Browsing by Author "Hiz, Ozcan"

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Complex Regional Pain Syndrome: a Vitamin K Dependent Entity
(Churchill Livingstone, 2010) Ediz, Levent; Hiz, Ozcan; Meral, Ismail; Alpayci, Mahmut
Complex regional pain syndrome (CRPS) is the complication of some injuries, such as a fracture, which affects the distal end of the injured extremity characterized by pain, allodynia, hyperalgesia, edema, abnormal vasomotor and sudomotor activity, movement disorders, joint stiffness, regional osteoporosis, and dystrophic changes in soft tissue. Exact pathogenic mechanism of CRPS is still unclear. Suggested pathogenic mechanisms of CRPS are evaluated in four major groups consist of classic inflammation, hypoxic changes and chronic ischemia, neurogenic inflammation and sympathetic dysregulation. All of these suggested pathogenic mechanisms produced by inflammatory cytokines mediated by nuclear factor kappaB. Vitamin K is a family of structurally similar, fat-soluble, 2-methyl-1,4-naphthoquinones. Vitamin K exerts a powerful influence on bone formation, especially in osteoporosis. Fat in bone stores some vitamin K. Gamma-carboxylation of the glutamic acid in osteocalcin is vitamin K dependent. Osteocalcin plays a role in calcium uptake and bone mineralization. Osteocalcin, the most abundant non-collagenous protein in bone, is produced by osteoblasts during bone matrix formation. Because osteocalcin is not carboxylated in case of vitamin K deficiency at the distal site of fracture or injury, it cannot bind to hydroxyapatite causing osteoporosis. Fracture starts a local inflammatory process in the fracture site and adjacent tissues as seen in CRPS. Vitamin K was shown to suppress the inflammatory cytokines and NF-kappaB and prevent oxidative, hypoxic, ischemic injury (which have key role in both initiation and progression of CRPS) to oligodendrocytes and neurons. We hypothesized that vitamin K has a key role and modulatory effect in CRPS pathogenesis. Vitamin K deficiency at the distal site of fracture occurs because of diminished and slowed circulation, local immobilization after extremity fracture or injury and use of vitamin K store at the distal site of the injured extremity and in the circulation for fracture healing and bone remodelling. In case of vitamin K deficiency at the distal site of fracture, classic inflammation starts with fracture at the distal tissues could not be restricted and classic inflammation, hypoxic changes, chronic ischemia, neurogenic inflammation, sympathetic dysregulation, which are the pathogenic mechanisms of CRPS, and patchy osteoporosis which occur due to high level of under-carboxylated osteocalcin could not be prevented. Briefly vitamin K level decreases in the distal site of the injured extremity consequently resulting in patchy osteoporosis due to high level of under-carboxylated osteocalcin and unrestricted inflammation which are the cause for both initiation and progression of CRPS. (C) 2010 Elsevier Ltd. All rights reserved.
The Effect of Anti-Ccp Antibodies on Synovial Fluid Oxidant and Anti-Oxidant Activities in Patients With Rheumatoid Arthritis
(Oxford Univ Press, 2011) Ediz, Levent; Tuluce, Yasin; Ozkol, Halil; Hiz, Ozcan; Gulcu, Elif; Toprak, Murat
Effects of Behcet's Disease on Sexual Function and Psychological Status of Male Patients
(Wiley-blackwell, 2011) Hiz, Ozcan; Ediz, Levent; Gulcu, Elif; Tekeoglu, Ibrahim
Introduction. There are no studies on the sexual function of male patients with Behcet's disease (BD), but it is probable that male sexual dysfunction may be seen in this chronic condition. Aim. The aim of this study was to assess the effect of BD on male sexual function and psychiatric status, and to examine the relationship between sexual function and depression in this population. Methods. Patients with a diagnosis of BD for at least one year were included in the study. The patients' age, educational level, and duration of disease were recorded. A healthy control group was selected with highly similar characteristics to the patient group. The sexual functions of the patient and the control groups were assessed using the International Index of Erectile Functions (IIEF), and their emotional status was evaluated using the Beck Depression Inventory (BDI). Main Outcome Measures. The results of the questionnaires in patient and control groups were compared. The relationship between the clinical findings and questionnaire scores was assessed in the patient group. Results. Forty-two patients with BD and 42 healthy individuals were included in the study. The mean subscale scores of the IIEF for erectile function were significantly lower in the patient group compared to the control group (P<0.001). The IIEF score was not related to active skin findings, active oral ulcers, active genital ulcers, eye involvement, or medication for BD, but it was related with history of arthritis. The BDI and IIEF scores were negatively correlated in the patient group. Conclusion. BD has a negative impact on men's psychological state and sexual function. We recommend that depression and sexual dysfunction be investigated and treated while assessing patients with BD. Hiz O, Ediz L, Gulcu E, and Tekeoglu I.. Effects of Behcet's disease on sexual function and psychological status of male patients. J Sex Med 2011;8:1426-1433.
