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Öğe Conservative treatment of femoral neuropathy following retroperitoneal hemorrhage: a case report and review of literature(Lippincott Williams & Wilkins, 2014) Tosun, Aliye; Inal, Elem; Keles, Isik; Tulmac, Murat; Tosun, Ozgur; Aydin, Gulumser; Orkun, SevimAnticoagulant drugs are used to reduce the incidence thromboembolic events in patients at risk. However, minor and major bleeding complications may occur during anticoagulation therapy. Femoral neuropathy secondary to retroperitoneal hematoma is a well known complication of anticoagulant drugs. However, treatment of these patients is still controversial, both conservative and surgical treatments have been advocated. Herein, we report a male patient receiving warfarin for 7 years who developed femoral neuropathy due to retroperitoneal hematoma and was successfully treated with conservative methods. We suggest that conservative treatment and appropriate rehabilitation program should be given to the patients who do not demonstrate any signs of a continued bleeding and any progressive neurological deficits. Blood Coagul Fibrinolysis 25:769-772 2014 (C) Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Correlations between autonomic dysfunction and circadian changes and arrhythmia prevalence in women with fibromyalgia syndrome(Turkish Soc Cardiology, 2009) Dogru, Mehmet Tolga; Aydin, Gueluemser; Tosun, Aliye; Keles, Isik; Gueneri, Mahmut; Arslan, Ayse; Orkun, SevimObjective: It is known that increased sympathetic activity and decreased parasympathetic activity are present in patients with fibromyalgia syndrome (FMS). This study aims to investigate the correlations of autonomic dysfunction and differences in autonomic circadian activity with arrhythmia prevalence in women with FMS. Methods: Fifty female patients with FMS and 30 healthy female controls were included in this cross-sectional, case-controlled study. A 12-lead electrocardiogram and 24-hour Holter monitoring were performed in all patients to evaluate arrhythmias and autonomic function tests. Heart rate variability (HRV) parameters were utilized to detect autonomic dysfunction in patients with FMS. HRV measurements were performed in total 24-hour, day time (06:00-22:59), night time (23:00-05:59) periods and during autonomic tests (stand - supine, inspiration-expiration and Valsalva tests) using 24-hour Holter monitoring recordings. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The correlation of data was tested by using Spearman correlation analysis. Results: The mean ages of the patient and control groups were 38 +/- 7.4 and 36 +/- 8.1 years, respectively. In HRV measurements, high frequency (HF) power, was significantly decreased in the patient group as compared with control group (167.4 msec(2) (107.0-312.0) vs.314.5 msec(2) (124.0-905.0), p=0.017). The low frequency/HF ratio (LF/HF) values for total 24 hours (2.22 +/- 0.18 vs. 1.22 +/- 0.12, p<0.001) and in the night time period (2.78 +/- 1.97 vs.1.15 +/- 0.77, p<0.001) were found to be significantly higher in the patient group than in control one. The ratio of LF/HFDay/LF/HFNight was markedly higher in the control group (2.67 (1.22-5.65) vs. 1.45 (0.83-2.05), p=0.004). The prevalence (p=0.028) and total number (127.1 +/- 21.4 vs. 187.3 +/- 62.3, p=0.019) of supraventricular extrasystoles in 24-hour period was higher in the patient group. Conclusion: The sympathetic activity was significantly increased and parasympathetic activity significantly decreased in FMS patients. Additionally, significant autonomic circadian activity changes were also detected in these patients. These autonomic changes might be linked to increased arrhythmia prevalence. (Anadolu Kardiyol Derg 2009, 9: 110-7)Öğe Does Autonomic Dysfunction Exist in Postmenopausal Osteoporosis?(Lippincott Williams & Wilkins, 2011) Tosun, Aliye; Dogru, Mehmet Tolga; Aydin, Gulumser; Keles, Isik; Arslan, Ayse; Guneri, Mahmut; Ebinc, HaksunTosun A, Dogru MT, AydNn G, Keles I, Arslan A, Guneri M, Orkun S, Ebinc H: Does autonomic dysfunction exist in postmenopausal osteoporosis? Am J Phys Med Rehabil 2011;90:1012-1019. Objective: The aim of this study was to investigate the presence of autonomic dysfunction in patients with osteoporosis. Design: This is a prospective controlled trial. Sixteen postmenopausal female patients with osteoporosis and 10 age-matched postmenopausal nonosteoporotic controls were included in the study. Participants were divided into the postmenopausal osteoporosis group and the nonosteoporotic control group according to bone mineral densities. Heart rate variability parameters and sympathetic skin responses were studied to evaluate autonomic functions. Results: The latencies of sympathetic skin responses obtained from both hands were significantly increased in the patient group when compared with the control group. The sympathetic skin response amplitude of the right hands and both feet of the patient group were found to be decreased significantly when compared with that of the control group. A 24-hr high-frequency value was significantly decreased in the patient group than in control group. A 24-hr low-/high-frequency value was significantly higher in the patient group than in the control group. Conclusions: Autonomic dysfunction characterized with increased sympathetic and decreased parasympathetic activity may be present in osteoporosis, and cardiac functions in patients with osteoporosis may also be affected by accompanying autonomic dysfunction.