Browsing by Author "Unlu Z."
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Item Efficacy of collar treatment for patients with cervical spondylatrosis complaining of vertigo(Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai), 2001) Unlu Z.; Cerrahoglu L.; Aslan A.; Tarhan S.Objective: Efficacy of collar treatment on clinical symptoms and vertebral blood flow was examined in 23 patients with cervical spondylartrosis complaining of vertigo. Methods: In pretreatment and posttreatment periods, the following parameters were studied: 1) frequency of cervicocephalic symptoms, 2) influence of severity of the vertigo on daily life activity, 3) range of active cervical joint movement, 4) pain in cervical palpation, 5) vertebral blood flow by Doppler ultrasonography, and audiologic and brainstem auditory evoked potential (BAEP) examinations for hearing. Results: Following 1 month of collar treatment, vertigo and amnesia were the only symptoms which were significantly relieved (p=0.01, p=0.03). In addition, the severity of the symptoms were noticeably decreased. Range of cervical joint movements on extention, lateral flexion and rotation were increased. Cervical palpation was reduced and the pain was less. However, no change was observed in vertebral blood flow, audiometric and BAEP examinations. Conclusion: It was concluded that vertigo in cervical spondylartrosis was not a consequence of vertebrobasillar insufficiency. Hypertonicity in cervical muscles was the primary reason for vertigo in these patients.Item Relationship between ossification of the stylohyoid ligament and enthesopathy: A comparative study(2002) Unlu Z.; Tarhan S.; Gunduz K.; Goktan C.Objective. Stylohyoid apparatus might be an anatomic region in the cervical spine involved by enthesopathy. The aim of this study was to assess the elongation and/or ossification at the stylohyoid apparatus in the degenerative or inflammatory diseases such as ankylosing spondylitis (AS), psoriatic arthropathy (PsA) and cervical spondyloarthrosis (CS) in which cervical spine involvement can be seen. Methods. Twenty-eight patients with AS, 25 patients with PsA, 31 patients with CS and 50 controls who did not have any complaints or symptoms related with elongated styloid process (SP) were included in the study. On the lateral cervical radiographs, the anterior and posterior aspects of each vertebral body and intervertebral disk were carefully evaluated for the presence and severity of syndesmophytes, osteophytes or ossification of the adjacent longitudinal ligaments in the patient group. The entire osseous length of the SP was measured on the lateral and lateral oblique mandibular or cervical views or the anteroposterior views radiographs in the patients and controls. Results. There were statistically significant differences between the patients with AS and control group and between the patients with PsA and control group with respect to the length of SP. The dimension of syndesmophytes or ligamentous ossification of the cervical spine involving C5-6 intervertebral disk level were significantly correlated with length of SP in the patients with AS. Conclusion. Elongated SP might be another manifestation of enthesopaty in cervical spine of the spondyloarthropathies.Item Lumbar stiffness but not thoracic radiographic changes relate to alteration of lung function tests in ankylosing spondylitis(2002) Cerrahoglu L.; Unlu Z.; Can M.; Goktan C.; Celik P.Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence of involvement of the CV joint in 80% of patients and of the CT joint in 60 %. We found a direct relation between the severity of CV, CT and SI joint affliction, and the severity of CV and SI joints were related to time of evolution of the disease. Pulmonary function tests revealed neither restrictive nor obstructive defects. No relation was found between pulmonary function and CV and CT joint affliction. Patients with stiffer spines had a tendency to have pulmonary function tests within the lower limit of the normal range. In patients with AS diaphragmatic breathing might compensate the chest respiration to some extent.Item Osteochondroma of the posterior nasal septum managed by endoscopic transnasal transseptal approach(2002) Unlu H.H.; Unlu Z.; Ayhan S.; Egrilmez M.A case of osteochondroma of the posterior nasal septum is presented. A 57-year-old female patient presented with a history of bilateral nasal obstruction