Sağlık Bilimleri Fakültesi / Faculty of Health Sciences

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A comparison of Gordon's functional health patterns model and standard nursing care in symptomatic heart failure patients: A randomized controlled trial
(W.B. Saunders, 2020-06) Türen, Sevda; Enç, Nuray
Background Heart failure (HF) is associated with poor quality of life and increased morbidity and mortality. Aim This study aimed to investigate effect of application of Gordon's functional health pattern (FHP) model in nursing care of symptomatic HF patients on quality of life, morbidity and mortality in the post-discharge 30-day. Methods This is a prospective randomized controlled study conducted in a single center. Experimental group received nursing care planned in accordance with Gordon's FHP model. 60 control and 60 experimental HF patients were included in the study. In the control group nursing care was given according to the standard protocol of the hospital whereas in the experimental group nursing care was given in accordance with Gordon's FHP model. Patients in both groups were followed up after discharge at 30th day. Results Mean Minnesota Living with Heart Failure Questionnaire score improved significantly in the experimental group compared to the control group at 30th day (40.2 ± 23.5 vs 62.3 ± 22.9 respectively, p = 0.001). Seven patients (11.7%) in the experimental group and 17 patients (28.3%) in the control group were readmitted in the post discharge 30-day (p = 0.02). Kaplan-Meier survival curve analysis revealed significant difference in 30-day event free survival rates between groups (log-rank p = 0.31). Conclusion Application of Gordon's FHP model in the nursing care of HF patients was associated with significantly improved quality of life, and reduced hospital readmission rates at 30th day. This was the only independent predictor of 30-day event free survival.
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Awareness of health sciences students about colorectal cancer risk factors
(2019-05) Üstündağ, Hülya; Zengin, Neriman; Andsoy, Işıl Işık; GÜL, ASİYE
Objective This descriptive study was conducted in order to determine the risk factors, symptoms and awareness of health sciences students with regards to colorectal cancer (CRC). Methods This study included 1,028 health science students from two different universities. Data for this study were collected via a questionnaire form that included questions about CRC risk factors, protective approaches and symptoms. Frequencies, percentages and averages of the data were assessed with Kruskal-Wallis and Mann-Whitney U tests. Results The most frequent risk factors of the students (mean age: 21.25 years) were smoking (90.5%), excessive alcohol consumption (87.4%), family history of cancer (84.2%) and obesity (82.6%), while the most common protective approaches were smoking cessation, avoiding alcohol, regular physical activity and a low-fat diet. There was a significant difference in the CRC awareness of students in terms of gender, the department and grade level at which they were studying, and having a family history of cancer. Conclusion Results of this study revealed that students had a sufficient awareness about risk factors and what they could do to diminish their risk, but their knowledge about CRC symptoms was less than expected. We believe that health sciences students should be given more education on CRC symptoms.
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Azaltılmış Plantar Ön-Ayak Duyusunun Taban Basıncı Üzerine Etkisinin İncelenmesi
(2018) Akalan, Ekin; Sert, Rukiye; Kuchimov, Shavkat Nadir; Leblebici, Gökçe; Ertürk, Gamze; Bilgili, Fuat; ÖNERGE, KÜBRA; 283338; 176320; 229941; 268636; 237820
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Bariatrik cerrahi planlanan obez hastalarda besin tüketimleri ile duygusal yeme davranışı arasındaki ilişki
