Browsing by Author "Yurtkuran, Merih M."

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Diz osteoartritinde ikiasit preparatı ve metiletki ve yan etkilerinin farklı molekül ağırlıklı hyaluronik prednisolon asetat preparatının klinik olarak karşılaştırılması
(Bayçınar Tıbbi Yayıncılık, 2013-09) Bingöl, Ümit; Yurtkuran, Merih M.; Uludağ Üniversitesi/Tıp Fakültesi/Fizik Tedavi ve Rehabilitasyon Anabilim Dalı.; 6507727900; 55408539300
Diz osteoartritinde iki farklı molekül ağırlıklı hyaluronan preparatı ve metil prednisolon asetat preparatının etki ve yan etkilerini karşılaştırmak. Gereç ve Yöntem: Bu çalışmaya American College of Rheumatology kriterlerine göre diz osteoartriti tanısı konulan toplam 75 hasta katıldı. Hastalar rastgele yöntemle üç gruba randomize edildiler. Çalışmayı 69 hasta tamamladı. Grup I (n= 22) 6-metilprednizolon Asetat (6-MPA), Grup II (n=24) düşük molekül ağırlıklı hyaluronik asit (DMA HA), Grup III (n=23) yüksek molekül ağırlıklı hyaluronik asit (YMA HA) tedavisine alındı. Her üç gruba da birer hafta ara ile üç kez intraartiküler enjeksiyon uygulandı. Çalışma prospektif ve tek kör olarak yürütüldü. Hastalar radyolojik evre, fonksiyonel evre, doktor ve hasta tatmini, günlük asetaminofen kullanımı, doktorun ve hastanın global osteoartrit değerlendirmesi, ağrı, SF-36, Lequesne algofonksiyonel indeks ve Womac osteoartrit indeksi parametreleriyle değerlendirildi. Değerlendirmeler tedavi öncesi, tedavi sonrası, üçüncü ve altıncı ayda yapıldı. Enjeksiyonlardan sonra effüzyon varlığı, lokal ve sistemik yan etkiler kaydedildi. Bulgular: Tedavi öncesinde gruplar arasında fonksiyonel evre dışında farklılık yoktu. Grup içi karşılaştırmalarda radyolojik evre ve fonksiyonel evre dışında SF-36 ’nın bazı alt bölümlerinde ve diğer parametrelerde altıncı aya kadar uzayan anlamlı düzelmeler saptandı. Gruplar arası karşılaştırmalarda ise hastanın ve doktorun tedavi öncesine göre ikinci aydaki global osteoartrit değerlendirmesinde (p<0,05), SF-36 sosyal fonksiyonda tedavi sonrasında (p<0,05) anlamlı farklılıklar saptandı. Geçici lokal yan etkiler dışında ciddi sistemik yan etki saptanmadı. Sonuç olarak iki farklı molekül ağırlığına sahip HA preparatı ile metilprednizolon asetatın karşılaştırıldığı bu ilk çalışma ile her üç grupta da SF-36’nın bazı bölümleri dışında tüm değişkenlerde 24. haftaya uzayan anlamlı iyileşmeler saptandı. Gruplar arası karşılaştırmalarda ise sadece ikinci ayda hastanın ve doktorun global osteoartrit değerlendirmesinde ve tedavi sonrasında SF-36 sosyal fonksiyon alt bölümünde Grup I (6-MPA) ve Grup II’de (DMA HA) Grup III’e (YMA HA) göre daha anlamlı iyileşme saptandı. Diğer parametrelerde ise anlamlı farklılık saptanmadı.