for 20 years. To the best of our knowledge, this is the second reported case of an osteochondroma of the nasal septum. It was treated by endoscopic transnasal transseptal surgery.Item Ultrasonographic evaluation of pes anserinus tendino-bursitis in patients with type 2 diabetes mellitus(2003) Unlu Z.; Ozmen B.; Tarhan S.; Boyvoda S.; Goktan C.Objective. To assess musculoskeletal ultrasonographic (US) findings in patients with type 2 diabetes mellitus (DM) with and without pes anserinus (PA) tendinitis or bursitis syndrome; and to determine possible etiologic factors such as systemic diabetic microvascular disease complications in these patients. Methods. The knee joints were examined with an ultrasound real-time scanner using a 10 MHz electronic linear transducer in 48 patients with type 2 DM and 25 controls. The presence of systemic diabetic microvascular disease complications was evaluated. Results. On examination 23 (23.9%) knees of the 14 (29.1%) patients with type 2 DM were found to have PA tendinitis or bursitis syndrome. US revealed that only 4 (8.3%) of the diabetic patients with PA tendinitis or bursitis syndrome had PA tendonitis findings. There were no significant differences in the thickness of PA tendons between the diabetic patients with bilateral knee PA tendinitis or bursitis syndrome (9 patients) and controls, or between the asymptomatic and symptomatic knees in patients with unilateral PA tendinitis or bursitis syndrome (5 patients). The prevalence of morphologic changes of the medial meniscus, effusion and synovitis in the suprapatellar recess, popliteal cyst, and radiographic osteoarthritis (OA) in the diabetic patients with PA tendinitis or bursitis syndrome was found to be increased. Conclusion. The prevalence of PA tendinitis or bursitis syndrome is not uncommon on examination in patients with type 2 DM. However, patients with clinically diagnosed PA tendinitis or bursitis syndrome less frequently have morphologic US changes of the PA tendons. Our results also suggest that structural changes such as meniscus lesions that occur in consequence of OA might have a role in the etiology of medial knee pain in diabetic patients.Item Sonographic training in rheumatology: A self teaching approach(2003) Filippucci E.; Unlu Z.; Farina A.; Grassi W.Objective: To evaluate a self teaching approach to be followed by a novice without previous practical experience in musculoskeletal ultrasonography. Methods: The novice was given short general training (two hours) by an experienced sonographer focusing on the approach to the ultrasound equipment, and asked to obtain the best sonographic images of different anatomical areas as similar as possible to the "gold standard" pictures in the online version of the guidelines for musculoskeletal ultrasonography in rheumatology (free access at http://www.sameint.it/eular/ultrasound). At the end of each scanning session, both novice and tutor scored "blindly" all the images from 0 (the lowest quality) to 10 (the highest quality), with a minimum quality score of 6 considered acceptable for standard clinical use. The tutor then explained how to improve the quality of the pictures. Fourteen consecutive inpatients (seven with rheumatoid arthritis, three with psoriatic arthritis, two with reactive arthritis, and two with osteoarthritis) and five healthy subjects were examined. Ultrasound examinations were performed with a Diasus (Dynamic Imaging Ltd, Livingston, Scotland, UK) using two broadband linear probes of 5-10 and 8-16 MHz frequency. Results: Sonographic training lasted one month and included 30 scanning sessions (24 hours of active scanning). 243 images were taken of the selected anatomical areas. The mean time required to produce each image was 6 minutes (SD 4.2; range 1-30). At the end of the training, the novice scored ≥6 for each standard scan. Conclusion: A novice can obtain acceptable sonographic images in 24 non-consecutive hours of active scanning after an intensive self teaching programme.Item Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: A comparative study(2003) Tarhan S.; Unlu Z.; Goktan C.The objectives of the present work were (1) to establish the prevalence of the abnormalities detected by magnetic resonance imaging (MRI) and ultrasonography (US); and (2) to compare these imaging techniques in detail. The study group consisted of 58 patients with symptomatic knee OA and 16 volunteer control