(2019-12) Batar, Nazli
Bu çalışma, bariatrik cerrahi planlanan obez bireylerin besin tüketim sıklıkları ile bireylerin kısıtlayıcı, duygusal ve dışsal yeme davranışları arasındaki etkileri incelemek amacıyla planlanmıştır. Gereç ve Yönterm Prospektif tanımlayıcı tipteki bu araştırma, İstanbul’da özel bir obezite kliniğine bariatrik cerrahi ameliyatı olmak için başvuran ve hekim tarafından uygun görülen 86 obez birey üzerinde yürütülmüştür. Veriler araştırmacı tarafından yüz yüze görüşme yöntemi ile toplanmıştır. Bulgular:Çalışmaya katılan obez bireylerin yaş ortalaması 41,64±12,62 yıl, Beden Kütle İndeksi (BKİ) ortalaması 37,73±4,17 kg/m2’dir. Katılımcıların %65’i kadın, %35’i erkektir. Bireylerin %72’si düzenli (haftada 5-6 kez ve daha fazla) 3 ana öğün yapmakta, %48’i düzenli ara öğün yapmamaktadır. Düzenli gece ara öğün yapanlar ile gece ara öğününü atlayan obez bireylerde dışsal yeme davranışı arasında anlamlı farklılık olduğu saptanmıştır (p=0,02). BKI>45 kg/m2 olan bireylerin dışsal yeme davranış düzeyinin BKI>35-39,9 kg/m2 olanlara göre yüksek olduğu istatistiksel açıdan anlamlı bulunmuştur (p=0,029). Düzenli çikolata tüketenlerin duygusal yeme davranış düzeyinin hiç tüketmeyenlere göre daha yüksek olduğu (p=0,02), hiç beyaz ekmek tüketmeyenlerin kısıtlayıcı yeme davranış düzeylerinin düzenli tüketenlere göre daha yüksek olduğu tespit edilmiştir (p=0,01).Sonuç: Bariatrik cerrahi sonrası yeterli ağırlık kaybı ve obezite ile ilişkili komorbiditelerde iyileşmenin sağlanabilmesi için baraitrik cerrahi öncesi ve sonrası multidisipliner ekip çalışmasının önemi unutulmamalıdır.
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BMC'de Multidisipliner Ekip ve Yaşanan Etik Sorunlar ve Protein
(2019-10) BATAR, NAZLI; 256218
Multidisipliner ekip çalışmasının bariatrik cerrahide rolü büyüktür. Bariatrik cerrahi öncesi ve sonrası bir bütün olarak düşünüldüğünde, multidisipliner yaklaşımın sağlıklı beslenme alışkanlığı kazanma ve yaşam tarzı değişikliği ile optimal sonuçlara daha kolay ulaşabileceği gibi ulaşılan ağırlığın korunabilmesi açısından da önemi yapılan çalışmalarla desteklenmektedir. Kılavuzlar günümüzde dört ana uzmanlık alanını tanımlamıştır. Cerrah, hemşire, diyetisyen ve psikiyatr veya psikologlar multidisipliner ekip içinde olmalıdır. Cerrahlar, bariatrik cerrahi ekibinde cerrahi tekniği uygulayan kişiler olarak lider olarak görev alırlar. Ekip lideri hastaneye veya kliniğe bağlı olarak görev yapar, hastanın ameliyat öncesi ve sonrası değerlendirmesinden ve takibinden sorumludurlar. Psikiyatr veya psikologlar, bariatrik cerrahinin uygunluğunu belirlemek için hastanın sosyal, psikolojik ve psikiyatrik değerlendirmesini sağlarlar. Diyetisyenler ameliyat öncesi ve sonrası hastaların beslenme durumunun saptanması ve değerlendirilmesinde, antropometrik ölçümlerin alınması ve değerlendirilmesinde, sağlıklı beslenme eğitimlerinin yapılmasında görev alırlar. Ameliyat sonrası hemşireler, disiplinler arası bakım, eğitim ve ameliyat sonrası izlemenin planlanmasına yardımcı olan ekip elemanlarındandır. Obezitenin giderek evrensel bir halk sağlığı sorunu haline gelmesi, obezitenin etkili tedavi yöntemlerinden olan bariatrik cerrahi tekniklerinin uygulanma sıklığını da arttıracaktır. Bariatrik cerrahinin bir ekip çalışması olduğunun unutulmamalı ve multidisipliner yaklaşımla hastaların ele alınması gerektiği vurgulanmaktadır. Alanında uzman bir diyetisyen ekip içinde her zaman büyük bir role sahip olacaktır. Ameliyat öncesi ve sonrası beslenme durumunun saptanması, antropometrik ölçümlerin değerlendirmeleri, hasta sonuçlarının iyileştirilmesi, olası beslenme komplikasyonlarının erken tespiti ve önlenmesinde diyetisyenler hastalara yol göstermelidir. Deneyimli diyetisyen ve multidisipliner ekip yaklaşımı ile hastalar özgü sistematik bir beslenme bakım süreci ile daha başarılı sonuçlar elde edileceği unutulmamalıdır.
