Browsing by Author "Tikiz C."
Now showing 1 - 20 of 33
Results Per Page
Sort Options
Item Selective cyclooxygenase-2 (COX-2) inhibitors: The COXIBs; [Selektif Siklo-oksijenaz-2 (COX-2) Inhibitörleri: KOKSIB'ler](2004) Tikiz C.Nonsteroidal anti-inflammatory drugs are the most widely used medications in the world. These agents are especially preferred to treat arthritis, headache and menstrual pain because of their analgesic and anti-inflammatory properties. During their long-term use they increase the risk of gastric erosion, peptic ulcus and bleeding by inhibiting the synthesis of prostaglandins which protect the gastric mucosa. The major limitation of these drugs is gastrointestinal (GI) toxicity occurring in 2% to 4% of patients every year. The inhibition of cyclooxygenase-1 (COX- 1) is the main factor in GI toxicity which necessiated further research on selective cyclooxygenase-2 (COX-2) inhibitors. In 1990, a novel cyclooxygenase protein was identified in monocytes which was stimulated by interleukin. After this observation, next year a different gene which was quite similar to COX-1 had been identified. Identification of this gene responsible from the synthesis of COX-2 rekindled the affords of the pharmacuetical industry to produce a safer analgesic and anti-inflammatory agent by selective inhibition of COX-2. Celecoxib and rofecoxib are the first two agents introduced for clinical use in 1999. They were prescribed more than 100 million for the 12 month period ending in July 2000 in the United States. In this review, the available data about the types, structural properties, mechanism of action and side effects of selective COX-2 inhibitors were summarized.Item 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.Item Sexual dysfunction in female subjects with fibromyalgia(Lippincott Williams and Wilkins, 2005) Tikiz C.; Muezzinoglu T.; Pirildar T.; Taskin E.O.; Firat A.; Tuzun C.Purpose: We investigated sexual function in females with fibromyalgia (FM) and evaluate whether coexistent major depression (MD) has an additional negative effect on sexual function. Materials and Methods: A total of 100 female subjects were enrolled in the study, including 40 with FM only, 27 with FM plus MD and 33 healthy volunteers as a control group. The diagnosis of MD was made according to Structured Clinical Interview for Diagnostic and Statistical Manual-IV interview and the Hamilton Depression Rate Scale was used to grade depression. Widespread pain and quality of life were assessed with the Lattinen Pain Scale and Fibromyalgia Impact Questionnaire, respectively. The Female Sexual Function Index (FSFI) was used to assess sexual dysfunction. Results: All subjects were comparable in age, occupation and education. Mean FSFI total score ± SD was significantly decreased in the FM and FM plus MD groups compared with that in healthy controls (21.83 ± 5.84 and 22.43 ± 7.0 vs 28.10 ± 6.52, respectively, p = 0.001). However, the FSFI score was not significantly different between patients with FM only and FM plus MD (p >0.05). Correlation analysis revealed a negative moderate correlation between total Lattinen pain score and FSFI score in the FM only and FM plus MD groups (r = -0.366, p = 0.047 and r = -0.403, p = 0.018, respectively). FSFI score did not correlate with FIQ and HDRS scores (p >0.05). Conclusions: This study demonstrates that female patients with FM have distinct sexual dysfunction compared with healthy controls and coexistent MD has no additional negative effect on sexual function. Thus, female subjects with FM should be evaluated in terms of sexual function to provide better quality of life. Copyright © 2005 by American Urological Association.Item Selective COX-2 inhibition with different doses of rofecoxib does not impair endothelial function in patients with coronary artery disease(2005) Tikiz C.; Ütük O.; Bayturan O.; Bayindir P.; Ekmekçi C.; Tikiz H.In this study, we investigated the effects of both 25 and 50 mg daily doses of rofecoxib on the endothelial functions of patients with coronary artery disease (CAD). For this purpose, 34 patients with documented severe CAD and who were under aspirin treatment (300 mg/day) were randomized to receive 4 weeks of treatment with a placebo (n = 10, group I), rofecoxib 25 mg/day (n = 12, group II), and