Effects of balneotherapy on serum interleukin-2 rezeptors, inflammation markers and cortisol levels in knee osteoarthrits
(Georg Thieme Verlag Kg, 2007-08) Alp, Alev; Yurtkuran, Merih M.; Özarda, Yeşim İlçöl; Uludağ Üniversitesi/Atatürk Rehabilitasyon/Uygulama ve Araştırma Merkezi.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; ABG-2019-2020; AAL-8873-2021; 56256023200; 55408539300; 35741320500
Aims: To investigate hormonal and T cell-mediated immune responses and pain intensity on the osteoarthritic patients before and after balneotherapy (BT). Methods: in this randomized controlled study, 47 patients with grade 2 and 3 knee osteoarthritis (KOA) were included in BT (n = 23) and heated tap water (TW) (n=24) therapy groups. Group I was treated with 37 degrees C spa water (BT group) in a small therapeutic pool. Group II (TW) was treated with heated tap water 37 degrees C in the same pool as placebo-control. Patients in both of the groups had 20min/day treatment for 10 days. Participants were assessed before treatment, after 10 clays-treatment and at the 12th week for sIL-2R, cortisol, erytrocyte sedimentation rate (ESR), C-reactive protein (CRP) and pain intensity (pVAS). Results: BT and heated TW therapy both decreased pain intensity and sIL-2R levels at the 2nd week and 12th weeks. BT was superior to heated tap water therapy in reducing pVAS after 10 days-treatment (p < 0.05) and sIL-2R levels after 1.0 days-treatment and at the 12th week (p < 0.05, p < 0.001). In BT group, decrease in CRP was superior to TW therapy group at after 10 days-treatment and at the 12th week (p < 0.05, p < 0.05). Conclusion: We observed improvement in pain and reduction in sIL-2R in osteoarthritic patients with BT and heated TW therapy. However, BT was superior to TW therapy for changes in pain, sIL-2R and CRP after the therapy and in the long term.
Evaluation of hormonal response and ultrasonic changes in the heel bone by aquatic exercise in sedentary postmenopausal women
(Lippincott Williams & Wilkins, 2003-12) Ay, Alev; Yurtkuran, Merih M.; Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı.; 6701739419; 55408539300
Objective: This study is based on whether moderate increased physical activity as aquatic exercise has anabolic effects on bone and evaluates this in,terms of quantitative ultrasound and hormonal variables. Design: In this study, 41 postmenopausal sedentary women were admitted to Ataturk Balneotherapy and Rehabilitation Center, according to T scores of broadband ultrasound attenuation. Subjects were followed for 6 mos in aquatic exercise and control groups. The subjects were told to perform the aerobic exercises according to the Borg Scale. Ultrasonic and hormonal evaluation was done before and after the 6-mo training study. Results: In the exercise group, there were 36%, 75%, and 54% increases in the serum levels of insulin-like growth factor-1, growth hormone, and calcitonin, respectively. In addition, a 31% decrease was found in the serum levels of parathormone compared with the initial values. In the control group, serum levels of growth hormone decreased by 61%, but there were no statistically significant changes in the serum levels of insulin-like growth factor-1, calcitonin, or parathormone. T scores of broadband ultrasound attenuation and speed of sound increased by 19% and 63% in the exercise group, respectively, whereas there were decreases in the control group for the same variables. There were statistically significant differences between the control and the aquatic exercise groups for the 6-mo percentage of changes in broadband ultrasound attenuation and speed-of-sound T scores, insulin-like growth factor-1, growth hormone, parathormone, and calcitonin. Conclusions: Aquatic exercise was determined to be effective to make an anabolic effect on the bone of the postmenopausal, sedentary subjects.
Evidence of defective growth hormone response and adaptive hormonal changes in fibromyalgia
(Georg Thieme Verlag Kg, 2014-02) Alp, Alev; Oral, Arzu Yılmaztepe; Ocakoğlu, Gökhan; Dirican, Melahat; Yurtkuran, Merih M.; Uludağ Üniversitesi/Tıp Fakültesi/Atatürk Rehabilitasyon ve Balneoterapi Merkezi.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0463-6818; HLG-6346-2023; A-5841-2017; ABG-2019-2020; 56256023200; 23091316500; 15832295800; 6601919847; 55408539300
Objective: To investigate pituitary and growth hormone status in patients with fibromyalgia (FM) and their response to balneotherapy. Materials and Methods: This is a nonrandomized controlled trial performed with the outpatients and hospital staff. 20 FM patients diagnosed according to American College of Rheumatology (ACR) criteria and 20 healthy controls who volunteered to participate in the study were selected from 64 outpatients and 24 hospital staff. All of the participants completed the study except 1 FM patient. Both groups had balneotherapy by the supervision of a physiotherapist for totally 3 weeks (15 sessions). Analysis of adrenocorticotropic hormone (ACTH), growth hormone (GH), cortisol and insuline like growth factor-1 (IGF-1) were done before and after the balneotherapy sessions at the first and the last days of the study in both of the groups. Pain is evaluated by the number of tender points (NTP) by a pressure algometer. Results: Both of the groups showed non-significant hormonal changes after balneotherapy session at the 1(st) day of the study, except IGF-1 increase in favor of FM patients. When the groups were compared by percent of changes, difference was found between the groups for change in GH, cortisol and IGF-1 levels. GH baseline values and IGF-1 were negatively correlated with the decrease in NTP in the FM patients. Conclusion: GH insensitivity and improper IGF-1 levels are observed in FM patients and it is found that decrease in tender points was in negative correlation with IGF-1 increase as a therapeutic response to balneotherapy.