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Breastfeeding Practices in Medical Nutrition Treatment of Phenylketonuria
(2019-09) Çakır Biçer, Nihan; Ersoy, Melike; 25392
Objective: Phenylketonuria (PKU) is an inherited metabolic disease with the increase of phenylalanine (phe) in the blood and body fluids in the absence of phenylalanine hydroxylase enzyme. PKU was the first inborn error of metabolism treated with medical nutrition therapy (MNT). The aim o f this study was to evaluate the breastfeeding practices in the MNT of PKU patients followed up at Dr. Sadi Konuk Training and Research Hospital, metabolism reference clinic for three years. Methods: Forty-two patients were reviewed for infants diagnosed with PKU between 2016 and 2019. Eighteen PKU patients (8 mild-PKU, 10 classic-PKU) over two years old and diagnosed with National Newborn Screening Program were included the study. MNT, blood phe, tyrosine (tyr) levels and anthropometric measurements of patients were evaluated retrospectively. Results: The mean age of patients is 2,5±0,4 years and 44% were male. The patients were diagnosed at a mean age of 13,7±6,7 days with blood phe and tyr levels of the patients were 1756 pmol/dL and 65 pmol/dL. After the diagnosis, 24-hour-BH4-loading test was applied, breastfeeding was interrupted until the blood phe level was <600 pmol/dL (mean 3,7±1,6 days) and breast milk was stored for reuse. In this process, MNT was applied phe-free medical formula with an average of 2,1 g/kg/day essential amino acid (eaa), 108 kcal/kg/day energy and 150 ml/kg/day fluid. After the blood phe level was <600 pmol/dL, free breastfeeding was initiated. Mean breastfeeding duration of patients was 17,8±9,3 moths. In the first 6 moths 0.9 g/kg/day eaa, 43 kcal/kg/day and 57 ml/kg/day fluid were applied and average blood phe and tyr levels were 240 pmol/dL and 70 pmol/dL. Complementary feeding education was given to all patients at 6 months. At the age of 6-12 months the patients received MNT containing average 0,9 g/kg/day eaa, 0,54 g/kg/day natural protein, 25 mg/kg/day phe, 74 kcal/kg/day energy and average blood phe and tyr levels were 314 pmol/dL and 69 pmol/dL. At the age of 12-24 months, the MNT containing average of 1,1 g/kg/day eaa, 1 g/kg/day natural protein, 26 mg/kg/day phe, 109 kcal/kg/day was recommended to patients and average blood phe and tyr levels were 312 pmol/dL and 82 pmol/dL and phe:tyr ratio was 3,8. Anthropometric measurements of the patients were observed to be within normal range during the study. Conclusion: Free breastfeeding is a successful and reliable practice that supports the healthy growth and development of the child in the life-long MNT of PKU.
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Case report: Necrotising fasciitis after removing the intrauterine device
(2018-12) Özkaya, B.; Küçük, A.; Tosun, H.; GÜL, ASİYE
Necrotising fasciitis is a rapidly progressive, destructive soft tissue infection that mainly involves fascia and subcutaneous tissues. Rapidly spread necrosis in tissues is often caused by systemic sepsis, toxic shock syndrome, multiorgan failure and thrombosis in the subcutaneous vasculature. Necrotising fasciitis can be seen in all the anatomical regions of the body; the extremities and perineum are frequently affected. In this case report, we emphasised the importance of nursing care of a necrotising fasciitis patient who has been treated for a long time with aggressive surgical treatment. Vacuum-assisted closure application is a non-invasive method with controlled and localised negative pressure on the wound to accelerate healing in acute/chronic wounds. Necrotising fasciitis can be successfully treated with early diagnosis, adequate debridement, and appropriate antibiotic therapy. A multidisciplinary approach is necessary for the comprehensive care of these patients.
