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Vejetasyon araştırma yöntemlerinden Braun-Blanquet metoduna dayalı üç boyutlu ordinasyon tekniğinin ve hazırlanan bilgisayar programının açıklanmasıdır

Bu çalışmada Akdeniz havzası çevresindeki sklerofil matoral toplulukların vejetasyon karakterleri ve floristik yapıları incelenmiştir. Bu bitki formasyonların ekolojik, biyoklimatik ve sindinamik özelliklerinin belirlenmesinde fitososyolojik çalışmalardan elde edilen veriler kullanılmıştır

Bu çalışmada, Türkmenistan’ın Sandıklı Çölü’nün biyocoğrafik durumu, floristik zenginliğiyle vejetasyon yapısı ve iklimi incelenmiştir

Bu çalışmada, araştırmacılar trafik akışının yoğn olduğu Ankara’da yetişen cadde ağacı Sophora japonica L.’nın dal ve kabuklarında biriken kurşun ve nikel miktarının aylık değişimini ortaya koymuşlardır. Trafik ışıkları ve kavşaklara yakın olan ağaçlarda ağır metal birikiminin daha yoğun olduğu tesbit edilmiştir. Yağmurlu mevsimlerde beklenmedik bir şekilde dallardaki ve kabuktaki kurşun ve nikel birikiminin arttığı görülmüştür. Kurşun ve nikel birikimi ağacın yaşına bağlı olarak kabukta dallara göre daha yavaş olmaktadır

et Bu proje ile bitkisel kaynaklı biyolojik zenginliklerimizin birikimlerini içeren ANK (Ankara Üniversitesi Fen Fakültesi, Biyoloji Bölümü) herbaryumundaki bitki önekleri (Polygonaceae familyası) tek tek elden geçirihniş ve listelenmiştir. ANK’ ta bulunan Polygonaceae familyasma ait 448 bitki örneğinin incelenmesi sonucu 5 cins ve bu cinslere ait toplam 58 takson tespit edilmiştir. Toplam tür sayısı 48’ dir. 5 tür Türkiye için endemik olup endemizm oranı % 10,4’ tür. En çok tür içeren ilk üç cins sırasıyla şöyledir: En zengin cins Polygonum’dur. Cinslerin tür sayıları: Polygonum L. 24, Rumex L. 19, Atraphaxis L. 2’dir. Türlerin fîtocoğrafık bölgeler dağılımları ve oranları ise; Bilinmeyenler 33 (% 68,7), İran-Turan elementi 10 (% 20,8), Avrupa-Sibirya elementi 3 (% 6,2), Akdeniz elementi 2 (% 4,1) şeklindedir

Objective: Romatoid arthritis is chronic enflamatuar autoimmune disease that is more common among the women and may allows persistant disability. Morbidity was reduced with recently treatment strategies. Several clinical, radiological and laboratory parameters may predict the prognosis of the disease. These parameters reflect treatment applied. Materials and Methods: In our study the projection success of prognosis of demographic, clinical and laboratory characteristics of our RA outpatients were evaulated retrospectively in period for 5 years and were discussed with literature. Results: In all parameters other than fatigue time there were meanly alterations compared to beginning. The numbers of deformity, bilaterally hand scopes, globally evaluations of doctor and patient were increased; swollen and tender joint numbers, functional capacity, ESR,CRP, hand index of Duruöz and HAQ questionnaire scores were decreased over time. Conclusion: Used clinically and laboratory parameters in RA may help to clinicians following to activity of disease and estimating of prognosis. We concluded that effective treatment methods may reatard the RA progression, but cannot completely prevent to loss of function., Amaç: Romatoid artrit (RA) kadınlarda daha fazla görülen, kalıcı sakatlığa yol açabilen, kronik inflamatuvar otoimmün bir hastalıktır. Yeni tedavi seçenekleri ile günümüzde morbidite oranı oldukça azalmıştır. Çeşitli klinik, radyolojik ve laboratuvar parametreler kullanılarak hastalığın seyri hakkında fikir edinilebilir. Bu parametreler, uygulanacak medikal tedavilere yön vermektedir. Gereç ve Yöntem: Çalışmamızda polikliniğimizde takip edilen RA hastalarının demografik, klinik, laboratuvar özelliklerinin hastalık progresyonunu tahmin etmedeki başarısı 5 yıllık süreçte retrospektif olarak değerlendirilmiş ve literatür eşliğinde tartışılmıştır. Bulgular: Başlangıca göre yorgunluk süresi dışında tüm parametrelerde anlamlı değişiklikler mevcuttu. Deformite sayısı, bilateral el kavrama gücü, hastanın ve hekimin global değerlendirmesi parametrelerinde zaman içerisinde artış saptanırken, şiş ve duyarlı eklem sayısı, fonksiyonel kapasite, ESR, CRP, Duruöz el indeksi ve HAQ anketi sonuçlarında azalma saptandı. Sonuç: RA da kullanılan klinik ve laboratuvar parametreler, hastalığın aktivitesini takipte ve prognozunu tahmin etmede klinisyenlere yardımcı olmaktadır. Çalışmamızda etkili tedavi yöntemleriyle, RA progresyonunun yavaşlatılabileceği ancak hastalığa bağlı işlev kayıplarının tamamen ortadan kaldırılamayacağı sonucuna ulaşılmıştır.

