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Silte Karamanlioglu D, Unlu Ozkan F, Ceren Arıkan EE, Pirdal BZ, Ozturk G, Aktas I. Detection of subclinical enthesitis by ultrasonography in patients with psoriasis and controls. ARP Rheumatol 2024; 3:29-39. [PMID: 38368555 DOI: 10.63032/unbm9076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Psoriasis is a widespread chronic inflammatory skin disease; enthesitis is inflammation of the tendon, ligament, and joint capsule insertion, prevalent in patients with psoriatic arthritis. OBJECTIVES The aim of study to evaluate the utility of the Madrid Sonography Enthesitis Index scoring system for accurate detection of subclinical enthesitis in patients with Psoriasis compared with healthy controls. Another objective was to assess increase in enthesis area and Psoriatic arthritis incidence, in a prospective 1-year follow-up. METHOD Patients aged ≥18 years who were diagnosed with Psoriasis, without musculoskeletal complaints, and who did not have any clinical sign and/or symptom of enthesitis and synovitis were included in the study. The patients and healthy controls were evaluated with ultrasonography. Ultrasonography evaluation consisted of the detection of gray-scale enthesitis and power Doppler signal in the enthesis areas. The Madrid Sonography Enthesitis Index scoring system was used to quantify the extent of the sonographic enthesis abnormalities. RESULTS The mean MASEI score, structure, thickness, erosion, and calcification were significantly higher in the Psoriasis group than in the control group. The mean MASEI score, structure, erosion, and calcification measurements were significantly higher at the last examination when compared to the first examination. The triceps was the most commonly affected tendon in both groups. CONCLUSION Ultrasonography is an important tool for diagnosis and follow-up of subclinical enthesitis in patients with psoriasis. Regardless of disease duration and severity, patients should be screened using ultrasonography at yearly intervals.
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Affiliation(s)
| | | | | | | | | | - Ilknur Aktas
- Fatih Sultan Mehmet Training and Research Hospital
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2
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Keles A, Ozkan FU, Giray E, Keles P, Karip B, Kahraman AN, Aktas İ. Ultrasound-Guided Suprascapular Nerve Block at Suprascapular Notch-Do We Really Target Suprascapular Notch or Not? Where Is Our Real Target? J Ultrasound Med 2023; 42:2167-2170. [PMID: 37070821 DOI: 10.1002/jum.16237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
Ultrasound (US)-guided suprascapular nerve block (SSNB) is a widely used procedure and while describing the US-guided SSNB in the suprascapular notch, the suprascapular fossa is often visualized and injection is performed in that location. Although it can be done in both location, to inject the right area, the terminology should be settled and the visualization of these areas which are unclear and confusing in the literature should be clarified. In this sense, we showed the course of the nerve on a cadaver and briefly describe a protocol to correctly visualize the suprascapular notch with US.
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Affiliation(s)
- Aslinur Keles
- Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Esra Giray
- Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Papatya Keles
- Department of Anatomy, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Burak Karip
- Department of Anatomy, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Nedim Kahraman
- Department of Radiology, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - İlknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Giray E, Karayigit M, Senocak KC, Illeez OG, Ozkan FU, Aktas I, Gozke E. Delayed radiation-induced motor neuron syndrome: A case report. J Back Musculoskelet Rehabil 2023; 36:1469-1475. [PMID: 37482982 DOI: 10.3233/bmr-220410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND Delayed radiation-induced motor neuron syndrome (DRIMNS) is an atypical motor neuron disorder that develops months or years after radiation therapy. In this study we present a case of DRIMNS that developed forty years after radiotherapy and to discuss differential diagnoses. CASE PRESENTATION A 56-year-old male patient was admitted to our clinic with complaints of increasing difficulty in walking for the past year. He had a history of operation and radiotherapy due to testicular tumor. Electroneuromyography (ENMG) and thoracic, lumbosacral, plexus and pelvic magnetic resonance imaging (MRI) were performed considering radiculopathy, plexopathy and motor neuron disease in the differential diagnosis. MRIs revealed no abnormality. Needle EMG of lower extremity and lumbar paraspinal muscles revealed fibrillation and positive sharp waves concomitant with fasciculations and reduced recruitment suggesting anterior horn cell/root involvement. DRIMNS was considered rather than motor neuron disease based on the long duration of symptoms with slow progressive course and history of radiotherapy to the pelvic region. CONCLUSION DRIMNS is a rare entity that should be considered in the differential diagnosis of lower extremity muscle weakness in a patient with a history of malignancy and radiotherapy. EMG findings are very valuable in making the diagnosis together with the clinical picture.
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Affiliation(s)
- Esra Giray
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Merve Karayigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Kubra Cambekli Senocak
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ozge Gulsum Illeez
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Eren Gozke
- Department of Neurology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Atici A, Kaysin MY, Akpinar P, Ozkan FU, Aktas I. Rehabilitation processes, stress and depression in patients with spinal cord injury during the COVID-19 pandemic in Turkey: a telephone survey. International Journal of Therapy and Rehabilitation 2022. [DOI: 10.12968/ijtr.2021.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Spinal cord injury is a chronic disease that can develop various complications and multisystem dysfunctions. Patients with spinal cord injury need long-term follow up and rehabilitation. During the COVID-19 pandemic, people had to observe social distancing and stay at home. The aim of this study was to evaluate the effects of the COVID-19 pandemic on the rehabilitation and health status of patients with spinal cord injury and assesses their stress levels and depression status. Methods A telephone-based survey was conducted with patients followed up by a spinal cord injury outpatient clinic about rehabilitation processes and any health problems experienced. Stress levels were assessed using the Perceived Stress Scale, while depression was assessed using the Beck Depression Inventory. Demographic characteristics, American Spinal Injury Association Impairment Scale levels, Functional Ambulation Categories and Spinal Cord Independence Measure scores were retrieved from the patients' files. Results The study included 115 patients, none of whom had contracted COVID-19. Of these patients, 44.3% joined the rehabilitation programme before the pandemic, and 3.5% had been able to participate in the rehabilitation programme during the pandemic. An increase in spasticity was recorded in 43.5% of the respondents, an increase of neuropathic pain was recorded in 37.4% of patients and complaints of neurogenic bladder and neurogenic bowel increased by 26.1% and 16.5% respectively. In addition, 4.3% reported novel decubitus ulcers, while 5.2% reported having experienced autonomic dysreflexia episodes. The Perceived Stress Scale scores were 18.32 ± 5.91. No significant difference was detected between the Beck Depression Inventory scores taken at the time of the study and those recorded before the pandemic. Conclusions An insufficiency in the rehabilitation process was noted among patients with spinal cord injuries, accompanied by increased complications. New approaches need to be developed to ensure that the rehabilitation processes of patients with spinal cord injury are not interrupted during a pandemic, and that patients' mental health is not ignored.
