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Biomedical subjects

Ali Cimen

Publications and source records attributed to Ali Cimen.

7 recordsLinked to original sources

Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia.

The aim of this prospective, randomized, double-blinded study was to evaluate the effect of pulsed radiofrequency (PRF) in comparison with conventional radiofrequency (CRF) in the treatment of idiopathic trigeminal neuralgia. A total of 40 patients with idiopathic trigeminal neuralgia were included. The 20 patients in each group were randomly assigned to one of the two treatment groups. Each patient in the Group 1 was treated with CRF, whereas each patient in the Group 2 was treated by PRF. Evaluation parameters were: pain intensity using a Visual Analogue Scale (VAS), patient satisfaction using a Patient Satisfaction Scale (PSS), additional pharmacological treatment, side effects, and complications related to the technique. The VAS scores decreased significantly (p<0.001) and PSS improved significantly after the procedure in Group 1. The VAS score decreased in only 2 of 20 patients from the PRF group (Group 2) and pain recurrence occurred 3 months after the procedure. At the end of 3 months, we decided to perform CRF in Group 2, because all patients in this group still had intractable pain. After the CRF treatment, the median VAS score decreased (p<0.001) and PSS improved (p<0.001) significantly. In conclusion, the results of our study demonstrate that unlike CRF, PRF is not an effective method of pain treatment for idiopathic trigeminal neuralgia.

Adult↗

Effects of pulsed versus conventional radiofrequency current on rabbit dorsal root ganglion morphology.

Lesioning using radiofrequency (RF) current has been increasingly used in clinical practice for the treatment of pain syndromes. Although formation of heat causing "thermocoagulation" of the nervous tissues is thought to be responsible of the clinical outcome, a more recent modality of RF application named pulsed radiofrequency (PRF) delivers the RF current without producing destructive levels of heat. In our study, we compared the effects of conventional RF (CRF) and PRF on rabbit dorsal root ganglion (DRG) morphology, including also control and sham operated groups. The setting of the experiment and the RF parameters used were similar to those used in current clinical practice. The specimens were analyzed both with light microscopy and electron microscopy, two weeks after the procedure. At the light microscopic level, all groups had preserved the normal DRG morphology and no differences were observed between them. In the electron microscopic analysis there were no pathological findings in the control and sham operated groups. But the ganglion cells in the RF groups had enlarged endoplasmic reticulum cisterns and increased number of cytoplasmic vacuoles which were more evident in the CRF group. Some of the ganglion cells in the CRF group had mitochondrial degeneration, nuclear membrane disorders or loss of nuclear membrane and neurolemma integrity. The myelinated and unmyelinated nerve fibers were of normal morphology in all groups. Our results suggest that PRF application is less destructive of cellular morphology than CRF at clinically used "doses". Before making certain judgements, more experimental and clinical studies should be planned.

Animals↗

[Neuropathic pain: mechanisms, diagnosis and treatment].

Neuropathic pain, resulting from the disturbances of central or peripheral nervous system with mechanisms that we cannot explain yet exactly, is really a troublesome situation both for the patient and the physician. Our knowledge about this difficult to diagnose and treat pain condition has improved a lot with the aid of recent experimental and clinical studies. This review summarizes the underlying mechanisms, common conditions, diagnosis and treatment of neuropathic pain.

Humans↗

[Percutaneous lumber nucleoplasty].

Low-back pain is one of the most common causes for seeking professional medical assistance and the most frequent cause of absence from work. It is not rare that the intervertebral discs are the etiological factor. Degenerated discs with internal disruptions may cause axial back pain whereas protrusion or herniation of a disc may result in radicular pain. Open surgical procedures targeting the intervertebral discs are carried out frequently for years. But especially because of its lack of superiority over the conventional therapies in the long-term and the risk of development of failed back surgery syndrome, the investigators are forced to develop minimally invasive techniques of disc decompression. In the last two decades, better understanding of the spinal anatomy, function and pain generating mechanisms along with the technological achievements, has accelerated the development of many modalities for the treatment of low back pain. Chemonucleolysis, automated percutaneous lumbar discectomy (APLD), intradiscal laser discectomy, intradiscal electrothermal therapy (IDET) and most recently percutaneous nucleoplasty are the minimally invasive techniques developed for this aim. Percutaneous nucleoplasty is a minimally invasive technique which uses radiofrequency energy to ablate the nucleus pulposus in a controlled manner for disc decompression. The current data about this new technique is insufficient yet, but the preliminary reports indicate that the technique is relatively safe and the outcomes are encouraging.

Diskectomy, Percutaneous↗

Results of the Leeds assessment of neuropathic symptoms and signs pain scale in Turkey: a validation study.

UNLABELLED: Classification of pain and identification of the specific pain mechanisms through utilization of clinical data are helpful to the physician in choosing the appropriate treatment model. For discrimination between different pain types, various tests could be used. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale is a scale based on the analysis of data obtained during bedside examination. The LANSS Pain Scale, as first used by Bennett, is a very useful tool that provides immediate information in the clinical setting and helps distinguish nociceptive pain from neuropathic pain. In this study we targeted validation of the LANSS Pain Scale in the Turkish population. A total of 104 patients who consulted the Algology Department of Istanbul Faculty of Medicine Outpatient Clinic were enrolled in our validation study. The sensitivity and specificity of the scale were found to be 89.9% and 94.2%, respectively. These results suggest a high validity level for the Turkish version of the LANSS Pain Scale. We believe that this scale is a useful tool for the differential diagnosis of neuropathic pain and can be used in future pharmacologic studies. PERSPECTIVE: Any measures that aid in differentiating neuropathic pain from nociceptive pain would facilitate effective management of pain. In daily practice the simplicity of the classification method is important. The present study suggests that Turkish version of LANSS can be used for the discrimination between neuropathic and nociceptive types of pain.

Adolescent↗

Myofascial pain syndrome in the differential diagnosis of chronic abdominal pain.

Myofascial pain syndrome is a painful musculoskeletal condition, and a quite common cause of chronic pain. It is characterized by the development of trigger points that are locally tender when active, and refer pain through specific patterns to other areas of the body. Its etiological factors are various; trauma, vertebral column diseases, systemic disorders, psychological distress, lack of motion, and chilling of the body parts. Myofascial pain syndrome may be misdiagnosed as arising from a visceral source especially if its probability is not kept in mind and a proper patient examination is lacking. Although there are many therapeutic approaches, trigger point injections can be diagnostic and therapeutic.

Abdominal Pain↗