Person: AKYÜZ, GÜLSEREN DERYA
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AKYÜZ
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GÜLSEREN DERYA
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Publication Metadata only The relationships of motor-evoked potentials to hand dexterity, motor function, and spasticity in chronic stroke patients: a transcranial magnetic stimulation study(SPRINGER HEIDELBERG, 2016) AKYÜZ, GÜLSEREN DERYA; Cakar, Engin; Akyuz, Gulseren; Durmus, Oguz; Bayman, Levent; Yagci, Ilker; Karadag-Saygi, Evrim; Gunduz, Osman HakanThe standardization of patient evaluation and monitoring methods has a special importance in evaluating the effectiveness of therapeutic methods using drugs or rehabilitative techniques in stroke rehabilitation. The aim of this study was to investigate the relationships between clinical instruments and transcranial magnetic stimulation (TMS)-evoked neurophysiological parameters in stroke patients. This study included 22 chronic post-stroke patients who were clinically assessed using the Motricity Index (MI), finger-tapping test (FTT), Motor Activity Log (MAL) 28, Brunnstrom motor staging and Ashworth Scale (ASH). Motor-evoked potential (MEP) latency and amplitude, resting motor threshold (rMT) and central motor conduction time (CMCT) were measured with TMS. Shorter MEP-latency, shorter CMCT, higher motor-evoked potential amplitude, and diminished rMT exhibited significant correlations with clinical measures evaluating motor stage, dexterity, and daily life functionality. rMT exhibited a negative correlation with hand and lower extremity Brunnstrom stages (r = -0.64, r = -0.51, respectively), MI score (r = -0.48), FTT score (r = -0.69), and also with amount of use scale and quality of movement scale of MAL 28 scores (r = -0.61, r = -0.62, respectively). Higher MEP amplitude and diminished rMT showed positive correlations with reduced ASH score (r = -0.65, r = 0.44, respectively). The TMS-evoked neurophysiologic parameters including MEP latency, amplitude, rMT and CMCT generally have positive correlation with clinical measures which evaluate motor stage, dexterity and daily life functionality. Additionally, spasticity has also remarkable relationships with MEP amplitude and rMT. These results suggest that TMS-evoked neurophysiological parameters were useful measures for monitoring post-stroke patients.Publication Metadata only A method for determining the grade of osteoporosis based on risk factors in postmenopausal women(SPRINGER LONDON LTD, 2005) AKYÜZ, GÜLSEREN DERYA; Ofluoglu, D; Gunduz, OH; Bekirolu, N; Kul-Panza, E; Akyuz, GThe aim of this study was to determine whether the probability of osteoporosis and osteopenia was affected by the risk factors, physical examination findings, or radiological investigations such as spinal X-rays in postmenopausal women. We assessed risk factors such as use of hormone replacement therapy, physical activity level, calcium intake, smoking, caffeine consumption, long-term immobilization, previous history of fracture, family history of fracture, presence of certain systemic diseases (hyperthyroidism or hyperparathyroidism), or use of medications (corticosteroids or others), physical examinations, and presence of vertebral fractures on spinal X-rays. Patients' bone mineral density (BMD) was evaluated using dual energy X-ray absorptiometry (DXA) in the lumbar spine, and we compared the risk factors between osteopenic and osteoporotic women according to DXA. We evaluated 235 postmenopausal women who attended our osteoporosis outpatient clinic. Those patients were divided into two groups as either osteopenic (n=67, mean age: 63.1 years) or osteoporotic (n=168, mean age: 66.2 years) according to WHO criteria. The lumbar spinal (L1-L2) T-score values were -1.5 +/- 0.6 and -3.1 +/- 0.6 in osteopenic and osteoporotic groups, respectively. There were significant differences between the two groups in terms of mean age and lumbar BMD (p=0.009 and p < 0.001, respectively). We also observed that vertebral tenderness on palpation, back pain, and existing vertebral fracture (fx) were significantly different between the osteopenic and osteoporotic groups (p < 0.05). As a result of