IL-1 cluster gene polymorphisms in Turkish patients with Behçet's disease
(Wiley, 2011-08) Özçimen, Ahmet Ata; Dilek, Kamil; Bingöl, Ümit; Sarıcaoğlu, Hayriye; Sarandöl, Aslı; Taşkapılıoğlu, Özlem; Yurtkuran, Merih M.; Yurtkuran, Mustafa Abbas; Oral, Haluk Barbaros; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji ve Romatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0003-0463-6818; 0000-0003-4436-3797; AAK-6623-2020; K-7285-2012; X-4479-2018; 56005080200; 6507727900; 6603722836; 14020405100; 23037226400; 55408539300; 7003389525; 7004498001
Several cytokine genes may play crucial roles in host susceptibility to Behcet's Disease (BD), since the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the IL-1 cluster gene polymorphisms with the development of BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD, and 77 healthy control subjects. All genotyping (IL-1 alpha, IL-1 beta, IL-1R and IL-1Ra) experiments were performed using sequence specific primers PCR (PCR-SSP). When compared to the healthy controls, the frequencies of IL-1Ra IL-1 alpha and IL-1R gene polymorphisms were not significantly different in BD patients. The frequency of IL-1 beta -511 TT genotype was higher in the BD group in comparison to the control group. Interestingly, we demonstrated that IL-1 beta +3962 gene polymorphism seems to be associated with the presence of Erythema nodosum in BD patients. Our data suggest that polymorphisms in IL-1 beta gene may affect host susceptibility to BD. In order to confirm the biological significance of our results, further studies should be performed in a large-scale study and/or in different ethnic groups.
Interleukin-4 gene polymorphisms confer Behcet's disease in Turkish population
(Wiley, 2011-06) Özçimen, Ahmet Ata; Oral, Haluk Barbaros; Dilek, Kamil; Taşkapılıoğlu, Özlem; Bingöl, Ümit; Sarandöl, Aslı; Sarıcaoğlu, Hayriye; Yurtkuran, Merih M.; Yurtkuran, Mustafa Abbas; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji ve Romatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; 0000-0003-0463-6818; K-7285-2012; 7004498001; 56005080200; 23037226400; 6507727900; 14020405100; 6603722836; 55408539300; 7003389525
Several cytokine genes may play crucial roles in host susceptibility to Behcet's Disease (BD), because the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the IL-4 and IL-4R alpha gene polymorphisms with the susceptibility to BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD and 76 healthy control subjects. All genotyping (IL-4 and IL-4R alpha) experiments were performed using PCR sequence-specific primers. When compared with the healthy controls, the frequency of IL-4 -1098 TG and -590 CT genotypes was higher in the patients with BD. Analysis of allele frequencies showed that IL-4 -1098 G and IL-4 -590 T alleles were more common in the patients with BD when compared with healthy controls. Also, IL-4 TTC and haplotypes were found to confer BD. Interestingly, we demonstrated that IL-4R alpha gene polymorphism seems to be associated with the Pathergy test positivity in patients with BD. Our data suggest that IL-4 gene promoter polymorphisms may affect susceptibility to BD and increase risk of developing the disease. However, in order to confirm and assess the association of IL-4 and IL-4R alpha gene polymorphisms with the BD, large cohort studies are needed.
