Browsing by Author "Leblebici, Berrin"

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Autosomal Dominant Osteopetrosis Type II
(2015) Ozkan, Aslihan Kusvuran; Doruk, Pinar; Adam, Mehmet; Celik, Zerrin Yilmaz; Leblebici, Berrin; 0000-0002-3528-3712; 0000-0002-6241-268X; 0000-0001-9158-220X; 24898439; AAA-8043-2021; AAM-3220-2021; A-1229-2015; ABD-2882-2021
Osteopetrosis is a rare genetic disorder caused by osteoclast failure. Dominant negative mutations of the ClCN7 gene cause the so-called, autosomal dominant osteopetrosis type II, which represents the most frequent and heterogeneous form of osteopetrosis, ranging from asymptomatic to intermediate-severe, thus suggesting additional genetic and environmental determinants affecting penetrance. Here, we present a case a 46 year-old woman complained low back pain for 15 years. The patient lacked any history of direct trauma and her pain was radiating to her left leg, increasing with physical activity, she had no pain at nights. The patient was diagnosed with autosomal dominant osteopetrosis on the basis of the presence of typical radiological appearance. Were present a case report of osteopetrosis type II (an autosomal dominantly inherited disease) as a cause for low back pain without any familial penetrance of the disease.
Bifid median sinir anomalisinin karpal tünel sendromu gelişmesine etkisi
(Başkent Üniversitesi Tıp Fakültesi, 2015) Yılmaz, Emine Ece; Leblebici, Berrin
Karpal tünel sendromu (KTS) en sık görülen tuzak nöropatisidir. KTS’nin etiyolojisinde çeşitli nedenler bildirilmiştir. Bunlardan bir tanesi de median sinirin anatomik varyasyonu olan bifid median sinir anomalisi (BMS)’dir. BMS’nin normale göre daha çok hacim kaplama olasılığı nedeni ile sinirin tuzaklanma ihtimalini arttırdığı düşünülmektedir. Bu çalışmada sağlıklı bireylere göre KTS’li hastalarda BMS sıklığı açısından fark olup olmadığını ortaya koymayı ve böylece BMS’nin KTS gelişimine etkisine açıklık getirmeyi amaçladık. Bu amaçla, 138 KTS’li hastanın 267 eli ve 159 sağlıklı gönüllünün 318 eli değerlendirildi. Tüm olguların demografik verileri, ayrıca hasta grubunun Boston Anket Skalası (BAS) ve Görsel Analog Skala (GAS) sonuçları kaydedildi. Tüm olgulara elektronöromiyografi (EMG) ve BMS değerlendirmesi için ultrasonografi (USG) yapıldı. EMG’de median ve ulnar sinir iletim çalışmaları ve gerekli olgularda iğne EMG uygulandı. USG görüntülemede önkol volar yüzden tarama yapılarak BMS “var-yok” şeklinde kaydedildi, ayrıca median sinir transvers kesit alanı (TKA) ölçüldü. Hasta ve kontrol grubun sonuçları karşılaştırıldı. Hastalar, Padua ve ark.’nın sınıflaması esas alınarak KTS derecelerine göre 6 gruba ayrılarak da incelendi. Ayrıca BMS saptanan ve saptanmayan olguların sonuçları da karşılaştırıldı. BMS sıklığı 267 hasta elde %11,6, 318 sağlıklı elde %11,0 olarak bulundu ve bu açıdan hasta ve kontrol grubu arasında istatistiksel fark saptanmadı (p=0,82). Hastalar KTS derecelerine göre gruplara ayrıldığında en fazla BMS görülen gruplar sırasıyla çok ileri, erken ve ileri KTS grupları idi. BMS olan ve olmayan hasta grupta EMG sonuçları, BAS ve GAS skorları açısından istatistiksel anlamlı fark bulunmadı. TKA ile BMS arasında da korelasyon bulunamadı (r=0,083). Sonuç olarak; BMS sıklığının KTS’li ve sağlıklı bireylerde farklı olmadığı ortaya konuldu ve BMS’nin KTS gelişimine etki eden bağımsız bir faktör olmadığı yönünde sonuçlar elde edildi. Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Various causes are reported in CTS etiology. Bifid median nerve (BMN), which is a median nerve anomaly, is one of these conditions leading to CTS. It is considered that BMN would increase the chance of neural entrapment by occupying a larger space in the carpal tunnel. In this study, our goal is to determine whether there is a difference of BMN prevalence in patients with CTS compared to healthy population, thus to clarify the influence of BMN on development of CTS. 267 hands of 138 CTS patients and 318 hands of 159 healthy volunteers were evaluated. Demographic features for all subjects and results from Boston Carpal Tunnel Questionnaire (BCTQ) and visual analog scale (VAS) were recorded for patients. Electromyography (EMG) and for BMN evaluation, ultrasonography (USG) were performed. In EMG, median and ulnar nerve conduction studies and if necessary, needle EMG were applied. In USG, entire forearm were screened from volar aspect and results were recorded as “BMN” and “no-BMN”. In addition, transverse sectional area (TSA) of all median nerves were measured. Results from patient and control groups were compared. Moreover, patients were analyzed in 6 subgroups, divided according to the CTS severity classification of Padua et. al. Besides, results from BMN and no-BMN groups were compared. Prevalence of BMN was found as 11.6% in 267 hands of patients and 11.0% in 318 hands of healthy population and there was no statistically significant difference between the two groups (p=0.82). When patients were divided into 6 subgroups according to CTS severity, BMS was most frequent in extreme, early and severe CTS groups, respectively. Also there was no difference in BCTQ or VAS scores between BMN and no-BMN groups. Also no correlation was found between BMN and TKA (r=0.083). In conclusion, the prevalence of BMN in patients with CTS does not differ from the prevalence in healthy individuals and the results of this study indicate that BMN is not an independent factor affecting the development of CTS.
Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction
(2020) Ciloglu, Osman; Cicek, Hakan; Yilmaz, Ahmet; Ozalay, Metin; Soker, Gokhan; Leblebici, Berrin; 0000-0002-6241-268X; 32392610; AAM-3220-2021
This study compared the clinical and radiological findings of nonanatomic transtibial (TT) technique with intraspongious fixation and anatomical anteromedial portal (AMP) technique with extracortical button implant in anterior cruciate ligament (ACL) reconstruction. A total of 54 patients with isolated ACL rupture were included in this prospective study. The patients who had the intraspongious fixation by nonanatomical TT technique were allocated to Group 1 (n = 27). The patients with extracortical fixation by anatomical AMP technique were placed in Group 2 (n = 27). The clinical scores of the patients were evaluated with the International Knee Documentation Committee Evaluation Form, Tegner activity score, and Lysholm II Functional Scoring. The tibial and femoral tunnels were evaluated with three-dimensional computed tomography. The kinematic examinations were performed with a Biodex System 3 Pro isokinetic dynamometer. There was no significant difference between the groups in terms of demographic data (p > 0.05). The postoperative clinical scores improved significantly in both the groups compared with the preoperative levels (p = 0.001), but there was no significant difference in the postoperative clinical scores between the groups (p > 0.05). In the extension and flexion of 60 to 180 degrees/s, the peak torque and the peak torque/body weight values of the repaired knee to intact knee ratios showed significant differences in favor of Group 2 (p = 0.001). In both the groups, no significant difference was found between the mean extent of the tunnel enlargement (p > 0.05). The mean tunnel height was significantly greater in Group 1 (45% +/- 9.86 vs. 34.11% +/- 10.0%) (p = 0.001). When the localization of the tunnel enlargements (proximal-middle-distal) was examined, a significant difference was found between the groups (p = 0.001). Although the AMP technique, which is a more anatomic reconstruction, had an advantage with regard to tunnel enlargement and the isokinetic muscle studies, there was no difference between the two techniques in terms of the clinical results.
