Person: AKYÜZ, GÜLSEREN DERYA
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AKYÜZ
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GÜLSEREN DERYA
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Publication Open Access Can assessment of disease burden and quality of life based on mobility level in patients with end-stage cancer provide an insight into unmet needs? An exploratory cross-sectional study(2022-02-01) AKYÜZ, GÜLSEREN DERYA; Bahar-Ozdemir Y., Kaya S., Akgul-Babacan N., Al T., Albayrak E., Coskun N., Akyuz G.Purpose The purpose of this study was to: 1) investigate the differences in the needs of end-stage cancer who can move independently, using mobility aids (MA), or are bedridden; and 2) determine the effects of these different mobility levels on the patients\" current quality of life (QoL), fatigue, and mental conditions. Methods The study employed an exploratory prospective cross-sectional study design, which was carried out in two hospitals. The study included 99 end-stage cancer. The mobility levels of the patients were evaluated in three groups: Group 1: bedridden; Group 2: mobile with MA; and Group 3: ambulatory (under supervision or fully independent). A core cancer-specific questionnaire-integrating system for assessing health-related QOL (EORTC-QLQ-C15-PAL), the Piper Fatigue Scale (PFS), and the Hospital Anxiety-Depression scale were utilized. The median age was 60years (31-83). Cancer types were as follows: gastrointestinal (45.5%), lung (38.4%), breast (4%), genitourinary system (4%), and others (8%). Forty-two percent of the patients were completely bedridden, 42.2% used MA, and 15.2% were independently ambulatory. The EORTC QLQ-C15-PAL physical (=.000) and emotional function values (=.029) differed among mobilization statuses. There was a significant difference among mobilization groups, in terms of behavioral values, in the PFS (=.006). The depression rate in the independent ambulatory group was lower than in the bedridden and MA groups (=0.011; =0.004). p p p p1 p2 Conclusion Health-related QoL, fatigue level, and emotional state vary in end-stage cancer who undergo evaluations according to their mobility levels. These patients should be assessed comprehensively, and treatment plans should be organized carefully, with a multidisciplinary approach.Publication Metadata only Evaluation of pain, quality of life, and patient satisfaction in parenterally treated patients with postmenopausal osteoporosis(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020) AKYÜZ, GÜLSEREN DERYA; Ozsoy-Unubol, Tugba; Akyuz, Gulseren; Mirzayeva, Samaya; Guler, TubaObjectives: This study aims to evaluate pain, quality of life, and patient satisfaction in parenterally treated patients with postmenopausal osteoporosis (OP). Patients and methods: Between May 2016 and January 2018, a total of 138 patients (mean age 63.78 years; range, 50 to 70 years) with postmenopausal OP were retrospectively analyzed. All patients were previously treated with denosumab (DEN) and parenteral forms of bisphosphonates such as zoledronic acid (ZOL) and ibandronate (IBN). The pain severity was evaluated using the Visual Analog Scale (VAS) and Brief Pain Inventory-Short Form (BPI-SF). The quality of life was evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41). For the evaluation of patient satisfaction, a three-item questionnaire including satisfaction with the medication, route, and frequency of administration was applied. Results: Of the patients, 50 received DEN, 48 received ZOL, and 40 received IBN treatment. There was no significant difference in any of the pain parameters. All domains of the Qualeffo-41 were similar among the three groups. The patients in the DEN group were more satisfied with their medication (DEN: 88%, ZOL: 43.75%, and IBN: 52.5%), its administration route (DEN: 84%, ZOL: 43.8%, and IBN: 57.5%), and the frequency of its administration (DEN: 84%, ZOL: 56.25%, and IBN: 52.5%) (p=0.0001). Conclusion: Neither of the medication showed a superior effect on quality of life. However, patients were more satisfied with medications used in a six-month interval and applied subcutaneously. Of these three treatment options, DEN seems to be a step ahead in terms of patient satisfaction.Publication Open Access The effect of adding robot-assisted hand rehabilitation to conventional rehabilitation program following stroke: A randomized-controlled study(2022-01-01) AKYÜZ, GÜLSEREN DERYA; Bayındır O., Akyüz G., Sekban N.© 2022 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.Objectives: This study aimed to investigate the effectiveness of adding robot-assisted hand therapy (HandTutor) to conventional rehabilitation program compared to a conventional rehabilitation program alone in stroke survivors. Patients and methods: Between March 2012 and December 2012, a total of 33 stroke patients (21 males, 12 females; median age: 56 years; range, 38 to 73 years) were included in this prospective, randomized-controlled study. The patients were randomly divided into two groups as experimental (n=16) and control (n=17). Both groups received conventional rehabilitation for 3 h/day, for two days/week, totally for five weeks, while the experimental group received additional 1-hour robot-assisted hand therapy during each session. Outcome measures were the Fugl-Meyer Assessment, Box and Block Test, Nine-Hole Peg Test, Jebsen-Taylor Hand Function Test, grip strength, and pinch strength. All patients were assessed at baseline, at the end of the treatment, and three months after the treatment. Results: Both groups showed statistically significant improvements in all the parameters (p0.05). The changes between baseline and three-month follow-up after the treatment revealed that adding robot-aided hand therapy led to greater changes in all the parameters related to functional activities and muscle strength, except for the Fugl-Meyer Assessment. Conclusion: Adding robot-assisted therapy to conventional rehabilitation may provide greater changes in upper extremity rehabilitation of subacute stroke patients compared to conventional rehabilitation program alone.