MCBÜ Açıkerişim Sistemi :: Browsing by Author "Ünlü Z."

Browsing by Author "Ünlü Z."

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The effect of simvastatin on serum cytokine levels and bone metabolism in postmenopausal subjects: Negative correlation between TNF-α, and anabolic bone parameters
(Springer Japan, 2004) Tikiz C.; Ünlü Z.; Tikiz H.; Ay K.; Angin A.; Onur E.; Var A.; Tüzün Ç.
In this prospective study, we aimed to evaluate the effect of simvastatin on bone metabolism and the correlation between changes in bone turnover parameters and serum cytokine levels. For this purpose, 38 postmenopausal subjects with hypercholesterolemia (>240mg/dl), not on osteoporosis treatment, were studied. Simvastatin was started at a dose of 20mg daily and continued for 3 months. Six patients were excluded from the study during the follow-up period. Pre- and post-treatment samples were analyzed for bone alkaline phosphatase (BAP) and osteocalcin (OCL), as markers of bone formation; for carboxyterminal telopeptide of collagen I (CTX), as a marker of bone resorption; and for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) cytokine levels. Total cholesterol level was decreased from 262.1 ± 30.9 to 210.2 ± 35.6mg/dl after simvastatin treatment (P < 0.0001). While no significant change was observed in serum CTX level, BAP and OCL levels were significantly increased (from 120.8 ± 56.6 to 149.5 ± 57.6 IU/I [P = 0.008], and from 20.8 ± 12.6 to 34.7 ± 18.4 μg/l [P = 0.015], respectively). In the analysis of cytokines, while no significant change was observed in IL-6 levels, the TNF-α level was found to be significantly decreased after simvastatin treatment (from 77.9 ± 31.6 pg/ml to 23.5 ± 12.6 pg/ml [P = 0.021]). Individual changes in TNF-α levels showed a moderate negative correlation with the individual changes in BAP and OCL levels (r = -0.550 [P = 0.001], and r = -0.497 [P = 0.004], respectively). In conclusion; 20-mg daily simvastatin treatment for 3 months significantly increased BAP and OCL levels (markers of bone formation) in hypercholesterolemic postmenopausal subjects, without affecting bone resorption. These findings support the idea that simvastatin has an anabolic effect on bone formation. Additionally, the presence of a negative correlation between TNF-α levels and the anabolic bone parameters suggests that a cytokine-lowering effect of simvastatin may also be involved in the remodeling process and could exert some additive beneficial effect on bone metabolism.
Transcutaneous electrical nerve stimulation therapy in the children with nocturnal enuresis; [Enüresis nokturnali çocuklarda transkütan elektri̇ksel si̇ni̇r sti̇mülasyonu (TENS) tedavi̇si̇]
(Nobelmedicus, 2005) Ünlü Z.; Tüzün Ç.; Taneli C.; Firat A.
We evaluated the efficacy of transcutaneous nerve stimulation (TENS) therapy on wetting behaviors, social functioning and bladder storage capacities in children with enuresis nocturna. A total of 8 enuretic children aged 8-16 years old were selected for study on basis of poor outcome despite extensive trials of conventional treatments. 15 seances of TENS therapy applied on the suprapubic region. Changes in wetting behaviors and social functioning before and after the therapy were assessed with a 7-point scale. Patients were asked to record their urine output using a frequency/volume chart for two consecutive days before and after the therapy. Two of the children became dry two months after the therapy. The total scores of wetting behaviors and social status were increased in two patients at two months after the therapy. Maximum functional bladder capacity, mean day-time bladder capacity, maximum nocturnal bladder capacity were increased only in two patients after the treatment. Number of daytime voids were decreased in these patients. According to our preliminary results, it seems that TENS therapy in the children with nocturnal enuresis showed improvement in some degree. Further studies are needed which are performed in larger series.
Comparison of the efficacy of lower and higher molecular weight viscosupplementation in the treatment of hip osteoarthritis
(2005) Tikiz C.; Ünlü Z.; Şener A.; Efe M.; Tüzün C.