The Effects of Helicobacter Pylori Eradication on the Number of Tender Points, Sleep Quality, Depression, and Anxiety in Patients With Fibromyalgia
(Turkish League Against Rheumatism, 2014) Gezici, Emrullah; Alpayci, Mahmut; Ozkan, Yasemin; Kucuk, Mehmet Emin; Unver, Hakan; Hiz, Ozcan
Objectives: This study aims to investigate the effects of Helicobacter pylori (H. pylori) eradication on the number of tender points, sleep quality, depression, and anxiety in patients with fibromyalgia syndrome. Patients and methods: The study was performed on 32 fibromyalgia syndrome patients (28 females, 4 males; mean age 38.5 +/- 8.6 years) suffering from dyspeptic complaints. All participants were evaluated by gastric endoscopy and bacterial culture for the presence of H. pylori. Patients included in the study were all H. pylon positive. The patients were assessed by the number of tender points, the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, and the Beck Anxiety Inventory pre- and post-treatment for eradication of H. pylon. Amoxicillin 1 g, clarithromycin 500 mg, and lansoprazole 30 mg were given twice daily for three weeks to all patients. Results: The number of tender points was significantly reduced at the evaluation of post-treatment compared with baseline (p<0.001). However, there were no significant differences between pre- and post-treatment for the scores of the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, and the Beck Anxiety Inventory (all p>0.05). Conclusion: Our study results show that H. pylon eradication has a positive impact on the number of tender points.
An Emergency Medical Situation in Rehabilitation Medicine: Autonomic Dysreflexia
(Aves, 2010) Ediz, Levent; Al, Behcet; Hiz, Ozcan
Autonomic dysrefl exia (AD), is an acute syndrome of uncontrolled sympathetic response, secondary to a precipitant, that generally occurs in patients with injury to the spinal cord at the levels of T6 and above. Recognition of the clinical features is extremely important because, although the condition can nearly always be managed successfully, failure to do so can have dire consequences, including death. In this review we discussed the clinical features, pathophysiology, emergency treatment and prophylaxis of AD.
Is Muscle-Sparing Thoracotomy Advantageous
(Ekin Tibbi Yayincilik Ltd Sti-ekin Medical Publ, 2011) Cobanoglu, Ufuk; Hiz, Ozcan; Melek, Mehmet; Edirne, Yesim
Background: The aim of this study was to compare muscle-sparing thoracotomy for the latissimus dorsi and the serratus anterior muscles (MST-L), and muscle-sparing thoracotomy for serratus anterior muscle (MST-S) with each other and with standard posterolateral thoracotomy (SPLT) in terms of advantages and disadvantages. Methods: Sixty patients (18 females, 42 males; mean age 42.6 +/- 16.6 years; range 15 to 72 years) in whom thoracotomy was indicated were randomly grouped into three categories. The groups were compared in terms of the effects of thoracotomy on shoulder range of motion, muscle strength, pulmonary function, postoperative pain, and duration of hospitalization. Results: Shoulder range of motion and serratus anterior muscle strength in the SPLT group were significantly lower than in the other groups. The latissimus dorsi muscle strength in the MST-L group was significantly better than that of the other groups. The parameters of pulmonary function on days 3 and 7 in the MST-L group were significantly better than those of the other groups. The duration of hospitalization in the MST-L group was significantly shorter than that of the other groups. Conclusion: The improvement of pulmonary function occurs earlier in thoracotomies that spare the chest wall muscles, and postoperative complications due to detachment are decreased. Although there is a better field of view in SPILT and MST-S than that of MST-L, considering the other advantages of MST-L, we recommend initiating with MST-L in all thoracotomies, except in emergency cases.
