Publications by authors named "Timur Ekiz"

97 Publications

Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience.

Tuberk Toraks 2021 Jun;69(2):125-132

Unit of Physical and Rehabilitation Medicine, Dermancan Medical Center, Adana, Turkey.

Introduction: The objective of this study was to investigate the clinical and radiological features and pulmonary function tests (PFTs) in patients with the pulmonary involvement of systemic rheumatic diseases (SRDs).

Materials And Methods: This study was conducted as a retrospective and single-center study. Patients diagnosed with an SRD and admitted/referred to the department of chest diseases of our hospital between January 2015 and June 2019 were enrolled. All patients were evaluated using High Resolution Computed Tomography (HRCT) and PFT.

Result: This study included 68 patients (15 males, 53 females) with a mean age of 62.38 ± 12.4 years. Forty-one (60.2%) patients had diagnosis of rheumatoid arthritis (RA), 10 (14.7%) patients had sjögren's syndrome (SS), 8 (11.7%) patients had systemic lupus erythematosus (SLE), 6 (8.8%) patients had systemic sclerosis (SSc), and 3 (4.4%) patients had mixed connective tissue disease (MCTD). While RA, SLE, MCTD patients were more commonly symptomatic, most of the SS patients were asymptomatic. Overall, 30 (44.1%) patients had normal PFT. Although 30 (%44.1) patients were asymptomatic and 30 (%44.1) patients had normal PFTs, at least one imaging finding was found in all patients according to HRCT imaging. "Bronchiectasis" was the most common HRCT finding in RA, followed by "chronic fibrotic changes" and "peribronchial thickening". "Chronic fibrotic changes" and "peribronchial thickening" were the most common changes in SS. Similarly, "peribronchial thickening" was the most common radiologic finding in SLE. As for SSc, "chronic fibrotic changes", "interlobular septal thickening", and "pleural effusion" were the most common radiologic findings.

Conclusions: Pulmonary involvement in systemic rheumatic diseases can occur with various radiological images even in asymptomatic patients. PFTs can be normal as well as an obstructive, restrictive or mixed pattern can be seen. Heterogeneous and combined HRCT findings can be seen in SRD patients.
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http://dx.doi.org/10.5578/tt.20219801DOI Listing
June 2021

Diagnosing sarcopenia: Functional perspectives and a new algorithm from the ISarcoPRM.

J Rehabil Med 2021 Jun 21;53(6):jrm00209. Epub 2021 Jun 21.

Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey. E-mail:

Sarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. It is a precursor of physical frailty, mobility limitation, and premature death. Muscle loss is mainly due to the loss of type II muscle fibres, and progressive loss of motor neurones is thought to be the primary underlying factor. Anterior thigh muscles undergo atrophy earlier, and the loss of anterior thigh muscle function may therefore be an antecedent finding. The aim of this review is to provide an in-depth (and holistic) neuromusculoskeletal approach to sarcopenia. In addition, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), a novel diagnostic algorithm is proposed, developed with the consensus of experts in the special interest group on sarcopenia (ISarcoPRM). The advantages of this algorithm over the others are: special caution concerning disorders related to the renin-angiotensin system at the case finding stage; emphasis on anterior thigh muscle mass and function loss; incorporation of ultrasound for the first time to measure the anterior thigh muscle; and addition of a chair stand test as a power/performance test to assess anterior thigh muscle function. Refining and testing the algorithm remains a priority for future research.
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http://dx.doi.org/10.2340/16501977-2851DOI Listing
June 2021

Ultrasonographic measurement of diaphragm thickness in patients with severe thoracic scoliosis.

J Ultrasound 2021 Mar 7;24(1):75-79. Epub 2021 Feb 7.

Department of Physical Medicine and Rehabilitation, Türkmenbaşı Medical Center, Adana, Turkey.

Purpose: This study aimed to measure diaphragm thickness using ultrasound in adult patients with severe idiopathic scoliosis.

Methods: This prospective case-control study included patients with severe idiopathic scoliosis and a healthy control group. The control and patient groups' demographic features, pulmonary function tests, diaphragm thickness, and thickening fraction measured using ultrasonography were compared.

