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Öğe BREAST CANCER IN A WOMAN WITH GUILLAIN-BARRE SYNDROE: A REMINDER TO CONSIDER PARANEOPLASTIC NEUROLOGICAL SYNDROME(Gunes Kitabevi Ltd Sti, 2016) Tuna, Filiz; Tastekin, Ebru; Ozdemir, Hande; Duzce, Ela; Tuna, Hakan72-year-old woman was referred to us for Guillain-Barre syndrome rehabilitation, during which her functional status improved (Hughes score 3-2, Functional Ambulation Classification Scale 2-4, Functional Independence Measure score 99-120). Despite her improvement, discharge was postponed because of a bloody discharge from her left nipple, which started 1 day before the last visit. The final diagnosis, after an excisional biopsy, was invasive ductal carcinoma with apocrine features. Guillain-Barre syndrome is an acute, rapidly progressing inflammatory polyneuropathy, with patients typically showing symmetrical, ascending weakness with a severe loss of reflexes. The current literature describes Guillain-Barre syndrome as a probable paraneoplastic neurological syndrome and cancer precursor. Guillain-Barre syndrome with this etiology, i.e., paraneoplastic neurological syndrome, may result from remote effects with immunological mechanisms that are not directly caused by the tumor or metastases infiltration. Guillain-Barre syndrome may develop as a paraneoplastic neurological syndrome, may be secondary to treatment, or may occur coincidentally with cancer. Because paraneoplastic neurological syndrome occurs at an early stage of cancer before metastasis, it is important to consider paraneoplastic neurological syndrome when evaluating Guillain-Barre syndrome patients.Öğe Effect of activity-based training versus strengthening exercises on upper extremity functions in Parkinson?s patients; A randomized controlled, single blind, superiority trial(Elsevier, 2022) Zare, Maryam; Ozdemir, Hande; Tavsan, Merve Yalcin; Tuna, Filiz; Sut, Necdet; Guler, Sibel; Kabayel, Derya DemirbagBackground:Idiopathic Parkinson's disease is a neurodegenerative disease which is appeared by symptoms such as resting tremor, bradykinesia, rigidity, and postural instability. Such symptoms as tremor, bradykinesia, and rigidity significantly affect patients' upper extremity function. Rehabilitation programs should be implemented to improve the upper extremity functions of patients. Objective:Activity-based training would improve dexterity and functional activities to a larger extent than strengthening exercises. This study aimed at evaluating the effect of activity-based training and strengthening exercises on upper extremity functions in Parkinson's disease and to compare the two methods. Method:40 Parkinson's patients with mean of 64.45 +/- 9.13 age were randomized and divided into two groups as activity-based training and strengthening exercise group. Patients were evaluated at the beginning and after 6 weeks of treatment with Unified Parkinson's Disease Rating Scale, Parkinson's Disease Questionnaire-39, Duruo spacing diaeresis z Hand Index, Jebsen Taylor Hand Function Test, Nine-Hole Peg Test, Jamar dynamometer, Jamar pinch meter, Semmes Weinstein Monofilament Test and two-point discrimination. Result:In both groups, upper extremity functions, handgrip strengths and quality of life of patients improved significantly. Tactile sense improved only in the activity-based training group. Conclusion:Activity-based training is not superior to strengthening exercise programs at improving upper extremity functions and dexterity of Parkinson's patients.Öğe Ehlers?Danlos syndrome-related genes and serum strontium, zinc, and lithium levels in generalized joint hypermobility: a case-control study(Taylor & Francis Inc, 2021) Tuna, Filiz; Doganlar, Zeynep Banu; Ozdemir, Hande; Kabayel, Derya Demirbag; Doganlar, OguzhanAim of the study: Generalized joint hypermobility (GJH) is a common feature of almost all Ehlers?Danlos syndrome (EDS) types; however, its genetic basis remains unclear. Therefore, it is crucial to distinguish the genetic basis of GJH from other connective tissue disorders, including the different subtypes of EDS. The aim of this study was to determine the blood EDS-related gene expressions and serum element levels in GJH and reveal their predictive characteristics and correlations with the Beighton score. Materials and Methods: A total of 39 women aged 18?23?years with GJH and 38 age- and sex-matched controls were included in the study. Inductively coupled plasma mass spectrometry was used to analyze the serum levels of zinc (Zn), strontium (Sr), and lithium (Li). The relative expression levels of the EDS-related genes were determined using quantitative real-time polymerase chain reaction (PCR). Results: Our results showed that women with GJH possessed significantly lower Li and higher Zn and Sr levels than the controls. In addition, the gene expressions of TNXB and SLC39A13 were significantly higher, whereas those of COL1A1, COL1A2, COL5A1, FKBP14, and DSE were lower in the GJH group. Pearson correlation analyses revealed a strong negative correlation between the Beighton score and B4GALT7, FKBP14, COL1A1, and Li. However, a significant positive correlation was noted between the Beighton score and SLC39A13, TNXB, Zn, Sr, and B3GALT6. Conclusion: Our findings provide valuable basal levels for conducting gene function analysis of joint hypermobility-related connective tissue disorders.