rofecoxib 50 mg/day (n = 12, group III). Brachial artery vasodilator responses were measured in order to evaluate endothelial function. The percentage of change in endothelial-dependent vasodilation in groups I, II, and III were similar at the baseline level and showed no significant change after treatment (6.2 ± 3.9% vs. 5.9 ± 3.1% and 5.8 ± 3.3% vs. 5.6 ± 3.8% and 6.1 ± 4.5% vs. 5.8 ± 4.1%, respectively; P > 0.05). Compared with the baseline, endothelium-independent vasodilatation, as assessed by nitroglycerine (NTG), remained unchanged after the treatment period (11.2 ± 6.9% vs. 10.3 ± 7.1% and 11.2 ± 6.3% vs. 9.9 ± 5.1% and 9.5 ± 4.9% and 8.8 ± 4.6%, respectively; P > 0.05). Treatment with both doses also showed no significant effects on high-sensitivity C-reactive protein (hs-CRP) levels and resting arterial diameters (P > 0.05). In conclusion, 4 weeks of treatment with standard and high doses of rofecoxib showed no significant effects on either endothelial-dependent or independent vasodilator response or plasma hs-CRP levels in patients with severe CAD taking concomitant aspirin. Copyright©2005 by Okayama University Medical School.Item The effects of botulinum-A toxin on bladder function and histology in spinal cord injured rats: Is there any difference between early and late application?(Lippincott Williams and Wilkins, 2005) Temeltas G.; Tikiz C.; Dagci T.; Tuglu I.; Yavasoglu A.Purpose: We explored the effects of early and late application of botulinum-A toxin (BTX-A) on reservoir function and histological bladder changes in spinal cord injured rats. Materials and Methods: The study was done in 30 Sprague-Dawley rats randomly allocated into 5 groups. Group 1 of 6 rats underwent sham operation only. Group 2 of 6 rats underwent spinal cord transection. Group 3 of 6 rats underwent spinal cord transection followed by BTX-A application into the detrusor muscle 7 days later. Group 4 of 6 rats underwent spinal cord transection, followed by BTX-A application into the detrusor muscle 28 days later. Group 5 of 6 rats underwent spinal cord transection followed by saline injection into the detrusor muscle after 28 days. Spinal cord injury was created by transecting the cord at the T9 to T10 level. All rats underwent cystometric examination initially and on day 42 before sacrifice. The bladders were removed and examined histologically for fibrosis and hyperplasia. Results: On cystometric examination BTX-A caused an improvement in baseline pressure, and the frequency and amplitude of uninhibited detrusor contractions (p <0.001). No significant differences were observed in maximal bladder capacity or urethral opening pressure (p >0.05). Histologically BTX-A led to decreased fibrosis and hyperplasia (p <0.001). No significant differences were found between histological or cystometric among the groups with respect to receiving BTX-A in the early and late periods (p >0.05). Conclusions: BTX-A has a functional and histological healing effect on detrusor hyperreflexia subsequent to spinal cord injury in rats. Although administering BTX-A in the early period had better quantifiable functional and histological outcomes compared to the late period, the difference was not statistically significant. Copyright © 2005 by American Urological Association.Item 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.Item Endothelial dysfunction in patients with primary Sjögren's syndrome(2005) Pirildar T.; Tikiz C.; Özkaya S.; Tarhan S.; Ütük O.; Tikiz H.; Tezcan U.K.The aim of this study was to determine the endothelial function in patients with primary Sjögren's syndrome (SS). We also aimed to determine whether endothelial (dys)function correlates with extraglandular manifestations, specific autoantibodies and the severity of salivary gland involvement of SS. Endothelium-dependent vasodilation and endothelium-independent vasodilation of the brachial artery were assessed by a high-resolution ultrasound on 25 patients with primary SS and on 29 healthy controls. Patients with primary SS had significantly less mean endothelium-dependent vasodilation than did controls (3.0±0.4% vs 4.2±0.3%; p=0.012). Endothelium-independent vasodilation induced by sublingual glycerol trinitrate was not different between the two groups (12.9±1.4% vs 14.1±1.2%; p=0.86;). We concluded that