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Öğe Ankilozan spondilitli hastalarda komorbit hastalıkların değerlendirmesi(Dicle Üniversitesi Tıp Fakültesi, 2014) Em, Serda; Bozkurt, Mehtap; Çağlayan, Mehmet; Oktayoğlu, Pelin; Karakoç, Mehmet; Nas, KemalAmaç: Bu çalışmanın amacı ankilozan spondilit (AS) hastalarında komorbit hastalıkları ve bulunma oranlarını belirlemektir. Yöntemler: Bu çalışmaya 70 AS’li hasta, 70 romatoid artritli (RA) hasta ve 70 sağlıklı kontrol alındı. Demografik ve klinik özellikler kaydedildi. Tüm gruplar hipertansiyon, Aterosklerotik Kalp Hastalığı (ASKH), kalp yetmezliği, tiroid hastalıkları, akciğer hastalıkları, Tip2 diyabet ve serebrovasküler olay (SVO) açısından sorgulandı ve daha kapsamlı bilgi elde etmek için hasta kayıtları retrospektif olarak incelendi. Bulgular: Hasta ve kontrol grupları yaş, boy ve kilo bakımından benzerdi. AS’li hastalarda hipertansiyon görülme sıklığı, sağlıklı kontrollerden anlamlı olarak yüksekti (p<0.05). Fakat AS ve RA hastaları hipertansiyon açısından karşılaştırıldığında böyle bir farklılık gözlenmedi (p>0.05). AS ve RA’lı hastalarda ASKH ve kalp yetmezliği görülme sıklığı benzerdi ve AS hastaları kontrol grupları ile karşılaştırıldığında anlamlı farklılık yoktu. AS’li hastalarda tiroid hastalıkları %12.8 olarak görülürken, Tip2 diyabet sıklığı %11.4 idi ve sağlıklı kontrollerle AS hastaları karşılaştırıldığında bu iki hastalık açısından iki grup arasındaki fark anlamlıydı (p<0.05). Sonuç: AS’li hastalarda, sağlıklı kontrollere göre hipertansiyon, tiroid hastalıkları ve diyabet görülme sıklığı anlamlı derecede yüksekti. Ancak RA’lı hastalar ve AS’li hastalar arasında komorbit hastalık açısından anlamlı fark tespit edilmedi.Öğe Assessment of the presence of carpal tunnel syndrome in patients with diabetes mellitus, hypothyroidism and acromegaly(Journal of Clinical and Diagnostic Research, 2015) Oktayoğlu, Pelin; Nas, Kemal; Kılınç, Faruk; Taşdemir, Nebahat; Bozkurt, Mehtap; Yıldız, İsmailABSTRACT Introduction: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. Aim: The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population. Materials and Methods: Patients were assigned into three groups as follows: patients with type II DM n: 100, patients with hypothyroidism n:48 and patients with acromegaly n:36. In addition, 50 healthy individuals were included in the study as control subjects. Patients were asked if they had any pain, symptoms of paraesthesia and numbness. Patients with peripheral neuropathy were excluded from the study. Boston Symptom Severity Scale and Functional Capacity Scale were used to assess symptom severity and functional capacity. CTS was investigated by performing electrophysiological study for both hands. Results: The incidence of CTS was significantly higher in all three groups compared to the control group (p>0.05). In addition, the incidence of CTS was significantly higher in the DM group compared to the hypothyroid and acromegaly groups (p<0.001). The incidence of bilateral CTS in the DM group was significantly higher compared to both hypothyroid and acromegaly groups and the control group (p<0.001). Conclusion: CTS has a higher incidence in DM, hypothyroid and acromegaly patients compared to healthy individuals. Clinicians should be careful about development of CTS in DM, hypothyroidism and acromegaly. They should adopt a multidisciplinary approach and co-operate with the psychiatrist.