the statistical analysis, we found an equation to determine osteopenic and osteoporotic women by using those four factors (age, vertebral tenderness on palpation, back pain, and existing vertebral fx) in multivariate stepwise logistic regression. The equation is as follows: Y (DXA) = -2.9024 + 0.044 (age in year) + 0.819 (vertebral fx) + 0.877 (pain) + 1.136 (vertebral tenderness). We can estimate whether a postmenopausal woman is osteopenic or osteoporotic based on these risk factors by using the stepwise logistic regression equation.Publication Metadata only The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey: a multicenter study(SPRINGER JAPAN KK, 2003) AKYÜZ, GÜLSEREN DERYA; Gur, A; Nas, K; Kayhan, O; Atay, MB; Akyuz, G; Sindal, D; Aksit, R; Oncel, S; Dilsen, G; Cevik, R; Gunduz, OH; Ersoy, Y; Altay, Z; Ozturk, C; Akkus, S; Senocak, O; Kavuncu, V; Kirnap, M; Tekeoglu, I; Erdogan, F; Sarac, AJ; Demiralp, L; Demirkesen, A; Adam, MThe purpose of this study was to investigate the associations of tooth loss with skeletal bone mass, years since menopause, educational level, current smoking status, dietary calcium intake, and number of pregnancies in postmenopausal osteoporotic women in Turkey. The study population consisted of 1171 postmenopausal women aged 40-86 years (mean age, 61.19 +/- 7.28 years). A detailed history was obtained from all women, including relevant lifestyle parameters, risk factors, and measurements of weight and height. Women were separated into three groups according to the number of teeth remaining as group 1 (edentulous, 457 women), group 2 (10 or fewer teeth, 232 women), and group 3 (more than 10 teeth remaining, 482 women). There was no significant difference among the three groups in mean age and menopausal age (P < 0.05). Body mass index of group 1 was significantly higher than that of group 2 (P < 0.01). Educational level was significantly different between three groups: groups 1 and 2 (P < 0.001), groups 1 and 3 (P < 0.0001), and groups 2 and 3 (P < 0.001). Educational level was lowest in group 1 and highest in group 3. Despite a low ratio of cigarette smoking in general, a smoking habit was most prevalent in group 3 and least in group 2. The ratio of women receiving adequate calcium was significantly lower in group 1 than in other groups (P < 0.001); mean calcium intake was similar in all groups. The number of pregnancies was significantly higher in group 1 than in other groups (P < 0.001). Lumbar bone mineral density (BMD) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001). Although no significant difference was found between groups 1 and 3, femoral neck BMD of group 2 was less than in others, and differences between groups 1 and 2 and between groups 2 and 3 (P < 0.001) were significant. Lumbar bone mineral content (BMC) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001), and lumbar BMC in group 2 was significantly higher than in group 3 (P < 0.05). Femoral neck BMC in group 1 was significantly higher than in groups 2 and 3 (P < 0.001). In conclusion, lumbar BMD and BMC in the edentulous group were significantly lower, whereas femoral neck BMD and BMC were significantly higher in edentulous group compared with the others. Our findings indicated that improvement in lifestyle factors and nutritional strategies for the treatment and prevention of osteoporosis may have additional benefit in reducing tooth loss.Publication Metadata only The effect of vitamin D replacement on spinal inhibitory pathways in women with chronic widespread pain(PERGAMON-ELSEVIER SCIENCE LTD, 2020) AKYÜZ, GÜLSEREN DERYA; Kenis-Coskun, Ozge; Giray, Esra; Gunduz, Osman Hakan; Akyuz, GulserenVitamin D replacement helps in pain reduction in patients with chronic widespread pain (CWP). But the current literature lack studies that investigate its mechanism. Cutaneous silent period (CSP) is the electrophysiologic analog of the spinal inhibitory pathways and an objective method to document their involvement. This study aims to show if vitamin D replacement has an effect on the spinal inhibitory pathways through CSP parameters. Female patients who have CWP with vitamin D deficiency were included. Patients received an 8-week replacement therapy