Bu araştırmanın amacı; Lamiaceae familyasına ait Salvia cinsinin Salvia albimaculata türünün farklı materyaller kullanılarak uçucu yağ bileşenlerinin ve oranlarını belirlenmesidir. Türkiye Lamiaceae familyasının önemli gen merkezlerinden biri olup, bu familya’ya ait 45 cins, 546 tür ve 731 takson bulunmaktadır. Salvia albimaculata Ülkemizde sadece Karaman-Ermenek civarında yayılış göstermektedir. Bu çok yıllık çalımsı bitki haziran ayında çiçeklenmektedir. Bu çalışma çerçevesinde Salvia albimaculata bitki türüne ait farklı organlar (yaprak, gövde) kullanılarak küçük parçalar alınmış, Clavenger cihazı, GC-MS cihazı ve Headspace cihazı kullanılarak analiz yapılmıştır. Analiz sonuçlarında kültür ortamından elde edilen herbada uçucu yağın GC-MS sonucunda %98,45’ini oluşturan 19 bileşen, Headspace sonucunda ise %96,39’unu oluşturan 17 bileşen tespit edilmiştir. Bu türün uçucu yağ oranı %0.76 olduğu belirtilmiştir., This study aimed to determine essential oil contents and components of Salvia albimaculata HEDGE ET HUB.-MOR. which is endemic species from Lamiaceae family in Turkey. Turkey is regarded as an important gene-centre for the Lamiaceae. This family includes about 200 genera and 3000 species. This family is either annual or perennial herbaceous, mostly aromatic, rarely shrubs or bush. The family is represented in Turkey by 45 genera, 546 species and total of 731 taxa. The rate of endemism in the family is 44.2 %. there are 360 endemic taxa in this family in Turkey. Salvia albimaculata is found Karaman-Ermenek area of Turkey. These perennial plants grow like bush and flower during June. This study reports chemical composition of leaves and stems of Salvia albimaculata using Clavenger type apparatus, Headspace GC-MS instrument and analysis. Analyzing results obtained from the herba, it contained 98.45% essential oil that contained 19 components. The headspace analysis detected 96.39% essential oil and 17 compounds. This species is the essential oil of the reported to be 0.76 %.

Biyolojik çeşitliliği koruma çalışmaları insanların barınma ve beslenme ihtiyaçlarına ve ekonomik gelişmelere genellikle zıt düşmektedir. Ancak var olan kaynaklardan verimli ve sürdürülebilir bir şekilde yararlanmayı sağlamak için her ülke kendi koşullarına göre, biyolojik çeşitliliğinin belirlenmesine yönelik çalışmalarını tamamlamalıdır. Bu amaçla AB ülkeleri kolay ve anlaşılır bir sınıflandırma sistemi olan Avrupa Doğa Bilgi Sistemi (EUNIS)’ni geliştirmişlerdir. Özellikle bitki örtüsünün hâkim olduğu karasal habitatların sınıflandırmasında, bitki sosyolojisi çalışmalarından faydalanılmıştır. Bu çalışma Türkiye’nin Öksin Alanındaki (Trakya hariç, güney Marmara, batı ve orta Karadeniz bölgesi) Doğu kayını ormanlarında yapılan fitososyolojik çalışmalardan yararlanılarak gerçekleştirilen örnek bir çalışmadır. Çalışma sonucunda Türkiye’nin Batı Öksin Alanındaki kayın ormanları EUNIS’e göre kodlanarak sınıflandırılmış ve Doğu Kayını’nın saf veya karışık ormanlarında 10 yeni habitat tipi önerilmiştir. Studies about conservation of biological diversity are often collided with nutritional and sheltering needs of people and economic developments. However, all countries must complete studies to determine their biological diversity according to their own conditions to ensure efficient and sustainable use of existent resources. For that purpose, EU countries have been developed an easy and understandable classification system which is called the European Nature Information System (EUNIS). On the classification of terrestrial habitats that are dominated by vegetation, plant sociological studies were used. In this case study, Oriental beech forests in Euxine province of Turkey (excluding Thrace, South of Marmara, Western and Central Black Sea region) have been coded according to EUNIS and also 10 new habitat types in the pure and mixed Oriental beech forests have been proposed by means of previous phytosociological studies.