Öğe Benign eklem hipermobilite sendromlu hastalarda emosyonel durum ve ilişkili faktörler(Dicle Üniversitesi Tıp Fakültesi, 2014) Em, Serda; Çağlayan, Mehmet; Oktayoğlu, Pelin; Bozkurt, Mehtap; Ceylan, Veysi; Nas, KemalAmaç: Benign eklem hipermobilite sendromlu (BEHS) hastalarda emosyonel durumu değerlendirmek ve emosyonel durum üzerine etkili hastalıkla ilgili faktörleri belirlemektir. Yöntemler: Beighton tanı kriterlerine göre BEHS tanısı konan 63 kadın hasta ve 60 sağlıklı kontrol bu çalışmaya dahil edildi. Hastalar sorgulandıktan sonra kas-iskelet sistem muayeneleri yapılarak elde edilen bulgular kaydedildi. Hastaların kronik ağrılarını değerlendirmek için Vizüel Analog skala (VAS) kullanıldı. BEHS’li hastalar ve kontrollerin anksiyete ve depresyon durumları Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ile değerlendirildi. Bulgular: Hasta ve kontrol grubu, yaş ortalaması bakımından benzerdi. Hastaların Beighton toplam skor ortalaması (6.64 ± 1.28) kontrol grubundan (0.65±0.86) anlamlı olarak yüksekti (p<0.001). Ortalama anksiyete ve depresyon oranları açısından hasta ve kontroller arasındaki fark anlamlıydı (sırasıyla, p<0.05; p<0.01). HADÖ anksiyete skoru, hem Beighton skoru ile hem de VAS ağrı skoru ile korele iken, depresyon skoru sadece VAS ağrı skoru ile ilişkiliydi. Sonuç: BEHS’li hastalarda, sağlıklı kontrollere göre anksiyete ve depresyon oranı anlamlı derecede yüksekti. Aynı zamanda hastalardaki hipermobilite derecesi ve ağrı şiddeti ile emosyonel durum arasında bir ilişki vardı. Bu nedenle BEHS’li hastaların takip ve tedavisinde emosyonel durum göz önüne alınmalıdırÖğe Determining quality of life and associated factors in patients with stroke(Turkish Society of Physical Medicine and Rehabilitation, 2015) Em, Serda; Bozkurt, Mehtap; Karakoç, Mehmet; Çağlayan, Mehmet; Akdeniz, Dicle; Oktayoğlu, Pelin; Varol, Sefer; Nas, KemalObjective: This study aims to examine the overall and domain-specific quality of life in patients with stroke and to identify variables predicting quality of life after stroke. Material and Methods: A total of 104 patients with sufficient cognitive functions having hemiplegia because of cerebrovascular accident and 108 controls were included in this study. Demographic and clinical features were recorded. The Barthel Index (BI) and Functional Ambulation Category scale were employed to assess the functional state of patients. Quality of life was evaluated by the Short Form 36 (SF-36) health survey, whereas the emotional state of the patients was evaluated by the Hospital Anxiety and Depression Scale (HADS). Functional status, motor impairment, and emotional state were determined as independent variables, and multiple regression analysis was used to predict quality of life. Results: Patients had significantly lower scores in the quality of life subscores and total scores in comparison with the controls (p<0.001). The mean anxiety and depression rates in the patients were significantly higher than those in controls (p<0.001). The sum of subscores and physical composite score of SF-36 were significantly lower in female and illiterate patients than in male and educated patients. Multiple regression analyses indicated that HADS depression was associated with mental health (p<0.001), whereas BI was independently associated with the physical health total score (p<0.05). The power of the statistical analysis for study population was 100% according to the given effect size (α=0.01). Conclusion: Present results demonstrated that patients with stroke have a significantly poor quality of life than the general population. The reduced quality of life after stroke appears to be related the emotional state, physical disability, and demographic properties such as gender and education. Therefore, prevention of disability and early diagnosis and treatment of depression are vital in improving the quality of life of patients with stroke.