnant women who were examined in Ankara University, Faculty ofMedicine, Obstetrics and Gynecology Department outpatients clinic included into the study.For both of the groups urethral rotation angles were measured by perinal ultrasonography inObstetrics and Gynecology Department and pelvic floor muscle strenghts were measured byperineometry in Physical Medicine and Rehabilitation Department.Significant results were achieved for both the exercise and control groups. Althoughthere wasn?t any significant difference in age, birth weight and body mass index between thegroups; urethral rotation angle, pelvic floor muscle strength, PISQ-12, UDI-6 and IIQ-7scores were evaluated significantly different both between trimesters and postpartum period.Although in both groups pelvic floor muscle strength increased and UDI-6 scores decreased,urethral rotation angle which is an important parameter did not change in control group. In theexercise group the decrease of urethral rotation angle was significant during postpartumperiod and between trimesters. Another important difference between both groups wereincrease in pelvic floor muscle strength and decrease in UDI-6 scores were not observed indifferent trimesters of control group. These results support the hypothesis that exercises inpregnancy are very important for lower urinary tract lesions.This study was held to investigate the effect of exercise on lower urinary systemsymptoms and pelvic floor muscle strength. Since a small number of patients were involved inthe study, the significance of the results may be suspicious. So more detailed studies arenecessary. Thus, parameters, UDI-6 survey scores and decreased urethral rotation angleexpress the importance of exercise in study group. We believe that to achieve more objectivedata similar studies on larger populations should be held.
Plasma copper (Cu), zinc (Zn) and magnesium (Mg) levels were measured in three groups of women; (... more Plasma copper (Cu), zinc (Zn) and magnesium (Mg) levels were measured in three groups of women; (1) pregnant women suffering from hyperemesis gravidarum (HG)(n=43); (2) pregnant women with uncomplicated pregnancies (n=11) and (3) non-pregnant women (n=11). Plasma Cu, Zn and Mg levels were measured by atomic absorbtion spectrophotometer. We determined that plasma Zn and Mg levels were lower in patients with HG and significant differences were noted between the control groups and HG patients (P < 0.05, P < 0.01). We still need further large cohort studies in order to understand if this is the cause or consequence of hyperemesis gravidarum.
Biz yaptigimiz bu calisma ile urojinekoloji poliklinigimizde AAMS tanisi konan hastalarda antikol... more Biz yaptigimiz bu calisma ile urojinekoloji poliklinigimizde AAMS tanisi konan hastalarda antikolinejik tedavi ile agirlikli vajinal koniler araciligi ile yapilan pelvik taban egzersizlerinin AAMS tedavisindeki etkisini karsilastirmayi hedefledik.Calismaya Temmuz 2008 ? Ocak 2010 tarihleri arasinda urojinekoloji poliklinigimize basvuran hastalardan oyku, fizik muayene, idrar gunlugu, 24 saatlik pet testi, urodinami testleri yapilan ve AAMS tanisi konan 39 hasta dahil edildi. Hastalar randomize olarak iki gruba ayrildi. Bir gruba vajinal kon ile pelvik taban kas egzersizleri yaptirildi, diger gruba ise tolterodin verildi. Randomizasyon sonrasinda vajinal kon grubunda 19, tolterodin grubunda 20 hasta mevcuttu. Her iki grup arasinda demografik ozellikler arasinda istatistiksel olarak anlamli fark yoktu. 8 haftalik tedavi sonrasinda urojinekolojik muayeneleri, idrar gunlukleri, 24 saatlik pet testi ve urodinami testleri tekrarlanan hastalarin idrara sikisma suresi, yapilan idrar volumu acisindan tedavi oncesine gore anlamli bir iyilesme gozlenmezken; 24 saatlik pet testinde iki grupta da anlamli bir iyilesme gozlendi.