Nurce Cilesizoglu Yavuz

Aims: Pulmonary rehabilitation (PR) is a cornerstone non-pharmacological intervention in chronic obstructive pulmonary disease (COPD), improving symptoms and functional capacity. However, the relationship between PR-related clinical improvement and routinely available systemic inflammatory markers remains incompletely understood. This study aimed to exploratorily evaluate associations between changes in inflammatory markers and clinical outcomes following PR in patients with COPD.Methods: This single-arm, prospective, before-and-after observational study was conducted between May and November 2025. Patients with COPD completed a six-week cardiopulmonary rehabilitation program. Clinical outcomes included the Modified Medical Research Council (mMRC) Dyspnea Scale, COPD assessment test (CAT), body-mass index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) Index, and six-minute walk test (6MWT). Laboratory assessments comprised complete blood count parameters, C-reactive protein (CRP), erythrocyte sedimentation rate, albumin, total protein, and selected derived inflammatory indices. Pre- and post-rehabilitation changes in clinical and inflammatory parameters were analyzed.Results: Thirty-six participants completed the rehabilitation program. Significant improvements were observed in mMRC, CAT, BODE Index, and 6MWT distance (all p

There are previously stated risk factors for the transition from psoriasis to psoriatic arthritis, but the immune mechanisms in this regard have not been adequately explained. In this study, we aimed to investigate this transition in terms of the complement system. Study was planned as a prospective analytical type. 46 psoriasis and 45 psoriatic arthritis patients were included in this study. Morning stiffness, nail involvement, disease activation questionnaire scores, neutrophil and lymphocyte percentage, neutrophil-lymphocyte rate, high-density lipoprotein, low-density lipoprotein, triglyceride, erythrocyte sedimentation rate, C-reactive protein, uric acid, complement 3 (C3) and 4 (C4) values were evaluated. Enthesis clinical assessment was done with the Leeds enthesis index (LEI). Ultrasonography was used to evaluate the enthesis sites. The severity of skin involvement in psoriasis was evaluated with the psoriasis area severity index (PASI). PASI scores were higher in psoriasis patients, while LEI scores, erythrocyte sedimentation rate and C-reactive protein levels were higher in psoriatic arthritis patients ( P = .016, P = <.001, P = .016, P = .027, P = .020, respectively). Among psoriasis patients, C3 levels were higher in the patients with nail involvement ( P = .035). C3 levels of psoriasis patients showed a moderate positive correlation between PASI and LEI scores ( r = 0.368, r = 0.404, respectively). In psoriasis patients, high-density lipoprotein values were found to be moderately negatively correlated with both C3 and C4 ( r = −0.311, r = −0.388, respectively). As a result of this study, C3 levels may play a role in the progression to psoriatic arthritis.

Background: To evaluate kinesiophobia and its relationship with disease-related characteristics and quality of life in lipedema patients. Methods: In this descriptive case-control study, 40 lipedema patients and 40 participants in the control group were included. All participants were evaluated in terms of body mass index (BMI), pain numeric rating scale (NRS) and pain threshold (PT) scores, kinesiophobia (Tampa Scale for Kinesiophobia - TSK), lower extremity functional scores (Lower Extremity Functional Scale - LEFS), and health-related quality of life (Nottingham Health Profile - NHP) scores. Additionally, the lipedema patients were evaluated in terms of extremity volumes, and total and mean lower extremity fat mass by dual-energy X-ray absorptiometry. Results: High kinesiophobia was detected in 78% of the lipedema patients and 55% of the control group ( p = .033). TSK ( p = .048), NRS ( p = .001), and NHP total scores ( p = .041) were higher and PT scores ( p = .007) were lower in lipedema patients compared to the control group. No difference was found between lipedema patients with high and low kinesiophobia in terms of fat mass or extremity volumes. A positive correlation was found between TSK score, NHP total score (r = 0.356, p = .024), NHP physical activity (ρ = 0.403, p = .010) and NHP energy (ρ = 0.436, p = .005) subscale scores . Conclusion: Kinesiophobia is highly prevalent in lipedema patients, regardless of disease-related data and affecting the quality of life of the patients, negatively.

