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Amatör sporcularda fiziksel aktivite düzeyleri ile izokinetik kas performansı
(2016) Miçooğulları, Ahmet; Yıldızgören, Mustafa Turgut; Turhanoğlu, Ayşe Dicle; Üstün, Nilgün; Güler, Hayal
Amaç: Fiziksel aktivite düzeyleri ile diz kaslarının izokinetik kuvveti arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmaya 20-24 yaş arasında olan 30 amatör sporcu ve 30 sağlıklı kontrol olmak üzere toplam 60 kişi alındı. Katılımcılar amatör sporcular (grup 1) ve kontrol (grup 2) olarak iki gruba ayrıldı. Katılımcıların fiziksel aktivite düzeyleri Uluslararası Fiziksel Aktivite (UFA) anketi ile değerlendirildi. Katılımcıların dominant diz fleksiyon ve ekstansiyon kas kuvvetleri izokinetik dinamometre ile 60°/sn ve 180°/sn'lik açısal hızlarda ölçüldü. Bulgular: Gruplar arasında cinsiyet, yaş, kilo, boy, vücut kitle indeksi ve sigara içme durumu yönünden istatistiksel olarak anlamlı fark yoktu (p>0,05). Gruplar arasında UFA skorları yönünden istatistiksel olarak anlamlı fark vardı (p<0,05). UFA skorları grup 1'de daha yüksekti. Gruplar arasında 60°/sn ve 180°/sn açısal hızlarda diz çevresi fleksör ve ekstansör pik torkları arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Grup 1, UFA skorlarına göre alt gruplara ayrıldığında aktive düzeyi yüksek olanların 60°/sn ve 180°/sn açısal hızlardaki pik tork değerleri anlamlı olarak daha yüksekti (p<0,05). Sonuç: Kas kuvvetini belirleyen birçok faktörün değerlendirildiği daha çok katılımcının alındığı ve daha uzun süre izlemin yapılabileceği çalışmalara gereksinim vardır.
Aşil tendinozisinin konservatif tedavisi ve takipte ultrasonografnin yeri : olgu sunumu
(2015) Yıldızgören, Mustafa Turgut; Osmanoğlu, Kasım; Üstün, Nilgün; Güler, Hayal; Turhanoğlu, Ayşe Dicle
Aşil tendinopatileri, sıklıkla tendona aşırı yüklenme sonucu gelişen ağrılı bir durumdur. Etyolojisinde tendon iskemisi, mikro yırtıklar, metabolik faktörler gibi birçok etken rol alır. Aşil tendonunda vaskülaritenin az olduğu non-insersiyonel tendon bölgesi, tendinopatinin sık geliştiği bir lokalizasyondur. Bu yazıda 57 yaşında, sağ topuk arkasında ağrı ve şişlik olan bir olguyu sunarak hastalığın tedavisi ve tedavi yanıtını izlemede ultrasonografnin önemini tartıştık. (Türk Osteoporoz Dergisi 2015;21: 37-9)
Association of vitamin D with disease activity in rheumatoid arthritis and ankylosing spondylitis
(2015) Yağız, Abdullah Erman; Üstün, Nilgün; Paksoy, Hacer; Üstün, İhsan; Mansuroğlu, Ayhan; Güler, Hayal; Turhanoğlu, Ayşe Dicle
Amaç: Vitamin D eksikliğinin, romatoid artrit (RA) ve ankilozan spondilit (AS) gibi otoimmun hastalıklarda başlatıcı bir neden mi yoksa hastalık aktivitesiyle ilişkili mi olduğu hala merak edilen bir konudur. Çalışmamızın amacı, Th1 baskın hastalıklardan olan RA ve AS hastalarında serum vitamin D seviyeleri ile hastalık aktiviteleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmamız, retrospektif olarak 92 RA’li hasta, 100 AS’li hasta ve 62 sağlıklı kontrolün dosyalarından elde edilmiş bilgileri içermektedir. Çalışmaya alınanların yaşı, cinsiyeti, hastalık süreleri, kullandığı ilaçlar, vitamin D seviyeleri, kalsiyum, C-reaktif protein (CRP) ve eritrosit sedimentasyon hızı (ESH) değerleri kayıt edildi. Hastalık aktiviteleri RA’li hastalarda hastalık aktivite skoru-28 (DAS28) ile, AS’li hastalarda ise bath ankilozan spondilit hastalık aktivite indeksi (BASDAİ) ile değerlendirildi. Bulgular: Vitamin D seviyeleri tüm gruplarda düşüktü. AS hastalarında, vitamin D seviyeleri ile BASDAİ, ESH ve CRP arasında istatiksel olarak negatif korelasyon yoktu (sırasıyla, r=-0.059, p=0.560, r=-0.072, p=0.473, r=-0.112, p=0.268). RA’li hastalarda ise vitamin D düzeyi ile DAS28 arasında anlamlı negatif korelasyon yoktu (r=-0.090, p=0.392). Tartışma: Çalışmamızda, tüm gruplarda vitamin D seviyeleri düşük bulundu ve bu vitamin D eksikliğinin, RA ve AS’in etyolojisinden ziyade hastalık aktivitesi ile ilişkili olabileceğini akla getirmektedir.