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Affiliation(s)
- Arzu Atici
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Meryem Yılmaz Kaysin
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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Illeez OG, Oktay KNK, Aktas I, Ozkan FU, Nazligül T, Begoglu FA, Kaysin MY, Atici A, Akpinar P. Comparison of the effects of duloxetine and pregabalin on pain and associated factors in patients with knee osteoarthritis. Rev Assoc Med Bras (1992) 2022; 68:377-383. [PMID: 35442367 DOI: 10.1590/1806-9282.20211047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the effects of duloxetine and pregabalin primarily on pain and functional status in patients with knee osteoarthritis and secondarily on quality of life, depression, anxiety, and sleep disturbance. METHODS A total of 66 patients with knee osteoarthritis were randomized to use duloxetine or pregabalin. Patients were evaluated by Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburg Sleep Quality Index before the treatment and after 4 and 12 weeks of treatment. RESULTS Improvements occurred in Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36 (with an exception of the mental health subgroup scores in duloxetine-treated group), Beck Depression Inventory, and Beck Anxiety Inventory scores in both groups from 4 weeks after baseline. Pittsburg Sleep Quality Index total scores and SF-36 mental health subgroup scores started to improve on the 4th and 12th weeks in pregabalin- and duloxetine-treated groups, respectively. CONCLUSION Osteoarthritis pain, a complex outcome with nociceptive and neuropathic components, leads to central sensitization in a chronic phase. Using centrally acting drugs in the control of pain and associated symptoms would increase the probability of treatment success.
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Affiliation(s)
- Ozge Gulsum Illeez
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Kubra Neslihan Kurt Oktay
- Yeditepe University Faculty of Medicine, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Ilknur Aktas
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Feyza Unlu Ozkan
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Tuba Nazligül
- University of Health Sciences, Van Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Van, Turkey
| | - Feyza Akan Begoglu
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Meryem Yilmaz Kaysin
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Arzu Atici
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Pinar Akpinar
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
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6
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Begoglu FA, Akpinar P, Ozkan FU, Ozturk G, Aktas I. Health status, coronaphobia, quality of life, anxiety and depression in patients with lymphedema during COVID-19 pandemic. Lymphology 2022; 55:21-32. [PMID: 35896112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Covid-19 has physical damage as well as serious impact on the mental health in the community. Symptoms such as anxiety, depression, fear, stress, and sleep problems were more commonly reported during Covid-19 pandemic. The aim of this study was to assess the health status, psychological conditions, quality of life, and possible risk factors of patients with lymphedema during the pandemic. The study included male and female patients aged ≥18 years with primary or secondary upper or lower extremity lymphedema (stage 1, 2, or 3) who were followed in our outpatient clinic. The patients were interviewed by phone. Health and social status were examined using a questionnaire, Covid-19 phobia was assessed using Covid-19 Phobia Scale (C19P-S), and quality of life was assessed using Lymphedema Quality of Life Questionnaire Arm or Leg (LYMQOL). Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). The HADS scores showed that 35% of the patients had severe risk for depression and 10% had severe risk for anxiety. Factors with negative effect on HADS were lower education level, sedentary lifestyle, failure to perform lymphedema exercises, weight gain, and lymphedema duration. The C19P-S scores were higher indicating greater phobia in the overall score and subscores in patients with primary lymphedema and secondary lymphedema without malignancy, younger patients, those who are not able to walk regularly, and those who are not able to perform self manual lymphatic drainage (self-MLD). Factors with negative effects on LYMQOL were stage 3 lymphedema, female gender, younger age, and longer disease duration. Patients who performed regular self-MLD and lymphedema exercises demonstrated positive effects on LYMQOL. The results of this study suggest that patients with lymphedema affected by the COVID-19 pandemic are mostly younger patients, individuals with primary lymphedema, individuals with non-malignant etiology, individuals who unable to perform regular walking, and those unable to perform self- MLD.
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Affiliation(s)
- F A Begoglu
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - P Akpinar
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - F U Ozkan
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - G Ozturk
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - I Aktas
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Karamanlioglu DS, Geler Kulcu D, Ozturk G, Akpinar P, Unlu Ozkan F, Aktas I. Effectiveness of pregabalin treatment for trigger points in patients with comorbid myofascial pain syndrome and fibromyalgia syndrome: a randomized controlled trial. Somatosens Mot Res 2021; 38:327-332. [PMID: 34544324 DOI: 10.1080/08990220.2021.1977265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM OF THE STUDY Myofascial pain syndrome (MPS) is a common problem in the general population. MPS should not be a local/peripheral painful syndrome and considered to be a syndrome of central sensitivity. We aimed to investigate the effect of pregabalin in patients with MPS in this study. MATERIALS AND METHODS We randomized 40 patients into two groups, and 17 patients per group completed the study. Female patients in group I received pregabalin and exercise therapy, whereas those in group II received exercise therapy alone. All patients were evaluated as follows: for pain by visual analog scale (VAS); trigger-point pressure pain threshold-(PPT) by algometry; neuropathic pain using the Douleur Neuropathique en 4 Questions (DN4) and quality of life with the Short Form-36 (SF36). Evaluations were performed pre-treatment and at the end of the first and third months of treatment. Clinical trial ID: NCT04600037, retrospectively registered 20/10/2020. RESULTS In group I, significant improvements were observed in VAS, trigger-point-PPT, physical component summary-SF-36, at the first and third months. In group II, statistically significant improvements were observed in VAS, trigger-point-PPT after the first and third months. Group I showed statistically better improvements in VAS, trigger points-PPT, physical component summary-SF36 compared with group II by the third month. CONCLUSION Pregabalin treatment is effective for controlling trigger points. Pregabalin treatment is also more effective than exercise treatment at improving quality of life in patients with MPS.
