[Purpose] This prospective longitudinal study evaluated the changes in bone metabolism markers an... more [Purpose] This prospective longitudinal study evaluated the changes in bone metabolism markers and bone mineral density of spinal cord injury patients over 3 years. We also assessed the relationships among the bone mineral density, bone metabolism, and clinical data of spinal cord injury patients. [Subjects and Methods] We assessed the clinical data (i.e., immobilization due to surgery, neurological status, neurological level, and extent of lesion) in 20 spinal cord injury patients. Bone mineral density, and hormonal and biochemical markers of the patients were measured at 0, 6, 12, and 36 months. [Results] Femoral neck T score decreased significantly at 36 months (p < 0.05). Among the hormonal markers, parathyroid hormone and vitamin D were significantly elevated, while bone turnover markers (i.e., deoxypyridinoline and osteocalcin) were significantly decreased at 12 and 36 months (p < 0.05). [Conclusion] Bone mineral density of the femoral neck decreases significantly during the long-term follow-up of patients with spinal cord injury due to osteoporosis. This could be due to changes in hormonal and bone turnover markers.
European journal of physical and rehabilitation medicine, 2010
Management of the lower urinary tract is crucially important in patients with spinal cord injurie... more Management of the lower urinary tract is crucially important in patients with spinal cord injuries in order to prevent damage to the upper urinary tract and to preserve renal function. This study was designed to compare the use of standard polyvinyl chloride (PVC), hydrophilic-coated, and gel-lubricated non-hydrophilic catheters with regard to urethral micro trauma, urinary system infection, and patient satisfaction in patients with spinal cord injuries. Study design. Randomized, controlled study. University hospital, inpatient clinic. Twenty-five male patients with spinal cord injuries. The patients were asked to use 3 different types of catheters. The selection of catheter order was determined randomly, and all 3 catheters were used for 6 weeks consecutively. All patients were assessed at the beginning of treatment and at weeks 6, 12, and 18, in terms of urethral cytology, urinalysis, urine culture, and patient satisfaction (Visual Analog Scale, VAS). Ten patients completed the st...
European journal of physical and rehabilitation medicine, 2009
The aim of the study was to compare the effects of conventional exercise (CE), swimming and walki... more The aim of the study was to compare the effects of conventional exercise (CE), swimming and walking on the pulmonary functions, aerobic capacity, quality of life, Bath indexes and psychological symptoms in patients with ankylosing spondylitis (AS). Forty-five patients were randomised into either swimming (group 1), walking (group 2), CE group (group 3). Patients in Group 1 performed CE and swimming, patients in Group 2 performed CE and walking and patients in Group 3 performed CE only. Exercise sessions were performed three times a week for a period of six weeks. Patients were assessed before and after the rehabilitation program, with respect to, pulmonary function test (forced vital capacity [FVC, mL], forced expiration volume in one second [FEV1, mL], FEV1/FVC (%) and vital capacity [VC, mL]), maximal oxygen uptake (pV.O2), 6-minute walking test (6MWT), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Met...
Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology, 2009
Spondylodiscitis is a serious and important clinical problem that can occur after iatrogenic inte... more Spondylodiscitis is a serious and important clinical problem that can occur after iatrogenic interventions and should be kept in mind. Spondylodiscitis after transrectal ultrasonography (TRUS)-guided prostate biopsy is an extremely rare complication. A 70-year-old patient who presented with severe back pain, intermittent high fever, loss of appetite, and fatigue following TRUS-guided prostate biopsy was diagnosed with thoracic spondylodiscitis (T6-7) after clinical, laboratory and radiological assessments and he was treated surgically. We present this case to remind medical professionals to keep spondylodiscitis in mind in the presence of sudden onset back and low-back pain, since TRUS-guided prostate biopsy is a frequently used procedure.
