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Biomedical subjects

Sevim Orkun

Publications and source records attributed to Sevim Orkun.

14 recordsLinked to original sources
PubMed2006

Predictive value of grip strength for bone mineral density in males: site specific or systemic?

This study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD.

Adult↗
PubMed2006

Relationship between sexual dysfunction and psychiatric status in premenopausal women with fibromyalgia.

OBJECTIVES: To evaluate the possible relationship between the sexual and psychiatric status of premenopausal female patients with fibromyalgia compared with healthy controls. METHODS: A total of 48 female patients with fibromyalgia and 38 age-matched healthy controls were enrolled in the study. All the subjects were asked to complete the Female Sexual Function Index (FSFI) for sexual status and the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) for psychiatric assessment. Serum biochemical analysis was done, and the serum hormonal levels were analyzed. RESULTS: The mean BDI score for patients was significantly greater than the score for the controls (P = 0.017) and the mean FSFI score was significantly lower than the score for the controls (P = 0.001). According to the FSFI data, female sexual dysfunction was found in 26 patients (54.2%) with fibromyalgia and only 6 controls (15.8%), a significant difference (Pearson chi-square = 14.46, P = 0.000). When the subscores of each domain of FSFI were evaluated, the most common sexual problem was diminished desire in patients (n = 30, 62.5%) and controls (n = 11, 28.9%). In the correlation analysis, the FSFI score showed a significant negative correlation with the BDI (r = -0.337, P = 0.002) and STAI (r = -0.413, P = 0.004) scores. No significant correlation was revealed between the FSFI and BDI or FSFI and STAI scores in the controls. CONCLUSIONS: Depression is one of the emotional disorders commonly encountered in women with fibromyalgia, most possibly leading to sexual dysfunction. Thus, sexual dysfunction related to impaired psychiatric status should be considered a common problem in premenopausal women with fibromyalgia.

Adult↗
PubMed2005

Familial Mediterranean fever and ankylosing spondylitis in a patient with juvenile idiopathic arthritis: A case report and review of the literature.

The association of familial Mediterranean fever (FMF) with juvenile idiopathic arthritis (JIA) or ankylosing spondylitis (AS), most commonly with negative HLA-B27 antigen, was described in several previous reports, although the pathogenic mechanism of this association still remains unknown. Herein we report an uncommon association of FMF with HLA-B27 positive AS as an occasional coincidence in a patient who had been diagnosed as having JIA 23 years previously.

Adult↗
PubMed2005

Endogenous sex steroids and bone mineral density in healthy men.

OBJECTIVE: To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. METHODS: Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. RESULTS: The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. CONCLUSION: Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD.

Absorptiometry, Photon↗
PubMed2005

Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function.

OBJECTIVES: To determine the relationship between the total and subscale scores of the Aging Male Symptoms (AMS) and International Index of Erectile Function (IIEF) questionnaires, age, and serum sex steroids levels. METHODS: A total of 348 patients enrolled in the study answered the AMS and IIEF questionnaires. Hormonal analysis, including total testosterone, free testosterone (FT), estradiol (E2), and dehydroepiandrosterone-sulphate (DHEA-S) measurement, were performed. The patients with a total AMS score of 29 were considered to have aging male symptoms and the patients with an IIEF score of less than 26 were considered to have sexual dysfunction. RESULTS: Although DHEA-S levels were significantly lower and E2 levels were greater in the men with aging male symptoms according to the AMS, the DHEA-S and FT levels were significantly lower in the men with sexual dysfunction, as determined by the IIEF score. Serum DHEA-S and FT levels and age correlated significantly with the IIEF scores. The total AMS score correlated significantly only with age. Although serum total testosterone, FT, and DHEA-S levels correlated significantly with the andrologic symptoms of AMS, the serum E2 levels correlated with psychological symptoms of AMS. CONCLUSIONS: Although aging male symptoms and the effects of hormonal changes on these symptoms have been controversial, DHEA-S and E2 might play some important roles in the symptoms of aging men.

Adult↗
PubMed2005

Plasma leptin concentrations in postmenopausal women with osteoporosis.