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Affiliation(s)
- Duygu Silte Karamanlioglu
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Duygu Geler Kulcu
- Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gulcan Ozturk
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Kurt Oktay KN, Akpinar P, Unlu Ozkan F, Aktas I, Ersoy Canillioglu Y, Erkanli Senturk G. The Effect of Alpha Lipoic Acid on the Recovery of Sciatic Nerve Injury in Rats: A Prospective Randomized Controlled Trial. Am J Phys Med Rehabil 2021; 100:780-789. [PMID: 33229887 DOI: 10.1097/phm.0000000000001642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the regenerative effects of alpha lipoic acid on the recovery of sciatic nerve crush injury (SNCI) in rats. DESIGN This was a randomized, experimental, and sham-controlled study. The sciatic nerves of 28 rats in four groups were traumatized for 60 secs: G1, sham operated + saline; G2, SNCI + saline; G3, SNCI + alpha lipoic acid 50 mg/kg/day; and G4, SNCI + alpha lipoic acid 100 mg/kg/day. Sciatic functional index values were measured on day 0, 1, 7, 14, 21, and 28. Sciatic nerve stimulation threshold values were recorded on day 1, 14, and 28. End-point histopathologic evaluation was conducted. RESULTS The mean sciatic functional index value of G2 but not G3/G4 on day 7 was significantly lower than on day 0 (P = 0.035, P = 0.447/P = 0.800). The mean sciatic functional index value of G2 but not G3/G4 increased significantly between day 7 and 14 (P = 0.035, P = 0.447/P = 0.438). The day 14 mean sciatic nerve stimulation threshold values of G3/G4 but not G2 were decreased significantly compared with those on day 1 (P = 0.022/P = 0.022, P = 0.933). The mean sciatic nerve stimulation threshold values of G3/G4 on day 14 were similar to those on day 0 (P = 0.106/P = 0.418). Regeneration in muscle and nerve connective tissues and nerve structures was observed in G3/G4. Inflammation in the muscle and nerve tissues of G4 was suppressed down to similar levels of G1. Myelinated nerve fibers were less degenerated in G3/G4. CONCLUSION Alpha lipoic acid has the potential to accelerate the process of nerve healing in the context of SNCI in rats.
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Affiliation(s)
- Kubra Neslihan Kurt Oktay
- From the University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation (KNKO, PA, FUO, IA); Bahcesehir University Faculty of Medicine, Department of Histology and Embryology (YEC); and Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Histology and Embryology (GES), Istanbul, Turkey
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Atici A, Bahadir Ulger FE, Akpinar P, Illeez OG, Geler Kulcu D, Unlu Ozkan F, Aktas I. Poor Accuracy of Clinical Diagnosis in Pes Anserine Tendinitis Bursitis Syndrome. Indian J Orthop 2021; 56:116-124. [PMID: 35070151 PMCID: PMC8748597 DOI: 10.1007/s43465-021-00424-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/12/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate the characteristics of the patients who are clinically diagnosed with pes anserine tendinitis bursitis syndrome (PATBS), and to determine the sensitivity and specificity of clinical diagnose based on magnetic resonance imaging (MRI). METHODS Included in this cross-sectional clinical study were 156 patients who were evaluated based on the clinical presence or absence of PATBS. All patients underwent Q-angle measurement, knee osteoarthritis (OA) grading according to the Kellgren-Lawrence classification, and medial joint space measurement, and their cartilage thickness, and any periarticular and intraarticular knee pathologies were recorded from an assessment of knee MRIs. RESULTS Of the total, 64 cases (41%) were diagnosed clinically with PATBS and 92 (59%) were not. There was no difference in the Q angles of the two groups (p > 0.05), while the medial joint spaces were significantly lower in the PATBS patients (p < 0.05). There were no significant differences between the two groups in an MRI assessment of meniscus and ligament lesions, chondromalacia patella, cyst, bursitis, effusion and synovial pathologies (p > 0.05). The sensitivity and specificity of the PATBS clinical diagnoses relative to the MRI findings were determined as 41.2% and 59.5%, respectively. CONCLUSION The medial joint space was found to be significantly lower in patients with PATBS, while there was no difference in any other knee pathologies between the two groups. The sensitivity and specificity of a PATBS clinical diagnosis were found to be low, and so it was concluded that clinical PATBS diagnoses may be inaccurate, particularly in the presence of such invasive therapies as injection, and that diagnoses based on imaging methods would be more accurate.
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Affiliation(s)
- Arzu Atici
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey
| | - Fatma Esra Bahadir Ulger
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey
| | - Ozge Gulsum Illeez
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey
| | - Duygu Geler Kulcu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey
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Cicek ED, Begoglu FA, Aktas I, Ozkan FU. Relationship of Dome Height of the First Metatarsal Head with Hallux Valgus Angle and Metatarsophalangeal Alignment. J Am Podiatr Med Assoc 2020; 110:442232. [PMID: 32756899 DOI: 10.7547/20-015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Hallux valgus (HV) is a progressive foot deformity in which the first metatarsophalangeal (MTP) joint is affected. The relationship between the dome height of the first metatarsal head and the HV deformity has not been studied previously. This study aimed to investigate a possible relation of the dome height of the first metatarsal head with articular alignment and the hallux valgus angle (HVA), which is frequently used to evaluate HV. METHODS A total of 129 feet of 68 patients were included in the study. Anteroposterior digital radiographic images of the foot taken in a weightbearing, standing position were used to assess the HVA, dome height, and shape of the first metatarsal head and the alignment of the MTP joint. The dome height of the first metatarsal head is the vertical distance from the base to the highest point of the articular surface doming. The alignment was categorized into three groups: aligned, deviated, and subluxated. Patients were assigned into three groups based on the HVA: Normal, Mild HV and Moderate HV. RESULTS A statistically significant, positive correlation was found between the HVA and the dome height of the first metatarsal head (r = 0.293, P = 0.001 and P < 0.05). The dome height was significantly lower in the patients with a normal HVA than those with a high HVA (P1 = 0.042, P2 = 0.039 and P < 0.05, respectively). The dome height of the first metatarsal head was found significantly higher in feet with subluxation, compared to feet aligned and deviated (P1 = 0.001; P2 = 0.0089 and P < 0.05, respectively). CONCLUSIONS Our study results suggest that HV deformity may be related to an increased dome height and the measurement of the dome height of the first metatarsal head might be used to evaluate an anatomic tendency toward HV development.
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Aktas İ, Unlu Ozkan F, Sari K. Comment on "Local sacroiliac injections in the treatment of spondyloarthritis. What is the evidence?" by Wendling et al. Joint Bone Spine 2020; 87:209-213. Joint Bone Spine 2020; 88:105083. [PMID: 33115665 DOI: 10.1016/j.jbspin.2020.105083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022]
Affiliation(s)
- İlknur Aktas
- University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, PM&R Clinic , Istanbul, Turkey
| | - Feyza Unlu Ozkan
- University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, PM&R Clinic , Istanbul, Turkey
| | - Kemal Sari
- University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, PM&R Clinic , Istanbul, Turkey.