The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Functio... more The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Dougados Functional Index (DFI) and assess their reliability, validity, and sensitivity to change. The Turkish versions of the BASFI and DFI were obtained after a translation and back-translation process. Seventy-one patients with ankylosing spondylitis (AS) were included in the study. For investigation of the reliability of the BASFI and DFI, 36 of the patients recompleted both indices on the following day. To assess validity, the patients were evaluated with the Bath AS Disease Activity Index (BASDAI), Bath AS Metrology Index (BASMI), Bath AS Patient Global Score (BAS-G), physicians' assessment of disease activity, Bath AS Radiology Index-spine (BASRI-s) and sacroiliac joints, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). To assess the sensitivity to change, 16 patients were included in an 8-week home exercise program. In addition, 16 who had been on nonsteroidal anti-inflammatory drug (NSAID) treatment were requested to stop the treatment for 1 to 2 weeks. There were no significant differences in BASFI and DFI scores on two occasions within 24 h (P>0.05). The results showed correlations between both of the functional indices and the aforementioned validation parameters except ESR, CRP, and radiologic changes in the sacroiliac joints. The BASFI and DFI scores and BASMI and BASDAI values showed significant improvements in the home-exercise group. For the group of patients whose NSAIDs were stopped, BASFI, DFI, and BASDAI scores showed significant increase, whereas the mean BASMI score did not change. The results indicate that the Turkish versions of the BASFI and DFI are reliable, valid, and sensitive to change.
The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Disease... more The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and assess its reliability, validity, and sensitivity to change. The Turkish version was obtained after a translation and back-translation process. Seventy-one patients with ankylosing spondylitis were assessed with it. To assess its validity, patients were also evaluated with the Turkish version of the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and physicians' assessments of disease activity. Over 24 h, the Turkish BASDAI did not show significant differences between the two assessments (P>0.05). Correlations were found between BASDAI and all of the evaluation parameters except BASMI (P<0.01). Both BASDAI and BASMI showed significant improvements after 8-week home exercise programmes. The results of this study show that the Turkish version of the BASDAI is reliable, valid, and sensitive to change.
Background: Multiple sclerosis (MS) results in a wide range of functional limitations that can le... more Background: Multiple sclerosis (MS) results in a wide range of functional limitations that can lead to multiple disabilities. Symptoms arising from bladder dysfunction can profoundly affect various aspects of an individual's daily life. Therefore, in determining bladder problems and initiating the appropriate treatment, there is increasing interest in the use of wellconstructed questionnaires studying quality of life.The aim of the study was to demonstrate the reliability and validity of the Qualiveen scale in Turkish language in patients with MS. Methods: Thirty seven MS patients with urinary problems were included in the study. For analysis of test-retest reliability, Turkish version of Qualiveen scale developed by "translation-back translation" method was performed to patients on the day of admission and one week after admission. To assess validity, patients were also evaluated with the Multiple Sclerosis Quality of Life Scale (MQoL-54) and Expanded Disability Status Scale (EDSS) Results: Internal consistency (Intraclass correlation coefficient: 0.81-0.92) and test-retest reliability (Cronbach alpha score: 0.82-0.92) of Qualiveen were found to be high. All the subscores of Qualiveen questionnaire, except for the limitations sub-score, showed a significant correlation with MQoL-54 Physical Health (p<0.05). In addition, all the sub-scores of Qualiveen questionnaire, except for inconvenience and limitations sub-scores, showed a significant correlation with MQoL-54 Mental Health (p<0.05). Moreover, a significant correlation was found between all sub-scores of Qualiveen questionnaire and EDSS (p<0.05). Conclusion: The Turkish Qualiveen questionnaire is a comprehensive questionnaire for quality of life evaluations in patients with urinary dysfunction that has proved to be useful for MS patients.
Journal of Obstetrics and Gynaecology Research, 2014
The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in... more The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in late pregnancy or early post-partum period leading to fragility fracture(s), most commonly in the vertebral bodies. We presented two cases with PAO who had compression fractures at multiple levels involving five vertebrae in one case and 10 vertebrae in the other. Their spinal bone mineral density values were below -2.5 standard deviations. Anti-osteoporotic treatments with nasal calcitonin 400 IU/day, vitamin D 300.000 IU single dose, calcium 1000 mg/day, vitamin D 880 IU/day were initiated. In one case, kyphoplasty was performed by a spinal surgeon. In addition to a thoracolumbosacral orthosis, a rehabilitation program including muscle strengthening, range of motion, relaxation and weight-bearing exercises was started for both cases. These cases emphasize that all pregnant women with complaints of back/lumbar pain should be carefully evaluated.
