Person: GÜNDÜZ, OSMAN HAKAN
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GÜNDÜZ
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OSMAN HAKAN
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Publication Open Access Comparison of cutaneous silent period parameters in patients with primary sjogren's syndrome with the healthy population(2022-06-01) KARADAĞ SAYGI, NAİME EVRİM; GÜNDÜZ, OSMAN HAKAN; Yolcu G., Abacar K., Kenis-Coskun O., Inanc N., Karadag-Saygi E., Gunduz O. H.Background: Neurological involvement has a great importance in the clinical spectrum of primary Sjögren’s syndrome (pSS) (1). The presence of small fiber neuropathy (SFN), which cannot be detected in routine electrophysiological examinations, causes the peripheral nervous system involvement to be underestimated in the course of the disease and causes pain-related symptoms in patients that cannot be explained by routine examinations (2). Various methods can be used in the detection of SFN, and cutaneous silent period (CSP) measurement is gaining popularity recently due to its non-invasiveness and practical application (3). Objectives: Evaluating SFN involvement in patients with pSS using CSP and evaluating its relationship with clinical parameters. Methods: Patients with a diagnosis of pSS followed in the rheumatology outpatient clinic and healthy volunteers demographically homogeneous with the patient group were included in the study. The CSP responses were recorded over the abductor pollicis brevis muscle in the upper extremity of all participants. The latency and duration values of the responses were obtained. In patient group, EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Hospital Anxiety and Depression Scale (HADS), Short Form-36 (SF-36) questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and Central Sensitization Inventory (CSI) were applied for the evaluation of symptom severity, mood, quality of life, presence of neuropathic pain and central sensitization, respectively. Comparison of CSP parameters between patients with pSS and healthy volunteers was determined as the primary outcome measure. The secondary outcome measure was the relationship between CSP parameters and ESSPRI, HADS, SF-36, LANSS and CSI scores. Results: A total of 36 patients and 36 healthy controls were included in the final analyses. There was no significant difference between the two groups in terms of demographic data. The mean CSP latency was significantly longer in patients with a mean of 78.18 (±7.51) when compared to controls with a mean of 67.91 (±6.41) (95% CI: 6.98- 13.55, p<0.001). Mean CSP duration was also significantly shorter in patients with a mean of 33.40 (±6.93) (95% CI: 9.57 -15.31, p<0.001). There were no significant differences in CSP parameters (latency and duration, respectively) according to patients’ neuropathic pain or central sensitization profile (p>0.05 for all analyses). There were significant correlations of CSP parameters with ESSPRI dryness (r=0.469, p=0.004; r=-0.553, p<0.001), fatigue (r=0.42, p=0.011; r=-0.505, p=0.002), pain (r=0.428, p=0.009; r=-0.57, p<0.001) subscores and mean ESSPRI score (r=0.631, p<0.001; r=-0.749, p<0.001). Significant correlations were not found between CSP parameters and SF-36 scores, other than CSP duration and “pain” subscore (r=-0.395, p=0.017). When the other correlations were investigated there were no significant correlations other than CSP duration and the HADS anxiety score (r=-0.201, p=0.02). Conclusion: As an indicator of CSP measurement, SFN is more common in patients with pSS than in the healthy population. The association with important clinical symptoms of the disease course such as dryness, fatigue, pain and anxiety highlights the importance of detecting small fiber neuropathyPublication Open Access The effect of central sensitization on interlaminar epidural steroid injection treatment outcomes in patients with cervical disc herniation: an observational study(2022-09-01) SAÇAKLIDIR, REKİB; ŞANAL TOPRAK, CANAN; GÜNDÜZ, OSMAN HAKAN; ŞENCAN, SAVAŞ; Sacaklidir R., ŞANAL TOPRAK C., Yucel F. N. , GÜNDÜZ O. H. , ŞENCAN S.