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Bilgin Badur N, Unlu Ozkan F, Aktas I. Efficacy of shortwave diathermy in ulnar nerve entrapment at the elbow: a double-blind randomized controlled clinical trial. Clin Rehabil 2020; 34:1048-1055. [PMID: 32567357 DOI: 10.1177/0269215520930062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To investigate the efficacy of shortwave diathermy in treatment of ulnar nerve entrapment at the elbow. DESIGN The study was a double blind, randomized controlled clinical trial. SETTING, PARTICIPANTS A total of 76 adult patients diagnosed with ulnar nerve entrapment at the elbow clinically and electrophysiologically, were randomly assigned into two groups. Patients were evaluated at baseline, after completing treatment and 1 and 3 months after treatment. Physical examination, quick-DASH (disabilities of arm, shoulder, hand) and SF-36 (short form) questionnaires for daily life activities, dynamometer for grip strength, and visual analog scale for pain were used. INTERVENTION A total of 10 sessions of shortwave diathermy were applied to patients in treatment group as five sessions/week, 2 weeks. Control group was given placebo shortwave diathermy. Both groups were given elbow splints and informed to avoid symptom provoking activities. MAIN OUTCOME MEASURES Visual analog scale, grip strength, SF-36, and quick-DASH results. RESULTS Out of 76 patients, 61 of them completed the study where n = 31 for treatment group and n = 30 for control group. Mean age was 46.18 ± 13.45 years. There were 32 (52.5%) women and 29 (47.5%) men. The p values between groups 3 months after intervention for visual analog scale, quick-DASH, SF-36 questionnaire, and dynamometer were 0.669, 0.277, 0.604, and 0.126, respectively (p > 0.05). CONCLUSION Application of shortwave diathermy to patients with ulnar nerve neuropathy at the elbow was not associated with any difference in outcome.
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Affiliation(s)
- Naciye Bilgin Badur
- Department of Physical Medicine and Rehabilitation, Sureyyapasa Chest Diseases and Thoracic Surgery Education and Training Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, Istanbul Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, Istanbul Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
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Aktas I, Kaya E, Akpinar P, Atici A, Unlu Ozkan F, Palamar D, Akgun K. Spasticity-induced Pectoralis minor syndrome: a case-report. Top Stroke Rehabil 2019; 27:316-319. [PMID: 31774031 DOI: 10.1080/10749357.2019.1691807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Pectoralis minor syndrome (PMS) develops when the neurovascular bundle compression occurs at the retropectoralis minor space. It may occur due to repetitive overhead activities, traumatic incident, structural causes, myofascial pain syndrome in the pectoralis minor muscle, as well as spasticity of the pectoralis minor muscle. In patients with hemiplegia, adductor muscles along with pectoralis minor muscle spasticity may be present in the upper extremity.Objective: We report a 19-year-old male patient with spastic hemiparesis who was diagnosed with PMS due to spasticity of the pectoralis minor muscle.Method: Diagnosis of PMS was confirmed by Ultrasound-guided 4 cc 1% lidocaine injection to the right pectoralis minor muscle and Ultrasound-guided onabotulinum toxin A injection was performed. Stretching exercises to the pectoral muscles were also added to the rehabilitation program.Result: Complaints of the patient were controlled by botulinum toxin injections at 3-month intervals.Conclusion: It should be kept in mind that spasticity in the upper extremity may develop in the pectoralis minor muscle, and may cause pressure on the neurovascular structures. Ultrasound-guided botulinum toxin injections can be a safe and effective treatment for PMS in a patent with post stroke spastic hemiparesis.
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Affiliation(s)
- Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Arzu Atici
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Deniz Palamar
- Department of Physical Medicine and Rehabilitation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Kenan Akgun
- Department of Physical Medicine and Rehabilitation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Ozturk G, Akpinar P, Karamanlioglu AD, Ozkan FU, Aktas I. Pregnancy-related osteoporotic vertebral compression fractures in two patients treated with low-molecular-weight heparin during pregnancy: case reports. Gynecol Endocrinol 2018; 34:378-380. [PMID: 29069943 DOI: 10.1080/09513590.2017.1393064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Pregnancy-related osteoporosis (PRO) is an uncommon metabolic bone disease that can result in vertebral fragility fractures. Here we report two cases of young women who had been previously treated with LMWH-enoxaparin and were diagnosed with PRO with vertebral fragility fractures after delivery. In first case report, a 33-year-old primigravid woman who was treated with 40 mg/day of enoxaparin for eight months to prevent venous thromboembolism was presented. After delivery, Dual energy X ray absorptiometry (DEXA) revealed osteoporosis in lumbar and femoral neck region. In magnetic resonance imaging (MRI), T4-T7 thoracic vertebral height losses were detected. In second case report, a 28-year-old primigravid woman which was treated with 40 mg/day enoxparin from the second month to the birth was presented. Osteoporosis in lumbar region was detected by DEXA. MRI revealed T12-L1 and L5 vertebral height losses. In conclusion, PRO can cause severe low back pain and should be considered in differential diagnosis. A detailed medical history should be essential to detect relationship between LMWH and PRO.
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Affiliation(s)
- Gulcan Ozturk
- a Fatih Sultan Mehmet Training and Research Hospital , Istanbul , Turkey
| | - Pinar Akpinar
- a Fatih Sultan Mehmet Training and Research Hospital , Istanbul , Turkey
| | | | - Feyza Unlu Ozkan
- a Fatih Sultan Mehmet Training and Research Hospital , Istanbul , Turkey
| | - Ilknur Aktas
- a Fatih Sultan Mehmet Training and Research Hospital , Istanbul , Turkey
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Nazligul T, Akpinar P, Aktas I, Unlu Ozkan F, Cagliyan Hartevioglu H. The effect of interferential current therapy on patients with subacromial impingement syndrome: a randomized, double-blind, sham-controlled study. Eur J Phys Rehabil Med 2017; 54:351-357. [PMID: 28895673 DOI: 10.23736/s1973-9087.17.04743-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although interferential current (IFC) is a common electrotherapeutic modality used to treat musculoskeletal pain, there is not any randomized controlled trial investigating its clinical efficacy in subacromial impingement syndrome (SAIS). AIM Investigation of effectiveness of IFC treatment in patients with SAIS. DESIGN Randomized, double-blind, sham-controlled study. SETTING Physical medicine and rehabilitation outpatient clinic. POPULATION Patients (N.=65) between 25 and 65 years of age, with a diagnosis of SAIS according to clinical evaluation and subacromial injection test. METHODS Patients were randomly distributed into two groups: 1) active IFC group (N.=33); 2) sham IFC group (N.=32). Exercise, cryotherapy, and a non-steroidal anti-inflammatory drug (NSAID) were given to both groups. Ten sessions of IFC with bipolar method were applied to the active IFC group daily 20 minutes per session, 5 days per week, for 2 weeks while sham IFC was applied to the sham IFC group with the same protocol. Visual Analog Scale (VAS), Constant scores, and Shoulder Disability Questionnaire (SDQ) were used for evaluation at baseline, immediately post-treatment, and 1 month post-treatment. Both the patients and the researcher who assessed the outcomes were blinded to the treatment protocol throughout the study period. RESULTS Sixty of the 65 patients (active IFC group N.=30, sham IFC group N.=30) completed the study, 3 patients from active IFC, 2 from sham IFC group dropped during the follow up period. Statistically significant improvement was observed in all parameters of both groups immediately and 1 month post-treatment (P<0.01). There were no statistical differences between the active IFC group and sham IFC group in all outcome parameters (P>0.05). CONCLUSIONS Our results demonstrated that IFC therapy does not provide additional benefit to NSAID, cryotherapy, and exercise program in treatment of SAIS. CLINICAL REHABILITATION IMPACT Our study responds to the needs of the lack of evidence in the field of rehabilitation. IFC therapy does not provide additional benefit for the treatment of SAIS.
