Person: AKYÜZ, GÜLSEREN DERYA
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AKYÜZ
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GÜLSEREN DERYA
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Publication Metadata only Ulnar nerve entrapment at wrist associated with carpal tunnel syndrome(ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER, 2003) AKYÜZ, GÜLSEREN DERYA; Gozke, E; Dortcan, N; Kocer, A; Cetinkaya, M; Akyuz, G; Us, OIn this study, ulnar nerve entrapments at the wrist were investigated using nerve conduction studies in cases with established diagnosis of carpal tunnel syndrome (CTS). Cases with cervical radiculopathy and polyneuropathy as well as patients with ulnar nerve entrapment at elbow were excluded from the study. Fifty-three cases (46 females, seven males) whose ages ranged between 20 and 72 years (mean: 49.3 +/- 13.78) were evaluated. Among 53 cases, 12 (22.6%) bilateral and 41 (77.3%) unilateral CTS were detected. Totally 65 wrists evaluated and prolongation of median nerve wrist-3rd digit distal sensory latencies (DSL; n: 59; 90.7%) and wrist-abductor pollicis brevis distal motor latencies (n: 48; 73.8%) were seen. In six wrists, diagnoses were established with the detection of an increase in the differences between wrist-4th digit DSL of median and ulnar nerve. This test was used if other test results were in normal limits. Prolongation of ulnar nerve wrist-5th digit DSL were found in 12 wrists (18.4%) in cases with CTS. Among these 12 wrists mild (n: 2), moderate (n: 7) and severe (n: 3) CTS were detected. Ulnar nerve motor conduction studies provided normal results. In conclusion, we are in the opinion that for the detection of associated ulnar nerve wrist entrapments, ulnar nerve conduction studies paying special attention to DSL convey importance in established cases with CTS. (C) 2003, Editions scientifiques et medicales Elsevier SAS. All rights reserved.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 Normative data of sympathetic skin response and RR interval variation in Turkish children(1999) TÜRKDOĞAN, DİLŞAD; Akyüz, G.; Türkdoğan-Sözüer, D.; Turan, B.; Canbolat, N.; Yilmaz, I.; Us, O.; Kayhan, O.Sympathetic skin response (SSR) and RR interval variation (RRIV) are used commonly for the assessment of sympathetic and parasympathetic nervous system function, respectively. We determined the normal values of SSR and RRIV in 23 (14 females, nine males) Turkish children aged 5 to 14 (mean 9.86, SD 2.48) years. SSR was recorded on the hands and feet during the electrical stimulation of both median and posterior tibial nerves, respectively. Similar response was elicited on both feet during the stimulation of the right median nerve. RRIV testing was performed during rest on the supine position and deep inspiration at a frequency of 6 times/min. The SSR was elicited in all children. The mean SSR latencies recorded on the feet during the stimulation of median or posterior tibial nerve were significantly more prolonged than those recorded at the hands (P < 0.001). There was no significant difference between the mean latencies of SSR recorded at the ipsilateral and contralateral palms or soles. The mean latencies recorded at the sole during stimulation of the median nerve were not significantly different compared to those that recorded at the sole during the posterior tibial nerve (P > 0.05). The SSR amplitudes were not assessed because of great variability and rapid habituation. The mean RRIV (46.54+/-11.29%) during deep breathing was significantly increased as compared to that (35.90+/-10.63%) during rest (P < 0.003). As a result, SSR and RRIV are preferred non-invasive tests for evaluation of autonomic nervous system in children. The SSR is useful and reliable if it is obtained in the optimum technical conditions. Further research is necessary to establish strict criteria for abnormality.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 effects of daily alendronate, daily calcitonin and alendronate every other day on bone mineral density in osteoporotic men(INFORMA HEALTHCARE, 2007) AKYÜZ, GÜLSEREN DERYA; Guven, Zeynep; Karadag-Saygi, Evrim; Unlu-Ozkan, Feyza; Akyuz, GulserenObjectives. Biphosphonates have been widely used in the treatment of osteoporosis, but there is not enough data on their use in men. The aim of this study is to investigate the effects of twelve months' treatment with daily 10 mg alendronate, every other day 10 mg alendronate and daily 200 IU calcitonin on bone mineral density (BMD) in men with osteoporosis. Materials and methods. 46 men with osteoporosis were randomly allocated to three groups: 15 patients in the first group received daily 10 mg alendronate and calcium (1000 mg/day), 14 patients in the second group used every other day 10 mg alendronate and calcium and 17 patients in the third group were given intranasal salmon calcitonin and calcium. At the baseline, sixth and twelfth months, BMD was measured at lumbar spine (L2-4), femoral neck and Ward's triangle zone by means of dual energy X-ray absorptiometry (LUNAR). Results. In daily and every other day alendronate and calcitonin groups there was a significant increase in BMD at lumbar spine (p = 0.004, p = 0.001, p = 0.04), but no difference at the femoral neck (p > 0.05) at the end of twelve months. When the groups were compared with each other, no significant differences in BMD levels at lumbar spine, femoral neck and Ward's triangle were found (p > 0.05).Publication Metadata only Bilateral tibial stress fracture in a young man due to hypercalciuric osteoporosis: a case report(SPRINGER, 2006) AKYÜZ, GÜLSEREN DERYA; Ofluoglu, D; Ofluoglu, O; Akyuz, GOsteoporosis is commonly thought of as a disease of postmenopausal women, and older men have a lower risk of fracture than women. A stress fracture is an overuse injury and an important cause of disability in the athletic population. Presented here is a 30-year-old healthy man with pain on the anterior surface of the bilateral tibia. He did not