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Öğe Akut romatoid artritli kadınlarda fonksiyonel özürlülük indeksleri ile hastalık aktivite belirteçlerinin korelasyonu(2001) Kokino, Siranuş; Eryavuz, Merih; Hakgüder, Aral; Birtane, MuratRomatoid artrit (RA) eklem ve çevresinde hasara yol açan, deformiteler oluşturan, sonuçta da fonksiyonel özürlülüğe yol açabilen, kronik enflamatuvar bir hastalıktır. Bu kesitsel çalışmanın amacı, ileri deformiteleri olmayan, yaşları 50 ile 65 arasındaki, akut RA'li kadınlarda hastalık aktivite belirteçleri olan Ritchie artiküler indeksi (RAI), eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) oranının fonksiyonel özürlülük indeksleri ile olan ilişkilerini saptamak ve etkinlik karşılaştırması yapmaktı. Akut artrit yakınmaları ile kliniğimize başvuran ve modifiye ARA kriterlerine göre RA tanısı konmuş 52 kadında fonksiyonel durum, Standford Sağlık Değerlendirme Formu (HAQ) ve Lee Fonksiyonel indeksi (LFI) ile değerlendirildi. Hastalarda eklem muayenesi ile RAI skoru, laboratuvar yöntem/erle de eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) düzeyleri saptanarak fonksiyonel ölçütlerle korelasyonları araştırıldı. Her iki fonksiyonel indeks birbirleri ile çok güçlü pozitif korelasyon gösterdiler (r=. 0.84, p<0.0001). ESH ve CRP'nin LFI ile olan anlamlı pozitif korelasyonları (Sırasıyla: r=0.33, p < 0.01; r=0.44, p < 0.001), aynı değişkenlerin HAQ ile anlamlı olarak saptanan pozitif korelasyon değerlerine göre az da olsa daha güçlü idi (Sırasıyla: r=0.25, p<0.05; r=0.30, p<0.05). RAI ise HAQ ve LFI ile laboratuvar değerlere göre daha güçlü pozitif korelasyon sergiledi (Sırası ile: r=0.49, p<0.01: r= 0.59, p< 0.001). Romatoid artritli kadınlarda akut dönemde, muayene anındaki saptanan fonksiyonel özürlülük ile en çok ilişkisi bulunan hastalık aktivitesi belirteçlerinin sırası ile RAI, CRP ve ESH olduğu gözlenmiştir. Muayenede saptanan eklem bulgularının laboratuvar verilerine göre daha belirleyici olduğunu düşünmekteyiz.Öğe Analysis of Spinal Posture With Three-Dimensional Ultrasonic System in Patients With Ankylosing Spondylitis(Turkish League Against Rheumatism, 2019) Kurtoglu, Hakan Sercan; Tuna, Filiz; Tuna, Hakan; Ulucam, Enis; Tastekin, Nurettin; Birtane, MuratObjectives: This study aims to investigate the relationship between postural changes detected in ankylosing spondylitis (AS) vertebrae and clinical and demographic characteristics of patients using a three-dimensional ultrasonic system. Patients and methods: A total of 44 AS patients (36 males, 8 females; mean age 39.1 +/- 9.8 years; range, 18 to 63 years) and 44 healthy volunteers (36 males, 8 females; mean age 38.4 +/- 9.4 years; range, 18 to 65 years) were included. Clinical, demographic, and laboratory data were recorded. Spinal posture analysis was performed using a Zebris CMS20 three-dimensional ultrasonic system. Results: Thoracic kyphosis angle was significantly higher in the AS group (45.4 +/- 12.8 degrees) than in the control group (36.9 +/- 7.7 degrees) (p=0.001). Lumbar lordosis angle was significantly lower in the AS group (20.7 +/- 10.6 degrees) than in the control group (28 +/- 8.2 degrees) (p=0.002). There were no significant differences in total trunk inclination or sacral angles (p>0.05). Increase in thoracolumbar length at maximum spinal flexion and decrease in thoracolumbar length at maximum spinal extension were significantly lower in the AS group (p<0.05). A negative correlation was found between the thoracic kyphosis angle and length increase in spine flexure as well as chest expansion. Thoracic kyphosis angle had a statistically significantly positive correlation with age at onset of symptoms and tragus-wall distance (p<0.05). Conclusion: Significant changes were observed in spinal posture in patients with AS. In addition, significant correlations were found between dynamic postural changes and spinal mobility. We think that postural evaluation and follow-up should be carried out with other parameters. Awareness of AS patients about postural changes should be increased, and proper exercise treatment should be applied.