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Affiliation(s)
- Tuba Nazligul
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey -
| | - Pinar Akpinar
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Hulya Cagliyan Hartevioglu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
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Akpinar P, Atici A, Ozkan FU, Aktas I, Kulcu DG, Sarı A, Durmus B. Reliability of the Modified Ashworth Scale and Modified Tardieu Scale in patients with spinal cord injuries. Spinal Cord 2017; 55:944-949. [PMID: 28485384 DOI: 10.1038/sc.2017.48] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Psychometrics study. OBJECTIVES To assess the reliability of the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) in patients with spinal cord injuries (SCIs). SETTING Inpatient rehabilitation clinics at two state hospitals. METHODS The study included 65 participants aged between 18 and 88 years with SCI with spasticity. All participants were at least 6 months after injury and had an American Spinal Injury Association Impairment Scale grade of A-D. The MAS and MTS scores were collected from the right hip adductor and hip extensor muscles, right knee extensor and knee flexor muscles and right plantar flexor muscles. Each participant was assessed twice by two experienced physiatrists 1 week apart. The raters were blinded to each other's scores. RESULTS Inter-rater and test-retest agreement for the MAS scores (κ=0.531-0.774) was moderate to substantial. Inter-rater and test-retest agreement for the MTS X scores (κ=0.692-0.917) was substantial to almost perfect. Inter-rater reliability and test-retest reliability of the MTS R2-R1 was excellent (intra-class correlation coefficient (ICC) 0.874-0.973, confidence interval (CI): 0.79-0.98) for all muscles tested. Inter-rater reliability of the MTS R2 for the hip adductor and knee extensor muscles was poor (ICC 0.248, CI: -0.00 to 0.47 and ICC 0.094, CI: -0.16 to 0.34, respectively). The test-retest reliability of the MTS R2 was also poor for the knee extensor muscles (ICC 0.318, CI: -0.06 to 0.53). CONCLUSION MAS has adequate reliability for determining lower-extremity spasticity in patients with SCI. The demonstration of excellent inter-rater reliability and test-retest reliability of the MTS R2-R1 suggests its utility as a complementary tool for informing treatment decisions in patients with SCI.
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Affiliation(s)
- P Akpinar
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - A Atici
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - F U Ozkan
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - I Aktas
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - D G Kulcu
- Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - A Sarı
- Department of Physical Medicine and Rehabilitation, Erenkoy Physical Medicine and Rehabilitation Hospital, Istanbul, Turkey
| | - B Durmus
- Department of Physical Medicine and Rehabilitation, Erenkoy Physical Medicine and Rehabilitation Hospital, Istanbul, Turkey
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Abstract
Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in adulthood, is rare in childhood. The symptoms may differ to those in adults, or may be misinterpreted owing to children's difficulties in expressing themselves. Cases of idiopathic, bilateral CTS under the age of 5 are rare. A 4-year-old girl presented with pain in both hands and difficulty opening them in the morning. Bilateral severe CTS was determined at electroneuromyography (ENMG). Bilateral wrist splints were advised for both hands. Improvement in ENMG was seen at 2 weeks following conservative treatment.
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Affiliation(s)
- Ozge Gulsum Illeez
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ozan Ozkaya
- Department of Pediatric Nephrology-Rheumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Korhan Ozkan
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul Medeniyet University, Istanbul, Turkey
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Aktas I, Nazikoglu C, Kepez A, Ozkan FU, Kaysin MY, Akpinar P, Dogan Z, Ileri C, Saymaz S, Erdogan O. Effect of intravenous zoledronic acid infusion on electrocardiographic parameters in patients with osteoporosis. Osteoporos Int 2016; 27:3543-3547. [PMID: 27344642 DOI: 10.1007/s00198-016-3684-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 06/20/2016] [Indexed: 12/27/2022]
Abstract
UNLABELLED We evaluated the effects of zoledronic acid (ZA) therapy on electrocardiographic (ECG) parameters for the first time in the literature. Measurements were performed on ECGs obtained before and after ZA infusion on the same day as well as 1 month after the infusion. ZA infusion did not have any short- or long-term effect on any parameter that might be associated with the tendency for atrial fibrillation or ventricular arrhythmias. INTRODUCTION The aim of the present study was to evaluate the early and late effects of ZA therapy on ECG parameters which might be associated with the tendency for atrial and ventricular arrhythmias. METHODS Consecutive patients with osteoporosis who were admitted to our clinic between December 2013 and December 2014 and who were scheduled to receive ZA infusion constituted our study population. Twelve-lead surface ECGs were obtained from all patients before and after ZA infusion on the same day as well as 1 month after the infusion. All ECG parameters were measured and compared with each other for each patient. RESULTS Data of 100 patients were used in the analysis (9 male; 70.5 ± 11.6 years of age). There were no significant differences between repeated measurements regarding pmax, pmin, and p dispersion values. QT max and QT min values were significantly increased after infusion; however, there were no significant changes in QT dispersion, Tp-e interval, and Tp-e dispersion values. CONCLUSIONS ZA infusion did not affect P wave dispersion both at the immediate post-infusion period and 1 month after infusion. QT values were significantly increased early after ZA infusion; however, there were no significant differences in parameters reflecting disparity of ventricular recovery times and transmural dispersion of ventricular repolarization. Based on these observations, it may be suggested that ZA infusion did not have any short- or long-term effect on any parameter that might be associated with the tendency for atrial fibrillation or ventricular arrhythmias.