Literatürde farklı molekül ağırlığına sahip hyaluronan preparatlarının birbiriyle, plaseboyla veya fizik tedavi modaliteleriyle değerlendirildikleri az sayıda çalışma vardır. Ancak farklı iki molekül ağırlığına sahip hyaluronan preparatı ile bir kortikosteroid preparatının etkinlikleri ve yan etkilerini değerlendiren bir çalışma yoktur. Biz bu çalışma ile diz osteoartritinde iki farklı molekül ağırlıklı hyaluronan preparatı ve metil prednisolon asetat preparatının etki ve yan etkilerini klinik olarak karşılaştırmayı amaçladık.Çalışmaya UÜ-SK Atatürk Rehabilitasyon Uygulama ve Araştırma Merkezi Kükürtlü Kaplıcaları polikliniğine başvurarak American College of Rheumatology (ACR) kriterlerine göre diz OA'i tanısı alan 69 hasta katıldı. Hastalar rastgele yöntemle üç gruba randomize edildiler. Grup I(n= 22) metilprednizolon Asetat (40 mg/ml), Grup II(n=24) hyaluronan preparatı( MA 500-730 kDA, Grup III(n=23) hyaluronan preparatı( MA 1 milyon kDa'dan büyük). Her üç grubada birer hafta ara ile üç kez intraartiküler enjeksiyon uygulandı. Çalışma prospektif ve tek kör olarak yürütüldü. Hastalar başlangıçta ve 6. ayda radyolojik evre, fonksiyonel evre, doktor ve hasta tatmini parametreleri ile, tedavi öncesi, tedavi sonrası, 2. ay ve 6. ayda günlük asetaminofen kullanımı, doktorun ve hastanın global osteoartrit değerlendirmesi, SF-36, Lequesne algofonksiyonel indeks ve Womac osteoartrit indeksi ile, ağrı ise her enjeksiyondan sonra, 2. ve 6. aylarda değerlendirildi. Enjeksiyonlardan sonra effüzyon varlığı, lokal ve sistemik yan etkiler kaydedildiTedavi öncesinde gruplar arasında fonksiyonel evre dışında farklılık yoktu. Grup içi karşılaştırmalarda radyolojik evre ve fonksyonel evre dışında SF36'nın bazı alt bölümlerinde ve diğer parametrelerde 6. aya kadar uzayan anlamlı düzelmeler saptandı. Gruplar arası karşılaştırmalarda ise hastanın ve doktorun tedavi öncesine göre 2. aydaki global osteoartrit değerlendirmesinde (p 1 million kDa). All three groups had three intraarticular injections at one-week intervals. The study was conducted with a prospective and single-blinded fashion. Patients were assessed at baseline and 6 months later for radiological stage, functional stage, patient and physician satisfaction parameters as well as before the treatment and at month 2 and 6 after treatment for daily acetaminophen intake, physician?s and patient?s global assessment, SF-36, Lequesne?s algofunctional index and Womac osteoarthritis index and pain was assessed following each injection at months 2 and 6. Any presence of effusion, local and systemic adverse events were recorded.There were no differences among groups at baseline except for the functional stage. Intra-group comparisons demonstrated significant improvements in 6th in some of the subsections of SF-36, excluding the radiological stage and functional stage, as well as in other parameters. In inter-group comparisons, significant differences were noted in patient?s and physician?s ratings of global osteoarthritis at 2nd month relative to pre-treatment (p

Fleksör tendon yaralanmalarının onarım sonrası rehabilitasyonunda ultrason (US) uygulamasının etkinliğini araştırmak amacıyla kontrollü klinik çalışma yapıldı.20 hastaya ait 35 fleksör tendon onarım sonrası üçüncü haftada rastgele iki gruba ayrıldı.Postoperatif üçüncü haftanın sonunda birinci gruba (10 hastada 18 parmak) 'ultrason ve egzersiz', ikinci gruba 'sadece egzersiz uygulaması başlandı ve üç hafta sürdürüldü.Hastalar total aktif hareket (TAH) ve parmakucu- distal palmar çizgi mesafesi (PU-DPÇ) parametreleri ile değerlendirildi. Sonuçlar ki-kare ve t-testi ile analiz edildi.Her iki grupta tedavi sonrasında tedavi öncesine göre istatistiksel olarak anlamlı düzelmeler saptandı.İki grubun tedavi sonrası ölçümleri birbiriyle kıyaslandığında ise TAH ve PU-DPÇ uzaklığında birinci grupta diğer gruptan istatistiksel olarak anlamlı bir şekilde daha fazla düzelme saptandı.Ultrasonun yara iyileşmesinin, dolayısıyla tendon iyileşmesinin çeşitli fazlarınında yararlı etkileri olduğu deneysel çalışmalarda kanıtlanmış olmasına rağmen çalışmamız bildiğimiz kadarıyla bu konudaki ilk kontrollü klinik çalışmadır.Çalışmamızın sonuçları ışığında, ultrasonun fleksör tendon yaralanmalarının onarım sonrası rehabilitasyonunda tedaviye yardımcı bir yöntem olarak kullanılabileceğini ileri sürebiliriz.