Multifocal Osteonecrosis in a Case With Systemic Lupus Erythematosus: Original Image
(Ortadogu Ad Pres & Publ Co, 2009) Hiz, Ozcan; Unver, Hakan; Ozkan, Yasemin; Yazmalar, Levent; Tekeoglu, Ibrahim
Although osteonecrosis (ON) is a well-known complication of systemic lupus erythematosus (SLE), the diagnosis is generally delayed. Steroid treatment is considered the major risk factor for the development of ON in SLE. ON involving at least tree anatomical localizations is called multifocal osteonecrosis (MFON). We presented a case with MFON diagnosed with SLE seven years ago. The patient has received corticosteroids at various doses and had obvious destruction in the shoulders and hips apparent in plain X-rays. Although the knees seemed normal in X-rays, scintigraphy and magnetic resonance imaging (MRI) revealed ON of the knees. SLE patients with ON in one joint should be screened with MRG and/or scintigraphy in the early stages of the disease even when the plain X-rays seem normaldue to the increased risk of multifocal ON involving other joints.
Overlap of Multiple Sclerosis and Antiphospholipid Syndrome
(Turkish League Against Rheumatism, 2009) Tekeoglu, Ibrahim; Tombul, Temel; Hiz, Ozcan; Gulcu, Elif; Toprak, Murat
Antiphospholipid syndrome (APS) and multiple sclerosis (MS) are two diseases that may show similar clinical and radiological findings and sometimes cause confusion. In the presence of thrombosis, repetitious abortion history, and lupus anticoagulant antibodies or anticardiolipin antibodies, APS should be considered. However, in previous studies, autoantibody levels were detected as being high in MS patients when compared to the normal population. Laboratory study of a patient with fever, fatigue, joint pain and cyanosis in the ankles since 1995 and history of two abortions at 6 weeks gestation revealed: C-reactive protein: (++++), erythrocyte sedimentation rate: 70 mm/hour, antinuclear antibodies: 1/1000 homogeneous, and LE cell positivity. Brain magnetic resonance imaging, visual evoked potantial, somatosensorial evoked potential, and oligoclonal band investigations of the patient, who applied to the Neurology Clinic of the hospital in 1999 with complaints of disruption in walking, imbalance and fatigue, were found compatible with MS. The patient had suffered from recurrent attacks and had been directed to our clinic with probable diagnosis of systemic lupus erythematosus when pain in knees and macular style skin lesion on the right ankle finally developed in 2007. Investigations conducted at six-month time intervals revealed anticardiolipin IgG: positive, anticardiolipin IgM: negative and antinuclear antibody (ANA): positive. When ANA and anticardiolipin IgG positivity and abortion history of the patient were evaluated together, APS accompanying MS was diagnosed and 100 mg aspirin was added to the treatment. In conclusion, MS and APS can not only appear together but may also imitate each other. Thus, cases diagnosed as MS should be carefully evaluated in terms of clinical and laboratory findings of APS. (Turk J Rheumatol 2009; 24: 106-9)
Paraplegia Due To Spinal Extradural Hydatid Disease and Syringomyelia After Surgical Intervention: a Case Report
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2011) Ediz, Levent; Tekeoglu, Ibrahim; Ceylan, Mehmet Fethi; Avcu, Serhat; Hiz, Ozcan
Primary spinal hydatid cysts are extremely rare and account for about 0.5-1% of all cases of hydatid disease. Syringomyelia is a cystic cavitation of the spinal cord containing fluid that is identical or similar to the cerebrospinal (CSF) and extracellular (ECF) fluids. Here, we report the first case in the literature of a patient with paraplegia due to primary extradural hydatid cyst who developed a syrinx after surgery. Turk J Phys Med Rehab 2011;57:182-5.