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 Open Access The effects of low bone mineral density on pain, quality of life and fatigue in patients with epilepsy(MARMARA UNIV, FAC MEDICINE, 2021-10-31) AKYÜZ, GÜLSEREN DERYA; Unal-Ulutatar, Cagri; Yazici Sacaklidir, Gonca; Midi, Ipek; Akyuz, Gulseren DeryaObjectives: To investigate the effects of low bone mineral density (BMD) on pain, quality of life (QoL), and fatigue in epileptic patients who use anticonvulsants. Patients and Methods: Epileptic patients aged 18 years or older who use anticonvulsant drugs were recruited into the study. Demographic and clinical features were recorded, including the duration of epilepsy, number of anticonvulsants used, previous fracture history and BMD scores. The functional parameters included back pain measured with the visual analogue scale (VAS) and brief pain inventory (BPI) scale, QoL assessed with the Qualeffo-41 questionnaire, and fatigue assessed with the fatigue severity scale (FSS). Results: Of the 100 patients screened for inclusion in the study, 63 epileptic patients met the inclusion criteria. The mean age and mean disease duration of all participants was 39.5 (+/- 11.2) and 19.3 (+/- 11.6) years, respectively. The median scores for VAS back pain, VAS low back pain, Qualeffo-41, FSS, pain severity, and pain interference (BPI) were significantly higher in patients with secondary osteoporosis compared to patients with normal BMD. There were significant correlations between lumbar spinal BMD and VAS back pain (rho = - 0.58, p < 0.0005), BPI pain severity (rho = - 0.56, p < 0.0005), BPI pain interference (rho = - 0.52, p < 0.0005), Qualeffo-41 (rho = - 0.56, p < 0.0005), and FSS (rho = - 0.41, p = 0.001). Conclusion: Epileptic patients suffering from low BMD showed increased pain, fatigue and impaired QoL. Therefore, BMD measurement should be recommended for the evaluation and management of epileptic patients.Publication Open Access The reliability and validity of the Turkish version of the brief pain inventory-short form in patients with cancer pain(2022-01-01) AKYÜZ, GÜLSEREN DERYA; Balta S., Ünal-Ulutatar Ç., Mirzayeva S., Başkaya M. Ç. , Akyüz G.© 2022 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.Objectives: The aim of this study was to evaluate the reliability and validity of the Turkish version of the Brief Pain Inventory (BPI-TR) in patients with cancer pain. Patients and methods: The study included 130 patients (70 females, 60 males; mean age: 56.1±13.3 years; range, 18 to 87 years) diagnosed with any type and stage of cancer between April 2017 and March 2018. Brief Pain Inventory, Pain Disability Index, EORTC QLQ C30 and Pain Management Index were used to collect data. The reliability of the scale was tested with \"internal consistency\" and its validity with \"construct validity\". Cronbach’s alpha values of >0.70 were accepted as the threshold for internal consistency. Construct validity was tested in the context of structural validity with factor analysis and also tested in terms of convergent construct validity by investigating its correlation with the Pain Disability Index (PDI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Results: The internal consistency of pain severity and pain-related interference was found as 0.91 and 0.95, respectively. The alpha coefficient was found to be between 0.795 and 0.873 for the pain severity index and between 0.729 and 0.861 for the pain-related interference index. There was a clear link between the BPI-TR pain severity index and the ninth question in the EORTC QLQ-C30 (rho=0.66, p<0.05). The association between the BPI-TR interference index and the 19th question in the EORTC QLQ-C30 was also strong (rho=0.77, p<0.05). The correlation between the BPI-TR interference index and the PDI was found to be moderate (rho=0.50, p<0.05). Conclusion: The BPI-TR was found to be a reliable and legitimate tool to evaluate cancer pain in the Turkish population.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 Long-term neuromusculoskeletal side effects and quality of life in nasopharyngeal cancer patients receiving radiochemotherapy(SPRINGER, 2020) ATASOY, BESTE MELEK; Kefeli, Aysegul Ucuncu; Sanal-Toprak, Canan; Asedov, Ruslan; Ozen, Zeynep; Akyuz, Gulseren; Dane, Faysal; Atasoy, Beste M.Aim In this study, we aimed to evaluate the neuromusculoskeletal late side effects and their impact on the quality of life of patients with nasopharyngeal carcinoma treated with radiochemotherapy. Patients and methods Twenty-seven patients were included. The mean follow-up was 61 months (range, 18-111 months). The median external radiotherapy dose applied to the nasopharynx and primary tumor was 70 Gy (range, 61-73 Gy). The mean dose received by the temporomandibular joint in the dose-volume histograms of these patients was 60.7 Gy. The maximal doses of the muscles responsible for cervical motion in different ranges were greater than 60 Gy, and the mean doses were greater than 40 Gy in the muscle groups, except for the extensor muscles. Results Two patients had brachial plexus involvement, while 89% of the patients had restriction in flexion and extension movements. Of the patients, 52% had trismus. There was a significant correlation between extension restriction and general heath score and the physical subscale of the quality-of-life questionnaire (p = 0.01). There was also a correlation between trismus and pain killer usage (p = 0.004). Conclusion This is the first study to analyze long-term muscle and nerve toxicity and their correlation between doses in nasopharyngeal cancer patients following radiochemotherapy. Despite the advances in radiotherapy techniques, it is necessary to pay attention to the doses of the nerves and muscles for late effects.