Öğe Attitudes of patients with spondylarthritis or rheumatoid arthritis regarding biological treatment during COVID-19 pandemic: A multi-center, phone-based, cross-sectional study(Turkish League Against Rheumatism, 2021) Zateri, Coskun; Birtane, Murat; Aktas, Ilknur; Sarikaya, Selda; Rezvani, Aylin; Altan, Lale; Dursun, NigarObjectives: In this study, we aimed to investigate the medical treatment attitudes of patients with spondylarthritis or rheumatoid arthritis (RA) who were using biological drugs during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: In this multi-center, cross-sectional study, a total of 277 patients (178 males, 99 females; median age: 45 years; range, 20 to 77 years) who were using biological disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatic diseases and were reached by phone between June 1st, 2020 and June 30th, 2020 were included. Demographic characteristics, working status, type of the rheumatic disease, comorbidities, smoking habits, and type of the bDMARDs were recorded. Disease activity was evaluated using the Visual Analog Scale (VAS). The patients were asked whether they continued the treatment plan, as it was before or changed and, if changed, how they changed the plan and what happened after the change. Results: Of the patients, 229 had spondylarthritis and 48 had RA. A total of 36.1% of the patients were smokers, and the most common comorbidity was hypertension (17.3%). Totally, 5.8% of the patients had a history of contact with a COVID-19 positive person. Only three (1.1%) patients were diagnosed with COVID-19 infection and none of them died. Of the patients, 64.3% continued their treatment, while 35.7% adopted various changes. Most patients made the decision about the treatment plan on their own (n=160, 57.8%), while 38.3% of them consulted their physicians and 13.9% of them consulted any health staff. The only significant parameter for changing the drug course was receiving intravenous bDMARDs (by infusion at hospital) (p=0.001). These patients had also a higher disease activity as measured by VAS, compared to the patients receiving non-infusion therapy (p=0.021). As a result of these changes, severity of the symptoms increased in 91 (32.9%) patients. Disruption of regular biological treatment and prior infusion therapy more likely worsened the complaints (p<0.001 and p=0.024, respectively). Conclusion: Intravenous bDMARD therapy seems to be the main factor affecting the continuity of the treatment in the pandemic period. During the pandemic period, alternative treatment options should be considered other than infusion therapy not to interrupt the treatment of these patients.Öğe Comparison of the Short-Term Efficacy of Physical Therapy in Subacromial Impingement Syndrome Patients with Stage I and II Magnetic Resonance Imaging Findings(Turkish League Against Rheumatism, 2011) Hakguder, Aral; Tastekin, Nurettin; Birtane, Murat; Uzunca, Kaan; Zateri, Coskun; Sut, NecdetObjectives: In this study, we compared the efficacy of a combined physical therapy program between stage I and II subacromial impingement syndrome patients. Patients and methods: Forty-three patients with subacromial impingement syndrome assessed as stage I and II according to the magnetic resonance imaging (MRI) findings were included in the study. Constant's and University of California Los Angeles Shoulder Scales were used to evaluate pain and function. Pain levels at rest, during motion and while asleep were also scored by visual analog scale before treatment, after treatment and at one month after treatment. Improvements within and between the groups were assessed. A physical therapy program consisting of ultrasound, superficial heat therapy and transcutaneous electrical nerve stimulation modalities combined with an appropriate exercise program was applied to both groups during half monthly sessions. Results: The between-groups comparisons performed after treatment and during follow-up revealed no significant difference in terms of the outcome measures assessed. Conclusion: Stage II patients responded to the physical therapy program as well as patients with stage I MRI findings.