We aimed to compare the efficacy of intra-articular injections of a lower molecular weight hyaluronan (LMW HA) (Ostenil) with a higher molecular weight viscosupplement (hylan G-F 20, Synvisc) in hip osteoarthritis. For this purpose, 43 patients (56 hips) with hip osteoarthritis with a visual analogue scale (VAS) pain score higher than 50/100, a Lequesne index greater than 6, and persistence of the pain for longer than 3 months despite all conservative methods were enrolled in the study and randomly assigned to two groups: 25 (32 hips) received LMW HA and the remaining 18 patients (24 hips) received hylan G-F 20. Three injections were administered once weekly to each patient under fluoroscopic guidance. During the 6-month follow-up period, the primary outcomes were assessed at the 1st, 3rd, and 6th month by VAS, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and Lequesne index. The intra-articular injections produced a significant reduction in VAS, WOMAC, and Lequesne index scores in both groups. After three injections, improvement was prominent at the 1st month and maintained for 6 months in both groups. The percentage reduction was 38 and 40% (p<0.001) in VAS pain score, 43 and 40% in WOMAC (p<0.001), and 47 and 49% in Lequesne index (p<0.001) in the LMW HA and hylan G-F groups at the 6th month, respectively. However, there were no significant differences in outcomes between any of the measurements at the 1st, 3rd, and 6th month between the two groups (p>0.05). No systemic adverse effect was recorded. Local adverse effects consisting of pain and/or swelling were noted in 3 of 32 hips (9%) injected with LMW HA and in 3 of 24 hips (12.5%) injected with hylan G-F 20. In conclusion, both types of viscosupplementation produced a significant clinical improvement during the 6-month follow-up period. However, no significant difference was found in outcomes between higher and lower molecular weight hyaluronan. © Clinical Rheumatology 2005.
The efficacy of behavioral modification program and pressure biofeedback method in children with encopresis who were resistant to standard treatment regimens; [Standart tedavilere dirençli enkoprezisli çocuklarda davraniş düzenleme programi ve basinç biofeedback yönteminin etkinliǧi]
(2005) Tuzun Ç.; Tikiz C.; Ünlü Z.; Kasirga E.
Objective: The purpose of this study was to evaluate the efficacy of pressure biofeedback (BF) method as an adjunct to behavioral modification program on anorectal function and continence restoration in children with encopresis. Materials and methods: Eight children (6 boys and 2 girls) were enrolled in the study. During the first four weeks, behavioral modification program including toilet training, fiber rich diet and conditioning was applied. During the following four weeks, pressure BF training as an adjunct to the behavioral modification program was applied for 60 minutes, two times a week to the children with persistent fecal incontinence. Anorectal function and quality of life were assessed with manometric measurements, Wexner and Holschneider incontinence scoring systems, quality of life measurement and defecation diaries before and immediately after the BF treatment and at 1st month. Results: Significant decrease in resting pressure was detected in manometric anal measurements immediately after the BF treatment and at 1st month (p<0.05). Although a rising trend was observed in maximum squeeze pressure, it did not reach to a statistical significance. A decrease in sensory threshold and an increase in time for half of the maximal squeeze pressure were observed in the manometric pressure measurements (p<0.005). A significant improvement in the quality of life and in the severity of incontinence was also found immediately after the BF treatment and at 1st month. Conclusion: Our study suggests that the application of pressure BF method as an adjunct to behavioral modification program may significantly improve anorectal functions and quality of life in children with encopresis who were resistant to standard treatment regimens.
Efficacy of low level laser treatment in plantar calcaneal enthesophytosis
(2006) Tikiz C.; Ünlü Z.; Ay K.; Tüzün Ç.
The present study was conducted to assess the efficacy of low-intensity laser therapy in the treatment of plantar calcaneal enthesophytosis (PCE). Forty patients suffering from pain at least for more than one month with the diagnosis of PCE were included in the study. Patients were randomized into two groups as; active laser group (ALG, n=20, mean age 49±10 years) and placebo laser group (PLG, n=20, mean age 54±5 years). Gallium-aluminum-arsenide (GaAlAs) infrared diode device (30mW, 830 nm) was used for low-level laser treatment (LLLT). Patients were treated five times weekly for 3 weeks. Baseline evaluation consisted of the severity of resting pain, morning pain, pain after activity, pain on palpation, and the effect of pain on daily activities and walking ability. Assessments were done before treatment, at the end of treatment and at 1-month follow-up. Baseline patient characteristics were similar in both groups. In intra-group comparisons, significant improvements were detected in all outcome measurements at both post-treatment and one-month follow-up period in ALG (p<0.05), however no significant difference was observed in PLG concerning the same time intervals. Inter-group comparisons also revealed significant difference in favor of ALG except walking period without pain at 1-month follow-up period. In conclusion, we suggest that low-level laser is an effective treatment modality for PCE and it can be used as an alternative treatment method to other conventional treatment modalities.
