Sağlık Bilimleri Enstitüsü / Health Science Institute
Permanent URI for this collectionhttps://hdl.handle.net/11727/1393
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Item Pseudomonas aeruginosa Bakteriyofaj kokteyli hazırlanması ve fare yanık yara enfeksiyon modelinde tedavideki etkinliğinin değerlendirilmesi(Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, 2024) Ata Vural, Ilgın; Üsküdar Güçlü, AylinPseudomonas aeruginosa, birçok hastane enfeksiyonundan sorumlu kateterize veya yanık hastalarında ciddi, akut ve kronik enfeksiyonlara neden olan fırsatçı bir patojendir. P.aeruginosa'da patogeneze katkıları bulunan çeşitli virülans faktörleri tanımlanmıştır. P.aeruginosa günümüzde özellikle permeabilitedeki azalma, mutasyonlar, enzimatik inaktivasyon veya dış atım pompaları gibi mekanizmalarla çok sayıda antimikrobiyal ajana dirençli duruma gelmiş ve tedavideki güçlükler nedeniyle yeni teröpatik ajanlara ihtiyaç duyulmaktadır. Bakteriyofajlar (faj) da, çok ilaca dirençli bakteriyel enfeksiyonların tedavisi için potansiyel bir terapötik adaydır. Bu çalışmada atık su, nehir ve göl gibi çeşitli su kaynaklarından, P.aeruginosa izolatlarına etkili faj izole etmek ve bu fajların klinik izolatlardaki etkinlik spektrumunu araştırmak, fajları karakterize etmek ve in vivo olarak da etkinliğini test etmek amaçlanmıştır. Faj izolasyonu için çeşitli su kaynaklarından periyodik olarak su örneği alınmıştır. İzole edilen fajlar zenginleştirilip saflaştırılmış ve etki spektrumları P.aeruginosa klinik izolatlarında araştırılmıştır. İn vivo çalışmalar için PAO1 suşuna en etkili litik aktiviteye sahip olan fajlar seçilmiştir. Fajların morfolojik yapılarının incelenmesi için transmisyon elektron mikroskop (TEM) görüntüsü alınmıştır. İzole edilen fajların konak aralığı analizi, farklı bakteri türleri üzerinde spot test ile belirlenmiştir. Etkin bulunan fajların tam genom analizleri yapılarak genomlarında virülans faktörlerini ve antibiyotik direnç kodlayan genleri taşımayan fajlar in vivo çalışmaya dahil edilmiştir. İn vitro testleri tamamlanan fajların 3 tanesiyle bir faj kokteyli oluşturulmuş ve in vivo etkinliği test edilmiştir. Bu amaçla fareler üzerinde total vücut yüzey alanının %10’unu kapsayacak şekilde yanık yarası oluşturulmuş, takiben ̴1.05x107 konsantrasyonunda hazırlanan P. aeruginosa PAO1 solüsyonundan 100 μl kullanılarak yanık yarasında subkutan yolla enfeksiyon oluşturulmuştur. Toplam 45 Balb/c türü fare 5 gruba ayrılmıştır(0.80 güç ve %95 güven düzeyinde tek yönlü varyans analizi G-Power ile belirlenmiştir). 1. Grup; yanık yarası oluşturulan ve enfeksiyon oluşturulmayan kontrol grubu (YK). 2. Grup; yanık yarası ve enfeksiyon oluşturulan tedavi almayan kontrol grubu (SHAM); 3. Grup; yanık yarası oluşturulan ve enfeksiyon oluşturulmayan, faj kokteyli uygulanan toksisite kontrol grubu (YF); 4.Grup yanık yarası ve enfeksiyon oluşturulan, faj kokteyli tedavisi alan (YEF); 5. grup; yanık yarası ve enfeksiyon oluşturulan, antibiyotik (sefepim) tedavisi alan grup (YEA). Enfeksiyona ait parametrelerin takibi için tüm gruplarda 3 ve 7. günlerde kalp kanı alınarak CRP bakılmıştır. Ayrıca, 3. ve 7.günlerde her gruptan sırasıyla 4 ve 5 adet hayvan olmak üzere sakrifiye edilerek kan ve doku örneği alınmıştır. Doku örneklerinde hem kantitatif kültür yöntemiyle bakteri yükü hesaplanmış hem de histopatolojik inceleme yapılarak enflamatuar süreç incelenmiştir. Ayrıca her gün doku iyileşmesinin takibi için yara yüzeyi ölçülerek % yara kapanma oranı hesaplanmış ve dijital fotoğraf makinesi ile kaydedilmiştir. Deney sonunda sağ kalım yüzdeleri de hesaplanarak grup içinde ve gruplar arasında karşılaştırılmıştır. Çalışmada incelenen 5 gruba ait tanımlayıcı istatistikler ve dağılım değerleri değerlendirildikten sonra histopatoloji, CRP ve bakteriyel yük grup SHAM, grup YEF ve grup YEA grupları arasında nonparametrik testler ile değerlendirilmiştir. Histopatolojik bulguların değerlendirilmesinde kruskal wallis testi, CRP ve bakteriyel yüklerin değerlendirilmesinde ise friedman testinden faydalanılmıştır. Çalışmamızda PAO1 suşuna etkili 3 adet litik faj izole edilmiştir. Bu fajların Tam genom dizilerinin sonuçlarına göre yapılan biyoinformatik analizlerle yeni fajlar oldukları belirlenmiştir. Fajlar isimlendirildikten sonra GenBank’a yüklenmiştir. Faj kokteylinin in