Öğe Diagnostic Role of Anti-Nuclear Antibodies in Rheumatic Diseases(Turkish League Against Rheumatism, 2012) Birtane, MuratAutoimmune diseases result from the assault of the host antibodies against host antigens. The systemic rheumatic diseases rarely have a single pathognomonic diagnostic criterion due to multiple organ and system involvement. Interestingly, each member of this disease group may be associated with different auto antibody types. The diagnosis depends on clinical features, as well as the auto antibodies detected in the sera of the patients. Antinuclear antibodies (ANA) usually target the specific antigens in the nuclear part of the cell, although they can sometimes show affinity against all types of subcellular structures and cell organelles including cell surfaces, cytoplasm, nuclei, or nucleoli. These may provide important data for an upcoming rheumatic disease, be valuable in the diagnosis and prognosis prediction when they are detected in the sera. Simply, ANA can be measured in two ways; one is the generic ANA for overall evaluation and the second is specific antibody detection for specific diseases. Generic ANA measurement can be performed using immunofluorescence techniques and ELISA. If it is positive, specific antibodies can further be investigated by automated methods. The immunofluorescence ANA testing is still gold standard. They show significance when detected in high titers in clinically suspected patients. Furthermore, staining patterns may provide information for the specific disease, indicating the cellular targets of specific antibodies. Generic ANA is highly sensitive for systemic lupus erythematosus (SLE) and scleroderma, while its specificity is lower in these pathologies. ANA may be found positive in healthy people and patients with many other pathological conditions. Therefore, they may be important to rule out the disease. In contrast to generic ANA, specific antibodies are usually specific for related diseases with a low level of sensitivity. Thus, its presence helps diagnosis, however its absence may not be sufficient to exclude the disease. The main antibodies in this category are anti-dsDNA, antiSmith (Sm), and antiribonucleoprotein (RNP) in the diagnosis of SLE; antihiston antibodies for drug-induced SLE; anti-Ro/SSA - anti La/SSB antibodies for Sjogren syndrome; and anticentromer, anti Scl 70 antibodies for scleroderma.Öğe Discriminative Value of Tender Points in Fibromyalgia Syndrome(Wiley-Blackwell Publishing, Inc, 2010) Tastekin, Nurettin; Uzunca, Kaan; Sut, Necdet; Birtane, Murat; Mercimek, Oznur BerkeObjective. The aim of this study is to assess the discriminative value of all tender points, alone and in combination, that are designated as criteria for fibromyalgia diagnosis by the American College of Rheumatology (ACR), by investigating the appropriate pressure magnitude that should be applied during tenderness examination. Design. Cross-sectional. Patients. This study was performed on 66 patients with fibromyalgia diagnosed according to ACR classification criteria and 50 control subjects. Setting. The outpatient rheumatology clinic of a PM&R department of a university hospital. Intervention. Pressure pain threshold values were measured by a dolorimeter on nine specific point pairs in both groups and a cutoff value for discriminating positivity and negativity was calculated for each. Then the most valuable tender point pairs were assessed for discrimination of fibromyalgia syndrome using ACR criteria set as a reference standard. Results. All tender points with determined pressure cutoff values were found out to significantly discriminate fibromyalgia syndrome and their area under curve values ranged from 0.779 to 0.934. Univariate logistic regression analysis revealed that lateral epicondyle and supraspinatus point pairs had the most powerful discriminative ability (odds ratio = 113.6 and 45.0, respectively). Multiple logistic regression analysis with backward stepwise method showed that lateral epicondyle and second rib point pairs were most discriminative with sensitivity and specificity rates of 87.9-94.0% and 77.3-84.0%, respectively. Conclusions. Fibromyalgia syndrome can have potential to be recognized simply by pressing fewer tender point areas but with various pressure cutoff levels identified for each tender point areas.