Results: End-expirium values were similar between the two groups (p = 0.902). However, end of inspirium, change level, and diaphragm thickening fraction were significantly lower in the scoliosis group (p < 0.001 for all). Cobb degree values were inversely correlated with forced expiratory volume in 1 s (%) (r =  - 0.909, p < 0.001), forced vital capacity (%) (r =  - 0.887, p < 0.001), and end-inspirium thickness (r =  - 0.673 and p < 0.001) values. Furthermore, diaphragm thickness at the end of inspirium was positively correlated with forced expiratory volume in 1 s (%) (r = 0.636, p = 0.001) and forced vital capacity (%) (r = 0.646, p = 0.001) values. No significant correlation was found between diaphragm thickening fraction and forced expiratory volume in 1 s or forced vital capacity.

Conclusion: Ultrasound can provide valuable information about diaphragm morphology and quantify diaphragm contraction.
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http://dx.doi.org/10.1007/s40477-020-00536-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925784PMC
March 2021

Rewinding sarcopenia: a narrative review on the renin-angiotensin system.

Aging Clin Exp Res 2021 Jan 4. Epub 2021 Jan 4.

Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey.

Background And Aims: The purpose of this review was two-fold. First, we aimed to provide an in-depth glance on the relationship between renin-angiotensin system (RAS) dysregulation and sarcopenia. Second, we aimed to touch upon potential treatments of sarcopenia (including RAS blockers, vitamin D, and exercise) in light of the pertinent literature.

Methods: Currently available research regarding the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers on knee extensor strength, grip strength, chair stand test, gate speed together with the effects of exercise on muscle mass, strength, physical performance, blood pressure and cognitive tests (particularly in older adults) was reviewed.

Results: Although some studies have shown favorable effects of ACEIs on muscle strength and/or physical function tests, some studies have reported no/negative association in between. The favorable impact of exercise on reducing blood pressure is shown, and exercise treatment is widely recommended in the relevant literature. Different types of exercises (aerobic, resistance, dancing, music movement, water-based, golf, knitting activities or multicomponent exercises) have shown improvement in cognitive functions as well.

Conclusion: Classical RAS activity results in deleterious effects not only on the cardiovascular but also on the neuromusculoskeletal system. Therefore, treatments targeting inhibition of the classical RAS activity seem to be important in the management of several age-related pathologies, including sarcopenia. As such, ACEIs, vitamin D, exercise, and healthy diet can have prominent effects not only on the modulation of RAS but also on physical and cognitive functions and sarcopenia as well.
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http://dx.doi.org/10.1007/s40520-020-01761-3DOI Listing
January 2021

Increased deep vein thrombosis cases during the COVID-19 quarantine.

Phlebology 2021 Mar 7;36(2):114-118. Epub 2020 Dec 7.

Department of Physical Medicine and Rehabilitation, Türkmenbası Medical Center, Adana, Turkey.

Objective: The aim of this study was to compare the number of deep vein thrombosis (DVT) cases during the quarantine period for COVID-19 to that of the last year.

Methods: This study was conducted as a single-center and retrospective study. All hospital admissions during April 2020 and May 2020 were screened from the hospital records, and DVT cases were recorded. Likewise, all hospital admissions during April 2019 and May 2019 were screened, and DVT cases were noted. DVT cases of both years were compared.

Results: Among 480931 patients admitted to our hospital in April 2019 and May 2019, DVT was detected in 82 patients (0.017%) (47 males, 35 females) with a mean age of 56.99 ± 9.1 years (ranges 39 to 79 years). Besides, among 145101 patients admitted to our hospital in April 2020 and May 2020, DVT was detected in 123 patients (0.084%) (51 males, 72 females) with a mean age of 58.64 ± 8.9 years (ranges 40 to 83 years). Despite the decrease in the total number of patients admitted to the hospital, there was a significant increase in the number of DVT patients. Interestingly, there were only two symptomatic pulmonary-embolism cases in the 2019 period, whereas there were seven symptomatic pulmonary embolisms secondary to DVT in the 2020 period. Unfortunately, one patient died due to pulmonary embolism secondary to DVT in 2020. The previous history of DVT was remarkable in patients admitted during the COVID-19 confinement.