(Sirasiyla p=0,003 ve p=0,001) Tedavi suresince tutmalari istenen idrar gunlugunde gunluk idrar sikligi, gece idrar sikligi ve idrar kacirma sikligi acisindan her iki grupta da anlamli bir iyilesme gozlenmistir. Sorgulama formlari degerlendirildiginde vajinal kon kullanan hastalarin IIQ-7, Wagner ve AAM-V8, tolterodin alan hastalarin ise IIQ-7, UDI-6 ve AAM-V8 formlarinda sikayetleri ile ilgili anlamli bir duzelme gozlemledik. Oysa urodinamik testde DAA oranlarindaki azalma, ilk idrar hissindeki ve maksimum vezikal basinctaki artma vajinal kon grubunda anlamli iken diger parametreler acisindan degisim iki grupta da saptanmadi.Daha onceki calismalarda pelvik taban kas egzersizlerinin ve antikolinerjiklerin AAMS tedavisinde etkin oldugu gosterilmistir. Biz ise calismamizda AAMS hastalarinda ilk basamak tedavi olarak pelvik taban kas egzersizlerinden biri olan vajinal kon uygulamasinin AAMS tedavisinde etkinligi kabul gormus antikolinerjikler kadar etkili oldugunu gosterdik.abstractThe aim of study were compared the efficacy anticholinergic treatment and pelvic floor muscle training with vaginal cones in patients who diagnosed OAB.Between July 2008 and January 2010, this study were enrolled 39 women who admited to our urogynecology clinic and diagnosed OAB with symptoms, physical examination, urinary diary, 24-hour pad test, urodynamic testing, patients were divided into two groups randomly. A group of vaginal cones mediated pelvic floor muscle excercises were performed while the other group were given tolterodine after randominization there were 19 patients in vaginal cone group and 20 patients in tolterodine group. demographic characteristics did not statistically differences between two groups. After 8 weeks of treatment patients reevaluated with urogynecologic examinations, urinary diaries, urodynamic testing and repeated 24-hour pad test the urine. The urine volumes, time compressed into urine of patients observed no significant improvement compared to before treatment. 24-hour pad test showed a significant improvement in both groups similar to patients frequency, nocturia, incontinence when maintained throught during treatment patients urinary diaries were evaluated. Significant difference was found after treatment patients complaints when evaluated quastionnare forms of vaginal cones group IIQ-7, Wagner, OAB-V8; quastionnare forms of tolterodine group IIQ-7, UDI-6, OAB-V8. Whereas at urodynamic testing decrease in the rate of DAA, feeling of the first urine and maximum vesical pressure increased were observed significant improvement at vaginal cones group. Both groups were showed no changes in the other parameters.In previous studies was shown to be effective pelvic floor muscle exercises and anticholinergics in the treatment of OAB. In our study, we have demonstrated that one of the pelvic floor training with vaginal cones can be effective as anticholinergic activity which preffered first step treatment of OAB.
Ankara Üniversitesi Tıp Fakültesi mecmuası, Feb 1, 2013
Amac: 2002-2003 Egitim Ogretim yilinda Ankara Universitesi Tip Fakultesi, yeterlige-dayali profes... more Amac: 2002-2003 Egitim Ogretim yilinda Ankara Universitesi Tip Fakultesi, yeterlige-dayali profesyonel becerilerin ve probleme dayali ogrenme oturumlarinin oldugu, entegre, ogrenci merkezli bir mufredata gecmiștir. Bundan onceki yillarda disipline-dayali, geleneksel mufredat ile egitim verilmiștir. Bu nedenle her iki mufredat, paralel olarak geleneksel mufredatla egitim goren ogrenciler 2007 yilinda mezun olana kadar devam etmiștir. Bu calișmanin amaci, Ankara Universitesi Tip Fakultesinde yurutulmekte olan iki farkli egitim sistemi ile (klasik ve entegre) egitim goren Donem 5 ogrencilerinin, empati beceri duzeylerini karșilaștirmaktir. Metot: Calișma grubunu 2005-2006 Egitim-Ogretim Yilinda klasik sistemle egitim goren 194 Donem 5 ogrencisi ve 2006-2007 Egitim-Ogretim Yilinda entegre sistemle egitim goren 127 Donem 5 ogrencisi olușturmaktadir. 321 ogrencinin verileri, her biri 7 dereceli 20 maddeden olușan “Jefferson Empati Skalasi” ile toplanmiștir. Donem 5 ogrencilerinin empati skorlarinin farklilik gosterip gostermedigini test etmek icin t-testi kullanilmiștir. Bulgular: Bulgular, Donem 5 ogrencilerinin empati skorlarinda iki farkli egitim sistemine gore anlamli bir farklilik oldugunu gostermiștir. Sonuc: Bu calișma, ogrenci merkezli mufredatin ogrencilerin empati skorlari uzerindeki etkisini gosteren bir on calișma niteligindedir. Yazarlar, yeni mufredatin ogrencilerin empati duzeylerini arttirmada etkili olabilecegini one surmektedirler. Fakat calișmanin sinirliliklari goz onunde bulundurularak sonuclarin genelleme yapmadan once dikkatle yorumlanmasi gerekir. Bunun icin daha iyi organize edilmiș calișmalara gerek vardir.