Objective: The purpose of this study was to investigate the effects and minimum effective dose of laser acupuncture in knee osteoarthritis (KOA), and to determine if it is superior to placebo treatment (sham) in the evaluation of clinical-functional outcome and quality of life. Methods: In this randomized, placebo-controlled study, patients with grade 2 and 3 primary KOA were selected. Group I (n = 27) received 904-nm low-level laser irradiation with 10 mW/cm(2) power density, 4 mW output power, 0.4 cm(2) spot size, 0.48 J dose per session, and 120-sec treatment time on the medial side of the knee to the acupuncture point Sp9. Group II (n = 25) received placebo-laser therapy at the same place on the same point. Patients in both of the groups had treatment 5 days per week (total duration of therapy was 10 days) and 20 min per day. The study was comprised of a 2-week (10-session) intervention. Participants were evaluated before treatment (baseline), after treatment (2nd week), and at the 12th week. In this double-blind study, a blind examiner carried out all outcome assessments. The main outcome measures were as follows: pain on movement (pVAS), 50-foot walking time (50 foot w), knee circumference (KC), medial tenderness score (MTS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and Nottingham Health Profile (NHP). Results: Statistically significant improvement was observed in PVAS, 50 foot w, and KC in group I. In Group H, statistically significant improvement was observed in PVAS, 50 foot w, and WOMAC. When groups were compared with each other, the improvement observed in KC was superior in Group I at the 2nd week (p = 0.005). Conclusion: Laser acupuncture was found to be effective only in reducing periarticular swelling when compared with placebo laser.

Objective: The objective of this study is to investigate the effect of low-power gallium-arsenide laser treatment on the patients with shoulder pain. Backround Data: Low-energy laser therapy has recently been popularized in the treatment of various rheumatologic, neurologic, and musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, fibromyalgia, carpal tunnel syndrome, rotator cuff tendinitis, and chronic back pain syndromes. Methods: A total of 40 patients who applied to our clinic with shoulder pain and complied with the selection criteria were included in the study. The patients were randomly assigned into Group I (n = 20, laser treatment) and Group II (n = 20, control). In Group I, patients were given laser treatment and an exercise protocol for 10 sessions during a period of 2 weeks. Laser was applied over tuberculum majus and minus, bicipital groove, and anterior and posterior faces of the capsule, regardless of the existence of sensitivity, for 1 min at each location at each session with a frequency of 2000 Hz using a GaAs diode laser instrument (Roland Serie Elettronica Pagani, wavelength 904 nm, frequency range of 5-7000 Hz, and maximum peak power of 27 W, 50 W, or 27 X 4 W). In Group II, placebo laser and the same exercise protocol was given for the same period. Patients were evaluated according to the parameters of pain, palpation sensitivity, algometric sensitivity, and shoulder joint range of motion before and after treatment. Results: Analysis of measurement results within each group showed a significant posttreatment improvement for some active and passive movements in both groups, and also for algometric sensitivity in Group I (p < 0.05-0.01). Posttreatment palpation sensitivity values showed improvement in 17 patients (85%) for Group I and six patients (30%) for Group II. Comparison between two groups showed superior results (p < 0.01 and p < 0.001) in Group I for the parameters of passive extension and palpation sensitivity but no significant difference for other parameters. Conclusions: The results of our study have shown better results in palpation sensitivity and passive extension, but no significant improvement in pain, active range, and algometric sensitivity in laser treatment group compared to the control group in the patients with shoulder pain.