The Effect of Hemodialysis on Balance Measurements and Risk of Fall
(2016) Erken, Ertugrul; Ozelsancak, Ruya; Sahin, Safak; Yilmaz, Emine Ece; Torun, Dilek; Leblebici, Berrin; Kuyucu, Yunus Emre; Sezer, Siren; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-6267-3695; 27497737; AAD-5716-2021; AAD-9111-2021
Patients with end-stage renal disease (ESRD) have increased risk of falls and fall-related complications. Other than aging and factors related to chronic kidney disease, treatment of hemodialysis may also contribute to this increased risk. The aim of this study was to demonstrate the impairment of balance after a session of hemodialysis with a quantitative assessment and reveal an increased fall risk that would possibly be related to treatment of hemodialysis for patients on maintenance hemodialysis. Fifty-six patients with ESRD on chronic hemodialysis program and 53 healthy individuals were involved in this study. Fall Index percentages were calculated, and fall risk categories were determined for all patients and healthy controls using Tetrax posturography device (Sunlight Medical Ltd Israel). The patient group was evaluated twice for balance, before and after a routine session of hemodialysis. Fall Index scores of healthy controls were lower than that of ESRD patients (p = 0.001). In the patient group, we found the mean Fall Index to be significantly higher at the post-dialysis assessment compared to the pre-dialysis assessment (p = 0.003). The number of patients with high risk of falling also increased at the post-dialysis assessment yet the difference did not reach significance. Fall Index was correlated with the increase in age only at the pre-dialysis balance measurement (p = 0.038). Patients with better dialysis adequacy had significantly lower Fall Index scores than the others at the pre-dialysis balance measurement (p = 0.004). The difference was not significant at the post-dialysis measurement. In the current study, we evaluated the balance of ESRD patients before and after a routine session of hemodialysis treatment. This is the first study to investigate the effect of hemodialysis on balance, using an electronic posturographic balance system. We found the Fall Index score to be significantly higher after hemodialysis, indicating a negative effect of hemodialysis on postural stability. As expected, our data showed an increased Fall Index score correlated with the increase in age both in ESRD patients and in healthy controls. However, the correlation with age was not observed for the patient group at the post-dialysis balance measurement. We might conceive that young patients with ESRD are also prone to fall risk after a session of hemodialysis. Methods that provide quantitative assessment for fall risk could be rather beneficial for high-risk populations such as patients on maintenance hemodialysis.
The effect of physician experience on the measurement reliability of the Reimers' hip migration percentage in children with cerebral palsy
(2015) Analan, Pinar Doruk; Yilmaz, Emine Ece; Adnan, Mehmet; Leblebici, Berrin; 26644686
[Purpose] Reimers' hip migration percentage (MP) is commonly used to document the extent of hip displacement in children with cerebral palsy (CP). However, factors such as poor administration of pelvic radiographs, a lack of concentration, inexperience, or a busy clinical environment may result in variations in the MP measurements. The aim of this study was to compare the differences in the MP results of two physiatrists with varying levels of experience to determine the role of experience in the measurement's accuracy. [Subjects and Methods] This retrospective study included 62 hip radiographs of 31 children with spastic CP. Two physiatrists with different experience levels calculated the baseline MP on two occasions six weeks apart. Correlations, intra-and inter-rater reliabilities, and differences in the MPs were compared. [Results] Correlations and inter-and intra-rater reliabilities of the measurements were excellent. There were no statistically significant intra-or inter-rater differences for either of the two measurement points. Inter-rater correlations for each session were 0.94. [Conclusion] Experience does not appear to be a factor in the evaluation of MP, and inter-rater differences do not cause problems regarding patient follow-up. Therefore, repeated pelvic radiographs are not necessary in the evaluation of MP in children with CP unless indicated.
Effects of therapeutic ultrasound and exercise on pain, function, and isokinetic shoulder rotator strength of patients with rotator cuff disease
(2015) Analan, Pinar Doruk; Leblebici, Berrin; Adam, Mehmet; 26644656
[Purpose] The aim of this prospective, double-blind, randomized, placebo-controlled study was to evaluate the effects of therapeutic continuous ultrasound (US) on patients with rotator cuff disease. [Subjects and Methods] Twenty-two patients were treated with a standard physiotherapy program consisting of a hot-pack, transcutaneous electrical nerve stimulation (TENS), exercises, and US that was supervised by the same physiotherapist. The patients were randomly assigned to either a group that received true US (n=11) or one that received sham US (n=11). [Results] There were significant differences between the pre- and post-intervention UCLA Shoulder Rating Scale and Constant-Murley Shoulder Outcome scores, VAS, and external rotation (ER) peak torque 60 degrees/second values for both the true and sham US groups. However, the between-group differences were not statistically significant. [Conclusion] In patients with rotator cuff disease, physiotherapy interventions effectively treat the pain, improve the clinical status, and increase the muscle strength of the shoulder ER at a low constant angular velocity, with functional improvement being seen immediately after treatment. However, at the end of the intervention, the US had yielded no additional efficacy to the physiotherapy treatment regimen of the patients with rotator cuff disease.