communicate any trauma or overuse activity. The neurologic and locomotor system examinations were normal. Radiological examinations revealed tibial stress fractures in both left and right tibia and he had low bone mineral density. Routine hematological tests, bone resorption and formation markers were normal, except for hypercalciuria. After analyzing the results of these tests, the patient was diagnosed with bilateral tibial stress fractures due to hypercalciuric secondary osteoporosis. Osteoporosis should be considered in the differential diagnosis of atraumatic insufficiency fractures, especially in young healthy adults.Publication Metadata only The effect of calcitonin on beta-endorphin levels in postmenopausal osteoporotic patients with back pain(SPRINGER LONDON LTD, 2007) AKYÜZ, GÜLSEREN DERYA; Ofluoglu, D.; Akyuz, G.; Unay, O.; Kayhan, O.The purpose of this study was to evaluate the efficacy of calcitonin on beta-endorphin levels in female patients experiencing back pain associated with postmenopausal osteoporosis. The secondary purpose was to assess the pain and quality of life in these patients. There were 30 patients with a mean age of 58.2 +/- 5.4 years in the treatment group and 26 patients with a mean age of 58.8 +/- 5.2 years in the placebo group in this randomized, placebo-controlled study. The patients subcutaneously received 100 IU salmon calcitonin or placebo injections and 1,000 mg elementary calcium for 2 weeks. Baseline plasma beta-endorphin levels were measured and repeated after 2 weeks. Patients' pain and quality of life (QOL) were evaluated by using the Visual Analogue Scale, Modified Face Scale, Beck Depression Index, and Nottingham Health Profile. Patients' global assessment of disease activity was also performed at baseline and at the end of the first and second week. We found that plasma beta-endorphin levels in the treatment group were significantly higher than the placebo group at the end of the second week (p < 0.001). Although pain and QOL scores were improved at the end of the second week in both groups (p < 0.05), the improvement in the treatment group was more significant when compared with the placebo group (p < 0.05). Therefore, calcitonin is an analgesic agent, as it increases the plasma beta-endorphin levels in patients with postmenopausal osteoporosis, which consequently improves QOL.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 Metadata only Involvement of sympathetic reflex activity in patients with acute and chronic stroke: A comparison with functional motor capacity(W B SAUNDERS CO-ELSEVIER INC, 2004) TÜRKDOĞAN, DİLŞAD; Muslumanoglu, L; Aki, S; Turkdogan, D; Us, O; Akyuz, GObjective: To investigate sympathetic nervous system functions in patients with acute and chronic phase of stroke by measuring sympathetic skin reflex (SSR) and the relationship between sympathetic dysfunction and motor function capacity. Design: Cross-sectional, case-control study. Setting: A physical medicine and rehabilitation department in a research hospital of a university referral center in Turkey. Participants: Fifty-six patients with stroke-13 in the acute phase and 43 in the chronic phase-and 42 age- and sex-matched healthy volunteers were included. Intervention: SSR was recorded with electric stimulation of the bilateral median nerves. Main Outcome Measures: SSR was recorded to assess sympathetic reflex activity in patients in the acute and chronic phase of stroke and in controls. Motor functions was classified using the Brunnstrom stages. Results: The mean SSR latency in the acute phase was significantly prolonged and the amplitudes were decreased compared with controls. In the chronic phase, the mean amplitudes were significantly attenuated compared with controls, whereas the mean latency did not change. The mean latency of SSR in patients in Brunnstrom groups 1 and 2 was longer, and the mean amplitude was smaller than in controls (P<.05). The mean amplitude was significantly reduced in patients classified as Brunnstrom groups 3 and 4 compared with controls (P<.05), but the mean latency was not affected. Conclusions: Depression of sympathetic reflex activity was more prominent in the acute phase of stroke and was associated with moderate or highly limited motor function capacity. Improvement of motor dysfunction may parallel recovery of sympathetic reflex activity.Publication Metadata only Relationship between arm span and height in postmenopausal osteoporotic women(SPRINGER HEIDELBERG, 2008) AKYÜZ, GÜLSEREN DERYA; Ofluoglu, Demet; Unlu, Feyza; Akyuz, GulserenOsteoporosis is a progressive systemic skeletal disease characterized by low bone density and microarchitectural deterioration of the bone. A minimum 3-cm difference between arm span and height makes up one of the criteria for suspecting osteoporosis. Therefore, it is easy to determine osteoporotic women by measuring the proportion of height to the arm span. The purposes of this study are to assess the relationship between arm span and height and to compare them in postmenopausal and young healthy women. This was a randomized-controlled, prospective study. There were two groups in this study. Group I included 70 postmenopausal osteoporotic women and group II had 70 healthy young women. Height, weight and arm span of the individuals were measured in all subjects. Bone mineral density and radiological examination of spine were also evaluated. Mean age of postmenopausal women was 64.4 +/- 8.6 years and it was 27.3 +/- 3.5 years in young healthy women. Mean height was 152 +/- 5.1 and 161.5 +/- 5.9 cm in group I and II, respectively. Mean arm span length was 159.6 +/- 6.3 cm in postmenopausal women and 163.5 +/- 6 cm in young healthy women. Mean arm span-height difference was significantly higher in postmenopausal women when compared to healthy young women (7.7 +/- 3.6 and 2 +/- 2.9 cm, respectively, P < 0.001). We suggest that arm span measurements can be used in the estimation of youth height and age-related loss in stature in postmenopausal women.