of vitamin D. Patients' pain were evaluated using the visual analog scale (VAS) and Leeds assessment of neuropathic symptoms and signs pain scale (LANSS). Quality of life with Nottingham Health Profile (NHP) and CSP parameters were also recorded before and after treatment. A total of 51 patients were included in the final analyses. The mean age of the patients was 44.3 +/- 12.7 (minimum 18-maximum 65). Mean symptom duration was 13.1 +/- 6.7 (minimum3-maximum 24) months. Patients' mean BMI was 21.6 +/- 3.9 (minimum 18.0 maximum 29.1). Patients' median VAS and LANSS scores decreased significantly (p < 0.01) and NHP scores improved significantly in all subsets (p < 0.01). Vitamin D replacement did not significantly change CSP latency and duration (p = 0.06 and p = 0.12). Vitamin D replacement does not seem to work via modifying the spinal inhibitory pathways that are involved in the formation of the cutaneous silent period. This is the first study to objectively investigate the effect of vitamin D replacement on central sensitization mechanisms.Publication Metadata only Early effect of nasal salmon calcitonin on the bone marker Crosslaps(SPRINGER HEIDELBERG, 2006) AKYÜZ, GÜLSEREN DERYA; Ofluoglu, D; Karadag-Saygi, E; Canbulat, C; Gunduz, OH; KUL-Panza, E; Akyuz, GThe aim of this study was to investigate the early effect of nasal salmon calcitonin on a bone-resorption marker, Crosslaps, in postmenopausal osteoporotic women. In this randomized, single-blind and placebo-controlled study we included 78 postmenopausal women with osteoporosis, between 45 and 65 years of age, with at least 5 years duration of menopause. Patients were randomly divided into two groups, the treatment and the placebo groups. Patients in the treatment group were given 100 IU day(-1)nasal salmon calcitonin, 1,000 mg day(-1)s elemental calcium, and 400 IU day(-1) vitamin D. Patients in the placebo group took only 1,000 mg day(-1)elemental calcium, and 400 IU day(-1) vitamin D. The outcome measurements were urinary deoxypyridinoline, serum alkaline phosphatase, osteocalcin, and Crosslaps. The treatment group consisted of 39 patients whose mean age was 60.4 +/- 6 years and the placebo group included 39 patients with a mean age of 60.5 +/- 4.9 years. There was no significant difference between two groups in terms of demographic characteristics. The results of bone marker measurements were analyzed statistically. Crosslaps levels in the treatment group were significantly lower (P < 0.05) than in the placebo group. Other bone marker levels at the end of the study were not significantly lower (P > 0.05) than those at baseline in both treatment and placebo groups, however. Salmon calcitonin affects bone turnover within a few months and bone-resorption markers such as Crosslaps can be used to monitor the effect of nasal salmon calcitonin in the early phase of treatment for postmenopausal osteoporosis.Publication Open Access The Prevalence of Osteoporosis in the Thrace Region of Turkey: A Community-Based Study(AVES, 2014-11-26) AKYÜZ, GÜLSEREN DERYA; Keskin, Yasar; Cekin, Murat Dincer; Gunduz, Hakan; Luleci, Nimet Emel; Giray, Esra; Sur, Haydar; Akyuz, GulserenObjective: This study was planned as a community-based research study to estimate the prevalence of osteoporosis and explore related risk factors in the Thrace region of Turkey. Material and Methods: The community-based study involved a total of 620 people, 498 women and 122 men, aged between 40 and 89 years. A questionnaire on the medical history and lifestyles of the participants was applied with a face-to-face interview. Body weight height, and arm span of each participant were measured, together with bone mineral density at the middle phalanges of the second, third, and fourth digits of the non-dominant hand using dual-energy X-ray laser absorptiometry. Results: Age, clothing, lack of regular exercise, and giving birth to more than two children seem to contribute to osteoporosis, while high education, high economic level, tea and moderate alcohol consumption, oral contraceptive use, and hormone replacement therapy seem to retard osteoporosis. Osteoporotic patients had more fractures in the past. Height and weight were significantly lower