International Journal of Rehabilitation Research, 2012
The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormaliti... more The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormalities detected by ultrasonography in complete and incomplete suprasacral spinal cord injury (SCI) patients with neurogenic detrusor overactivity. Thirty-eight suprasacral SCI patients who underwent ultrasonography evaluation of the UUT and urodynamic investigation were evaluated retrospectively. The mean maximum detrusor pressure was 51.08+28.71 cmH2O for the American Spinal Injury Association (ASIA)-A group and 61.42+30.93 cmH2O for the ASIA-B-E group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The mean cystometric capacity was 269.38+139.98 for the ASIA-A group and 223.36+135.59 ml for the ASIA-B-E group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Abnormalities in the UUT were found in 15.4% of the complete SCI patients and 16% of the incomplete SCI patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). No differences were found in urodynamic parameters and UUT abnormalities between the complete and the incomplete suprasacral SCI patients. Therefore, incomplete SCI patients should be observed with the same caution as complete SCI patients.
It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing sp... more It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing spondylitis (AS). Assessment of Spondyloarthritis International Society (ASAS) has recently published new criteria set for diagnosing IBP. In the present study, we evaluated the performance of the new ASAS IBP criteria and to compare the performance of IBP criteria sets in axial spondyloarthritis (axSpA) patients with and without radiographic sacroiliitis. The study sample included a total of 274 patients with a diagnosis of axSpA and 50 patients with a diagnosis of chronic (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;3 months) mechanical back pain (MBP). A face-to-face interview by using a standardized questionnaire addressing all the components of IBP was performed. Data about HLA-B27 status and C-reactive protein levels were obtained from the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts. There were significantly more male patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) in the AS group (68.6 %) than in the non-radiographic axSpA group (29.6 %) and also than in the MBP group (37.5 %). Among the criteria sets, the Calin criteria showed the best sensitivity (91.2 %), and the Berlin criteria showed the best specificity (82.4 %) in differentiation of IBP from MBP. If the morning stiffness item of the Calin criteria was defined as lasting &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 min (Calin 30), the specificity improved (72.9 %), but at a price of loss in sensitivity (82.4 %). In this study, new ASAS criteria for IBP performed almost as good as but not better than the existing criteria sets. Performances of the criteria sets were quite comparable in the differentiation of IBP from MBP in patients with and without radiographic sacroiliitis.
To compare the effects of trospium hydrochloride and electrical stimulation on urodynamic paramet... more To compare the effects of trospium hydrochloride and electrical stimulation on urodynamic parameters, bladder diary, quality of life and psychological symptoms in female patients with overactive bladder syndrome. Prospective, randomized controlled trial. Department of Physical Medicine and Rehabilitation, University Hospital. Thirty-five patients were divided into either trospium chloride (Group 1) or intravaginal electrical stimulation therapy (Group 2). All patients were assessed at the beginning of the treatment, at weeks 6 (end of treatment), 10 and 18 according to urodynamic parameters, voiding diary parameters, severity of urgency (visual analogue scale, VAS), the Incontinence Impact Questionnaire Short Form (IIQ-7), and the Beck Depression Inventory. Statistically significant improvements were observed in both groups according to some urodynamic parameters, voiding diary parameters, VAS urgency severity, Incontinence Impact Questionnaire Short Form and Beck Depression Inventory scores at the end of the treatment (P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). During the 18-week follow-up period, deteriorations were observed in many parameters in both groups although improvements in the frequency of urgency, the frequency of incontinence episodes, VAS urgency severity, and Beck Depression Inventory score in Group 2 persisted (P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Significant differences were not detected between groups at the end of the treatment or during the posttreatment follow-up controls (P&amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). No difference was detected between trospium hydrochloride and intravaginal electrical stimulation in the treatment of female overactive bladder syndrome. Discontinuation of both treatments caused deterioration in most of the objective and subjective symptoms of overactive bladder syndrome.
Multiple sclerosis is a chronic, immune-mediated disease of the central nervous system that typic... more Multiple sclerosis is a chronic, immune-mediated disease of the central nervous system that typically strikes young adults. It is often associated with a wide range of functional deficits and progressive disability. Common symptoms of multiple sclerosis include vision problems, spasticity, weakness, ataxia, bladder and bowel dysfunctions, fatigue, pain syndromes, tremors, vertigo, cognitive impairment, and mood disorders. Multiple sclerosis has a major negative impact on patient health-related quality of life (HRQoL). Quality of life (QoL) is a multidimensional construct composed of functional, physical, emotional, social and spiritual well-being. Researches have reported that individuals with multiple sclerosis have lower QoL than non-diseased and diseased populations. The inclusion of HRQoL questionnaires in the patient follow-up is a relevant issue to optimize treatment, facilitate treatment decisions and improve adherence, as well as to reduce the inconveniences derived from medication such as side effects.
