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Öğe EFFECT OF EXPIRATORY MUSCLE TRAINING ON STOMATOGNATHIC SYSTEM IN PATIENTS WITH STROKE(2023) Dursun, Ömer; Çankaya, Tamer; Dilekçi, ErdalObjective: The aim of this study was to assess the effect of expiratory muscle training on the stomatognathic system in patients with stroke. Method: A total of 31 patients with stroke were included in the study: 16 patients with stroke (age=66.63±8.38, height=166.38±8.59, BMI=28.09±4.81) as the control group and 15 patients with stroke (age=65.60±7.62, height=168.20±8.78, BMI=28.95±6.92) as the study group. Temporomandibular joint range of motion and dysfunction, pressure pain threshold of masticatory muscles, facial asymmetry existence, head posture, oral hygiene, oral hygiene habit, masticatory performance, intraoral pH, deglutition, and deep neck flexor muscle endurance of the patients with stroke were assessed. Assessment methods were in order by digital caliper, the Fonseca Questionnaire, algometry, labial commissure and craniocervical angle measurement, general oral health assessment index, and questionnaire, sieve test, digital pH gauge, repetitive saliva swallow test, Eating Assessment Tool, and deep neck flexor endurance test. Patients with stroke in the study group were enrolled in an expiratory muscle training program consisting of 5 sets of 10 repetitions daily for three weeks in addition to conventional physiotherapy; the control group enrolled in the conventional physiotherapy program. Patients with stroke in the study group were called twice a week to assess their compliance with the expiratory muscle training. Results: In intragroup comparison significant increase was found in the inferior portion of the left masseter, mandibular protrusion, and a decrease in labial commissure angle and Fonseca Questionnaire score of the control group (p<0.05). In the study group a significant increase was observed in mandibular depression (p<0.05). In intragroup comparison, both groups had similar intraoral pH, masticatory performance, craniocervical angle and neck flexor muscle endurance (p>0.05). While significant difference was found in lateral deviation, eating assessment inventory and labial commissure angle in intergroup comparison (p<0.05), other parameters were similar (p>0.05). Improvement in labial commissure angle was in favor of the control group (p<0.05). Conclusion: Expiratory muscle training might be preferred to increase mandibular lateral deviation and improve deglutition in subacute or chronic-stage patients with stroke.Öğe The effects of balneotherapy in elderly patients with chronic low back pain treated with physical therapy: A pilot study(2019) Özkuk, Kağan; Dilekçi, ErdalObjective: The aim of this study was to compare whether balneotherapy has a positive effect on the treatment of elderly individuals receiving physical therapy for chronic low back pain (CLBP). Methods: 244 participants were randomly placed into two groups. The first group was treated with physical therapy (PT), the second group was treated with PT and balneotherapy (BT). Assessments were made using the PainVAS, Quebec Back Pain Disability Scale (Quebec), Health Assessment Questionnaire (HAQ) before treatment (T0) and after treatment (T1). Results: In both groups, there was a statistically significantly decrease in terms of pain-VAS, Quebec and HAQ scores (p<0.001). When pain-VAS scores were compared between the two groups, pain-VAS T0 was significantly higher and pain-VAS T1 was significantly lower in the BT+PT group than the PT group (p=0.001). When the HAQ and Quebec values were compared between the groups, the T0 value was similar in the BT+PT and PT groups (HAQ p=0.068, Quebec p=0.495) while the BT+PT group HAQ and QuebecT1 scoreswere significantly lower than the PT group (p<0.001). The BT+PT group change values were significantly higher than the PT group (p<0.001). Conclusion: These results recommend that combining therapies may be more effective in treating CLBP and balneotherapy may increase the effectiveness of the treatment.