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Öğe Akut aort anevrizma diseksiyonu sonrası gelişen parapleji: Bir olgu sunumu(2004) Tuna, Hakan; İzgi, Akın; Karadağ, Ayhan; Yıldız, Mustafa; Kokino, SiranuşAort diseksiyonu, yaşamı tehdit eden, ani göğüs ve/veya bel ağrısı ile karakterize bir hastalıktır. Aortik diseksiyon yaklaşık olarak % 2-8 inme ve paraplejiye neden olur. Biz acil servise spinal kord yaralanmalarının nontravmatik sebepleri arasında yer alan aort diseksiyonu sonrasında sırt ağrısı ve her iki bacağını hareket ettirememe şikayeti ile başvuran 56 yaşında erkek olguyu sunduk. Olguda rehabilitasyon programı süresince karşılaşılan problemler (osteoporoz, kırık, kompleks bölgesel ağrı sendromu) literatür eşliğinde tartışıldı.Öğe Analysis of Spinal Posture With Three-Dimensional Ultrasonic System in Patients With Ankylosing Spondylitis(Turkish League Against Rheumatism, 2019) Kurtoglu, Hakan Sercan; Tuna, Filiz; Tuna, Hakan; Ulucam, Enis; Tastekin, Nurettin; Birtane, MuratObjectives: This study aims to investigate the relationship between postural changes detected in ankylosing spondylitis (AS) vertebrae and clinical and demographic characteristics of patients using a three-dimensional ultrasonic system. Patients and methods: A total of 44 AS patients (36 males, 8 females; mean age 39.1 +/- 9.8 years; range, 18 to 63 years) and 44 healthy volunteers (36 males, 8 females; mean age 38.4 +/- 9.4 years; range, 18 to 65 years) were included. Clinical, demographic, and laboratory data were recorded. Spinal posture analysis was performed using a Zebris CMS20 three-dimensional ultrasonic system. Results: Thoracic kyphosis angle was significantly higher in the AS group (45.4 +/- 12.8 degrees) than in the control group (36.9 +/- 7.7 degrees) (p=0.001). Lumbar lordosis angle was significantly lower in the AS group (20.7 +/- 10.6 degrees) than in the control group (28 +/- 8.2 degrees) (p=0.002). There were no significant differences in total trunk inclination or sacral angles (p>0.05). Increase in thoracolumbar length at maximum spinal flexion and decrease in thoracolumbar length at maximum spinal extension were significantly lower in the AS group (p<0.05). A negative correlation was found between the thoracic kyphosis angle and length increase in spine flexure as well as chest expansion. Thoracic kyphosis angle had a statistically significantly positive correlation with age at onset of symptoms and tragus-wall distance (p<0.05). Conclusion: Significant changes were observed in spinal posture in patients with AS. In addition, significant correlations were found between dynamic postural changes and spinal mobility. We think that postural evaluation and follow-up should be carried out with other parameters. Awareness of AS patients about postural changes should be increased, and proper exercise treatment should be applied.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 BREAST CANCER IN A WOMAN WITH GUILLAIN-BARRÉ SYNDROME: A REMINDER TO CONSIDER PARANEOPLASTIC NEUROLOGICAL SYNDROME(2016) Tuna, Filiz; Taştekin, Ebru; Özdemir, Hande; Düzce, Ela; Tuna, HakanGuillain-Barré sendromu saptanan 72 yaşındaki kadın hasta, rehabilitasyon amacıyla tarafımızayönlendirildi. Rehabilitasyon sürecinde, fonksiyonel düzeyinde bir kazanım elde edildi (Hughesskoru 3'ten 2'ye, Functional Ambulation Classification düzeyi 2'den 4'de, Functional Independence Measure skoru 99'dan 120'ye değişim gösterdi). Bu gelişmeye rağmen, son vizitten bir günönce sol meme ucundan gelen kanlı akıntı şikayeti nedeniyle taburcu işlemi ertelendi. Eksizyonelbiyopsi sonucu nihai tanı apokrin özellik taşıyan invasiv ductal carcinoma olarak tanımlandı. Guillain-Barré sendromu akut, hızlı progresyon gösteren bir inflamatuar polinöropati dir. Bu hastalarda çoğunlukla reflex kaybının eşlik ettiği, simetrik, asendan güçsüzlük saptanır. Güncel literaturde, Guillain-Barré sendromu muhtemel paraneoplastik sendrom ve kanser öncüsü olarak tanımlanır. Bu tür bir Guillain-Barré sendromu, yani paraneoplastik sendrom; tümör veya metastaz infiltrasonunun doğrudan etkisi dışında, immünolojik