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Öğe Effects of alendronate on bone mineral density and bone metabolic markers in patients with liver transplantation(Springer London Ltd, 2006) Atamaz, F.; Hepguler, S.; Akyildiz, M.; Karasu, Z.; Kilic, M.Introduction: The purpose of this study was to evaluate the effects of alendronate (ALN) on bone mineral density (BMD) and bone turnover markers in patients with orthotopic liver transplantation (OLT). Methods: In the prospective, controlled, open study with 24 months of follow-up, 98 patients with OLT were randomised to receive ALN 70 mg weekly or no ALN; calcium (Ca) 1,000 mg daily and 0.5 mcg calcitriol daily were provided to all patients. Lumbar spine (LS) and hip BMDs were measured at 6-month intervals by dual-energy X-ray absorptiometry (DEXA). Spinal radiographs were obtained to assess vertebral fractures. Additionally, bone turnover markers, serum parathyroid hormone (PTH) and biochemical parameters were determined every 3 months. Results: Compared with the control group, the ALN group showed significant increases in BMD of the LS (5.1 +/- 3.9% vs 0.4 +/- 4.2%, p < 0.05 at 12 months, 8.9 +/- 5.7% vs 1.4 +/- 4.9%, p < 0.05 at 24 months), femoral neck (4.3 +/- 3.8% vs -1.1 +/- 3.1%, p < 0.05 at 12 months, 8.7 +/- 4.8% vs 0.6 +/- 4.5%, p < 0.05 at 24 months) and total femur (3.6 +/- 3.8% vs -0.6 +/- 4.0%, p < 0.05 at 12 months, 6.2 +/- 3.8% vs 0.3 +/- 4.6%, p < 0.05 at 24 months). In the ALN group, osteocalcin and urinary deoxypyridinoline (DPD) decreased significantly at the sixth month, with no further change, by -35.6% and -63.0%, on average, respectively (p < 0.05). In the control group, a significant increase in biochemical markers of bone turnover was observed in comparison to baseline values (p < 0.05). PTH increased within reference levels without a difference between groups. Two nonvertebral fractures (4.2%) and nine vertebral fractures (18.8%) in the control group and three vertebral fractures (6.8%) in the ALN group occurred during the follow-up. The weekly ALN was well tolerated, and no severe side effects occurred. Conclusion: This is the first randomised study including a control group to demonstrate that weekly ALN was able to significantly increase BMD in patients with OLT when compared with Ca and calcitriol alone. However, ALN did not appear to offer protection against fractures.Öğe Gender-related differences in the femur geometry measurements and their relationship to bone mineral density(Springer, 2007) Ozturk, C.; Atamaz, F.; Hepguler, S.Öğe Interobserver and intraobserver reliability in lower-limb flexibility measurements(Edizioni Minerva Medica, 2011) Atamaz, F.; Ozcaldiran, B.; Ozdedeli, S.; Capaci, K.; Durmaz, B.Aim. To describe the inter- and intraobserver reliability of lower extremity flexibility tests, and to explore the effect of sports activity on the results. Methods. A total of 66 subjects consisting of 20 professional athletes, 26 active subjects performing any sporting activity and 20 control subjects were included. Various flexibility tests were performed to determine hamstring, quadriceps and hip adductor muscle flexibility by two examiners blinded to each other for interobserver reliability. Intraobserver reliability of tests were evaluated by one the examiners 1 week later. Inter- and intraobserver reliability was analyzed with intraclass correlation coefficient (ICC), coefficient of variation (CV) and critical difference (CD). Results. ICC analysis showed that inter- and intra-observer reliability results were satisfactory for all measurements. Athletes performed the best results of inter- and intraobserver reliability for flexibility tests in means of CV and CD compared with active and control groups (P<0.05). Popliteal angle measurement was the most reliable one among hamstring flexibility tests where as the least reliable test was chair sit and reach test in all groups. Conclusion. This is the first study evaluating extensively the reliability of flexibility tests in different intensities of sports activity. Flexibility measurements of quadriceps and hip adductor muscles can be used reliably in clinical practice as hamstring flexibility tests. The intensity of performed activity may have an effect on the reliability of flexibility tests.