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Chemotherapy and radiation induced pulmonary dysfunction in hodgkin lymphoma patients
(2016-12) İzmir Güner, Şebnem; Teoman Yanmaz, Mustafa; Selvi, Ahmet; Usul, Çiğdem
Although the deterioration in pulmonary functions is a well-known important problem due to the treatment of the Hodgkin's lymphoma patients, the immediate and long term effects of the therapy and its distinctive components were not shown clearly yet. We planned to investigate effects of multiple agent chemotherapy and/or radiotherapy to pulmonary functions immediately and thereafter and the possible effects of the managing this situation. 34 patients were included the study. The patients were evaluated for peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1), forced expiratory vital capacity (FVC), mean total lung capacity (TLC) values, FEV1/FVC ratio, diffusing capacity for carbonmonoxide (DLco), diffusing capacity for carbonmonoxide corrected for hemoglobin concentration (DLCO) before and at 1, 6 and 12 months after the initiation of the treatment. Demographic characteristics; disease stages; chemotherapy protocols; whether radiotherapy is received; if yes, the region and the dose received were recorded. The tests were finally analysed in two separated groups; group A treated with only chemotherapy and group B; treated with combination therapy, chemotherapy and radiotherapy. In group A, FVC and FEV1 is similar before and after treatment. FEV1/FVC ratio was increased (P = 0.0001) in this group despite increasing in mean TLC values (P = 0.001). No meaningful changes were observed in PEF and DLCO values in group A. In group B, FVC, FEV1 and PEF were decreased after treatment (for FVC P = 0.028, for FEV1 P = 0.04). Despite a decrease in first month of the treatment in FEV1/FVC ratio and DLco these two parameters were recovered at the end of the first year in group B patients. TLC values were increased after treatment in group B as in group A (P = 0.035). We believe that, if these patients are managed well in 1 year; necessary precautions are provided; and patients are well-informed, then there wouldn't be too much risk and mortality rate for long-term side effects of ABVD and mediastinal RT.
Open Access
Comparison of Kinesio Taping, Trigger Point Injection, and Neural Therapy in the Treatment of Acute Myofascial Pain Syndrome: A Randomized Controlled Study
(Kare Publishing, 2023) Ay, Saime; Tur, Birkan Sonel; Karakaş, Merve; Gökmen, Derya; ALTINBİLEK, TURGAY; Evcik, Deniz
Objectives: Myofascial pain syndrome (MPS) is a regional painful soft-tissue disorder, characterized by trigger points (TrPs) and taut bands in the muscles. In this study, we aimed to compare the effectiveness of kinesio taping (KT), TrPs injection, and neural therapy (NT) on pain and disability in acute MPS.Methods: 104 patients with MPS in the cervical region were allocated into three groups. Group 1 (n=35) were treated with KT, Group 2 (n=35) received local anesthetic (LA) (lidocaine of 0.5%) TrPs injection, and Group 3 (n=34) received NT with the same LA solution. Patients were assessed by means of pain, pressure pain threshold (PPT), and disability. Pain severity was measured by Visual Analog Scale. The neck pain disability scale was used for assessing disability. PPT was measured by using an algometer. Measurements were taken before and after treatment of 3(rd) and 7(th) days.Results: There were improvements on pain and disability in all groups at the end of treatments at 3(rd) day and during follow-up period (p<0.001) and no differences were found between the groups. There was significant difference in PPT values in TrPs injection and NT groups in comparisons between all time periods, however, the change, depending on time in the KT group, was not statistically significant.Conclusion: The results of this study show that all these three treatment methods found to be effective on pain relief and disability in acute MPS. In terms of PPT, injection treatments seem to be superior than KT.
