Browsing by Author "Ayhan, Fikriye Figen"

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Citation Count: 0
Breast Cancer Management During the COVID Pandemic
(Coll Physicians & Surgeons Pakistan, 2024) Sariyildiz, Gulcin Turkmen; Ayhan, Fikriye Figen; Anesthesia Program
Objective: To explore the impact of COVID-19 among both the newly diagnosed patients and patients under follow-up for breast cancer by focusing on patients' accessibility to management and comparing the distribution of them before and during pandemic. Study Design: Single -centric retrospective study. Place and Duration of the Study: Department of General Surgery and Department of Physical Medicine and Rehabilitation, Atilim University, Medicana International Ankara Hospital, Ankara, Turkiye, from March 2018 to 2022. Methodology: The data were collected to analyse numbers and distributions of physician visits regarding breast cancer. Results: The mean age of patients was 55.98 +/- 12.60 years. The percentages of newly diagnosed cases showed similarity (7.37% vs. 9.79%) before and during the pandemic (p = 0.18). The number of imaging studies decreased by 53.33% in patients under follow-up (p = 0.006), despite screening tests showed a similar trend (p = 0.145). General surgery visits marked up (+44.6%), in contrast to plastic surgery visits (-42.04%, p <0.001). Patients' admissions decreased in many COVID-19 related clinics (pulmonology, emergency, internal medicine, and intensive care), but cardiology (+96.59%) and rehabilitation (+75%) admissions increased during the pandemic (p <0.001). The number of medical oncology and radiation oncology visits did not change (p >0.05). Conclusion: Total number of physician visits was similar before and during the pandemic despite the changing distribution. While COVID-19 led to markedly rising trends of surgical, cardiological, and rehabilitative management in patients with breast cancer, falling trends were seen in other specialities except oncology which showed a plateau during two years. The falling trends of visits to pulmonology, emergency, internal medicine, and intensive care clinics may be explained by crowded COVID-19 cases.
Citation Count: 0
The clinical and demographical characteristics of Turkish pediatric lymphedema patients: a multicenter study
(Tubitak Scientific & Technological Research Council Turkey, 2022) Borman, Pinar; Balcan, Aysegul; Eyigor, Sibel; Coskun, Evrim; Ayhan, Figen; Cakit, Burcu Duyur; Dogan, Sevil Ceyhan
Background/aim: Reducing lymphedema-associated burden and disability in the pediatric setting requires improved awareness and understanding clinical properties of the lymphedema. The aim of this study was to evaluate the clinical and demographic characteristics of patients with pediatric lymphedema presented to different lymphedema centers in Turkey. Materials and methods: The socio-demographic and clinical characteristics of the children including age, gender, presence of genetic syndromes, duration of edema, site and stage of lymphedema and the received therapies were determined. Parental and children education on self-management techniques were recorded. Results: A total of 122 children (female: 66, male: 56) with a mean age of 120.7 +/- 71.2 months were included from 7 centers. Of them; 92% had primary, 8% had secondary lymphedema mostly due to infection and trauma. Lymphedema was part of a syndrome in 18% of the children. The most common site of involvement was the lower extremity, followed by upper extremity and genital involvement. Lymphedema was complicated in 17 % of children, mainly with a clinical picture of cellulitis, infection, and pain. The median duration of lymphedema was 41 (5-216) months. Although most of the children had stage 2 lymphedema, only 40% of them received treatment. The most commonly received treatment was compression therapy. No family or child was educated for self-care management before. Conclusion: In conclusion, pediatric lymphedema has a comparable gender distribution and usually involves the lower extremities. Although most of the children had advanced disease, more than half of the patients did not receive any treatment indicating the unmet need for management of lymphedema. The education of patients and/or children about self-management methods were lacking. We suggest educational activities for both families of children with lymphedema and health care providers, in order to facilitate early reference to lymphedema units and to receive prompt preventive and therapeutic approaches for this suffering condition.
Citation Count: 1
The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study
(Turkish League Against Rheumatism, 2022) Duruoz, Mehmet Tuncay; Gursoy, Didem Erdem; Tuncer, Tiraje; Altan, Lale; Ayhan, Figen; Bal, Ajda; Ugurlu, Hatice
Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6 +/- 9.8 years) with hand OA were included in the study from 26 centers across Turkiye by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [ VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruoz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results: The DHI had significant correlations with VAS- pain (r= 0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p= 0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p= 0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.
