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Öğe Adalimumab tedavisi alan romatoid artritli hastada seksüel disfonksiyon(Dicle Üniversitesi Tıp Fakültesi, 2015) Yazmalar, Levent; Sarıyıldız, Mustafa Akif; Batmaz, İbrahimRomatoid artrit (RA) simetrik poliartrit ve artralji, sabah tutukluğu, yorgunluk ve romatoid nodüllerle karakterize kronik, sistemik ve enflamatuar hastalıktır. Genetik, enfeksiyöz, hormonal veya çevresel faktörleri içeren multifaktöriyel etkenler RA gelişimine katkıda bulunabilir. Bununla birlikte kesin etiyoloji hala tanımlanmamıştır. Hem erkek hem de bayan RA’lı hastalar azalmış seksüel fonksiyonlardan şikayetçidir. Ayrıca, RA’lı hastalarda hastalık aktivitesi, ilaçlar ve psikolojik problemler seksüel fonksiyonları etkileyebilmektedir. Cinsel sağlık insan yaşamında önemlidir. Buna rağmen klinik pratikte RA ile seksüel problemler arasındaki ilişki sıklıkla dikkate alınmamaktadır. Biz RA’lı bir erkek hastada adalimumab başlandıktan sonra gelişen seksüel disfonksiyon vakasını sunuyoruzÖğe Association of Neuron-Specific Enolase with Sleep Quality, Cognitive Function And Quality of Life in Patients with Fibromyalgia Syndrome(Clinical & Exper Rheumatology, 2014) Verim, Sabahattin; Cavas, Husamettin; Nas, Kemal; Yazmalar, Levent; Batmaz, Ibrahim; Cevik, Remzi[Abstract Not Available]Öğe Decreased neck muscle strength in patients with the loss of cervical lordosis(Elsevier Sci Ltd, 2016) Alpayci, Mahmut; Senkoy, Emre; Delen, Veysel; Sah, Volkan; Yazmalar, Levent; Erden, Metin; Toprak, MuratBackground: The loss of cervical lordosis is associated with some negative clinical outcomes. No previous study has examined cervical muscle strength, specifically in patients with the loss of cervical lordosis. This study aims to investigate whether there is weakness of the cervical muscles or an imbalance between cervical flexor and extensor muscle strength in patients with the loss of cervical lordosis compared with healthy controls matched by age, gender, body mass index (BMI), and employment status. Methods: Thirty-two patients with the loss of cervical lordosis (23 F, 9 M) and 31 healthy volunteers (23 F, 8 M) were included in the study. Maximal isometric neck extension and flexion strength, and the strength ratio between extension and flexion were used as evaluation parameters. All measurements were conducted by a blinded assessor using a digital force gauge. The participants were positioned on a chair in a neutral cervical position and without the trunk inclined during measurements. Findings: Maximal isometric neck extension and flexion strength values were significantly lower in the patients versus healthy controls (P<0.001 and P = 0.040, respectively). The mean (SD) values of the extension/flexion ratio were 1.21 (0.34) in the patients and 1.46 +/- 0.33 in the controls (P = 0.004). Interpretation: According to our results, patients with the loss of cervical lordosis have reduced neck muscle strength, especially in the extensors. These findings may be beneficial for optimizing cervical exercise prescriptions. (C) 2016 Elsevier Ltd. All rights reserved.Öğe Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis(Int Scientific Information, Inc, 2016) Bulut, Mehmet Deniz; Alpayci, Mahmut; Senkoy, Emre; Bora, Aydin; Yazmalar, Levent; Yavuz, Alpaslan; Gulsen, IsmailBackground: Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. Material/Methods: Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. Results: The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. Conclusions: The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.Öğe Depressive and Anxious Temperaments in Patients with Complex Regional Pain Syndrome Secondary to Tendon Injury(Taylor & Francis Ltd, 2014) Batmaz, Ibrahim; Dilek, Banu; Sariyildiz, Mustafa Akif; Erbatur, Serkan; Bez, Yasin; Yazmalar, Levent; Bozkurt, MehtapObjective: To determine the affective temperaments and somatoform amplification of the symptoms and its relation with the complex regional pain syndrome [CRPS] in patients who had tendon injuries of the forearm and hand. Methods: Sixty-seven patients [60 males, 7 females] with a forearm or hand tendon injury were enrolled in the present study. The patients were divided into two groups: CRPS and non-CRPS. The patients' pain levels within the last 48 hours were assessed using the visual analog scale [VAS]. The temperament of the patients was evaluated using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto questionnaire [TEMPS-A]. Their anxiety levels were evaluated with the help of the State-Trait Anxiety Inventory [STAI]. The depression assessment was performed using the Beck Depression Inventory [BDI]. The Somato sensory Amplification Scale [SSAS] was employed for the evaluation of the somatoform disorders. Results: The mean age of the patients was 26.21 +/- 8.01 years [age range: 18 to 57 years]. Among the patients 24 [35.8%] had developed CRPS. When the patients with and without CRPS were compared in terms of their psychological scores, the STAI-II and BDI scores were observed to be significantly deteriorated in the CRPS group in comparison to the non-CRPS group [p<0.05]. Among the TEMPS-A subtypes, anxious [16.7%] and depressive [41.7%] temperaments were more dominant in the CRPS group and the ratio was significantly more deteriorated than the non-CRPS group [p<0.05]. No significant difference was observed between the groups regarding the SSAS scores [p>0.05]. Conclusion: The present study is the first one evaluating the affective temperaments of CRPS patients with tendon injury, and the main findings point out that depressive and anxious temperaments are the most common dominant affective temperaments among our patients.Öğe Diz osteoartritli hastalarda uyku kalitesinin ağrı, radyolojik hasar, fonksiyonel durum ve depresif semptomlar ile ilişkisi(Modestum Publishing Ltd., 2013) Sarıyıldız, Mustafa Akif; Batmaz, İbrahim; Kaya, Mehmet Cemal; Bozkurt, Mehtap; Okçu, Mehmet; Yıldız, Mehmet; Yazmalar, Levent; Çelepkolu, TahsinAmaç: Bu çalışmanın amacı diz osteoartriti (OA) tanılı hastalarda uyku kalitesini değerlendirmek ve uyku kalitesi ile klinik parametreler, ağrı, fonksiyonel durum, radyolojik hasar ve psikolojik durum arasındaki ilişkiyi incelemektir. Yöntemler: Diz osteoartriti tanılı 52 hasta ve 35 sağlıklı gönüllü çalışmaya dahil edildi. Hastaların yaş, eğitim seviyesi, medeni durumu gibi demografik özellikleri kaydedildi. Hastalıkla ilişkili yeti yitimi, Western Ontario ve McMaster Üniversitesi Osteoartrit indeksi (WOMAC) ile değerlendirildi. Genel ağrı, genel yorgunluk ve diz ağrısı seviyesi görsel analog skala ile değerlendirildi. Psikolojik durum hastane anksiyete depresyon skalası ile ölçüldü. Diz osteoartritinin radyolojik evresi Kellgren Lawrence skoruna göre hesaplandı. Hasta ve kontrol grubunun uyku kalitesi, Pittsburgh uyku kalitesi indeksi (PUKİ) yardımıyla değerlendirildi. Bulgular: Diz osteoartriti olan hastalarda, öznel uyku kalitesi, uykuya dalma süresi, alışılmış uyku etkinliği ve total PUKİ skoru kontrol grubuna göre anlamlı olarak yüksekti (p<0,05). Spearman analizi sonuçlarına göre, total PUKİ skoru ile yaş, yaygın ağrı, diz ağrısı, WOMAC ağrı, radyolojik evre ve depresif semptomlar arasında anlamlı korelasyonlar saptandı (p<0,05). Sonuç: Diz OA tanılı hastalarda uyku kalitesi bozulmaktadır. Bozulmuş uyku kalitesi özellikle diz ağrısı, yaş, depresif semptomlar ve radyolojik evre ile ilişkilidir.Öğe The effectiveness of transforaminal epidural steroid injections on radicular pain, functionality, psychological status and sleep quality in patients with lumbar disc herniation(Ios Press, 2017) Sariyildiz, Mustafa Akif; Batmaz, Ibrahim; Yazmalar, Levent; Gunes, Mehmet; Turan, YahyaBACKGROUND: The significance of fluoroscopy-guided transforaminal epidural steroid injections (TFESI) in the treatment of lumbar disc herniation (LDH) is well known. The aim of our study is to investigate the effectiveness of TFESI on radicular pain, functionality, psychological status, and sleep quality in patients with LDH. METHODS: Seventy-five LDH patients (36 males, 39 females) were enrolled in the study. All patients received a fluoroscopically guided TFESI (betamethasone 40 mg, lidocaine 2%). Also all patients were evaluated according to (with the visual analogue scale) radicular pain, Oswestry disability index (ODI), hospital axiety and depression scale, and Pittsburgh sleep quality index (PSQI) at baseline, at two weeks, and 12 months post injections. RESULTS: Mean age was 46.4 +/- 12.5. When compared to baseline measurements there were significant improvements in radicular pain, ODI, modified schober, Laseque angle, finger to floor distance, depressive symptoms and PSQI scores at two weeks and 12 months after injection. Improvement of at least 50% in radicular pain relief, ODI score and sleep quality index was detected at two weeks 83%, 71%, 69% respectively. This rate showed regression at 12 months of 73%, 65% and 62% respectively. Duration of symptoms was significantly negatively correlated with changes in scores of radicular pain, ODI, depressive symptoms, and PSQI. There were no significant correlations with symptom duration and anxious symptoms. CONCLUSION: Fluoroscopy guided TFESI had positive effects on radicular pain, functionality, depressive symptoms and sleep quality in management of LDH.