Value of ultrasonography on diagnosis and assessment of pain and grip strength in patients with lateral epicondylitis
(2009) Tarhan S.; Ünlü Z.; Ovali G.Y.; Pabuşçu Y.
Objective: Lateral epicondylitis (LE) is generally diagnosed clinically. Ultrasonography (US) can provide useful information about the location, extent, and severity of LE. Our objective was to use US to confirm LE and to investigate the relationships between pain, grip strength, physical examination, and disability in these patients. Material and Methods: Fifty-two patients with unilateral LE were examined by US. Pain and functional status were assessed using a visual analog scale (VAS), physical functioning and bodily pain scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a patient-rated forearm evaluation questionnaire (PRFEQ). Grip strength and manual tests for LE were evaluated. Results: Clinical diagnosis of LE was confirmed by US in 28 (53.8%) patients. Our results showed close associations between clinical examination findings and SF-36 and PRFEQ assessments with pain in patients who had sonographic abnormalities. Grip strength was also correlated with clinical and functional evaluations in these cases. Conclusion: We concluded that evaluation of disability in LE requires methods different from those included in the traditional clinical examination. Pain and grip strength measurements provide numerical and quantitative data for evaluation of severity and disability in patients with sonographic findings of LE.
Complementary and alternative therapies cerebral palsy: Review; [Serebral palsi i̇çin tamamlayici ve alternatif tedaviler]
(2010) Ünlü Z.; Aslanalp Z.; Mete Özmen E.
We reviewed the recent popular complementary and alternative therapies which are effectiveness in the treatment of the cerebral palsy controversial. We did not find any review concerning with the effectiveness of the altemetive and complementary therapies in the cerebral palsy in the Turkish literature. Copyright © 2010 by Türk Tibbi Rehabilitasyon Kurumu Derneǧi.
Ultrasonographic measurement of the femoral cartilage thickness in hemiparetic patients after stroke
(2012) Tunç H.; Öken Ö.; Kara M.; Tiftik T.; Doǧu B.; Ünlü Z.; Özçakar L.
The aim of the study was to evaluate the femoral cartilage thicknesses of hemiparetic patients after stroke using musculoskeletal ultrasonography and to determine whether there is any correlation between cartilage thicknesses and the clinical characteristics of the patients. Femoral cartilage thicknesses of both knees were measured in 87 (33 women, 54 men) hemiparetic patients. The mean age of the patients was 61.8 years (SD 11.1 years, range 32-87 years) and the mean duration of stroke was 12.3 months (SD 10.5 months, range 1-36 months). The outcome was measured in terms of motor recovery (Brunnstrom stages), spasticity (Modified Ashworth Scale), walking ability (Functional Ambulation Categories), and motor functioning (Functional Independence Measurement instrument). Ultrasonographic measurements were made axially from the suprapatellar window using linear probes while the patients' knees were held in maximum flexion. Three (midpoint) measurements were taken from both knees [lateral condyle (LFC), intercondylar area, and medial condyle (MFC)]. The mean cartilage thicknesses were found to be less on the paretic side (statistically significant only for LFC) when compared with the nonparetic side. Cartilage thickness values were found to be negatively correlated with the duration of immobilization (with paretic side LFC) and BMI (with both sides' MFC) and positively correlated with the Functional Independence Measurement motor score (with paretic side LFC) and the Functional Ambulation Categories scores (with both sides' LFC and MFC). Femoral cartilage is thinner on the paretic side in stroke patients. As the thickness values correlate with the duration of the disease and the ambulatory status of the patients, we suggest that early mobilization would be important in maintaining their cartilage integrity. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Evidence-based recommendations for the management of knee osteoarthritis: A consensus report of the Turkish league against rheumatism; [Diz osteoartrit tedavisinde kanıta dayalı öneriler: Türkiye romatizma araştırma ve savaş derneǧi uzlaşı raporu]
(Turkish League Against Rheumatism (TLAR), 2012) Tuncer T.; Çay H.F.; Kaçar C.; Altan L.; Atik O.S.; Aydin A.T.; Figen Ayhan F.; Çorekçi Yanik B.; Durmaz B.; Eskiyurt N.; Genç H.; Gokçe Kutsal Y.; Günaydin R.; Hepgüler S.; Hizmetli S.; Kaya T.; Kurtaiş Y.; Ölmez N.; Saridoǧan M.; Sindel D.; Sonel Tur B.; Sütbeyaz S.; Şendur O.F.; Uǧurlu H.; Ünlü Z.