Citation Count: 0
The effect of combined hydrolyzed type 2 collagen, methylsulfonylmethane, glucosamine sulfate and chondroitin sulfate supplementation on knee osteoarthritis symptoms
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2024) Ayhan, Fikriye Figen; Çoban, Ayşegül Demirci; Karasu, Ayça Utkan; Karaoğlan, Belgin; Çınar, Ece; Eyigör, Sibel; Dalyan, Meltem
Objectives: This study aimed to evaluate the effects of the combined hydrolyzed type 2 collagen, methylsulfonylmethane (MSM), glucosamine sulfate (GS), and chondroitin sulfate (CS) supplement on knee pain intensity in patients with knee osteoarthritis (OA). Patients and methods: This multicenter, observational, noninterventional study included 98 patients (78 females, 20 males; mean age: 52.8±6.5 years; range, 40 to 64 years) who had Grade 1-3 knee OA between May 2022 and November 2022. The patients were prescribed the combination of hydrolyzed type 2 collagen, MSM, GS, and CS as a supplement for knee OA. The sachet form of the combined supplement containing 1250 mg hydrolyzed type 2 collagen, 750 mg MSM, 750 mg GS, and 400 mg CS was used once daily for two consecutive months. Patients were evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS)-pain, and Health Assessment Questionnaire (HAQ). Patients were scheduled to visit for follow-up four weeks (Visit 2) and eight weeks (Visit 3) after Visit 1 (baseline; day 0 of the study). Results: For the VAS-pain, WOMAC, WOMAC-subscale, and HAQ scores, the differences in improvement between the three visits were significant (p<0.001 for all). The patient compliance with the supplement was a median of 96.77%, both for Visit 2 and Visit 3. Conclusion: The combination of hydrolyzed type 2 collagen, MSM, GS, and CS for eight weeks in knee OA was considered an effective and safe nutritional supplement.
Citation Count: 0
The effect of combined hydrolyzed type 2 collagen, methylsulfonylmethane, glucosamine sulfate and chondroitin sulfate supplementation on knee osteoarthritis symptoms
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2024) Ayhan, Fikriye Figen; Coban, Aysegul Demirci; Karasu, Ayca Utkan; Karaoglan, Belgin; Cinar, Ece; Eyigor, Sibel; Dalyan, Meltem
Objectives: This study aimed to evaluate the effects of the combined hydrolyzed type 2 collagen, methylsulfonylmethane (MSM), glucosamine sulfate (GS), and chondroitin sulfate (CS) supplement on knee pain intensity in patients with knee osteoarthritis (OA).Patients and methods: This multicenter, observational, noninterventional study included 98 patients (78 females, 20 males; mean age: 52.8 +/- 6.5 years; range, 40 to 64 years) who had Grade 1-3 knee OA between May 2022 and November 2022. The patients were prescribed the combination of hydrolyzed type 2 collagen, MSM, GS, and CS as a supplement for knee OA. The sachet form of the combined supplement containing 1250 mg hydrolyzed type 2 collagen, 750 mg MSM, 750 mg GS, and 400 mg CS was used once daily for two consecutive months. Patients were evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS)-pain, and Health Assessment Questionnaire (HAQ). Patients were scheduled to visit for follow-up four weeks (Visit 2) and eight weeks (Visit 3) after Visit 1 (baseline; day 0 of the study).Results: For the VAS-pain, WOMAC, WOMAC-subscale, and HAQ scores, the differences in improvement between the three visits were significant (p<0.001 for all). The patient compliance with the supplement was a median of 96.77%, both for Visit 2 and Visit 3. Conclusion: The combination of hydrolyzed type 2 collagen, MSM, GS, and CS for eight weeks in knee OA was considered an effective and safe nutritional supplement.
