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Umay EK, Yilmaz V, Gundogdu I, Ozturk E, Gurcay E, Karaahmet O, Saylam G, Ceylan T, Cakci A. What Happens to Swallowing Muscles after Stroke?: A Prospective Randomized Controlled Electrophysiological Study. Neurol India 2020; 67:1459-1466. [PMID: 31857535 DOI: 10.4103/0028-3886.273645] [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: 11/04/2022]
Abstract
Background Stroke is the most frequent reason of neurological dysphagia Electrophysiological studies can be used to evaluate oral, pharyngeal and initial phase of esophageal phase. Aims This study aims to noninvasively evaluate mastication, mimic, and tongue muscles of stroke patients, which play an important role in the oral phase of swallowing process and compare them with healthy individuals. Setting and Design This study was conducted at the Physical Medicine and Rehabilitation Clinic of our hospital between January 2014 and December 2016. Materials and Methods Fifty-one patients who were admitted to our clinic with stroke and 51 healthy individuals were evaluated for the study. Demographic features of individuals were recorded. The swallowing intervals and motor action potentials (MAPs) of trigeminal, facial and hypoglossal nerves were measured. After four weeks of treatment schedule, patients were re-evaluated. Statistical Analysis The Wilcoxon Signed Rank test, the Mann-Whitney U test and Fisher exact test were used in this study. Results The all swallowing intervals were found prolonged compared to the healthy controls (P < 0.05). The MAPs of the masseter, orbicularis oculi, and intrinsic tongue muscles were significantly lower in patient group (P < 0.05). After treatment, we found significant improvement for all parameters in patient group, but the swallowing intervals were still significantly prolonged, and MAPs of these muscles were still lower (P < 0.05). Conclusion Although swallowing is examined as different phases, the process is complicated and should be evaluated totally. In post-stroke dysphagia, oral phase of swallowing process is as important as phayngeal phase and perioral, mastication, and tongue muscles are influenced even in an early period as a month.
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Affiliation(s)
- Ebru Karaca Umay
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Volkan Yilmaz
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Ibrahim Gundogdu
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Erhan Ozturk
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Eda Gurcay
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Ozgur Karaahmet
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Guleser Saylam
- Otolaryngology-Head and Neck Surgery Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Tijen Ceylan
- Otolaryngology-Head and Neck Surgery Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Aytul Cakci
- Physical Medicine and Rehabilitation Department, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
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Çitamak B, Bozaci AC, Altan M, Haberal HB, Kahraman O, Ceylan T, Doğan HS, Tekgül S. Surgical outcome of patients with vesicoureteral reflux from a single institution in reference to the ESPU guidelines: a retrospective analysis. J Pediatr Urol 2019; 15:73.e1-73.e6. [PMID: 30472078 DOI: 10.1016/j.jpurol.2018.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 10/09/2017] [Accepted: 10/20/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Vesicoureteral reflux (VUR) is an anatomic or functional disorder, and it is a condition associated with renal scarring, hypertension, and end-stage renal disease. Renal damage can be prevented by appropriate medical and surgical intervention for selected patients. OBJECTIVES The objective of this study was to retrospectively analyze the surgically treated patient group of this study in reference to the risk analysis criteria used in European Association of Urology (EAU), European Society for Paediatric Urology (ESPU) guidelines to see the outcome of the study management protocol within the last 15 years in respect to this risk analysis. STUDY DESIGN A total of 686 patients who were operated upon in a single institution for VUR between 1997 and 2016 were retrospectively analyzed. According to the criteria in EAU/ESPU guidelines, the patients were classified into three groups: low, medium, and high risk. Risk factors were compared between the groups. RESULTS The patient numbers for low, medium, and high risk were 92 (13.4%), 485 (70.7%), and 109 (15.9%), respectively. In the high-risk group, surgeons tended to do more ureteroneocystostomy (UNC) (82.6%), whereas in the low-risk group, surgeons tended to do more subureteric injection (STING) (76.1%). The success rates for STING and UNC were found to be 75% and 93%, respectively. Although there was a difference in success rates among patients treated with STING or UNC, this difference was not statistically significant in success rates regarding risk groups for patients treated with STING or UNC. DISCUSSION The most recent guideline was that which was published by the EAU/ESPU organization in 2012. This guideline is established based on the risk analysis. The analysis revealed that patients in the low-risk group tended to undergo endoscopic surgery treatment method, whereas patients in the high-risk group tended to undergo open surgery. Therefore, the study management over the last 10 years has been mainly in line with the current recommendations. CONCLUSION The analysis shows that when the patients are classified according to the EAU/ESPU risk classification, surgeons tended to perform more endoscopic and more open surgery for the low- and high-risk groups, respectively. Although each surgical modality had similar success rates in each group, open surgical results were overall much higher than those of endoscopic surgery in each group. This was a specifically important finding in high-risk group where the endoscopically treated group of patients was small in number, and the need for a definitive correction is essential in this group because of increased risk of renal injury.