endothelium-dependent vasodilation was impaired in primary SS patients, in particular those presenting with Raynaud's phenomenon, when compared with the healthy controls and this impairment was not associated with the presence of RF, ANA, anti-Ro/SS-A, anti-La/SS-B and with the other extraglandular manifestations of the disease. © Springer-Verlag 2005.Item Effects of simvastatin on bone mineral density and remodeling parameters in postmenopausal osteopenic subjects: 1-year follow-up study(2005) Tikiz C.; Tikiz H.; Taneli F.; Gümüşer G.; Tüzün Ç.Observational studies suggest that statin use may be associated with lower incidence of fracture. However, there are conflicting data for their effects on bone remodeling parameters and bone mineral density (BMD). In the present study, we aimed to investigate the effects of simvastatin on bone metabolism and BMD in subjects with hypercholesterolemia (> 240 mg/dl). For this purpose, 32 postmenopausal osteopenic subjects who were given simvastatin treatment (20 mg/day) and not on osteoporosis treatment were included in the study. During the 1-year follow-up period, the total cholesterol level decreased from 262.1 ± 30.9 to 202.2 ± 30.1 mg/dl (p < 0.0001). At a period as early as the 3rd month, levels of the anabolic markers, e.g., bone-specific alkaline phosphatase (BSAP) and osteocalcin (OCL), were found to be significantly increased (from 120.8 ± 56.6 to 149.5 ± 57.6 IU/l, p = 0.008, and from 20.8 ± 12.6 to 34.7 ± 18.4 μg/l, p = 0.015, respectively) while no significant change was observed in the resorptive marker of serum N-telopeptide of type I collagen (CTX). At the 6th and 12th month, BSAP and OCL were both found to be decreased below the pretreatment values. While a significant reduction was found in BSAP levels (from 120.8 ± 56.6 to 55.9 ± 18.8 IU/l, p < 0.001), no significant change was observed in CTX levels after the 6-month treatment period. Parathyroid hormone showed a gradual profound increase during the follow-up period (from 62.7 ± 41.5 to 108.4 ± 51.7 pg/ml, p < 0.001). No significant change was found in BMD levels at the spine, femoral neck, Ward's triangle, and trochanter at the end of the 1-year follow-up period. In conclusion, simvastatin treatment showed a short-lasting anabolic effect on bone metabolism. However, this effect was lost by prolongation of therapy. The decrease in both anabolic and resorptive markers at the 6th and 12th month suggests that simvastatin affects bone metabolism mostly in favor of inhibition of the bone turnover in a long-term observation period although this inhibitory effect was not reflected in BMD. © Clinical Rheumatology 2005.Item 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.Item Comparison of the effects of alendronate and risedronate on bone mineral density and bone turnover markers in postmenopausal osteoporosis(2006) Sarioglu M.; Tuzun C.; Unlu Z.; Tikiz C.; Taneli F.; Uyanik B.S.The aim of the study was to compare the effects of once-weekly alendronate sodium and daily risedronate sodium treatment on bone mineral density (BMD) and bone turnover markers in postmenopausal osteoporotic subjects. For this purpose, 50 patients were included in this study and randomly classified into two groups. Group I (n = 25) received risedronate (5 mg/day) and group II (n = 25) received alendronate Na (70 mg/ week). The study duration was limited to 12 months. The efficacy of the treatment was evaluated by BMD measurements at spine and hip at 6th and 12th months of the treatment, as well as by the measurement of bone turnover markers such as serum osteocalcin (OC), bone-specific alkaline phosphatase (BASP), urine deoxypyridinoline (DPD) and calcium/creatine ratio in 24-h urine at 1st, 3rd, 6th and 12th months. The evaluation of the changes in BMD in all regions revealed a significant increase in BMD in both groups compared to baseline values except for spine (L2-L4) in alendronate group at 6th and 12th month and femoral neck in risedronate group at 6th month. However, the difference in percentage increase in BMD measurements was not statistically significant between the two groups at 6th and 12th months. In both groups, serum OC, BSAP and urine DPD were found to be significantly attenuated at 1st month of the treatment period, and continued to be lowered