Diz osteoartritinde iki farklı molekül ağırlıklı hyaluronan preparatı ve metil prednisolon asetat preparatının etki ve yan etkilerini karşılaştırmak. Gereç ve Yöntem: Bu çalışmaya American College of Rheumatology kriterlerine göre diz osteoartriti tanısı konulan toplam 75 hasta katıldı. Hastalar rastgele yöntemle üç gruba randomize edildiler. Çalışmayı 69 hasta tamamladı. Grup I (n= 22) 6-metilprednizolon Asetat (6-MPA), Grup II (n=24) düşük molekül ağırlıklı hyaluronik asit (DMA HA), Grup III (n=23) yüksek molekül ağırlıklı hyaluronik asit (YMA HA) tedavisine alındı. Her üç gruba da birer hafta ara ile üç kez intraartiküler enjeksiyon uygulandı. Çalışma prospektif ve tek kör olarak yürütüldü. Hastalar radyolojik evre, fonksiyonel evre, doktor ve hasta tatmini, günlük asetaminofen kullanımı, doktorun ve hastanın global osteoartrit değerlendirmesi, ağrı, SF-36, Lequesne algofonksiyonel indeks ve Womac osteoartrit indeksi parametreleriyle değerlendirildi. Değerlendirmeler tedavi öncesi, tedavi sonrası, üçüncü ve altıncı ayda yapıldı. Enjeksiyonlardan sonra effüzyon varlığı, lokal ve sistemik yan etkiler kaydedildi. Bulgular: Tedavi öncesinde gruplar arasında fonksiyonel evre dışında farklılık yoktu. Grup içi karşılaştırmalarda radyolojik evre ve fonksiyonel evre dışında SF-36 ’nın bazı alt bölümlerinde ve diğer parametrelerde altıncı aya kadar uzayan anlamlı düzelmeler saptandı. Gruplar arası karşılaştırmalarda ise hastanın ve doktorun tedavi öncesine göre ikinci aydaki global osteoartrit değerlendirmesinde (p

Ankilozan spondilit ağırlıklı olarak omurgayı etkileyen ve ciddi fonksiyonel bozukluklara yol açabilen kronik inflamatuvar bir hastalıktır. Bu çalışmada ankilozan spondilitli hastalarda konvansiyonel egzersiz programının hastalık aktivitesi, fonksiyonel durum ve yaşam kalitesi üzerindeki etkinliğini değerlendirmek amaçlandı.Modifiye New York sınıflama kriterlerine göre ankilozan spondilit tanısı almış 50 hasta çalışmaya alındı. Hastalar 2 gruba randomize edildi ve çalışma tek kör olarak yürütüldü. Grup 1'deki hastalara bir fizyoterapist gözetiminde konvansiyonel egzersiz programı uygulatıldı. Grup 2'deki hastalara aynı egzersiz programı aynı fizyoterapist tarafından öğretilip broşür şeklinde dağıtıldı ve egzersizleri evde yapmaları istendi. Egzersiz programı 50 dakika olmak üzere günde 1 kez, haftada 5 gün, 3 hafta boyunca uygulandı. Gündüz ve gece ağrısı, ESR ve CRP düzeyleri, sabah tutukluğu, BASDAI, BASFI, BASMI, spinal mobilite ölçümleri ve Nottingham Sağlık Profili (NSP) parametreleri başlangıçta, tedavi bitiminde ve tedavi bitiminden 6 ve 12 hafta sonra değerlendirildi.Çalışmayı toplam 40 hasta (gözetim eşliğinde egzersiz grubu n=21, ev egzersiz grubu n=19) tamamladı. Tedavi bitiminde her 2 grupta birçok parametrede anlamlı iyileşmeler görüldü. 6. ve 12. hafta değerlendirmelerinde anlamlı iyileşme saptanan parametre sayısı giderek azaldı. Gruplar arası karşılaştırmada gözetim eşliğinde egzersiz grubu tedavi sonrası NSP uyku skoru ile 6. hafta servikal rotasyon (sol) değerleri bakımından ev egzersiz grubuna üstündü (p

Several cytokine genes may play crucial roles in host susceptibility to Behcet's Disease (BD), since the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the IL-1 cluster gene polymorphisms with the development of BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD, and 77 healthy control subjects. All genotyping (IL-1 alpha, IL-1 beta, IL-1R and IL-1Ra) experiments were performed using sequence specific primers PCR (PCR-SSP). When compared to the healthy controls, the frequencies of IL-1Ra IL-1 alpha and IL-1R gene polymorphisms were not significantly different in BD patients. The frequency of IL-1 beta -511 TT genotype was higher in the BD group in comparison to the control group. Interestingly, we demonstrated that IL-1 beta +3962 gene polymorphism seems to be associated with the presence of Erythema nodosum in BD patients. Our data suggest that polymorphisms in IL-1 beta gene may affect host susceptibility to BD. In order to confirm the biological significance of our results, further studies should be performed in a large-scale study and/or in different ethnic groups.