subjects. Knee joint was evaluated for femoral condylar cartilage changes, effusion, synovial thickening and popliteal cysts using MRI and US. All knees with OA had cartilage abnormalities on US examinations and normal cartilage was detected in less than 3% of these knee by MRI. Majority of the knees with OA had effusion using US (70%) or MRI (85%). Synovial thickening observed on US (34%) and MRI (50%) were common in the knees with OA. Popliteal cysts were detected in 40% of the knees with OA using US and 35% using MRI. This study confirmed that there was a significant correlation between the MRI and US techniques for evaluating the cartilage and soft tissue changes in the patients with knee OA. There were more significant differences between the controls and the symptomatic knees which had Kellgren-Lawrence (K-L) grade 2 or more OA for the cartilage and soft tissue abnormalities on MRI and US. The prevalence of cartilage changes, effusion, synovial thickening and popliteal cyst using MRI and US were increased as the radiographic grade of OA increased. US examinations could be an alternative to initial evaluation tool to MRI in patients with knee OA.Item Serologic examinations of hepatitis, cytomegalovirus, and rubella in patients with Bell's palsy(2003) Unlu Z.; Aslan A.; Ozbakkaloglu B.; Tunger O.; Surucuoglu S.Objective: The aim of this retrospective case review was to investigate serologic evidence of cytomegalovirus, rubella virus, and hepatitis A, B, and C viruses in patients with Bell's palsy. Design: A total of 24 patients with idiopathic facial paralysis, without a history of trauma, any evidence of a tumor on high-resolution computed tomographic imaging, or any otologic disease, and 33 healthy individuals as a control group were included in this study. Facial paralysis of the patient was evaluated with the House-Brackmann grading scale. Specific immunoglobulin G and M titers were determined for cytomegalovirus, rubella, hepatitis A, hepatitis B, and hepatitis C by enzyme-linked immunosorbent assay. Results: Serologic positivity for hepatitis B was found in 15 of 21 Bell's palsy patients, compared with 32.1% in the control group. The difference was statistically significant. There was no difference in the prevalence of serologic positivity for cytomegalovirus, hepatitis A, and rubella between the patient and control groups. In one Bell's palsy patient, serologic evidence of recent cytomegalovirus infection was indicated by changes in antibody titers between samples taken on presentation and on the 16th day. There was no serologic evidence of hepatitis C in either Bell's palsy patients or the control group. Conclusion: There seems to be an association between hepatitis B and idiopathic facial paralysis. In addition, cytomegalovirus might contribute to the development of Bell's palsy in some ceases with Bell's palsy. Further studies are required to confirm these data.Item Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema(2005) Unlu Z.; Orguc S.; Ovali G.Y.; Tarhan S.; Dayan I.; Angin A.We describe a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome) in a 66-year-old man. This report discusses magnetic resonance imaging findings of RS3PE syndrome and the changes after steroid therapy. © Clinical Rheumatology 2005.Item The correlation between magnetic resonance detected cartilage defects and spiking of tibial tubercles in osteoarthritis of the knee joint(2006) Unlu Z.; Tarhan S.; Goktan C.; Tuzun C.The aim of the study was to ascertain whether spiking of the tibial tubercle is associated with cartilage defects detected by magnetic resonance imaging (MRI) in patients with osteoarthritis (OA) of the knee joint. Angulation of the tip of the medial and lateral tubercles, and the height of the tubercles above the tibial plateau were measured on a standard anteroposterior radiograph of the knee joint. Cartilage defects in the tibiofemoral joint (TFJ) were determined by MRI examination. The lengthening and sharpening of the angles of the tubercles were significantly more prominent in the patients than controls. A strong association was found between angulation (if less than 70°) and especially the height (if more than 0.16) of the medial tibial spike and MRI-detected cartilage defects in the medial tibiofemoral compartment. The predictive value of the spiking of tibial tubercles for MRI-detected cartilage defects in TFJ is related to the degree and size of