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Öğe Does the fibromyalgia affect the quality of life in the patients with inflammatory bowel disease(2021) Dilekci, Erdal; Can, Güray; Gürler, Müjgan; Dilekçi, Esra Nur Ademoğlu; Kayhan, Meral AkdoğanAim: Data on soft tissue rheumatism, especially fibromyalgia syndrome is limited in inflammatory bowel disease. Our aim in our study is to determine the prevalence of fibromyalgia syndrome and to evaluate the impact on quality of life in inflammatory bowel disease. Material and Method: 60 ulcerative colitis and 34 Crohn’s disease patients were included. 2010/2011 and 2016 American College of Rheumatology criteria were used for fibromyalgia syndrome diagnosis. A Fibromyalgia impact survey was applied to all patients. Results: According to the American College of Rheumatology-2010/2011 criteria, fibromyalgia syndrome frequencies were determined as 29.8% in inflammatory bowel disease, 23.4% in Crohn’s disease, and 33.3% in ulcerative colitis (P>0.05). The frequency of fibromyalgia syndrome was significantly higher in inflammatory bowel disease and especially more in females. There was no significant difference between ulcerative colitis and Crohn’s disease in terms of widespread-pain-index, somatic- symptom-severity, and fibromyalgia syndrome scores. Fibromyalgia impact scores were found significantly higher in those with fibromyalgia syndrome in inflammatory bowel disease, ulcerative colitis, and Crohn’s disease. Conclusions: This is the first study to show the frequency of fibromyalgia syndrome in patients with inflammatory bowel disease in the Turkish population. Fibromyalgia syndrome is increased in inflammatory bowel disease patients and more in ulcerative colitis and female. The quality of life is more affected in inflammatory bowel disease patients with fibromyalgia syndrome.Öğe Effect of balneotherapy on pain and fatigue in elderly with knee osteoarthritis receiving physical therapy: a randomized trial(Springer, 2019) Dilekci, Erdal; Ozkuk, Kagan; Kaki, BarisThis study aimed to investigate whether balneotherapy (BT) applied in combination with physical therapy (PT) has a more positive effect in patients aged 65 years and older with knee osteoarthritis (KOA) compared to PT alone. A total of 305 individuals were randomized into two groups. Group I was applied PT alone; group II was applied PT+BT. Assessments were made using the Pain (VAS), EQ-5D-3L Scale, Western Ontario And McMaster Universities Osteoarthritis Index (WOMAC), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale, Epworth Sleepiness scale (EPWORTH) and the Outcome Measures in Rheumatology-The Osteoarthritis Research Society International set of responder criteria for osteoarthritis (OMERACT-OARSI) at the beginning (T0) and at the end (T1) of treatment. Statistically significant interactions found between treatment (PT alone or PT+BT) and time (before treatment and after treatment) in terms of Pain-VAS, Pain-WOMAC, Stiffness-WOMAC, Physical Function-WOMAC, Total-WOMAC, EQ-5D, EQ-VAS, FACIT-F, and EPWORTH scores (p<0.0001 for all). According to OMERACT-OARSI criteria, the responder rate was 89.04% in PT alone group and 98.74% in PT+BT group. Balneotherapy plus physical therapy was more effective than physical therapy alone in KOA patients aged over 65 years. Reducing pain, especially, positively contributes to functionality, quality of life, fatigue and sleepiness of KOA patients.Öğe Evaluation of the applications of traditional and complementary medicine in the perspective of family medicine in a tertiary referral center(2020) Kayhan, Mehmet; Dilekci, ErdalTo evaluate the clinical and demographic characteristics of the patients who apply to Traditional and Complementary Medicine (TCM) center. The medical charts of patients, who were admitted to AIBU Izzet Baysal Physical Therapy and Rehabilitation Training and Research Hospital, TCM centre, from September 2018 to August 2019, were retrospectively reviewed. Only patients over the age of 18 were included in the study. 