Conclusion: In conclusion, COVID-19 confinement seems to be associated with increased rates of DVT. Strict preventive measures such as exercise training or prophylactic drug use should be considered to prevent immobility-related DVT during the COVID-19 quarantine.
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http://dx.doi.org/10.1177/0268355520977294DOI Listing
March 2021

Diaphragm thickness and stiffness in patients with hyperkyphosis due to osteoporotic vertebral fracture: an ultrasonographic and elastographic study.

Pol J Radiol 2020 5;85:e575-e580. Epub 2020 Oct 5.

Turkmenbasi Medical Centre, Adana, Turkey.

Purpose: The objective of this study was to evaluate the thickness and stiffness of the diaphragm, using ultrasound (US) and strain elastography (SE) in patients with hyperkyphosis due to osteoporotic vertebral fracture.

Material And Methods: This prospective and case-control study was conducted between October 2019 and December 2019. Diaphragm thickness, SE, and strain ratio values of patients with hyperkyphosis due to osteoporotic vertebral fracture were compared with those of the control group.

Results: There were 42 patients (14 males, 28 females) with a mean age of 81.10 ± 6.3 years in the kyphosis group and 36 subjects (11 males, 25 females) with a mean age of 81.00 ± 5.5 years in the control group. End-inspirium thickness, change level, and thickening ratio of the diaphragm were significantly higher in the control group ( < 0.001 for all). Strain ratio values were significantly higher in the kyphosis group, and the rate of hardest colour code was significantly higher in the control group. The diaphragm thickness at end-inspirium and thickening ratio values correlated positively with the forced expiratory volume in the first second (FEV, %) and forced vital capacity (FVC, %) values. The strain ratio values correlated inversely with the FEV (%) and FVC (%) values. The diaphragm thickness at end-inspirium and thickening ratio values correlated inversely with the Cobb values and number of vertebra fractures. A positive correlation was determined between the strain ratio values and the Cobb values and number of vertebra fractures.

Conclusions: Ultrasonography is a promising imaging tool to evaluate and quantify the diaphragm function and stiffness in relevant patients.
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http://dx.doi.org/10.5114/pjr.2020.99751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654313PMC
October 2020

Reassessing Sarcopenia in Hypertension: STAR and ACE Inhibitors Excel.

Int J Clin Pract 2021 Mar 20;75(3):e13800. Epub 2020 Nov 20.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Background: Hypertension and sarcopenia are commonly seen in older adults. The renin-angiotensin system and the therapeutic use of angiotensin-converting enzyme (ACE) inhibitors have been on the agenda of sarcopenia in different perspectives. Our aim was to explore the frequency of sarcopenia in patients with hypertension and to investigate the association between the use of ACE inhibitors and sarcopenia.

Methods: A total of 272 community-dwelling adults were recruited. Anterior thigh muscle thickness was measured by ultrasound. Handgrip strength, gait speed, and chair stand test were evaluated. Low muscle mass was diagnosed in the presence of low sonographic thigh adjustment ratio (STAR) values and sarcopenia was diagnosed if low STAR values were coupled with low functional tests.

Results: 136 subjects (50.0%) had no comorbid disease; 102 (37.5%) had one, 21 (7.7%) had two, nine (3.3%) had three and four (1.5%) had four comorbid diseases. Both low muscle mass (41.9% vs 13.2%) and sarcopenia (32.2% vs 7.8%) were more commonly seen in hypertensive when compared with normotensive older adults. Subgroup analysis of older adults with hypertension revealed that sarcopenia was less prevalent (P = .003) in patients using ACE inhibitors (8.7%) than those using angiotensin II receptor blockers (48.7%) and other antihypertensive drugs (46.4%). After binary logistic regression analyses; only the presence of hypertension seemed to independently predict the development of sarcopenia in older adults [OR = 6.5 (95% CI: 2.4-17.8, P < .001)].