throughout the 3rd, 6th and 12th months (P < 0.05). However, there was no statistically-significant difference between both groups of patients (P > 0.05). In conclusion, our results suggest that both treatment protocols provide treatment options of similar efficiency for postmenopausal osteoporosis, and have almost-similar effects in enhancing the BMD and in slowing the bone turnover. Risedronate seems to havea more potent effect in the spinal region than that of alendronate, although this potency was not statistically significant. © Springer-Verlag 2004.Item 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.Item Hip fractures in elderly and problems during rehabilitation; [Yaşlilarda kalça kiriǧi ve rehabi̇li̇tasyon sorunlari](2006) Tüzün Çiǧdem; Tikiz C.Hip fractures, one of the main reasons for disability, are frequently seen in older population. Several diseases including osteoporosis, neuromotor dysfunctions such as a stroke or Parkinson's disease, cognitive and balance disorders put the elderly to a higher risk for hip fracture compared to the younger population. In this group of patients, surgery is best treatment modality in order to obtain a satisfactory functional status. However, in these patients, age and coexisting medical illness may cause an increase in complications resulting in higher mortality after the surgical interventions. Moreover, the quality of life may be adversely affected in survivors after the surgery. In this manuscript, the rehabilitation of the elderly patients suffering from hip fracture and the potential problems during the rehabilitation program has been reviewed besides the preventive care method.Item Prevalence of depressive disorders among patients with fibromyalgia seeking help for the first time and its relationship with alexithymia; [Fizik tedavi ve rehabilitasyon polikliniǧine ilk kez başvuran ve fibromiyalji tanisi konan hastalarda depresif bozukluklarin görülme sikliǧi ve aleksitimi ile ilişkisi](2007) Taşkin E.O.; Tikiz C.; Gürlek Yüksel E.; Firat A.; Tüzün Ç.; Aydemir Ö.Objective: In this study, it was aimed to determine the prevalence of depression and its relationship with alexithymia among patients with fibromyalgia who apply to the Physical Therapy and Rehabilitation outpatient clinic for the first time. Methods: The research included 50 patients who applied to the Physical Therapy and Rehabilitation outpatient clinic for the first time and diagnosed as FM according to the American College of Rheumatology Scale. The subjects were evaluated with the SCID-I affective disorders module, 20-item Toronto Alexithymia Scale (TAS-20), 17-item Hamilton Depression Scale (HAM-D) and a demographic data form. Data were analyzed using t-test for continuous numerical parameters and chi-square test for categorized parameters. Pearson correlation test was used for determination of correlation between HAM-D and TAS-20 scores. Results: The prevalence of major depressive episode, depressive disorder NOS and dysthymia were found to be 44%, 10% and 14% respectively. None of the patients were seeking help for their depressive disorder and were using antidepressant treatment. TAS-20 scores of the patients with depression were higher (p=0.022) than scores of the non-depressive patients. Alexithymic patients had higher HAM-D mean values (p=0.035) and there was a positive correlation between TAS-20 and HAM-D scores (p=0.014). Conclusion: In fibromyalgia, the prevalence rate of depression is found to be significant. The prevalence rate of depression was even higher in alexithymic patients. Patients with fibromyalgia seem to have difficulty in experiencing their depression, and thus they do not seek psychiatric help. Therefore, these patients must be evaluated additionally for depression during the management of fibromyalgia.Item Physical therapeutic approaches in chronic pain management; [Kronik aǧri tedavisinde fizik tedavi yaklaşimlari](2007) Tikiz C.Chronic pain is a complex disease process during which physical, psychological, social factors play a role and which can continue after the recovery from the disease or trauma. This complex problem, which is hard to treat, can only managed by a comprehensive and multidisciplinary approach. In patients with chronic pain, pain behavior can be modified by using physical therapy