Öğe Diz osteoartritinde radyolojik bulgularla ağrı veya fonksiyon arasında ilişki var mıdır? İki ayrı konvansiyonel radyografik yöntem ile elde edilen radyolojik bulguları değerlendiren kesitsel bir analiz(2001) Birtane, Murat; Pekindil, Gökhan; Yıldız, Mustafa; Karadağ, Ayhan; Demirbağ, Derya; Kokino, SiranuşDiz osteoartritinde (OA) radyoloji ile klinik semptomlar arasında doğrudan bir ilişki olduğu konusunda şüpheler vardır. Bu çalışmanın amacı diz OA'inde Kellgren-Lawrence (K/L) sınıflaması, semikantitatif osteofit skoru (SOS), hasta yatar pozisyonda diz ekstansiyonda iken alınan AP grafilerde belirlenen ortalama medial eklem aralığı mesafesi (YMEAM) skoru ve hasta ayakta yere basarken ve diz semifleksiyonda (30°) alınan AP grafilerde belirlenen ortalama medial eklem aralığı mesafesi (AMEAM) skoru, gibi radyolojik parametrelerin ağrı, eklem hareket açıklığı (EHA) ve fonksiyon ile olası ilişkilerini saptamaktı. Çalışmaya alınan 7'si erkek, 30'u kadın ve yaş ortalaması 58.2 olan 37 diz OA'li hastada, ağrı vizüel analog skala ile, EHA goniometre ile, fonksiyon da Lequesne fonksiyonel indeksi (LFI) ile değerlendirildi. K/L evre 4 hastalarda hareket ağrısı, erken evrelere göre daha fazla, aktif ve pasif fleksiyon açıklığı daha az idi. Radyolojik kriterlerden YMEAM değerleri hariç tüm diğer parametrelerle sadece hareket ağrısı arasında anlamlı pozitif korelasyon, tüm radyolojik kriterler ile de aktif fleksiyon değerleri arasında anlamlı negatif korelasyon saptandı. LFI ve diğer ağrı tipleri ile korelasyon bulunmadı. Lineer regresyon analizinde bağımsız değişkenlerden sadece SOS'nun hareket ağrısının belirleyici değişkeni olduğu saptandı (Hareket ağrı skoru=3.757+1.064xSOS). Diz OA'li hastalarda hareket ağrısını belirlemek için tercihen hasta ayakta yere basarken ve dizleri semifleksiyonda iken radyografisinin alınıp, değerlendirmeye SOS ve K/L sınıflamasının yanısıra AMEAM skorlandırılmasının da dahil edilmesinin daha mantıklı olacağını düşünmekteyiz.Öğe Does quantitative tibial ultrasound predict low bone mineral density defined by dual energy X-ray absorptiometry?(Yonsei Univ College Medicine, 2008) Tuna, Hakan; Birtane, Murat; Ekuklu, Galip; Cermik, Fikret; Tuna, Filiz; Kokino, SiranusPurpose: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. Materials and Methods: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. Results: The SOS values were observed to be significantly higher in the normal BMD (t score > - 1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < - 1). SOS was negatively correlated with age (r = - 0.66) and month since menopause (r = - 0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. Conclusion: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.Öğe Edirne Huzurevi sakinlerinde yaşam kalitesine etki eden etmenlerin irdelenmesi(2000) Birtane, Murat; Tuna, Hakan; Ekuklu, Galip; Uzunca, Kaan; Akçi, Ceyda; Kokino, SiranuşYaşam kalitesi yaşlanma ile birlikte bozulma eğilimindedir. Bu çalışmada huzurevinde barınan yaşlılardaki yaşam kalitesini etkileyen faktörler araştırıldı. Bu amaçla 21'i (%21.9) kadın, 75'i (%78.1) erkek toplam 96 olguda demografik özellikler ve eğitim seviyesi belirlendi. Sistemik hastalık öyküsü ve baston kullanımı sorgulamasının yanı sıra görme kaybı, kognitif fonksiyonlar, aktivite skoru ve yaşam kalitesi değerlendirildi. Kognitif fonksiyon Mini-Mental Durum Değerlendirme Skalası (MMDDS) ile araştırıldı. Aktivite skoru ise temizlik, alışveriş, ulaşım, yemek yeme, yıkanma, giyinme, tuvalet, tranfer, kontinans ve beslenme gibi aktivitelerin bağımsızlık durumuna göre verilen puanlar toplanarak hesaplandı. Yaşam kalitesi Nottingham Sağlık Profili Değerlendirmesi (NSPD) ile belirlendi. Yaşam kalitesine etki eden faktörler, bağımlı değişkeni NSPD skoru, bağımsız değişkenleri de yaş, sistemik hastalık öyküsü, baston kullanımı, görme kaybı, MMDDS ve aktivite skoru olan stepwise lineer regresyon analizi ile değerlendirildi. Bu analiz sonucu anlamlı etkisi bulunan etmenlerin, NSPD'inin alt grupları ile arasındaki korelas-yonlar