Several cytokine genes may play crucial roles in host susceptibility to Behcet's Disease (BD), because the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the IL-4 and IL-4R alpha gene polymorphisms with the susceptibility to BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD and 76 healthy control subjects. All genotyping (IL-4 and IL-4R alpha) experiments were performed using PCR sequence-specific primers. When compared with the healthy controls, the frequency of IL-4 -1098 TG and -590 CT genotypes was higher in the patients with BD. Analysis of allele frequencies showed that IL-4 -1098 G and IL-4 -590 T alleles were more common in the patients with BD when compared with healthy controls. Also, IL-4 TTC and haplotypes were found to confer BD. Interestingly, we demonstrated that IL-4R alpha gene polymorphism seems to be associated with the Pathergy test positivity in patients with BD. Our data suggest that IL-4 gene promoter polymorphisms may affect susceptibility to BD and increase risk of developing the disease. However, in order to confirm and assess the association of IL-4 and IL-4R alpha gene polymorphisms with the BD, large cohort studies are needed.

Bu randomize kontrollü çalışma, lateral epikondilit (LE) tedavisinde otolog kan enjeksiyonunun etkinliğini araştırmak amacıyla yapıldı.LE tanısı konan 70 hasta kontrol (Grup 1, n=35) ve enjeksiyon (Grup 2, n=35) gruplarına randomize edildi. Her iki gruba 4 hafta epikondil bandajı ve ev egzersiz programı, Grup 2'ye ek olarak lateral epikondil çevresindeki en duyarlı noktaya otolog kan enjeksiyonu (2 ml venöz kan 1 ml of %2 prilokain ile karıştırılarak) uygulandı.Tüm hastalar kör bir araştırıcı tarafından başlangıç, 4. hafta (primer sonlanım noktası), 3 ve 6. ayda basmakla duyarlılık, algometrik duyarlılık, ağrısız el kavrama gücü, Nottingam Sağlık Profili (NSP), Kol, Omuz, El Sorunları Anketi (Hızlı formu), Hasta Bazlı Lateral Epikondilit Değerlendirme Testi, Nirschl evrelemesi ve tedaviye yanıt skoru kullanılarak değerlendirildi. Dört hafta sonunda 1. gruptan bandaj ve ev egzersiz programına ?orta? ya da ?kötü? yanıt veren hastalara (n=21: Grup 3) devam eden tedaviye ek olarak otolog kan enjeksiyonu yapıldı. Bu hastalar enjeksiyon sonrası 1, 3 ve 6. ayda yeniden değerlendirildi.Grup 1 ve 2'de NSP'nin bazı alt grupları dışında tüm parametrelerde 4. haftada anlamlı düzelme görüldü (p

Objective: Patients who are the natural consumers of healthcare services play a critical part in the healthcare system because of their previous experiences in this field. Defining patient satisfaction is a very important factor to rate the health system and healthcare worker performance and to improve of quality. Up to date, many questionnaire models have been used for this purpose. This study was designed to create a questionnaire to rate the patient satisfaction level and to test the reliability and validity of the questionnaire. Material and Methods: A 7-item scale designed to measure the domains of patient satisfaction among patients was developed by the authors in preparation for this study and was field-tested on patients who were given physical therapy and/or balneotherapy for 2 weeks. The study was carried out between 2002 and 2003 for 12 months and after the therapy course was over. Descriptive statistics and estimates of reliability of measurements obtained with the instrument were computed. Reliability and validity were assessed. A total of 304 individuals completed the questionnaire. Results: Questionnaires were distributed to 250 female and 133 male (total 383) patients aged 16-83 years. 304 of 383 patients (%79.4) completed the 7 items of the scale, while 79 patients gave no answer. Reliability of the scale was identified by the Cronbach alpha coefficient. Analysis of the scale revealed that it was highly reliable (Cronbach alpha=0.9390) and structural type of validity was established as well. Conclusion: This scale was designed to rate the satisfaction of those patients who attended half day balneotherapy and/or physical therapy and the results proved that it was highly reliable and structurally valid.

Altan L, Korkmaz N, Bingol U, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study. Objective To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder. Design Randomized, prospective, controlled, and single-blind trial. Setting Physical medicine and rehabilitation department. Participants Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria. Intervention The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation. Main Outcome Measures Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile. Results Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24. Conclusions We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.