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Affiliation(s)
- I Aktas
- Physical Therapy and Rehabilitation Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - C Nazikoglu
- Family Medicine Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A Kepez
- Cardiology Clinic, Marmara University Training and Research Hospital, Pendik, Istanbul, Turkey.
| | - F U Ozkan
- Physical Therapy and Rehabilitation Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - M Y Kaysin
- Physical Therapy and Rehabilitation Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - P Akpinar
- Physical Therapy and Rehabilitation Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Z Dogan
- Cardiology Clinic, Marmara University Training and Research Hospital, Pendik, Istanbul, Turkey
| | - C Ileri
- Cardiology Clinic, Marmara University Training and Research Hospital, Pendik, Istanbul, Turkey
| | - S Saymaz
- Cardiology Clinic, Marmara University Training and Research Hospital, Pendik, Istanbul, Turkey
| | - O Erdogan
- Cardiology Clinic, Marmara University Training and Research Hospital, Pendik, Istanbul, Turkey
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Illeez OG, Atıcı A, Ulger EB, Kulcu DG, Ozkan FU, Aktas I. The transitional vertebra and sacroiliac joint dysfunction association. Eur Spine J 2016; 27:187-193. [DOI: 10.1007/s00586-016-4879-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 10/26/2016] [Accepted: 11/11/2016] [Indexed: 01/12/2023]
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Aktas I, Palamar D, Ozkan FU, Akgun K. Testicular pain due to thoracolumbar junction syndrome: A case report. Rev Int Androl 2016. [DOI: 10.1016/j.androl.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Sacral stress fracture and sacroiliitis are two conditions that present with pain. Sacral stress fractures are a rare cause of lumbar and hip pain. Sacral insufficiency fractures are a type of sacral stress fractures. Sacroiliitis represents inflammation of the sacroiliac joints. Coexistence of sacroiliitis and sacral insufficiency fracture (SIF) has not been reported before. Case 1: A 39-year-old woman reporting inflammatory back pain. Imaging revealed bilateral chronic sacroiliitis and bilateral SIF. Case 2: A 31-year-old woman presenting with left hip and inguinal pain. Imaging revealed left sacroiliitis and ipsilateral SIF. Calcium and vitamin D supplementation together with nonsteroidal anti-inflammatory drug (NSAID) treatment were given. Sulfasalazine was added to the treatment of the second patient who developed peripheral arthritis during follow-ups. Early diagnosis is best made with magnetic resonance imaging (MRI) since roentgenograms may be negative initially. Furthermore, MRI findings of both entities share common features leading to a diagnostic dilemma. Interpretation of radiological findings assisted by detailed history and clinical findings is crucial for diagnosis and treatment.
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Affiliation(s)
- O G Memetoğlu
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
| | - F U Ozkan
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - N S Boy
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - I Aktas
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - D G Kulcu
- Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - A Taraktas
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Şilte Karamanlioğlu D, Aktas I, Ozkan FU, Kaysin M, Girgin N. Effectiveness of ultrasound treatment applied with exercise therapy on patients with ankylosing spondylitis: a double-blind, randomized, placebo-controlled trial. Rheumatol Int 2016; 36:653-61. [PMID: 26923690 DOI: 10.1007/s00296-016-3441-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 02/10/2016] [Indexed: 11/26/2022]
Abstract
The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p < 0.05), tragus-wall distance (p < 0.05), PGA (p < 0.01), and DGA (p < 0.05) at 2 weeks as well as for the parameters of daily pain (p < 0.01), PGA (p < 0.05), DGA (p < 0.01), BASDAI (p < 0.05), ASDAS-CRP (p < 0.05), ASDAS-ESR (p < 0.01), lumbar side flexion (p < 0.01), the modified Schober test (p < 0.01), and ASQoL (p < 0.05) at 6 weeks. Our study showed that ultrasound treatment increases the effect of exercise in patients with ankylosing spondylitis.
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Affiliation(s)
| | - Ilknur Aktas
- Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Meryem Kaysin
- Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
| | - Nuray Girgin
- Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
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Ozkan FU, Uzer G, Türkmen I, Yildiz Y, Senol S, Ozkan K, Turkmensoy F, Ramadan S, Aktas I. Intra-articular hyaluronate, tenoxicam and vitamin E in a rat model of osteoarthritis: evaluation and comparison of chondroprotective efficacy. Int J Clin Exp Med 2015; 8:1018-1026. [PMID: 25785088 PMCID: PMC4358543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. METHODS An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. RESULTS Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the control group (P=0.004, P=0.016, P=0.012 respectively). There was no statistically siginificant difference between the treatment groups in terms of total Mankin scores (P>0.05). CONCLUSION Intra-articular application of HA, tenoxicam and Vit E are chondroprotective in early osteoarthritis model in rats. Chondroprotective activity of tenoxicam and Vit E are comparable with the beneficial effects of HA on articular cartilage.
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Affiliation(s)
- Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospitalİstanbul, Turkey
| | - Gokcer Uzer
- Department of Orthopedics and Traumatology, Bezmialem University Hospitalİstanbul, Turkey
| | - Ismail Türkmen
- Department of Othopedics and Traumatology, Medeniyet University Goztepe Education and Research Hospitalİstanbul, Turkey
| | - Yavuz Yildiz
- Department of Othopedics and Traumatology, Medeniyet University Goztepe Education and Research Hospitalİstanbul, Turkey
| | - Serkan Senol
- Department of Pathology, Medeniyet University Goztepe Education and Research Hospitalİstanbul, Turkey
| | - Korhan Ozkan
- Department of Othopedics and Traumatology, Medeniyet University Goztepe Education and Research Hospitalİstanbul, Turkey
| | - Fatih Turkmensoy
- Department of Othopedics and Traumatology, Medeniyet University Goztepe Education and Research Hospitalİstanbul, Turkey
| | - Saime Ramadan
- Department of Pathology, Anadolu Saglik Merkeziİstanbul, Turkey
| | - Ilknur Aktas
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospitalİstanbul, Turkey
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Cift H, Ozkan K, Söylemez S, Ozkan FU, Cift HB. Ulnar-sided pain due to extensor carpi ulnaris tendon subluxation: a case report. J Med Case Rep 2012; 6:394. [PMID: 23173564 PMCID: PMC3533833 DOI: 10.1186/1752-1947-6-394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 10/05/2012] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED INTRODUCTION We present the case of a patient with extensor carpi ulnaris tendon subluxation who was first treated for distal radioulnar joint sprain. CASE PRESENTATION A 25-year-old Caucasian man was seen at our policlinic one month after he had fallen on his outstretched hand. A diagnosis of extensor carpi ulnaris subluxation was made clinically but we also had the magnetic resonance imaging scan of the patient's wrist which displayed an increased signal on T2-weighted images consistent with inflammation around the extensor carpi ulnaris tendon. The extensor carpi ulnaris tendon was found to be dislocating during supination and relocating during pronation. The sheath was reconstructed using extensor retinaculum due to attenuation of subsheath. CONCLUSION There was no recurrent dislocation of the extensor carpi ulnaris tendon of the patient at his last follow up 12 months after the operation.
