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    Comparison of an epicondylitis bandage with a wrist orthosis in patients with lateral epicondylitis
    (Sage Publications Ltd, 2018) Akkurt, Halil Ekrem; Kocabas, Hilal; Yilmaz, Halim; Eser, Cemile; Sen, Zafer; Erol, Kemal; Goksu, Hamit
    Background: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes. Objective: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis. Study design: Randomized controlled trial. Methods: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force. Results: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints (p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores (p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values (p > 0.05). Conclusion: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements. Clinical relevance Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life.
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    The effect of low-intensity pulsed ultrasound on rib fracture: An experimental study
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2020) Calik, Saniye Goknil; Calik, Mustafa; Kasdogan, Zumrut Ela Arslan; Yilmaz, Halim; Karaca, Gulten; Akkurt, Halil Ekrem; Esen, Haci Hasan
    Background: In this study, we aimed to investigate the effects of low-intensity pulsed ultrasound on rib fracture healing in a rat model. Methods: A total of 72 male Wistar-Albino rats were randomly divided into three equal groups. To induce a rib fracture, right thoracotomy was performed under general anesthesia and a 0.5-cm segment was removed from the fourth and fifth ribs. After 24 h of surgery, low-intensity pulsed ultrasound was implemented according to the groups. Group 1 served as the control group for the observation of normal bone healing. Low-intensity pulsed ultrasound was applied at a dose of 20% (2 msn pulse-8 msn pause) 100 mW/cm(2) and 50% (5 msn pulse-5 msn pause) 200 mW/cm(2) for six min, respectively in Group 2 and Group 3. All subjects were followed for six weeks. Eight animals from each group were sacrificed at two, four, and six weeks for further assessment. Histological alterations in the bone were examined. Results: Although there was no statistically significant difference in osteoblasts, osteoclasts, new bone formation, and lymphocyte count among the groups, histological consolidation was significantly increased by low-intensity pulsed ultrasound. While low-intensity pulsed ultrasound induced osteoblastic, osteoclastic, and new bone formation, it inhibited lymphocyte infiltration. Conclusion: Low-intensity pulsed ultrasound, either at low or high doses, induced the histological consolidation of rib fractures and inhibited lymphocyte infiltration. This effect was more prominent in the long-term and at higher dose with increased daily and total administration time. We, therefore, believe that accelerating the natural healing process in patients with rib fractures would enable to treat more effectively in short-term.
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    Effectiveness of Home Exercise Program in Patientswith Knee Osteoarthritis
    (2013) Yılmaz, Halim; Demir Polat, H. Almula; Karaca, Gülten; Küçükşen, Sami; Akkurt, Halil Ekrem
    Diz osteoartritli (OA) hastalarda izotonik, izometrik ve eklem hareket açıklığı (EHA) egzersizlerinden oluşan ev programının ağrı, fonksiyonel kapasite ve yaşam kalitesi üzerine etkisini araştırmak. Diz OA tanısı alan 75 hasta çalışmaya alındı. Hastalara 8 hafta aktif EHA, kuadriseps ve hamstringler için izometrik ve izotonik egzersizlerden oluşan ev programı uygulandı. Hastalarda bazalde, tedavi bitiminde ve tedavi bittikten sonra 12 haftada Vizüel Analog Skala (VAS) ile ağrı şiddeti, The Western Ontario and Mcmaster Universities Arthritis İndeks (WOMAC) ile fonksiyonel durum, Lequesne diz eklemi şiddet indeksi (LŞİ) ile hastalığın şiddeti, 36- Item Short-Form Health Survey (SF-36) ile yaşam kalitesi belirlendi. 8 haftanın sonundaDiz OAli 75 hastanın 52nin ev egzersiz programını düzenli uyguladığı tespit edildi. 52 diz OAli hastanın tedavi bitiminde VAS, WOMAC, LŞİ ve SF-36 alt skorlarından fiziksel fonksiyon, ağrı ve sosyal fonksiyon skorlarında bazale göre belirgin düzelme mevcuttu ve bu düzelme azalmakla birlikte tedavi bittikten sonra 12 haftada da devam ediyordu. Yine hastalarda egzersiz programı bitiminde SF-36 alt skorlarından mental sağlık, emosyonel rol, fiziksel rol, genel sağlık ve vitalite skorlarında bazale göre belirgin düzelme mevcuttu, ancak bu düzelme tedavi bittikten sonra 12 haftada devam etmiyordu. Sonuçlarımız diz OAli hastalarda ev egzersiz programının fonksiyonel düzeyi arttırdığı, ağrı düzeyini azalttığı ve yaşam kalitesini düzelttiğini göstermektedir. Bu nedenle diz OAli hastaları takip eden sağlık profesyonelleri tedavi planlarken ev egzersiz programlarını mutlaka gözönünde bulundurmalıdır.