Can foot pain and musculoskeletal disorders be counted as risk factors for falls in the elderly?
(2010) Turhanoğlu, Ayşe Dicle; Güler, Hayal; Kalıcı, Aydıner; İnanoğlu, Deniz; Özer, Cahit
Introduction: In this study, it was aimed to determine whether musculoskeletal disorders (FMDs) and/or foot pain (FP) were risk factors for falls and deteriorating health status in the elderly. Materials and Method: Two hundred fifty five patients aged over 60 years were enrolled in the study. The elderly filled the questionnaire about FP and falling. The FMDs in the study included hallux valgus (HV), hammer toe (HT), mallet toe (MT), claw toe (CT), overlapping toe (OT), pes cavus (PC), pes planus (PP), metatarsalgia (MA) and plantar fasciitis (PF). Participants’ risk of falling was assessed using The Performance-Oriented-Mobility-Assessment and the health status was measured using The Short-Form (SF)-36. Results: A total of 255 patients with a mean age of 67.90±6.15 were examined; 175(69%) were female and 78 (31%) were male. Ninety-seven (38%) of the subjects reported FP and 103 (43.8%) patients were diagnosed as having FMDs. The most common FMD was HV (18.4%), followed by PF (15.9%), PP (13.3%), MA (12.9%), HT (7.8%), MT (4.3%), OT (3.5%), CT (1.6%) and PC (1.9%). FP, HV, PP, MA, PF, CT and OT were associated with risk of falling (p<0.05). There was a relationship between falls and the presence of FMD (p<0.01) and foot pain (p<0.01). PCSs of the patients with FP were lower than that of those without FP (p<0.05) Conclusion: FMDs and FP should be considered as risk factors for falling in the elderly.
Comparison of ketoprofen phonophoresis with ketoprofen and lidocaine-prilocaine phonophoresis in patients with subacromial impingement syndrome
(2009) Güler, Hayal; Turhano?lu, Ayşe Dicle; Inano?lu, Kerem; Inano?lu, Deniz; Özer, Cahit
Objective: The aim of the present study was to compare ketoprofen phonophoresis with ketoprofen and lidocaineprilocaine phonophoresis in patients with subacromial impingement syndrome (SIS). Material and Methods: Seventy patients (39 female, 31 male) with SIS were included in this study. The patients were divided into two groups and a 15-session physical therapy and rehabilitation program was performed in each group. Ketoprofen and lidocaine-prilocaine phonophoresis were performed in the first group and ketoprofen phonophoresis alone in the second group. Hot pack, transcutaneous electrical nerve stimulation (TENS) and exercises were applied in all patients. Severity of shoulder pain was determined by visual analogue scale (VAS). Range of motion (ROM) was measured by goniometer. Functional capacity of patients was evaluated by UCLA (The University of California-Los Angeles) score. All of the measurements were performed before treatment and in the 1st and 3rd months after treatment. Results: There was no significant difference between the two groups in VAS and UCLA scores before treatment initiation (p>0.05). VAS scores of Group 1 were lower than of Group 2 (p=0.020) in the 3rd month follow-up. ROMs and flexion, abduction and internal rotation were higher in Group 2 than Group 1 (p=0.009, p=0.001, p=0.019, respectively) before treatment. Abduction measurements in Group 2 were higher than in Group 1 in the 1st month after treatment (p=0.024). However, there was no significant difference between the two groups in UCLA and ROM values in the 3rd month (p>0.05). There was also no significant difference between the two groups in external rotation values before and after treatment (p>0.05). Conclusion: Our study showed that ketoprofen and lidocaine-prilocaine phonophoresis were more effective on pain and ROM than ketoprofen phonophoresis alone in the 3rd month after treatment in patients with SIS.