belirledi. Yaşlıların 74'ünde (%77.1) kronik sistem hastalığı var iken 49 (%51) kişide görme kaybı mevcuttu. Otuz dört (%35.4) kişi baston kullanmakta idi. Tüm olguların ortalama MMDDS'u 19.7±6.7, aktivite skoru 27.3±4.3 ve NSPD skoru 62.3±9.8 idi. Lineer regresyon analizine göre sadece MMDDS ve aktivite skorunun yaşam kalitesi göstergesi olan NSPD üzerinde anlamlı etkisi olduğu saptandı. Bu aşağıdaki eşitlikle formülize edildi (NSPD= 41.945+0.332 x MMDDS+0.640 x aktivite skoru). Korelasyon analizi sonucu aktivite skoru ve MMDDS ile NPSD'nin alt grupları olan ağrı, enerji seviyesi, emosyonel durum, fiziksel yetenekler ve sosyal izolasyon arasında anlamlı korelasyonlar elde edildi (p<0.05). 65 yaş üstü popülasyonda yaşam kalitesini öncelikle kognitif fonksiyonların ve aktivite derecesinin etkilediğini düşünmekteyiz.Öğe The Effect of Disease Duration on Foot Plantar Pressure Values in Patients with Type 2 Diabetes Mellitus(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Tuna, Hakan; Birtane, Murat; Guldiken, Sibel; Soysal, Neslihan Atile; Taspinar, Ozgur; Sut, Necdet; Tastekin, NurettinObjective: Diabetic foot problems and consequent ulceration in older patients are a major cause of morbidity and permanent disability. One of the major risk factors for ulceration is foot pressure changes. We, in this study, aimed to identify any relation between disease duration and plantar pressure of patients with type 2 diabetes. Material and Methods: This study was done on 168 feet of 84 diabetic patients. Demographic parameters and body mass index were noted. The patients were allocated according to disease duration as being more (Group 1) or less than 10 years (Group 2). Static and dynamic pedographic evaluation was performed for each of the patients, and results were compared between the groups. Results: The static pedobarographic evaluation revealed significantly higher forefoot plantar force percentage values in the left feet of patients in group 1. We found that peak phalanx pressure was significantly higher in the left foot, while the contact area was lower in the right foot of group 1 patients, by dynamic pedobarographic evaluation. Conclusion: Contact area decreases and peak pressure increases during walking in forefoot after 10 years of disease duration in type 2 diabetic patients.Öğe Effectiveness of Neuromuscular Electrical Stimulation on Auxiliary Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease Treated in the Intensive Care Unit(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Kurtoglu, Dilek Kocan; Tastekin, Nurettin; Birtane, Murat; Tabakoglu, Erhan; Sut, NecdetObjective: Chronic obstructive pulmonary disease is a major public health problem. In the present study, we aimed to investigate the possible effects of upper extremity exercises and neuromuscular electrical stimulation therapy applied to auxiliary respiratory muscles on arterial blood gases, blood pressure, heart rate values, and quality of life in patients with chronic obstructive pulmonary disease. Material and Methods: Thirty patients who were diagnosed with stage 4 severe chronic obstructive pulmonary disease by a pulmonologist and who needed intensive care were included in the study. The patients were equally allocated into two groups containing 15 patients each: control and intervention. Both groups were given an unassisted upper extremity exercise program for four weeks, and only one group was given neuromuscular electrical stimulation on auxiliary respiratory muscles for 10 days. Arterial blood gas measurements, peak heart rate, and breathing frequency were recorded. St. George's Respiratory Questionnaire and short form-36 were performed for the evaluation of the quality of life. Functional capacity was determined by functional independent measurement. Evaluations of the patients were performed on the 1st, 8th, 15th, and 30th days of the study. Results: There were statistically significant improvements in peak heart rate, breathing frequency per minute, and functional independency scores in the group where exercise and neuromuscular electrical stimulation had been concomitantly applied (p<0.05). Conclusion: This study revealed positive effects of neuromuscular electrical stimulation in addition with therapeutic exercises on the cardiorespiratory system in the short run.