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Öğe Bilateral upper-extremity deep vein thrombosis following central cord syndrome(Maney Publishing, 2013) Onmez, Hilal; Cingoz, Havva Turac; Kucuksen, Sami; Anliacik, Emel; Yasar, Ozan; Yilmaz, Halim; Salli, AliDeep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded. Method: Case report. Findings: A bilateral upper-extremity DVT developed in a 51-year-old woman with SCI (central cord syndrome) being followed in our rehabilitation clinic. Medical treatment resulted in improvement in the clinical status of the patient as well as the regression in the thrombus. Conclusion: In patients with SCI, DVT should be kept in mind in the presence of pain and edema in the upper extremities, and prophylactic DVT treatment should be considered.Öğe 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, HamitBackground: 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.Öğe The effect of etanercept on a case of amyloidosis secondary to ankylosing spondylitis: results of 2-year follow-up(Publisaude-Edicoes Medicas Lda, 2013) Yilmaz, Halim; Kocabas, Hilal; Erkin, GultenSecondary amyloidosis (type AA) is rarely encountered but can be a significant complication of ankylosing spondylitis (AS) and may lead to proteinuria and renal dysfunction. Anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents may be used to induce clinical remission by suppressing systemic inflammation in secondary amyloidosis. The patient described, with the diagnosis of AS, was diagnosed with secondary amyloidosis, despite treatment with disease modifying anti-rheumatic medication. He developed marked proteinuria, renal dysfunction and low levels of serum albumin. Diagnosis of amyloidosis was confirmed by renal biopsy During a 2-year treatment period with etanercept, an anti-TNF-alpha agent, a definite improvement was determined in all parameters. This case illustrates that in the treatment of secondary amyloidosis related to AS, etanercept, an anti-TNF-alpha agent, can be considered an effective therapeutic option.Öğe 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 HasanBackground: 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.Öğe Effectiveness of Home Exercise Program in Patients-with Knee Osteoarthritis(Modestum Ltd, 2013) Yilmaz, Halim; Polat, H. Almula Demir; Karaca, Gulten; Kucuksen, Sami; Akkurt, H. EkremTo investigate effects of home exercise program including isotonic, isometric and joint range of motion (ROM) exercises on pain, functional capacity and quality of life in knee OA patients. Seventy-five patients with knee OA were included into the study. Patients were exposed to home exercise program including 8-week active ROM, and isometric and isotonic exercises for quadriceps and hamstrings. In patients, severity of pain, functional capacity, severity of disease and quality of life were assessed with Visual Analogue Scale (VAS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Lequesne's knee severity index (LSI) and 36-Item Short-Form Health Survey (SF-36) on admission, at the end of and 12th week after the treatment, respectively. At the end of 8th week, of 75 patients, 52 were determined to perform home exercise program regularly. At the end of treatment for 52 patients with knee OA, a significant improvement was seen in physical function, bodily pain and social functioning scores among subscales of SF-36, and VAS, WOMAC and LSI, compared to basal findings. The improvement also continued at 12th week after the treatment. Also, a marked amelioration was observed in role limitation physical, health perception, mental health, role limitation emotional and energy scores among subscales of SF-36, after completing exercise program; however, the amelioration disappared at 12th week after the teratment. Our findings indicate home exercise program increases functional level, decreases pain severity and improves quality of life. Therefore, physicians following-up patients with knee OA should take home exercise programs into consideration while planning treatment regimes.Öğe Effects of Multiple Sclerosis on Female Sexuality: A Controlled Study(Elsevier Sci Ltd, 2014) Gumus, Haluk; Akpinar, Zehra; Yilmaz, HalimAim. The aim of this study was to investigate the effects of multiple sclerosis (MS) on female sexuality. Methods. Present study included 142 females (70 MS patients, 72 healthy controls). MS patients were evaluated by Expanded Disability Status Scale (EDSS) for functional status, by Beck Depression Inventory (BDI) for severity of depression, by Visual Analog Scale (VAS) for severity of pain, and by Female Sexual Function Inventory (FSFI) for sexual function. Main Outcome Measures. FSFI, BDI, EDSS, and VAS were the main outcome measures. Results. The number of weekly sexual intercourse, total FSFI, and FSFI subscale scores were lower in MS women compared with controls. FSFI total and FSFI subscale scores were statistically significantly lower in MS women with BDI score >= 17 compared with those with BDI score <17. A negative correlation was found between total FSFI score and BDI, EDSS, VAS, age, and duration of complaint, but a positive correlation was found with education level in MS women. Conclusions. Sexual functions are negatively affected in MS women. Sexual functions in MS women seem to be associated with enhanced disability, pain, duration of the disease, and degree of concomitant depression. Therefore, women with MS should also be evaluated in terms of sexual function during routine follow-ups.