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Affiliation(s)
- Hakan Cift
- Department of Orthopaedics and Traumatology, Sb. Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey
- Bostanci mah. Mehmet Sevki Pasa cd. Isik apt. 32/12, Istanbul, Turkey
| | - Korhan Ozkan
- Department of Orthopaedics and Traumatology, Sb. Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Salih Söylemez
- Department of Orthopaedics and Traumatology, Sb. Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Department of Physical Therapy and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Hacer Burcu Cift
- Department of Anesthesia and Reanimation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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25
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Abstract
Aims: The aim of our study was to compare the effects of suprascapular nerve block in patients with frozen shoulder and diabetes mellitus unresponsive to intraarticular steroid injections. Settings and Design: Ten patients without improvement of sign and symptoms after intraarticular injections were made a suprascapular nerve block. Methods: Pain levels and active range of movement of patients were recorded at initial attendance and after 1, 4, and 12 weeks. All patients’ simple pain scores, total pain scores, and range of motion of their shoulders were improved significantly after suprascapular nerve block. Statistical Analysis: In this study, the statistical analyses were performed by using the SPSS 8.0 program (SPSS Software, SPSS Inc., USA). To compare pre- and post-injection results of simple pain score, total pain score, shoulder abduction and external rotation, Wilcoxon test was used. Results: Patient's simple pain scores, total pain scores also abduction, external rotation and internal rotation angles were improved significantly after suprascapular nerve block. Conclusion: Effective results after suprascapular nerve blockage was obtained for the treatment of refractory frozen shoulder cases.
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Affiliation(s)
- Korhan Ozkan
- Department of Orthopaedic & Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey
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26
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Abstract
In radius neck fractures, reduction manipulations applied on the radial head with percutaneous K-wires may lead to epiphysis or physis damage. In this study, 16 cases were evaluated without using any percutaneous manipulations upon the displaced radius head. Rather, an Ender-pin-like, curve-tipped K-wire was inserted intramedullary (Metaizeau technique) after a certain amount of reduction by manual manipulation under fluoroscopic guidance. Complete reduction was obtained with wire rotations in 16 patients. A total of 16 patients with open growth plates with an average age of 8 years were enrolled within the scope of the study. Thirteen patients (81.25%) showed excellent clinical results, two patients (12.5%) showed good results, and one patient (6.25%) showed average results. None of the cases exhibited poor results. A single K-wire was used in nine cases, whereas two K-wires were used for fixation rigidity in seven cases with larger medullas. No sign of neurovascular deficit, synostosis, or infection was observed in any of the cases. In conclusion, the use of two wires in patients with larger medullas and emphasis on the importance of closed reduction, even without percutaneous K-wire manipulation, might lead to the development of a new treatment approach for pediatric patients with radial head fractures.
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Affiliation(s)
- Ender Ugutmen
- Department of Orthopedics and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey
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27
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Ozkan FU, Ozkan K, Ramadan S, Guven Z. Chondroprotective effect of N-acetylglucosamine and hyaluronate in early stages of osteoarthritis--an experimental study in rabbits. Bull NYU Hosp Jt Dis 2009; 67:352-357. [PMID: 20001938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Osteoarthritis, the most common joint disease in the world, is characterized by joint pain, stiffness, and limitation of range of motion. Osteoarthritis is a slowly progressive disease and its morbidity increases with age. The most commonly involved sites are the spine, knee, hip, and hand joints. Although the ideal treatment for osteoarthritis should be the one that acts on the underlying mechanism, thus preventing joint destruction and disease progression, such an effective treatment option does not exist. Therefore, contemporary treatment aims to relieve pain, increase range of motion, and optimize joint function. Analgesics and nonsteroidal antiinflammatory drugs are most commonly used for the symptomatic treatment, but mainly their gastrointestinal side effects, especially in elderly patients, limit their usage. In this study, the chondroprotective effects of an aminomonosaccharide glucosamine and a polysaccharide hyaluronic acid in a rabbit osteoarthritis model were investigated. Anterior cruciate ligament transection was performed in 32 New Zealand rabbits to establish a model of osteoarthritis. Rabbits were randomized into four groups, each consisting of eight rabbits. Two weeks after the operation, intraarticular injections were performed to the right knees once a week for 5 weeks; intraarticular glucosamine to the first group, intraarticular hyaluronate to the second group, intraarticular hyaluronate and intramuscular glucosamine to the third group, and intraarticular saline solution to the fourth group, which served as the control group. At the end of the eighth week, the rabbits were sacrificed and their right knees with proximal femur and distal tibia were harvested. Joint surfaces of their femur and tibia were examined macroscopically, and sections from the medial femoral condyles were examined microscopically. Macroscopic evaluation revealed that the cartilage surface was preserved in the glucosamine, hyaluronate, and hyaluronate plus glucosamine groups, when compared with the control group. Microscopic evaluation showed that glucosamine, hyaluronate, and glucosamine plus hyaluronate have chondroprotective effect, but no statistically significant difference was found between study groups.
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Affiliation(s)
- Feyza Unlu Ozkan
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Training Hospital, Istanbul, Turkey
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28
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Unay K, Ozkan K, Ugutmen E, Ozkan FU, Eren A, Bilsel K. Simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of the fifth phalanx: A case report. Cases Journal 2008; 1:208. [PMID: 18834501 PMCID: PMC2566569 DOI: 10.1186/1757-1626-1-208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 10/03/2008] [Indexed: 11/10/2022]
Abstract
Abstract
Introduction
There is no case of simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of a finger in the literature.
Case presentation
A 61 years old male patient sustained an ipsilateral dorsal dislocation of the PIP joint of his fifth finger and dorsal dislocation of the metacarpophalangeal joint. Closed reduction of proximal interphalangeal joint was achieved while open reduction of the metacarpophalangeal joint was carried out.
