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Öğe COMPARISON OF THE EFFICACY OF GABAPENTIN AND PREGABALIN FOR NEUROPATHIC PAIN IN PATIENTS WITH SPINAL CORD INJURY: A CROSSOVER STUDY(CARBONE EDITORE, 2014) Kaydok, Ercan; Levendoglu, Funda; Ozerbil, Murat Onder; Karahan, Ali YavuzObjectives: To compare the efficacy and Side effects of gabapentin and pregabalin for the treatment of neuropathic pain(NP) in spinal cord injury (SCI). Methods: Twenty eight patients were included in the study. The patients were randomized to receive pregabalin or gabapentin. VAS(Vistial analog scak) pain score, neuropathie pain scale(NPS), Lattinen test(LT), Beck Depression Inventory(BDI) pain diary measures were used for the patient evaluation. We assessed patients at 4th and 8th weeks.Treatment groups were crOssed over after 2 weeks of wash-out period to receive the other treatment. Results: At the end of the study there: was significant improvement in VAS both with gabapentin and pregabalin (p<0.001). Statistically significant difference was present during the first 4 weeks in the asSessinent with VAS as for pregabalin group compared to gabapentin group(p<0.05). But after 8 weeks of treatments the significance disappeared between the pregabalin and the gabapentin groups (p>0.05). In NPS, and LT parameters, no difference was present between the two study groups before or after the treatment (p>0.05). In both groups no significant improvement was seen in emotional status as assessed with BD (p>0.05). Frequency of side effects and exclusion from the study due to side effects were higher for the pregabalin group but it was not significant between the groups (p>0.05). Conclusions: It is concluded that both drugs are effective and safe for the treatment of NP due to SC1 but no difference exist between the two drugs. We are in the opinion that large studies that include more patients and placebo control should be carried out for more accurate data about this topic.Öğe Complex Regional Pain Syndrome in a Patient with Muscular Dystrophy(WILEY-BLACKWELL, 2014) Apiliogullari, Seza; Gunduz, Ergun; Aydin, Bahattin Kerem; Levendoglu, Funda[Abstract not Available]Öğe Complex regional pain syndrome in stroke patients(LIPPINCOTT WILLIAMS & WILKINS, 2007) Kocabas, Hilal; Levendoglu, Funda; Ozerbil, Onder Murat; Yuruten, BetigulThe objective of this study was to investigate the incidence, and the factors influencing the development, of complex regional pain syndrome-1 in the upper extremity in herniplegic patients within the first 28 weeks following a stroke. We followed up 82 stroke patients. All patients were evaluated at weeks 2, 6, 14 and 28 after suffering a stroke. Outcomes were assessed using passive range of motion of shoulder, presence of subluxation, Ashworth score, Motricity index arm score, Brunnstrorn stages and depression score. The incidence of complex regional pain syndrome-I was 48.8% in the first 28 weeks. Significant correlation was found between complex regional pain syndrome-1 and the presence of subluxation, Ashworth score, Motricity index arm score, Brunnstrom stage and depression score (r= 0.259, P= 0.019; r= 0.271, P= 0.014; r= - 0.393, P < 0.001; r= - 0.385, P < 0.001; r= 0.293, P=0.008, respectively). In this study, there was a relationship between complex regional pain syndrome-I and subluxation, loss of range of motion, spasticity of shoulder muscles and muscle strength. In order to prevent the development of complex regional pain syndrome-1, exercises directed at increasing the range of motion for the glenolhumeral joint, strengthening shoulder muscles and reduction of spasticity will establish the integrity of the shoulder joint.Öğe CT measurement of trunk muscle areas in patients with chronic low back pain(TURKISH SOC RADIOLOGY, 2007) Kamaz, Muezeyyen; Kiresi, Demet; Oguz, Hasan; Emlik, Dilek; Levendoglu, FundaPURPOSE The objective of this study was to determine the cross-sectional area changes of the paraspinal, isolated multifidus, quadratus lumborum, psoas, and the gluteus maximus muscles with CT in patients with chronic low back pain. MATERIALS AND METHODS In this study, we evaluated 36 patients with chronic low back pain and 34 healthy volunteers. The mean age of the patients was 43.2 +/- 6.9 years (range, 30-58 years) and the mean age of control group was 44.4 +/- 6.9 years (range, 31-61 years). We defined pain that lasts more then one year as chronic pain. Female patients were selected for standardization. All patients were housewives. None of the patients or controls engaged in physical activity other than routine housework. We used a visual analog scale and the Oswestry Pain Questionnaire for clinical evalu ation. We made CT cross-sections of the paraspinal muscles at the upper and lower endplates of L4, and of the gluteus maximus at the head of the interfoveal level. RESULTS In the patient group the multifidus, psoas, and quadratus lumborum cross-sectional areas were smaller than in the control group, and the P values were P=0.002, P=0.042, and P=0.047, respectively, at the L4 endplate. At the L4 endplate level, cross-sectional areas of the multifidus and paravertebral muscles in the patient group were smaller than in the control group, and the difference was statistically significant (P=0.001, P=0.010, respectively). We did not find any significant difference between the patient and the control groups in gluteus maximus cross-sectional area. CONCLUSION Chronic low back pain caused atrophy of the paraspinal, isolated multifidus, quadratus lumborum, psoas, and the gluteus maximus muscles to varying degrees, which was most prominent in the multifidus. Atrophy was noted in all of the studied muscles, except the gluteus maximus. The reliability of CT in measuring the cross-sectional areas of the back muscles was acceptable.Öğe The Effect of Corset on Walking Time in Lumbar Spinal Stenosis(ORTADOGU AD PRES & PUBL CO, 2009) Levendoglu, Funda; Oguz, Hasan; Polat, Esra; Bodur, SaidObjective: To investigate the quantitative effects of lumbar corset used in lumbar spinal stenosis (LSS) on walking time. Material and Methods: The study population comprised 70 LSS patients with a mean age (+/- SD) of 59.23 +/- 5.90 years. The equipment included a treadmill, unloading station and lumbar corsets. All patients were made to walk on a treadmill with 0-degree inclination at a speed of 1.2 km/h. During this walk, a system was available that could reduce the body weight by 20 or 25%. The patients walked five times as follows: without corset, with elastic woolen corset, with lumbar corset and with either 20 or 25% reduction in body weight. Symptom initiation time (SIT), and total walking time (TWT) were recorded. Statistical evaluations were performed with the software program SPSS 11.0. Results: As a result of walking with lumbar corset SIT and TWT were significantly longer compared to walking without corset (p < 0.001). The use of lumbar corset had a similar effect to that of 20% body weight reduction and lengthened the total walking time by reducing mechanical weight bearing. Conclusion: Lumbar corset increases SIT and TWT in patients with lumbar spinal stenosis. It is beneficial for symptoms similar to that obtained by 20% body weight reduction.Öğe Loading is more effective than posture in lumbar spinal stenosis: a study with a treadmill equipment(SPRINGER, 2007) Oguz, Hasan; Levendoglu, Funda; Ogun, Tunc Cevat; Tantug, AysenurThe objective of this study was to assess the correlation between neurogenic intermittent claudication (NIC) in LSS and different positions as well as loading status, using the treadmill device. The study was a prospective clinical trial on lumbar spinal stenosis (LSS) using a treadmill equipment. The study population comprised of 80 LSS patients with a mean age of 61. The equipment included a treadmill, unloading station and loading vests. The patients were instructed to walk in five different positions. The initiation time of symptoms and total walking time were recorded. The examination was stopped after 20 min or at the onset of severe symptoms. In order to obtain pretest demographic data on subjects, visual analog scale, Roland-Morris questionnaire, pain disability index, and Beck depression index were used. The initiation time of symptoms (ITS) and total walking time (TWT) were measured during the test. Unloading provided a longer and loading a shorter ITS and TWT. Decline or incline positions did not affect ITS or TWT. The changes in posture had no correlation with the appearance of symptoms in LSS patients with NIC on a treadmill in this study, rather ITS and TWT were determined by axial loading and unloading.