Öğe Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis(Springer, 2007) Uzunca, Kaan; Birtane, Murat; Tastekin, NurettinWe aimed to investigate the efficacy of pulsed electromagnetic field (PEMF) in lateral epicondylitis comparing the modality with sham PEMF and local steroid injection. Sixty patients with lateral epicondylitis were randomly and equally distributed into three groups as follows: Group I received PEMF, Group II sham PEMF, and Group III a corticosteroid + anesthetic agent injection. Pain levels during rest, activity, nighttime, resisted wrist dorsiflexion, and forearm supination were investigated with visual analog scale (VAS). Pain threshold on elbow was determined with algometer. All patients were evaluated before treatment at the third week and the third month. VAS values during activity and pain levels during resisted wrist dorsiflexion were significantly lower in Group III than Group I at the third week. Group I patients had lower pain during rest, activity and nighttime than Group III at third month. PEMF seems to reduce lateral epicondylitis pain better than sham PEMF. Corticosteroid and anesthetic agent injections can be used in patients for rapid return to activities.Öğe Effects of Hypermobility on Schober Test and Chest Expansion Scores(Trakya Üniversitesi, 2017) Girit, Çağrı; Varnalı, Semih; Çifcibaşı, Hilal Sena; Birtane, MuratAims: Hypermobility is a condition which increases the joint mobility range. Beighton method is used in diagnosisof hypermobility. Schober test and chest expansion measurement are frequently used to evaluate mobility of spineand expansion ability of chest in ankylosing spondylitis volunteers. In this study, it is aimed to investigate the impactof hypermobility on Schober test and chest expansion.Methods: The data of 300 healthy volunteers aged between 18 and 32 was collected. Beighton score, chest expansionand Schober score of all volunteers were measured and statistically analyzed using SPSS. Student’s t-test wasperformed to compare both groups. As for descriptive statistics, mean ± standard deviation and numbers were used.Results: One hundred twenty-two cases having Beighton score of 4 and above included in hypermobility groupwhile 178 cases under 4 served as control group without hypermobility. No significant relation in terms of chest expansionand Schober score was found out between groups. There was a slight positive correlation between Beightonscore and Schober score in whole group. In male population, both test scores had a correlation with Beighton scorewhile only chest expansion had correlation in female population.Conclusion: Although Beighton score seemed to have no effect on Schober or chest expansion scores in betweengroup comparisons, correlation analysis revealed that hypermobility may affect the scores, especially in males.Öğe The Effects of Taurine, Melatonin and N-Acetylcystein on Cadmium Exposure Bone Changes The Surprising Effect of Taurine(Gazi Univ, Fac Med, 2020) Tastekin, Nurettin; Aydogdu, Nurettin; Altun, Gulay Durmus; Erbas, Hakan; Uzunca, Kaan; Birtane, Murat; Kaplan, MustafaBackground: Chronic environmental and occupational exposure to cadmium can result in skeletal system changes. The main objective of the present study was to investigate and compare the effects of taurine, melatonin and N-acetyl cysteine on cadmium exposure induced bone density loss. Methods: 90 adult male Sprague-Dawley rats were allocated into four main groups: Group I was the control group; Group II was the cadmium exposure group; Group 3 was cadmium exposure for 3 months + concurrent antioxidant administration group. The concept of Group 4 was cadmium exposure for 3 months + subsequent antioxidant administration. Bone mineral density values were evaluated in all the groups. Serum calcium, phosphorus, alkaline phosphatase (ALP) enzyme activities and 24 hours urine calcium excretion levels were measured. Kruskal-Wallis test was used to compare the all groups. Between two group comparisons, the Mann-Whitney U test was used. Results: There was no significant difference in terms of bone mineral density values only between control group and cadmium exposure group (p 0.05). Mean bone mineral density values obtained in cadmium + concurrent taurine and cadmium + subsequent taurine groups were significantly lower than all the other groups (p<0.05). 