Conclusion
The single most important element preventing reduction of the metacarpophalangeal joint was an interposition of the volar plate between proximal end of the phalanx and the head of the metacarpal.
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29
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Ozkan NK, Ozkan K, Ugutmen E, Eceviz E, Ozkan FU. Bilateral Freiberg’s disease in adjacent metatarsals. Eur J Orthop Surg Traumatol 2008. [DOI: 10.1007/s00590-008-0358-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Ugutmen E, Ozkan K, Kilincoglu V, Ozkan FU, Toker S, Eceviz E, Altintas F. Anterior Cruciate Ligament Reconstruction by using Otogeneous Hamstring Tendons with Home-based Rehabilitation. J Int Med Res 2008; 36:253-9. [DOI: 10.1177/147323000803600206] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We investigated patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction using otogeneous hamstring tendons with a cross-pin technique to compare a post-operative home-based rehabilitation programme with a clinic-based programme. ACL reconstruction was performed on 104 patients (103 male) by the same surgeon. The mean age of the patients was 31.5 years (range 18–43 years) and the mean time interval between injury and operation was 34.3 months. Patients were randomly allocated to either a home-based ( n = 52) or clinic-based rehabilitation programme ( n = 52). Mean follow-up was 31.1 months (range 12–66 months). Patients underwent a series of examinations before and after surgery in order to evaluate functional recovery of their injured knee. The results demonstrated that using otogeneous hamstring tendons for ACL reconstruction was safe and produced satisfactory results. The study also demonstrated that a home-based rehabilitation programme was as effective as a clinic-based programme.
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Affiliation(s)
- E Ugutmen
- Department of Orthopaedics and Traumatology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - K Ozkan
- Department of Orthopaedics and Traumatology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - V Kilincoglu
- Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Hospital, Istanbul, Turkey
| | - FU Ozkan
- Department of Physical Therapy and Rehabilitation, Fatih Sultan Mehmet Hospital, Istanbul, Turkey
| | - S Toker
- Department of Orthopaedics and Traumatology, Dumlupinar university, Kutahya, Turkey
| | - E Eceviz
- Department of Orthopaedics and Traumatology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - F Altintas
- Department of Orthopaedics and Traumatology, Goztepe Education and Research Hospital, Istanbul, Turkey
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31
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Ozkan K, Eralp L, Kocaoglu M, Ahishali B, Bilgic B, Mutlu Z, Turker M, Ozkan FU, Sahin K, Guven M. The effect of transforming growth factor beta1 (TGF-beta1) on the regenerate bone in distraction osteogenesis. Growth Factors 2007; 25:101-7. [PMID: 17891595 DOI: 10.1080/08977190701352594] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Distraction osteogenesis is a well established clinical treatment for limb length discrepancy and skeletal deformities. Transforming growth factor beta 1 (TGF-beta1) is a multifunctional peptide which controls proliferation and expression of cells specific to bone like chondrocytes, osteoblasts, osteoclasts including mesenchymal precursor cells. To decrease the external fixation time with increasing the strength of regenerate (newly formed bone after distraction) we tested the effect of locally applied transforming growth factor beta 1 on distraction osteogenesis. A total of 28 mature female white New zealand rabbits weighing 3,5 kg-4,5 kg were studied. 10 animals were belonging to biomechanical testing group (5 for the study and 5 for the control subgroups), and the others were to histology group. In biomechanical group after tibial osteotomy TGF-beta1 was applied subperiosteally for 5 days just proximal to osteotomy site. Control group received only the solvent. Seven days after tibial osteotomy distraction was started at a rate of 0.25 mm/12 hours for 3 weeks with a unilateral fixator. Rabbits were sacrificed at the end of a consolidation period 8 week after tibial osteotomy. We assessed density of the elongation zone of rabbit tibial bones with the computed tomography. Then biomechanical parametres were assessed using the torsional testing using the material testing machine. In histology group rabbits were classified as control and study (rabbits that were given TGF-beta1). Rabbits were sacrificed at the end of first week, second week and fourth week also at the end of consolidation period 8 week after tibial osteotomy. Immunohistochemical and histologic parameters were examined. Biomechanical testing was applied as torsional testing. These values are used in determination of maximal loading, stiffness and energy absorbed during testing (brittleness). The histomorphometric examination looked for the differences between the study and control groups in terms of bone formation pattern, bone quality and quantity. The immunohistochemical studies investigated the mechanism of TGF-beta1, and its presence in different cell types. The results of this study suggest that locally applied TGF-beta1 improves the mineral density of distraction gap and load to failure(energy absorbed during testing). Though there is no significant histomorphometric difference between the study and control groups, there is an increased bone mineral density and an according maximum energy absorbance in the study group. This effect can be explained by the following mechanism: TGF-beta1 exerts its effect on two different receptor types (Type 1 and 2). Type 1 receptors are localized to bone matrix and type 2 receptors are localized to the intracellular space. The specific stains utilized in the current experiment are specific to type 2 receptors. They have been shown to be down-regulated by exogenous TGF-beta1 injections. Most probably, type 1 receptors are up-regulated by this exogenous administration, but unfortunately, there is currently no specific stain on tha market to display type 1 receptors and to prove this explanation.
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Affiliation(s)
- Korhan Ozkan
- Department of Orthopedics and Traumatology, Goztepe Education and Research Hospital, Istanbul, Turkey.
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32
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Abstract
Investigators in the present study explored the effects of hyperbaric oxygen (HBO) therapy on distraction osteogenesis in a rabbit limb-lengthening model. HBO treatment was provided to participants in a small animal pressure chamber once a day during the latent period of distraction osteogenesis at 2.5 absolute atmospheres of pressure. Bone mineral density measurements were obtained through torsional testing. The control group received no HBO treatment. Animals were killed 8 wk postoperatively for biomechanical testing. There was a statistically significant increase in bone mineral density in the HBO group compared with that in the non-HBO group, but no statistically significant differences were observed between biomechanical parameters of the 2 groups. The investigators suggest that these results must be further studied through histologic examination to determine the stepwise effects of HBO during and after collagen synthesis.
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Affiliation(s)
- Levant Eralp
- Department of Orthopaedics and Traumatology, Medical Faculty of Istanbul, University of Istanbul, Istanbul, Turkey
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33
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Abstract
Trigger toe is a rare entity, with only a few cases reported in the literature. It is usually seen in ballet dancers as a result of compression of the flexor hallucis longus tendon in the tarsal tunnel beneath the medial malleolus. We report a case of trigger toe due to a constricting lesion on the extensor hallucis longus tendon.
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Affiliation(s)
- Korhan Ozkan
- Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey
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