Öğe Radiological and functional assessment of pulmonary involvement in the rheumatoid arthritis patients(SPRINGER HEIDELBERG, 2007) Kanat, Fikret; Levendoglu, Funda; Teke, TurgutThe aim was to evaluate the findings of high resolution computed tomography (HRCT) and pulmonary function tests (PFT) in the rheumatoid arthritis (RA) patients with and without pulmonary symptoms and to determine their role in prediction of respiratory system involvement. Among 54 consecutive RA patients, 22 (41%) were symptomatic and 32 (59%) were asymptomatic after detailed respiratory examination. Abnormal findings in PFTs were present in 10 (45%) symptomatic and 15 (47%) asymptomatic patients. PFT results were similar in both groups. A total of 18 (82%) symptomatic and 16 (50%) asymptomatic patients had abnormalities in HRCT scans. About 16 (80%) of 20 patients with normal HRCT scans had no pulmonary symptoms at all and we noted a significant correlation (P < 0.05). HRCT was more useful mean than PFTs in evaluation of pulmonary involvement in the RA patients; however, no correlation was present between various respiratory symptoms and abnormal findings both in PFTs and HRCT scans.Öğe Serum CXCL10 levels and neuromuscular manifestations in patients with autoimmune thyroid diseases(TAYLOR & FRANCIS LTD, 2011) Cakir, Mehtap; Levendoglu, Funda; Kiyici, Aysel; Coskun, YaseminObjective: Serum C-X-C motif chemokine 10 (CXCL10) levels have been shown to be elevated in autoimmune thyroid diseases (AITD). This study sought to determine whether newly diagnosed AITD patients with neuromuscular findings had higher levels of CXCL10 than those without neuromuscular manifestations. Design: A total of 80 patients were recruited to the study, which included treatment-naive hypothyroid Hashimoto's thyroiditis (n == 19) and hyperthyroid Graves' disease (GD; n == 21), euthyroid thyroid autoantibody-positive (n == 20) and -negative (n == 20) patients. Methods: All patients underwent a thorough sensorimotor and neuromuscular examination. Serum samples were kept in -- 20 degrees A degrees C for further CXCL10 measurements with ELISA. Results: There was a significant difference with regard to serum CXCL10 levels only between GD and euthyroid thyroid autoantibody-negative patient groups [187(12-418) vs. 37.5(2-542) pg/ml, p < 0.05]. However, a comparison of newly diagnosed AITD patients with and without neuromuscular manifestations in terms of serum CXCL10 levels yielded no significant difference. When a correlation of existence of a neuromuscular manifestation and serum CXCL10 levels was evaluated, a significantly positive correlation was noted between carpal tunnel syndrome (CTS) and serum CXCL10 levels [207 (95-748) pg/ml in CTS-positive vs. 117 (2-977) pg/ml in CTS-negative patients, p < 0.05]. Conclusions: In this study, from a number of neuromuscular manifestations, only the existence of CTS correlated with significantly higher CXCL10 levels in the whole study group. Further studies with larger numbers of patients with autoimmune-based hyper- and hypothyroidism may better clarify the hypothesis regarding a relationship between serum CXCL10 levels and neuromuscular manifestations of AITD.Öğe Transient Sensory Recovery in Stroke Patients After Pulsed Radiofrequency Electrical Stimulation on Dorsal Root Ganglia A Case Series(LIPPINCOTT WILLIAMS & WILKINS, 2017) Apiliogullari, Seza; Gezer, Ilknur A.; Levendoglu, FundaIntroduction: The integrity of the somatosensory system is important for motor recovery and neuroplasticity after strokes. Peripheral stimulation or central stimulation in patients with central nervous system lesions can be an effective modality in improving function and in facilitating neuroplasticity. Case Report: We present 2 hemiplegic cases with sensory motor deficit and the result of the pulsed radiofrequency (PRF) electrical stimulation to the dorsal root ganglia. After PRF electrical stimulation, significant improvement was achieved in the examination of patients with superficial and deep sensation. However, during the follow-up visits were observed that the effect of PRF electrical stimulation disappeared. Conclusions: We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the effect of PRF electrical stimulation on dorsal root ganglia to treat sensory deficits in poststroke patients.