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Correlations Between Hypermobility, Muscle Strength and 3D Gait Parameters in Children With Increased Femoral Anteversion
(2019-09) EVRENDILEK, HALENUR; 268497
Introduction Increased femoral anteversion is a transverse plane problem that cause gait alterations in developing children and because of the moment arm changes produces muscle weakness around the hip (1). Especially, in addition with hypermobility, these children mostly have fatigue, additional muscle weakness and functional deterioration on lower extremity (2). Therefore, the aim of this study was to determine the relations between the hypermobility, muscle strength and gait parameters in children with IFA. Research Question Are there any correlation between the hypermobility, muscle strength and gait parameters in children with IFA? Methods 7 children with IFA (14 limbs, av.age: 9.14 ± 0.3, trochanteric prominens angle test (TPAT): 28 ± 6.2°) have participated in this study. As part of physical assessment; hypermobility, femoral anteversion angle, maximum isometric hip extensor and abductor, knee extensor and flexor muscles strengths were evaluated by Beighton test (3), TPAT (4) and hand-held dynamometer (HHD) (Lafayette Instruments,USA)(5) respectively. Furthermore, all participants' self-selected of walking were analyzed by 3D gait analysis (BTS Bioengineering). Kinematic gait parameters of pelvis, hip and knee were interested gait parameters. According to data distributions, Pearson's or Spearman's coefficient test were utilized for statistics (p<0.05) and interpreted by Cohen's classification (6). Results High-level correlation was found between Beighton scores and both hip extensor (r: -.70) and knee extensor (r: -.91) muscle strengths, and mean and minimum knee knee flexion angles. TPAT was highly correlated with only hip abductor HHD scores and mean hip rotation angle during walking (Table 1). Discussion In the literature, number of gait alterations were determined in children with IFA as increased mean hip internal rotation, pelvic obliquity range, peak knee extension at stance(7). The present study revealed that some of the kinematic alterations might be related to muscle strengths of the weak hip extensor and abductor, knee extensor and flexor muscles. Although, in agreement with the literature the mean hip internal rotation and hip abductors muscles strength were found significantly related to TPAT. In additionally, hypermobility, which is a commonly seen with the children with IFA, might have a role at the weakness of the hip and knee extensors and hyperextension at stance phase. In conclusion, it is important to strength hip extensor and abductor, knee extensor and flexor muscles to contribute to lower extremity function in children with IFA especially if the child is hypermobile.
Open Access
Detection and molecular examination of pathogens in honey and bees in the northern Marmara Region, Turkey
(Kafkas Universitesi Veteriner Fakultesi, 2020-03-02) Bayrakal, Gülay Merve; Akkaya, Hayrettin; Sezgin, Funda Hatice; Dümen, Emek; EKİCİ, GÖZDE
Honey, which has many positive health effects, is fondly consumed in our country and in the world. Although honey is considered to be a micro-organism-free food because of its antimicrobial and bacteriostatic effects, studies refute this idea. In addition to primary contamination, personnel, tools and equipment used in beekeeping and honey production is a potential source of secondary contamination. In addition, honey, which can carry many microorganisms as a result of cross-contamination, is among the important foods and can threat public health. Therefore, it is thought that screening of pathogens that may be present in honey would contribute to the studies. Due to the geographical location, the diversity of climate and vegetation, Turkey is located in the upper row of honey producting countries. In this study, 900 samples examined in Kırklareli province in Northern Marmara Region. Kırklareli region has been chosen as the research area since it is considered as an important province in honey production and is a border province located in the industrial zone. The aim of the study was to investigate the presence of parasitological, bacterial, fungal and viral parameters which are important for the quality of the consumer, bee, larvae, colony and honey. According to the obtained data, positive results were found in many parameters and statistically significant results were obtained.