Comparison of the Efficacy of Extracorporeal Shock Wave Therapy and Traditional Physiotherapy in Myofascial Trigger Points
(2022) Güler, Kadir; Güler, Hayal; Yıldızgören, Mustafa Turgut; Seyfettin, Ayça; Karazincir, Sinem; Turhanoğlu, Ayşe Dicle
Objective: The main purpose of this study is to compare the\refficacy of radial-extracorporeal shock wave therapy (r-ESWT) and traditional physiotherapy (TP) in the treatment of myofascial trigger points in\rthe upper trapezius muscle. Material and Methods: A total of 74 patients\rwith myofascial trigger points were randomly separated into the ESWT\r(n=37) group and the TP (n=37) group. The groups received treatment for\r2 weeks. A total of 66 (r-ESWT, n=30; TP, n=36) patients completed the\rstudy. Neck pain and disability were evaluated with Visual Analogue Scale\r(VAS), Quick-Disabilities of Arm, Shoulder and Hand Questionnaire (QDASH), and the Nottingham Health Profile (NHP). Active trigger points\rwere evaluated using ultrasound shear wave elastography (SWE). All outcome measurements were assessed before treatment, then at 2 weeks, and 1\rmonth after the completion of the treatment. Results: Significant improvements of VAS, Q-DASH, NHP, and SWE scores were observed at all time\rpoints after treatment in both treatment groups. When the change levels were\rcompared between the groups, the decrease in VAS, and the improvement\rin Q-DASH and NHP scores were significantly higher in the TP group than\rin the ESWT group. There was no significant difference between the groups\rin terms of the amount of change in SWE. Conclusion: The both methods\rwere useful in alleviating pain, improving function, and reducing shear modulus in myofascial trigger points, although TP seemed to be more effective\rthan ESWT.
Comparison of the Therapeutic Efficacy of Extracorporeal Shock Wave Therapy Versus Corticosteroid Iontophoresis in Carpal Tunnel Syndrome: A Prospective Randomized Study
(2022) Osmanoğlu, Kasım; Yıldızgören, Mustafa Turgut; Güler, Hayal; Turhanoğlu, Ayşe Dicle
Objective: To compare the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) and corticosteroid iontophoresis (CI) in patients with carpal tunnel syndrome (CTS).\rMaterial and Methods: This randomized prospective study included \ra total of 72 wrists diagnosed with CTS of 54 patients with a mean age \rof 42.2±8.7 years (range, 22-59 years). The patients were randomly \rseparated into two groups. Group 1 (n=37) received r-ESWT, and \rGroup 2 (n=35) received CI. Evaluations were made at baseline and at \r0, 1 and 3 months after treatment using the visual analog scale (VAS), \rBoston Symptom Severity Scale (BSSS), Boston Functional Capacity \rScale (BFCS), grip strength, and electrophysiological examination. Results: Compared to baseline, the VAS, BSSS, BFCS, grip strength values at the 0, 1 and 3 months after treatment improved significantly in \rboth groups (all p<0.001). However the nerve conduction study results \rwere significantly improved only in r-ESWT group (all p<0.001). \rWhen the change levels were compared between the groups, the decrease in VAS (all p<0.001), the improvement in BSSS (p=0.029, \rp=0.023 and p=0.040, respectively), BFCS (p<0.001, p=0.001 and \rp<0.001, respectively), grip strength (all p<0.001), sensory nerve conduction velocity (p=0.001, p<0.001 and p<0.001, respectively) and distal motor latency (p=0.001, p=0.001 and p<0.001, respectively) before \rand at 0, 1 and 3 months after treatment were significantly higher in \rthe r-ESWT group than the CI group. Conclusion: This study revealed \rthat both methods were useful in alleviating pain and improving function in CTS, however r-ESWT seems to be more effective than CI.
Does kinesiology taping improve muscle strength and function in knee osteoarthritis? A single-blind, randomized and controlled study
(Turkish League Against Rheumatism (TLAR), 2018) Öğüt, Halil; Güler, Hayal; Yıldızgören, Mustafa Turgut; Velioğlu, Turgut; Turhanoğlu, Ayşe Dicle;
Objectives: This study aims to evaluate the efficacy of kinesiology taping (KT) on pain, movement restriction, walking speed, daily living activities, and isokinetic muscle performance in female patients with knee osteoarthritis (OA). Patients and methods: The study included 61 female patients (mean age 53.5±3.5 years; range 50 to 60 years) who were admitted to Physical Medicine and Rehabilitation Outpatient Clinic with complaints of mechanical knee pain. Knee OA was diagnosed according to the clinical/radiological criteria of the American College of Rheumatology and patients with Kellgren-Lawrence grade 2 and 3 were included. Patients were randomly divided into two groups. Both groups received transcutaneous electrical nerve stimulation for 30 minutes, hot pack for 30 minutes, and therapeutic ultrasound for 10 minutes in a day for three weeks (five days in a week). Also, one group was treated with KT (KT group, n=31) while the other group was treated with sham-KT (sham-KT group, n=30) one time a week for three weeks. A home program of around the knee strengthening exercises was recommended for all patients. All patients were evaluated with Visual Analog Scale (VAS), Western Ontario and McMaster Osteoarthritis Index (WOMAC) values, goniometric measurement of active knee range of motion, 50-meter walking distance, and isokinetic knee extensor muscle peak torque measurements before treatment, at the end of treatment, and at one month and three months after treatment. Results: There was a significant improvement in after treatment and first month VAS values in the KT group compared to the sham-KT group (p<0.05). In the KT group, the WOMAC pain and WOMAC total scores decreased significantly after treatment compared to the sham-KT group (p<0.05). VAS values were significantly decreased after treatment in both groups (p<0.05). In both groups; WOMAC pain, stiffness, physical function, and total values decreased significantly after treatment (p<0.05). In both groups, isokinetic quadriceps peak torque measurements were increased after treatment (p<0.05). Conclusion: The application of KT to females with knee OA appears to be a method that may be effective on pain and functional capacity