Öğe Efficiency of therapeutic ultrasound on pain, disability, anxiety, depression, sleep and quality of life in patients with subacromial impingement syndrome: A randomized controlled study(Ios Press, 2016) Yazmalar, Levent; Sariyildiz, Mustafa Akif; Batmaz, Ibrahim; Alpayci, Mahmut; Burkan, Yahya Kemal; Ozkan, Yasemin; Okcu, MehmetBACKGROUND: Subacromial impingement syndrome (SIS) is characterized by pain and disability of shoulder. Various treatment methods have been used for SIS. OBJECTIVES: The aim of our study was to evaluate efficacy of therapeutic ultrasound (US) on pain, disability, anxiety, depression, sleep quality and quality of life in patients with SIS. METHODS: Patients with SIS were randomly divided into two groups, including the group 1 (continuous US group; 3 MHz, 1.5 W/cm(2), n = 26) and group 2 (sham US group, n = 24). Additionally, transcutaneous electrical nerve stimulation (TENS) + exercise program were added in both groups. Pain and disability of the shoulder were assessed by the Shoulder Pain and Disability Index (SPADI), while anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Quality of life was evalutaed by the Nottingham Health Profile (NHP). Patients were evaluated at baseline and after end of three weeks. RESULTS: Both groups had significantly improvements in terms of SPADI-pain, SPADI-disability, SPADI-total, NHP-pain and NHP-sleep scores after the three weeks interventions. There were significantly improvements in the Group 1 in terms of PSQI-total, and NHP-physical activity. Group 2 had significantly improvements in terms of anxiety-HADS, depression-HADS and NHP-emotional reaction scores. In the inter-group comparison, there were no significantly differences in the change scores were observed in any domains of SPADI scores, anxiety, depression and sleep scores, or any NHP scores. CONCLUSIONS: Our study showed that US does not have any benefits on SIS. TENS + exercise program are not effective on anxiety, depression and fatigue, however TENS + exercise program are effective on pain, disability and sleep disturbance in patients with SIS.Öğe Elevated serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis and its association with disease activity and quality of life(Springer Heidelberg, 2013) Oktayoglu, Pelin; Em, Serda; Tahtasiz, Mehmet; Bozkurt, Mehtap; Ucar, Demet; Yazmalar, Levent; Nas, KemalThis study was carried out to determine the serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis (AS) and to evaluate its correlation with disease activity and quality of life. According to our knowledge, it is the first trial evaluating HMGB1 levels in AS. Serum samples of 30 patients (18 males and 12 females) with AS and 29 healthy controls (HC) (15 females and 14 males) were collected. HMGB1 levels were measured by enzyme-linked immunosorbent assay, activity of disease was assessed according to the Bath AS Disease Activity Index (BASDAI), and functional status of patients was evaluated with Bath AS Functional Index (BASFI). Modified Schober, chest expansion values and AS Quality of Life Questionnaire (ASQoL) scores were noted. The serum levels of HMGB1 were obtained significantly increased in AS patients compared to HC (p < 0.05). There was no significant correlation between HMGB1 levels and ESR (p > 0.05), and CRP (p > 0.05) values. BASDAI, BASFI and ASQoL scores were also not correlated with serum levels of HMGB1 (p > 0.05). Our results suggest that HMGB1 might play an important role in the pathogenesis of AS; however, it seems not to be a good candidate for reflecting disease activity, functional abilities and the quality of life in patients with AS; on the other hand, the increased levels of HMGB1 in patients may open a new dimension for targeting this cytokine as a new therapy option in AS.