Objectives: Knee osteoarthritis (OA) is a common disease which causes pain, disability and great socioeconomic burden as a result. Turkish League Against Rheumatism (TLAR) initiated a project to prepare national, "evidence-based recommendations for the management of knee osteoarthritis" supported by expertopinion in order to assist the physicians who are interested in knee OA in their daily clinical practice. Materials and methods: The expert committee was composed of 25 academicians, 23 of whom were physical medicine and rehabilitation (PM&R) specialists (three also had rheumatology subspeciality) and two were orthopedic surgeons. At the first meeting, the previous guidelines were discussed, and 2008 Osteoarthritis Research Society International (OARSI) recommendations were decided to be taken as the fundamental template for national recommendations. Databases of the Pubmed, Embase, Cochrane, and Turkish Medical Index were used to search the literature, and this was carried out for the period between 2009-2010 for international publications since studies up to 2009 were present in the 2010 OARSI update. No limit was applied for searching of national publications. The selected relevant publications were graded according to evidence level and quality, and were sent to the members who were then asked to suggest propositions according to their experiences, knowledge, and review of the literature. After amalgamation and editing of new proposals, Delphi rounds were started. After five Delphi rounds, the propositions on which the members were in consensus, were discussed with regard to evidence and the "strength of recommendation" was determined by measuring on visual analog scale (VAS) for each proposal at the final meeting. Results: Nineteen propositions (one for general principles, nine for nonpharmacologic treatments, seven for pharmacologic treatments, and two for surgical treatments) were accepted as the "TLAR Evidence-Based Recommendations for the Management of Knee OA" in consensus as a result of Delphi rounds. Conclusion: Evidence-based recommendations for the management of knee OA were developed by TLAR for the first time in our country. The recommendations should be updated regularly according to new evidence and insights. It is expected that physicians who are interested in knee OA will benefit greatly from this report in their daily clinical practice. © 2012 Turkish League Against Rheumatism. All rights reserved.
Comparison of the efficacy of low-level laser therapy and pulsed ultrasound treatment in carpal tunnel syndrome: A placebo-controlled study; [Karpal tünel sendromunda düşük enerjili lazer ve kesikli ultrason tedavi etkinliklerinin karşi{dotless}laşti{dotless}ri{dotless}lmasi{dotless}: Plasebo kontrollü bir çali{dotless}şma]
(2013) Tikiz C.; Duruöz T.; Ünlü Z.; Cerrahoǧlu L.; Yalçinsoy E.
Objective: To evaluate the effect of low-level laser treatment (LLLT) and pulsed ultrasound (US) treatment in carpal tunnel syndrome (CTS) and to compare the effects of both treatment modalities. Materials and Methods: 60 patients diagnosed with CTS were randomly divided into four groups as US group (group 1), placebo US group (group 2), LLLT group (group 3) and plasebo LLLT group (group 4). Both treatments were applied five days a week for three weeks. Clinical and electrophysiological assessments were performed before and 3, 6 and 12 months after treatment. Pain, hypoesthesia and handgrip strength were evaluated. The Boston Questionnaire was used to assess the severity of symptoms and functional status. Results: 52 patients with 101 hands completed the study. Demographic and electrophysiological parameters were similar in the four groups. Both pulsed US treatment and LLLT were found to provide significant improvements in clinical parameters such as pain, sensory loss, symptom severity score and functional capacity score (p<0.05). No significant beneficial effect was observed in both placebo groups (p<0.05). Evaluations of the electrophysiological parameters showed no significant difference between the groups (p>0.05). In terms of clinical efficacy, pulsed US was found to be superior to LLLT (p<0.05). Conclusion: The two treatment modalities showed significant improvements in subjective clinical symptoms while no significant changes were observed in any electrophysiological parameters. © Turkish Journal of Physical Medicine and Rehabilitation.