The effect of anti-tumor necrosis factor-alpha treatment on muscle performance and endurance in patients with ankylosing spondylitis : a prospective follow-up study
(2017) Demirkapı, Musa; Yıldızgören, Mustafa Turgut; Güler, Hayal; Turhanoğlu, Ayşe Dicle
Objectives: This study aims to evaluate muscle performance by using isokinetic dynamometer before and at third month of anti-tumor necrosis factor-alpha treatment in ankylosing spondylitis patients.Patients and methods: Thirty ankylosing spondylitis patients (23 males, 7 females; mean age 39.3±8.6 years; range 18 to 45 years) starting on antitumor necrosis factor-alpha treatment and 30 healthy controls (23 males, 7 females; mean age 39.1±8.8 years; range 18 to 48 years) with similar age, body mass index, and sex were enrolled. The clinical anthropometric measurements of chest expansion, lumbar Schober test, hand-finger floor distance and visual analog scale-global, C-reactive protein, erythrocyte sedimentation rate, Ankylosing Spondylitis Disease Activity Score-C-reactive protein and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index were determined before and at third month of the treatment.Results: There was no statistically significant difference in age, sex and, body mass index between the groups (p>0.05). A statistically significant difference was detected between 60?/second and 180?/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). A significant difference was detected in respect to total work of patients with 180?/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). There was a statistically significant difference between the findings of 60?/second and 180?/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). Isokinetic test results were better at third month after treatment than before treatment.Conclusion: The results of this study showed that both functional limitations and performance and endurance of muscles may be improved with anti-tumor necrosis factor-alpha treatment in ankylosing spondylitis patients.
The effect of vitamin D supplemention balance and quality of life in older women
(2008) Güler, Hayal; Turhano?lu, Ayşe; Özer, Cahit
Introduction: In this study it was aimed to investigate the effect of vitamin D supplementation on balance and quality of life in older women. Materials and Method: Female patients older than 60 years were enrolled. Participants' fall risk was assessed using The Performance-Oriented Mobility Assessment (TPOMA) and, health status using Short Form Health Survey(SF-36). Active vitamin D supplementation was described as usage of calcitriol:0.25-0.50mcg/daily or alfacalcidol:0.5-1mcg/daily, and vitamin D was described as usage of cholecalciferol:800IU/daily. Results: Of 180 patients 28 (15.6%) were using active vitamin D when 47(26.1%) were using vitamin D. One hundred and five patients (58.3%) received no vitamin D supplementation. There was no statistically significant difference between three groups according to age, body mass index(BMI), Physical Component Score(PCS), Mental Component Score(MCS), TPOMA total score, category of TPOMA, and presence of balance disorder. Of all patients 75(41.7%) were using either active vitamin D or vitamin D. There was also no significant difference between vitamin D users and the rest of the study patients according to age, BMI, PCS, MCS, TPOMA total score, category of TPOMA, and presence of balance disorder. Conclusion: We found no association between vitamin D supplementation and balance and quality of life in older women adults. Further studies are necessary to investigate the relatiop between vitamin D supplementation and these parameters.
Fibromyalgia, obesity and obesity related measurements
(2006) Güler, Hayal; Sahin, Gunsah; As, Ismet
Objective: To evaluate the relationship between obesity and fibromyalgia (FM). Methods: 241 female patients with FM were seen consecutively in outpatient clinic and they were analyzed. Spearman correlation was used. The relationship between FM and obesity was compared with respect to the BMI (body mass index) value. A p value of 0.05 was accepted as significant. Results: Body mass index was significantly correlated with age in FM patients. BMI was also correlated with waist/hip ratio. A significant positive correlation was found between health assessment questionnaire (HAQ) and VAS score in all patients. HAQ was also correlated positively with tender points (P < 0.05). We divided patients into two groups according to BMI values (obese and non-obese). Subjects with BMI value >25 were considered as obese. Obese patients were older than non-obese patients. The values of waist/hip ratio and skin fold thickness and number of tender points were higher in obese patients. Also, the mean duration of disease was longer in obese patients. There was no statistically significant difference in VAS score and HAQ between obese and non-obese patients. However, in obese patients, BMI was significantly correlated with HAQ and VAS score (P < 0.05) in contrast to the non-obese patients. Conclusion: Decreased physical functioning in FM patients should be taken into account and patients were encouraged to lose weight and to increase exercise. © 2006 VSP.