[Purpose] This prospective longitudinal study evaluated the changes in bone metabolism markers an... more [Purpose] This prospective longitudinal study evaluated the changes in bone metabolism markers and bone mineral density of spinal cord injury patients over 3 years. We also assessed the relationships among the bone mineral density, bone metabolism, and clinical data of spinal cord injury patients. [Subjects and Methods] We assessed the clinical data (i.e., immobilization due to surgery, neurological status, neurological level, and extent of lesion) in 20 spinal cord injury patients. Bone mineral density, and hormonal and biochemical markers of the patients were measured at 0, 6, 12, and 36 months. [Results] Femoral neck T score decreased significantly at 36 months (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Among the hormonal markers, parathyroid hormone and vitamin D were significantly elevated, while bone turnover markers (i.e., deoxypyridinoline and osteocalcin) were significantly decreased at 12 and 36 months (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). [Conclusion] Bone mineral density of the femoral neck decreases significantly during the long-term follow-up of patients with spinal cord injury due to osteoporosis. This could be due to changes in hormonal and bone turnover markers.
European journal of physical and rehabilitation medicine, 2010
Management of the lower urinary tract is crucially important in patients with spinal cord injurie... more Management of the lower urinary tract is crucially important in patients with spinal cord injuries in order to prevent damage to the upper urinary tract and to preserve renal function. This study was designed to compare the use of standard polyvinyl chloride (PVC), hydrophilic-coated, and gel-lubricated non-hydrophilic catheters with regard to urethral micro trauma, urinary system infection, and patient satisfaction in patients with spinal cord injuries. Study design. Randomized, controlled study. University hospital, inpatient clinic. Twenty-five male patients with spinal cord injuries. The patients were asked to use 3 different types of catheters. The selection of catheter order was determined randomly, and all 3 catheters were used for 6 weeks consecutively. All patients were assessed at the beginning of treatment and at weeks 6, 12, and 18, in terms of urethral cytology, urinalysis, urine culture, and patient satisfaction (Visual Analog Scale, VAS). Ten patients completed the st...
European journal of physical and rehabilitation medicine, 2009
The aim of the study was to compare the effects of conventional exercise (CE), swimming and walki... more The aim of the study was to compare the effects of conventional exercise (CE), swimming and walking on the pulmonary functions, aerobic capacity, quality of life, Bath indexes and psychological symptoms in patients with ankylosing spondylitis (AS). Forty-five patients were randomised into either swimming (group 1), walking (group 2), CE group (group 3). Patients in Group 1 performed CE and swimming, patients in Group 2 performed CE and walking and patients in Group 3 performed CE only. Exercise sessions were performed three times a week for a period of six weeks. Patients were assessed before and after the rehabilitation program, with respect to, pulmonary function test (forced vital capacity [FVC, mL], forced expiration volume in one second [FEV1, mL], FEV1/FVC (%) and vital capacity [VC, mL]), maximal oxygen uptake (pV.O2), 6-minute walking test (6MWT), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Met...
Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology, 2009
Spondylodiscitis is a serious and important clinical problem that can occur after iatrogenic inte... more Spondylodiscitis is a serious and important clinical problem that can occur after iatrogenic interventions and should be kept in mind. Spondylodiscitis after transrectal ultrasonography (TRUS)-guided prostate biopsy is an extremely rare complication. A 70-year-old patient who presented with severe back pain, intermittent high fever, loss of appetite, and fatigue following TRUS-guided prostate biopsy was diagnosed with thoracic spondylodiscitis (T6-7) after clinical, laboratory and radiological assessments and he was treated surgically. We present this case to remind medical professionals to keep spondylodiscitis in mind in the presence of sudden onset back and low-back pain, since TRUS-guided prostate biopsy is a frequently used procedure.