Öğe Effects of ovariectomy and ascorbic acid supplement on oxidative stress parameters and bone mineral density in rats(Taylor & Francis Ltd, 2011) Arslan, Ayse; Orkun, Sevim; Aydin, Gulumser; Keles, Isik; Tosun, Aliye; Arslan, Mustafa; Caglayan, OsmanObjectives: The aim of this study is to investigate the effects of ovariectomy on bone mineral density (BMD) and oxidative state in rats, and the alterations in these effects that vitamin C supplementation may produce. Materials and methods: Twenty female Wistar albino rats were randomly divided into three groups: control (C, n = 6); ovariectomy (O, n = 7); and ovariectomy + vitamin C supplement (OV, n = 7). Oxidative stress (OS) was assessed 100 days postovariectomy by measuring the activity of several enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase, as well as the concentrations of malondialdehyde (MDA), nitric oxide (NO), and total sulfhydryl groups in plasma and bone homogenates. Results: A significant decrease in BMD was observed in O group compared with C group (p = 0.015), and a significant increase was observed in OV compared with O group (p = 0.003). When groups were compared with respect to parameters of OS, MDA and NO levels in bone tissue were significantly higher in O than in C (p = 0.032, p = 0.022) and were significantly lower in OV than in O (p = 0.025, p = 0.018). SOD activity was significantly higher in O than in C (p = 0.032). In plasma, MDA activity was significantly higher in O than in C (p = 0.022) and NO level was significantly higher in O than in C and OV (p = 0.017, p = 0.018). Conclusions: Our results suggest that ovariectomy may produce osteoporosis and OS in females, and vitamin C supplementation may provide alterations regarding improvement in OS and BMD values. We assume that studies including more subjects are needed to make a decisive conclusion about OS-BMD relation.Öğe Electrophysiologic evaluation of genitofemoral nerve in children with inguinal hernia repair(W B Saunders Co-Elsevier Inc, 2008) Soyer, Tutku; Tosun, Aliye; Keles, Isik; Inal, Elem; Cesur, Oezkan; Cakmak, MuratAim: Genitofemoral nerve (GFN) injury may occur because of chronic pressure of hernia sac or surgical intervention. A prospective study was performed to evaluate GFN electrophysiologically in children with inguinal hernia repair. Methods: Children with inguinal hernia were evaluated for GFN electrophysiologically before and after (3-6 months postoperatively) inguinal hernia repair. Bilateral GFN motor response latencies and durations were investigated electrophysiologically by surface electrodes. Wilcoxon signed ranked test was used for statistical analysis, and P values lower than .05 was considered to be significant. Results: Eleven patients with a mean age of 4.45 +/- 2.16 were enrolled in the study. Mean latency of patients was 2.37 +/- 0.89 milliseconds preoperatively and 3.14 +/- 1.02 milliseconds postoperatively. Latency of GFN was found prolonged after hernia repair (P = .008). Duration of GFN motor response was 9.94 +/- 1.49 milliseconds and 11.18 +/- 2.44 milliseconds, respectively, in preoperative and postoperative recordings. There was no significant difference detected in mean durations (P > .05). Conclusion: Latency of GFN may prolong after inguinal hernia repair. Prolongation of GFN latency may be the result of surgical injury during hernia repair and consequently also related with chronic groin pain. (C) 2008 Elsevier Inc. All rights reserved.Öğe Lipoma Arborescens in Childhood: A Report of Two Sisters(Turkish League Against Rheumatism, 2012) Aydin, Gulumser; Keles, Isik; Tosun, Ozgur; Tosun, Aliye; Yilmaz, Latife Ozlem; Karagulle, Tuba Kendi; Orkun, SevimLipoma arborescens (LA) is a rare benign lesion of synovial joints and bursae. The knee is the most common site of the involvement. Magnetic resonance imaging findings are typical in the diagnosis. The number of case reports of LA in children is significantly lower compared to the adults. In this article, two nine-year-old and 15-year-old sisters who were examined for the complaints of bilateral pain and swelling in knees were presented. Magnetic resonance imaging demonstrated typical features of LA in the right knees of both children. Pediatric patients with mono/oligoarticular effusion and synovial hypertrophy without systemic involvement, LA should be considered in differential diagnosis. Magnetic resonance imaging is a sensitive modality in the diagnosis of LA.Öğe Symptoms of Musculoskeletal Disorders Among Ammunition Factory Workers in Turkey(Routledge Journals, Taylor & Francis Ltd, 2013) Pinar, Tevfik; Cakmak, Z. Aytul; Saygun, Meral; Akdur, Recep; Ulu, Nuriye; Keles, Isik; Saylam, Hamdi SaimThe aim of this study was to assess the prevalence of symptoms of work-related musculoskeletal disorders (MSDs) and to determine the risk factors among ammunition factory workers in Turkey. This cross-sectional study was performed on 955 ammunition factory workers. Potential risk factors were investigated with a questionnaire and multivariate logistic regression analysis was performed. During the previous year, 39.3% of ammunition workers experienced symptoms of work-related MSDs. Logistic regression analysis showed smoking (odds ratio [OR] = 1.372), chronic diseases (OR = 1.795), body mass index (BMI; overweight) (OR = 1.631), working year (OR = 1.509), cold temperature (OR = 1.838), and work load (OR = 2.210) were significant independent risk factors for the development of symptoms of MSDs. It was found that both work-related conditions and personal and environmental factors are important for the development of occupational MSDs.