Increased epicardial fat tissue is a marker of subclinic atherosclerosis in ankylosing spondylitis
(2014) Üstün, Nilgün; Yağız, Erman; Güler, Hayal; Turhanoğlu, Ayşe; Kurt, Mustafa; Atcı, Nesrin
Amaç: Çalışmada ankilozan spondilit (AS) hastalarında epikardiyal yağ kalınlığı, karotis intima media kalınlığı (CIMT) ve aortik sertlik indeksi (ASI) gibi subklinik ateroskleroz belirteçleri değerlendirildi ve ilaveten subklinik ateroskleroz belirteçleri ile hastalık aktivite/fonksiyon/mobilite indeksleri arasındaki ilişki araştırıldı. Hastalar ve yöntemler: Çalışmaya 26 AS hastası (22 erkek, 4 kadın; ort. yaş 43 yıl) ve yaş ve cinsiyet uyumlu 26 sağlıklı kontrol (21 erkek, 5 kadın; ort. yaş 42 yıl) alındı. Kardiyovasküler veya eşlik eden hastalıkları olan hastalar ve kontroller çalışmadan çıkarıldı. Hastalık aktivitesi Bath Ankilozan Spondilit Hastalık Aktivite İndeksi, fonksiyonel kapasite Bath Ankilozan Spondilit Fonksiyonel İndeksi ve mobilite durumu Bath Ankilozan Spondilit Metroloji İndeksi ile değerlendirildi. Tüm hastalar epikardiyal yağ kalınlığı ve ASI .l.ülmek üzere transtorasik ekokardiyografiye ve CIMT .l.ülmek üzere ultrason ile muayeneye tabi tutuldu. Bulgular: Ankilozan spondilitli hastalar ve kontroller arasında demografik ve kardiyovasküler özellikler açısından anlamlı fark yoktu (p>0.05). Epikardiyal yağ kalınlığı (5.15±1.13 ve 4.11±1.22; p=0.003), CIMT (0.70±0.16 ve 0.60±0.10; p=0.012) ve ASI (14.2±10.8 ve 8.6±3.1; p=0.018) değerleri kontrollere kıyasla hastalarda daha yüksek idi. Subklinik ateroskleroz belirteçleri ile hastalık aktivite/fonksiyon/mobilite indeksleri arasında anlamlı ilişki yoktu (p>0.05). Sonuç: Ankilozan spondilit hastalarında sağlıklı kontrollere kıyasla epikardiyal yağ kalınlığı, CIMT ve ASI anlamlı olarak daha yüksekti.
Isokinetic assessment of the wrist muscles in females with fibromyalgia
(2016) Güler, Hayal; Yıldızgören, Mustafa Turgut; Üstün, Nilgun; Paksoy, Hacer; Turhanoğlu, Ayşe Dicle
Objectives: This study aims to evaluate wrist muscle strength and muscle fatigue in females with fibromyalgia syndrome (FMS) and compare the results with those of healthy controls.Patients and methods: Thirty consecutive female FMS patients (mean age 39.8±6.7 years; range 25 to 49 years) and 50 age and body mass index similar healthy females (mean age 35.4±7.9 years; range 27 to 48 years) were enrolled. Patients' clinical characteristics were recorded and symptoms were evaluated by the Fibromyalgia Impact Questionnaire. In addition to the demographic characteristics, physical activities of all subjects were questioned, isokinetic muscle performance was measured, and fatigue index was calculated by endurance test.Results: The peak torque values of the wrist extensor and flexor muscles (at an angular velocity of 90°/second) were higher in the control group than in the FMS group (both p<0.01). There were no differences between the groups in terms of the fatigue indexes of the flexor and extensor muscles of the wrist (both p>0.05). While there were differences between the groups regarding weekly hours of walking (p=0.01) and house cleaning (p<0.001), no differences were determined for weekly hours of bicycling, gardening, doing sports, or total physical activity. There was no correlation between the peak torque values and clinical characteristics in FMS group.Conclusion: Patients with FMS had decreased muscle strength compared to healthy controls. Further studies with larger participants are needed to explain the relationship between upper limb muscle performance and FMS, as well as the underlying pathogenesis
Kienböck's disease: Case report
(2009) Güler, Hayal; Turhano?lu, Ayşe Dicle; Yazgan, Işil; Balc, Ali
Osteonecrosis is defined as the death of bone due to interruption of the blood supply to the bone. KienbÖck's disease is osteonecrosis of lunate bone as a result of heavy repetitive loading on wrist. We planned to present a 39-year-old patient having pain, swelling and limitation of range of motion (ROM) in right wrist, because KienbÖck's disease should be into account in differential diagnosis of such patients. X-ray of the right wrist of patient demonstrated sclerosis, cystic appearance and irregularity in lunate bone. Irregularities, loss of volume and diffuse low-intensity appearance were observed in lunate bone on T1-weighted MR images. T2-weighted fat-saturated MR images demonstrated diffuse hyperintensity in the same areas which is suggested bone-marrow edema. These findings were determined as the changes with related osteonecrosis of the lunate bone. Resting splint and antiinflammatory treatment were given to the patient. The patient was consulted to the department of orthopedics and traumatology. Patient refused operation. Pain, swelling and limitation of ROM of the patients improved after 3 weeks. In conclusion, KienbÖck's disease should be into account in the differential diagnosis of patients having pain, swelling and limitation of ROM in wrist.