Öğe Is QUALIOST Appropriate for the Patients With Orthotopic Liver Transplantation in Measuring Quality of Life?(Elsevier Science Inc, 2013) Atamaz, F.; Hepguler, S.; Ozturk, C.; Pinar, Y.The quality of life questionnaire in osteoporosis (QUALIOST) measures the impact of this condition. The purpose of this study was to assess the psychometric properties of QUALIOST among 38 orthotopic liver transplantation (OLT) patients who had been diagnosed with osteoporosis or osteopenia versus 42 control subjects with osteoporosis or osteopenia associated with other conditions. Bone mineral density (gr/cm(2)) measurements were performed by dual-energy X-ray absorptiometry as well as thoracic and lumbar spine radiographs to assess fractures. Reliability studies evaluated by intraclass correlation coefficients (ICC) and internal consistency (Cronbach alpha). For the validity studies, correlation analysis was performed between this scale and Short Form-36 (SF-36) results. The questionnaire was filled out completely by all the patients with 0.9% and 1.3% of omitted answer rates for OLT and control patients. ICC and Cronbach's alpha values were good for all domains with values above .90. In both groups we observed significant negative high correlations between the domains of the questionnaire and all SF-36 dimensions (P < .001). At least one vertebral fracture was diagnosed in 17 (44.7%) and 20 (47.6%) patients with OLT and control respectively. The comparison analysis revealed that the scores of QUALIOST of patients with vertebral fracture were significantly higher than those without a fracture in both groups (P < .05). In conclusion, we evaluated the validity and reliability of a scale measuring quality of life in patients who had osteoporosis secondary to OLT. The results showed that the Turkish QUALIOST showed acceptable validity and reliability in these patients.Öğe Is QUALIOST Appropriate for the Patients With Orthotopic Liver Transplantation in Measuring Quality of Life?(Elsevier Science Inc, 2013) Atamaz, F.; Hepguler, S.; Ozturk, C.; Pinar, Y.The quality of life questionnaire in osteoporosis (QUALIOST) measures the impact of this condition. The purpose of this study was to assess the psychometric properties of QUALIOST among 38 orthotopic liver transplantation (OLT) patients who had been diagnosed with osteoporosis or osteopenia versus 42 control subjects with osteoporosis or osteopenia associated with other conditions. Bone mineral density (gr/cm(2)) measurements were performed by dual-energy X-ray absorptiometry as well as thoracic and lumbar spine radiographs to assess fractures. Reliability studies evaluated by intraclass correlation coefficients (ICC) and internal consistency (Cronbach alpha). For the validity studies, correlation analysis was performed between this scale and Short Form-36 (SF-36) results. The questionnaire was filled out completely by all the patients with 0.9% and 1.3% of omitted answer rates for OLT and control patients. ICC and Cronbach's alpha values were good for all domains with values above .90. In both groups we observed significant negative high correlations between the domains of the questionnaire and all SF-36 dimensions (P < .001). At least one vertebral fracture was diagnosed in 17 (44.7%) and 20 (47.6%) patients with OLT and control respectively. The comparison analysis revealed that the scores of QUALIOST of patients with vertebral fracture were significantly higher than those without a fracture in both groups (P < .05). In conclusion, we evaluated the validity and reliability of a scale measuring quality of life in patients who had osteoporosis secondary to OLT. The results showed that the Turkish QUALIOST showed acceptable validity and reliability in these patients.Öğe Long-term effects of alendronate therapy on bone loss after liver transplantation(Springer London Ltd, 2006) Atamaz, F.; Hepguler, S.; Akyildiz, M.; Karasu, Z.; Kilic, M.Öğe Osteoporosis is a important problem in which period after liver transplantation?