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Öğe Autologous blood injections in the treatment of lateral epicondylitis: A review of the literature(2011) Ulu M.A.; Karakoç M.; Sariyildiz M.A.; Nas K.Lateral epicondylitis is a common overuse syndrome of the upper extremity. Various factors including chronic microtraumas and local ischemia have been implicated in its etiology. The lack of evidence concerning its pathophysiology has resulted in the exploration of numerous treatment strategies. However, there is still no treatment which is based on a high level of evidence and on which a consensus has been reached. Histopathological examinations revealed that the disease is a degenerative process accompanied by angiofibroblastic hyperplasia rather than an inflammatory condition, and new treatment modalities have been introduced based on this finding. The injection of autologous blood into the painful tendon area is one of these modalities. Herein, the role of autologous blood injection in the treatment of lateral epicondylitis was reviewed in the light of the literature. Copyright © 2011 by Türk Tibbi Rehabilitasyon Kurumu Derneği.Öğe Determination of osteoporosis risk factors using a mutiple logistic regression model in postmenopausal Turkish women(2005) Akkus Z.; Camdeviren H.; Celik F.; Gur A.; Nas K.Objectives: To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. Methods: We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. Result: We classified 80.1% (281/351) of the participants using the regression model. Furthermore, the specificity value of the model was 67% (84/126) of the control group while the sensitivity value was 88% (197/25) of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test (p=0.193). The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. Conclusion: Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation.Öğe Effects of cervical degenerative changes on vertebral artery blood flow in patients with and without vertigo(2003) Çevik R.; Bilici A.; Can A.; Kocamaz S.; Gür A.; Nas K.Vertigo is an important clinical finding of vertebrobasiller insufficiency syndrome which occurs as a result of cervical spondylosis. The aim of present study was to investigate blood flow velocity of vertebral artery in patients having cervical spondylosis with and without vertigo by color Doppler ultrasonography, and its relation with degenerative changes of cervical spine. Thirty patients with vertigo due to spondylosis (I group), 20 patients with spondylosis and without vertigo (II group), and 20 healthy controls were included to the study. Maximum systolic velocity and end diastolic velocity of vertebral arteries were measured bilaterally in all subjects by color Doppler ultrasonography. Mean ages of study groups were 49.2 ± 8.5, 47.35 ± 8.23 and 45.63 ± 4.75, respectively There were significant differentiations among three groups in all VA blood flow velocities (p<0.01 and p<0.001). There were significant correlations between stage of cervical degenerative changes and all VA blood flow velocities (p<0,001). In conclusion, color Doppler ultrasonography, which is non-invasive and uncomplicated tecnique, is a useful method to evaluate vertebral artery blood flow velocity in patients having cervical spondylosis with vertigo.Öğe Musculoskeletal involvement in brucellosis in different age groups: A study of 195 cases(SMW supporting association, 2002) Geyik M.F.; Gür A.; Nas K.; Çevik R.; Saraç J.; Dikici, Bünyamin; Ayaz C.Objective: The aim of the present study was to determine the distribution and characteristics of arthritis in 195 patients with musculoskeletal involvement due to brucellosis in different age groups in the southeastern region of Turkey. Patients and methods: We carried out a retrospective analysis of 283 patients with brucellosis records and identified 195 with musculoskeletal involvement. Patients were classified into acute-subacute (<12 months) and chronic (>12 months) brucellosis. Patients were also classified into three age groups: <15 years old (group A), 15-45 years (group B), and over 45 years (group C). In addition, patients were classified into five subgroups according to type of arthritis: peripheral arthritis, polyarthritis, spondylitis, sacroiliitis, and spondylitis/sacroiliitis. Results: 195 (69%) of the 283 patients [138 female (49%), 145 male (51%)] had musculoskeletal involvement. Of the patients with musculoskeletal involvement 113 (58%) were female and 82 (42 %) were male, ranging in age from 3 to 71 years (mean age 33.14 ± 15.03). Of 195 patients studied, 39 (14%) were <15 years old (group A), 122 (43%) were aged 15-45 (group B), and 34 (12%) were over 45 (group C). The most commonly affected joints were the sacroiliac joint in 108 patients (55%), peripheral joints in 106 (54%), and spondylitis in 60 (31%). Of 108 patients with sacroiliitis, 19 were in group A, 76 in group B, and 13 in group C. Bilateral sacroiliitis was less common in group B (23 patients) than in groups A (3) and C (3) (p <0.05). Spondylitis was more common in group B (18%). Sacroiliitis and polyarthritis were more common than other types of musculoskeletal involvement in females, whereas in males the distribution of all types was similar. In patients aged under 15 and 15-45, sacroiliitis and polyarthritis were common compared with other types of arthritis, but the distribution was similar in patients over 45. Conclusion: In southeastern Anatolia musculoskeletal involvement in brucellosis is frequent. The series presented suggests that musculoskeletal involvement in group A is higher than groups A and C. The prevalence of musculoskeletal involvement appears to differ according to age, sex and clinical type.