Investigation of the effect of GaAs laser therapy on lateral epicondylitis
(Mary Ann Liebert, 2010-06) Emanet, Saniye Konur; Altan, Lale İnceoğlu; Yurtkuran, Merih M.; Uludağ Üniversitesi/Tıp Fakültesi/Fizik Tedavi ve Rehabilitasyon Anabilim Dalı.; AAH-1652-2021; 36140090600; 6603281363; 55408539300
Background and Objective: There are conflicting reports regarding the efficacy of low energy laser therapy in treatment of lateral epicondylitis (LE). Contradictory results are considered to be due to different joint treatment protocols regarding variables such as dose, duration, and frequency. The aim of this study was to investigate the efficacy of gallium-arsenide (GaAs) laser therapy, which was performed with the dose regimen recommended by the World Association for Laser Therapy, in relieving pain and improving functional activities in patients with LE. Patients and Methods: Forty-nine patients (50 elbows) evaluated in our outpatient clinic were included in the study. Elbows were randomized into two groups: laser (n = 25) and placebo laser (n = 25). Either laser or placebo laser therapy was applied to patients for 15 sessions (5 d per week for 3 weeks). Main outcome measures were visual analog scale, tenderness, Disability of the Arm Shoulder and Hand (DASH) questionnaire, the Patient-Related Lateral Epicondylitis Evaluation (PRTEE) test, pain-free grip strength, and the Nottingham Health Profile (NHP) questionnaire. Evaluations were performed before treatment, at the end of 3 weeks of treatment, and after the 12th week of treatment ended. Results: Upon post-treatment evaluation, a significant improvement in all parameters was observed for both groups (p < 0.05). No significant difference was found when the laser and placebo groups were compared. At the 12 week evaluation, a significant sustained improvement in all parameters was observed. On intergroup evaluation, a significant improvement was observed in favor of the active treatment group regarding pain with resisted extension of the wrist, tenderness with pressure, and for both the total and subgroup scores of the DASH questionnaire and PRTEE test, as well as for the pain subgroup of the NHP questionnaire (p < 0.05). Conclusion: Although low energy laser therapy had no advantage compared to placebo in patients with LE for the short term, a significant improvement, particularly in functional parameters, was achieved in the long term. Laser, which has relatively no side effects, might be included among long-term treatment options for LE.
Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire
(Springer, 2013-11) Yurtkuran, Merih M.; Bingöl, Ümit; Uludağ Üniversitesi/Tıp Fakültesi/Fizik Tedavi ve Rehabilitasyon Anabilim Dalı.; EGT-2006-2022; JLG-9743-2023; 55408539300; 6507727900
The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire is a disease-specific measure of needs-based quality of life developed in the UK and the Netherlands. This study describes translation, validation, and reliability of the scale into Turkish population. The ASQoL was translated into Turkish using the dual-panel process. Content validity was assessed via cognitive debriefing interviews with ankylosing spondylitis (AS) patients. Patients with AS according to modified New York criteria were recruited into the study from 12 hospitals of all part of Turkey. Psychometric and scaling properties were assessed via a two administration survey involving the ASQoL, the Nottingham Health Profile (NHP), Bath AS Functional Index (BASFI), and Bath AS Disease Activity Index (BASDAI). Classical psychometrics assessed reliability, convergent validity (correlation of ASQoL with NHP, BASFI, and BASDAI) and discriminative validity (correlation of ASQoL with perceived AS-severity and general health). Cognitive debriefing showed the new Turkish ASQoL to be clear, relevant, and comprehensive. Completed survey questionnaires were received from 277 AS patients (80 % Male, mean age 42.2/SD 11.6, mean AS duration 9.4 years/SD 9.4). Test-retest reliability was excellent (0.96), indicating low random measurement error for the scale. Correlations of ASQoL with NHP sections were low to moderate (NHP Sleep 0.34; NHP Emotional Reactions 0.83) suggesting the measures assess related but distinct constructs. The measure was able to discriminate between patients based on their perceived disease severity (p < 0.0001) and self-reported general health (p < 0.0001). The Turkish version of ASQoL has good reliability and validity properties. It is practical and useful scale to assess the quality of life in AS patients in Turkish population.