Conclusions: Sarcopenia is highly prevalent in hypertensive older adults. Amongst many antihypertensive medications, ACE inhibitors seem to have favourable effects on both disorders.
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http://dx.doi.org/10.1111/ijcp.13800DOI Listing
March 2021

Distally-fixed non-modular monoblock fluted long-stem hemiarthroplasty versus proximal femoral nailing for elderly patients with an osteoporotic intertrochanteric fracture: a retrospective comparative study.

Hip Int 2020 Oct 6:1120700020963529. Epub 2020 Oct 6.

Department of Physical and Rehabilitation Medicine, Türkmenbaşı Medical Centre, Adana, Turkey.

Background: The treatment of Intertrochanteric fractures in the elderly osteoporotic patient is still controversial. The aim of this study was to compare the outcomes of proximal femoral nailing (PFN) and a distally-fixed non-modular monoblock fluted long-stem hemiarthroplasty (HA) in elderly patients with an osteoporotic intertrochanteric fracture.

Methods: This retrospective study included patients who had undergone surgery for an unstable intertrochanteric fracture. The patients were separated into PFN and HA groups. The demographic features of the 2 groups were compared. All patients were evaluated using the Singh index, ASA score, AO/OTA classification, Harris Hip Score (HHS), and Parker and Palmer mobility score.

Results: The most common complications were nonunion (12.0%) and cut-out of the screw (10.7%) in the PFN group, and dislocation of the prosthesis (6.7%) and wound infection (5.7%) in the HA group. Overall, the 2-year mortality rate was 29.3%. Mortality, particularly within the first 3 months, was 2.4 times higher in the PFN Group than in the HA group (40% vs. 19.75%). Although the HHS was significantly higher in the first year for the HA group, no significant difference was seen between the 2 groups at 24 months.

Conclusions: Although PFN and HA have similar good outcomes at 2 years, HA allows earlier mobilisation and has fewer complications and a lower mortality rate.
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http://dx.doi.org/10.1177/1120700020963529DOI Listing
October 2020

Management of thoracolumbar injury classification and severity score of 4 (TLICS=4) thoracolumbar vertebra fractures: Surgery versus conservative treatment.

Ulus Travma Acil Cerrahi Derg 2020 Sep;26(5):805-810

Department of Physical Therapy and Rehabilitation, İstanbul Gedik University Faculty of Health Sciences, İstanbul-Turkey.

Background: This study aims to compare clinical and radiographic outcomes of surgical treatment and conservative treatment with bracing in neurologically intact patients with score 4 of TLICS thoracolumbar vertebra fractures.

Methods: Patients with traumatic thoracolumbar junction fractures (T11-L2), the score of TLICS 4, and minimum 24-month follow-up were included in this study. Patients were divided into surgery and bracing groups. The groups were compared concerning clinical and demographical features, local kyphotic angles (LKA), vertebra height loss percentage (VHL), Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and time to return to work.

Results: There were 74 patients (71 males, 3 females) in the surgery group and 76 patients (58 males, 18 females) in the bracing group. Although the surgery group showed better improvement in VAS scores within six months postoperatively, no significant difference was observed at the 24th-month evaluation (p<0.001 and p=0.270, respectively). ODI, LKA and VHL were significantly lower in the surgery group (p<0.001, p<0.001 and p<0.001, respectively). In addition, return to work was significantly earlier in the surgery group (p<0.001).

Conclusion: The findings obtained in this study suggest that the surgical treatment for TLICS 4 patients with thoracolumbar fractures has better clinical and radiographic outcomes than the bracing. Moreover, returning time to the work of patients is shortened with surgical treatment. The surgical treatment seems to be the first and the appropriate choice in the management of TLICS 4 thoracolumbar vertebral fractures.
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http://dx.doi.org/10.14744/tjtes.2020.30524DOI Listing
September 2020

The Relationship Between Primary Knee Osteoarthritis and Aortic Stiffness, Distensibility, and Valve Calcifications: A Case-Control Study.

J Clin Rheumatol 2020 Sep 10. Epub 2020 Sep 10.