mekanizmalara bağlı oluşan uzak bir etkidenkaynaklanabilir. Guillain-Barré sendromu; bir paraneoplastik sendrom olabilir, kanserle birlikte tesadüfi olarak veya tedaviye ikincil olarak gelişebilir. Bununla birlikte, paraneoplastik sendromunmetastazlar oluşmadan önce, kanserin erken evresinde ortaya çıkması, Guillain-Barré sendromuolarak değerlendirilen tüm hastalarda paraneoplastik sendromu düşünmeyi elzem kılarÖğe Comparing the efficacy of exercise, internal and external shoe modification in pes planus: A clinical and pedobarographic study(Ios Press, 2017) Taspinar, Ozgur; Kabayel, Derya Demirbag; Ozdemir, Ferda; Tuna, Hakan; Keskin, Yasar; Mercimek, Oznur Berke; Sut, NecdetPes planus is a condition that can cause pain along the innerfoot due to the absence or abnormal depression of the longitudinal arch. There are few studies available that compare therapy modalities used in these patients. In our study, those treated with conservative therapies-internal and external shoe modifications and pes planus exercises -were compared clinically and pedobarographyically. 60 pes planus patients were included in the study. In the first group; internal modification was performed by placing a medial longitudinal arch support inside the shoe. In the second group, external shoe modification was performed using the Thomas heel. In the third group of patients however, only an exercise program was executed. The patients' foot pain levels, functional asssessment, satisfaction and quality of life were recorded. Pedobarography was used in measuring both static and dynamic plantar pressure. Assessments were carried out at baseline and at the end of the first and third months respectively where intra-and inter-group comparisons were performed. Each group was composed of 20 subjects. While improvement in terms of foot pain, foot function index and quality of life was observed in all the study groups (p < 0.05), the most improvement was observed in the group of patients treated with internal modification (p < 0.016). This was followed by the external modification and the exercise groups respectively. No difference was observed between the internal and external modification groups in terms of patient satisfaction. Cross-sectionally; clinical assessments, pedobarographic analysis were correlated. The changes observed after static and dynamic pedobarographic studies were not significantly different between the study groups. At the end of the study it was observed that internal modification yielded the most significant clinical improvement. In the literature, there are limited publications comparing the conservative treatments with each other. In this study we aimed to compare the conservative treatments for flatfoot.Öğe Differences of Behaviour in Medical and Non-Medical Studentssuffering From Myofascial Pain(Trakya Üniversitesi, 2017) Nalbantlar, Yasin; Emin, Ahmet; Uzunoğlu, İlknur; Demir, Gözde Zeynep; Teker, Seher Gevri; Armutlugöynük, Hülya; Tuna, HakanAims: The aim of this study is to determine whether there is a difference in triggering factors of myofascial pain, the frequency, professional help seeking, the use of exercise, and the use of drugs between the students of the medical faculty and the other faculties.Methods: This survey study was conducted among 200 voluntary Trakya University students; 100 of them were from the medical faculty and the other 100 were from the other faculties. All participants suffered from myofascial pain. ‘‘Standardized Nordic Questionnaires for The Analysis of Musculoskeletal Symptoms’’ has been used to prepare the questionnaires. Chi-Square test was used for statistical analysis.Results: It was found that the most common trigger factor of myofascial pain is studying. In the medical faculties, the proportion was 62% and in the other faculties, it was 44%. The second most common factor was the usage of computers (medical faculty students (16%) other faculty students (27%)). Pain frequency was more than 5 times a week among medical school students it was 32% and 40% among the other faculty students. 