Öğe Improving Care of Older Patients with Hemophilia During COVID-19 Pandemic, Reducing the Risk of Venous Thrombosis with Home Exercises(Sage Publications Inc, 2022) Demirci, Ufuk; Umit, Elif G.; Ozdemir, Hande; Demirbag Kabayel, Derya; Demir, Ahmet Muzaffer[Abstract Not Available]Öğe The last station before fracture: Assessment of falling and loss of balance in elderly(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Koyuncu, Gulay; Tuna, Filiz; Yavuz, Selcuk; Kabayel, Derya Demirbak; Koyuncu, Mesut; Ozdemir, Hande; Sut, NecdetObjectives: This study aims to investigate the rate of balance disorders and risk of falling in the geriatric population who do not complain of a balance disorder. Patients and methods: Sixty-eight elderly participants (24 males, 44 females; mean age 72.1 +/- 5.5 years), who were admitted to outpatient clinic between May 2012 and September 2012, were included in the study. Demographic data were recorded. Participants were divided into two age groups as young old (65-74 years) and old (75-85 years). Static balance was evaluated with Sharpened Romberg and the one-legged stance test. The dynamic balance and walking of the individuals were evaluated with Timed Up and Go (TUG) test, Berg Balance Scale (BBS), Tinetti (balance and gait) test (TT), and 20-meter walk test. Results: None of the participants had sought medical help due to loss of balance or falling. According to BBS, 41% of the participants had a moderate risk of falling; 66% had moderate and high risk of falling according to TT; and 63% of them had a high risk of falling according to TUG. Thirty-four percent of elderly had experienced at least one fall over the last year. Loss of balance was more significant in women and number of falls was more (p<0.05). The total evaluation results in TUG and TT for the individuals in the young old group were better than the individuals in the older age group in terms of balance. Conclusion: Loss of balance is a common finding in geriatric individuals and is associated with the risk of falling. Physicians, who frequently encounter with the geriatric population, should take this condition into account even for the patients who do not complain of a balance disorder. Thus, rehabilitation may be an option to prevent the fall and related complications, through the evaluation of balance.Öğe The mitral valve prolapse frequency in healthy females with generalized joint hypermobility: A case-control study(Turkish League Against Rheumatism, 2021) Ozdemir, Hande; Tuna, Filiz; Aktoz, Meryem; Tastekin, Nurettin; Kabayel, Derya DemirbagObjectives: The aim of this study was to investigate the frequency of mitral valve prolapse between healthy females with generalized joint hypermobility and healthy controls. Patients and methods: This observational, cross-sectional, controlled study included female individuals with generalized joint hypermobility (n=39, mean age: 20.5 +/- 1.1 years; range, 19 to 23 years) and healthy controls (n=42, mean age: 20.6 +/- 1.2 years; range, 18 to 23 years) between July 2017 and November 2017. The generalized joint hypermobility consisted of women with a Beighton score of <= 4, while the control group consisted of women with a Beighton score of <= 3. Echocardiography was performed to all participants. Mitral valve prolapse was defined as having single or bileaflet prolapse of at least 2 mm beyond the long-axis annular plane with or without mitral leaflet thickening. Results: No significant difference was found in the age, height, body weight, and body mass index between the groups (p>0.05). The median Beighton score was 5 in the generalized joint hypermobility group and 2 in the control group. No mitral valve prolapse was detected in those with generalized joint hypermobility, while non-classical mitral valve prolapse was observed in one participant in the control group, indicating no statistically significant difference between the two groups (p> 0.05). Conclusion: Our study results suggest that the frequency of mitral valve prolapse is comparable between the women with generalized joint hypermobility and healthy controls. Based on these results, routine assessment of mitral valve prolapse is not recommended in this population.Öğe Reducing the Risk of Venous Thrombosis During Self-Isolation and COVID-19 Pandemic for Patients With Cancer: Focus on Home Exercises Prescription(Sage Publications Inc, 2020) Demirci, Ufuk; Ozdemir, Hande; Demirbag-Kabayel, Derya; Umit, Elif G.; Demir, Ahmet Muzaffer[Abstract Not Available]Öğe Risk factors, fractures, and management of pregnancy-associated osteoporosis: a retrospective study of 14 Turkish patients(Taylor & Francis Ltd, 2020) Tuna, Filiz; Akleylek, Cansu; Ozdemir, Hande; Kabayel, Derya DemirbagPregnancy-associated osteoporosis (PAO) is a rare but painful disease. The current study aimed to investigate the demographic and clinical features, risk factors, treatment options, and outcomes of Turkish patients with PAO. In our retrospective, cross-sectional, and descriptive study the time to PAO diagnosis was 3.6 months. Pain and loss of height were detected in 78.6% and 28.6% of patients, respectively. As such, 60.6% of patients reported fractures at the thoracic area, 30.3% at the lumbar area, and 9.1% at the sacral area. While 14.3% of patients had optimal vitamin D status during pregnancy, 64.3% had vitamin D deficiency, and 21.4% had vitamin D insufficiency. Of the patients, 21.4% received anticoagulant therapy during their pregnancy. Dual X-ray absorptiometry scans revealed that osteoporosis was predominantly in the trabecular bone (L1-L4 Z-score -2.9, Femur Z score -2.19). Management options included supplements of calcium with vitamin D (93%), weaning the baby (79%), specific treatments for osteoporosis (64%), use of a supportive corset (50%), and exercise (21%), respectively. In addition, after delivery, 35.7% of patients were administered denosumab, 21.4% bisphosphonate, and 7.1% were given teriparatide. Data of the clinical features, treatments, and outcomes of PAO may contribute to early detection and management.