Department of Physical and Rehabilitation Medicine, Türkmenbaşı Medical Center, Adana, Turkey.

Objective: The purpose of our study was to evaluate aortic stiffness and distensibility changes and the presence of aortic and mitral valve calcifications in patients with primary knee osteoarthritis (OA), using 2-dimensional and Doppler transthoracic echocardiography.

Methods: This case-control study included 115 participants with OA and a control group between May 2019 and November 2019. The Kellgren-Lawrence classification was used for the diagnosis and classification of knee OA, based on radiological images. We compared the demographic data, 2-dimensional and Doppler transthoracic echocardiography results, and laboratory findings between the OA patient group and the control group.

Results: There was a significant difference between aortic strain, aortic distensibility, aortic stiffness, and C-reactive protein values between the OA patient group and the control group (p < 0.001 for all). Post hoc analyses revealed that aortic strain and aortic distensibility values were significantly lower, and aortic stiffness values were significantly higher in the grade 4 OA group than those of other groups (p < 0.05 for all). In addition, the C-reactive protein values of the grades 3 and 4 patients were significantly higher than those of other groups (p < 0.05 for all). No significant difference was observed between the groups in terms of aortic and mitral valve calcifications (p > 0.05 for all).

Conclusion: Aortic strain and distensibility values were lower in the advanced grades of primary knee OA, whereas aortic stiffness values and the frequency of valve calcifications were higher.
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http://dx.doi.org/10.1097/RHU.0000000000001568DOI Listing
September 2020

Obstructive sleep apnea, renin-angiotensin system, and COVID-19: possible interactions.

J Clin Sleep Med 2020 08;16(8):1403-1404

Department of Pulmonary Diseases, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.

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http://dx.doi.org/10.5664/jcsm.8576DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446083PMC
August 2020

Ultrasonographic assessment of the aging trunk muscles: 'brutal tone' but should be impartial.

Eur J Appl Physiol 2020 Nov 14;120(11):2559-2560. Epub 2020 Aug 14.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

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http://dx.doi.org/10.1007/s00421-020-04469-4DOI Listing
November 2020

Ultrasonographic evaluation of the patellar tendon length and elasticity after open-wedge high tibial osteotomy: A comparison with radiological and clinical parameters.

Knee 2020 Aug 25;27(4):1128-1134. Epub 2020 Jun 25.

Department of Physical Medicine and Rehabilitation, Turkmenbasi Medical Center, Adana, Turkey.

Background: The aim of this study was to evaluate the length and elasticity of the patellar tendon after open-wedge high tibial osteotomy (OWHTO).

Methods: This case-controlled, analytical study included patients who underwent unilateral OWHTO operation and a control group. The length, thickness, strain elastography, and strain ratio of the patellar tendon were measured. The outcome measures were the Insall-Salvati Index (ISI), Blackburne-Peel Index (BPI), Caton Index (CI), the International Knee Documentation Committee Score (IKDC), Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS), Ahlbäck classification, and mechanical axis. Elasticity of the patellar tendon obtained by strain elastography were graded as follows; hardest or hard tissue, intermediate tissue, and soft tissue.

Results: The patellar tendon length was significantly shorter and patellar tendon thickness was significantly greater on the operated side compared with the values of the non-operated side and the control group (P<0.001 for all). Intermediate tissue was the most common elasticity grade (77%) for strain elastography on the operated side. Hardest tissue was the most common elasticity grade on the non-operated side of the patients (49.1%) and of the control group (70.0%). Patellar tendon length was correlated positively with IKDC, OKS, and KOOS values and patellar tendon thickness and strain ratio were correlated negatively with IKDC, OKS, and KOOS values.

Conclusion: The patellar tendon seems to be shortened and thickened, with reduced stiffness after OWHTO. The ultrasound parameters are also associated with functional outcomes.
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http://dx.doi.org/10.1016/j.knee.2020.05.016DOI Listing
August 2020

In silico diagnosis for sarcopenia is not possible without anthropometric, strength, and performance assessments.