Evaluation of postural balance and risk of fall in a healthy adult population
(2016) Analan, Pinar Doruk; Yilmaz, Emine Ece; Leblebici, Berrin
Purpose: In this retrospective study, it was aimed to evaluate the risk of fall and balance, and to determine whether there is a correlation between the risk of fall and vestibular evoked myogenic potentials, which are the evaluating the vestibular system, in the healthy adults who are working in a factory. Material and Methods: The data of 69 male participants have been reached. Bilateral Vestibular Evoked Myogenic Potentials data and Berg Balance Scale of the participants have been recorded along with balance tests and risks of fall by using the Tetrax Interactive Balance System. The correlations between these measurements were measured Results: There was no statistically significant correlation between age and the risk of fall. Also, There ere no significant correlation between the values of latency and amplitude of the bilateral Vestibular Evoked Myogenic Potential waves, Berg Balance Scale, balance tests, and risk of fall. Berg Balance Scale scores showed a considerably good balance while the risk of fall ranged between 0% and 78%. Conclusion: Advanced age may be not alone significant factor for the risk of fall. Berg Balance Scale may not exactly show the risk of fall in the young adult population. Vestibular Evoked Myogenic Potentials measurements may not provide a significant contribution to evaluate the risk of fall and balance. Our study underlines that there may be a risk of falling more than expected in the community.
Factors Associated with Fibromyalgia Syndrome in Peritoneal Dialysis Patients
(2019) Ozelsancak, Ruya; Analan, Pinar Doruk; Leblebici, Berrin; 0000-0002-3528-3712; 0000-0002-0788-8319; 30787502; AAA-8043-2021; AAD-5716-2021
Purpose: We evaluated the prevalence of fibromyalgia syndrome (FMS) in peritoneal dialysis (PD) patients and whether this syndrome is associated with gender, age, duration of PD, or other laboratory parameters. Methods: A total of 60 chronic PD patients (26 women, 34 men) and 60 healthy controls (30 women, 30 men) were included. We recorded each participant's age, gender, cause of kidney failure, PD duration, laboratory parameters, education level, and symptoms related to FMS, diagnosed according to the 2010 American College of Rheumatology criteria. Results: Eleven patients (18%) in the PD group and nine (15%) in the control group met the diagnostic criteria for FMS. There were no statistically significant differences in age; gender; education level; PD duration; laboratory parameters; or sleepdisturbance, fatigue, or cognitive symptoms between the FMS and non-FMS groups among the PD patients. We next compared control and PD patients with FMS. Both groups were of a similar age and gender and had similar sleep disturbance and cognitive symptoms, but more patients had fatigue in the control group. Conclusions: The prevalence of FMS among PD patients was similar to that in the general population, and FMS was not associated with gender, age, duration of PD, or other laboratory parameters.
Fibromyalgia Syndrome in Turkish Hemodialysis Patients
(2016) Leblebici, Berrin; Ozelsancak, Ruya; Yilmaz, Emine Ece; Doruk, Pinar; https://orcid.org/0000-0002-6241-268X; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-8602-6038; https://orcid.org/0000-0002-3528-3712; 26198740; AAM-3220-2021; AAD-5716-2021; AAA-8043-2021
The aim of our study was to evaluate the frequency of fibromyalgia syndrome (FMS) in hemodialysis (HD) patients and to assess whether this syndrome is associated with gender, age, duration of HD, or various laboratory parameters. This study was composed of 221 chronic HD patients (99 females and 122 males), and we recorded each participant's age, gender, causes of kidney failure, HD duration, education level, and symptoms related to FMS, which was diagnosed according to the 2010 American College of Rheumatology criteria. We documented the laboratory parameters for all patients. In addition, patients with FMS filled out the Fibromyalgia Impact Questionnaire. Twenty-two patients met the diagnostic criteria for FMS (9%), and there were no statistically significant differences related to age, gender, or HD duration between FMS and non-FMS groups (P>0.05). In addition, the education levels were lower in patients diagnosed with FMS (P<0.05), and there were statistically significant differences related to sleep disturbance, fatigue, and cognitive symptoms between the two groups (P<0.05) as well. However, their laboratory parameters were similar (P>0.05). There was a higher prevalence of FMS in HD patients than in the general population. Sleep disturbances, fatigue, education level, and cognitive symptoms were associated with FMS, but there was no correlation between the laboratory parameters and this condition.