Femoral cartilage thickness measurements in healthy individuals: Learning, practicing and publishing with TURK-MUSCULUS
(IOS Press, 2014) Özçakar L.; Tunç H.; Öken O.; Ünlü Z.; Durmuş B.; Baysal O.; Altay Z.; Tok F.; Akkaya N.; Doʇu B.; Çapkin E.; Bardak A.; Çarli A.B.; Buʇdayci D.; Toktaş H.; Diraçoʇlu D.; Gündüz B.; Erhan B.; Kocabaş H.; Erden G.; Günendi Z.; Kesikburun S.; Omaç O.K.; Taşkaynatan M.A.; Şenel K.; Uʇur M.; Yalçinkaya E.Y.; Öneş K.; Atan C.; Akgün K.; Bilgici A.; Kuru O.; Ozgocmen
BACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population. The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle). RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses. CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard. © 2014 - IOS Press and the authors. All rights reserved.
Ultrasonographic evaluation of the flexor pollicis longus tendon in frequent mobile phone texters
(Lippincott Williams and Wilkins, 2015) Akkaya N.; Dogu B.; Ünlü Z.; Çarl A.B.; Akkaya S.; Tekin L.; Özçakar L.
Objective: The aim of this study was to assess flexor pollicis longus tendon by using ultrasound imaging in frequent mobile phone texters. Subjects: In total, 149 subjects, aged 18Y40 yrs, were recruited as frequent mobile phone texters (n = 71) and infrequent texters (n = 78). Methods: Demographic data and estimate frequency of texting were noted. Thumb pain during activity, range of motion for thumb joints, grip and pinch strengths, and Quick Disabilities of arm, shoulder, and hand were evaluated. Standardized bilateral ultrasound evaluations were performed using a linear array probe, and tendon area measurements were done with axial imaging at midthenar region and midproximal phalangeal region with manual trace technique. Results: The groups were similar except for the mean estimate number of messages/month (P = 0.001). Whereas grip and pinch strength values were significantly higher (frequent texter group, P = 0.001; infrequent texter group, grip strength P = 0.018; pinch strengths, P = 0.001) on the texting side in both groups, flexor pollicis longus tendons were larger (P = 0.001) and the activity pain was higher (P = 0.005) on the texting sides only in the frequent texter group. Flexor pollicis longus thickness significantly correlated with messages/month only in the frequent texter group (r = 0.592, P = 0.001). Conclusions: Flexor pollicis longus tendons seem to be thicker at the midthenar level in subjects who frequently use mobile phone texting. Because this increase in thickness parallels the number of messages per day, the authors believe that further studies are needed to elucidate whether such changes become problematic later on in life. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study
(Turkish Society of Physical Medicine and Rehabilitation, 2022) Bagcier F.; Kibar S.; Evcik D.; Ketenci A.; Sindel D.; Tur B.S.; Ünlü Z.; Tıkız C.; Keskin D.; Alp A.; Ay S.; Yanık B.; Külcü D.G.; Karakaş M.; Ural Nazlıkul F.G.; Kurt Oktay K.N.; Aksoy M.K.; Fındıkoğlu G.; Eser F.; Atıcı A.; Yurdakul O.V.; Koçak F.A.; Kurt E.E.; Özkan Y.; Doğan Ş.K.; Sultanoğlu T.E.; Ordahan B.; Umay E.K.; Demirhan E.; Yağcı H.Ç.; Balbaloğlu Ö.; Tezel N.; Satış S.; Atar S.; Akaltun M.S.
Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS. ©2022 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.
The caregiver burden of informal caregivers for stroke patients with and without dysphagia: A multi-center, cross-sectional study in Türkiye
(Turkish Society of Physical Medicine and Rehabilitation, 2023) Giray E.; Eyigör S.; Çalık Y.; Gezer İ.A.; Sarı A.; Umay E.; Akaltun M.S.; Tıkız C.; Ünlü Z.; Vural M.; Aydeniz B.; Karahan A.Y.
Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients’ swallowing-related quality of life (QoL), and patients’ stroke-specific QoL. Patients and methods: This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient’s swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients’ swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver’s relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments. ©2023 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.
SARcopenia Assessment in Hypertension
(Lippincott Williams and Wilkins, 2023) Kara M.; Kara Ö.; Ceran Y.; Kaymak B.; Kaya T.C.; Çıtır B.N.; Durmuş M.E.; Durmuşoğlu E.; Razaq S.; Doğan Y.; Shehab D.; Alkandari S.A.; Abdulsalam A.J.; Ata A.M.; Koyuncu E.G.; Coşkun E.; Turan G.; Dilek B.; Culha M.A.; Yıldırım P.; Mezian K.; Doğu B.; Kılıç G.; Ünlü Z.; Barbosa J.; Pinho S.; Analay P.; Palamar D.; Güvener O.; Ocak H.; Malas F.Ü.; Baday M.; Çakır B.; Özçakar L.
Objectives: The aims of the study were to investigate the relationship between sarcopenia and renin-angiotensin system-related disorders and to explore the effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on muscle mass/function and physical performance. Design: This multicenter, cross-sectional study was performed using ISarcoPRM algorithm for the diagnosis of sarcopenia. Results: Of the 2613 participants (mean age = 61.0 ± 9.5 yrs), 1775 (67.9%) were hypertensive. All sarcopenia-related parameters (except chair stand test in males) were worse in hypertensive group than in normotensive group (all P < 0.05). When clinical/potential confounders were adjusted, hypertension was found to be an independent predictor of sarcopenia in males (odds ratio = 2.403 [95% confidence interval = 1.514-3.813]) and females (odds ratio = 1.906 [95% confidence interval = 1.328-2.734], both P < 0.001). After adjusting for confounding factors, we found that all sarcopenia-related parameters (except grip strength and chair stand test in males) were independently/negatively related to hypertension (all P < 0.05). In females, angiotensin-converting enzyme inhibitors users had higher grip strength and chair stand test performance values but had lower anterior thigh muscle thickness and gait speed values, as compared with those using angiotensin II receptor blockers (all P < 0.05). Conclusions: Hypertension was associated with increased risk of sarcopenia at least 2 times. Among antihypertensives, while angiotensin-converting enzyme inhibitors had higher muscle function values, angiotensin II receptor blockers had higher muscle mass and physical performance values only in females. © 2022 Wolters Kluwer Health, Inc.
The Relationship Among Probable SARCopenia, Osteoporosis and SuprasPinatus Tendon Tears in Postmenopausal Women: The SARCOSP Study
(Springer, 2024) Kara M.; Kara Ö.; Durmuş M.E.; Analay P.; Şener F.E.; Çıtır B.N.; Korkmaz G.O.; Ünlü Z.; Tiftik T.; Gürçay E.; Mülkoğlu C.; Yalçınkaya B.; Bağcıer F.; Aksakal M.F.; Erdoğan K.; Sertçelik A.; Çakır B.; Kaymak B.; Özçakar L.
We aimed to investigate the relationship among probable sarcopenia, osteoporosis (OP) and supraspinatus tendon (SSP) tears in postmenopausal women. Postmenopausal women screened/followed for OP were recruited. Demographic data, comorbidities, exercise/smoking status, and handgrip strength values were recorded. Probable sarcopenia was diagnosed as handgrip strength values < 20 kg. Achilles and SSP thicknesses were measured using ultrasound. Among 1443 postmenopausal women, 268 (18.6%) subjects had SSP tears. Unilateral tears were on the dominant side in 146 (10.1%) and on the non-dominant side in 55 women (3.8%). In contrast to those without, women with SSP tears had older age, lower level of education, thinner SSP and lower grip strength (all p < 0.05). In addition, they had higher frequencies of hypertension, hyperlipidemia, DM, OP and probable sarcopenia, but lower exercise frequency (all p < 0.05). Binary logistic regression modeling revealed that age [odds ratio (OR): 1.046 (1.024–1.067 95% CI)], hypertension [OR: 1.560 (1.145–2.124 95% CI)], OP [OR: 1.371 (1.022–1.839 95% CI)] and probable sarcopenia [OR: 1.386 (1.031–1.861 95% CI)] were significant predictors for SSP tears (all p < 0.05). This study showed that age, presence of hypertension, probable sarcopenia and OP were related with SSP tears in postmenopausal women. To this end, although OP appeared to be related to SSP tears, SSP tear/thickness evaluation can be recommended for OP patients, especially those who have other risk factors such as older age, higher BMI, hypertension, and probable sarcopenia. © The Author(s) 2024.