Skeletal Radiol 2021 Feb 18;50(2):463-464. Epub 2020 Jul 18.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

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http://dx.doi.org/10.1007/s00256-020-03554-1DOI Listing
February 2021

Sarcopenia and COVID-19: A Manifold Insight on Hypertension and the Renin Angiotensin System.

Am J Phys Med Rehabil 2020 10;99(10):880-882

From the Department of Physical Medicine and Rehabilitation, Türkmenbaşi Medical Center, Adana, Turkey (TE); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, Turkey (FÖ); and Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy (VR).

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http://dx.doi.org/10.1097/PHM.0000000000001528DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375181PMC
October 2020

COVID-19 and Crimean-Congo Hemorrhagic Fever: Similarities and Differences.

Heart Lung 2020 Nov - Dec;49(6):892-893. Epub 2020 Jun 3.

Türkmenbaşı Medical Center, Department of Physical and Rehabilitation Medicine, Adana, Turkey.

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http://dx.doi.org/10.1016/j.hrtlng.2020.05.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266772PMC
June 2020

Obstructive sleep apnea syndrome-related hypertension and sarcopenia: a brief glance on the renin-angiotensin-aldosterone system.

Sleep Breath 2021 Jun 11;25(2):1159-1161. Epub 2020 Jun 11.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

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http://dx.doi.org/10.1007/s11325-020-02119-9DOI Listing
June 2021

Measuring grip strength in COVID-19: A simple way to predict overall frailty/impairment.

Heart Lung 2020 Nov - Dec;49(6):853-854. Epub 2020 May 28.

Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.

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http://dx.doi.org/10.1016/j.hrtlng.2020.05.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254015PMC
November 2020

Relationship between COVID-19 and obesity.

Diabetes Metab Syndr 2020 Sep - Oct;14(5):761-763. Epub 2020 Jun 2.

Gaziosmanpaşa University Faculty of Medicine, Department of Pulmonary Diseases, Tokat, Turkey.

N/A.
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http://dx.doi.org/10.1016/j.dsx.2020.05.047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266606PMC
September 2020

Fighting against frailty and sarcopenia - As well as COVID-19?

Med Hypotheses 2020 11 1;144:109911. Epub 2020 Jun 1.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

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http://dx.doi.org/10.1016/j.mehy.2020.109911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263226PMC
November 2020

Revisiting vitamin D and home-based exercises for patients with sleep apnea facing the COVID-19 quarantine.

J Clin Sleep Med 2020 08;16(8):1409-1410

Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.

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http://dx.doi.org/10.5664/jcsm.8586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446077PMC
August 2020

Letter to the editors in response to: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be harmful in patients with diabetes during COVID-19 pandemic (Cure et al.).

Diabetes Metab Syndr 2020 Jul - Aug;14(4):525-526. Epub 2020 May 5.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

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http://dx.doi.org/10.1016/j.dsx.2020.04.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198989PMC
July 2020

'Scientific Strabismus' or two related pandemics: coronavirus disease and vitamin D deficiency.

Br J Nutr 2020 10 12;124(7):736-741. Epub 2020 May 12.

Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey.

The WHO has announced the novel coronavirus disease (COVID-19) outbreak to be a global pandemic. The distribution of community outbreaks shows seasonal patterns along certain latitude, temperature and humidity, that is, similar to the behaviour of seasonal viral respiratory tract infections. COVID-19 displays significant spread in northern mid-latitude countries with an average temperature of 5–11°C and low humidity. Vitamin D deficiency has also been described as pandemic, especially in Europe. Regardless of age, ethnicity and latitude, recent data showed that 40 % of Europeans are vitamin D deficient (25-hydroxyvitamin D (25(OH)D) levels <50 nmol/l), and 13 % are severely deficient (25(OH)D < 30 nmol/l). A quadratic relationship was found between the prevalences of vitamin D deficiency in most commonly affected countries by COVID-19 and the latitudes. Vitamin D deficiency is more common in the subtropical and mid-latitude countries than the tropical and high-latitude countries. The most commonly affected countries with severe vitamin D deficiency are from the subtropical (Saudi Arabia 46 %; Qatar 46 %; Iran 33·4 %; Chile 26·4 %) and mid-latitude (France 27·3 %; Portugal 21·2 %; Austria 19·3 %) regions. Severe vitamin D deficiency was found to be nearly 0 % in some high-latitude countries (e.g. Norway, Finland, Sweden, Denmark and Netherlands). Accordingly, we would like to call attention to the possible association between severe vitamin D deficiency and mortality pertaining to COVID-19. Given its rare side effects and relatively wide safety, prophylactic vitamin D supplementation and/or food fortification might reasonably serve as a very convenient adjuvant therapy for these two worldwide public health problems alike.
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http://dx.doi.org/10.1017/S0007114520001749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300194PMC
October 2020