Calismaya 2005 ? 2007 yillari arasinda A.U.T.F. Kadin Hastaliklari ve Dogum AnabilimDali Poliklin... more Calismaya 2005 ? 2007 yillari arasinda A.U.T.F. Kadin Hastaliklari ve Dogum AnabilimDali Polikliniginde muayene olan nullipar gebeler dahil edilmistir. Her iki gruptaki gebelerinuretra rotasyon acilari perineal ultrason ile Kadin Hastaliklari ve Dogum Anabilim Dalinda,perineometri ise Fiziksel TIP ve Rehabilitasyon Anabilim Dalinda yapilarak pelvik taban kaskuvveti olculmustur.Calisma sonucunda hem egzersiz grubunda hem de kontrol grubunda anlamli sonuclar eldeedilmistir. Yas, dogum agirliklari ve BM? gibi parametrelerde her iki grupta anlamli farkcikmamasina ragmen, uretra rotasyon acisinda, pelvik taban kas kuvvetinde, P?SQ-12, UD?-6ve ??Q-7 skorlamalarindaki sonuclar hem gebelik trimesterler arasi hem de postpartumdonemde anlamli olarak degerlendirilmistir. Her iki grupta pelvik taban kas kuvvetinde artis,UD?-6 skorlamasinda anlamli azalma tespit edilsede, uretra rotasyon acisi gibi onemliparametrede kontrol grubunda her hangi bir degisiklik izlenmemistir. Egzersiz grubunda iseuretra rotasyon acisindaki azalma sadece postpartum donemde degil hem de gebeliktrimesterleri arasinda anlamli fark gostermistir. Her iki grup arasindaki diger onemli farkpelvik taban kas kuvvetindeki artisin ve UD?-6 skorlamalarinda anlamli azalmanin kontrolgrubunda gebelik trimesterler arasi gorulmemesidir. Buda gebelikte yapilan egzersizlerin alturiner semptom acisindan bir daha onemini ortaya koymaktadir.Ozet olarak bizde buradan yola cikarak nullipar gebelerde egzersizin alt uriner sistemsemptomlarina,pelvik taban kas kuvvetine etkisini arastirmak icin bu calismayi yaptik. Hastasayisinin az olmasi verilerin optimum ihtimalini dusurse de, daha kapsamli calismalarin dahaiyi sonuclar verecegini dusundurmektedir.Buna ragmen vaka grubundaki parametrelerdeUD?-6 anket skorlarinda ve uretra rotasyon acisindaki azalma egzersizin onemini bir dahaortaya koymaktadir. Gunumuzde bu calismanin devamini getirmek ve objektif bulgular eldeetmek icin daha genis serilerde calismalara ihtiyac oldugu dusuncesindeyiz.AbstractNulliparous pregnant women who were examined in Ankara University, Faculty ofMedicine, Obstetrics and Gynecology Department outpatients clinic included into the study.For both of the groups urethral rotation angles were measured by perinal ultrasonography inObstetrics and Gynecology Department and pelvic floor muscle strenghts were measured byperineometry in Physical Medicine and Rehabilitation Department.Significant results were achieved for both the exercise and control groups. Althoughthere wasn?t any significant difference in age, birth weight and body mass index between thegroups; urethral rotation angle, pelvic floor muscle strength, PISQ-12, UDI-6 and IIQ-7scores were evaluated significantly different both between trimesters and postpartum period.Although in both groups pelvic floor muscle strength increased and UDI-6 scores decreased,urethral rotation angle which is an important parameter did not change in control group. In theexercise group the decrease of urethral rotation angle was significant during postpartumperiod and between trimesters. Another important difference between both groups wereincrease in pelvic floor muscle strength and decrease in UDI-6 scores were not observed indifferent trimesters of control group. These results support the hypothesis that exercises inpregnancy are very important for lower urinary tract lesions.This study was held to investigate the effect of exercise on lower urinary systemsymptoms and pelvic floor muscle strength. Since a small number of patients were involved inthe study, the significance of the results may be suspicious. So more detailed studies arenecessary. Thus, parameters, UDI-6 survey scores and decreased urethral rotation angleexpress the importance of exercise in study group. We believe that to achieve more objectivedata similar studies on larger populations should be held.
Plasma copper (Cu), zinc (Zn) and magnesium (Mg) levels were measured in three groups of women; (... more Plasma copper (Cu), zinc (Zn) and magnesium (Mg) levels were measured in three groups of women; (1) pregnant women suffering from hyperemesis gravidarum (HG)(n=43); (2) pregnant women with uncomplicated pregnancies (n=11) and (3) non-pregnant women (n=11). Plasma Cu, Zn and Mg levels were measured by atomic absorbtion spectrophotometer. We determined that plasma Zn and Mg levels were lower in patients with HG and significant differences were noted between the control groups and HG patients (P < 0.05, P < 0.01). We still need further large cohort studies in order to understand if this is the cause or consequence of hyperemesis gravidarum.