the spiking. The presence of tibial spiking itself may not be a reliable sign of early OA. Copyright ©2006 by Okayama University Medial School.Item Intra-articular injection of tenoxicam in the treatment of osteoarthritis of the knee(2006) Unlu Z.; Ay K.Objectives: The aim of this study was to determine whether tenoxicam, administered by the intra-articular route, is useful for the treatment of osteoarthritis [ OA] of the knee. Methods: Patients with knee OAwere placed into three groups. Patients with no evidence of inflammation were randomized into Groups 1 and 2. Group 3 consisted of patients with knee OA with associated signs of inflammation. Groups 1 and 3 received three weekly intra-articular injections of tenoxicam, whereas only physical exercise was applied to Group 2. The Western Ontario McMaster Universities Index [WOMAC], the Lequesne Index for knee OA, and physical examination findings of the knee joint were used in the clinical and functional evaluations at baseline and months 1, 3, and 6. Results: A total of 63 subjects participated in this study. Statistically significant improvements from baseline were detected in Group 1 and Group 3, but not in Group 2. There was no lasting benefit from tenoxicam therapy since Groups 1 and 2 showed no significant differences at the six-month conclusion of the study. Similarly, Group 1 and Group 3 did not differ significantly. Conclusions: Intra-articular tenoxicam therapy seemed to show greater efficacy for pain and improvement of functional performance than exercise therapy alone, but the effects were no longer present. Tenoxicam, given intra-articularly, may provide benefit from the symptoms of OA, but the effects are transient. Copyright © by The Haworth Press, Inc. All rights reserved.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 Comparison of intra-articular tenoxicam and oral tenoxicam for pain and physical functioning in osteoarthritis of the knee(2006) Unlu Z.; Ay K.; Tuzun C.This study was designed to compare efficacy of local administration of a nonsteroidal anti-inflammatory drug with systemic administration in patients with osteoarthritis (OA) of the knee. For this purpose, intra-articular tenoxicam and oral tenoxicam therapies were applied and the improvement in control of pain and physical functioning were evaluated. A total of 69 patients with OA of the knee were randomized into three groups. Patients in the first group (41 knees of 23 patients) were treated for 1-3 weeks with once weekly intra-articular injection of tenoxicam 20 mg. Patients in the second group (45 knees of 26 patients) received 20 mg/day tenoxicam orally for 3 weeks and only physical exercises were applied to the third group (32 knees of 20 patients). Physical examination of the knee joint, Western Ontario and McMaster Universities Index and the Lequesne Algofunctional Index were used as outcome measurements at baseline, and the 1st, 3rd and 6th months. More significant improvement in pain and disability parameters was observed in groups 1 and 2 than group 3 compared with baseline measures. Among the patients' responses a few of the differences were statistically significant, more in favour of tenoxicam, and tenoxicam seemed to be superior to exercise alone especially at the final evaluation. There was no significant difference between the oral and intra-articular tenoxicam treatment regimens. The results of this study showed that treatment of OA of the knee with intra-articular tenoxicam is as effective as that with oral tenoxicam. It can be thought that intra-articular administration can be preferred to oral therapy due to minimal possibility of systemic side effects. © Clinical Rheumatology 2005.Item Unusual long bone and metacarpo-carpal abnormalities in a case of pseudo-pseudohypoparathyroidism(2007) Unlu Z.; Orguc S.; Yilmaz Ovali G.; Bayindir P.A case of pseudo-pseudohypoparathyroidism (PPH) with shortening of the left femur and tibia and coalition of the base of the fourth metacarpals with capitatum and hamatum in bilateral wrist joints was presented. Involvement of the fourth digits both in hands and feet were more prominent on the left side, with shortening of the left leg. © Clinical Rheumatology 2006.Item Comparison of 3 Physical Therapy Modalities For Acute Pain in Lumbar Disc Herniation Measured by Clinical Evaluation and Magnetic Resonance Imaging(2008) Unlu Z.; Tasci S.; Tarhan S.; Pabuscu Y.; Islak S.Objective: This study measures and compares the outcome of traction, ultrasound, and low-power laser (LPL) therapies by using magnetic resonance imaging and clinical parameters in patients presenting with acute leg pain and low back pain caused by lumbar disc herniation (LDH). Methods: A total of 60 patients were enrolled in this study and randomly assigned into 1 of 3 groups equally according to the therapies applied, either with traction, ultrasound, or LPL. Treatment consisted of 15 sessions over a period of 3 weeks. Magnetic resonance imaging examinations were done before and immediately after the treatment. Physical examination of the lumbar spine, severity of pain, functional disability by Roland Disability Questionnaire, and Modified Oswestry Disability Questionnaire were assessed at baseline, immediately after, and at 1 and 3 months after treatment. Results: There were significant reductions in pain and disability scores between baseline and follow-up periods, but there was not a significant difference between the 3 treatment groups at any of the 4 interview times. There were significant reductions of size of the herniated mass on magnetic resonance imaging after treatment, but no differences between groups. Conclusions: This study showed that traction, ultrasound, and LPL therapies were all effective in the treatment of this group of patients with acute LDH. These results suggest that conservative measures such as traction, laser, and ultrasound treatments might have an important role in the treatment of acute LDH. © 2008 National University of Health Sciences.Item Sonographic-guided injection of corticosteroid in the treatment of lateral epicondylitis(2009) Unlu Z.; Tarhan S.; Ovali G.Y.; Pabuscu Y.Objective: In this study the advantage of ultrasonography [US] in diagnosis and therapy of lateral epicondylitis [LE] was investigated in patients with lateral elbow pain and clinically diagnosed as LE. Methods: Fifty-two patients with LE were examined using sonography. For the patients in whom normal US examination was found, a blind injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine was performed [Group 1]. The patients whose clinical diagnosis was confirmed with US received a sonographic-guided injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine [Group 2]. Outcome measurements were performed at baseline, two weeks, one month, and three months. Pain and functional status were assessed using a visual analog scale, physical functioning and bodily pain scales of the Medical Outcomes Study 36 Item Short-Form Health Survey, a patient-rated forearm evaluation questionnaire, and a patient-specific functional scale. Painless grip strength bilaterally was also measured. Results: Twenty-four [46.2 percent] patients had a normal-appearing common extensor origin on US. The group in which diagnosis of LE was confirmed on US and sonographic-guided corticosteroid injections improved significantly from the baseline to the third month follow up [P < 0.000] in both clinical assessment and physical examination findings. Conclusions: Our case series suggested that sonography of the common extensor origin can be used to confirm LE in patients with lateral elbow pain. Although sonographic-guided injections produced more clinical improvement, further studies are needed to determine effectiveness of sonographic-guided injections. © 2009 by Informa Healthcare USA, Inc. All rights reserved.Item An idiopathic case of calcium pyrophosphate dihydrate crystal deposition disease with crowned dens syndrome in a young patient(2009) Unlu Z.; Tarhan S.; Ozmen E.M.Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is rare in patients under the age of 40 in the absence of metabolic or familial predisposition. A high incidence of involvement of the transverse ligament of the atlas in CPPD deposition disease was reported. However, involvement of the craniocervical junction is rarely symptomatic. We report a rare case in a young male with severe idiopathic CPPD crystal deposition disease, including crowned dens syndrome in the cervical spine. Copyright © 2009 by The Southern Medical Association.Item 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis(Springer Verlag, 2018) Tuncer T.; Cay F.H.; Altan L.; Gurer G.; Kacar C.; Ozcakir S.; Atik S.; Ayhan F.; Durmaz B.; Eskiyurt N.; Genc H.; GokceKutsal Y.; Gunaydin R.; Hepguler S.; Hizmetli S.; Kaya T.; Kurtais Y.; Saridogan M.; Sindel