Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
14 results
Search Results
Item Complex Regional Pain Syndrome in an Adult Following Tetanus-Diphteria Toxoid Vaccine: Case Report and Review of the Literature(2014) Seyrek, Aslihan; Yemisci, Oya Umit; Sozay, Seyhan; https://orcid.org/0000-0002-0501-5127; https://orcid.org/0000-0002-8460-7699; AAJ-8820-2021; AAJ-2936-2021Background: Complex regional pain syndrome [CRPS] is a painful and disabling chronic neuropathic disorder, and unfortunately, due to its wide spectrum of clinical manifestations, the diagnosis may often be missed by primary-care physicians. To the authors' knowledge, there are no reported cases of CRPS following immunization with tetanus-diphteria toxoid booster vaccine in an adult. Findings: We present a 26-year-old woman with severe pain, swelling, and limited range of motion of the left forearm following a booster dose of the tetanus-diphteria toxoid vaccine. Conclusion: Disease awareness among practitioners, early recognition, and appropriate treatment is essential to minimize the risk of adverse outcome.Item A Comparison of Magnetic Resonance Imaging and Electroneuromyography for Denervated Muscle Diagnosis(2017) Tepeli, Betul; Karatas, Metin; Coskun, Mehmet; Yemisci, Oya Umit; https://orcid.org/0000-0002-0501-5127; 27893494; AAJ-8820-2021Purpose: The aim of this study was to evaluate the diagnostic value of magnetic resonance imaging (MRI) for muscle denervation due to focal lesions of the median nerve and to compare electrophysiological findings with MRI findings. Methods: Twenty-six patients with electrophysiological studies diagnosed for focal lesions of the median nerve were included in this study. Electrophysiological studies and MRI were conducted on 34 patients' hands. Patients' hands were divided into two groups based on edema findings revealed by the MRI: group 1 (edema-negative group; n = 24) and group 2 (edema-positive group; n = 10). Results: Positive correlations were found between the existence of edema in MRI and fibrillation, positive sharp waves, denervation, and the level of reduced recruitment pattern. In median nerve conduction studies, amplitude of compound muscle action potential and palm-to-wrist segment mixed-nerve action potentials were significantly lower, and also the third-digit wrist sensory nerve conduction velocity and mixed-nerve palm-wrist conduction velocity were significantly slower in group 2. Conclusions: For muscle denervation resulting from median nerve lesions, MRI findings correlated with electrophysiological findings; further study is required for the use of MRI.Item Virtual Reality in Upper Extremity Rehabilitation of Stroke Patients: A Randomized Controlled Trial(2018) Afsar, Sevgi Ikbali; Mirzayev, Ilkin; Yemisci, Oya Umit; Saracgil, Sacide Nur Cosar; 0000-0002-4003-3646; 0000-0002-0501-5127; 0000-0001-8306-463X; 30193810; E-2103-2019; AAJ-8820-2021; AAF-1085-2021Objective: Virtual reality game system is one of novel approaches, which can improve hemiplegic extremity functions of stroke patients. We aimed to evaluate the effect of the Microsoft Xbox 360 Kinect video game system on upper limb motor functions for subacute stroke patients. Methods: The study included 42 stroke patients of which 35 (19 Virtual reality group, 16 control group) completed the study. All patients received 60 minutes of conventional therapy for upper extremity, 5 times per-week for 4 weeks. Virtual reality group additionally received Xbox Kinect game system 30 minutes per-day. Patients were evaluated prior to the rehabilitation and at the end of 4 weeks. Box&Block Test, Functional independence measure self-care score, Brunnstorm stage and Fugl-Meyer upper extremity motor function scale were used as outcome measures. Results: The Brunnstrom stages and the scores on the Fugl-Meyer upper extremity, Box&Block Test and Functional independence measure improved significantly from baseline to post-treatment in both the experimental and the control groups. The Brunnstrom stage-upper extremity and Box&Block Test gain for the experimental group were significantly higher compared to the control group, while the Brunnstrom stage-hand, the Functional independence measure gain and Fugl-Meyer gain were similar between the groups. Conclusions: We found evidence that kinect-based game system in addition to conventional therapy may have supplemental benefit for stroke