Osteoporosis is less common in obese individuals with increased bone mineral density (BMD) and plasma leptin concentrations. The aim of this study was to determine the correlation between leptin levels and BMD in postmenopausal women. The study consisted of 90 postmenopausal women with a mean age of 53.45 +/- 0.87 years who visited our outpatient clinic for the evaluation of BMD. Thirty-six post-menopausal women with osteoporosis (mean age: 54.52 +/- 1.41 years and mean body mass index (BMI, kg/m2) 29.33 +/- 0.66), 30 age- and BMI-matched postmenopausal women with normal BMD, and 24 postmenopausal women (mean age: 52.79 +/- 1.48 years and mean BMI: 29.45 +/- 0.89) with osteopenic BMD were included in the study. Plasma concentrations of leptin after an overnight fast were measured by radioimmunoassay. BMD values were measured by dual-energy X-ray absorptiometry (DEXA) at the L2-L4 lumbar spine and femoral neck. The median spine BMD value in the patient group (0.67 +/- 0.08 g/cm2, mean +/- SEM) was significantly lower than that in the control group (1.02 +/- 0.25 g/cm2, mean +/- SEM) and osteopenic group (0.87 +/- 0.05 g/cm2, mean +/- SEM) (p < 0.005). The mean spine BMD value (T score -3.63 +/- 0.25, mean +/- SEM) and the mean femur neck BMD value (T score -2.55 +/- 0.18, mean +/- SEM) of the osteoporosis group were significantly lower than that in the normal BMD group (+ 0.33 +/- 0.14 and + 0.27 +/- 0.18, P < 0.001) and in the osteopenia group (-1.74 +/- 0,1 and -1.18 +/- 0.05, p < 0.005). The mean plasma leptin concentration in the osteoporotic group (17.03 +/- 1.40 ng/ml) was not significantly different from that in the normal BMD group and the osteopenia group (16.55 +/- 1.50 ng/ml; 16.16 +/- 1.60, respectively, p > 0.150). Plasma leptin concentrations were correlated with BMI in three groups (r(s) = 0.450, p = 0.025 in normal BMD group and r(s) = 0.4254, P = 0.009 in the osteoporotic group, and r(s) = 395, p = 0.015 in the osteopenia group. There was no correlation between plasma leptin concentrations and BMD values in three groups (r(s) = -0.89 in normal BMD group, r(s) = -0.124 in osteopenia group, and r(s) = -0.195 in osteoporosis group). From this study we conclude that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.

Absorptiometry, Photon↗
PubMed2005

Diagnostic precision of ultrasonography in patients with carpal tunnel syndrome.

OBJECTIVE: To evaluate the diagnostic value of ultrasonography in patients with electrophysiologically confirmed carpal tunnel syndrome. DESIGN: A prospective ultrasonographic study of 35 wrists with electrophysiologically confirmed carpal tunnel syndrome and of 40 normal wrists. Receiver-operating-characteristics curves for the ultrasonographic measurements of median nerve were plotted to identify the most optimal cutoff values. RESULTS: The ultrasonographic measurements of median nerves were found to be increased significantly in patients with carpal tunnel syndrome when compared with controls, particularly in terms of cross-sectional area (P<0.001) and the bowing of the flexor retinaculum (P<0.01) but not in the flattening ratio (P>0.05). According to receiver-operating-characteristics curve results, the most optimal cutoff value for the cross-sectional area of the median nerve was obtained at the level of middle carpal tunnel, which was 9.3 mm, with a sensitivity of 80% and specificity of 77.5%. The optimal cutoff value for the bowing of the flexor retinaculum was 3.7 mm, with a sensitivity of 71.4% and specificity of 55%. No optimum cutoff value could be identified from the receiver-operating-characteristics curves for the flattening ratio of median nerve. CONCLUSION: Ultrasonographic examination of the median nerve seems to be a promising method in the diagnosis of carpal tunnel syndrome, evaluating the morphologic changes of the median nerve in patients with clinical signs and symptoms. Further studies with wider series are needed to confirm our preliminary results.

Adult↗
PubMed2005

Transcutaneous electrical nerve stimulation versus baclofen in spasticity: clinical and electrophysiologic comparison.

OBJECTIVES: Clinical and electrophysiologic comparison of the efficacy of transcutaneous electrical nerve stimulation (TENS) and oral baclofen in the treatment of spasticity. DESIGN: Patients with spinal cord injury and spasticity were included in the study. Ten patients were assigned to oral baclofen and 11 to TENS groups. For the comparison of H-reflex variables, 20 healthy individuals were allocated to a control group. TENS was applied to the tibial nerve for 15 days at a frequency of 100 Hz. Clinical (spasm frequency scale, painful spasm scale, lower limb Ashworth score, clonus score, deep tendon reflex score, plantar stimulation response score) and electrophysiologic evaluations (H-reflex response at the highest amplitude, latency of maximum H-reflex, and ratio of H-reflex response at the highest amplitude to M response at maximum amplitude) of the lower limb and functional evaluations (functional disability score and FIM) were carried out in baclofen and TENS groups before and after treatment. Posttreatment evaluation was made 24 hrs after the 15th session in the TENS group. In addition, clinical spasticity scores and electrophysiologic variables were measured 15 mins after the first application and 15 mins after the 15th session. RESULTS: Significant improvement was detected in lower limb Ashworth score, spasm frequency scale, deep tendon reflex score, functional disability score, and FIM in the baclofen (P = 0.011, P = 0.014, P = 0.025, P = 0.004, and P = 0.005, respectively) and TENS (P = 0.020, P = 0.014, P = 0.025, P = 0.003, and P = 0.003, respectively) group after treatment. Decrease in H-reflex maximum amplitude was significant in the TENS group (P = 0.026). Most marked improvement was observed in the third evaluation, 15 mins after the 15th session, particularly in lower limb Ashworth score (P = 0.006) and H-reflex maximum amplitude (P = 0.006) in the TENS group. The percentage change in clinical, electrophysiologic, and functional variables caused by baclofen was not different from that caused by repeated applications of TENS in the short- and long-term evaluations (P > 0.05). CONCLUSION: TENS may be recommended as a supplement to medical treatment in the management of spasticity.