Öğe Evaluation of the Anterior Segment Parameters of the Patients with Scleroderma(Taylor & Francis Inc, 2017) Sahin, Muhammed; Yuksel, Harun; Sahin, Alparslan; Cingue, Abdullah Kursat; Turkcu, Fatih Mehmet; Kaya, Savas; Yazmalar, LeventPurpose: To evaluate corneal parameters of scleroderma (SC) patients by Pentacam-HR. Methods: Twenty-two eyes of 22 SC patients and 33 eyes of 33 control subjects were enrolled. All participants underwent Pentacam (Pentacam-HR, Oculus, Germany) evaluation. Both SC and control groups were divided into two subgroups as dry eye (DE) (Schirmer test with topical anesthesia (STA) <5 mm) and without DE (STA >5 mm). Results: Pachymetric measurements and mean corneal volume (CV) were significantly lower in the SC group than in the control group (p<0.001). Pachymetric measurements and CV of SC patients with DE were significantly lower than all the other subgroups. Control subgroups with or without DE were similar in pachymetric measurements and CV. Conclusions: The results suggest that SC patients have thinner corneas compared with control subjects. Additionally, coexistence of DE seems to have an additional impact in the thinning of cornea in SC patients.Öğe Fibromyalgia incidence among patients with hepatitis B infection(Wiley, 2016) Yazmalar, Levent; Deveci, Ozcan; Batmaz, Ibrahim; Ipek, Davut; Celepkolu, Tahsin; Alpayci, Mahmut; Hattapoglu, ErkamAim: The purpose of our investigation was to evaluate the incidence of fibromyalgia syndrome (FMS) and identify FMS-related clinical symptoms in hepatitis B virus (HBV) patients. Methods: One hundred and eighteen HBV surface antigen (HbsAg)-positive patients (40 with chronic active hepatitis B, 40 hepatitis B carriers and 38, all of whom had been antiretroviral-treated for at least 3 months) were included in this study. In addition, 60 age- and gender-matched HbsAg-negative healthy controls were included in the study. Results: There was no significant difference in age, gender or body mass index (BMI) between the two groups (P > 0.05). Serum aspartate aminotransferase and alanine aminotransferase levels were significantly higher in HBV patients relative to the control group (P < 0.05). The incidence of FMS, widespread body pain, fatigue, sleep disturbance, anxiety, morning stiffness, arthralgia was significantly greater among HBV patients relative to the control group. Additionally, the mean tender point counts and the visual analog scale values were significantly higher among the HBV patients (P < 0.05). Conclusions: The results of the present study demonstrate that FMS incidence is greater among HBV patients relative to control subjects. However, there were no differences in FMS incidence among the subgroups of HBV diagnoses.Öğe The frequency and effect of fibromyalgia in patients with Behcet's disease(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Toprak, Murat; Erden, Metin; Alpayci, Mahmut; Ediz, Levent; Yazmalar, Levent; Hiz, Ozcan; Tekeoglu, IbrahimObjectives: This study aims to investigate the scores of depression, anxiety, sleep and quality of life (QoL), to identify the prevalence of fibromyalgia (FM) in Behcet's disease (BD), and to evaluate whether there is a difference between BD patients with and without FM in these scores. Patients and methods: Between March 2008 and January 2009, 97 patients with BD and 95 age- and sex-matched healthy controls were included in the study. The patients with BD were divided into two groups according to the presence or absence of FM. All participants were evaluated by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and Medical Outcomes Study Short Form-36 (SF-36). Results: Compared to the controls, FM prevalence was higher (19.6% vs 3.2%) with increased BDI and BAI scores, while the subscores of SF-36 including physical function, physical role, pain, general health, social function, and emotional role decreased in BD patients (for all p<0.001). All BD patients with FM were females (n=19), while only 46% of BD patients without FM were females (n=36) (p<0.001). In BD patients with FM, compared to female BD patients without FM, the mean age (p=0.017), disease duration (p=0.028), and BDI scores (p=0.017) were significantly higher, while the PSQI scores (p=0.001) and SF-36 subscores, except general health (p=0.114), were significantly lower (for all p<0.05). Conclusion: Our study results suggest that patients with BD have an increased severity of depression and anxiety, higher frequency of FM, and worsened QoL than healthy individuals. In addition, the presence of FM seems to be related with female sex, longer disease duration, older age, depression, sleep disturbance, and poor QoL in BD patients.