Öğe Evde sağlık hastalarında D vitamini düzeyleri(2018) Dilekçi, Erdal; Dilekçi, Esra Nur Ademoğlu; Demirkol, Muhammed Emin; Ögün, Muhammed NurAmaç: Bu çalışmada mobilize olamayan, güneş ışığından faydalanamayan ve malnütrisyonun sık görüldüğü evde sağlık hastalarında, serum albümin ve 25-hidroksi D (25[OH]D) vitamini düzeylerini incelenmeyi amaçladık. Gereç ve Yöntem: Bu çalışmaya Ocak 2017 ve Temmuz 2017 tarihleri arasında Bolu ilinde evde sağlık hizmetleri tarafından takipli, evden dışarıya çıkamayan ve tümü aile bireyleri tarafından bakılan yatağa bağımlı 57 evde bakım hastası dahil edildi. Kontrol grubu HBYS’de kayıtlı 42 sağlıklı bireyden oluşturuldu. Kişilerin demografik verileri ve kan değerleri takip dosyalarından retrospektif olarak elde edildi. Tüm hastalarda ve kontrol grubunda serum 25(OH) D, kalsiyum ve albümin düzeyleri incelendi. Bulgular: Evde sağlık hastalarının yaş ortalaması 77.7 ± 14.01 yıl, kontrol grubunun yaş ortalaması 74.2 ± 17.03 yıl idi. Serum 25(OH) D düzeyleri hasta grubunda 11.77 ± 9.07 ng/dL, kontrol grubunda 22.62 ± 7.41 ng/dL idi (p<0.001). Serum kalsiyum ve albümin düzeyleri hasta grubunda kontrol grubuna göre istatistiksel olarak anlamlı derecede daha düşüktü (p<0.001). Sonuç: Evde sağlık hizmeti kapsamında takip edilen hastalar malnütrisyon ve D vitamini eksikliği açısından risk altında olup hastaların bu açıdan takibi ve tedavisi önem teşkil etmektedir. Bu konudaki bulgularımızı doğrulamak için ileri çalışmalara ihtiyaç vardır.Öğe Fizik tedavi ve rehabilitasyon hastanesi polikliniklerine başvuran 65 yaş ve üstü hastaların aile hekimliği bakış açısıyla değerlendirilmesi(2018) Kayhan, Mehmet; Dilekçi, Erdal; Gücük, SebahatAmaç: Çalışmamız 65 yaş ve üstü hastalarımızın fizik tedavi hastanesine başvurma tanılarının incelenmesi ve birinci basamak sağlık hizmet sunumu açısından değerlendirilmesi amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmamız 01 Ocak - 31 Aralık 2016 tarihleri arasında Fizik Tedavi ve Rehabilitasyon Hastanesi polikliniklerine başvuran 65 yaş ve üstü hastaların elektronik kayıtları retrospektif olarak incelenerek yapıldı. Bulgular: Çalışmaya toplam 3920 hasta alındı. Bu hastaların 2392‘si (%61) kadın, 1528‘i (%39) erkekdi. Fizik tedavi ve rehabilitasyon hastalıkları arasında rehabilitasyon tedavisi alan hastaların tanılarına göre bel bölgesi hastalıkları %17 ile ilk sırada saptandı. Benzer şekilde diz bölgesi hastalıkları tanılarının sıklığı %15,8 iken hastaların toplamda %46,4‘ünde bu tanı saptandı. Sağlık uygulama tebliğinin fizik tedavi ve rehabilitasyon tanı grupları listesindeki gruplandırmalara göre A tanı grubunun sıklığı%7,5 (n:522) , B tanı grubu sıklığı %1,5 (n:107), C tanı grubunun sıklığı %22,5 (n:1556) olarak saptandı. Sonuç: Birinci basamak sağlık hizmeti sunumunda hastalarımız kas iskelet sistemi şikayetleriyle ilgili bilinçlendirilmelidir. Bu süreçte özellikle aile hekimleri tarafından ağrıyla mücadele etmeleri konusunda destek sağlanmasının, bu yaş grubu hastalarımızın yaşam kalitelerinin yükseltilmesi açısından önemli olduğunu düşünmekteyiz.