Öğe Diz osteoartritli hastaların tedavisinde fonoforez ve konvansiyonel ultrasonun etkinliğinin karşılaştırılması(2017) Oktayoğlu, Pelin; Gür, AliÇalışmamızda, primer diz osteoartritli hastaların tedavilerinde fizik tedavi ajanlarından ultrason ve fonoforez uygulamalarının etkinliğini karşılaştırdık. Dicle Üniversitesi Tıp Fakültesi FTR polikliniğine başvuran American College of Rheumatology kriterlerine göre diz osteoartriti tanısı koyulan 40 hasta çalışmaya alındı. Hastalar fonoforez ve ultrason tedavisi almak üzere 2 gruba randomize edildi. Açık, kontrollü olarak yapılan çalışmada hastaların tedavi öncesi diz maksimum fleksiyon derecesi ölçüldü. Sabah tutukluğu, ağrısız yürüme süresi, ağrısız yürüme mesafesi kaydededildi. Ağrı değerlendirilmesinde vizüel analog skala (VAS) ve Western Ontario Mc Master Osteoarthritis Index (WOMAC) ağrı skoru kullanıldı. Eklem sertliği için WOMAC eklem sertliği, fiziksel fonksiyonlar için WOMAC fiziksel fonksiyon skoru, Lequesne's fonksiyonel indeks ve Stanford Health Assesment Questionnaire (HAQ)'dan yararlanıldı. Anksiyete, durumsal ve sürekli anksiyete ölçeği, depresyon Beck Depresyon ölçeği kullanılarak değerlendirildi. Hastalara her dize 10 dakika olmak üzere toplam 20 dakika olacak şekilde 10 seans tedavi uygulandı. Birinci gruba fonoforezde %1.16 diklofenak dietilamonyum jel kullanıldı, 2. gruba ultrason tedavisi yapıldı Fonoforez grubunda yapılan takiplerde ağrısız yürüme mesafesi, yürüme VAS, istirahat VAS, fleksiyon VAS değerlerinde anlamlı düzelme, ağrısız yürüme süresinde 15. gün hariç tüm kontrollerde iyileşmeler saptandı. Ultrason grubunun takiplerinde yürüme VAS, fleksiyon VAS, WOMAC ağrı ve WOMAC fiziksel fonksiyon parametrelerinde anlamlı iyileşme görüldü. Her iki tedavi modalitesinin, bazı parametrelerde başlangıca göre anlamlı düzelmeler sağladığı, fonoforezin ağrısız yürüme süresini uzatma ve 2. ay istirahat VAS değerini azaltmada ultrasona göre anlamlı olarak daha üstün olduğu saptandı. Sonuç olarak çalışmamız her iki tedavinin, diz osteoartritinde güvenli ve etkili bir şekilde kullanılabileceğini ortaya koymuştur.Öğe Effects of lumbosacral angles on development of low back pain(Journal Of Musculoskeletal Pain, 2014) Çağlayan, Mehmet; Tacar, Orhan; Demirant, Ayda; Oktayoğlu, Pelin; Karakoç, Mehmet; Çetin, Abdurrahman; Em, Serda; Bozkurt, Mehtap; Uçar, Demet; Nas, KemalObjective: Low back pain [LBP] is an important health issue due the diagnosis and treatment expenses and loss of workforce it leads to. Biomechanical changes in the vertebral column caused by changes in the lumbosacral angles [LSAs] may lead to LBP. The purpose of this study was to assess body mass index [BMI] and LSAs in patients with LBP and investigate the association between LBP, LSAs and BMI. Methods: Lumbar lordotic angle [LLA], LSA, sacro-horizontal angle [SHA] and sacral inclination angle [SIA] were measured in 117 patients with chronic LBP and 85 healthy normal controls [HNCs] by means of lumbosacral radiography. In addition, association between LSAs, BMI and LBP was investigated. Results: There were no significant differences between patients and HNCs regarding LSAs and BMI. LLA was lower in male patients with LBP compared to male HNCs without LBP [p = 0.013]. In addition, SIA [p = 0.002] and BMI [p = 0.006] were higher in female patients with LBP compared to male patients with LBP. It was found that an increase in LLA increased the risk of having LPB by approximately 1.04-folds [ranging from 1.01 to 1.08; p = 0.045]. On the other hand, no association was found between LSAs and BMI. Conclusion: Changes in LSAs may cause LBP. An increase in LLA may be influential in increasing the risk of LBP. Therefore, measurement of LSAs may guide the physician who is to make clinical decisions in examination of patients with LBP.