The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Functio... more The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Dougados Functional Index (DFI) and assess their reliability, validity, and sensitivity to change. The Turkish versions of the BASFI and DFI were obtained after a translation and back-translation process. Seventy-one patients with ankylosing spondylitis (AS) were included in the study. For investigation of the reliability of the BASFI and DFI, 36 of the patients recompleted both indices on the following day. To assess validity, the patients were evaluated with the Bath AS Disease Activity Index (BASDAI), Bath AS Metrology Index (BASMI), Bath AS Patient Global Score (BAS-G), physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; assessment of disease activity, Bath AS Radiology Index-spine (BASRI-s) and sacroiliac joints, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). To assess the sensitivity to change, 16 patients were included in an 8-week home exercise program. In addition, 16 who had been on nonsteroidal anti-inflammatory drug (NSAID) treatment were requested to stop the treatment for 1 to 2 weeks. There were no significant differences in BASFI and DFI scores on two occasions within 24 h (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The results showed correlations between both of the functional indices and the aforementioned validation parameters except ESR, CRP, and radiologic changes in the sacroiliac joints. The BASFI and DFI scores and BASMI and BASDAI values showed significant improvements in the home-exercise group. For the group of patients whose NSAIDs were stopped, BASFI, DFI, and BASDAI scores showed significant increase, whereas the mean BASMI score did not change. The results indicate that the Turkish versions of the BASFI and DFI are reliable, valid, and sensitive to change.
The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Disease... more The aim of this study was to develop a Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and assess its reliability, validity, and sensitivity to change. The Turkish version was obtained after a translation and back-translation process. Seventy-one patients with ankylosing spondylitis were assessed with it. To assess its validity, patients were also evaluated with the Turkish version of the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; assessments of disease activity. Over 24 h, the Turkish BASDAI did not show significant differences between the two assessments (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Correlations were found between BASDAI and all of the evaluation parameters except BASMI (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Both BASDAI and BASMI showed significant improvements after 8-week home exercise programmes. The results of this study show that the Turkish version of the BASDAI is reliable, valid, and sensitive to change.
Background: Multiple sclerosis (MS) results in a wide range of functional limitations that can le... more Background: Multiple sclerosis (MS) results in a wide range of functional limitations that can lead to multiple disabilities. Symptoms arising from bladder dysfunction can profoundly affect various aspects of an individual's daily life. Therefore, in determining bladder problems and initiating the appropriate treatment, there is increasing interest in the use of wellconstructed questionnaires studying quality of life.The aim of the study was to demonstrate the reliability and validity of the Qualiveen scale in Turkish language in patients with MS. Methods: Thirty seven MS patients with urinary problems were included in the study. For analysis of test-retest reliability, Turkish version of Qualiveen scale developed by "translation-back translation" method was performed to patients on the day of admission and one week after admission. To assess validity, patients were also evaluated with the Multiple Sclerosis Quality of Life Scale (MQoL-54) and Expanded Disability Status Scale (EDSS) Results: Internal consistency (Intraclass correlation coefficient: 0.81-0.92) and test-retest reliability (Cronbach alpha score: 0.82-0.92) of Qualiveen were found to be high. All the subscores of Qualiveen questionnaire, except for the limitations sub-score, showed a significant correlation with MQoL-54 Physical Health (p<0.05). In addition, all the sub-scores of Qualiveen questionnaire, except for inconvenience and limitations sub-scores, showed a significant correlation with MQoL-54 Mental Health (p<0.05). Moreover, a significant correlation was found between all sub-scores of Qualiveen questionnaire and EDSS (p<0.05). Conclusion: The Turkish Qualiveen questionnaire is a comprehensive questionnaire for quality of life evaluations in patients with urinary dysfunction that has proved to be useful for MS patients.
Journal of Obstetrics and Gynaecology Research, 2014
The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in... more The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in late pregnancy or early post-partum period leading to fragility fracture(s), most commonly in the vertebral bodies. We presented two cases with PAO who had compression fractures at multiple levels involving five vertebrae in one case and 10 vertebrae in the other. Their spinal bone mineral density values were below -2.5 standard deviations. Anti-osteoporotic treatments with nasal calcitonin 400 IU/day, vitamin D 300.000 IU single dose, calcium 1000 mg/day, vitamin D 880 IU/day were initiated. In one case, kyphoplasty was performed by a spinal surgeon. In addition to a thoracolumbosacral orthosis, a rehabilitation program including muscle strengthening, range of motion, relaxation and weight-bearing exercises was started for both cases. These cases emphasize that all pregnant women with complaints of back/lumbar pain should be carefully evaluated.