Öğe The frequency and effect of fibromyalgia in patients with Behçet’s disease(2017) Ediz, Levent; Erden, Metin; Tekeoğlu, İbrahim; Alpaycı, Mahmut; Yazmalar, Levent; Toprak, Murat; Hız, ÖzcanThis study aims to investigate the scores of depression, anxiety, sleep and quality of life (QoL), to identify the prevalence offibromyalgia (FM) in Behçet’s disease (BD), and to evaluate whether there is a difference between BD patients with and without FM in thesescores.Patients and methods: Between March 2008 and January 2009, 97 patients with BD and 95 age- and sex-matched healthy controls wereincluded in the study. The patients with BD were divided into two groups according to the presence or absence of FM. All participants wereevaluated by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and MedicalOutcomes Study Short Form-36 (SF-36).Results: Compared to the controls, FM prevalence was higher (19.6% vs 3.2%) with increased BDI and BAI scores, while the subscores of SF-36including physical function, physical role, pain, general health, social function, and emotional role decreased in BD patients (for all p<0.001). AllBD patients with FM were females (n=19), while only 46% of BD patients without FM were females (n=36) (p<0.001). In BD patients with FM,compared to female BD patients without FM, the mean age (p=0.017), disease duration (p=0.028), and BDI scores (p=0.017) were significantlyhigher, while the PSQI scores (p=0.001) and SF-36 subscores, except general health (p=0.114), were significantly lower (for all p<0.05).Conclusion: Our study results suggest that patients with BD have an increased severity of depression and anxiety, higher frequency of FM,and worsened QoL than healthy individuals. In addition, the presence of FM seems to be related with female sex, longer disease duration,older age, depression, sleep disturbance, and poor QoL in BD patients.Öğe High frequency of fibromyalgia in patients with acne vulgaris(Turkish League Against Rheumatism, 2016) Yazmalar, Levent; Çelepkolu, Tahsin; Batmaz, İbrahim; Sarıyıldız, Mustafa Akif; Sula, Bilal; Alpaycı, Mahmut; An, İsa; Burkan, Yahya Kemal; Uçak, Haydar; Çevik, RemziABSTRACT: Objectives: This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Patients and methods: Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age, sexand body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included. Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Results: Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulgaris patients than controls. Conclusion: This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21.6% versus 5.3%, respectively).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 Osteogenesis imperfektalı yetişkin hastada zoledronik asit tedavisi: Bir olgu ve literatür derlemesi(Dicle Üniversitesi Tıp Fakültesi, 2014) Yazmalar, Levent; Batmaz, İbrahim; Dağlı, Zübeyr; Hattapoğlu, Erkam; Sarıyıldız, Mustafa AkifOsteogenesis İmperfecta (Oİ) düşük kemik kütlesi ve kemik kırılganlığı ile karakterize nadir görülen kalıtsal bir hastalıktır. Temel patoloji tip-1 kollajen biyosentezinin bozukluğu sonucunda kollajenin kusurlu ve eksik miktarda üretilmesidir. Bu nedenlerle kemik kütlesinde azalma, kırılgan ve gevrek kemik oluşumu sonucunda artmış multiple fraktürler görülür. Eklemlerin hiperekstansibilitesi, mavi sklera, işitme kaybı, kısa boy ve dentinogenesis imperfecta Oİ’da görülen diğer bulgulardır. Oİ’nın tedavisinde bifosfanatlar en sık kullanılan ilaçlardır. Biz de bu açıdan zoledronik asit ile tedavi edilen yetişkin Osteogenesis imperfektalı olguyu literatür eşliğinde sunuyoruzÖğe RADIOLOGICAL DAMAGE IN RHEUMATOID ARTHRITIS: RELATIONSHIP BETWEEN THE DURATION OF MORNING STIFFNESS, DEPRESSIVE SYMPTOMS, AND DISEASE DURATION(Carbone Editore, 2015) Celepkolu, Tahsin; Sariyildiz, Mustafa Akif; Yazmalar, Levent; Bucaktepe, P. Gamze Erten; Cetincakmak, Mehmet Guli; Satici, OmerAims: The aim of this study was to evaluate radiological damage and disease-related variables in patients with rheumatoid arthritis (RA). Material and methods: Ninety patients diagnosed with RA were enrolled in this cross-sectional and descriptive study. All of the patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales and the Beck Depression Inventory. The Disease Activity Score 28 scale was used to assess disease activity, and antibodies against mutated citrullinated vimentin (Anti MCV) were identified with an Enzyme-Linked Immuno Sorbent Assay. Radiological damage was calculated with the modified Larsen method. Results: According to the