879 (84.4%) of the patients were female, 163 of them were (15.6%) male. 44 (4.2%) patients in the 18 - 24 age group, 137 (13.1%) patients in the 25 - 34 age group, 223 (21.4%) people in the 35 - 44 age group, 287 (27.5%) patients in the 45 - 54 age group, 205 (19.7%) patients were in the 55-64 age group, and 146 (14.0%) patients were in the age group 65 and over. Mean age of the patients was 48.64 ± 13.86 (19-87). 365 (35.0%) of TCM applications were made in spring, 266 (25.5%) in winter, 223 (21.5%) in summer and 188 (18.0%) in autumn. In this study, the most preferred TCM applications are acupuncture (48.1%), ozone therapy (34.3%) and mug treatment (13%), respectively. Determining by whom, in which age group and in which period of the year are more preferred TCM applications, which have been increasingly used in recent years, may prevent problems that may develop during the service delivery process.Öğe Evaluation of the relationship between uric acid and bone mineral density in postmenopausal women: a single center retrospective study(2020) Dilekci, Erdal; Dilekçi, Esra Nur AdemoğluObjectives: Osteoporosis is an important public health problem which is characterized by loss of bone mass resulting in susceptibility to fractures. There is much evidence indicating that uric acid, a final enzymatic product of purine metabolism, has beneficial antioxidant effects on several chronic diseases such as diabetes mellitus, hypertension and cardiovascular diseases. We aimed to evaluate the relationship between serum uric acid levels and bone mineral density (BMD) on postmenopausal osteoporosis in the present study. Material and Method: This study was carried out at the Bolu İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Department of Physical Medicine and Rehabilitation. The medical records of 1200 postmenopausal women between January 2019 and 2020 who had dual energy x-ray absorptiometry (DEXA) examination and serum uric acid levels recorded were screened retrospectively. In total, 92 individuals with osteoporosis and 399 healthy individuals were included in the study after exclusion of subjects with systemic diseases or taking drugs affecting bone metabolism or uric acid levels. Bone mineral density and T scores of femur neck (F neck) and lumbar spine (L2-L4), glucose, AST, ALT, creatinine, alkaline phosphatase, calcium, phosphate, parathormone (PTH), albumin and total protein were all recorded in individuals. Results: Serum uric acid concentrations were found to be significantly lower in the osteoporosis group compared with the control group [4.65(2.40-7.80) vs 5.20 (3.80-9.40); p<0.001, respectively]. In correlation analysis, uric acid was significantly associated with fasting blood glucose (r=0.129, p=0.004), creatinine (r=0.374, p<0.001), calcium (r=0.201, p<0.001), total protein (r=0.123, p=0.006) and TSH (r=0.108, p=0.017). Correlation analysis also revealed a significant and positive correlation between uric acid and L2-L4 BMD (r=0.255, p<0.001). L2-L4 BMD was found to be independently related with uric acid in multivariate linear regression analysis after adjustment for confounding factors (B=1.619, p<0.001). Conclusion: Our findings revealed that serum uric acid levels and lumbar (L2-L4) BMD were independently associated with each other in postmenopausal osteoporosis. Further studies are needed to determine the association of uric acid with osteoporosis and to address the utility of uric acid in clinical practice.