Öğe Evaluation of Sexual Dysfunction in Women with Rheumatoid Arthritis: A Controlled Study(Elsevier Sci Ltd, 2012) Yilmaz, Halim; Polat, Halime Almula Demir; Yilmaz, Sema Dereli; Erkin, Gulten; Kucuksen, Sami; Salli, Ali; Ugurlu, HaticeObjective. To evaluate sexual function in women with rheumatoid arthritis (RA) and compare them with healthy controls. Materials and Methods. Ninety-five patients with RA and 108 healthy controls were included in the study. Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory (BDI) and Index of Female Sexual Function (IFSF), respectively. Morning stiffness in women with RA, pain (Visual Analog ScaleVAS), disability rate (Health Assessment QuestionnaireHAQ), and disease activity score (DAS-28) were defined. Results. Total IFSF and mean of IFSF subgroup scores and significance of sexual life score were lower in patients with RA than controls, whereas mean BDI score was higher. The mean of the total IFSF scores was significantly lower in patients with RA with BDI =17 than that of patients with BDI <17. The mean of the total IFSF score decreased as disease severity increased. There was a strong negative correlation between total IFSF and DAS-28 scores, a moderate negative correlation between total IFSF score and HAQ, BDI, VAS score, age, and morning stiffness, and weak negative correlation between total IFSF and body mass index. Conclusion. RA is observed to have negative effects on sexual functions of women. Presence of depressive symptoms with RA and increased disease severity increase the degree of sexual dysfunction. Women patients with RA should also be asked about their sexual lives while being evaluated. Yilmaz H, Polat HAD, Yilmaz SD, Erkin G, Kucuksen S, Salli A, and Ugurlu H. Evaluation of sexual dysfunction in women with rheumatoid arthritis: A controlled study. J Sex Med **;**:****.Öğe Functional status, depression, and quality of life in female patients with postmastectomy lymphedema(Springer Wien, 2024) Varman, Busra; Yilmaz, Halim; Eryilmaz, Mehmet Ali; Mustu, Yurdagul Bahran; Varman, AlperBackgroundThis study aimed to evaluate QOL in female patients who had developed lymphedema (LE) following unilateral breast cancer surgery and investigate its relationship to shoulder pain, sleep and depression.MethodsA total of 69 female patients who had undergone unilateral mastectomy because of breast cancer and had been diagnosed with LE and 69 healthy controls were included in the study. While the QOL of participants was evaluated by the Short Form-36 (SF-36), depression levels were determined by the Beck Depression Inventory (BDI) and quality of sleep was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Shoulder pain on the operated side in the patient group was appraised by the visual analogue scale (VAS).ResultsThis study revealed that LE patients had increased levels of depression, sleep disorders, and arm pain, while a decrease was found in the level of upper extremity functions and QOL. Therefore QOL, depression, and sleep disorders should be investigated in detail alongside upper extremity problems in the diagnosis and follow-up of patients with postmastectomy LE.ConclusionPostmastectomy LE causes chronic pain and depression and impairs patients' functionality and QOL.Öğe 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, GultenThe 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.Öğe Long term effects of high intensity laser therapy in lateral epicondylitis patients(Springer London Ltd, 2016) Akkurt, Ekrem; Kucuksen, Sami; Yilmaz, Halim; Parlak, Selman; Salli, Ali; Karaca, GultenThe objective of this study is to investigate short- and long-term effects of high-intensity laser therapy (HILT) in lateral epicondylitis (LE) patients. Thirty patients with LE diagnosis (23 unilateral and 7 bilateral in total 37 elbows) were treated using HILT. LE patients were evaluated before, right after, and 6 months following HILT intervention post-treatment using visual analogue scale for pain (VAS) during activity and resting. Disabilities of the Arm, Shoulder, and Hand (DASH) Score and hand grip strength test (HGST) were used. The participants of the present study were also evaluated using Short-Form 36 (SF-36) before and 6 months after the treatment. Out of the 30 patients, 8 were male and 22 female with a mean age of 47.2 +/- 9.7. The activity and resting VAS, DASH, and HGST scores revealed statistically significant improvement (p = 0.001) following treatment. Whereas VAS activity, DASH, and HGST scores increased after treatment until post-treatment 6 months significantly (p = 0.001), VAS resting scores remained stable (p = 0.476). A statistically significant improvement was also evident in the physical and mental components of SF-36 scores following treatment until post-treatment 6 months compared to pre-treatment scores (p = 0.001). In conclusion, the results of the present study suggest that HILT is a reliable, safe, and effective treatment option in LE patients in the short and long term considering pain, functional status, and quality of life.