34% of medical school students and 17% of other faculties’ students were doing exercise to relieve myofascial pain. 18% of medical faculty students and 33% of other faculties’ students were taking medication to relieve myofascial pain. 15% of medical faculty students and 18% of other faculties’ students at least once consulted a doctor because of myofascial pain.Conclusion: There was no significant difference found in terms of triggering factors and frequency of pain. However, usage of medication and participating in regular exercise were found to be significantly different between medical students and other faculties’ studentsÖğe Does quantitative tibial ultrasound predict low bone mineral density defined by dual energy X-ray absorptiometry?(Yonsei Univ College Medicine, 2008) Tuna, Hakan; Birtane, Murat; Ekuklu, Galip; Cermik, Fikret; Tuna, Filiz; Kokino, SiranusPurpose: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. Materials and Methods: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. Results: The SOS values were observed to be significantly higher in the normal BMD (t score > - 1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < - 1). SOS was negatively correlated with age (r = - 0.66) and month since menopause (r = - 0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. Conclusion: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.Öğe Edirne Huzurevi sakinlerinde yaşam kalitesine etki eden etmenlerin irdelenmesi(2000) Birtane, Murat; Tuna, Hakan; Ekuklu, Galip; Uzunca, Kaan; Akçi, Ceyda; Kokino, SiranuşYaşam kalitesi yaşlanma ile birlikte bozulma eğilimindedir. Bu çalışmada huzurevinde barınan yaşlılardaki yaşam kalitesini etkileyen faktörler araştırıldı. Bu amaçla 21'i (%21.9) kadın, 75'i (%78.1) erkek toplam 96 olguda demografik özellikler ve eğitim seviyesi belirlendi. Sistemik hastalık öyküsü ve baston kullanımı sorgulamasının yanı sıra görme kaybı, kognitif fonksiyonlar, aktivite skoru ve yaşam kalitesi değerlendirildi. Kognitif fonksiyon Mini-Mental Durum Değerlendirme Skalası (MMDDS) ile araştırıldı. Aktivite skoru ise temizlik, alışveriş, ulaşım, yemek yeme, yıkanma, giyinme, tuvalet, tranfer, kontinans ve beslenme gibi aktivitelerin bağımsızlık durumuna göre verilen puanlar toplanarak hesaplandı. Yaşam kalitesi Nottingham Sağlık Profili Değerlendirmesi (NSPD) ile belirlendi. Yaşam kalitesine etki eden faktörler, bağımlı değişkeni NSPD skoru, bağımsız değişkenleri de yaş, sistemik hastalık öyküsü, baston kullanımı, görme kaybı, MMDDS ve aktivite skoru olan stepwise lineer regresyon analizi ile değerlendirildi. Bu analiz sonucu anlamlı etkisi bulunan etmenlerin, NSPD'inin alt grupları ile arasındaki korelas-yonlar belirledi. Yaşlıların 74'ünde (%77.1) kronik sistem hastalığı var iken 49 (%51) kişide görme kaybı mevcuttu. Otuz dört (%35.4) kişi baston kullanmakta idi. Tüm olguların ortalama MMDDS'u 19.7±6.7, aktivite skoru 27.3±4.3 ve NSPD skoru 62.3±9.8 idi. Lineer regresyon analizine göre sadece MMDDS ve aktivite skorunun yaşam kalitesi göstergesi olan NSPD üzerinde anlamlı etkisi olduğu saptandı. Bu aşağıdaki eşitlikle formülize edildi (NSPD= 41.945+0.332 x MMDDS+0.640 x aktivite skoru). Korelasyon analizi sonucu aktivite skoru ve MMDDS ile NPSD'nin alt grupları olan ağrı, enerji seviyesi, emosyonel durum, fiziksel yetenekler ve sosyal izolasyon arasında anlamlı korelasyonlar elde edildi (p<0.05). 65 yaş üstü popülasyonda yaşam kalitesini öncelikle kognitif fonksiyonların ve aktivite derecesinin etkilediğini düşünmekteyiz.Öğe The Effect of Disease Duration on Foot Plantar Pressure Values in Patients with Type 2 Diabetes Mellitus(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Tuna, Hakan; Birtane, Murat; Guldiken, Sibel; Soysal, Neslihan Atile; Taspinar, Ozgur; Sut, Necdet; Tastekin, NurettinObjective: Diabetic foot problems and consequent ulceration in older patients are a major cause of morbidity and permanent disability. One of the major risk factors for ulceration is foot pressure changes. We, in this study, aimed to identify any relation between disease duration and plantar pressure of patients with type 2 diabetes. Material and