El osteoartriti (OA), toplumda ileri yaşta sık görülen, hayat kalitesini etkileyebilen dejeneratif bir hastalıktır. Bu çalışma, el osteoartritli hastalarda düşük enerjili lazer uygulamasının etkinliğini randomize, prospektif, kontrollü ve çift-kör olarak araştırmak amacıyla planlandı.Çalışma Uludağ Üniversitesi Atatürk Rehabilitasyon Uygulama Araştırma Merkezinde Ocak 2009-Mayıs 2009 tarihleri arasında gerçekleştirildi. Amerikan Romatoloji Cemiyeti el OA tanı kriterlerini karşılayan 70 hasta çalışmaya alındı. Hastalar iki gruba ayrıldı (lazer n=35, plasebo lazer n=35). Tedavi seansları haftada 5 gün olmak üzere ardışık 2 hafta boyunca uygulandı. Tüm hastalara 14 hafta süresince günde 3 kez aynı el egzersiz programı uygulandı. Vizüel Analog Skala (VAS) ile ölçülen istirahatte ağrı, hareketle ağrı, tutukluk, el ve parmak kavrama güçleri, Short Form-36 (SF-36), Duruöz el indeksi, Australian/Canadian Hand Osteoarthritis Index (AUSCAN) değerlendirmeleri başlangıçta, 2., 6. ve 14.haftalarda yapıldı.Toplam 63 hasta (lazer n=31, plasebo lazer n= 32) çalışmayı tamamladı. Gruplar arasında hastaların yaş, yakınma süresi, tedavi uygulanan eklem sayısı ortalamaları, dominant el ve etkilenen el tarafı bakımından anlamlı fark yoktu. İzlem döneminde her iki grupta da başlangıca göre bazı parametrelerde anlamlı düzelmeler görüldü. Gruplar arası karşılaştırmalarda lazer grubu 2., 6. ve 14.haftalarda istirahatte ağrı, hareketle ağrı, Duruöz, AUSCAN, SF-36 alt maddeleri ile 2.haftada tutukluk, 6. ve 14.haftalarda el ve parmak kavrama güçleri bakımından plaseboya üstündü. Sonuç olarak, lazer grubu tüm parametrelerde plaseboya üstündü. Gruplarda aynı egzersiz protokolü uygulandığı için bu farkın doğrudan lazer tedavisiyle sağlandığını söyleyebilmek güçtür. Bu anlamda lazer tedavisinin doğrudan plaseboyla karşılaştırıldığı çalışmalara ihtiyaç duyulmaktadır. Çalışmada uygulanan yönteme ilişkin herhangi bir yan etki gözlemlenmedi. Hand osteoarthritis (OA) is a common degenerative disease in the elder population and may affect the quality of life. This study was planned to investigate the efficiency of low level laser therapy in the treatment of patients with hand osteoarthritis as randomized, prospective, controlled and double-blind. The study was conducted at Uludağ University Atatürk Rehabilitation and Research Center between January 2009 and May 2009. 70 patients who met the hand osteoarthritis diagnosis criteria of American College of Rheumatology (ACR) were included in the study. The patients were separated into two groups (laser n=35, placebo laser n=35). Therapy sessions were organized as 5 days a week for 2 sequential weeks. All patients were given the same hand exercises 3 times a day for 14 weeks. Pain at rest, pain with motion, stiffness measured with Visual Analogue Scale (VAS), hand grip and pinch strength, Short Form-36 (SF-36), Duruöz hand index, Australian/Canadian Hand Osteoarthritis Index (AUSCAN) were evaluated at the beginning, in 2nd, 6th and 14th weeks. 63 patients (laser n=31, placebo laser n=32) completed the study. There were no significant differences in patients? average age, duration of complaints, number of joints treated, dominant hand and affected hand side. Durig the follow-up some parameters significantly improved in both groups when compared with pretreatment values. In intergroup comparisons pain at rest, pain with motion, Duruöz, AUSCAN, SF-36 subitems in 2nd, 6th, 14th weeks and stiffness in the 2nd week, hand grip and pinch strength in 6th and 14th weeks were superior in laser group than placebo. In conclusion, laser group was superior than placebo in all parameters. The same exercise protocol was given to the groups therefore it is difficult to link this effect directly to laser treatment. As a result, further studies comparing laser treatment directly with placebo are needed. No side effect related with the application was seen in our study. 95

To investigate if spa water is superior to tap water (TW) in relieving the symptoms of pain, joint motion, life quality in knee osteoarthritis (KOA) patients. In this randomized placebo-controlled trial, 52 patients with KOA were followed in two groups. In group I (n = 27), patients were treated in the pool full of spa water at 37 degrees C for 20 min a day, 5 days a week, for a period of 2 weeks. In group II (n = 25), the same protocol was used but spa water was replaced by TW heated to 37 degrees C. Patients in both groups were given a home-based standardized exercise program. Evaluation parameters were pain (pVAS), tenderness score (TS), 50-ft walking duration, quadriceps muscle strength (QMS), active flexion degree (AFD), WOMAC OA index, and Nottingham Health Profile (NHP). The first evaluation was done after the informed consent was obtained. Second and third evaluations were done at the 2nd and 12th week. PVAS, 50-ft walking duration, AFD, TS, WOMAC, and NHP variables improved in group I. Same variables except QMS improved also in group II. Comparison of the groups just after treatment showed that only pVAS (P = 0.015), NHP pain score (P = 0.020), and TS (P = 0.002) differed significantly in favor of group I at the 2nd or 12th week. Both of the thermal treatment modalities were found to be effective in the management of the clinical symptoms and quality of life in KOA patients. However, pain and tenderness improved statistically better with balneotherapy. There were no significant differences between the groups for the other variables.

Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with varying rates of success. The objective of our study was to investigate the effect of laser therapy on cervical myofascial pain syndrome with a placebo-controlled double-blind prospective study model. It was performed with a total of 53 patients (35 females and 18 males) with cervical myofascial pain syndrome. In group 1 (n = 23), GaAs laser treatment was applied over three trigger points bilaterally and also one point in the taut bands in trapezius muscle bilaterally with a frequency of 1000 Hz for 2 min over each point once a day for 10 days during a period of 2 weeks. In group 2 (n = 25), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups were instructed to perform daily isometric exercises and stretching just short of pain for 2 weeks at home. Evaluations were performed just before treatment (week 0), immediately after (week 2), and 12 weeks later (week 14). Evaluation parameters included pain, algometric measurements, and cervical lateral flexion. Statistical analysis was done on data collected from three evaluation stages. The results were evaluated in 48 patients (32 females, 16 males). Week 2 and week 14 results showed significant improvement in all parameters for both groups. However, comparison of the percentage changes both immediately and 12 weeks after treatment did not show a significant difference relative to pretreatment values. In conclusion, the results of our study have not shown the superiority of GaAs laser therapy over placebo in the treatment of cervical myofascial pain syndrome, but we suggest that further studies on this topic be done using different laser types and dosages in larger patient populations.

Objective: To investigate the effect of laser photostimulation in rehabilitation of human digital flexor tendons with a placebo-controlled double-blind prospective study model. Background Data: Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with a varying rate of success and it has also been shown to have a positive effect on tendon healing in animal experiments, but no clinical study on laser photostimulation in the treatment of human tendons has been reported to date. Materials and Methods: This study was performed in a total of 25 patients with 41 digital flexor tendon injuries in five anatomical zones. In Group I (21 digits in 13 patients), whirlpool and infrared GaAs diode laser with a frequency of 100 Hz. was applied between the 8(th) and 21(st) days postoperatively and all patients were given the Washington rehabilitation program until the end of the 12(th) week. In Group II (20 digits in 12 patients), the same treatment protocol was given but the laser instrument was switched off during applications. Results: The results of the study showed a significant improvement in the laser-treated group only for the parameter of edema reduction (p < 0.01) but the difference between the two groups was non-significant for pain reduction, hand grip strength, and functional evaluation performed according to Strickland and Buck-Gramcko systems using total active motion and fingertip-to distal palmar crease distance parameters (p > 0.05). Conclusions: Significant improvement obtained in edema reduction both immediately and 12 weeks after supplementary GaAs laser application in our study has been interpreted as an important contribution to the rehabilitation of human flexor tendon injuries because edema is known to have a detrimental effect on functional recovery during both early and late stages of tendon healing. However, our study has failed to show a significant positive effect of supplementary GaAs laser application on the other functional recovery parameters of human flexor tendon injury rehabilitation and we suggest further clinical study in this topic be done using different laser types and dosages in order to delineate the role of this promising treatment modality.

Objective: The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome (FMS) patients. Methods: Fifty female patients diagnosed with FMS according to the American College of Rheumatism (ACR) criteria were randomly assigned to two groups: group 1 (n = 25) with pool-based exercise, and in group 2 (n = 25) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks. In both groups, pre(week 0) and post-treatment (weeks 12 and 24) evaluation was performed by one of the authors, who was blind to the patient group. Evaluation parameters included pain, morning stiffness, sleep, tender points, global evaluation by the patient and the physician, fibromyalgia impact questionnaire, chair test, and Beck depression inventory. Statistical analysis was done on data collected from three evaluation stages. Results: Twenty-four exercise and 22 balneotherapy patients completed the study. Pretreatment (week 0) measurements did not show any difference between the groups. In group 1, statistically significant improvement was observed in all parameters (P < 0.01) except for the chair test at both weeks 12 and 24. In group 2, week 12 measurements showed significant improvement in all parameters (P < 0.01) except for the chair test and Beck depression inventory. Week 24 evaluation results in group 2 showed significant improvements in pain and fatigue according to visual analogue scale (VAS), 5-point scale, number of tender points, algometric and myalgic scores, and patient and physician global evaluation (P