patients. However, for virtual reality game systems to enter the routine practice of stroke rehabilitation, randomized controlled clinical trials with longer follow-up periods and larger sample sizes are needed especially to determine an optimal duration and intensity of the treatment.Item Acute Effects Of Instrument Assisted Soft Tissue Mobilization Technique On Pain And Joint Position Error In Individuals With Chronic Neck Pain: A Double-Blind, Randomized Controlled Trial(2023) Gercek, Hasan; Unuvar, Bayram Sonmez; Yemisci, Oya Umit; Aytar, Aydan; 36538383Purpose/AimThe aim of this study was to determine the acute effects of IASTM on cervical joint position error and pain in individuals with chronic neck pain.MethodsA total of 39 individuals with chronic neck pain were included in this study. Participants were randomized into three groups: Instrument-assisted soft-tissue mobilization(IASTM (n = 13), sham (n = 13), and control (n = 13). In the IASTM group, intervention was applied to the sternocleidomastoid and trapezius muscles with an application time of 45 s and a frequency of 60 beats/min. In the sham group, IASTM was applied at a 90 degrees angle without pressure. The control group did not receive any intervention. The pain severity and joint position error(JPE) were evaluated before and after the intervention, by using the visual analogue scale and a cervical range of motion device.ResultsThe effects of time and treatment group on visual analogue scale(VAS) score were statistically significant (p = .001). Instrument-assisted soft-tissue mobilization was more effective in VAS score than sham and control group (p < .001). Significant improvement was found in JPE in all range of motions of the cervical region in the instrument-assisted soft-tissue mobilization group (p < .05). In the sham group, significant improvements were observed in cervical extension, left rotation, and left lateral flexion movements in JPE during each cervical spine active movement (p < .05). Instrument-assisted soft-tissue mobilization group was more effective in JPE all directions than sham and control group.ConclusionsInstrument-assisted soft-tissue mobilization may be a useful technique in individuals with chronic neck pain. Instrument-assisted soft-tissue mobilization decreases VAS and improves JPE.Item Inpatient rehabilitation outcomes in neoplastic spinal cord compression vs. traumatic spinal cord injury(2022) Afsar, Sevgi Ikbali; Cosar, Sacide Nur Saracgil; Yemisci, Oya Umit; Boluk, Huma; 0000-0002-4003-3646; 0000-0001-8306-463X; 0000-0002-0501-5127; 0000-0001-6771-3265; 32701391; E-2103-2019; AAF-1085-2021; AAJ-8820-2021; AAX-8965-2021Objective: To compare neurological and functional outcomes, and complications of patients with neoplastic vs traumatic spinal cord injury (SCI) after in-patient rehabilitation. Design: This study is a retrospective analysis. Setting: In-patient rehabilitation unit of a tertiary research hospital. Participants: A total of 252 patients with a SCI were included; 43 with neoplastic SCI (mean age: 60.9 +/- 15.7 years, 60.5% were males) and 209 with traumatic SCI (mean age: 43.1 +/- 16.8 years, 71.3% were males). Outcome measures: Comparisons were made of demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) and Functional Ambulation Categories (FAC) scores, length of stay (LOS), bladder independence, medical comorbidities and complications in both groups. Results: Patients with neoplastic SCI were significantly older than those with traumatic SCI (P < 0.01). No difference was present between the groups in terms of sex and lesion level (P > 0.05). Incomplete SCI was significantly higher in the neoplastic group when compared with the traumatic group (P < 0.01). The LOS was significantly shorter in the neoplastic group than traumatic group (34.8 +/- 41.03 vs. 60.02 +/- 53.1, P < 0.01). There were no differences in the admission FIM scores (69.3 +/- 24.7 vs. 58.7 +/- 18.9, P > 0.05), discharge FIM scores (82.1 +/- 25.1 vs. 74.02 +/- 23.3, P > 0.05) and FIM efficiencies (0.43 +/- 0.72 vs. 0.36 +/- 0.51, P > 0.05) for the neoplastic and traumatic groups, respectively. However, neoplastic SCI patients demonstrated lower FIM gains compared to traumatic patients (12.9 +/- 11.9 vs. 15.4 +/- 15.2, P < 0.05). During rehabilitation, urinary tract infection (48.4% vs. 69.4%) and decubitus ulcer (11.6% vs. 35.9%) were significantly more common in the