Osteopenisi olan ankilozan spondilitli hastalarda kemik mineral yoğunluğu ile hastalık aktivitesi arasındaki ilişkinin değerlendirilmesi
(2013) Güler, Hayal; Üstün, Nilgün; Bolaç, Veli Enes; Yağız, Abdullah Erman; Mansuroğlu, Ayhan; Yengil, Erhan; Turhanoğlu, Ayşe Dicle
Amaç: Ankilozan Spondilit (AS), kronik inflamatuvar bir hastalıktır. Lokal sitokin salınımı ve immobiliteye bağlı olarak AS’de spinal osteopeni yaygındır. Bu çalışmada, osteopenisi olan Ankilozan Spondilitli hastalarda kemik mineral yoğunluğu ile hastalık aktivitesi arasındaki ilişkiyi değerlendirdik. Gereç ve Yöntem: 61 AS’li hasta (26K, 35E) çalışmaya alındı. Hastaların; hastalık süresi, sabah tutukluğu süresi, schober testi, Eritrosit sedimentasyon hızı (ESH) ve C reaktif protein (CRP) değerleri kaydedildi. Hastalık aktivitesi Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ile değerlendirildi. Kemik mineral yoğunluğu (KMY) GE/LUNAR DPX PRO cihazı kullanılarak ölçüldü. Bulgular: Hastaların ortalama yaşı 38,67±10,81, ortalama hastalık süresi 7,87±7,09 yıl idi. 34 (%55,7) hastada osteopeni vardı. Bu hastaların ortalama lomber ve femur KMY değerleri 1,03±0,16 ve 0,88±0,09 olarak bulundu. 27 (%44,3) hastanın KMY ölçümleri normal sınırlardaydı. Bu hastaların ortalama lomber ve femur KMY değerleri 1,20±0,11 ve 1,11±0,15 olarak bulundu. KMY değerleri normal olan grupla osteopeni olan grup arasında ESH, CRP, ve BASDAI değerleri açısından istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Osteopenisi olan grupta, KMY değerleri ile ESH, CRP, ve BASDAI değerleri arasında bir korelasyon saptanmadı (p>0,05). Sonuç: Çalışmamızda, osteopenisi olan AS’li hastalarda kemik mineral yoğunluğu ile hastalık aktivitesi arasında ilişki bulunmamıştır.
The presence of the tender points in female patients with hepatitis C virus infection: Is it related with the clinical findings of fibromyalgia?: A preliminary report
(Turkiye Klinikleri, 2006) Kandemir, Özlem; Şahin, Günşah; Güler, Hayal; Şahin, Elif
Objective: Fibromyalgia (FM) may be related with hepatitis C virus (HCV) infection. Tender points are also the hallmark of the FM and may be precipitated by infection. We planned a study to determine if HCV infection is associated with the development of tender points, which are the diagnostic hallmark of FM. Material and Methods: A total of 40 female subjects diagnosed as having HCV infection were assessed by physical examinations (palpation of 18 tender points) and laboratory tests. In addition, visual analogue scale (VAS) for pain assessment was performed for all subjects. Patients were compared with age and sex matched FM patients [diagnosed by American College of Rheumatology (ACR) criteria] and healthy controls. Results: There was a statistically significant difference between patients with HCV infection and FM patients regarding tender points (p< 0.01). Patients with HCV infection had lower counts of tender points than FM patients had. Tender points were also lower in controls. In addition, VAS score was significantly different in all groups (p< 0.01). FM patients had the highest VAS score. Conclusions: Patients with HCV infection did not meet FM criteria in terms of tender points. Tender points, which are diagnostic for FM, are not a common finding in HCV infection. As a result, we may suggest that HCV infection may not be related with FM and its etiopathogenesis. Copyright © 2006 by Türkiye Klinikleri.