Methods: This study was done on 168 feet of 84 diabetic patients. Demographic parameters and body mass index were noted. The patients were allocated according to disease duration as being more (Group 1) or less than 10 years (Group 2). Static and dynamic pedographic evaluation was performed for each of the patients, and results were compared between the groups. Results: The static pedobarographic evaluation revealed significantly higher forefoot plantar force percentage values in the left feet of patients in group 1. We found that peak phalanx pressure was significantly higher in the left foot, while the contact area was lower in the right foot of group 1 patients, by dynamic pedobarographic evaluation. Conclusion: Contact area decreases and peak pressure increases during walking in forefoot after 10 years of disease duration in type 2 diabetic patients.Öğe Effect of Static and Dynamic Stretching on Knee Muscle Strength in Trained Players(2020) Ali, Chasan Mola; Tuna, Filiz; Alptekin, Hasan Kerem; Kabayel, Derya Demirbağ; Tuna, HakanObjective: The study examined the effects of two different stretching exercises on knee muscle strength in basketball players in order to determine the most appropriate pre-competition protocols for basketball conditioning.Method: Thirty-two basketball players (mean age 22.75±2.73 years, weight 87.47±10.99 kg, height 188.85±7.35 cm, body mass index 24.46±1.89) participated in this study. They performed two different stretching protocols according to basketball training experience in randomly assigned order: randomized in consecutive manner according to admission order, well-trained basketball players (training frequency = 5 days/week, groups I and II), less-trained basketball players (1 day/week, groups III and IV). Basketball players in groups I and III were exposed to isokinetic tests-one each after dynamic stretching and, 1 week later, after static stretching. In groups II and IV, similar evaluations were made after static stretching and, 1 week later, after dynamic stretching. Five days/week were included in the well-trained group. The less-trained group consisted of basketball players who trained 1 day/week.Results: In less-trained basketball players, static stretching resulted in higher extensor muscular strength and endurance values, whereas dynamic stretching increased knee flexor strength and endurance. Conclusion: Our results suggest that before competitions, stretching exercises should be chosen depending on the conditioning of the basketball player (well-trained, less-trained). Including both static and dynamic stretching into the “stretching” concept seems effective.Öğe The Efficacy of Flutter® and Active Cycle of Breathing Techniques in Patients with Bronchiectasis: A Prospective, Randomized, Comparative Study(Bilimsel Tip Publishing House, 2018) Uzmezoglu, Bilge; Altiay, Gundeniz; Ozdemir, Levent; Tuna, Hakan; Sut, NecdetOBJECTIVES: The objective of the study was to compare the efficacy of an oscillating positive expiratory device and the active cycle of breathing techniques (ACBT) in patients with bronchiectasis. MATERIALS AND METHODS: A home-based study that lasted for 4 weeks was designed to compare the oscillating physiotherapy device Flutter (R) and the ACBT in 40 patients, who were randomly assigned into two groups containing 20 patients each. The effect of the two methods of physiotherapy on sputum production, pulmonary functions, and the quality of life was compared. RESULTS: The results of the present study indicate that both the methods were associated with a reduced number of patients complaining of cough and fatigue and increased sputum production (p=0.000, p=0.004, and p=0.002, respectively). In addition, statistically significant reductions were determined by the Medical Research Council and Borg Dyspnea scores (p=0.001 and 0.002, respectively). The Flutter (R) device caused a more significant effect on the perception of dyspnea. Overall, there was an improvement in the physical sub-scale of the Short Form (SF)-36 Quality of Life Questionnaire scores of 36 patients who completed the study (p=0.001). During the physiotherapy period, no changes in pulmonary functions were observed. Exacerbations were recorded in 3 patients in the ACBT group and in 1 patient in the Flutter (R) group. CONCLUSION: The Flutter (R) device and ACBT represent effective home-based physiotherapeutic methods. The Flutter (R) device appears to be more effective with regard to sputum production.