Pes Cavus and Charcot Marie Tooth Disease: a Case Report and Brief Review of the Literature
(derman Medical Publ, 2011) Edizi, Levent; Hiz, Ozcan; Ceylon, Mehmet Fethi; Toprok, Murat, I; Ozkant, Yasemin
Charcot-Marie-Tooth (CMT) is a disease that is highly heterogeneous, both clinically and genetically. Clinical and electrophysiological data are essential for diagnosis. Children with CMT experience acquired foot weakness, contracture and deformity (pes cavus and hammer toes) from an early age. Early intervention targeting the foot and ankle may prevent long-term disability in CMT. Here we present a CMT patient with acquired pes cavus and hammer toes and review the literature briefly for diagnosis, treatment, and rehabilitation of CMT. As a result we conclude that CMT should also come into mind in the differential diagnosis of acquired pes cavus and hammer toes.
Physical Medicine and Rehabilitation Consultations in Patients Hospitalized in a University Hospital
(derman Medical Publ, 2011) Hiz, Ozcan; Ediz, Levent; Toprak, Murat; Tekeoglu, Ibrahim
Aim This study was designed to overview our limitations, the point of view of other clinical disciplines about our department, and to outline the sphere of our interests by analysing the consultation data requested from the Department of Physical Medicine and Rehabilitation (PM& R) for patients hospitalized in other departments. Material and Methods This trial was performed using the data of consultations made by our PM& R department in patients hospitalized in other clinical departments between December 2007 and December 2008. The department which requested the consultation, the reason for the consultation request, the diagnosis made and the treatment recommended by our PM& R Department were all recorded. The results were given in the number of patients and percentages. Results A total of 373 consultations were requested by 17 different departments (186 females and 187 males) throughout the study. The most common diagnoses made by our department were neurological and rheumatological diseases. Conclusions The results of our study suggest that our department is primarily regarded as a rehabilitation unit, while it is also known as a therapeutic clinic, particularly for rheumatological diseases, which we mainly attribute to the presence of a rheumatology division in our department. In the light of our findings, we concluded that diagnosis and therapy of rheumatological diseases should be particularly included in the educational programs of PM& R residents.
Pleuropericarditis Associated With Sulphasalazine in a Case of Rheumatoid Arthritis: a Drug-Induced Lupus-Like Syndrome
(Turkish League Against Rheumatism, 2011) Hiz, Ozcan; Gulcu, Elif; Ozkan, Yasemin; Tekeoglu, Ibrahim; Aladag, Nesim
Pericarditis, a life-threatening condition, can be seen in rheumatic diseases. It may occur secondary to rheumatic diseases or drugs used in the treatment. In this article, we present a case of 47-year-old female, who had joint complaints for 15 years and had treatment of methotrexate and corticosteroid for six years. In the last three months, after the addition of sulphasalazine to her treatment, she developed chest pain, palpitations, rash, fever, and pleuropericarditis and was subsequently diagnosed with systemic lupus erythematosus induced by sulfasalazine. When cardiac disease is seen in a patient with rheumatoid arthritis, medication should be discontinued immediately, and it should be kept in mind that cardiac involvement may be associated with drugs.
The Prevelance of Restless Legs Syndrome in Turkish Patients With Rheumatoid Arthritis
(Oxford Univ Press, 2011) Ediz, Levent; Hiz, Ozcan; Ceylan, Mehmet Fethi; Toprak, Murat; Tekeoglu, Ibrahim
Pulmonary Involvement in Rheumatic Diseases: Hrct Findings
(derman Medical Publ, 2011) Tokeoglu, Ibrahnn; Hiz, Ozcan; Ozbay, Bulent; Toprak, Murat; Avcu, Serhat
Aim Systemic rheumatic disease (SRD) may affect all the components of the pulmonary system. This study was designed to investigate the frequency and pattern of pulmonary involvement of systemic collagen tissue diseases. Material and Methods A total of 128 patients -44 with rheumatoid arthritis (RA), 8 with giant cell arteritis, 14 with systemic lupus erythematosus (SLE), 8 with juvenile chronic arthritis, 24 with ankylosing spondylitis (AS), 6 with scleroderma, 12 with Behcet's disease, 4 with mixed connective tissue disease (MCTD), 4 with polymyositis and 4 with dermatomyositis-who had presented to the Department of Physical Medicine and Rehabilitation/Rheumatology between January 2007 and December 2008 were included in the study. All the patients were informed about the study in detail and all gave written consent before enrollment. HRCT was performed in all patients. Results Pulmonary involvement was detected in 21 patients with RA (48%), in 8 patients with SLE (57%), in 16 patients with AS (67%), in 4 patients with scleroderma (67%), and in 4 patients with MCTD (50%). No pulmonary involvement was observed in patients with Behcet's disease, polymyositis and dermatomyositis. Conclusions Our results suggest that patients with SRD may present with pulmonary involvement in varying degrees. Pulmonary symptoms may be underdiagnosed due to limited capacity of exercise secondary to musculoskeletal involvement. Therefore, a routine pulmonary X-ray should be performed in the process of the diagnosis and prior to treatment, even in the lack of complaints suggesting pulmonary involvement. Further investigations including HRCT should be performed if needed.