vivo etkinliği değerlendirilmiştir. Histopatolojik incelemelerde SHAM, YEF ve YEA grupları arasında istatiksel olarak herhangi bir farklılık tespit edilememiştir (p=0,2687; KW=2,808). CRP bakımından SHAM, YEF ve YEA grupları arasında istatiksel olarak herhangi bir farklılık tespit edilememiştir (p=0,5000; 𝑋𝑟2= 3,00). Tüm gruplar bakımından 3. ve 7. günlerde CRP değerleri kıyaslandığında ise gruplar arasında istatiksel olarak bir farklılık elde edilmiştir (p=0,0417; 𝑋𝑟2 = 7,600). Gruplar arasındaki farklılık özellikle YK ve SHAM grupları arasında gözlenmiştir. SHAM, YEF ve YEA grupları arasında 3. ve 7. gün bakteri yükü bakımından farlılık elde edilmiştir (p=0,0093; 𝑋𝑟2 = 7,60). Özellikle SHAM ve YEF grupları arasındaki farklılık önemli bulunmuştur(p=0,0354). Çalışmamızda elde ettiğimiz faj kokteyli, antibiyotik tedavisine bir alternatif olabileceğinden klinik çalışmalara öncü niteliği taşımaktadır. Pseudomonas aeruginosa is an opportunistic pathogen responsible for serious, acute, and chronic infections in catheterized or burn patients, contributing to numerous hospital-acquired infections. Various virulence factors have been identified that contribute to the pathogenesis of P. aeruginosa. Nowadays, P. aeruginosa has become resistant to many antimicrobial agents through mechanisms such as decreased permeability, mutations, enzymatic inactivation, or efflux pumps, necessitating new therapeutic agents due to treatment difficulties. Bacteriophages (phages) are potential therapeutic candidates for the treatment of multidrug-resistant bacterial infections. This study aims to isolate phages effective against P. aeruginosa isolates from various water sources such as wastewater, rivers, and lakes, investigate their efficacy spectrum on clinical isolates, characterize the phages, and test their in vivo efficacy. Water samples were periodically collected from various water sources for phage isolation. The isolated phages were enriched, purified, and their efficacy spectrum was investigated on P. aeruginosa clinical isolates. Phages with the most effective lytic activity against the PAO1 strain were selected for in vivo studies. Transmission electron microscopy (TEM) was used to examine the morphological structures of the phages. The host range analysis of the isolated phages was determined using spot tests on different bacterial species. Phages that did not carry virulence factors or antibiotic resistance genes in their genomes, as determined by complete genome analysis, were included in the in vivo study. A phage cocktail was prepared with three phages that completed in vitro tests and its in vivo efficacy was tested. For this purpose, burn wounds covering 10% of the total body surface area were created on mice, followed by subcutaneous infection of the burn wound with 100 μl of P. aeruginosa PAO1 solution prepared at a concentration of ̴1.05x10⁷. A total of 45 Balb/c mice were divided into 5 groups (determined by one-way analysis of variance with 0.80 power and 95% confidence level using G-Power). Group 1: control group with burn wound and no infection (YK). Group 2: control group with burn wound and infection but no treatment (SHAM). Group 3: toxicity control group with burn wound, no infection, and phage cocktail application (YF). Group 4: treatment group with burn wound, infection, and phage cocktail therapy (YEF). Group 5: treatment group with burn wound, infection, and antibiotic (cefepime) therapy (YEA). To monitor infection parameters, CRP was measured from heart blood samples taken on days 3 and 7 in all groups. Additionally, on days 3 and 7, 4 and 5 animals from each group were sacrificed respectively, and blood and tissue samples were taken. The bacterial load in tissue samples was calculated using quantitative culture methods and the inflammatory process was examined histopathologically. Furthermore, wound surface area was measured daily to calculate the percentage of wound closure and recorded with a digital camera. Survival rates were calculated at the end of the experiment and compared within and between groups. After evaluating the descriptive statistics and distribution values of the five groups examined in the study, histopathology, CRP, and bacterial load were assessed between the SHAM, YEF, and YEA groups using non-parametric tests. The