© 2022, American Society of Interventional Pain Physicians. All rights reserved.Background: Central sensitization (CS) is a hyperexcitability that is manifested by the increased response of the central nervous system to sensory stimuli. It has been shown that the presence of CS may have a negative effect on the clinical picture in some musculoskeletal diseases and also have a negative effect on spinal procedures. Objectives: To investigate the effect of CS on interlaminar epidural steroid injection (ILESI) treatment outcomes in patients with cervical disc herniation (CDH). Study Design: An observational study. Setting: A university hospital pain management center. Methods: Patients, who underwent ILESI between 2020-2021 due to CDH, were included in the study. The Numeric Rating Scale (NRS-11), Neck Pain and Disability Scale (NPDS), Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), and Short Form-12 (SF-12) were used for evaluation of patients. Patients were assessed before the procedure, at the first hour, and 3 months after the procedure. The presence of CS was investigated by the Central Sensitization Inventory (CSI). Results: A total of 51 patients were included in the study. Twenty-three of the patients had CS, as assessed by the CSI. Although, patients who underwent ESI, had significantly lower NRS-11, S-LANSS, and NPDS scores, and higher SF-12 scores at all follow-up points. The first and third months, NRS-11, S-LANSS, and NPDS were significantly higher, and SF-12 scores were lower in the CS group compared to patients without CS. Limitations: The short follow-up period and relatively low number of patients can be considered as a limitation. The fact that CS is not evaluated with a more objective method, such as Quantitative Sensory Testing (QST), can be considered as another limitation. Since most clinicians use CSI, so from a \"real world\" perspective the lack of QST may be observed as a strength of the study. The third limitation is that we did not evaluate the patients’ pre-and posttreatment analgesic consumption. Finally, we did not include patients with a history of psychiatric illness, but not evaluating the current psychiatric conditions of the patients could be considered a limitation. Nevertheless, the main strengths of this study are its prospective design and, to our knowledge, it is the first study to explore the effects of CS on cervical ESI treatment. Conclusions: The presence of CS has a negative effect on pain scores, disability, and quality of life in patients undergoing cervical ESI due to CDH.Publication Open Access Rare complication of ganglion impar blockade with the transsacrococcygeal approach: A case of rectal perforation(2022-06-01) OKÇU, MEHMET; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; OKÇU M., ŞENCAN S., GÜNDÜZ O. H.Although it has been reported that caution should be exercised in terms of rectal perforation, as the ganglion impar is located just behind the rectum in the presacral space, the authors could not find any case or images of rectal perforation occurring during ganglion impar blockade in the literature. In this report, the case of a 38-year-old female with rectal perforation that developed during ganglion impar blockade, performed by the transsacrococcygeal approach under fluoroscopy guidance, is presented. Wrong needle selection and the structurally short presacral space of the patient may have influenced the development of rectal perforation in the patient. This study presents the first case and images of rectal perforation in the literature that developed during the application of ganglion impar blockade using the transsacrococcygeal technique. In ganglion impar block applications, technically appropriate needles should be used, and care should be taken in terms of rectal perforation.Publication Open Access Cervical Radiculopathy Impact Scale: Translation, cross-cultural adaptation, reliability and validity of the Turkish version(2022-12-01) ŞENCAN, SAVAŞ; SAÇAKLIDIR, REKİB; ÖZTÜRK, EKİM CAN; GÜNDÜZ, OSMAN HAKAN; Çelenlioğlu A. E. , ŞENCAN S., Saçaklıdır R., ÖZTÜRK E. C. , GÜNDÜZ O. H.© 2022 Turkish League Against Rheumatism. All rights reserved.Objectives: The aim of this study was to translate and cross-culturally adapt the English version of the Cervical Radiculopathy Impact Scale (CRIS) and to investigate the validity and reliability of the Turkish version of the CRIS. Patients and methods: Between October 2021 and February 2022, a total of 105 patients (48 males, 57 females; mean age: 45.4±11.8 years; range, 36.5 to 55.5 years) who were diagnosed with cervical radiculopathy due to disc herniation were included. Disability and quality of life were evaluated with the Neck Disability Index (NDI), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Short Form-12 (SF-12). Pain severity was evaluated using the Numerical Rating Scale (NRS) in three subscales (neck pain, pain radiating to the arm, and numbness in the finger, hand, or arm). The internal consistency for CRIS was assessed using the Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Explanatory factor analyses were performed for construct validity. To examine the content validity, the correlations among the three subgroup scores of CRIS and the other scale scores were analyzed. Results: The internal consistency of CRIS was found to be high (α=0.937). A high reliability was obtained for test-retest reliability for the three subscales of CRIS (Symptoms, Energy and postures, Actions and activities) (ICC: 0.950, 0.941, 0.962, respectively; p<0.001). All