Citation Count: 6
Evaluation of dysfunctional high-density lipoprotein levels with myeloperoxidase/paraoxonase-1 ratio in rheumatoid arthritis
(Wiley, 2021) Alisik, Tugba; Alisik, Murat; Nacir, Baris; Ayhan, Fikriye Figen; Genc, Hakan; Erel, Ozcan
Background The aim of this study is to evaluate dysfunctional high-density lipoprotein cholesterol (HDL) by measuring myeloperoxidase (MPO)/paraoxonase 1 (PON1) ratio in patients with rheumatoid arthritis (RA) and to investigate the relationship between dysfunctional HDL and cardiovascular disease (CVD) in RA patients. Methods Sixty-seven healthy individuals and 130 RA patients were included in the study. Routine lipid panels (triglyceride (TG), low-density lipoprotein cholesterol (LDL), HDL, total cholesterol (TC), PON1 and MPO levels were measured. Disease activity scores-28 (DAS28) of RA patients were calculated. Cardiological examination records of the patients were assessed to detect patients who also have CVD. Results There were no significant differences between RA and control groups in routine lipid profiles (P > .05 for all). MPO/PON1 ratios were significantly elevated in the RA group compared with the control group (P < .001). MPO/PON1 ratios were higher in RA patients with CVD history compared with those without CVD (P < .05). MPO/PON1 ratios were correlated with DAS28 scores (rho: 0.357, P < .001). Conclusion HDL dysfunction determined by the MPO/PON1 ratio may be associated with the pathophysiology of increased CVD in RA. Thus, evaluating dysfunctional HDL levels by measuring the MPO/PON1 ratio in RA patients may allow more detailed patient follow-up, as well as the reduction of CVD events in RA patients with therapeutic agents aiming to increase the functional properties of HDL by decreasing this ratio.
Citation Count: 1
The Randomized Controlled Study of Low-Level Laser Therapy, Kinesio-Taping and Manual Lymphatic Drainage in Patients With Stage II Breast Cancer-Related Lymphedema
(Galenos Publ House, 2023) Yılmaz, Sedef Selçuk; Ayhan, Fikriye Figen
Objective: To compare the effects of low-level laser therapy, kinesio-taping and manual lymphatic drainage (MLD) on the affected arm volume, quality of life, arm function, neuropathic pain and shoulder mobility in patients with stage II breast cancer-related lymphedema. Materials and Methods: Forty-five breast cancer patients with stage II lymphedema were included. The patients were randomized to three groups and treated with MLD, kinesio-taping or low-level laser therapy. After these different therapeutic modalities, all patients received multilayer compression bandaging, lymphedema remedial exercises, skin care, and a patient education program by the same lymphedema therapist. All treatments were applied 5-days a week for three weeks. The lymphedema compression garments were prescribed to all patients and follow-up visits were planned at the end of the treatment, and at four and 12 weeks. The efficacy of the treatments was evaluated by volumetric calculations based on circumferential measurements using the formula for a truncated cone, in addition to goniometric assessments for shoulder joint ROM, and questionnaires: Quick-disability of arm, shoulder and hand for arm disability; pain-detect for neuropathic pain; and quality of life for arm lymphedema (LYMQOL-arm). Results: The baseline patient and disease characteristics, and outcome measures were similar between groups. All treatment modalities were found to be effective in decreasing arm volume, and improving quality of life, upper extremity disability and neuropathic pain. The percentage of decreased arm volume or treatment success was better in kinesio-taping group than in the MLD group at the end of the treatment, and at four and 12 weeks after treatment (p = 0.009, p = 0.039, and p = 0.042, respectively). Conclusion: Kinesio-taping led to better results than MLD and was similarly effective compared with low-level laser in stage II breast cancer-related lymphedema at the twelfth week of follow-up. Kinesio-taping and low-level laser should be considered as alternative treatments in early-moderate stages of lymphedema. After these modalities, multi-layer compression and compression bandaging remain cornerstones of lymphedema treatment.