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    Evaluation of Sexual Dysfunction in Females With Ankylosing Spondylitis
    (2016) Akkurt, Halil Ekrem; Yılmaz, Halim; Yılmaz, Sema; Parlak, Lütfiye; Ordahan, Banu; Sallı, Ali
    Objectives: This study aims to evaluate sexual function in females with ankylosing spondylitis (AS), compare them with healthy controls, and demonstrate the effects of AS on female sexual functions.Patients and methods: Fifty-four AS patients (mean age 39.33±8.57 years; range 20 to 55 years) and 56 similar aged healthy controls were included in the study. Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory and Female Sexual Function Index (FSFI), respectively. Other assessment methods included the visual analog scale for pain, fatigue, and importance of sexual life; Bath Ankylosing Spondylitis Disease Activity Index for disease activity, Bath Ankylosing Spondylitis Functional Index for functionality, Bath Ankylosing Spondylitis Metrology Index for spinal mobility, and Short Form-36 (SF-36) for quality of life.Results: Total FSFI and all FSFI subscale scores and number of weekly sexual intercourse were significantly lower while Beck Depression Inventory score was significantly higher in females with AS when compared to controls. In AS patients with depression, total FSFI score and FSFI subscales scores of desire and arousal were significantly lower than those without depression. In females with AS, there were negative correlations between total FSFI score and duration of complaint, Beck Depression Inventory score, Bath Ankylosing Spondylitis Metrology Index score, visual analog scale score, age, and duration of marriage while positive correlations existed between total FSFI score and visual analog scale importance of sexual life score and number of weekly sexual intercourse, SF-36 fatigue, SF-36 social function, SF-36 pain, and SF-36 mental component scores.Conclusion: Sexual dysfunction was more common in female AS patients without marked impairment in body image and hip involvement when compared to normal population. Sexual problems which are generally neglected should be handled regardless of disease activity when evaluating patients with AS and establishing a treatment plan.
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    Is pain the only symptom in patients with benign joint hypermobility syndrome?
    (Springer London Ltd, 2015) Albayrak, Ilknur; Yilmaz, Halim; Akkurt, Halil Ekrem; Salli, Ali; Karaca, Gulten
    The aims of this study were to evaluate pain, depression level, fatigue, sleep, and quality of life (QoL) among patients with benign joint hypermobility syndrome (BJHS) and to compare their results with those of healthy controls. The study involved 115 patients and 114 healthy volunteers. Pain level was rated using visual analogue scale (VAS) for all patients. Depression level, fatigue, sleep quality, and QoL of all the participants were evaluated by the Beck Depression Inventory (BDI), the Checklist Individual Strength (CIS), the Pittsburgh Sleep Quality Index (PSQI), and the Short Form-36 (SF-36), respectively. VAS value was 6.29 +/- 0.94 in the patient group. Comparison of two groups showed that there were statistically significant differences between the patient group and the control group with respect to BDI, total CIS, PSQI scores, SF-36 subscales (physical function, role physical, bodily pain, general health, role emotional, and mental health), and mental component summary (p < 0.001). While pain is the predominant symptom among BJHS patients, depression, fatigue, impaired sleep, and QoL also commonly occur. Thus, all of these components should be taken into account when assessing patients with BJHS.
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    Multipl Sklerozlu Erkek Hastalarda Cinsel Disfonksiyonun Değerlendirilmesi
    (2018) Odabaş, Ömer Faruk; Gümüş, Haluk; Akkurt, Halil Ekrem; Uca, Ali Ulvi; Yılmaz, Halim
    Amaç: Erkek cinselliği üzerine multiple skleroz (MS)’un etkileriniaraştırmak.Yöntem: Vaka grubuna 61 MS’li erkek hasta, kontrol grubuna 60sağlıklı erkek birey dahil edildi. MS’li hastaların fonksiyonel durumlarıGenişletilmiş Özürlülük Durum Skalası (Expanded Disability StatusScala –EDSS), depresyon düzeyleri Beck Depresyon Ölçeği (BDİ), ağrıdüzeyleri Vizüel Analog Skala (VAS), cinsel işlevleri International Indexof Erectile Function (IIEF) ve yaşam kaliteleri short form-36 (SF-36) iledeğerlendirildi.Bulgular: MS’li hastalar EDSS 5,5 olan 45 hasta ve EDSS 5,5 olan 19hasta şeklinde sınıflandırıldı. MS’li hastalarda ortalama VAS ve BDİskorları kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksekidi (p0,05). MS’li hastalarda ortalama IIEF skorları ve SF-36 tüm altgrup skorları kontrol grubuna göre istatistiksel olarak anlamlı derecededüşük idi (p0,05). MS’li hasta grubunda EDSS ortalaması 2,752,42idi. MS’li erkek hastalarda IIEF skorları ile SF-36 mental ve fizikselkomponent ortalamaları arasında pozitif yönde korelasyon mevcut ikenIIEF skorları ile yaş, hastalık süresi, atak sayısı, evlilik yılı, EDSS, VAS veBDI skorları arasında negatif yönde korelasyon mevcut idi (p0,00). BDI17 depresyon lehine değerlendirildiğinde MS’li hastaların %62,5’unda,kontrol grubunun %11,7’inde depresyon saptandı (p0,001).Sonuç: MS’li erkek hastalarda cinsel fonksiyonlar olumsuz yöndeetkilenmektedir. MS’li erkek hastalarda cinsel fonksiyonlar; artmışözürlülük (EDSS), ağrı ve eşlik eden depresyon düzeyi ile ilişkiligörünmektedir. Bu nedenle, MS’li erkek hastalar takipleri sırasındaözürlülük yanında cinsel işlev bakımından da değerlendirilmelidir.