Coronavirus disease 2019 and obstructive sleep apnea syndrome.

Sleep Breath 2021 03 28;25(1):371. Epub 2020 Apr 28.

Department of Neurology, Konya Medicana Hospital, Konya, Turkey.

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http://dx.doi.org/10.1007/s11325-020-02087-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186112PMC
March 2021

EURO-MUSCULUS/USPRM Global Report on Musculoskeletal Ultrasound Publications.

Am J Phys Med Rehabil 2020 09;99(9):847-852

From the Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical and Rehabilitation Medicine Education and Research Hospital, Ankara, Turkey (EG); Department of Physical Medicine and Rehabilitation, Türkmenbaşi Medical Center, Adana, Turkey (TE); Department of Physical Medicine and Rehabilitation, İstanbul Physical and Rehabilitation Medicine Training and Research Hospital, İstanbul, Turkey (MS); Department of Physical Medicine and Rehabilitation, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey (EY); Department of Physical Medicine and Rehabilitation, Dr. Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey (AMA); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (K-VC, W-TW); Department of Physical Medicine and Rehabilitation, Pamukkale University Medical School, Denizli, Turkey (NA); Department of Rehabilitation Medicine, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic (KM); Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy (AP); Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (DC); Department of Physical Medicine and Rehabilitation, Leiria Hospital Center, Leiria, Portugal (SS); Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey (TT); Department of Physical and Rehabilitation Medicine, Patras University Hospital, Rio, Greece (NB); Department of Physical Medicine and Rehabilitation, Yildirim Beyazit University Medical School, Ankara, Turkey (GA); Department of Physical Medicine and Rehabilitation, Health Rehabilitation Research Group, University of Antioquia, Colombia (MG-P); and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy (FF).

The developments in technology have improved access to the use of musculoskeletal ultrasound (MSUS) in different clinical settings. Accordingly, MSUS has been applied to a wide range of musculoskeletal problems including inflammatory and degenerative diseases, sport injuries, and regional pain syndromes both for clinical practice and research. In this report, the authors aimed to globally examine the publications on MSUS among different specialties, countries, and topics. Sixteen reviewers under the umbrella of the European Musculoskeletal Ultrasonography Society Group and the Ultrasound Study Group of International Society of Physical and Rehabilitation Medicine have evaluated approximately 15,000 publications on MSUS. The authors believe that the results of this comparative analysis may provide a holistic snapshot with regard to the utility of MSUS, not only for clinicians/academicians but also for the industry. Accordingly, while aiming to further increase their awareness, this article would possibly guide future investments as well.
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http://dx.doi.org/10.1097/PHM.0000000000001390DOI Listing
September 2020

The magnetic resonance neurography of a Parsonage-Turner syndrome case.

North Clin Istanb 2020 25;7(1):65-66. Epub 2019 Jun 25.

Department of Physical Medicine and Rehabilitation, Dermancan Medical Center, Adana, Turkey.

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http://dx.doi.org/10.14744/nci.2019.77905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103742PMC
June 2019

Evaluation of Olfactory Bulb Volumes in Patients With Rheumatoid Arthritis: A Retrospective Study.

Arch Rheumatol 2019 09 22;34(3):334-337. Epub 2019 Apr 22.

Department of Physical Medicine and Rehabilitation, Dermancan Medical Center, Adana, Turkey.