in osteoporotic women. Conclusion: Lifestyle affects the prevalence of osteoporosis. Drinking tea and alcohol seems to be controversial with regard to osteoporosis risk.Publication Metadata only A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial(GEORG THIEME VERLAG KG, 2021) AKYÜZ, GÜLSEREN DERYA; Giray, Esra; Ermerak, Nezih Onur; Bahar-Ozdemir, Yeliz; Kalkandelen, Melihat; Yuksel, Mustafa; Gunduz, Osman Hakan; Akyuz, GulserenIntroduction Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC. Materials and Methods Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23hours, compression orthosis 8hours, and control group. All groups received exercises for 1hour a day for 3 weeks. Additionally, compression orthosis 23hours group wore the orthosis for 23hours a day, while compression orthosis 8hours group wore the orthosis for 8hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety. Results The compression orthosis 23hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups. Conclusion Compression orthosis use for 23hours can be recommended rather than its use for 8hours because 23hours of orthosis use has better correction and similar adverse effects.Publication Metadata only Comparative electrophysiological techniques in the diagnosis of carpal tunnel syndrome in patients with diabetic polyneuropathy(ELSEVIER IRELAND LTD, 2010) AKYÜZ, GÜLSEREN DERYA; Yagci, Ilker; Gunduz, Osman Hakan; Sancak, Seda; Agirman, Mehmet; Mesci, Erkan; Akyuz, GulserenObjective: To determine utility of comparative electrophysiological techniques in differentiating carpal tunnel syndrome (CTS) in the background of diabetic polyneuropathy (DPN). Design: Ninety diabetic patients were classified into three groups: normal, CTS, and DPN according to nerve conduction studies (NCSs). The patients in the DPN group were divided into two subgroups of DPN and DPN-CTS according to clinical criteria. The comparative electrophysiological parameters including median-radial sensory distal latency difference (M-RSLD), median-ulnar sensory distal latency difference (M-USLD) and lumbrical-interosseous median-ulnar distal latency difference (LIMULD) were compared in subgroups of DPN, DPN-CTS and CTS. Results: Thirty-five (38.8%), 47(52.3%), and 8(8.9%) patients were diagnosed as CTS, DPN, and normal, respectively, according to NCS. After clinical stratification, 25 patients were diagnosed as DPN and 22 patients were diagnosed as DPN-CTS. The mean M-USLD and LIMULD values were similar in CTS and DPN-CTS groups, but larger than DPN statistically (p < 0.05 for all). LIMULD, M-RSLD and M-USLD were positive in 88.4, 73 and 54% in the DPN-CTS group, respectively. Conclusions: Electrophysiological abnormalities were common in diabetic patients and LIMULD can identify CTS in diabetic DPN patients better than M-RSLD and M-USLD. (C) 2010 Elsevier Ireland Ltd. All rights reserved.Publication Open Access Effectiveness of Low Level Laser Therapy on Pain and Functional Status in Ankylosing Spondylitis(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012-01-23) AKYÜZ, GÜLSEREN DERYA; Aydin, Elif; Gunduz, Osman Hakan; Akcan, Eylem; Akyuz, GulserenObjective: The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) on pain, functional status and disease activity in patients with ankylosing spondylitis (AS). Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 37 patients. Group 1 (n=19) was treated with LLLT for 10 sessions (1.2J, 30 mW), group 2 received placebo laser. LLLT was applied on the L3 to S1 supraspinous ligaments and sacroiliac joints bilaterally with a skin-contact method. Evaluation parameters were Visual Analogue Scale (VAS), at rest and during movements, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. Results: Compared with the pre-therapy, LLLT group showed significant improvement in VAS (p<0.05), ASQoL (p<0.01) and BASDAI (p<0.001) scores during movement at the end of the treatment and at the second month (p<0.05). However, there was no statistically significant difference between treatment and placebo groups. Conclusion: This is the first study to assess the effects of LLLT in patients with AS. The results show LLLT seemed to improve pain and functional status in patients with AS.