Öğe Evaluation of hearing loss in patients with ankylosing spondylitis(Aves Yayıncılık, 2014) Bozkurt, Mehtap; Çağlayan, Mehmet; Uçar, Demet; Oktayoğlu, Pelin; Em, Serda; Gün, Ramazan; Gür, Ali; Nas, KemalMaterials and Methods: A total of 50 AS patients and 34 healthy controls were enrolled into the study. Physical examinations and disease activity score measurements were performed in patients with AS. Results: The mean age was 32.20 years (18-55) in AS patients and 35.58 (20-50) in the control group. The mean disease duration was 5.27 years (0-22) in patients with AS. Hearing loss was detected in seven (14%) of the AS patients and three (8.8%) of the control patients. In terms of hearing loss, a statistically signifcant difference was not found between the two groups. Sensorineural hearing loss was the most commonly detected type of hearing loss in the two groups. Hearing loss was present in two (28.5%) of the seven AS patients in whom the duration of disease was more than 10 years. There was no statistically signifcant correlation between the duration of disease and hearing loss. Conclusion: There was no signifcant difference between the AS and control groups with respect to hearing loss. The rate of hearing loss increased in line with the duration of disease. Objective: The aim of this study was to evaluate the rate of hearing loss in patients with ankylosing spondylitis (AS) and to analyze whether the rates of hearing loss were different from the control group or not.Öğe İnmeli hastalarda uyku kalitesi ve ilişkili faktörlerin değerlendirilmesi(Fırat Üniversitesi Tıp Fakültesi, 2015) Akdeniz, Dicle; Em, Serda; Çağlayan, Mehmet; Bozkurt, Mehtap; Oktayoğlu, Pelin; Karakoç, Mehmet; Nas, KemalAmaç: Bu çalışmanın amacı inmeli hastalarda uyku kalitesini değerlendirmek; uyku kalitesi üzerine fonksiyonel durum, emosyonel durum ve motor iyileşmenin etkisini belirlemektir. Gereç ve Yöntem: Serebrovasküler olaya bağlı inmesi olan 62 hasta ve 62 sağlıklı gönüllü çalışmaya alındı. Çalışma grubunun sosyodemografik verileri ve hastaların klinik bulguları kaydedildi. Fonksiyonel durumu değerlendirmek için Barthel İndeksi (Bİ) ve Fonksiyonel Ambulasyon Sınıflaması kullanıldı. Uyku kalitesi Pittsburgh Uyku Kalitesi indeksi (PUKİ) ile değerlendirilirken, emosyonel durum Hastane Anksiyete Depresyon Ölçeği (HADÖ) ile belirlendi. Fonksiyonel durum, motor bozukluk ve emosyonel durum bağımsız değişkenler olarak alındı ve multipl regresyon analizi uyku kalitesini tahmin etmek için kullanıldı. Bulgular: Hastalarda PUKİ’nin tüm alt skorları ve total skoru kontrol grubuna göre anlamlı olarak yüksekti (p<0.001). Total PUKİ skoru ile HADÖ anksiyete ve depresyon skoru korele idi (p<0.01). Bİ ile PUKİ total skoru arasında da anlamlı negatif korelasyon vardı. Multipl regresyon analizi HADÖ depresyon duygu durumunun uyku kalitesini tahmin etmede en önemli faktör olduğunu gösterdi (p<0.01). Sonuç: Çalışmamız kontrol grubuna göre inme hastalarının uyku kalitesinde bozulma olduğunu gösterdi. Aynı zamanda hastaların emosyonel durumları ve fiziksel disabiliteleri ile uyku kalitesi de ilişkiliydi. Çalışmamıza göre depresyon uyku kalitesini belirleyen en önemli faktör olduğu için özellikle depresyonun erken tanı ve tedavisi ile inmeli hastaların uyku kalitesinin artacağını düşünmekteyiz.Öğe Is there an association between chronic urticaria and fibromyalgia syndrome?