A Randomized Controlled Trial of Electrostimulation Effects on Effussion, Swelling and Pain Recovery After Anterior Cruciate Ligament Reconstruction: a Pilot Study
(Sage Publications Ltd, 2012) Ediz, Levent; Ceylan, Mehmet Fethi; Turktas, Ugur; Yanmis, Ibrahim; Hiz, Ozcan
Objective: To evaluate rehabilitation results of electrostimulation especially on joint effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. Design: A randomized controlled trial; the assessor was not blinded to the group allocation. Setting: Orthopaedics-traumatology and physical medicine-rehabilitation departments. Subjects: Twenty-nine consecutive patients underwent anterior cruciate ligament reconstruction. Interventions: Both groups began the voluntary exercise protocol one day post-surgery. The intervention group (n = 15) also received 30 sessions electrostimulation treatment protocol started four days after the operation. Main measures: Numerical bulge-dancing patella signs for effusion assessment; differences in circumferences of the mid-centre of the patella between operated and non-operated knees for swelling assessment. Aself-report of average daily resting pain assessed by visual analogue scale; Intenational Knee Documentation Committee scoring system and Tegner Activity Scale for subjective response assessment. Results: Twenty-six subjects including 13 patients from the intervention group completed the study. Significantly less effusion and swelling were determined in the intervention group after seven days (1.8 +/- 1.3 versus 2.4 +/- 1.7 for effusion and 1.7 +/- 1.2 versus 3.4 +/- 1.5 for swelling) to 12 weeks (0.2 +/- 0.7 versus 0.6 +/- 0.8 for effusion and 0.2 +/- 0.8 versus 0.8 +/- 0.9 for swelling) postoperative (P < 0.05). Patients treated with electrostimulation had significantly lower pain scores from seven days up to 12 weeks after the operation (P < 0.05). Conclusion: Electrostimulation along with exercise therapy appears superior to exercise alone regarding knee effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. Still, there is need for further clinical studies using a radiologic method to demonstrate this effect of electrostimulation.
A Randomized Controlled Trial on the Efficacy of Intermittent and Continuous Traction for Patients With Knee Osteoarthritis
(Sage Publications Ltd, 2013) Alpayci, Mahmut; Ozkan, Yasemin; Yazmalar, Levent; Hiz, Ozcan; Ediz, Levent
Objective: To investigate the efficacy of intermittent and continuous traction in the treatment of knee osteoarthritis. Design: A randomized, controlled, observer-blind seven-week trial. Setting: Hospital-based outpatient practice. Subjects: Ninety-eight patients with stage 3 knee osteoarthritis according to Kellgren-Lawrence radiological rating scale. Interventions: All 98 patients were randomly assigned to three treatment groups, for three weeks (weekends excluded). The control group (n=30, mean age: 59.30 +/- 8.16) received hot pack and short wave diathermy; the intermittent group (n=30, mean age: 58.20 +/- 7.78) received hot pack, short wave diathermy and intermittent traction; and the continuous group (n=30, mean age: 57.97 +/- 9.53) received hot pack, short wave diathermy and continuous traction. Outcome measurements: The values of the Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale, and knee passive range of motion were measured at baseline, three-week and seven-week follow-up. Results: Compared with baseline at weeks 3 and 7, all the outcome measures, except range of motion, were significantly reduced in all groups (all P <= 0.001). In terms of the change data from baseline to week 3, both traction groups were significantly superior to the control in the WOMAC physical function scores. Considering the change data from baseline to week 7, both traction groups were significantly superior to the control in the pain scores, physical function and total scores, while only the continuous group was significantly better than the control in the stiffness scores (control: 1.17 +/- 1.64; continuous: 2.38 +/- 1.44) (P=0.014). Compared with baseline at weeks 3 and 7, range of motion values significantly increased in both traction groups (P < 0.05) but not in the control (P > 0.05). However, there were no significant differences among the three groups considering the change data from baseline to week 7 in range of motion values (P=0.300). Conclusions: Joint traction was found to be beneficial for the improvement of pain and physical function loss related to knee osteoarthritis.