traumatic group than the neoplastic group (P < 0.05). Conclusion: Neoplastic SCI patients who commonly present at rehabilitation units exhibit different characteristics from traumatic SCI patients but the rehabilitation results are similar. Similar functional development can be achieved in a shorter period of time with inpatient rehabilitation in the neoplastic SCI group.Item Sympathetic skin responses and electromyographic reaction times in chronic autoimmune thyroiditis: An overlooked electrodiagnostic study(2022) Yemisci, Oya Umit; Ozen, Selin; Sisman, Tubanur Ozturk; Anil, Cuneyd; Cosar, Sacide Nur Saracgil; 0000-0002-0501-5127; 0000-0001-8306-463X; 35949958; AAJ-8820-2021; AAF-1085-2021Objectives: This study aims to evaluate peripheral nerve functions, sympathetic skin responses (SSRs), and electromyographic (EMG) reaction times in hypothyroid patients and to compare them to healthy individuals. Patients and methods: Between January 2007 and September 2007, a total of 54 patients with Hashimoto's thyroiditis including 35 euthyroid (3 males, 32 females; mean age: 45.2 +/- 10.2 years; range, 35 to 60 years) and 19 with subclinical hypothyroidism (2 males, 17 females; mean age: 43.2 +/- 12.6 years; range, 40 to 65 years) were included in the study. The control group consisted of 35 healthy individuals (5 males, 30 females; mean age: 39.1 +/- 9.3 years; range, 29 to 52 years). Nerve conduction studies (NCSs), SSRs of the hand and foot obtained by stimulation of the contralateral median nerve, and EMG reaction times of the extensor indicis proprius muscle were performed in all subjects. Results: There was no significant difference in peripheral NCSs and SSRs between patients and the control group. However, reaction times were longer in the AIT patients compared to the healthy individuals suggesting alterations in cognitive function related to the primary disease process in AIT. Conclusion: Electrodiagnosis of autonomic nervous system involvement and cognitive impairment can be challenging in AIT. However, EMG reaction times and SSRs are practical and useful tools that are often overlooked. On the other hand, SSRs may be combined with more quantitative tests, such as sudomotor axon reflex testing, to allow us to better determine the extent of involvement of the autonomic nervous system in AIT.Item Ultrasonographic And Electrophysiological Outcomes Of Carpal Tunnel Syndrome Treated With Low-Level Laser Therapy: A Double-Blind, Prospective, Randomized, Sham-Controlled Study(2022) Nalbant, Merve; Yemisci, Oya Umit; Ozen, Selin; Tezcan, Sehnaz; https://orcid.org/0000-0002-0501-5127; 35949869; AAJ-8820-2021Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4 +/- 8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen's test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.Item Prognostic Value of Magnetic Resonance Imaging in the Evaluation of Physical Therapy Outcomes in Patients with Adhesive Capsulitis(2021) Cosar, Sacide Nur Saracgil; Ozen, Selin; Coskun, Mehmet; Yemisci, Oya Umit; Kurtcebe, Ali Niyazi; 0000-0001-8306-463X; 0000-0002-7290-8558; 0000-0002-0501-5127; 34396065; AAF-1085-2021; ABC-1305-2020; AAJ-8820-2021Objectives: This study aims to investigate whether the treatment outcomes of patients with a clinical diagnosis of adhesive capsulitis (AC) and magnetic resonance imaging (MRI) findings consistent with AC undergoing physical therapy (PT) differs to those with AC in the absence of these MRI findings. Patients and methods: Between January 2012 and October 2012, a total of 30 patients (8 males, 22 females; mean age 55.6 +/- 12.1 years; range, 35 to 85 years) with a clinical diagnosis of AC underwent MRI of the index shoulder. The MRI scans were evaluated for findings associated with AC: intensity of the inferior glenohumeral ligament (IGHL) and rotator interval (RI). All patients received a total of 15 sessions of PT: hot pack, transcutaneous electrical nerve stimulation, ultrasound, and shoulder exercises. The patients were assessed for shoulder range of motion (ROM) using the Visual Analog Scale ( VAS) for shoulder pain, Quick Disabilities of the Arm Shoulder and Hand (Q-DASH), and Health Assessment Questionnaire (HAQ) prior to and following completion of PT. Results: Of the patients, 21 had no MRI findings consistent with AC (Group 1), nine patients had changes in the IGHL and/or RI characteristic of AC (Group 2). In both groups, there