Person: AKYÜZ, GÜLSEREN DERYA
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AKYÜZ
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GÜLSEREN DERYA
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Publication Open Access Assessment of the Relationships Between Spinopelvic Radiologic Parameters and Balance, Gait and Falls Efficacy in Patients with Postmenopausal Osteoporosis(GALENOS YAYINCILIK, 2018-12-01) AKYÜZ, GÜLSEREN DERYA; Giray, Esra; Akyuz, GulserenObjective: The aim of this study is to investigate the relationship between sagittal balance, spinopelvic parameters, bone mineral density, balance, and falls efficacy in postmenopausal osteoporosis patients. Materials and Methods: Forty patients between the ages of 40-80 with a diagnosis of postmenopausal osteoporosis were included in the study. Spinopelvic parameters (sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis, pelvic tilt, pelvic incidence, sacral slope) were calculated from spine radiographs. Patients were applied Tinetti Balance and Gait Assessment and Falls Efficacy Scale. Relationship between bone mineral density measurements, clinical parameters, spinopelvic parameters, balance and gait, and falls efficacy were investigated. Results: Mean age of the patients was 63.42 +/- 8.98 and the mean L1-L4 T score was 2.5 +/- 0.68. Statistically significant negative correlation was found between the L1-L4 and L2-L4 vertebrae bone mineral density and T score, and sacral slope. Negative statistical correlations were found between SVA and Tinetti Balance and Gait Assessment balance subtest and total scores. There was no statistically significant relationship with other spinopelvic parameters. There was no significant correlation between SVA and spinopelvic parameters and Falls Efficacy Scale, while a statistically significant negative correlation detected between Falls Efficacy Scale and Tinetti Balance and Gait Assessment balance and gait subtests and total scores. Among the patients with normal, mild and severe deformity sagittal balance, there was statistically significant difference in terms of Tinetti Balance and Gait Assessment balance and gait subtests scores and total scores, while there was no difference with regards to Falls Efficacy Scale. Conclusion: In postmenopausal women with osteoporosis, SVA, sagittal balance parameters, and balance and gait functions were found to be associated.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 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 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.Publication Open Access Gastrointestinal side effect profile due to the use of alendronate in the treatment of osteoporosis(YONSEI UNIV COLL MEDICINE, 2003) AKYÜZ, GÜLSEREN DERYA; Aki, S; Eskiyurt, N; Akarirmak, U; Tuzun, F; Eryavuz, M; Alper, S; Arpacioglu, O; Atalay, F; Kavuncu, V; Kokino, S; Kuru, O; Nas, K; Ozerbil, O; Savas, G; Sendur, OF; Soy, D; Akyuz, GThe aim of our study was to evaluate the upper gastrointestinal (GI) tract side effect profile in 759 female patients that had taken alendronate (10 mg/day), for at least 6 months, for the treatment of osteoporosis, in relation to the safety of alendronate and the compliance of patients to its absorption rules. This study was a multicentered retrospective, clinical, non-placebo controlled, study of 759 female subjects carried out at 26 centres in 6 different regions of Turkey. The mean age of our patients was 62.6 +/- 8.6, with 51.2% in the age range 60 to 69 years. 158 patients (20.8%) were considered to have upper GI tract complaints with nausea as the most often encountered symptom. Of the subjects with upper GI tract complaints, 20% reported discontinued drug use, and 30% reported the requirement of an additional drug in order to abolish their complaints. Approximately 537 (71%) of the patients stated they had been given written information about the administration of the drug, and at least 93 patients (12%) and 73 patients (18.4%) acknowledged non compliance with the safety and absorption rules, respectively. In our study, no significant difference was found between the adherence to the safety measures and upper GI tract complaints (p>0.05), but that upper GI tract complaints were higher in patients taking additional medication to alendronate (p<0.05).Publication Open Access Impact of the Training on the Compliance and Persistence of Weekly Bisphosphonate Treatment in Postmenopausal Osteoporosis: A Randomized Controlled Study(IVYSPRING INT PUBL, 2013) AKYÜZ, GÜLSEREN DERYA; Tuzun, Sansin; Akyuz, Gulseren; Eskiyurt, Nurten; Memis, Asuman; Kuran, Banu; Icagasioglu, Afitap; Sarpel, Tunay; Ozdemir, Ferda; Ozgirgin, Nese; Gunaydin, Rezzan; Cakci, Aytul; Yurtkuran, MerihLong-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2nd, 5th, 8th, and 11th months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3rd, 6th, 9th, and 12th months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire.. Of 448 patients (mean age 62.4 +/- 7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7 +/- 25.4 vs. 34.0 +/- 14.6, p<0.001); however, the difference was not significant between AT and PT groups both in visit 1 and visit 5. In conclusion, in addition to active training, passive training provided at the 1st visit did not improve the persistence and compliance of the patients for bisphosphonate treatment.