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Determination of Biomechanical İnfluences of İncreased Femoral Anteversion (twisted leg) on Running for Developing İndividua
(2018-08) APTİ, ADNAN; ARAT, REFİK; 259584
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Determination of Playing Related Postural Problems in Guitar Students
(2019-06) AKEL, BURCU SEMİN; 114564
Objective: A significant percentage (%37) of musicians suffer musculoskeletal disorders that are sufficiently serious to affect performance. A common risk factor for musculoskeletal disorders is a poor posture.ln this study, we aimed to determine of playing-related postural problems in guitar students. Materials and Methods: Nineteen guitar bachelor students participated. Demographic data were recorded and static and dynamic posture analysis were performed via observation and video recordings; which were analyzed by a physiotherapist, an occupationaltherapist and a guitarist. Awkward postures were recorded. Posture was evaluated both globally and for individual body regions. Overall posture was divided into 3 categories: rigid, slumped, physiological. Pain was assessed with The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians. Results: Most of the individuals (55%) experienced pain or problems that might hinder their playing skills in the last year.The most common locations of pain or problems were: shoulder, wrist, scapula and neck.The overall static posture was poor in 38% of participants when standing(33%rigid, 5% slumped). During playing, the posture was more often slumped than rigid(66%). The location of the gravity axis in the sagittal plane were forward-shifted(%55), however the physiological posture was maintained at the frontal plane.The most common problems encountered were shoulder imbalance (%61), rotation of the head(%77), rotation of body(%72), right wrist excessive ulnar deviation(%33) and thumb positioning(%72). Conclusions: According to the posture analysis, rotation and slumpy positioning was the main problem. This situation puts greater problems on the muscles of the back and abdomen and may effect proper breathing. The regions that have poor posture was neck, shou Ider, wrist and thumb. Considering this, we believe that educating music students in proper playing posture and postural awareness can be beneficial in decreasing performance-related postural problems.
Open Access
Determination of the Connection Between the Asthma Patients and Mycobiota in the Environment They Live in
(Selçuk Üniversitesi Mantarcılık Uygulama ve Araştırma Merkezi Müdürlüğü, 2023) KORKMAZ, ARAS FAHRETTİN; Çolakoğlu, Günay Tülay; Karaltı, İskender
In the 12-month period between February 2014 and January 2015, this study was carried out in the homes of 55 asthma patients living in 14 different regions of Istanbul (Ataşehir, Bulgurlu, Fikirtepe, Hasanpaşa, İçerenköy, Moda, Göztepe, Çekmeköy, Ümraniye, Altayçeşme Neighborhood, Esenkent Neighborhood, Feyzullah Neighborhood, Gülsuyu Neighborhood, Yalı Neighborhood). Air ideal (Biomerieux, France) air vacuuming device was used to determine the fungal flora in the domestic ambient air of the relevant patients. In this context, in order to prevent bacterial growth, Streptomycin antibiotic was added and Rose Bengali potato dextrose agar was placed in the slot of the device and the air filter of the device was installed. The device, which was placed at a height of 75-85 cm from the ground, was operated for 3-5 minutes and 200 liters of domestic ambient air was vacuumed. A total of 1071 microfungi colonies isolated in the study were found to belong to a total of 10 genuses and 23 species. The obtained genera are Alternaria (Arıküfü), Aspergillus (Asper), Aureobasidium (Karamaya), Chaetomium (Günoku), Cladosporium (Havaküfü), Fusarium (Solduran), Mucor (Ekmekküfü), Paecilomyces (Günküfü), Penicillium (Penisilyum) and Rhizopus (Karaküf). Among them, the most isolated genera were Aspergillus, Penicillium, Cladosporium, Alternaria and Fusarium. The most isolated species in this study were Aspergillus niger (Kara asper), Fusarium poae (Buğday solduran), Alternaria alternata (Astımküfü), Cladosporium cladosporioides (Karakökküfü), Penicillium brevicompactum (Sağlam penisilyum), Cladosporium macrocarpum (İrikurutan), Cladosporium sphaerospermum (Güllekurutan) and Penicillium glabrum (Bol penisilyum). In the 12-month period, the lowest microfungi concentration was observed in January and the highest microfungi concentration was observed in May. During the study, the temperature of the sample areas were measured with a thermometer and the humidity rates were measured with a hygrometer. In this study, the types of allergen microfungus that cause the onset of asthma disease or the progression of the degree of disease are stated. These were determined as Alternaria alternariae (Fıstık küfü), Alternaria alternata, Aspergillus fumigatus (Kıran asper), Aspergillus niger, Aureobasidium pullulans (Karamaya), Chaetomium globosum (Top günoku), Cladosporium cladosporioides, Cladosporium herbarum (Yaygınkurutan), Cladosporium sphaerospermum, Penicillium chrysogenum (Penisilyum), Penicillium glabrum.