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Affiliation(s)
- B Çitamak
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - A C Bozaci
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - M Altan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - H B Haberal
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - O Kahraman
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - T Ceylan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - H S Doğan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - S Tekgül
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
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Karaca Umay E, Gurcay E, Bahceci K, Ozturk E, Yilmaz V, Gundogdu İ, Ceylan T, Eren Y, Cakci A. Validity and reliability of Turkish version of the gugging swallowing screen test in the early period of hemispheric stroke. NEUROL SCI NEUROPHYS 2018. [DOI: 10.5152/nsn.2018.10436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Umay EK, Karaahmet F, Gurcay E, Balli F, Ozturk E, Karaahmet O, Eren Y, Ceylan T. Dysphagia in myasthenia gravis: the tip of the Iceberg. Acta Neurol Belg 2018; 118:259-266. [PMID: 29417423 DOI: 10.1007/s13760-018-0884-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 11/30/2017] [Accepted: 01/18/2018] [Indexed: 11/24/2022]
Abstract
We evaluated swallowing function in patients with myasthenia gravis (MG) with or without dysphagia symptoms using different evaluation parameters and compared the results with those of healthy subjects. A total of 36 patients with MG and 25 healthy volunteers were included in the study. The subjects were classified into three groups; patients without dysphagia (group 1), patients with dysphagia (group 2), and healthy participants (group 3). The presence and severity of dysphagia, the oropharyngeal, pharyngeal, pharyngoesophageal, and esophageal phases were assessed using a screening test, manometric test, electrophysiologic studies [electroneuromyography (EMG)], fiberoptic endoscopic evaluation of swallowing (FEES), and barium swallow pharyngeal esophagography (BSPE), respectively. There was a significant difference between group 1 and group 3 in terms of BSPE (p = 0.001) and manometry tests (p = 0.001). A significant difference was found in all methods between group 2 and group 3 (p = 0.001, for all). In the comparison of the patient groups, although the number of patients with dysphagia in group 2 was significantly higher in the clinical tests (p = 0.007), FEES (p = 0.001), and EMG (p = 0.043) than in group 1, no difference was detected for BSPE (p = 0.119) and manometry (p = 0.644). Swallowing functions in patients with MG may be affected even without symptoms. This condition should be considered in their follow-up.
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Affiliation(s)
- Ebru Karaca Umay
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey.
| | - Fatih Karaahmet
- Ankara Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey
| | - Eda Gurcay
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey
| | - Fatma Balli
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey
| | - Erhan Ozturk
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey
| | - Ozgur Karaahmet
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey
| | - Yasemin Eren
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | - Tijen Ceylan
- University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Otolaryngology-Head & Neck Surgery Clinic, Ankara, Turkey
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Ceylan T, Fırat H, Kuran G, Ardıç S, Bilgin E, Çelenk F. Quick Diagnosis in Obstructive Sleep Apnea Syndrome: WatchPAT-200. Iran Red Crescent Med J 2012; 14:475-8. [PMID: 23105983 PMCID: PMC3470841] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 07/09/2012] [Accepted: 07/11/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is a highly prevelant disorder and found in approximately 2-4% of middle-aged adults. OBJECTIVES To assess the efficacy of Watch-PAT-200 in the diagnosis of obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS Patients suspected of having OSAS underwent overnight Level I polisomnography and simultaneously wore Watch-PAT-200 in the sleep laboratory. RESULTS 51 adult patients included in the study. The average age was 45.3±10.5 years and the average body mass index (BMI) was 29.4±4.0 kg/m2. There was a high agreement between PSG and Watch PAT regarding apnea-hypopnea index, respiratory disturbance index and oxygen desaturation index. Significant but a low agreement was found in stage 1 and 2 of non-REM sleep when two methods compared. No agreement was found between PSG and Watch-PAT regarding stage 3 and 4 of non-REM sleep. Very low agreement was found between PSG and Watch-PAT regarding the REM sleep. CONCLUSIONS Watch-PAT-200 is an effective method in the diagnosis of OSAS.