Objectives: This study aims to evaluate olfactory bulb (OB) volume in patients with rheumatoid arthritis (RA) using magnetic resonance imaging.

Patients And Methods: In this retrospective and case-control study, OB volumes of 37 RA patients (6 males, 31 females; mean age 48.6±10.8 years; range, 18 to 65 years) were compared with those of 36 healthy control subjects (5 males, 31 females; mean age 46.5±6.9 years; range, 22 to 62 years). OB images were gained with a protocol of 256×256 matrix and a 24-cm field of view, repetition time=5000 milliseconds (TR 5000 msec), echo time=130 milliseconds (TE 130 msec), number of excitations=2 (NEX 2) and a 5 mm slice thickness. OB volume was computed with the aid of the above images using three dimensional views. The surface of each slice area was calculated in mm2 and all surfaces were added and multiplied by front-back length to obtain a volume in mm3.

Results: Left (70.5±14.4 vs. 91.1±12.2 mm3), right (73.9±15.1 vs. 91.2±12.4 mm3), and total (144.5±27.4 vs. 182.8±21.5 mm3) OB volumes were significantly lower in the RA group than in the control group (all p<0.05).

Conclusion: Patients with RA may be under risk of decreased OB volumes and related impaired odor functions which might affect the quality of life and activities of daily living adversely.
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http://dx.doi.org/10.5606/ArchRheumatol.2019.6752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768790PMC
September 2019

Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers' Depression on Caregiver Burden.

J Geriatr Psychiatry Neurol 2020 09 16;33(5):243-249. Epub 2019 Sep 16.

İstanbul Gedik University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, İstanbul, Turkey.

Objective: We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers' depression, on the caregiver burden.

Method: One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI).

Results: Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( = .009, χ = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( = .000, χ = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( < .05).

Conclusions: The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.
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http://dx.doi.org/10.1177/0891988719874123DOI Listing
September 2020

Ultrasonographic measurement of the diaphragm thickness in patients with obstructive sleep apnea syndrome.

Sleep Breath 2020 Mar 28;24(1):89-94. Epub 2019 Aug 28.

Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul Gedik University, Istanbul, Turkey.

Purpose: The aim of this study was to evaluate the diaphragm thickness in patients with obstructive sleep apnea syndrome (OSAS).

Methods: This prospective study included patients who underwent polysomnography evaluation for the first time with a clinical suspicion of OSAS. All patients underwent polysomnographic evaluation with a 55-channel Alice 6 computerized system (Respironics; Philips, IL). Diaphragm thickness was measured as the distance between the peritoneum and the pleura using electronic calipers with a 7-12-MHz linear probe (PHILIPS EPIQ 5G).

Results: A total of 108 patients (67 males, 41 females) were enrolled in the current study. The mean age of the patients was 48.92 ± 11.47 years. The diaphragm thicknesses were significantly higher in OSAS patients both at end-inspirium and end-expirium compared with the normal group (p < 0.05). No significant difference was observed regarding the change level and thickening ratio (%) (p > 0.05). When the patients were allocated into OSAS subtypes; diaphragm thicknesses at the end of inspirium and expirium on both sides were significantly higher in the severe OSAS group and OSAS+OHS group compared with the other groups of normal, mild OSAS, and moderate OSAS subgroups (p < 0.05 for all). There was no significant difference between the groups regarding the thickening ratio (p > 0.05 for all). There was a positive correlation between the severity of OSAS and diaphragm thickness.

Conclusion: Diaphragm thickness seems to be increased in OSAS patients and the thickness correlates with the severity of OSAS. However, the thickness ratio of OSAS patients does not differ from that of normal subjects.
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http://dx.doi.org/10.1007/s11325-019-01931-2DOI Listing
March 2020

Osteopathic manipulative treatment: A "fishing expedition".

Turk J Phys Med Rehabil 2018 Dec 4;64(4):371-372. Epub 2018 Nov 4.

Department of Physical Medicine and Rehabilitation, Türkmenbaşı Medical Center, Adana, Turkey.

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http://dx.doi.org/10.5606/tftrd.2018.3412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6648036PMC
December 2018