three subscale scores of CRIS were correlated with the NDI, QuickDASH, SF-12 (physical and mental) and NRS scores (r=0.358-0.713, p<0.001). Factor analysis showed that the scale had five factors. Conclusion: The CRIS is a valid and reliable instrument for Turkish patients with cervical radiculopathy due to disc herniation.Publication Open Access Effect of sacralization on the success of lumbar transforaminal epidural steroid injection treatment: prospective clinical trial(2022-06-01) ŞENCAN, SAVAŞ; BİLİM, SERHAD; GÜNDÜZ, OSMAN HAKAN; ŞENCAN S., Azizov S., Celenlioglu A. E., Bilim S., GÜNDÜZ O. H.Objective The aim of this study was to invastigate the efect of the sacralization on the results of transforaminal epidural steroid injection for radicular low back pain. Materials and methods The study included 64 patients diagnosed with radicular low back pain due to unilateral and singlelevel lumbar disk herniation. Patients were divided into 2 groups: patients with sacralization (Group S) and patients without lumbosacral transitional vertebrae (Group A). Injection was applied to the relevant level. Patients were evaluated with Numeric Rating Scale and Modifed Oswestry Disability Index before, at week 3 and month 3 after the procedure. Sacralization presence was determined by MRI. Sacralization was categorized by anteroposterior lumbar radiography using Castellvi classifcation. Treatment success was considered as≥50% reduction in NRS scores. Results Numeric Rating Scale and Modifed Oswestry Disability Index scores decreased in both groups on both week 3 and month 3 (p<0.05). Pain scores of Group S (median value 5 (3–6)) were signifcantly higher than Group A ((median value 3 (0–5)) in the third month follow-up (p=0.026), but no signifcant diference was observed at other time points. There was no signifcant diference in Modifed Oswestry Disability Index scores between the groups at all follow-ups (p>0.05). Treatment success in the third month was 44.8% in Group S and 65.6% in Group A. Conclusion Transforaminal epidural steroid injection is an efective and safe method for radicular low back pain. Sacralization presence should be evaluated before treatment considering that it may be a risk factor reducing treatment success.Publication Open Access Incidence and disease course of covid-19 infection among unvaccinated patients who received local corticosteroid injections(2023-04-01) OKÇU, MEHMET; GÜNDÜZ, OSMAN HAKAN; ŞENCAN, SAVAŞ; OKÇU M., Azizov S., GÜNDÜZ O. H., ŞENCAN S.Objective There are concerns that local corticosteroid injections may increase the risk of COVID-19 infection because of the immunosuppressive effect of corticosteroids. This study aimed to examine the relationship between local corticosteroid injections and the risk of COVID-19 infection. Design The date and type of procedure as well as the dose and type of corticosteroids used in patients who underwent local corticosteroid injections within 1 yr after the first COVID-19 case in the country were examined retrospectively and recorded. Patients who did not receive corticosteroids were included in the control group. Coronavirus disease 2019 infection histories of all patients were recorded. Results There was no significant difference between the patients who received local corticosteroids and the control group in terms of the incidence of COVID-19 infections, and the number of patients who needed hospitalization or intensive care treatment. In addition, it was found that the administration of two injections, the type of procedure performed, and the dose and type of steroids were not associated with the incidence or severity of COVID-19 infections. Conclusions It has been shown that local corticosteroid injections are not associated with the incidence of COVID-19 infections and the number of patients who need hospitalization or intensive care treatment due to COVID-19.Publication Open Access Comparison of Caudal Versus Transforaminal Epidural Steroid Injection in Post Lumbar Surgery Syndrome After Single-level Discectomy: A Prospective, Randomized Trial(2022-03-01) ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; Celenlioglu A. E., ŞENCAN S., Bilim S., Sancar M., GÜNDÜZ O. H.Background: Epidural fibrosis (EF) is one of the leading causes of post lumbar surgery syndrome (PLSS). Although there are studies in the literature suggesting that lumbar epidural steroid injections are an effective method in the pain management of PLSS caused by EF, no study is available comparing the effectiveness and safety of caudal and transforaminal approaches. Objectives: To investigate the efficacy of caudal epidural steroid injection (CESI) versus transforaminal epidural steroid injection (TFESI) in patients with PLSS. Study Design: A prospective, randomized, assessor-blind study. Setting: Interventional pain