modalities along with other medical and psychological approaches and as a result, their quality of life can be improved by decreasing restrictions in their daily activities. In this review, the efficacy of physical therapy modalities used commonly in chronic painful conditions is discussed in the light of the relevant literature. Copyright © 2007 by Türk Tibbi Rehabilitasyon Kurumu Derneǧi.Item Relationship between cyclic citrullinated peptide antibodies positivity and HLA-DRB1 shared epitope alleles in patients with rheumatoid arthritis in Turkey; [Türk romatoid artritli hastalarda siklik sitrüline peptit antikor pozitifliǧi ile HLA-DRB1 ortak epitop alelleri arasındaki i̇lişki](Aves Yayincilik, 2010) Dayan I.; Tikiz C.; Taneli F.; Ulman C.; Ulutaş G.; Tüzün C.Objective: The most characteristic genetic risk factors for rheumatoid arthritis (RA), the HLA-DRB1 shared epitope (SE) alleles, encode for a common amino acid sequence in the peptide-presenting part of the HLA class II molecule. These SE alleles have been described recently to be a risk factor for the development of antibodies against citrullinated proteins in RA. The current study was performed to investigate the association between the cyclic citrullinated peptide antibodies (anti-CCP) and HLA-DR1 HLA-DRB1 shared epitope alleles in patients with RA in Turkey. Materials and Methods: Sixty patients with RA who were newly diagnosed or under conventional treatment in our clinic and 60 healthy volunteers as controls were enrolled in the study. In patients with RA anti-CCP levels were investigated with enzyme-linked immunosorbent assay and HLA-DRB1 subtyping and SE was assessed by polymerase chain reaction. Only anti-CCP was measured in healthy volunteers. Results: SE was positive in 50% of the patients with RA. Amongst the SE carriers, 30% of them were carrying double copy of SE. While anti-CCP was positive in 73,3% of patients with RA, this ratio was 0% in healthy volunteers. We determined that the existence of SE increases the positivity of anti-CCP (OR=4,3, 95% [CI], P=0.04), and a significant relationship was found between the anti-CCP positivity and the RF positivity. (OR=5,3, 95% [CI] P<0.05). Conclusion: The results of the present study revealed that Turkish patients with RA carrying SE with HLA-DRB1 genes is significantly related with the production of anti-CCP. The diagnostic sensitivity and specificity of anti-CCP for RA is determined as 73,3% and 100% respectively.Item Low-Level Laser Therapy is More Effective Than Pulse Ultrasound Treatment onWound Healing: Comperative Experimental Study; [Düşükenerji seviyeli laser tedavisi yara iyileşmesinde kesikli ultrason tedavisinden daha etkindir: Karşılaştırmalı deneysel çalışma](Turkiye Klinikleri, 2010) Tikiz C.; Angin A.; Demireli P.; Taneli F.; Özyurt B.; Tüzün C.Objective: To investigate and compare the effects of pulse ultrasound (US) and low-level laser therapy (LLLT) on wound healing. Material and Methods: Thirty-two rats were included in the study and two full-thickness skin wounds were made on dorsum area of the rats bilaterally, with a 17 mm hole-punch. The animals were divided into two groups. Pulsed US (with a power of 0.1 W/cm2, a frequency of 1 MHz, 5 minutes daily) was applied to to the right sided wounds of Group A (n= 16) and Ga-As laser (830 nm wavelength, 0.5 J/ cm2 dosage of 1 MHz frequency for 1 minute duration) was applied to right sided wounds of Group B (n= 16). Left sided wound were considered as controls and same procedures were applied without any current (sham). Biochemical and histopathological evaluations were performed in each group on 7th and 15th days. Results: Inflammatory cells tended to decrease in both treatment groups on the 7th day, however, this finding did not reach a statistical significance (p> 0.05). Fibroblasts and collagen were found to be significantly increased in the laser group when compared to the other group on the 7th day (p< 0.05). Angiogenesis was found to be significantly increased only in the laser group when compared to the other group on the 15th day (p< 0.05). There were no significant differences in tissue nitric oxide values between the groups although the values in the laser group tended to be higher on the 15th day (p=0.058) Conclusion: In this comparative study, LLLT