Relationship Between Anti-Ccp Antibodies and Oxidant and Anti-Oxidant Activity in Patients With Rheumatoid Arthritis
(Ivyspring int Publ, 2011) Ediz, Levent; Hiz, Ozcan; Ozkol, Halil; Gulcu, Elif; Toprak, Murat; Ceylan, Mehmet Fethi
Objective/Aim: A new group of autoantibodies in Rheumatoid Arthritis (RA), the anti-cyclic citrullinated peptide (anti-CCP) antibodies directed to citrulline-containing proteins, which are of value for the severity of RA. Up to date, the relationship between anti-CCP antibodies and oxidant, anti-oxidant activity in patients with RA has not been elucidated in the previous studies. In this study we aimed to investigate the effect of anti-CCP antibodies in the circulation on whole blood, serum and synovial fluid oxidant and anti-oxidant activity in patients with RA. Materials and Methods: RA patients with anti-CCP (+) (n=25) and anti-CCP (-) (n=24) were recruited into the study. All patients had a positive rheumatoid factor (RF). The patients who were under treatment with only non-steroidal antiinflammatory drugs (NSAID) at the study time included in the study. Catalase (CAT), Glutathione peroxidase (GSHPx), Myeloperoxidase (MPO) activities and the levels of Malondialdehyde (MDA) were measured in whole blood, serum and synovial fluid in both groups. Results: There were no significant differences in terms of the mean whole blood and serum antioxidative activity (CAT, GSHpx) and the mean blood and serum MDA and MPO values (oxidative activity), between the patients with anti-CCP(+) and those with anti-CCP(-). There was increased synovial oxidant activity (MDA and MPO levels) (p<0.05) in anti-CCP(+) RA patients with or without ESR negativity when compared with anti-CCP(-) RA patients. There was positive correlation between anti-CCP antibody levels and synovial MDA and MPO levels (r=0.435, p<0.05, r=0.563, p<0.05 respectively) in anti-CCP (+) group. Conclusions: In conclusion, anti-CCP antibody positivity seems to be associated with increased synovial fluid oxidant activity (increased MDA and MPO levels) in patients with RA. These conclusions need to be validated in a larger controlled study population.
The Relationship Between Chronic Low Back Pain and Bone Mineral Density in Young and Middle-Aged Males
(Galenos Yayincilik, 2012) Hiz, Ozcan; Ediz, Levent; Ercan, Songul; Arslan, Mehmet; Avcu, Serhat; Tekeoglu, Ibrahim
Objective: In this study, we investigated the relationship between chronic low back pain and bone mineral density in a young and middle-aged male pdpulation. Materials and Methods: A total of 104 male patients with chronic low back pain were enrolled in the study. All subjects completed the Oswestry Disability Index (ODD. Additionally, the intervertebral disc degeneration (DD) was graded according to the Thompson's classification. After bone mineral density was measured the patients were divided into two groups: normal (n=50) and low (n=54) bone density groups. In addition, for comparing the data of patient sub-groups, bone mineral density was measured in 30 healthy subjects. Results: T and Z-scores of the L2 - L4 and the femoral neck were found to be significantly lower in the patient group compared to the control group. In the patient group, there was a positive correlation between the ODI score and the DD score. There were negative correlations between both the ODI score and the DD score and L2-L4 and femoral neck T scores and Z-score. The DD and ODI scores were found to be significantly higher in a patient with low bone density compared to a patient with normal bone density. Conclusion: We think that the low bone mineral density in young and middle-aged male patients with chronic lower back pain is related to disability and physical inactivity. Turk J Phys Med Rehab 2072;58:294-8.