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Development of Fistula in a Patient With Crohn's Disease: a case report
(2019-06) GÜL, ASİYE; 112620
INTRODUCTION: A fistula is an abnormal connection between two epithelized surfaces. 15- 25% of the fistulas develop spontaneously and 75-85% develop after surgery. Spontaneous fistulas develop after radiotherapy, diverticulitis, appendicitis, peptic ulcer perforation, pancreatitis, intestinal tuberculosis, inflammatory bowel disease. Malnutrition, sepsis, shock, circulatory failure, corticosteroid treatment, difficulties in surgical anastomosis cause fistula formation. Fistula develops 20% -40% with Crohn's disease. 75% of intestinal fistulas open to the skin. It has psychological, physiological, sociological and economic effects in patients with fistula. Objective: In this study, it was emphasized the importance of nursing care of a patient with Crohn's disease, difficult management, and long-standing fistula. Case: Mr. ET who has Crohn's disease, is 27 years old, married, graduated from primary school, lived in the village outside of Istanbul. The patient admitted to the emergency department with severe abdominal pain at the time of his visit to his brother. The emergency operation performed due to Ileus and common small intestinal dilatation. Segmenter small intestine resection and ileostomy performed and the patient followed up in the intensive care unit. Because of intraabdominal abscess, a vacuum system is applied. Afterward, two fistulas developed in the abdominal region. The total parenteral and enteral food is used for weight loss. Antibiotic therapy initiated for infection. Three months later, the fistula healed and the patient discharged on his own request. Conclusion: Complicated nursing care and multidisciplinary care must be provide for the problems that may occur in the patient who is hospitalize for a long time after the fistula.
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Distinguishing the Influences of Increased Femoral Anteversion From Hypermobility During Walking For Neurologically Intact Individuals
(2018-09) Akalan, Ekin; Karaca, Gülşah; Kuchimov, Shavkat Nadir; Bilgili, Fuat; Temelli, Yener; Leblebici, Gökçe; Ertürk, Gamze; Evrendirek, Halenur; ÖNERGE, KÜBRA; APTİ, ADNAN; 176320; 268498; 259584; 237820; 190878; 229941; 283338; 268636; 268497
Increased femoral anteversion (IFA) is a transverse plane problem that may lead to alterations on lower body kinematics during walking (1,2). IFA and hypermobility syndrome are commonly seen together in healthy individuals (3). Therefore, describing the pure effects of IFA related gait parameters is very difficult for children with hypermobility and IFA together.
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Does clinically measured ankle plantar flexor muscle strength or weakness correlate with walking performance in healthy individuals?
(2018) Akalan, N.Ekin; Kuchimov, Shavkat Nadir; Temelli, Yener; Ören, Merve; Nene, Anand; APTİ, ADNAN
OBJECTIVE: Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants. METHODS: The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec. x 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p < 0.05). RESULTS: Reduced PFMS (%23, p < 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r > 0.3, p < 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r = 0.68, p < 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r = 0.44, p = 0.70) and strongly correlated with the non-normalized Pre-S condition (r = 0.62, p < 0.01). DISCUSSION: HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.
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Does hip flexor muscle weakness cause stiff-knee gait in long-term after medial open reduction surgery for children with developmental dislocation?