Kruskal-Wallis test was used for the evaluation of histopathological findings, while the Friedman test was employed for the assessment of CRP and bacterial loads. In our study, three lytic phages effective against the PAO1 strain were isolated. Bioinformatic analyses based on the complete genome sequences of these phages revealed that they are novel. After being named, the phages were uploaded to GenBank. The in vivo efficacy of the phage cocktail was evaluated. Histopathological examinations showed no statistical differences between the SHAM, YEF, and YEA groups (p=0.2687; KW=2.808). Regarding CRP levels, no statistical differences were found between the SHAM, YEF, and YEA groups (p=0.5000; 𝑋𝑟2= 3.00). However, when comparing the CRP values on days 3 and 7 across all groups, a significant difference was observed (p=0.0417; 𝑋𝑟2 = 7.600). This difference was particularly noted between the YK and SHAM groups. A difference in bacterial load was also observed between the SHAM, YEF, and YEA groups on days 3 and 7 (p=0.0093; 𝑋𝑟2 = 7.60), with a significant difference especially noted between the SHAM and YEF groups (p=0.0354). The phage cocktail obtained in our study holds potential as an alternative to antibiotic treatment, thus serving as a precursor to clinical studies.Item Over kanseri hücrelerinde DNA hasarı ve golgi stresine yanıtta apoptotik mekanizmaların araştırılması(Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, 2024) Aka, Yeliz; Ataç, F. BelginOver kanseri, metastatik aşamada tanı konması ve gelişen kemoterapi direnci nedeniyle tüm jinekolojik kanserler arasında mortalite oranı en yüksek olan kanser türüdür. Tümörün cerrahi olarak çıkarılmasına ve platin bazlı kemoterapiye rağmen, birçok over kanseri hastası kanser tekrarlaması nedeniyle hastalığa yenik düşmektedir. Bu nedenle, over kanseri hastalarının prognozunu iyileştirmek için yeni tedavi stratejileri esastır. Replikasyon stresi over kanserinin yaygın bir özelliğidir ve ATR/CHK1 sinyallemesi hücreleri replikasyon stresine karşı korumada öncelikli olarak rol oynar. ATR inhibitörünün tekil uygulamaları olmakla birlikte kombine tedavi uygulamalar da spesifik hedefler olarak etkinlik gösterirler. Over kanserlerinde ATR inhibitörleri birçok çalışmada kombine olarak mitokondriyal hücre ölüm yolaklarını aktive etse de çalışmalar kısıtlı kalmaktadır. Bu tez çalışmasıyla over kanseri hücrelerinde etkinlik gösterebilecek yeni bir moleküler kombinasyon tedavisinin, hem de bu kombinatoryal uygulamanın moleküler çalışma mekanizmalarının bulunması hedeflenmiştir. Yüksek verimli küçük molekül tarama analizini kullanarak, over kanseri hücrelerinde en etkili hücre ölümü indükleyen kombinasyon olarak AZD6738 (ATR inhibitörü) /Brefeldin A (Golgi stres indükleyicisi) belirlenmiştir. Deneysel çalışmalar ile AZD6738/Brefeldin A'nın eş zamanlı uygulanması, SKOV3 (***p<0.001, kontrol vs AZD6738+BFA) ve IGROV1 (**p<0.01, kontrol vs AZD6738+BFA) over kanseri hücrelerinde kaspaz-3 ve kaspaz-9 aktivasyonu ile apoptotik hücre ölümüne neden olmaktadır. AZD6738/Brefeldin A maruziyeti ayrıca sitozole sitokrom c translokasyonunu da indükler; bu, mitokondriyal hücre ölüm yolunun karakteristik bir özelliğidir. Buradaki en önemli moleküler süreç, SKOV3 ve IGROV1 hücrelerinde AZD6738/Brefeldin A'nın kombinatoryal kullanımı, anti-apoptotik BCL-2 ailesi üyeleri BCL-2, BCL-XL ve MCL1'in ifade seviyelerinde azalmaya yol açarken, özellikle BIM ve PUMA olmak üzere pro-apoptotik BCL-2 proteinlerinin ifade seviyelerinde artışa neden olur. Tüm bu bulgular, AZD6738/Brefeldin A'nın over kanseri için potansiyel bir tedavi yaklaşımı olduğunu düşündürmektedir. Ovarian cancer has the highest mortality rate among all gynecologic cancers due to its diagnosis at the metastatic stage and developing chemotherapy resistance. Despite surgical removal of the tumor and platinum-based chemotherapy, many ovarian cancer patients succumb to the disease due to cancer recurrence. Therefore, new treatment strategies are essential to improve the prognosis of ovarian cancer patients. Replication stress is a common feature of ovarian cancer, and ATR/CHK1 signaling plays a primary role in protecting cells from replication stress. Although ATR inhibitors have single applications, combination therapeutic applications also show efficacy as specific