(Turkish League Against Rheumatism, 2014) Oktayoğlu, Pelin; Uçmak, Derya; Çağlayan, Mehmet; Uçar, Demet; Bozkurt, Mehtap; Em, Serda; Yazmalar, Levent; Nas, KemalAbstract:Objectives: Chronic urticaria (CU) and fibromyalgia (FM) are different types of diseases with unclear etiopathogeneses but share many clinical and histochemical features. This study aims to make a recognization on these features and examines whether patients with CU are also affected by FM. Patients and methods: Forty patients with CU and 38 healthy controls were enrolled to this study. All of the participants were assessed according to the 1990 American College of Rheumatology (ACR) classification criteria for FM and asked questions regarding the clinical features of FM. The quality of life was assessed by the Nottingham Health Profile (NHP), while the psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS). Results: The incidence of FM was higher among the patients with CU (32.5%) than the controls (10.5%) (p=0.019). We indicated that the patients with CU suffered restrictions regarding to quality of life as assessed by the NHP. NHP-sleep (p=0.035), NHP-social isolation (p=0.032) and NHP-emotional reaction (p=0.027) scores were significantly higher compared to HCs. The HADS-depression scores were also significantly higher in the patients with CU (p=0.006). The patients with CU and concomitant FM had higher total NHP scores than those without FM (p<0.001). Conclusion: Clinicians must be alerted to the possible coexistence of FM in CU patients. Patients with CU have higher rates of FM than the general population and this results in more restrictions in daily life in these patients than those with CU alone. Therefore, additional treatment protocols may be required to be implicated for the treatment of patients with both CU and FM.Öğe Paraplegia due to missed thoracic meningioma after lumbar spinal decompression surgery: A case report and review of the literature(Dicle Üniversitesi Tıp Fakültesi, 2014) Bozkurt, Mehtap; Göçmez, Cüneyt; Okçu, Mehmet; Türkcü, Gül; Em, Serda; Oktayoğlu, Pelin; Uçar, Demet; Nas, KemalSpinal meningiomas are often localized to the thoracic level and symptoms from a spinal meningioma are determined by the location of the mass. We present a case of thoracic paraplegia due to a thoracic spinal cord tumor (meningioma) that was not detected during lumbar spinal decompressive surgery. Thoracic mass was detected in level of T2-3 on magnetic resonance imaging (MRI). The patient was re-operated and the patient’s neurologic symptoms were partially relieved. Surgeons should know that a thoracic silent meningioma can aggrevate neurological symptoms after lumbar spinal decompression surgery and should inform their patient before surgery.Öğe Protrüzyo asetabulinin nadir bir nedeni: Kollajen tip 1 alfa1gen polimorfzmi zemininde gelişen osteoporoz(2014) Bozkurt, Mehtap; Oktayoğlu, Pelin; Nas, Kemal; Aydınol, Belkıs; Çağlayan, MehmetProtrüzyo asetabuli (PA), radyografk incelemede asetabulumun pelvise doğru protrüzyonu şeklinde karşımıza çıkan ve pek çok etyolojiknedene bağlı olarak görülebilen, kalça ağrısının nadir sebeplerinden biridir. Bilateral kalça ağrısıyla polikliniğimize müracaat eden ve primerosteoporoza bağlı PA saptadığımız ve osteoporoza yönelik yapılan gen analizinde kollajen tip 1 alfa 1 (COL1A1) Sp1 bağlanma bölgesindepolimorfzm saptadığımız 20 yaşındaki genç hastamızı olgu olarak sunmayı amaçladık. (Türk Osteoporoz Dergisi 2014;20: 135-6)Öğe The role of alpha defensins in patients with ankylosing spondylitis(Georg Thieme Verlag, 2021) Oktayoğlu, Pelin; Mete, Nuriye; Çaǧlayan, MehmetObjectives Defensins are a family of antimicrobial peptides. Elevated levels of human neutrophil peptides (HNP 1-3) are seen in blood samples of patients with inflammatory bowel disease (IBD) and in many rheumatic diseases. It has been suggested that they may play a significant