suggested Cut-off point for the Larsen score (scores >= 28), 35.5% (n=32) of the patients with RA had an erosive score. The patients with erosive RA had significantly higher Anti MCV, disease duration and Beck depression scores than did the non-erosive RA group. Multivariate regression analyses indicated that the Beck depression score, disease duration and duration of morning stiffness were independently associated with the radiological score. Conclusion: Radiological damage in RA patients is a result of multifactorial origins and is associated with disease-related variables such as disease duration, duration of morning stiffness, Anti- Cyclic citrullinated peptide levels and depressive symptoms.Öğe Rehabilitation of spinal cord injuries(Baishideng Publishing Group Inc, 2015) Nas, Kemal; Yazmalar, Levent; Sah, Volkan; Aydin, Abdulkadir; Ones, KadriyeSpinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary.Öğe The relationship between bone mineral density and levels of RANKL, osteoprotegerin and cathepsin-K in patients with rheumatoid arthritis(Dicle Üniversitesi Tıp Fakültesi, 2012) Çakırca, Gökhan; Mete, Nuriye; Batmaz, Ibrahim; Sarıyıldız, Mustafa Akif; Ulu, Mehmet Ali; Yazmalar, Levent; Çelepkolu, Tahsin; Çevik, RemziObjectives: The aim of this study was to evaluate the levels of osteoprotegerin (OPG), nuclear factor kappa B receptor activator ligand (RANKL), cathepsin K in patients with rheumatoid arthritis (RA) and the relation between these parameters and bone mineral density (BMD). Materials and methods: Totally 90 cases including 30 postmenopausal and healthy women, 30 with postmenopausal osteoporosis and 30 with postmenopause RA were enrolled in the study. The serum RANKL, OPG and cathepsin K were measured by ELISA method. Results: The levels of serum RANKL and OPG in the patients with postmenopausal RA were found significantly higher compared to the postmenopausal healthy women whereas the rate of serum OPG/RANKL was found significantly lower. In addition, the rate of OPG and OPG/RANKL were significantly lower in patients with postmenopausal RA compared to the postmenopausal osteoporosis, whereas the level of serum RANKL was significantly higher. Positive correlation was detected between bone densities of lumbar spine (LS), femur neck (FN) and the rate of OPG/RANKL in patients with postmenopausal RA. Also negative correlation was detected between LS and FN bone densities and RANKL levels. Conclusions: The system of RANKL/RANK/OPG may have a role in osteoporosis and RA pathogenesis and the rate of OPG/RANKL might be a significant determiner of bone densityÖğe The relationship between facet joint osteoarthritis and Modic changes of the lumbar spine: a retrospective magnetic resonance imaging study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Alpayci, Mahmut; Bulut, Mehmet Deniz; Yazmalar, Levent; Yavuz, Alpaslan; Toprak, Murat; Koparan, Ibrahim Halil; Gulsen, IsmailObjectives: This study aims to assess the facet joint osteoarthritis in patients with lumbar Modic changes and to investigate the relationship between the Modic types and severity of the facet joint degeneration. Patients and methods: A total of 120 patients (55 males, 65 females; mean age 55.18 +/- 9.47 years; range 40 to 75 years) were included in the study. The patients were divided into four equal groups of 30 patients according to Modic type (No Modic changes, type 1, type 2, type 3). All groups were matched with age, sex, and spinal level. A total of 180 lumbar facet joints of the patients with Modic changes (60 facet joints for each Modic type) and 60 lumbar facet joints of the patients without Modic changes were analyzed. The severity of the facet joint osteoarthritis was assessed. The degree of the facet degeneration was evaluated by using the Pathria grading system with magnetic resonance imaging. Results: Facet joint degeneration increased gradually, as the type of Modic change increased. Compared to the group without Modic changes, all three groups with Modic changes had more degenerative facet joints (all p <= 0.002). The severity of the facet joint degeneration was significantly higher in type 3 versus type 1 Modic changes (p=0.022). Conclusion: Our study results suggest that Modic changes, particularly type 3, are strongly associated with the facet joint osteoarthritis of the lumbar spine. Clinically, facet joint degeneration should be considered in the examination of low back pain inpatients with Modic changes.