24 hours urine calcium excretion levels were significantly higher in groups which taurine and n-asetylcystein were administered after cadmium exposure. Conclusion: Taurine, which is thought to have protective effects as an antioxidant caused a marked bone damage after exposure to cadmium. Further studies are needed to clarify this effect of taurine.Öğe The efficacy of linear polarized polychromatic light on burn wound healing: An experimental study on rats(Oxford Univ Press, 2007) Karadag, Ceyda Akci; Birtane, Murat; Aygit, A. Cemal; Uzunca, Kaan; Doganay, LatifeWe aimed to investigate the questionable effect of linear polarized polychromatic light on burn wound healing in rats. Two deep second-degree burn wounds on the backside of each of 21 Sprague-Dawley rats were created with a standard burning procedure by applying a heated plaque. Burned regions located right dorsolaterally and classified as group I lesions were treated with linear polarized polychromatic light + open dressing + antibacterial pomade, whereas group 11 lesions were located left dorsolaterally and treated with only open dressing + antibacterial pomade. Macroscopic evaluation was performed for determination of the completed wound closure rate, measurement of burn wound area, and investigation of macroscopic edema, hyperemia, and epithelialization. Histopathological evaluation included monitoring of epithelialization, vascularization, origination of granulation tissue, inflammatory cell response, and total histopathological score on days 7, 14, and 21 after burn creation. Macroscopic evaluation revealed more obvious epithelialization in group I lesions between days 6 and 15. The number of completely closed wounds was higher in group I than in group 11 on days 16 and 21. The average area of burn wounds was lower from day 5, hyperemia was less on days 2 to 17, and edema was less from day 4 to day 13 in group I lesions. Histopathological evaluation revealed a higher rate of epithelialization on day 7 and higher vascularization occurrence on day 21 in group I lesions. Linear polarized polychromatic light seems to be effective in the treatment of burn wounds and in the promotion of healing. This may be related to linear polarized polychromatic light stimulation of epithelialization and vascularization.Öğe Erişkin tip pes planusta ağrı ve dizabilitenin radyografik ve pedobarografik parametreler ile ilişkisi(2006) Uzunca, Kaan; Taştekin, Nurettin; Birtane, MuratAmaç: Pes planus ayağın longitudinal medial arkının düşük olması ya da arkın olmaması ile karakterize bir sorundur. Klinik olarak yürüme sırasında veya ayakta durma ile ortaya çıkan ağrı şikâyeti ile karşılaşılmaktadır. Biz çalışmamızda pes planuslu hastalarda ağrı ve dizabilitenin ayak taban basınçları ve radyografik bulgular ile ilişkisini araştırmayı amaçladık.Hastalar ve Yöntem: Pes planus tanısı alan 30 olgunun ayak ağrısı ve ayak aktiviteleri ile ilgili yaşadıkları fonksiyonel kısıtlılıklar, ayak fonksiyonel indeksinin ağrı ve dizabilite bölümleri kullanılarak değerlendirildi. Hastaların pedobarografik inceleme ile statik ve dinamik taban basınçları ölçüldü. Lateral ayak radyografisinde kalkaneal eğim açısı ölçüldü. Ölçülen basınçların ve kalkaneal eğim açısının ağrı ve dizabilite ile ilişkisi araştırıldı.Bulgular: Pes planuslu olgularda ağrı ve dizabilite ile statik değerlendirmedeki basınçlar arasında bir ilişki tespit edilemezken (p>0.05), dinamik değerlendirmede ağrı ile ayağın ön-dış kısmı ve orta ayak pik basınçları arasında negatif bir ilişki tespit edildi (p<0.05). Dizabilite ile taban temas alanı arasında pozitif korelasyon bulundu (p<0.05). Kalkaneal eğim açısı ile ağrı ve dizabilite skorları arasında negatif korelasyon mevcuttu (p<0.05).Sonuç: Pes planuslu hastalarda medial longitudinal arkın düşük olması veya azalması, arkın şok emici etkisinin bozulmasına neden olarak, ayakta özellikle yürüme esnasında belirginleşen ağrı ve dizabilite ile bir beraberlik gösterebilir.