A case of trigeminal neuralgia that occurred after COVID-19 vaccination
(Termedia Publishing House Ltd., 2024) Ünlü Z.; Özbek İ.C.
[No abstract available]
Additional contribution of phonophoresis and low-level laser therapy to exercise in the treatment of carpal tunnel syndrome: A clinical, electrophysiological, and ultrasonographic evaluation; [Karpal tünel sendromunun tedavisinde fonoforez ve düşük seviyeli lazer tedavisinin egzersize ek katkısının klinik, elektrofizyolojik ve ultrasonografik olarak değerlendirilmesi]
(Turkish Society of Algology, 2024) Karaman N.; Ünlü Z.; Selçuki D.; Cerrahoğlu L.
Objectives: Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve compression syndrome. This study aims to evaluate the additive contribution of phonophoresis and low-level laser therapy (LLLT) to tendon and nerve gliding exercises electrophysiologically, ultrasonographically, and clinically in the treatment of moderate CTS. Methods: The sample consisted of 45 patients with moderate CTS, randomized into three groups. Group 1 received phonophoresis and exercise, Group 2 received LLLT and exercise, and Group 3 received exercise alone. Participants were evaluated electrophysiologically, clinically, and ultrasonographically before treatment and at the 6th and 12th weeks after the treatment. Results: An improvement was observed in clinical parameters (Boston Functional Status Scale, Boston Symptom Severity Scale, visual analog scale at rest, and visual analog scale during activity) for all groups at the 6th and 12th weeks after the treatment (p<0.05). An improvement was also noted in the ultrasonographic parameter (cross-sectional area) for all groups at the 12th week after the treatment (p=0.017). Conclusion: Phonophoresis and LLLT do not provide additional effects to exercise therapy. Exercise therapy alone may positively contribute to ultrasonographic and clinical outcomes in the treatment of moderate CTS. © 2024 Turkish Society of Algology.
Lipedema awareness in fibromyalgia
(SAGE Publications Ltd, 2025) Bolkan Günaydın E.; Ünlü Z.; Ay S.; Karapınar T.O.
Objectives: To evaluate the presence of lipedema and lipedema-related factors in fibromyalgia patients. Methods: The study included 100 female patients over the age of 18 who met the fibromyalgia diagnostic criteria. The patients were evaluated for the presence/stages of lipedema. The body mass index (BMI), waist-hip ratio, waist-height ratio, and presence of hematoma tendency/telangiectasias were recorded. Patients were asked to mark the severity of their pain (widespread/on lipedema) on a 10 cm visual analog scale (VAS). The ACR 2016 Fibromyalgia Diagnostic Criteria, The Beck Depression Inventory (BDI), and The Revised Fibromyalgia Impact Questionnaire were applied. Results: Lipedema was observed in 50% of the patients (58% Stage 1 lipedema). In the lipedema group, age, duration of fibromyalgia diagnosis, hematoma tendency/presence of telangiectasias (for all; p <.001), menopausal status (p =.004), BDI score (p =.04), BMI (p =.02), history of medication for fibromyalgia (p =.01) were higher, and age at menarche (p =.01) was lower. Lipedema stage was moderately positively correlated with BMI, number of pregnancies (for both; r:0.53 p <.001) and waist-height ratio (r:0.43 p:0.002), while VAS-lipedema pain intensity was strongly positively correlated with VAS-widespread pain intensity (r:0.62 p <.001), and moderately positively correlated with symptom severity score (r:0.55 p <.001), BMI (r:0.54 p <.001), and fibromyalgia severity score (r:0.51 p <.001). Long fibromyalgia diagnosis time (p: 0.005), and low age at menarche (p: 0.05) were significant risk factors for the presence of lipedema. Conclusions: Lipedema is common in fibromyalgia patients. Long fibromyalgia diagnosis time and low age at menarche are significant risk factors for the presence of lipedema. © The Author(s) 2025.

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