Öğe İnflamatuvar Barsak Hastalıklarında Osteoporoz Sıklığı(2019) Dilekci, Erdal; Tezel, Ahmet; Can, Güray; Demirkol, Mehmet Emin; Dilekçi, Esra Nur Ademoğlu; Gürler, Müjgan; Erkuş, Edipİnflamatuvar barsak hastalıkları, ağırlıklı olarak gastrointestinal sistemi tutan sistemik kronik inflamatuvar bir hastalık grubudur. İnflamatuvar barsak hastalıklarında ekstraintestinal bulgular sıklıkla birlikte bulunmaktadır. Bunlar içinde metabolik kemik hastalıkları azımsanmayacak ölçüde sıktır. Çalışmamızda kendi inflamatuvar barsak hastalıkları kohortumuzda osteoporoz ve osteopeni sıklığını ortaya koymayı amaçladık. Bu çalışmaya 71 ülseratif kolit, 44 Crohn hastasının kemik mineral dansite verileri retrospektif olarak değerlendirildi. İnflamatuvar barsak hastalığında tanı, tutulum paterni, hastalık davranışı, cinsiyet ve kemik mineral dansite lokalizasyonlarına göre kemik dansiteleri, T ve Z skorları karşılaştırıldı. Ülseratif kolit hastalarının %53,5’inde, Crohn hastalarının %50’sinde osteopeni saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Ülseratif kolit hastalarının %22,5’inde, Crohn hastalarının %25’inde osteoporoz saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Crohn hastalığında osteopeni en sık femur boynu ve wards üçgeninde (%47,7 ve %47,7), ülseratif kolit hastalarında osteopeni en sık wards üçgeninde (%52,1) saptandı. Ülseratif kolit ve Crohn hastalığında osteoporoz en sık lomber bölgede (sırasıyla %15,5 ve %18,2) tespit edildi. Ülseratif kolit ve Crohn hastalığı arasında osteoporoz ve osteopeni açısından anlamlı fark izlenmedi. Ülseratif kolit ve Crohn hastalığında alttip, davranış, cinsiyet ve kemik mineral dansite lokalizasyon açısından karşılaştırıldığında anlamlı fark saptanmadı. İnflamatuvar barsak hastalığında osteoporoz ve osteopeni sıklığı artmıştır. Bulgularımızı doğrulamak için daha büyük örneklem büyüklüğüyle ve iyi dizayn edilmiş prospektif çalışmalara ihtiyaç vardır.Öğe The short-term effects of balneotherapy on pain, disability and fatigue in patients with chronic low back pain treated with physical therapy: A randomized controlled trial(Churchill Livingstone, 2020) Dilekci, Erdal; Ozkuk, Kagan; Kaki, BarisObjective: This study aimed to compare whether there are positive effects of balneotherapy(BT) on pain, quality of life and disability of individuals receiving physical therapy(PT) for chronic low back pain and to examine the effect of body mass index(BMI) on treatment. Materials and method: This prospective, controlled, single blind study was conducted. Patients were randomized into two groups through a simple randomization in a 1:1 ratio. The clinician and biostatistics expert were blinded. PT group was applied PT, BT + PT group was applied PT + BT. All patients were included in the study for 3 weeks (total of 15 sessions, 5 days per week). All patients applied hot pack, transcutaneous electrical nerve stimulation and ultrasound. Patients in the BT + PT group applied BT in thermo mineralized water pool (20 min at 38-40 degrees C). Assessments were made using Pain-Visual Analog Scale(VAS), EQ-5D-3 L Scale(EQ5), EQ-VAS, Functional Assessment of Chronic Illness Therapy-Fatigue(FACIT-F), Roland-Morris Disability Questionnaire (RMDQ) and Quebec Back Pain Disability Scale(QBPDS) at the beginning (W0) and end (W3) of treatment. While performing statistical analysis, patients were divided into 3 categories of BMI1(18.5-24.9 kg/m(2)), BMI2 (25.0-29.9 kg/m(2)) and BMI3(>= 30.0 kg/m(2)). Results: 270 patients were randomized. 129 patients in PT group and 133 patients in PT + BT group completed the study. In the BT + PT group, there were increases in the EQ5 and EQ-VAS variables and decreases in all other variables compared to the PT group which were found to be statistically significant (for QBPDS p < 0.05, the others p < 0.01). The differences in all variables W0 and W3 were at least half reductions and increases which were found to be statistically significant (p < 0.01). In terms of BMI, there were significant differences for all groups, especially BMI3 had higher means for all variables apart from EQ5 and EQ-VAS than the other two categories. BMI1 was the BMI category with highest means for EQ5 and EQ-VAS. The Group x Time interaction was found to be statistically significant for Pain-VAS, EQ5, EQ-VAS, FACIT-F, QBPDS and RMDQ(p < 0.01). For Pain-VAS, the effect of the Group x Time x BMI interaction was found to be statistically significant(p < 0.05). Conclusion: BT plus PT was more effective than PT. BT may have positive contributions to reducing pain, functionality of patients, quality of life, fatigue and disability status.