Öğe Health Literacy and The Use of Primary Health Care Services of Inpatients with Musculoskeletal Complaints(Eurasian Society of Family Medicine, 2020) Gücük, Sebahat; Dilekçi, Erdal; Kayhan, MehmetAim: Our study aimed to determine the relationship between health literacy and the use of primary health care services in our patient group, where the demand for health services is quite frequent due to their complaints. Methods: This cross-sectional study was carried out with 725 patients with various diagnoses of musculoskeletal disorders hospitalizing to whom physical therapy and/or rehabilitation was applied. The volunteer participants filled out a sociodemographic questionnaire which consisted of 26 questions and Adult Health Literacy Scale using face-to-face interview method. Results: The mean total score of health literacy of the participants was identified as 12.02±3.77. In terms of those who previously took medical home service before for any reason, who received counseling by the midwife, and who have consulted their family physician about their current complaints, health literacy score was found to be significantly higher than the others. Conclusion: In order to increase the level of health literacy, which is an integral part of preventive health services especially in primary health care which is the first medical contact point, training programs should be planned according to the level of people’s need and understanding in every opportunity like seeing the patient in polyclinic or giving mobile care or during health screening programs. © 2020, Eurasian Society of Family Medicine. All rights reserved.Öğe Is circulating survivin altered in acromegaly?(2018) Ademoğlu, Esra; Dilekçi, Erdal; Candan, Zehra; Gorar, Suheyla; Niyazoğlu, MutluAcromegaly is a chronic disorder which is characterized by growth hormone (GH) excess. In most of cases, GH hypersecretion is derived from somatotroph cell tumors. Survivin is a member of apoptosis protein family, which was recently showed to be expressed in tissue samples of different benign and malignant human tumors. This study is intended to determine circulating levels of survivin in newly diagnosed acromegaly patients with somatotroph adenomas. 19 newly diagnosed acromegaly patients with somatotroph adenomas were inclu-ded in the study. Concurrently, 19 healthy individuals were included as control group. Serum survivin levels, GH, insulin like growth factor-1 (IGF-1) and, some other biochemical parame-ters as fasting glucose, creatinine, alanine aminotransferase, cholesterol, triglyceride, high den-sity lipoprotein cholesterol, low density lipoprotein cholesterol were measured in each subject. Correlation analysis was performed between survivin and GH, IGF-1. Serum survivin levels tended to be higher in acromegaly group, but this was not reach statistical significance (p>0.05). Serum survivin levels were comparable among acromegaly patients and controls. Neither GH nor IGF-1 correlated with serum survivin. Larger scale studies are needed concerning the circulating levels of survivin in patients with acromegaly.Öğe Piriformis sendromu: Bir olgu sunumu(2018) Dilekçi, ErdalPiriformis sendromu, kalça ve bel ağrısı ile karakterize nadir görülen nöromusculer bir patolojidir. Non diskojenik lumbalji ve siyatalji nedenidir. Kalçada ağrı, bacak ağrısının kalçanın iç rotasyonuyla artması, palpasyonla siyatik sinir ağrısının ortaya çıkması piriformis sendromunun temel özellikleridir. Klinik olarak lomber disk hernisi ile sıklıkla karışabilmektedir. Piriformis sendromu bel ağrısının çok nadir görülen bir nedeni olup, tanı konulabilmesi için öncelikle bu hastalığın hatırlanması sonra da diğer olası sebeplerin ekarte edilmesi gerekir. Ayrıntılı anamnez ve dikkatli bir fizik muayene ile tanı konmaktadır. Bu yazıda, Manyetik rezonanans (MR) görüntülemede L4-5 kök basısı olan ve yanlışlıkla lomber disk hernisi tanısı alan bir piriformis sendrom olgusunu dikkat çekmeyi amaçladık.
