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    Comparison of clinical outcomes of ultrasonography-guided and blind local injections in facet syndrome: A 6-week randomized controlled trial
    (Ios Press, 2020) Karkucak, Murat; Batmaz, Ibrahim; Kerimoglu, Servet; Ayar, Ahmet
    BACKGROUND: Facet syndrome is defined as pain that arises from any structure of the facet joints, including the fibrous capsule, synovial membrane, hyaline cartilage, and bone. OBJECTIVES: To compare the effectiveness of US-guided and blind injections on clinical outcome in facet syndrome. MATERIALS AND METHODS: Forty-seven patients with the diagnosis of facet syndrome were included. Patients were consecutively randomized into one of the two groups. The patient's history, physical examination and routine laboratory parameters were obtained and diagnose was established based on physical findings. Two injections (mixture of 2 ml of 1% lidocaine hydrochloride and 20 mg of triamcinolone, to a single or maximum two sites depending on the clinical characteristics of the facet joint) were performed with 15 days apart, as blinded or US-guided manner. Clinical outcome assessments were carried out at 0, 2nd and 6th weeks, using Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and State-Trait Anxiety Inventory (STAI). RESULTS: The patients' initial VAS and ODI were not significantly different. When the two groups were compared in the 6th week in terms of VAS scores, improvement was more pronounced in the US-guided injection group (US-guided group (n = 23) before 7.6 (2.2) cm, after 3.0 (1.7) cm, P = 0.0001 vs blind group (n = 24) before 7.2 (1.3) cm, after 5.2 (2.0) cm, P = 0.0001). The improvement in initial and 6th week ODI was statistically significant in the US-guided injection group ( P = 0.006). Except STAI I for US-group, trait anxiety scale scores were significant in both groups. CONCLUSION: The US-guided local injections offer better clinical outcome in the treatment of facet syndrome.
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    Education and Visual Information Improves Effectiveness of Ultrasound-Guided Local Injections on Shoulder Pain and Associated Anxiety Level A Randomized Controlled Study
    (Lippincott Williams & Wilkins, 2016) Karkucak, Murat; Cilesizoglu, Nurce; Capkin, Erhan; Can, Ipek; Batmaz, Ibrahim; Kerimoglu, Servet; Onder, Mustafa Avni
    Objective Local injections are widely used in patients with a painful shoulder. The aim of this study was to evaluate the possible impact of patients' visual information on the effectiveness of ultrasound (US)-guided local injections on anxiety levels and shoulder pain. Design A total of 151 patients, scheduled for local injection owing to shoulder pain, were randomly assigned into two groups in a consecutive order. Patients in group I (n = 72) were provided information related to US findings and allowed to watch the procedures from the monitor, whereas patients in group II (n = 79) received the injection only without any collaboration. Data were collected from both groups immediately before and after injections through visual analog scale and questionnaire (the State-Trait Anxiety Inventory [STAI] forms 1 and 2). Results US-guided local injections provided significant improvement of anxiety and pain in both groups, irrespective of providing visual information. Group I and group II comparisons with respect to the visual analog scale, STAI 1, and STAI 2 yielded significant difference only for postinjection STAI 2 in group I (P = 0.006). Intragroup comparisons revealed significant differences between preinjection and postinjection values (group I: visual analog scale, P = 0.001; STAI form 1, P = 0.001; STAI form 2, P = 0.002; group II: visual analog scale, P = 0.001; STAI form 1, P = 0.002; STAI form 2, P = 0.042). There was no significant difference between the groups in terms of postinjection satisfaction levels from the procedures (P = 0.824). Conclusions Performing US-guided shoulder injections with patient visual information provides positive contributions to coping with pain and anxiety. In particular, the patient collaboration-based US-guided injections have positive consequences on patients' long-standing trait-anxiety levels.