Öğe Ergenlik dönemindeki çocuklarda statik ve dinamik ayak basınç değerleri(2004) Tuna, Hakan; Yıldız, Mustafa; Çeltik, Coşkun; Kokino, SiranuşAmaç: Türk toplumunda ergenlik dönemi yaş grubunun statik ve dinamikpedobarografik normal verilerinin belirlenmesi ve bu değerler ile demografikveriler arasındaki ilişkilerin araştırılması amaçlandı. Çalışma planı: Çalışmaya, AOFAS'nin (American Orthopaedic Foot and AnkleSociety) ayak bileği ve ayak klinik değerlendirme sistemiyle sağlıklı ayağasahip oldukları belirlenen 50 gönüllü (25 kız, 25 erkek, ört. yaş 14; dağılım13-15) alındı. Tüm olguların statik ve dinamik ayak basınçları Mini-Emedpedobarografi cihazı kullanılarak ölçüldü. Sonuçlar: Statik ölçümlerde kızlarda sağ ayağın ön-orta ve parmak kısımlarının, erkeklerde ise sol ayağın orta kısmının pedobarografik değerleri belirgin olarak diğer cinsten yüksekti (p<0.05). Tüm olgular birlikte değerlendirildiğinde sağ ve sol ayak statik basınç ölçümleri arasında anlamlı farklılık bulunmadı. Kızlarda sağ ayağın orta basınç değerleri sol ayağa göre yüksek bulundu. Erkeklerde ise sağ ve sol ayaklar arasında basınç değerleri açısından anlamlı fark gözlenmedi. Dinamik ölçümlerde erkeklerde sağ ayakta ayak temas alanı, kızlarda ise sol ayağın ön iç kısmında maksimum basınç değerleri diğer bölgelerden anlamlı derecede yüksek bulundu (p<0.05). Statik ölçümlerde kilo ve vücut kütle indeksi ile ayak maksimum basınçları arasında kuvvetli (r=0.87 ve r=0.83), temas alanı ile orta düzeyde (r=0.63 ve r=0.59) ilişki saptandı. Dinamik ölçümlerde kilo ve vücut kütle indeksi ile ayak temas alanı arasında orta düzeyde (r=0.64 ve r=0.54) ilişki bulundu. Çıkarımlar: Ergenlik dönemindeki çocukların normal ayak basınç değerlerininbilinmesi, ayağın gelişim evrelerinin izlenmesinde, ayak hastalıklarınındeğerlendirilmesinde ve yaş ile uyumlu ayakkabı değişikliklerinin yapılmasındaönemlidir.Öğe Evaluating flutter device and the active cycle of breathing technique in non-cystic bronchiectasis: The prospective randomised study(European Respiratory Soc Journals Ltd, 2012) Altiay, Gundeniz; Uzmezoglu, Bilge; Sut, Necdet; Tuna, Hakan; Hatipoglu, Osman Nuri[Abstract Not Available]Öğe Evaluation of Physical Exercise'S Effects on Low Back Pain Among University Students With Short Form-36 and Oswestry Disability Index(Trakya Üniversitesi, 2020) Mutlu, Arda Ulaş; Aydın, Bilgesu; Ecertaştan, Özge; Öğüt, Eren; Güvenç Tuna, Bilge; Tuna, HakanAims: This study aims to investigate the main effects of physical exercise on lower back pain with the Short Form-36 Health Survey and Oswestry Disability Index scores. Methods: University students between 18-25 years old who suffer from low back pain were enrolled in the study. Short Form-36 Health Survey and Oswestry Disability Index were used as the reference scales of lower back pain and quality of life, respectively. There are some questions in the questionnaire to scale the average comfort of the place they sleep and sit during the day, which is the result of the Personal Comfort Score. The Mann-Whitney U test was used for non-normal distributed variables. Correlation and Linear Regression were used to analyze data. SPSS 25.0 was used for all statistical analysis. Results: A total of 139 university students (94 females, 45 males) were included in the study. The median age was 20 years (IQR=2) for female students and 20 years (IQR=1) for male students. Oswestry Disability Index scores of fe- male students were higher, while Short Form-36 scores were lower than the male students. Male students' physical functioning scores were higher than female students. Each one-unit increase in Personal Comfort Score is associated with an increase in the rate between the energy/fatigue (3.34 units). Body Mass Index considerably affected the pain and Oswestry Disability Score, an increase in one unit of baseline BMI upsurged the Short Form-36 pain score to 0.13, and Oswestry disability score to 0.55. Conc- lusion: In our study, Body Mass Index is found to be associated with Oswestry Disability Index and Short Form-36 score, which are used for the severity of low back pain and defining the life quality and of patients. PCS had a positive correlation between energy/fatigue. In addition, There was a positive correlation between physical exercise and general health score.