Romatoid artrit ve ankilozan spondilit hastalarında göz bulgularının değerlendirilmesi
(2014) Yağız, Abdullah Erman; Üstün, Nilgül; Ayhan Tuzcu, Esra; İlhan, Nilüfer; Güler, Hayal; Turhanoğlu, Ayşe Dicle
Amaç: Romatoid artrit ve ankilozan spondilitte eklem bulguları dışında göz tutulumları da görülebilmektedir. Bu çalışmanın amacı, romatoid artrit ve ankilozan spondilit hastaları arasında göz tutulumu sıklığını, tipini belirlemek ve hastalık aktiviteleri ile arasındaki ilişkiyi değerlendirmektir. Metaryal ve metod: Çalışmamıza 37 romatoid artritli ve 47 ankilozan spondilitli hasta alınmıştır. Hastalarda tam kan sayımı, biyokimyasal parametreler, eritrosit sedimentasyon hızı, C-reaktif protein düzeylerine bakılmıştır. Hastalık aktivitesi romatoid artritli hastalarda hastalık aktivite skoru 28, ankilozan spondilitli hastalarda ise bath ankilozan spondilit hastalık aktivite indeksi ile değerlendirilmiştir. Ankilozan spondilitli hastaların spinal hareket durumlarını belirlemede bath ankilozan spondilit metroloji indeksi kullanılmıştır. Tüm hastalara ayrıntılı göz muayenesi göz kliniğinde aynı hekim tarafından yapılmıştır. Bulgular: Çalışmamızda romatoid artritli hastaların %35.1'inde kuru göz, %13.5'unda punktat keratit, %8.1'inde arka subkapsüler katarakt saptanmıştır. Romatoid artritli hastalarda kuru göz ile yaş, hastalık süresi, hastalık aktivite skoru, eritrosit sedimentasyon hızı, ve C-reaktif protein değerleri arasında anlamlı ilişki bulunamamıştır (p>0.05). Ankilozan sponilit hastalarının %19.1'inde göz kuruluğu, %17.1'inde glokom, %10.6'ınde üveit, %6.4'ünde subkapsüler katarakt saptanmıştır. Ankilozan spondilitli üveiti olan hastaların hastalık süresinin olmayanlara göre anlamlı olarak daha yüksek olduğu belirlenmiştir (p= 0.036). Ancak üveiti olan hastalarla olmayanlar arasında yaş, hastalık aktivite indeksi, metroloji indeksi, eritrosit sedimentasyon hızı ve C-reaktif protein değerleri arasında anlamlı ilişki bulunamamıştır (p>0.05). Sonuç: Bu çalışmada sonuç olarak, romatoid artritli ve ankilozan spondilit hastalarında kuru göz en sık rastlanan göz bulgusudur. Ankilozan spondilitli hastalarda üveit ile hastalık süresi arasında anlamlı ilişki saptanmıştır. Ancak hastalık aktivite göstergeleriyle romatoid artritli hastalarda kuru göz, ankilozan spondilitli hastalarda üveit arasında anlamlı bir ilişki bulunamamıştır.
Semptomsuz ve sigara içmeyen romatoid artritli hastalarda erken dönem akciğer tutulumunun yüksek rezolüsyonlu bilgisayarlı tomografi ile değerlendirilmesi
(2009) Karazincir, Sinem; Akoğlu, Sebahat; Güler, Hayal; Balcı, Ali; Babayiğit, Cenk; Eğilmez, Ertuğrul
Bu çalışmanın amacı; solunum sistemi semptomu bulunmayan ve hayatı boyunca hiç sigara kullanmamış romatoid artritli (RA) hastalarda yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT) ile pulmoner tutulumun değerlendirilmesidir. Çalışmaya, klinik olarak asemptomatik ve hayatı boyunca sigara kullanmamış 25 RA’lı hasta alındı. Klinik ve laboratuvar incelemeler yapıldıktan sonra, PA akciğer grafisi, solunum fonksiyon testi (SFT) ve YRBT tetkikleri yapıldı. Hava hapsini değerlendirmek için YRBT’de ekspiryum sonu kesitler elde edildi. PA akciğer grafisinde %12, SFT’de %16, YRBT’de %48 oranında anormallik saptandı. YRBT’de en sık olarak interstisyel akciğer hastalığı (İAH) ile uyumlu bulgular saptandı (%36). Hava hapsi ikinci sıklıkta saptadığımız bulgu (%20) idi. Hava hapsi ekspiryum sonu kesitlerde daha belirgindi. Bronşektazi %16, nodül %12, plevral tutulum %12 oranında izlendi. Hiçbir olguda amfizem ve bal peteği görünümü izlenmedi. Hastalık aktivite kriterleri, romatoid faktör pozitifliği, SFT sonuçları ve hastalık süresi ile YRBT bulguları arasında istatistiksel olarak anlamlı ilişki saptanmadı. RA olgularında akciğer tutulumunun her zaman solunum sistemi semptomuna ve solunum fonksiyon bozukluğuna yol açmadığı bu çalışma ile de gösterilmiştir. Asemptomatik, sigara içmemiş RA olgularında, radyolojik olarak akciğer tutulumunun saptanmasının sağkalımı tahmin etmede ya da tedavi kararında ne gibi etkiler yapabileceğini araştıran yeni çalışmalara gereksinim vardır.