D.; Sutbeyaz S.; Sendur O.F.; Ugurlu H.; Unlu Z.In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.Item The GUSS test as a good indicator to evaluate dysphagia in healthy older people: a multicenter reliability and validity study(Springer International Publishing, 2019) Umay E.; Eyigor S.; Karahan A.Y.; Gezer I.A.; Kurkcu A.; Keskin D.; Karaca G.; Unlu Z.; Tıkız C.; Vural M.; Aydeniz B.; Alemdaroglu E.; Bilir E.E.; Yalıman A.; Sen E.I.; Akaltun M.S.; Altındag O.; Keles B.Y.; Bilgilisoy M.; Ozcete Z.A.; Demirhan A.; Gundogdu I.; Inanir M.; Calik Y.Purpose: Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Methods: This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. The study included 1163 participants aged ≥65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity. Results: The age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. The average total GUSS score was 18.57 ± 1.41. The Cronbach’s alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. The cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%. Conclusions: The GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice. © 2019, © 2019, European Geriatric Medicine Society.Item Which swallowing difficulty of food consistency is best predictor for oropharyngeal dysphagia risk in older person?(Springer International Publishing, 2019) Umay E.; Eyigor S.; Karahan A.Y.; Keskin D.; Karaca G.; Unlu Z.; Tıkız C.; Vural M.; Aydeniz B.; Alemdaroglu E.; Bilir E.E.; Yalıman A.; Sen E.I.; Akaltun M.S.; Altındag O.; Keles B.Y.; Bilgilisoy M.; Ozcete Z.A.; Demirhan A.; Gundogdu I.Aim: Our aim was to investigate which swallowing difficulty of food consistency in older people who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD) risk. Findings: We have found that the eating/drinking difficulty of thick liquids was the highest predictive value with respect to OD risk and the eating difficulty of mixed content food had the highest diagnostic ratio. Message: The present study reports that even in older person who do not go to the hospital with the complaints of swallowing difficulty, the difficulty of swallowing thick liquids and especially the mixed content food should be questioned. Purpose: The present study aimed to investigate which swallowing difficulty of food consistency in participants over 65 years of age who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD). Methods: The cross-sectional and multicenter study was conducted at 12 hospitals including 883 participants aged ≥65 years who were fed orally and who were admitted to the physical medicine and rehabilitation outpatient clinics between September 2017 and December 2018. Demographic characteristics were recorded. Katz Daily Living Activities Index (KDLAI), swallowing-related quality of life scale (Swal-QoL) and 10-item Eating Assessment Tool (EAT-10) were used. The participants were asked the “yes” or “no” questions including swallowing difficulty of various types of food consistency with the face-to-face interview. Results: Participants were divided into two groups as normal swallowing (EAT-10 < 3 group) (n = 639) and OD risk groups (EAT-10 ≥ 3 group) (n = 244) according to the EAT-10 scores. While there was no difference related to number of teeth and KDLAI scores between groups (p = 0.327 and p = 0.221, respectively), the significant difference was found between groups in terms of yes/no questions and Swal-QoL scores (p < 0.05). Receiver operating characteristic analysis revealed that eating difficulty of mixed content food provided maximum sensitivity (99%) and eating/drinking difficulty of thick liquid had maximum specificity (77%). The higher area under curve was in eating/drinking difficulty of thick liquid (0.891), and higher positive likelihood ratio (LR) was eating/drinking difficulty of thick liquid (4.26) as well as lower negative LR was eating difficulty of mixed content food (0.01). The higher diagnostic odds ratio was eating difficulty of mixed content food (367.0), and the higher posttest probability was eating/drinking difficulty of thick liquid (0.211). Conclusion: While eating difficulty of hard solid food is the most common symptom in healthy participants over 65 years of age, the eating difficulty of thick liquids is the highest predictive value related to oropharyngeal dysphagia risk. Also, the eating difficulty of mixed content food had the highest diagnostic ratio. © 2019, European Geriatric Medicine Society.