targets. Although ATR inhibitors activate mitochondrial cell death pathways in combination in many studies in ovarian cancer, studies remain limited. This thesis study aimed to find a new molecular combination therapy that could be effective in ovarian cancer cells, as well as the molecular working mechanisms of this combinatorial application. Using high-throughput small molecule screening analysis, AZD6738 (ATR inhibitor)/Brefeldin A (Golgi stress inducer) was determined as the most effective cell deathinducing combination in ovarian cancer cells. Experimental studies have shown that simultaneous application of AZD6738/Brefeldin A causes apoptotic cell death in SKOV3 (***p<0.001, control vs AZD6738+BFA) and IGROV1 (**p<0.01, control vs AZD6738+BFA) ovarian cancer cells, together with caspase-3 and caspase-9 activation. AZD6738/Brefeldin A exposure also induces cytochrome c translocation to the cytosol, which is a characteristic feature of the mitochondrial cell death pathway. The most important molecular process here is that the combinatorial use of AZD6738/Brefeldin A in SKOV3 and IGROV1 cells leads to a decrease in the expression levels of anti-apoptotic BCL-2 family members BCL-2, BCL-XL and MCL1, while it leads to an increase in the expression levels of pro-apoptotic BCL-2 proteins, especially BIM and PUMA. All these findings suggest that AZD6738/Brefeldin A is a potential therapeutic approach for ovarian cancer.Item Developing an Educational Material Based on The Needs and Health Literacy of Patients Receiving Radiotherapy and Their Relatives(2014) Ozdogan, P. Seref; Kav, S.; https://orcid.org/0000-0003-0361-7498; V-9745-2019Item Investigating The Effects of Poverty on Health and Quality of Life in Poor People Aged 65 and Over in Etimesgut District, Ankara(2014) Yilmaz, Fikriye; Celik, Cansu; Numanoglu Tekin, Rukiye; https://orcid.org/0000-0002-4884-3803; AAZ-4775-2020Introduction: The purpose of this research was to examine the effects of poverty on health and quality of life of poor people aged 65 and over in Etimesgut District, Ankara. Materials and Method: A questionnaire was administered to 116 people over the age of 65 who were deemed a priority group for assistance by the Etimesgut Social Assistance and Solidarity Foundation in Ankara. The questionnaire comprised questions related to socio-demographic characteristics, health status and health care utilization of elderly people, along with the World Health Organization Quality of Life Instrument-Older Adults Module. Research data were evaluated using the Chi-Square Test, Independent Samples T Test, One-Way Analysis of Variance, Mann-Whitney U Test and Kruskal-Wallis Test. Results: The average monthly income of the elderly participants was 168.94 +/- 54.67 Turkish liras and they lived completely under the poverty line determined for Turkey. However, it was found that women, illiterate participants and those receiving the old age pension were poorer, and of those whose income was below average, more delayed/did not seek help when they were ill. Statistical analysis revealed that total quality of life scores of participants aged 65-74 and literate participants were higher; the "social participation" scores of participants whose income was below average and those received an old-age pension were lower. Conclusion: Poverty has negative effects on the health status, health care utilization and quality of life of elderly people.Item The Effects of Instrument-Assisted Soft Tissue Mobilization and Kinesio Taping on Pain, Functional Disability and Depression in Patients with Chronic Low Back Pain: A Randomized Trial(2022) Cakmak, Ozge; Atici, Emine; Gulsen, MustafaPurpose: Low back pain is a common condition that can become chronic, which reduces the life quality of the patient by causing functional disability and depression. This study aimed to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and kinesio taping (KT) along with conservative treatment in patients with chronic nonspecific low back pain (CNLBP). Methods: A total of 30 patients with chronic low back pain aged between 30-50 years included in the study were randomized to IASTM (n=15) and KT (n=15) groups. Both the groups underwent conservative treatment that comprised of a hot pack, ultrasound, transcutaneous electrical nerve stimulation (TENS) and home exercises. In this study, assessments were made using the Visual Analogue Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), and Beck Depression Inventory (BDI). The measurements were carried out at the beginning and end of the treatment. Results: As a result of the study, IASTM method improved in parameters such as pain (p<0.05), functionality (p=0.001) and depression (p<0.05). As a result of the study, the KT group improved in parameters such as pain, functionality and depression compared to pre-treatment (p<0.05). However, the two treatments were not superior to each other in pain (p=0.241), functionality (p=0.687) and depression (p=0.699) parameters. Conclusion: It has been observed that both treatments have positive effects on many parameters such as pain, disability, depression and mental state in patients with CNLBP. This study demonstrates that IASTM and KT treatments can be used to support therapeutic effects in patients with CNLBP.Item Relationship Between Exercise Perception With Physical Activity Level, Body Awareness, and Illness Cognition in Renal Transplant Patients: A Pilot Study(2019) Tigli, Ayca; Soy, Ebru Hatice Ayvazoglu; Aytar, Aydan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 30777573; AAC-5566-2019; HIR-3735-2022; AAE-1041-2021; AAJ-8097-2021Objectives: Transplantation offers better quality of life and long-term survival benefits. Further knowledge is needed regarding exercise in daily life of transplant recipients. Here, we investigated the relationship between exercise perception and physical activity level, body awareness, and illness cognition in renal transplant patients. Materials and Methods: Our study included 53 renal transplant recipients (Standardized Mini-Mental Test score = 26.35 +/- 1.36; age = 41.11 +/- 13.52 year, body mass index = 25.96 +/- 5.26 kg/m(2), elapsed time after transplant = 3.68 +/- 1.53 year). Perceived benefits and barriers to exercise, physical activity level, body awareness, and illness cognition were assessed with the Exercise Benefits/Barriers Scale, International Physical Activity Questionnaire, Body Awareness Questionnaire, and Patient Illness Perception Questionnaire, respectively. Correlations were established with Spearman test for nonparametric data, with regression analysis used to find determinants of physical activity levels. Results: We observed correlations between physical activity level and perceived benefits and barriers to exercise. There was a positive relationship between body awareness and perceived benefits and barriers to exercise and also illness cognition, with significant correlation between perceived benefits and barriers to exercise and illness cognition (P < .05). Perceived benefits and barriers to exercise (P = .006, R = 0.373, R2 = 0.139, beta = 0.373, t = 2.867, F = 8.22) were determining factors for physical activity level. Conclusions: Psychologic and physical factors, including negative emotions and body dissatisfaction, are risk factors for poor quality of life. Although it is important to increase quality of life, tools to enhance body awareness and to develop strategies to alter motor behaviors in daily living activities are needed. Treatment and assessment strategies on body awareness and illness perception should be considered, with emphasis on the importance of physical activity posttransplant.Item Exposure of Pregnant Women to Violence by Partners and Affecting Factors in Turkey(2016) Alan, Hacer; Koc, Gulten; Taskin, Lale; Eroglu, Kafiye; Terzioglu, FusunThis study aims to determine the exposure of women to violence by their partners during pregnancy and the factors affecting this condition. The current study conducted as descriptive included a total of 442 pregnant women who were married and at the last trimester of their pregnancy. The data were collected using a semi-structure questionnaire and face to face interview with the pregnant women and were evaluated using descriptive statistics, chi-square test, and logistic regression analysis. Of the pregnant women, 39.8 % experienced at least one type of violence, and the most common type of violence experienced was verbal violence (31.4 %). Among the participants, 18.2 % exposed to violence expressed that their partners perpetrated violence because of jealousy, and 30.1 % reported that they just cried when exposed to violence. According to the results of the logistic regression analysis, insufficient prenatal care increases all types of violence in pregnancy. Working with pregnant women and their partners together under the scope of prenatal care services, and especially planning the attempts to prevent violence by discussing the causes of violence with couples, will facilitate more successful violence prevention programs.Item Scenarios to Manage The Hepatitis C Disease Burden and Associated Economic Impact of Treatment in Turkey(2017) Ormeci, Necati; Malhan, Simten; Balik, Ismail; Ergor, Gul; Razavi, Homie; Robbins, Sarah; 29027109Hepatitis C virus (HCV) infection is a significant health problem. The aim of this study is to evaluate the cost-effectiveness of HCV treatment and estimate its economic burden in Turkey. An Excel-based disease progression model was used to estimate the HCV-infected population for 2015-2030. Direct costs in US dollars (USD) including diagnostic, laboratory, and healthcare costs were provided by experts in the country. Indirect costs were estimated as lost productivity using the World Health Organization (WHO) disability-adjusted life years (DALYs) metric from the Global Burden of Disease study. Three scenarios were developed to estimate the cost-effectiveness of HCV treatment through 2030: Base 2016, Increase Treatment and SVR (where SVR is sustained virological response), and WHO Targets. Additionally, the WHO Targets scenario was assessed at three different treatment price points: 10,900 USD, 16,730 USD (base cost), and 27,285 USD. Cumulative total direct and indirect costs (2015-2030) for the WHO Targets scenario were estimated to be 10.8 billion USD, or a 1.5 % increase compared with Base 2016. However, by the following decade, due to a marked decline in DALYs, cumulative direct and indirect costs were estimated to be 45 % less when compared with Base 2016. At a threshold of 9125 USD, all scenarios were cost-effective. By implementing the WHO Targets scenario, Turkey would be able to lower HCV prevalence by 80 % and reduce the total number of liver-related deaths by > 65 % by 2030. Treating HCV infection in the country is cost-effective if healthcare and indirect costs are taken into consideration.Item The Effects of Clinical Pilates Exercises on Patients with Shoulder Pain: A Randomised Clinical Trial(2017) Atilgan, Esra; Aytar, Aydan; Caglar, Aslican; Tigli, Ayca Aytar; Arin, Gamze; Yapali, Gokmen; Kisacik, Pinar; Berberoglu, Utku; Sener, Hulya Ozlem; Unal, Edibe; 29037638; HIR-3735-2022Aim: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Material and methods: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). Results: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). Conclusion: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them. (c) 2017 Elsevier Ltd. All rights reserved.Item Effectiveness Of Negative-Pressure Wound Therapy Compared To Wet-Dry Dressing In Pressure Injuries(2022) Sahin, Ezgi; Rizalar, Selda; Ozker, Emre; 35022147This study aims to compare the effects of Negative-Pressure Wound Therapy (NPWT) and wet-to-dry dressing on Stages 3 and 4 pressure injuries (PI), This study is a randomized controlled trial. A total of 30 patients with Stages 3 and 4 pressure injuries were included in the study. The patients were divided into two groups: NPWT group and the wet-to-dry dressing group. All patients received 3 rounds of treatment. Data were collected with a Patient Identification Form, Pressure Ulcer Scale for Healing (PUSH) Tool and the findings of the Three-Dimensional Wound Measurement (3DWM) device. We found that granulation tissue formation was more significant in the experimental group (p < .05), and that there was more significant wound shrinkage (p < .05) with a more significant decrease in the PUSH Tool scores (p < .05). The wounds were assessed with the tool and the 3DWM system. Device measurements were found to be correlated with PUSH Tool findings (p < .05). There was a significant correlation between device-measured granulation findings and PUSH Tool score results of the experimental group's third measurements (p < .05). We conclude that NPWT is an effective treatment method for pressure injuries, and 3DWM device is a useable wound assessment tool.