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Öğe Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers' Depression on Caregiver Burden(Sage Publications Inc, 2020) Ilik, Faik; Buyukgol, Huseyin; Kayhan, Fatih; Ertem, Devrimsel Harika; Ekiz, TimurObjective: 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 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (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 (P = .009, chi(2) = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs (P = .000, chi(2) = 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 (P < .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.Öğe Management of thoracolumbar injury classification and severity score of 4 (TLICS=4) thoracolumbar vertebra fractures: surgery versus conservative treatment(Turkish Association of Trauma and Emergency Surgery, 2020) Karaali, Evren; Çiloğlu, Osman; Duramaz, Altuğ; Kuşvuran Özkan, Aslıhan; Ekiz, TimurBACKGROUND: 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.Öğe Ultrasonographic evaluation of the diaphragm thickness in patients with multiple sclerosis(Elsevier Sci Ltd, 2019) Sahin, Hamza; Dogan, Adil; Ekiz, TimurBackground: Diaphragm weakness or dysfunction have been previously reported in multiple sclerosis (MS) patients. The aim of this study was to evaluate diaphragm thickness and thickenning ratio (TR) using ultrasound in MS patients. Methods: This prospective study comprised MS patients and a control group. Ultrasound examination was performed using a linear transducer (6-15 MHz). The diaphragm was seen as a hypoechoic structre between the peritoneum and pleura. End-expirium and end-inspirium measurements were obtained. Change levels and TR (%) were calculated. All participants were assessed using the Expanded Distability Status Scale (EDSS) and Fatigue Severity Scale (FSS). Results: Evaluation was made of 45 MS patients (11 males, 34 females) with a mean age of 37.36 +/- 9.0 years and 36 healthy subjects (3 males, 33 females) with a mean age of 35.19 +/- 9.3 years. The diaphragm thicknesses were similar at end-expirium (1.86 +/- 0.3 vs. 1.83 +/- 0.3 mm) and end-inspirium (3.14 +/- 0.6 vs. 3.46 +/- 0.6 mm). The change level with inspirium (0.90 +/- 0.6 vs. 1.31 +/- 0.7 mm) and TR (49.77 +/- 37.7 vs. 72.30 +/- 40.1%) were significantly higher in the control group compared to the values of MS patients. A weak and negative correlation was determined between EDSS and TR values (r = -0.293, p = 0.008), and no significant correlation was observed between the FSS values and diaphragm thickness (p > 0.05 for all). Conclusion: Although the diaphragm thickness of MS patients seems to be similar to those of healthy subjects, the change level and TR of MS patients seem to be lower. Furthermore, the change level and TR were found to be associated with EDSS.Öğe Ultrasonographic measurement of the diaphragm thickness in patients with obstructive sleep apnea syndrome(Springer Heidelberg, 2020) Pazarli, Ahmet Cemal; Ozmen, Zafer; Koseoglu, Handan Inonu; Ekiz, TimurPurpose 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.