Öğe Muscle Energy Technique Versus Corticosteroid Injection for Management of Chronic Lateral Epicondylitis: Randomized Controlled Trial With 1-Year Follow-up(W B Saunders Co-Elsevier Inc, 2013) Kucuksen, Sami; Yilmaz, Halim; Salli, Ali; Ugurlu, HaticeObjective: To determine the short- and long-term effectiveness of the muscle energy technique (MET) compared with corticosteroid injections (CSIs) for chronic lateral epicondylitis (LE). Design: Randomized controlled trial with 1 year of follow-up. Setting: Outpatient clinic of a university's department of physical medicine and rehabilitation. Participants: Patients with chronic LE (N=82; 45 women, 37 men). Interventions: Eight sessions of MET, or a single CSI was applied. Main Outcome Measures: Grip strength, pain intensity, and functional status were assessed using the pain-free grip strength (PFGS), a visual analog scale (VAS), and the Disabilities of the Aim, Shoulder and Hand (DASH) questionnaire, respectively. Measurements were performed before beginning treatment and at 6, 26, and 52 weeks afterward. Results: When the baseline PFGS, VAS, and DASH scores were compared with the scores at the 52-week follow-up, statistically significant improvements were observed in both groups over time. The patients who received a CSI showed significantly better effects at 6 weeks according to the PFGS and VAS scores, but declined thereafter. At the 26- and 52-week follow-ups, the patients who received the MET were statistically significantly better in terms of grip strength and pain scores. At 52 weeks, the mean PFGS score in the MET group was significantly higher (75.08 +/- 26.19 vs 62.24 +/- 21.83; P=.007) and the mean VAS score was significantly lower (3.28 +/- 2.86 vs 4.95 +/- 2.36; P=.001) than those of the CSI group. Although improvements in the DASH scores were more pronounced in the MET group, the differences in DASH scores between the groups were not statistically significant. Conclusions: This study showed that while both MET and CSI improved measures of strength, pain, and function compared with baseline, subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain. We conclude that MET appears to be an effective intervention in the treatment of LE. (C) 2013 by the American Congress of Rehabilitation MedicineÖğe The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine(Springer London Ltd, 2013) Kucuksen, Sami; Genc, Emine; Yilmaz, Halim; Salli, Ali; Gezer, Ilknur Albayrak; Karahan, Ali Yavuz; Salbas, EnderThe objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred and eighteen consecutive patients (mean age = 38 years, 75 % women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with (n = 22) and without (n = 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test [HIT-6]) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey [SF-36]). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4 %) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.Öğe Quality of Life in Osteoporosis: A Controlled Study(Galenos Yayincilik, 2012) Yilmaz, Halim; Erkin, Gulten; Polat, Halime Almula Demir; Kucuksen, Sami; Salli, Ali; Ugurlu, HaticeAim: To evaluate quality of life in women without vertebral and nonvertebral fractures, with postmenopausal osteoporosis (PMO), osteopenic and normal bone mineral density (BMD), and to determine effective factors on quality of life. Materials and Methods: Without fractures, 266 women with PMO, 310 with osteopenia and 255 with normal women BMD were enrolled in the study. BMD measurement was performed on lumbar vertebra (L1-L4) and femur neck via dual energy X-ray absorbtiometry (DXA). Quality of life was assessed with Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). QUALEFFO total scores and subscales were compared in all groups. Factors about quality of life in women with PMO were defined with correlation analysis. Variations of the highest correlation and quality of life were included into linear regression model. Results: In non-fractured women with PMO, QUALEFFO total scores and subscales were higher than those with osteopenia and normal BMD. In women with PMO, a positive correlation was found between QUALEFFO total scores, and age, Body Mass Index (BMI), parity and duration of menopause, and a negative correlation between QUALEFFO total scores, and level of education, economical status and femur neck BMD scores. In linear regression analysis, among significant factors of quality of life were BMI, femur neck BMD, parity and duration of menopause. Conclusion: Our results indicate that quality of life in non-fractured women with PMO is disordered higher than those with osteopenia and normal BMD, and quality of life are affected by numerous factors.