Adult↗
PubMed2004

Multifocal osteoarticular tuberculosis: a case report.

Osteoarticular tuberculosis is a quite uncommon form of extrapulmonary tuberculosis. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. We report herein a case of multifocal osteoarticular tuberculosis of insidious onset with no history of prior health problems or constitutional signs and symptoms. Despite widespread osteoarticular involvement, the outcome of the patient was favorable after the management. Osteoarticular tuberculosis must be considered in patients with insidious musculoskeletal symptomatology.

Adult↗
PubMed2004

[How does the habit of teeth clenching affect the symptoms and signs of patients with temporomandibular disorders?].

OBJECTIVES: We aimed to compare the symptoms and signs of patients with temporomandibular disorders (TMD) with and without a history of diurnal teeth clenching. PATIENTS AND METHODS: The study was designed prospectively and included 34 patients with a diagnosis of bilateral temporomandibular joint pain and/or dysfunction. A "Patient Questionnaire Form" and "Patient Assessment Form" generated by the Diagnosis and Treatment Unit of Temporomandibular Disorders, Istanbul Medical Faculty, Istanbul University, were used in the evaluation of the patients. RESULTS: The mean ages of patients with (group I, n=17) and without (group II, n=17) teeth clenching habit were 28.6+/-10.6 and 31.5+/-13.8 years, respectively. Female patients accounted for 76.5% and 47.1% in group I and group II, respectively. The age and gender showed no significant difference between the two groups (p>0.05). Stress factor was significantly higher in group I and was found to aggravate pain and other complaints, according to the questionnaire (p<0.05). Pain associated with jaw movements of all directions and pain radiating to the ear region were found to be significantly higher in group I (p<0.05). Total palpation index, based on physical examination of bilateral extra- and intra-oral masticatory muscles, neck muscles, and capsule of the temporomandibular joints was significantly higher in group I (p<0.05). CONCLUSION: Our findings indicate that habit of teeth clenching in patients with TMD affects biomechanically both muscles and joints of the masticatory system, resulting in muscle/joint pain, and that stress factor aggravates those symptoms. This finding may be useful in the treatment of symptoms and signs of patients with TMD.

Adult↗
PubMed2003

Tuberculous sacroiliitis: a case report.

Tuberculosis can affect sacroiliac joints, but only a few such cases have been reported. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. We report herein a culture-proven case of tuberculous sacroiliitis which initially mimicked neoplastic infiltration on CT scan.

Abscess↗
PubMed2003

Cricoarytenoiditis in rheumatoid arthritis: radiologic and clinical study.

The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this study, clinical assessment, laryngeal endoscopy, and high-resolution computed tomography (HRCT) were used in 15 patients with RA to evaluate the diagnostic criteria of CA joint involvement. Symptoms owing to CA joint involvement were present in 66.6% of the patients. The frequency of involvement was 13.3% on laryngeal endoscopy but 80.0% with HRCT assessment. The most common HRCT findings were CA prominence (46.6%), density and volume changes (46.6%), and CA subluxation (39.9%). In some of the patients, soft tissue swelling (20%) near the CA joint and narrowing in the piriform sinus (33.3%) were also observed. Radiologic abnormalities related to CA joint involvement generally precede clinical symptomatology. Therefore, HRCT evaluation may be a useful method in the assessment of CA joint involvement in RA patients to exclude possible causes of laryngeal signs and symptoms.

Adult↗
PubMed2002

Temporomandibular joint involvement in rheumatoid arthritis: a radiological and clinical study.

Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%), mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT findings. In seven (46.7%) of the patients, there were no symptoms or clinical findings implying TMJ involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.

Adult↗