was found to significantly accelerate mainly proliferative phase while pulse US had no effect on wound healing. Our results support the consideration that LLLT may constitute a beneficial treatment modality for wound healing.Item Effects of Different Intensity Resistance Exercise Programs on Bone Turnover Markers, Osteoprotegerin and Receptor Activator of Nuclear Factor Kappa? Ligand in Post-Menopausal Women; [Farklı şiddetteki direnç egzersiz programlarının postmenopozal kadınların kemik turn-over markerleri, osteoprotegerin ve nükleer faktör kappa B reseptör aktivatör ligandı üzerine etkileri](Turkiye Klinikleri, 2010) Karaarslan S.; Büyükyazi G.; Taneli F.; Ulmans C.; Tikiz C.; Gümüşer G.; Şahan P.Objective: To investigate the effects of 12-week two-different intensity resistance training programs on bone turnover markers, bone mineral density (BMD), osteoprotogerin (OPG), and soluble receptor activator of nuclear factor kappa β ligand (sRANKL) in postmenopausal women. Material and Methods: Forty healthy women (aged 45-60 years) participated in the study. High-intensity group (HIG; n=14) worked 4 days a week and performed two sets of 8-10 repetitions at ~70-80% of 1 repeat maximum (RM). Low-intensity group (LIG; n= 13) worked in the same duration, with 13-17 repetitions, at ~40-50% of 1RM. Control group (CG; n = 13) did not perform any exercises. Body composition, 1RM value for 10 exercises, repetitions of sit-ups for 30 seconds, bone formation and resorption markers, serum osteocalcine (OC), bone alkaline phosphatase (BAP), βCrossLabs, OPG, and sRANKL levels were measured before and after the training program. BMD was measured via dual energy X-ray absorptiometry. Results: Resistance training caused increases in spine BMD in HIG and LIG (p< 0.05), and OC levels increased in the HIG (p< 0.05). We observed a significant difference between the percent change in HIG versus the percent change in CG in the spine BMD values (p< 0.01). sRANKL levels decreased significantly in all three groups. Strength measures increased in both exercise groups (p< 0.001), favoring the HIG. Conclusion: High-intensity resistance training may be more effective for increasing muscle strength and protecting against osteoporosis and fractures. Due to insignificant changes in OPG levels and significant reductions in sRANKL in all groups, measures of circulating OPG and sRANKL levels seem not to be so useful to predict BMD or bone turnover status after resistance training programs. Therefore, these parameters remain to be determined directly in the bone microenvironments together with BMD measures and bone turnover markers.Item The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis; [Romatoid artrit'li hastalarda etanercept ile yapilan anti-tümör nekroz faktör (TNF)-alfa tedavisinin endotel fonksiyonlari üzerine etkisi](2010) Tikiz H.; Arslan Ö.; Pirildar T.; Tikiz C.; Bayindir P.Objective: To investigate the effects of tumor necrosis factor (TNF)-〈 antagonism with etanercept (ENC) on endothelial functions in patients with active rheumatoid arthritis (RA). Methods: A total of 21 patients with RA were enrolled in this prospective study. Eleven of them (8 women, 3 men mean age 47.0±10.1 years) with high disease activity despite the conventional treatment were assigned to Group 1 and were given ENC treatment twice a week (25 mg SC injection) for 12 weeks. Ten patients with RA (8 women, 2 men mean age 55.0±6.4 years) under conventional methotrexate and prednisone therapy were assigned as Control group (Group 2). Endothelium-dependent and -independent vasodilator responses of the brachial artery were assessed by high-resolution ultrasound. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured at baseline and at the post treatment period. Mann-Whitney U and Wilcoxon tests were used to compare the data and correlation analysis was performed using Pearson correlation test. Results: Endothelium-dependent vasodilatation improved from 5.2±0.8% to 7.9±1.3% (p=0.04) in ENC group, while no significant change was observed in the control group (from 6.6±1.1% to 7.0±1.8% p=0.67). No significant changes were found in endothelium-independent vasodilatation and baseline brachial artery diameters in both groups. A significant reduction in ESR and CRP were observed in patients receiving ENC (from 16.2±6.8 to 9.2± 5.1 mm/h, p=0.003 and from 14.68±3.4 to 9.25± 3.7 mg/L, p=0.003, respectively). Conclusion: Treatment with ENC for 12 weeks significantly improved endothelial function in patients with active RA compared to those under conventional therapy. The findings of the present study support the hypothesis that the use of TNF-〈 blockers in patients with active RA may reduce the high incidence of cardiovascular complications. (Anadolu Kardiyol Derg 2010; 10: 98-103) © Copyright 2010 by AVES Yayincilik Ltd.Item The beneficial effects of physical exercise on antioxidant status in asthmatic children(2011) Onur E.; Kabaroĝlu C.; Günay T.; Var A.; Yilmaz T.; Dündar P.; Tikiz C.; Güvenç Y.; Yüksel H.Background: The pathogenesis of asthma involves both airway inflammation and an oxidant/antioxidant imbalance. It is demonstrated in asthmatic adults that exercise programmes improve lung function, a mechanism yet to be elucidated. The purpose of this study was to investigate the possible beneficial effects of physical exercise on antioxidant status in asthmatic children which may lead to ameliorated lung function. Methods: The study enrolled thirteen control and thirty asthmatic children. The asthmatic group was subdivided into two: the first group receiving only pharmacological treatment (n = 15) and the second receiving pharmacological treatment with exercise programme (n = 15) for 8 weeks. Blood samples were drawn from the subjects before and after treatment periods. As oxidant stress markers blood levels of malondialdehyde (MDA) and total nitric oxide (NO), and as antioxidant status, glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activities were assessed. Results: Before any treatment was initiated, MDA and NO levels in the asthmatic group were significantly higher than the controls (3.40 ± 0.96 nmol/ml vs 2.46 ± 0.58 nmol/ml, and 12.53 ± 2.10 vs 9.40 ± 1.39 micromol/L, respectively). Both SOD (p = 0.0001) and GSH-Px (p = 0.023) activities were significantly lower in the asthmatic group. Pharmacological treatment and exercise programme together significantly improved lung performance and decreased the levels of oxidant stress markers, in concordance with a significantly increase in antioxidant enzyme activity measures when compared to the pharmacological treatment. Conclusion: Structured exercise programme in asthmatic children resulted in better lung function, which may be attributed to its effect on antioxidant status. © 2010 SEICAP.Item Can urinary gamma glutamyl transferase be used as a bone resorption marker in postmenopausal osteoporosis?; [Üriner gamma glutamil transferaz postmenapozal osteoporozlu olgularda kemik yıkım belirteci olarak kullanılabilir mi?](Turkish Biochemistry Society, 2011) Tikiz C.; Ulman C.; Taneli F.; Acar E.Y.; Gümüşer G.; Horasan G.D.Objectives: To evaluate whether γ-glutamyl transferase can be used as a new novel bone resorption marker in postmenopusal osteoporotic subjects. Design and methods: 156 postmenopausal subjects were divided into three groups according to their lumbar spine T-score measured by dual-energy X-ray absorptiometry as normal, (control group, n=56), osteopenic (n=50) and osteoporotic (n=50). Deoxypyridinoline and γ-glutamyl transferase from urine samples and osteocalcin and bone specific alkaline phosphates from blood samples were assessed. Results: Osteocalcin and bone specific alkaline phosphates levels were increased in osteoporotic group (p<0.05). Although there is a tendency to increase in deoxypyridinoline values in osteoporotic group, this difference did not reach to a statistical significance. No significant differences were observed in urinary γ-glutamyl transferase levels between the three groups (p>0.05). No significant correlation was found between urinary γ-glutamyl transferase and deoxypyridinoline, bone specific alkaline phosphates and osteocalcin (p>0.05). Urinary γ-glutamyl transferase levels showed no significant correlation with neither bone mineral density nor T scores in all subjects (r= 0.058 p= 0.625, r=-0.074 p=0.533 respectively). Conclusions: Our primary findings did not support the suggestion that urinary γ-glutamyl transferase could be used as a potential marker for bone resorption in postmenopusal osteoporotic subjects. © 2011 TurkJBiochem.com.