role in the progression and pathogenesis of these diseases. Therefore, we aimed to investigate the levels of HNP 1-3 in sera of patients with ankylosing spondylitis (AS) and its association with disease activity and other clinical features of AS. Methods A total of 36 patients, who met the Modified New York Criteria for AS, and 50 healthy controls (HCs) were included in this study. The Bath AS Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) were used to assess disease activity. The Bath AS Radiology Index (BASRI) was used to assess radiological damage. Spinal and hip measurements were determined by the Bath AS Metrology Index (BASMI). An AS Quality of Life (ASQoL) questionnaire was administered to assess the disease-related quality of life. Serum HNP 1-3 levels were determined using the ELISA kit. Results Mean serum HNP 1-3 levels were significantly higher in patients with AS (287.01±201.307 vs. 152.09±43.75 pg/ml) compared with HCs (p=0.001). HNP 1-3 levels did not correlate with BASDAI (p=0.519), ASDAS-CRP (p=0.424), BASRI (p=0.280), BASMI (p=0.168), ASQoL (p=0.307), ESR (p=0.706) and CRP (p=0.157) values. Conclusion Elevated serum levels of HNP 1-3 may play an important role in the pathogenetic mechanisms of AS. This result may give us an opportunity to develop new treatment strategies considering the role of these peptides in the pathogenetic mechanisms of AS.Öğe Serum prolidase enzyme activity and oxidative status in patients with Behçet's disease(Taylor and Francis, 2014) Bozkurt, Mehtap; Yüksel, Hatice; Em, Serda; Oktayoğlu, Pelin; Yıldız, Mehmet; Akdeniz, Dicle; Nas, KemalObjectives: To assess serum prolidase enzyme activity and oxidative stress in patients with Behçet's disease (BD). Methods: The study population consisted of BD patients (n = 42) and healthy participants (n = 29). BD patients were classified as active (n = 18) or inactive (n = 24) according to disease activity. Serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and malondialdehyde (MDA) levels were measured. Results: In BD patients with active disease, serum prolidase activity was significantly higher compared with the inactive and control participants. Serum prolidase activity was also significantly higher in all BD patients in comparison with controls. Serum prolidase activity was also positively correlated with OSI, C-reactive protein, and active BD. MDA, TOS, and OSI levels were all significantly higher in the BD group when compared with the healthy control participants. Serum TAS levels were significantly lower in BD patients in comparison with healthy controls. Conclusion: High prolidase activity may indicate critical biological activities relevant to pathological events in BD, and this activity may be a biological indicator of disease. Further studies are needed to verify these findings.Öğe Severe pure acute motor axonal neuropathy(Erciyes University Faculty of Medicine, 2015) Taşdemir, Nebahat; Karakoç, Mehmet; Oktayoğlu, Pelin; Nas, KemalAcute motor axonal neuropathy (AMAN) is a subtype of Guillain Barré syndrome. Characteristic electrophysiological featuresof AMAN are reduced amplitude or absence of muscle action potentials. Our patient described progressive weakness in his legand was not able to independently walk; he had a feeling weakness in his arms within 24 h after the onset of symptoms. Hewas diagnosed with AMAN according to the clinical and electrophysiological features. He could independently walk after twoyears following intensive physical therapy and monitoring. Neurologists and physiatrist should conduct long term monitoring andrehabilitation for patients with AMAN because neurological deficits may persist for a long time.