Subakromiyal sıkışma sendromu olan hastalarda ketoprofen fonoforezi ile ketoprofen ve lidokain-prilokain fonoforez uygulamasının karşılaştırılması
(2009) Güler, Hayal; Turhanoğlu, Ayşe Dicle; İnanoğlu, Kerem; İnanoğlu, Deniz; Özer, Cahit
Amaç: Çalışmanın amacı, subakromiyal sıkışma sendromu olan hastalarda ketoprofen ve lidokain-prilokain fonoforez uygulamasının, tek başına ketoprofen fonoforezine bir üstünlüğü olup olmadığının değerlendirilmesi idi. Yöntem ve Gereçler: Çalışmaya subakromiyal sıkışma sendromu olan 70 (39 kadın, 31 erkek) hasta alındı. Hastalar iki gruba ayrıldı ve her iki grubada 15 seans fizik tedavi ve rehabilitasyon programı uygulandı. Birinci gruba ketoprofen ve lidokain- prilokain fonoforezi, ikinci gruba sadece ketoprofen fonoforezi uygulandı. Ayrıca tüm hastalara sıcak paket, TENS ve egzersiz uygulandı. Hastaların omuz ağrısı şiddeti vizüel analog skala (VAS) ile değerlendiridi. Eklem hareket açıklığı (EHA) gonyometre ile ölçüldü. Hastaların fonksiyonel durumu UCLA (The University of California-Los Angeles) skorlaması ile değerlendirildi. Tüm değerlendirmeler tedavi öncesinde, tedavi sonrası 1.ayda ve tedavi sonrası 3. ayda yapıldı. Bulgular: Tedavi öncesi iki grup arasında VAS, UCLA skorları açısından istatistiksel olarak fark yoktu (p>0.05). Tedavi sonrası 3.ay takiplerinde; grup 1'in VAS skorları grup 2'den daha düşük bulundu (p=0.020). Tedavi öncesi grup 2'nin EHA; fleksiyon, abduksiyon, iç rotasyon ölçümleri grup 1'den daha yüksekti (p=0.009, p=0.001, p=0.019). Tedavi sonrası 1. ay takiplerinde de grup 2'nin, abduksiyon ölçümleri grup 1'den daha yüksekti (p=0.024). Fakat tedavi sonrası 3.ay takiplerinde iki grup arasında UCLA ve EHA değerleri açısından istatistiksel olarak fark yoktu (p>0.05). Ayrıca, iki grup arasında tedavi öncesi ve sonrası dış rotasyon ölçümleri açısından fark yoktu (p>0.05). Sonuç: Çalışmamızda, subakromiyal sıkışma sendromu olan hastalarda, tedavi sonrası 3.ay değerlendirmede, ketoprofen ve lidokain- prilokain fonoforezi ağrı ve EHA üzerine daha etkili bulunmuştur.
Tramadol Iontophoresis added to treatment of knee osteoarthritis
(2010) Turhanoğlu, Ayşe Dicle; Güler, Hayal; İnanoğlu, Deniz; İnanoğlu, Kerem; Turhanoğlu, Selim
Objective: The objective of the present study was to investigate whether tramadol iontophoresis added to therapy is superior to the therapy methods alone (transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound, and exercise therapy) in patients with knee OA. Materials and Methods: A total of 72 patients who admitted to the outpatient clinic of Physical Medicine and Rehabilitation were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. The patients were randomly separated into two groups. Group 1 received physical therapy and Group 2 received tramadol iontophoresis in addition to the therapy for a period of two weeks. Patients were evaluated according to pain and functional capacity assessed using visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) before therapy and following the 10th session, and at 1 and 3 months.Results: The mean age and duration of the knee pain were 58.53±8.38, 5.00±2.66 years in the control group and 58.15±7.70, 4.71±2.70 years in the tramadol iontophoresis group. There were no significant differences between groups in the mean age and duration of the knee pain, body mass index (BMI), VAS and WOMAC scores before therapy. Following the 10th session, and after 1 and 3 months, VAS and WOMAC scores were significantly decreased in both groups when compared with the baseline values (p<0.001). VAS scores were significantly lower in the tramadol iontophoresis group compared to controls following the 10th session (p<0.001). However, no significant difference was found between WOMAC scores of the tramadol iontophoresis and control groups (p>0.05). Conclusion: We conclude that tramadol iontophoresis added to physical therapy may be useful for relieving pain of knee OA during the treatment period

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