management center at a tertiary care center. Methods: Patients with low back and radicular pain related to EF following single-level lumbar discectomy were included. The patients were randomly divided into 2 groups: a CESI group and a TFESI group. All patients were assessed before the procedure (baseline) and at one hour, 3 weeks, and 3 months after the procedure using the Numeric Rating Scale (NRS-11) and at baseline, 3 weeks, and 3 months using the modified Oswestry Disability Index (mODI). Treatment success was defined as a ≥ 50% decrease in the NRS-11 scores compared to baseline. Results: A total of 56 patients (n = 26 CESI group; n = 30 TFESI group) were included. NRS-11 and mODI scores showed a significant decline in both groups at all follow-ups (P < 0.001). At 3 weeks, the improvement in the mODI scores was significantly higher in the TFESI group (P = 0.020). In all follow-ups, the NRS-11 scores were similar between the groups. At 3 weeks, the rates of patients with a ≥ 50% decrease in NRS-11 scores were 53.8% and 60% in the CESI group and TFESI group, respectively, while these rates were 30% and 26.7%, respectively, at 3 months. Limitations: This study had no placebo-control group and a relatively short follow-up. Conclusion: Both CESI and TFESI are effective and safe methods in the treatment of PLSS caused by EF following lumbar discectomy. These methods can reduce pain and disability. Although both methods have similar treatment success rates, TFESI seems to be a more effective treatment method in reducing disability at 3-week follow-up. Keywords: Post lumbar surgery syndrome, failed back surgery syndrome, post laminectomy syndrome, epidural fibrosis, epidural steroid injections, transforaminal, caudal, radiculopathy, back painPublication Open Access An unusual obstacle to the thoracic interlaminar epidural injection for the treatment of post-herpetic neuralgia(2023-01-01) BİLİM, SERHAD; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; BİLİM S., ŞENCAN S., GÜNDÜZ O. H.Interlaminar epidural steroid injections corresponding to dermatomes affected by post-herpetic neuralgia (PHN) were found effective in reducing pain. Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition that mainly occurs with calcification and ossification of spinal ligaments such as anterior and posterior longitudinal, interspinous, supraspinous ligament, and ligamentum flavum. In this case, it is presented that the failure of the access to the T7-T8 interlaminar space due to the supra/interspinous ligament calcification and ossification accompanied by thoracic DISH in a 73-year-old male for the treatment of PHN.Publication Metadata only Reliability and validity of Turkish versions of sciatica bothersomeness and sciatica frequency index(2022-01-01) SAÇAKLIDIR, REKİB; GÜNDÜZ, OSMAN HAKAN; ŞENCAN, SAVAŞ; ŞENCAN S., SAÇAKLIDIR R., GÜNDÜZ O. H.BACKGROUND: The Sciatica Frequency Index (SFI) and Sciatica Bothersomeness Index (SBI) are two separate indices scored for both the bothersomeness and frequency of radiating symptoms. There is no Turkish scale used specifically for sciatica.Publication Open Access YouTube as a source of information on sacroiliac joint injection: A reliability and quality analysis(2023-03-17) ÖZTÜRK, EKİM CAN; SAÇAKLIDIR, REKİB; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; ÖZTÜRK E. C., Yilmaz H., SAÇAKLIDIR R., ŞENCAN S., GÜNDÜZ O. H.Sacroiliac joint (SIJ) injection is recommended for both diagnosis and relief of SIJ pain. YouTube has become a widely used source for health professionals and patients to obtain information about various procedures but the quality of YouTube videos including medical content is questionable. Therefore, the aim of this study is to evaluate the quality of SIJ injection videos on YouTube. This cross-sectional study was conducted through March 2022 by searching the phrase \"sacroiliac joint injection\"on YouTube. After resetting search history top 100 videos were screened. Duration of videos, number of views, number of likes, number of comments, view ratio (number of views/d), time passed since upload date, guide used for injection, and source of videos were recorded. The DISCERN and the Global Quality Scale were used to assess the quality and reliability of the videos. Of the 100 videos screened 42 videos met the inclusion criteria. The videos (73.8%) were predominantly uploaded by physicians. Most frequently used guide for injections was ultrasound with 45.4%. According to the DISCERN classification, 35.7% of the videos were \"very poor,\"30.9% were \"poor,\"21.4% were \"fair,\"7.1% were \"good\"and 4.7% were \"excellent.\"Physicians and patients should be aware of that many of the videos about SIJ injections are categorized as \"poor\"or \"very poor,\"which means they may mislead trainees, resulting in inadequate treatments.