Prevalence of Persistent Median Artery in Carpal Tunnel Syndrome: Sonographic Assessment
(2016) Altinkaya, Naime; Leblebici, Berrin; https://orcid.org/0000-0003-1348-8167; https://orcid.org/0000-0002-6241-268X; 26324380; AAM-5169-2021; AAM-3220-2021
This study investigated the frequency of persistent median artery (PMA) in patients with carpal tunnel syndrome (CTS) and controls. A total of 84 CTS patient wrists, and 136 wrists of control subjects without CTS, were examined on ultrasonography (US) and color Doppler US (CDUS), and by electrophysiological evaluations. The frequency of PMA in CTS was evaluated. Of 84 CTS patient wrists, 2 (2.4 %) had a PMA (both on the right side). Of 136 control wrists, 12 (9 %) had a PMA, which was unilateral in eight (three right and five left), and bilateral in two, cases. There was no significant difference between the CTS patient and control groups with respect to the frequency of PMA (P > 0.05). There was no significant difference between the CTS patient and control groups in the frequency of PMA. We suggest that an ipsilateral PMA does not increase the risk of CTS.
Yanık sonrası akut dönemde gelişen kemik kaybı
(Osteoporoz Dünyasından ,13 ,2 ,33-36, 2007) Leblebici, Berrin; Adam, Mehmet; Tarım, Akın M.; Akman, Nafız M.; Haberal, Mehmet A.
Bu çalışmanın amacı yanık sonrası akut dönemde kemik kaybının olup olmadığı ve çeşitli parametrelerin kemik kaybı üzerine etkisini araştırmaktır. Hastalar ve Yöntem: Bu çalışma, yanık yüzey alanı %20 ve üzerinde olan 20-50 yaşındaki 19 hasta üzerinde gerçekleştirildi. Hastalar yanık nedeni, yeri, yüzdesi, derecesi, ambulasyon durumu ve fonksiyonel açıdan değerlendirildi. Birinci ayın sonunda total L1-L4 vertebra, distal sol önkol ve total sol femur kemik mineral yoğunluğu ölçüldü. Z skorunun -1'in altında olması kemik kaybı olarak değerlendirildi. Bulgular: Ondördü erkek beşi kadın olan 19 hastanın yaş ortalaması 33.09±11.61 idi. Hastalarımızın %68.4 ünde distal sol ön kol, %21.1 inde total sol femur, %36.8 inde total L1-L4 vertebra z skoru <-1 olarak bulundu. Yanık total vücut yüzey alanı yüzdesi, Fonksiyonel Ambulasyon Skalası ve Fonksiyonel Bağımsızlık Ölçütü ile distal sol ön kol, total sol femur ve total L1-4 vertebra Z skorları arasında istatistiksel açıdan anlamlı bir ilişki yoktu. Sonuç: Yanık hastalarında ilk bir ayda görülen kemik mineral yoğunluğundaki azalma kemik kaybının erken dönemde başladığını göstermekte olup akut dönemdeki kaybın yanık yüzdesi ve fonksiyonel durum ile ilişkili olmadığı bulunmuştur. The purpose of this study was to determine whether a bone loss occurs during acute period following burn injury or not, and to investigate the effects of various parameters on it. Materials and Methods: This study was conducted on 19 patients, ages between 20 and 50, who had a burn injury with more than %20 of Total Body Surface Area (TBSA). We recorded the patients' burn cause, localization, percantage, ambulation and functional status. At the end of the first month, we measured bone mıneral densıty of total L1-L4 vertebrae, left distal forearm, left total femur, in all patients. A Z score less than -1 was accepted to be the indicator of bone loss. Results: The mean age of the patients (14 male and 5 female) was 33.09±11.61. We found a Z score less then -1 in 68.4% of left distal forearm, 21.1% of left total femur and 36.8% of total L1-L4 vertabrae measurements. There were no significant correlations between TBSA, Functional Ambulatıon Scale and Functional Independence Measure, and Z scores. Conclusion: There is a reduction in Bone Mineral Density in patıents wıth moderate/severe burn ınjuries in the acute period which is not correlated wıth neither TBSA nor functional status.