Biz yaptigimiz bu calisma ile urojinekoloji poliklinigimizde AAMS tanisi konan hastalarda antikol... more Biz yaptigimiz bu calisma ile urojinekoloji poliklinigimizde AAMS tanisi konan hastalarda antikolinejik tedavi ile agirlikli vajinal koniler araciligi ile yapilan pelvik taban egzersizlerinin AAMS tedavisindeki etkisini karsilastirmayi hedefledik.Calismaya Temmuz 2008 ? Ocak 2010 tarihleri arasinda urojinekoloji poliklinigimize basvuran hastalardan oyku, fizik muayene, idrar gunlugu, 24 saatlik pet testi, urodinami testleri yapilan ve AAMS tanisi konan 39 hasta dahil edildi. Hastalar randomize olarak iki gruba ayrildi. Bir gruba vajinal kon ile pelvik taban kas egzersizleri yaptirildi, diger gruba ise tolterodin verildi. Randomizasyon sonrasinda vajinal kon grubunda 19, tolterodin grubunda 20 hasta mevcuttu. Her iki grup arasinda demografik ozellikler arasinda istatistiksel olarak anlamli fark yoktu. 8 haftalik tedavi sonrasinda urojinekolojik muayeneleri, idrar gunlukleri, 24 saatlik pet testi ve urodinami testleri tekrarlanan hastalarin idrara sikisma suresi, yapilan idrar volumu acisindan tedavi oncesine gore anlamli bir iyilesme gozlenmezken; 24 saatlik pet testinde iki grupta da anlamli bir iyilesme gozlendi.(Sirasiyla p=0,003 ve p=0,001) Tedavi suresince tutmalari istenen idrar gunlugunde gunluk idrar sikligi, gece idrar sikligi ve idrar kacirma sikligi acisindan her iki grupta da anlamli bir iyilesme gozlenmistir. Sorgulama formlari degerlendirildiginde vajinal kon kullanan hastalarin IIQ-7, Wagner ve AAM-V8, tolterodin alan hastalarin ise IIQ-7, UDI-6 ve AAM-V8 formlarinda sikayetleri ile ilgili anlamli bir duzelme gozlemledik. Oysa urodinamik testde DAA oranlarindaki azalma, ilk idrar hissindeki ve maksimum vezikal basinctaki artma vajinal kon grubunda anlamli iken diger parametreler acisindan degisim iki grupta da saptanmadi.Daha onceki calismalarda pelvik taban kas egzersizlerinin ve antikolinerjiklerin AAMS tedavisinde etkin oldugu gosterilmistir. Biz ise calismamizda AAMS hastalarinda ilk basamak tedavi olarak pelvik taban kas egzersizlerinden biri olan vajinal kon uygulamasinin AAMS tedavisinde etkinligi kabul gormus antikolinerjikler kadar etkili oldugunu gosterdik.abstractThe aim of study were compared the efficacy anticholinergic treatment and pelvic floor muscle training with vaginal cones in patients who diagnosed OAB.Between July 2008 and January 2010, this study were enrolled 39 women who admited to our urogynecology clinic and diagnosed OAB with symptoms, physical examination, urinary diary, 24-hour pad test, urodynamic testing, patients were divided into two groups randomly. A group of vaginal cones mediated pelvic floor muscle excercises were performed while the other group were given tolterodine after randominization there were 19 patients in vaginal cone group and 20 patients in tolterodine group. demographic characteristics did not statistically differences between two groups. After 8 weeks of treatment patients reevaluated with urogynecologic examinations, urinary diaries, urodynamic testing and repeated 24-hour pad test the urine. The urine volumes, time compressed into urine of patients observed no significant improvement compared to before treatment. 24-hour pad test showed a significant improvement in both groups similar to patients frequency, nocturia, incontinence when maintained throught during treatment patients urinary diaries were evaluated. Significant difference was found after treatment patients complaints when evaluated quastionnare forms of vaginal cones group IIQ-7, Wagner, OAB-V8; quastionnare forms of tolterodine group IIQ-7, UDI-6, OAB-V8. Whereas at urodynamic testing decrease in the rate of DAA, feeling of the first urine and maximum vesical pressure increased were observed significant improvement at vaginal cones group. Both groups were showed no changes in the other parameters.In previous studies was shown to be effective pelvic floor muscle exercises and anticholinergics in the treatment of OAB. In our study, we have demonstrated that one of the pelvic floor training with vaginal cones can be effective as anticholinergic activity which preffered first step treatment of OAB.
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