Öğe The evaluation of quality of life in fibromyalgia syndrome: a comparison with rheumatoid arthritis by using SF-36 Health Survey(Springer London Ltd, 2007) Birtane, Murat; Uzunca, Kaan; Tastekin, Nurettin; Tuna, HakanMusculoskeletal disorders are the most common causes of deterioration in quality of life (QOL). We in this study aimed to assess (1) the impact of fibromyalgia syndrome (FS) on QOL comparing with that of rheumatoid arthritis (RA) patients and control subjects and (2) the impact of these two musculoskeletal disorders on various components of QOL using SF-36 Health Survey. Thirty-five patients with RA, 30 patients with FS, and 30 voluntary control subjects were included in the study. The groups were comparable in terms of demographic characteristics. QOL was evaluated by using Short-Form (SF)-36 Health Survey in all study participants, and Fibromyalgia Impact Questionnaire (FIQ), which is a specific health-status instrument for FS, was used in FS patients. Physical functioning, physical role, social functioning, bodily pain, general health, vitality, emotional role, and mental health scores were significantly lower in RA and FS patients than in control subjects (p < 0.05). The between-groups comparisons revealed that FS patients had significantly lower mental health scores than RA patients (49.87 vs 62.51, respectively), (p < 0.001). Total FIQ score correlated significantly with physical functioning, physical role, and bodily pain in FS patients. All parameters of SF-36 Health Survey except for social functioning correlated significantly with some of the variables of FIQ. FS has a negative impact on QOL, like RA. Furthermore, mental health was more severely affected in FS patients when compared with RA patients.Öğe Gut hastalığında Baker kist rüptürü: olgu sunumu(2004) Tuna, Hakan; Yıldız, Mustafa; Ünlü, Ercüment; Sarpkaya, Ülkü; Kokino, Siranuşİki yıldır gut teşhisi ile takip edilen 54 yaşındaki erkek hasta sağ diz ardı ve baldırında ağrı ve şişlik şikayetleri ile polikliniğimize başvurdu. Başlangıçta Baker kist rüptürü te?hisi konulup, diğer taraftan ayırıcı tanıda derin ven trombozu düşünülerek yapılan ultrasonografi ve manyetik rezonans görüntüleme yöntemleri sonucunda Baker kist rüptürü olduğu saptandı. İnflamatuar artiritlerde de görüldüğü gibi popliteal kistlerin rüptürü derin ven trombozunu taklit edebilir. Gutta Baker kisti rüptürü olgusu sunuldu. Ayrıca ilgili literatür olgu eşliğinde gözden geçirildi.Öğe Gut tofüsü nedeniyle peroneal sinir lezyonu: Olgu sunumu(2000) Özdemir, Ferda; Taştekin, Nurettin; Tuna, HakanCut, hiperürisemi ve tekrarlayıcı artrit ataklarıyla seyreden, daha ileri dönemlerde kronik artrit ve ürik asit taşlarının görüldüğü metabolik bir hastalıktır. Bu makalede tofüslü kronik gut döneminde bulunan ve tofüs nedeniyle peroneal sinir lezyonu gelişen bir olgu sunulmuştur. 63 yaşındaki erkek hastanın, 20 yıla yakın süredir şikayetlerinin bulunması, tanının geç konulması, düzensiz diyet ve ilaç kullanımı nedenlerinden dolayı kronik, tofüslü gut periyodunun gelişmesi görülmüştür. Vücudunun birçok yerinde tofüsler ve sol ayak 1. metatarsofalangeal eklemde (MTF), distal falanksta destrüktif lezyon gelişmiştir. Tofüs kompresyonu şu ana kadar rastlanmayan peroneal sinirde lezyonuna neden olmuştur. Bu sunumla gut hastalığında da bir çok hastalıkta olduğu gibi erken tanı ve tedavinin gelişebilecek komplikasyonları önlemede ne kadar önemli olduğunu vurgulamak istedik.