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Affiliation(s)
- Tijen Ceylan
- Department of Otorhinolaryngology, Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Hikmet Fırat
- Department of Pulmonary Medicine, Yıldırım Beyazıt Education and Research Hospital, Ankar, Turkey
| | - Gökhan Kuran
- Department of Otorhinolaryngology, Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Sadık Ardıç
- Department of Pulmonary Medicine, Yıldırım Beyazıt Education and Research Hospital, Ankar, Turkey
| | - Esra Bilgin
- Department of Pulmonary Medicine, Yıldırım Beyazıt Education and Research Hospital, Ankar, Turkey
| | - Fatih Çelenk
- Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Akcam FZ, Kaya O, Ceylan T. Comment on: Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2011; 66:1199-200; author reply 1200-2. [PMID: 21393152 DOI: 10.1093/jac/dkq532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ozyürek E, Cetintaş S, Ceylan T, Oğüş E, Haberal A, Gürakan B, Ozbek N. Complete blood count parameters for healthy, small-for-gestational-age, full-term newborns. ACTA ACUST UNITED AC 2006; 28:97-104. [PMID: 16630213 DOI: 10.1111/j.1365-2257.2006.00767.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [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: 11/28/2022]
Abstract
No previous study has investigated the full range of complete blood count (CBC) parameters in small-for-gestational-age (SGA) newborns. The main aim of this study was to compare CBC and peripheral smear parameters in term, healthy SGA neonates and appropriate-for-gestational-age (AGA) neonates, and to establish CBC reference values for full-term SGA newborns. One hundred thirty-two healthy, term newborns (73 SGA and 59 AGA) were included. On day 1, we obtained 109 samples and on day 7 we obtained 77 samples. A CBC and peripheral smear were analyzed for each sample collected and group data were compared. We observed higher mean values for normoblast count, hemoglobin, hematocrit, and red blood cell (RBC) count in the SGA babies than in the AGA babies on day 1. The mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration values for the SGA babies were decreased because of the relatively high RBC count and relatively high mean corpuscular volume we observed in this group. Of the SGA newborns, 21.9% had neutropenia and 4.7% had absolute neutrophil counts lower than 1500/microl on day 1. On both day 1 and day 7, the SGA newborns had higher mean absolute metamyelocyte counts and higher mean I : T (immature : total neutrophil ratio) values than the AGA group. The SGA babies had a lower mean absolute lymphocyte count on day 7 than the AGA group. We detected thrombocytopenia in almost one-third of the 64 SGA newborns tested on day 1. In summary, our study clearly demonstrates that CBC parameters for healthy, full-term, SGA newborns are different from those of healthy, term AGA newborns. This is the first study that has documented different mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, metamyelocyte counts, lymphocyte counts, and I : T in SGA babies compared with AGA babies.
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Affiliation(s)
- E Ozyürek
- Hematology Section, Department of Pediatrics, Başkent University Faculty of Medicine, Ankara, Turkey
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Başaloğlu H, Turgut M, Taşer FA, Ceylan T, Başaloğlu HK, Ceylan AA. Morphometry of the sacrum for clinical use. Surg Radiol Anat 2005; 27:467-71. [PMID: 16211321 DOI: 10.1007/s00276-005-0036-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2003] [Accepted: 08/04/2005] [Indexed: 10/25/2022]
Abstract
Degenerative disease and instability in the lower lumbar spine may necessitate fusion and stabilization supplemented by instrumentation to the sacrum. However, screw placement in a reasonable position is more difficult to achieve because of the unique anatomy of the first sacral (S1) vertebra. Therefore, this study has been conducted to evaluate sacrum anatomy of the Western Anatolian population in terms of morphometric measurements and make a comparison with previous studies as well as giving a guidance to the surgeons. In this study, 60 dry adult sacrums (30 male and 30 female) were assessed for morphometric analysis. The measurement data for the sacrum and S1 vertebra revealed that there was no significant difference between both sexes except the sacral width and sacral canal width (p<0.05). In the present study, the ratio of S1 corpus' width to sacral width was lower in females compared with males. A detailed knowledge of the morphometric data about sacrum is very important for spinal surgery, as pedicle screw insertion is crucial in spinal instrumentation in order to prevent neurological injury and/or fixation failure.
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Affiliation(s)
- H Başaloğlu
- Department of Anatomy, Adnan Menderes University School of Medicine, Aydin, Turkey
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