The Severity of Periodontal Disease in Patients With Rheumatoid Arthritis: a Comparative Study
(Nobel Ilac, 2015) Ozkan, Yasemin; Alpayci, Mahmut; Ozkan, Mehmet; Hiz, Ozcan; Bozan, Nazim
Objective: There is an increasing interest in the associations between oral health and auto-inflammatory diseases. Rheumatoid arthritis (RA) and periodontal disease (PD) are the most common chronic inflammatory conditions often coexist as well. The aim of this study is to evaluate and compare RA patients and healthy controls in terms of PD severity and jaw gripping force. To our knowledge, there is only one study evaluating jaw gripping force of patients with RA in the literature. Material and Method: RA patients (n=60) and healthy controls (n=60) were included in the study. Both RA patients and the control group were examined for their gingival index, plaque index, probing dept, attachment loss, and number of teeth. In addition, jaw gripping forces of all participants were measured by digital dynamometer. The data obtained were compared between two groups. Results: There were no significant differences in participants' age, gender, body mass index, education level, frequency of tooth brushing and smoking between two groups (all, p>0.05). RA patients' scores were significantly lower compared to controls considering the number of teeth (respectively, 16 and 20; p<0.001) and jaw gripping force (respectively, 0.6 and 1.30; p<0.001). Conclusion: There is a strong association between RA and PD. The severity of PD is significantly increased in RA patients compared to healthy controls. Periodontal health should be considered in the management of patients with RA.
Shoulder Subluxation and Shoulder-Hand Syndrome After Stroke; Effect of Brain Lesion Location and Side
(derman Medical Publ, 2011) Ediz, Levent; Hiz, Ozcan; Ceylan, Mehmet Fethi; Toprak, Murat
Aim The effect of brain lesion location and involved brain side in the development of shoulder subluxation (SS) and shoulder hand syndrome (SHS) is still unclear. The aim of the current study was to evaluate the relationships of SS and SHS with brain lesion location and stroke side. Material and Methods The inpatient files of the hemiplegic patients, who were hospitalized for rehabilitation, were evaluated resrospectively. Brain lesion location and involved hemisphere side were assessed by brain CT at the insult time. Brain lesion location groups were comprised as following 4 groups which included 35 patients in each group. Group I: Small superficial infarct. This type infarcts involve small area infarct (no more than 20 mm in diameter) on a cerebral lobe, such as a small right or left frontal lobe infarct. Group II: Large superficial infarct. Infarcts more than 20 mm in diameter on a cerebral lobe or two or more lobes of one cerebral hemisphere, such as a frontoparietal infarct in the left cerebral hemisphere or frontotemporo-parietal infarct in right or left cerebral hemisphere. Group III: Deep infarct. Infarcts of the internal capsule, basal ganglia or thalamus. Group IV: Combination of deep and large superficial infarcts (combined group II+III). Internal capsule or basal ganglia or thalamic infarct combined with fronto-temporal or fronto-parietal or temporoparieto- occipital infarct on one cerebral hemisphere. A total of 140 hemiplegic patients then devided into 2 groups according to the development of SS and/or SHS. Results A significant correlation was found between brain lesion locations and SS and/or SHS development. The groups with combined deep and large superficial, and large superficial infarcts showed more frequent SS and/or SHS development. Patients with SS and/or SHS had got low stages at baseline in the upper extremity according to upper extremity Brunnstroma level, upper extremity Ashworth stage and low stages of functional independence measure (FIM) scores. There wasn't significant difference in shoulder problem development in terms of involved hemisphere side. Conclusions In our study, brain lesion location especially combined deep and large superficial, and large superficial infarcts seem to be a predictor factor for development of SS and/or SHS. But involved hemisphere side is not a predictor factor. Prospective trials are needed to make definite conclusions.