Citation Count: 4
The Role of Patient Awareness and Knowledge in Developing Secondary Lymphedema after Breast and Gynecologic Cancer Surgery
(Mary Ann Liebert, inc, 2020) Pervane Vural, Secil; Ayhan, Fikriye Figen; Soran, Atilla
Background:This study aimed to compare the effects of awareness and knowledge on demographic and clinical factors in patients with breast cancer-related lymphedema (BCRL) and gynecologic cancer-related lymphedema (GCRL) in the oncologic rehabilitation setting. Methods and Results:A total of 506 female patients with upper or lower extremity lymphedema, were evaluated for lymphedema education in their postoperative period. Only 74 survivors (25%) with BCRL and 34 survivors (16.83%) with GCRL reported that they had received information about lymphedema by physicians/primary health care providers. In breast cancer survivors, the time of diagnostic delay for lymphedema was shorter in the informed group (p < 0.001), and there was a higher rate of cellulite attacks in uninformed patients (p = 0.021). Duration between surgery and lymphedema was longer and duration of diagnostic delay for lymphedema was shorter in the informed group than uninformed group in gynecologic cancer survivors (p = 0.019,p < 0.001). There was a higher rate of cellulite history in the uninformed patients than informed patients in gynecologic cancer survivors (p < 0.001). In gynecologic cancer survivors who were educated about lymphedema were at an earlier stage than noneducated patients (p = 0.024). Conclusion:The rate of awareness about lymphedema among patients with a history of surgery for gynecologic malignancies is lower compared with those for breast cancer. In female cancer survivors, awareness and knowledge about lymphedema may lead to a later onset of lymphedema, lower lymphedema grades, and fewer infection.
Citation Count: 2
The role of ultrasonography in follow-up of effectiveness of Complex Decongestive Therapy (CDT) in different subgroups of patients with breast cancer-related lymphoedema
(Wiley, 2021) Duyur Cakit, Burcu; Ayhan, F. Figen; Gumruk Aslan, Sefa; Genc, Hakan
Objective To determine the role of ultrasonography in the follow-up of effectiveness of complex decongestive therapy (CDT) in different subgroups of patients with breast cancer-related lymphoedema (BCRL). Methods Forty-seven patients with unilateral upper BCRL were enrolled in the study. The patient group was divided into two subgroups according to body mass index (BMI) as obese and non-obese and three subgroups according to International Society of Lymphology staging. All patients underwent CDT, the circumference measurements and ultrasonographic soft tissue thicknesses evaluations were performed at two anatomic sites, and upper extremity limb volumes were calculated using the truncated cone formula before and after CDT. Results There were significant decreases in both circumferential measurements and ultrasonographic soft tissue thicknesses in non-obese patients and stage 2 lymphoedema patients after 15 sessions of CDT. The ultrasonographic soft tissue thickness values were correlated with the upper arm and forearm circumference values before (r = 0.491, p < .001, r = 0.841, p < .001, respectively) and after (r = 0.535, p < .001, r = 0.714, p < .001, respectively) CDT. Conclusions Ultrasonography presents as a reliable method to measure the soft tissue thickness and treatment efficacy after CDT in only non-obese and stage 2 patients with BCRL.
Citation Count: 0
Short-term effectiveness of epidermis dermis fascia kinesiotaping technique in myofascial pain syndrome on upper trapezius: A multi-center, double-blind, randomized clinical study
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2024) Kulcu, Duygu Geler; Yavas, Arzu Ding; Cakmak, Bahar; Erhan, Belgin; Tur, Birkan Sonel; Ayhan, Figen; Keles, Elif Cigdem
Objectives: This study aims to investigate the efficacy of epidermis dermis fascia (EDF) kinesiotaping (KT) technique on pain intensity, number of active trigger points (TrPs), cervical range of motion (ROM) angles, and disability levels in patients with myofascial pain syndrome (MPS) on upper trapezius (UT) muscle. Patients and methods: Between January 2019 and January 2020, a total of 180 patients (21 males, 159 females; mean age: 35.9 +/- 9.0 years; range, 18 to 56 years) with MPS were included. The patients were randomized into either KT with EDF technique (Group 1) or sham KT (Group 2). Outcome measures were Visual Analog Scale (VAS) pain score, number of active TrPs, cervical ROM angles, and Neck Pain Disability Scale (NPDS). Results: Both groups improved in terms of all outcome parameters except for cervical flexion and extension angles in Group 2. The VAS pain scores significantly decreased in Group 1 (p<0.05), compared to Group 2. The number of active TrPs (p=0.001) and NPDS scores (p=0.016) of Group 1 significantly improved than Group 2. Cervical flexion (p=0.001), extension (p=0.001), and left and right lateral flexion angles (p<0.0001) significantly improved in Group 1. Cervical left (p=0.001) and right (p<0.0001) lateral flexion angles significantly improved in Group 2. There was no significant difference between the groups regarding cervical ROM angles. Conclusion: Our study results suggest that KT with the EDF technique is an effective method in reducing pain and number of active TrPs, improving disability and cervical ROM angles.