Öğe Prevalence of disability in Diyarbakir(2000) Nas K.; Çevik R.; Gür A.; Erdo?an F.; Saraç A.J.; Atli Turhano?lu A.D.While the ideal vision for everyone may be to lead a physically and mentally healthy life well into old age, every year many millions die prematurely or are disabled by diseases and condition that are to a large extent preventable. In our study, the prevalence of disabilities was investigated at four zones of Diyarbakir which determinant by socioeconomic situation. The epidemiological survey was carried out from a total of 38685 persons and questionnaires formed by World Health Organization (WHO) were used. The prevalence of disabilities was found to be 14.84% (5742 persons). The prevalence of visceral disabilities was found to be 6.8% (2629 persons) and locomotor disabilities was found to be 2.66%(1013 persons). The relationships between disabilities and factors such as age, educational status, economic status, and marriages among relatives were found to be significant (p<0.001).Öğe Regional cerebral blood flow and cytokines in young females with fibromyalgia(2002) Gur A.; Karakoc M.; Erdogan S.; Nas K.; Cevik R.; Sarac A.J.Objective. To determine whether there is any difference in regional cerebral blood flow (rCBF) and serum cytokine levels and association between clinical parameters and rCBF and serum cytokine levels in young females with flbromyalgia (FM). The other aim was to search whether the depression state has any effect on these two parameters. Methods. Nineteen women with FM and 20 healthy women had 99mTc-HMPAO brain single-photon-emission computed tomography (SPECT) to evaluate rCBF. Serum interleukin (IL) levels (IL I?, IL 2r, IL 6 and IL 8) were measured. Clinical and psychological evaluation was also carried out in FM patients and healthy controls. Results. The patients with FM had significantly higher radioactivity uptake ratio in right and left caudate nucleus (p = 0.009, p = 0.001, respectively) than healthy controls. There was statistically significant decrease in the 99mTc-HMPAO uptake in the right superior parietal (p = 0.041), gyrus rectalis (p 0.036) and pons (p = 0.023). FM patients had significantly higher serum IL 2r and IL 8 levels (p = 0.023, p = 0.011, respectively) than controls. Additionally, FM patients had significantly higher Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), and Hamilton Depression Rate scale (HDRS) scores (p = 0.000) than controls. Interestingly, the patients with mild depressive symptoms or without (i.e.HDRS-score ? 16) had significantly higher serum IL 8 levels (p = 0.027) and increased radioactivity uptake ratio in the pons (P = 0.036) than the patients with more severe depressive symptoms (i.e. HDRS-score > 16). With regard to regional cerebral blood flow, significant correlations were detected between RSP and morning stiffness (r = 0.70, p < 0.01) and sleep disturbance (r = -0.53, p < 0.05), and between gyrus rectalis and FIQ score. There were significant correlations between LCN and IL-2 (P = 0.025), between RSP and morning stiffness (P = 0.006), sleep disturbance (P = 0.021) according to multiple regression analysis test. Conclusion. This study shows a significant increase in rCBF of caudate nuclei, a reduction in the pons, some cortical regions activity and a increase in IL 8, IL2r levels of young female patients with FM. These findings are more prominent in patients with low HDRS scores.Öğe Spinal cord injury in Turkey(Nova Science Publishers, Inc., 2012) Nas K.Traumatic spinal cord injury (SCI) often results in profound and long-term disability,which is life changing for the injured individual and his or her family. These injuries alsohave tremendous social costs associated with expensive health care treatment,rehabilitation, and lost productivity. The estimated annual incidence of traumatic SCI is12.7 per million inhabitants in Turkey. The mortality rate of SCI is estimated to be 12%-15% in Turkey. SCI patients became either tetraplegic (32.18%) and paraplegic (67.82%)after injury. The most common level of injury was C5 among tetraplegics, T12 and L1for paraplegics. The most prevalent associated injury was head trauma followed byextremity fractures. Regarding the etiology, traffic accident is the most common cause ofspinal cord injury, the second most-common cause is falls from height and the third isgunshot injury. The incidences of gunshot wounds and injuries from falls are higher inTurkey than other countries, which can be explained by special socio-economic andcultural differences. The high incidence of gunshot wounds is the result of the violenceexperienced mainly in south-eastern of Turkey. Moreover, the higher frequency of fallsfrom height can be associated with the fact that most falls occurred in the summer when itis very hot in this region and people are forced to sleep on the top of their houses, whichdo not have barriers along the roof perimeter. Traumatic SCI is more frequent amongmales than females and among those between the ages of 15 and 39 years. Consideringthat traffic accidents, falls from height and gunshot wounds are the leading cause oftraumatic SCI, it can be concluded that the prevention measures should be focusedmainly on these types of traumas in order to reduce the frequency of SCI in Turkey. © 2012 by Nova Science Publishers, Inc. All rights reserved.