Öğe İleri yaşta antirezorptif tedavinin vertebra dışı kırık oluşumundaki etkinliği: Retrospektif çalışma(2005) Tuna, Hakan; Özdemir, Ferda; Zateri, Coşkun; Gül, Hatice; Kokino, SiranuşOrtalama insan ömrünün uzaması yaşlı nüfusu arttırmış ve postmenopozal osteoporotik kadınlarda senil osteoporozun eklenmesi ile kırık riski yükselmiştir. Bu durumun yaşlı kadın populasyonunda sağlık bakım maliyetlerini ve özürlülüğü belirgin bir şekilde arttırdığı bilinmektedir. Çalışmamızda risk faktörlerinin eşit olarak dağıldığını düşündüğümüz, antirezorptif tedavi kullanan ve kullanmayan iki grup arasında vertebra dışı kırık oluşumu açısından fark olup olmadığını araştırdık. Birinci grup yaş ortalaması 73.7 olan 64 olgudan oluşan ve 3 ila 5 yıl süredir osteoporoz tedavisi görmekte olanlar ve ikinci grup ise yaş ortalaması 72.7 olan 28 olgudan oluşan ve osteoporoz tedavisi almamış olanlardan oluştu. Femur boynu t skorları dışında tüm bölgelerde antirezorptif tedavi kullanmayan grup lehine istatistiksel olarak anlamlılık içeren düşük değerler saptandı. Antirezorptif tedavi almayan grupta kırık oluşumunun yüksek olması istatistiksel olarak anlamlı farklılık gösterdi. Antirezorptif tedavi kullanan ve kullanmayanlarda DEXA değerleri ile vertebra dışı kırık oluşumu arasındaki ilişkiyi saptama amacıyla yaptığımız çalışma, antirezorptif tedavi kullanımının kırık oluşumunu önlediğini göstermektedir.Öğe Immediate effect of kinesio taping on deep cervical flexor endurance: A non-controlled, quasi-experimental pre-post quantitative study(Taylor & Francis Ltd, 2022) Tuna, Filiz; Tuncer, Berna; Can, Hilal Basak; Sut, Necdet; Tuna, HakanObjective Whether Kinesio taping (R) (KT) might change the endurance of the cervical deep flexor muscles.Methods: Healthy university students were assessed at baseline, immediately after the KT application over the posterior cervical muscles, and at a 24-h follow-up. The clinical assessment of the endurance of the deep cervical flexor muscles using the craniocervical flexion test (CCFT) was performed.Results: Sixty-two students (32 women) with a mean age of 20.4 +/- 1.3 years completed the study protocol. Statistically significant pre- to post-taping differences in performance of the craniocervical flexion movement were found between baseline-immediate and baseline-24-h follow-up (p<0.001). A statistically significant difference in the endurance of the cervical deepflexor muscles was found between baseline-immediate (for stage 2 result and cumulative endurance score), baseline-24-h follow-up (for stage 2result and cumulative endurance score), and immediate-24-h follow-up (for stage 2 result, for cumulative endurance score) p<0.01.Conclusion: Cervical KT increased endurance for the short term.Öğe Importance of Calibration for Effective use of Therapeutic Ultrasound(Galenos Yayincilik, 2011) Tuna, HakanTherapeutic ultrasound is one of the most widely used electrophysical agents. The users are generally not well aware of the details of the technology of ultrasonic generators and cannot be asked to perform the complicated physical measurements to test their equipment. Frequently, the only way to check the performance of the device is the observance of oil or water bubbles on the surface of the piezoelectiric probe. If bubbles are present, the generator is regarded as operating correctly. Many surveys on the output of therapeutic ultrasound equipment have revealed discrepancies between the indicated and actual ultrasonic output of many devices. International safety standards recommend a limit below 30% variation in acoustic intensity for ultrasound therapy equipment. So, further improvements in the accuracy of ultrasound machine calibration are needed. Proper calibration is essential to provide patients with a more accurate ultrasound dosage and, therefore, with a safer and more appropriate treatment. This review highlights the need for users to be aware of the potential inaccuracy of the machine and of the importance of regular calibration. They could be informed better with a systematic training in their education curricula on specific variables of ultrasound machines. Turk J Phys Med Rehab 2011;57:94-100.