(2019-09) EVRENDILEK, HALENUR; 268497
Introduction Medial open reduction surgery (MOR) is performed as a treatment for children with developmental dislocation of the hip (DDH) by sectioning iliopsoas tendons [1]. A 10 years follow-up study of MOR was determined that hip flexor strength decreased in children with DDH [2] . Furthermore, the weakness of iliopsoas muscle was any one of the reasons of stiff knee gait pattern (SKG) [3], Therefore, the aim of the study was to determine whether the sagittal plane knee kinematics alters in long-term after bilateral MOR for children with DDH. Research Question What are the long-term biomechanical effects of bilateral MOR on sagittal plane knee kinematics in children with dislocation of the hip? Methods Five children (DDH group, 10 limbs, Av. age: 11.2 ± 2.8 y.o.) who had medial open reduction surgery bilaterally (10.4 years ago, Av. age: 9.6 ± 6 months o.) and six children without any orthopedic disorder (Control group, 12 limbs, Av. age: 10.8 ± 2.4 y.o) have participated in this study. All participants' selfselected speed of gait were analyzed by 3D gait analysis (BTS Bioengineering). The spatiotemporal parameters, sagittal plane hip and knee parameters and four defined SKG parameters (Pl: peak knee flexion angle, P2: range of knee flexion from toe-off to peak flexion, P3: total range of knee motion, P4: timing of peak knee flexion in swing, >3 significantly changed SKG parameters described as stiff knee ) [4] were examined. Independent t-test and Mann Whitney U test were used for comparison (p < 0.05) Results Between two groups, age, mean velocity were not significantly different (p>0.05). In DDH group, sagittal plane hip and knee range, P l, P2, P3,P4, maximum hip and knee flexion velocity were lower significantly than control group (Table 1). Discussion Normally, in late-stance, the iliopsoas is elongated depending on hip extension, then contracts at the beginning of the swing to initiate hip flexion. [5], Weakness of iliopsoas muscle, as a long-term effect of MOR surgery, reduces hip and knee flexion velocity at pre-swing and swing phases. This study showed that DDH altered all four SKG parameters significantly [4] relative to controls. This study also confirmed that hip flexion weakness may cause SKG pattern even neurologically intact individuals (3). Because of the SKG pattern increases not only the risk of reduced toe clearance and tripping but also energy expenditure [4], adding hip flexor strengthening exercises into rehabilitation programs might have a critical role for SKG treatment.
Metadata only
Does One Leg Standing Duration Have Relation With GMFM Scores and Stability in Stance Phase for Hemiplegic Children ?
(2018-09) N. Ekin Akalan; Halenur, Evrendilek; Karaca, Gülşah; Bilgili, Fuat; Ertürk, Gamze; 268636; 176320; 268497; 268498; 237820
This paper reports the results of a study to validate a measure of gross motor function in detecting change in the motor function of disabled children. Physiotherapists used this instrument to assess 111 patients with cerebral palsy, 25 with head injury and 34 non-disabled preschool children on two occasions, the second after an interval of four to six months. Parents and therapists independently rated the children's function within two weeks of each assessment, and a sample of paired assessments was videotaped for 'blind' evaluation by therapists. Correlations between scores for change on this measure and the judgments of change by parents, therapists and 'blind' evaluators supported the hypothesis that the instrument would be responsive to both negative and positive changes.
Open Access
The Effect of Interferential Currents and Tens on Pain and Functionality in Patients With Chronic Mechanical Low Back Pain
(Galenos Publishing House, 2024) Çolak, Tuğba Kuru; Sert, Nihat; Sert, Buse; APTİ, ADNAN
Objective: This study aimed to compare the effects of interferential current (IFC) and transcutaneous electrical nerve stimulation (TENS) on pain, disability, and flexibility for treating patients with chronic low back pain (CLBP). Materials and Methods: This study included 50 volunteer patients diagnosed with CLBP randomly assigned to IFC and TENS treatment. In addition to electrical stimulation, therapeutic ultrasound, hot packs, and exercise were administered to both groups. All patients underwent 20 sessions of treatment for 4 weeks and 5 days on weekdays. The Numerical Pain Scale, Oswestry Scale (ODI), and sit-and-reach test were used for evaluation. Patients were evaluated 3 times: before treatment, at the 10th session, and after treatment. The paired t-test was used for statistical analysis. Results: Significant improvement was seen in both treatment groups’ pain levels when the levels of pain before and after treatment were compared. Before and after treatment, both groups in the sit-and-reach test and Oswestry evaluation showed a significant improvement (p>0.05). The change in pain and disability scores did not show superiority in the TENS and IFC groups (p>0.05). Only in the sit-and-reach test did the IFC group show significantly more improvement after the 20th session treatment (p=0.026). Conclusion: IFC and TENS should be used in patients with CLBP to control pain and improve function. However, studies with electrical currents determined by different biophysical parameters are needed to determine the superiority of TENS and IFC in terms of treatment outcome measures. ©Copyright 2024 The Author. Published by Galenos Publishing House on behalf of Turkish Spine Society.

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