Öğe Evaluating Improvement Rates Correctly after Treatment Interventions in Rheumatological Diseases(Turkish League Against Rheumatism, 2013) Tastekin, Nurettin; Birtane, Murat[Abstract Not Available]Öğe The evaluation of quality of life in fibromyalgia syndrome: a comparison with rheumatoid arthritis by using SF-36 Health Survey(Springer London Ltd, 2007) Birtane, Murat; Uzunca, Kaan; Tastekin, Nurettin; Tuna, HakanMusculoskeletal disorders are the most common causes of deterioration in quality of life (QOL). We in this study aimed to assess (1) the impact of fibromyalgia syndrome (FS) on QOL comparing with that of rheumatoid arthritis (RA) patients and control subjects and (2) the impact of these two musculoskeletal disorders on various components of QOL using SF-36 Health Survey. Thirty-five patients with RA, 30 patients with FS, and 30 voluntary control subjects were included in the study. The groups were comparable in terms of demographic characteristics. QOL was evaluated by using Short-Form (SF)-36 Health Survey in all study participants, and Fibromyalgia Impact Questionnaire (FIQ), which is a specific health-status instrument for FS, was used in FS patients. Physical functioning, physical role, social functioning, bodily pain, general health, vitality, emotional role, and mental health scores were significantly lower in RA and FS patients than in control subjects (p < 0.05). The between-groups comparisons revealed that FS patients had significantly lower mental health scores than RA patients (49.87 vs 62.51, respectively), (p < 0.001). Total FIQ score correlated significantly with physical functioning, physical role, and bodily pain in FS patients. All parameters of SF-36 Health Survey except for social functioning correlated significantly with some of the variables of FIQ. FS has a negative impact on QOL, like RA. Furthermore, mental health was more severely affected in FS patients when compared with RA patients.Öğe Fibromiyalji Tanılı Hastalarda Denge ve Postürün Değerlendirilmesi(2024) Şahin, Onur; Taştekin, Nurettin; Uluçam, Enis; Karahan, Menekşe; Süt, Necdet; Birtane, MuratDenge sorunları son zamanlarda Fibromiyalji (FMS)’li hastalarda dikkat çeken semptomlar arasında gösterilmiştir. Bu çalışmada fibromiyalji hastalarında denge ve postürün değerlendirilmesini, bu durumların varlığı ile fibromiyalji şiddeti arasındaki ilişkiyi değerlendirme amaçlanmıştır. Çalışmaya TÜTF Hastanesi Fizik Tedavi ve Rehabilitasyon polikliniğine başvuran FMS tanılı 30-55 yaş aralığındaki 45 birey ve kontrol grubu olarak 44 birey dahil edildi. Olguların sosyo-demografik özellikleri, şikâyet ve tanı süresi kaydedildi. Vizüel analog skala (VAS) ile ağrı şiddeti, Fonksiyonel durum için Fibromiyalji Etki Skalası (FEA), Fibromiyalji Semptom Şiddet Skalası, Yaygın Ağrı İndeksi sorgulanarak kaydedildi. Olguların dinamik dengeleri Berg denge testi, statik dengeleri ise tek bacak üstünde durma testi ile değerlendirildi. Zebris CMS-20P-2 cihazı ile bilgisayar ortamında üç boyutlu ultrasonik sistem ile omurga postür analizi yapıldı. FMS grubunda sağ ve sol tek ayak üzerinde durma süreleri ile toplam Berg Denge Ölçeği sonuçlarının anlamlı derecede daha düşük bulunmuştur. Berg Denge Skoru ile Toplam FEA skoru, Semptom Şiddet Skalası skoru A, Fibromiyalji Şiddet skoru ve Total Gövde İnklinasyon Açısı arasında ters yönde ve orta düzeyde anlamlı ilişki olduğu bulduk. Omurga postür analizi ile hasta ve kontrol grupları arasındaki postür analizi sonuçlarının farklı saptanmamıştır. Sonuç olarak FMS’li hastalarda denge bozukluğunun sağlıklı bireylere göre daha sık rastlandığını tespit ettik. Postür analizinde her iki grup arasında anlamlı fark saptayamadık. Özellikle postür srunlarını ortaya koyabilmek için büyük popülasyonlu çalışmalara ihtiyaç vardır.Öğe FREQUENCY OF RESTLESS LEGS SYNDROME IN RHEUMATOID ARTHRITIS(Oxford Univ Press, 2011) Zateri, Coskun; Kilinc, Serdar; Birtane, Murat; Tastekin, Nurettin[Abstract Not Available]
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