was a significant improvement in active and passive shoulder ROM and VAS scores for shoulder pain at rest (Group 1: p<0.001, Group 2: p=0.017) with movement (Group 1: p<0.001, Group 2: p=0.007) and at night (Group 1: p<0.001, Group 2: p=0.012) following PT. However, there was no significant inter-group difference in scores. Similar findings were recorded for Q-DASH and HAQ. Conclusion: Based on these study findings, the presence of characteristic MRI findings of AC with a clinical diagnosis do not predict clinical response to physical therapy.Item Computer Game Assisted Task Specific Exercises in the Treatment of Motor and Cognitive Function and Quality of Life in Stroke: A Randomized Control Study(2021) Ozen, Selin; Senlikci, Huma Boluk; Guzel, Sukran; Yemisci, Oya Umit; 0000-0001-6771-3265; 0000-0002-7290-8558; 0000-0001-9852-0917; 34293643; AAX-8965-2021; ABC-1305-2020; AAG-3148-2021Objectives: Computer game assisted task specific exercises (CGATSE) are rehabilitation gaming systems (RGS) used in stroke rehabilitation to facilitate patient performance of high intensity, task based, repetitive exercises aiming to enhance neuroplasticity. CGATSE maybe an appealing option in home based rehabilitation of stroke patients, especially during the COVID-19 pandemic. This study aimed to determine the effects of CGATSE on hemiplegic arm-hand function, cognitive function and quality of life in stroke. Materials and methods: Thirty stroke patients were randomized into two groups. All participants received twenty sessions of physical therapy. In addition, the therapy group undertook thirty minutes of CGATSE using the Rejoyce gaming system; while the control group undertook thirty minutes of occupational therapy (OT). Motor function was evaluated before and after treatment using the Fugl Meyer upper extremity (FMUE), Brunnstrom stages of stroke recovery (BSSR) arm and hand. The CGATSE group also completed the Rejoyce arm hand function test (RAHFT). Cognitive function was evaluated using the mini mental state examination, Montreal Cognitive Assessment (MoCA) and Stroke Specific Quality of Life (SS-QOL) scale. Results: The FMUE, BSSR arm and SSQOL improved in both groups (p < 0.05). BSSR of the hand improved only in the CGATSE group (p = 0.024). RAHFT scores improved in the CGATSE group (p = 0.008). MoCA scores significantly improved in the control group (p = 0.008). Conclusions: CGATSE may be beneficial in providing continuation of care after stroke, especially during the Covid-19 pandemic when home based rehabilitation options are becoming increasingly important. Benefits of CGATSE in improving cognitive function is less clear. RGS aimed at improving motor function may be compared to gaming systems designed to target cognitive development and more detailed higher cortical function deficit tests can be used as outcome measures.Item A Rare Benign Tumor With Diagnostic Difficulties: Synovial Chondromatosis(2020) Yemisci, Oya Umit; Ozen, Selin; Koseoglu, Hamide Kart; 0000-0002-7290-8558; 0000-0002-0501-5127; 32851378; ABC-1305-2020; AAJ-8820-2021In this article, we present a case of a 47-year-old male patient presenting with an insidious onset of hip pain and loss of range of motion. The patient was initially treated conservatively to no avail. Detailed investigations included magnetic resonance imaging of the left hip which revealed a synovitis. Blood results were unremarkable apart from moderately raised inflammatory markers. Differential diagnoses of both intra-and extra-articular hip pain were ruled out and the patient treated for a preliminary diagnosis of psoriatic arthritis for a total of six months. Persistent pain resulted in a re-visit of the diagnosis and further clinical evaluation. This time, an X-ray of the hip revealed calcification at the joint. A computed tomography followed and revealed synovial thickening and intra-articular calcification. A biopsy was consistent with primary synovial chondromatosis (SC). Open synovectomy was performed approximately one year after the onset of symptoms. This case emphasizes the importance of re-visiting initial evaluations and diagnoses when faced with a difficult case of persistent hip pain so to avoid misdiagnosis and unnecessary pharmacological treatment. In view of its rarity and diagnostic challenges, future work on SC should concentrate on gathering data which can be used to produce a diagnostic algorithm.