(Springer London Ltd, 2006) Hepguler, S.; Atamaz, F.; Akyildiz, M.; Karasu, Z.; Kilic, M.Öğe The prevention of bone fractures after liver transplantation: Experience with alendronate treatment(Elsevier Science Inc, 2006) Atamaz, F.; Hepguler, S.; Karasu, Z.; Kilic, M.; Tokat, Y.Objective. The aim of this study was to prevent fractures in the first postoperative year. Methods and patients. We studied 59 patients (48 men, 11 women) aged 42.6 +/- 11.4 years, who underwent liver transplantation. All patients received oral alendronate 70 mg weekly and calcium 1 g and calcitriol 0.5 mu g daily. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at the lumbar spine and proximal femur at baseline as well as at 6 and 12 months after transplantation for comparison with an historical control group (n = 31). Spinal radiographs were obtained to assess vertebral fractures at the same time. Additionally, serum osteocalcin, serum parathyroid hormone (PTH), urinary deoxypyridinoline (DPD), and biochemical parameters were determined every 3 months. Results. At baseline, femoral total BMD of men was significantly greater than that of women (P < .05, .85 +/- .1 vs .74 +/- .1). A significant increase in BMD was observed at 12 months (P < .05), no patient developed a bone fracture. Comparison analysis of genders showed that there was a significant difference in favor of men (P < .05). The lumbar BMD, neck T-, and Z-scores were significantly higher among patients treated with alendronate than historical controls (P < .05). After 3 months, serum PTH was increased and serum osteocalcin and urinary DPD were reduced. No severe side effects from alendronate treatment were observed during the study. Conclusion. A direct sign of the success of our study was no fracture observed during the first postoperative year. Alendronate should be considered for patients with low bone mass after liver transplantation.Öğe Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire(Springer Heidelberg, 2013) Duruoz, M. T.; Doward, L.; Turan, Y.; Cerrahoglu, L.; Yurtkuran, M.; Calis, M.; Tas, N.; Ozgocmen, S.; Yoleri, O.; Durmaz, B.; Oncel, S.; Tuncer, T.; Sendur, O.; Birtane, M.; Tuzun, F.; Bingol, U.; Kirnap, M.; Erturk, G. Celik; Ardicoglu, O.; Memis, A.; Atamaz, F.; Kizil, R.; Kacar, C.; Gurer, G.; Uzunca, K.; Sari, H.The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire is a disease-specific measure of needs-based quality of life developed in the UK and the Netherlands. This study describes translation, validation, and reliability of the scale into Turkish population. The ASQoL was translated into Turkish using the dual-panel process. Content validity was assessed via cognitive debriefing interviews with ankylosing spondylitis (AS) patients. Patients with AS according to modified New York criteria were recruited into the study from 12 hospitals of all part of Turkey. Psychometric and scaling properties were assessed via a two administration survey involving the ASQoL, the Nottingham Health Profile (NHP), Bath AS Functional Index (BASFI), and Bath AS Disease Activity Index (BASDAI). Classical psychometrics assessed reliability, convergent validity (correlation of ASQoL with NHP, BASFI, and BASDAI) and discriminative validity (correlation of ASQoL with perceived AS-severity and general health). Cognitive debriefing showed the new Turkish ASQoL to be clear, relevant, and comprehensive. Completed survey questionnaires were received from 277 AS patients (80 % Male, mean age 42.2/SD 11.6, mean AS duration 9.4 years/SD 9.4). Test-retest reliability was excellent (0.96), indicating low random measurement error for the scale. Correlations of ASQoL with NHP sections were low to moderate (NHP Sleep 0.34; NHP Emotional Reactions 0.83) suggesting the measures assess related but distinct constructs. The measure was able to discriminate between patients based on their perceived disease severity (p < 0.0001) and self-reported general health (p < 0.0001). The Turkish version of ASQoL has good reliability and validity properties. It is practical and useful scale to assess the quality of life in AS patients in Turkish population.