International Journal of Rehabilitation Research, 2012
The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormaliti... more The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormalities detected by ultrasonography in complete and incomplete suprasacral spinal cord injury (SCI) patients with neurogenic detrusor overactivity. Thirty-eight suprasacral SCI patients who underwent ultrasonography evaluation of the UUT and urodynamic investigation were evaluated retrospectively. The mean maximum detrusor pressure was 51.08+28.71 cmH2O for the American Spinal Injury Association (ASIA)-A group and 61.42+30.93 cmH2O for the ASIA-B-E group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The mean cystometric capacity was 269.38+139.98 for the ASIA-A group and 223.36+135.59 ml for the ASIA-B-E group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Abnormalities in the UUT were found in 15.4% of the complete SCI patients and 16% of the incomplete SCI patients (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). No differences were found in urodynamic parameters and UUT abnormalities between the complete and the incomplete suprasacral SCI patients. Therefore, incomplete SCI patients should be observed with the same caution as complete SCI patients.
It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing sp... more It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing spondylitis (AS). Assessment of Spondyloarthritis International Society (ASAS) has recently published new criteria set for diagnosing IBP. In the present study, we evaluated the performance of the new ASAS IBP criteria and to compare the performance of IBP criteria sets in axial spondyloarthritis (axSpA) patients with and without radiographic sacroiliitis. The study sample included a total of 274 patients with a diagnosis of axSpA and 50 patients with a diagnosis of chronic (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;3 months) mechanical back pain (MBP). A face-to-face interview by using a standardized questionnaire addressing all the components of IBP was performed. Data about HLA-B27 status and C-reactive protein levels were obtained from the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts. There were significantly more male patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) in the AS group (68.6 %) than in the non-radiographic axSpA group (29.6 %) and also than in the MBP group (37.5 %). Among the criteria sets, the Calin criteria showed the best sensitivity (91.2 %), and the Berlin criteria showed the best specificity (82.4 %) in differentiation of IBP from MBP. If the morning stiffness item of the Calin criteria was defined as lasting &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 min (Calin 30), the specificity improved (72.9 %), but at a price of loss in sensitivity (82.4 %). In this study, new ASAS criteria for IBP performed almost as good as but not better than the existing criteria sets. Performances of the criteria sets were quite comparable in the differentiation of IBP from MBP in patients with and without radiographic sacroiliitis.
To compare the effects of trospium hydrochloride and electrical stimulation on urodynamic paramet... more To compare the effects of trospium hydrochloride and electrical stimulation on urodynamic parameters, bladder diary, quality of life and psychological symptoms in female patients with overactive bladder syndrome. Prospective, randomized controlled trial. Department of Physical Medicine and Rehabilitation, University Hospital. Thirty-five patients were divided into either trospium chloride (Group 1) or intravaginal electrical stimulation therapy (Group 2). All patients were assessed at the beginning of the treatment, at weeks 6 (end of treatment), 10 and 18 according to urodynamic parameters, voiding diary parameters, severity of urgency (visual analogue scale, VAS), the Incontinence Impact Questionnaire Short Form (IIQ-7), and the Beck Depression Inventory. Statistically significant improvements were observed in both groups according to some urodynamic parameters, voiding diary parameters, VAS urgency severity, Incontinence Impact Questionnaire Short Form and Beck Depression Inventory scores at the end of the treatment (P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). During the 18-week follow-up period, deteriorations were observed in many parameters in both groups although improvements in the frequency of urgency, the frequency of incontinence episodes, VAS urgency severity, and Beck Depression Inventory score in Group 2 persisted (P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Significant differences were not detected between groups at the end of the treatment or during the posttreatment follow-up controls (P&amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). No difference was detected between trospium hydrochloride and intravaginal electrical stimulation in the treatment of female overactive bladder syndrome. Discontinuation of both treatments caused deterioration in most of the objective and subjective symptoms of overactive bladder syndrome.
Multiple sclerosis is a chronic, immune-mediated disease of the central nervous system that typic... more Multiple sclerosis is a chronic, immune-mediated disease of the central nervous system that typically strikes young adults. It is often associated with a wide range of functional deficits and progressive disability. Common symptoms of multiple sclerosis include vision problems, spasticity, weakness, ataxia, bladder and bowel dysfunctions, fatigue, pain syndromes, tremors, vertigo, cognitive impairment, and mood disorders. Multiple sclerosis has a major negative impact on patient health-related quality of life (HRQoL). Quality of life (QoL) is a multidimensional construct composed of functional, physical, emotional, social and spiritual well-being. Researches have reported that individuals with multiple sclerosis have lower QoL than non-diseased and diseased populations. The inclusion of HRQoL questionnaires in the patient follow-up is a relevant issue to optimize treatment, facilitate treatment decisions and improve adherence, as well as to reduce the inconveniences derived from medication such as side effects.
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