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Öğe Do physical therapy modalities have additional benefit over exercise therapy in the management of Ankylosing Spondylitis? A randomized controlled trial(2021) Donmez, Ulku; Ozturk, Cihat; Cinar, Ece; Kocanaogulları, Hayriye; Gucenmez, Sercan; Hepguler, SiminAim: The aim of this study was to evaluate the effectiveness of microwave therapy and global postural reeducation (GPR) exercises on disease activity, pain, quality of life and functional status in patients with ankylosing spondylitis (AS). Materials and Methods: 77 patients diagnosed with AS were included in the study. First group (n: 25) was treated with global postural reeducation exercises 5 days a week, for 3 weeks. Patients in the second group (n: 26), in addition to GPR, were treated with microwave therapy before each exercise session to warm lumbar paraspinal muscles. Third group (n: 26) consisted of controls. Subjects were evaluated at baseline, on the third week, third and six months. Results: In the first group, improvement in all parameters was found to be significant (p<0.05). Second group exhibited statistical improvement in all outcome measures (p<0.05) except daytime pain (p >0.05). In the control group, improvements in BASMI, BASDAI and Beck depression scores were statistically significant (p<0.05). Intergroup comparisons showed a statistically significant difference among groups in all outcome measures at the sixth month follow-up (p<0.05). First and second groups which received GPR demonstrated greater improvement in BASMI, BASFI, BASDAI and Beck depression inventory scores compared with the control group (p<0.05). Conclusion: Our results show that GPR has beneficial effects on disease activity, quality of life, pain and depression in patients with AS. We could not detect any additional benefits of microwave therapy applied before exercise.Öğe Lymphedema Treatment in a Patient with a History of Intestinal Transplantation and Mesenchymal Stem Cell Transplantation(Aves, 2015) Eyigor, Sibel; Donmez, Ulku; Kilinc, Selcuk; Dogan, Murat; Tugmen, Cem; Baran, Masallah; Kebapci, Eyup; Karaca, CezmiLymphedema is a rare complication of sirolimus treatment in transplantation patients. We present a case of a 14-year-old female patient who developed lymphedema in three extremities. The patient had undergone ileal and colon resections after sustaining a gunshot to her abdomen. Four months after the injury, she had developed a short bowel syndrome and underwent small intestine transplantation from a cadaver and mesenchymal stem cell transplantation to prevent rejection. Because kidney failure developed at postoperative month 3, mycophenolate mofetil therapy was discontinued and sirolimus therapy was initiated. The patient was monitored under this therapy until postoperative month 11 when she had swelling in both the legs and left arm. Her condition significantly improved with complex decongestive therapy. This is the first case in the literature involving mesenchymal stem cell transplantation together with ileum transplantation. This case is also noteworthy in terms of lymphedema treatment administered and the involvement of three extremities.Öğe Lymphedema Treatment in a Patient with a History of Intestinal Transplantation and Mesenchymal Stem Cell Transplantation(Aves, 2015) Eyigor, Sibel; Donmez, Ulku; Kilinc, Selcuk; Dogan, Murat; Tugmen, Cem; Baran, Masallah; Kebapci, Eyup; Karaca, CezmiLymphedema is a rare complication of sirolimus treatment in transplantation patients. We present a case of a 14-year-old female patient who developed lymphedema in three extremities. The patient had undergone ileal and colon resections after sustaining a gunshot to her abdomen. Four months after the injury, she had developed a short bowel syndrome and underwent small intestine transplantation from a cadaver and mesenchymal stem cell transplantation to prevent rejection. Because kidney failure developed at postoperative month 3, mycophenolate mofetil therapy was discontinued and sirolimus therapy was initiated. The patient was monitored under this therapy until postoperative month 11 when she had swelling in both the legs and left arm. Her condition significantly improved with complex decongestive therapy. This is the first case in the literature involving mesenchymal stem cell transplantation together with ileum transplantation. This case is also noteworthy in terms of lymphedema treatment administered and the involvement of three extremities.Öğe Lymphedema Treatment in a Patient with a History of Intestinal Transplantation and Mesenchymal Stem Cell Transplantation(Aves, 2015) Eyigor, Sibel; Donmez, Ulku; Kilinc, Selcuk; Dogan, Murat; Tugmen, Cem; Baran, Masallah; Kebapci, Eyup; Karaca, CezmiLymphedema is a rare complication of sirolimus treatment in transplantation patients. We present a case of a 14-year-old female patient who developed lymphedema in three extremities. The patient had undergone ileal and colon resections after sustaining a gunshot to her abdomen. Four months after the injury, she had developed a short bowel syndrome and underwent small intestine transplantation from a cadaver and mesenchymal stem cell transplantation to prevent rejection. Because kidney failure developed at postoperative month 3, mycophenolate mofetil therapy was discontinued and sirolimus therapy was initiated. The patient was monitored under this therapy until postoperative month 11 when she had swelling in both the legs and left arm. Her condition significantly improved with complex decongestive therapy. This is the first case in the literature involving mesenchymal stem cell transplantation together with ileum transplantation. This case is also noteworthy in terms of lymphedema treatment administered and the involvement of three extremities.Öğe Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment(Taylor & Francis Ltd, 2016) Akkoc, Yesim; Ersoz, Murat; Yuceyar, Nur; Tunc, Hakan; Koklu, Kurtulus; Yoldas, Tahir Kurtulus; Donmez, Ulku; Uzunkopru, Cihat; Alemdaroglu, Ebru; Bilen, Sule; Emre, Ufuk; Otzdolap, Senay; Tuncay, Elif; Yucesan, Canan; Gok, Haydar; Ercan, Merve Bahar; Uygunol, Kursat; Kocer, Belgin; Zinnuroglu, MuratObjective: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. Design: Survey study. Setting: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. Participants: Consecutive MS patients scheduled for outpatient follow-up (n=309). Intervention: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. Results: The mean age +/- SD was 39.3 +/- 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P<0.001), upper urinary tract assessment by ultrasound (P<0.001), urodynamic assessment (P<0.001), admitted to a doctor for urinary symptoms (P<0.001), and current or past catheter use (P=0.002). Conclusion: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.