Objective: This study aimed to investigate differences in depression, anxiety and somatosensory amplification between fibromyalgia (FM) patients with and without type D personality (TDP) and healthy controls and to examine the mediating role of somatosensory amplification in the relationship between TDP and FM severity. Methods: A total of 159 participants were included in the cross‐sectional case‐control study and divided into three groups: FM patients with TDP ( n = 56, mean age = 45.93 ± 11.01), FM patients without TDP ( n = 48, mean age = 49.17 ± 11.18) and healthy controls ( n = 55, mean age = 46.1 ± 9.64). Participants were assessed with the Fibromyalgia Impact Questionnaire (FIQ; administered only to FM patients), TDP Scale, Beck Depression Inventory, Beck Anxiety Inventory and Somatosensory Amplification Scale. Mediation analysis was performed to determine the mediating role of somatosensory amplification. Results: FM patients with TDP had significantly higher levels of depression, anxiety and somatosensory amplification compared to both FM patients without TDP and healthy controls ( p < 0.001). Correlation analyses showed strong positive associations between TDP and anxiety ( r = 0.729, p < 0.001) and depression ( r = 0.794, p < 0.001). Somatosensory amplification was found to have a significant mediating role in the relationship between TDP and FM severity ( b = 0.084, 95% CI = 0.018–0.172, p < 0.05). Conclusion: These results highlight TDP as an important psychological risk factor associated with increased depression, anxiety, and somatosensory amplification in FM patients. The apparent mediating role of somatosensory amplification suggests that addressing this mechanism and psychological stress with targeted psychosocial interventions may improve the efficacy of FM treatment.

This study aimed to investigate the impact of septoplasty on fibromyalgia symptoms in patients with septum deviation. Patients who were over 18 years of age, had been diagnosed with nasal septum deviation, and indicated for septoplasty were selected consecutively and included in the study. Patients were evaluated twice, at baseline and after septoplasty at 3 months. The patients’ widespread pain and symptom severity scores were calculated according to the American College of Rheumatology 2016 Revised Fibromyalgia Diagnostic Criteria. A Revised Fibromyalgia Impact Questionnaire was filled out to evaluate the patients’ fibromyalgia symptoms. The Pittsburgh Sleep Quality Index was used to assess the sleep quality of patients. Thirty-five patients, 21 (60.0%) male and 14 (40.0%) female, were accepted to the study. Nine (25.9%) patients had fibromyalgia at the beginning, and none of the patients met the fibromyalgia criteria after the surgery. After septoplasty, a statistically significant decrease was detected in the patients’ widespread pain index, symptom severity scale, total score, and Pittsburgh Sleep Quality Index and Revised Fibromyalgia Impact Questionnaire scores (P = .006, P = .004, P = .028, P = .014, and P < .001, respectively). As a result of the study, it was observed that fibromyalgia symptoms of patients with septum deviation improved after surgical correction of the deviation.

Twenty two year old female patient had applied physical medicine and rehabilitation outpatient clinic for foot drop. It was learned that she had had bariatric surgery for obesity treatment three months ago and vitamin and mineral supplements were administered in the postoperative period. The patient started to feel weakness in her left big toe two months after the surgery, but she ignored it and noticed that her left foot was falling off three weeks later without any trauma. In the physical examination, it was observed that she could not dorsiflexion of her left big toe and left foot. Electromyogram evidenced focal left peroneal mononeuropathy at the fibular head. Rapid weight loss due to bariatric surgery, which has become widespread in recent years for the treatment of obesity, has also brought medical complications. Among these complications, neurological complications have an important place and both the central and peripheric nervous systems can be affected. Foot drop is also considered an important peripheral complication that may develop due to peroneal nerve palsy after this surgery and a rapid decrease in body weight is associated with a higher risk of foot drop

Stroke is a chronic health problem that affects all areas of life. The presence of thyroid autoantibodies can augment the severity of stroke. The aim of this work is to investigate whether there is a relationship between the site of stroke involvement and the anti-thyroid peroxidase antibody (anti-TPO) or not. This is the first study in the English-language literature.

Aim: This study aimed to evaluate if rehabilitation without specific cognitive rehabilitation improved cognitive functions in patients who had suffered a stroke more than 1 year ago, and to correlate this finding with risk factors. Material and Methods: Thirty stroke patients were included in the study. A rehabilitation program was administered to the patients for a total of 30 sessions, 5 days a week. In addition, demographic data of the patients were collected, as well as several risk factors that may impair their cognitive function. The pre-and post-treatment cognitive function of the patients was evaluated using mini-mental state examination (MMSE) and functional independence measure (FIM)-cognitive. With the FIM cognitive evaluation, cognitive functions such as comprehension, expression, social interaction, problem solving, and memory were evaluated. With MMSE, from cognitive functions; orientation, registration, attention and calculation, recall, language, and praxis were evaluated. Pre- and post-treatment motor function was measured by the Brunnstrom motor recovery stage (BMRS). Pre- and post-treatment walking ability was assessed with Functional Ambulation Categories (FAC). Along with the general comparison of cognitive function pre- and post-treatment, additional pre- and post-treatment comparisons were made according to risk factors. Results: According to MMSE and FIM-cognitive scores, improvement in cognitive function was detected following treatment (p<0.001, p=0.001, respectively). There was no statistical improvement in FAC and BMRS scores. According to MMSE, cognitive functions were more impaired before treatment in women, those with <5 years of education, and those with aphasia (p=0.025, p=0.004, p=0.002, respectively). According to FIM-cognitive, cognitive functions were lower in patients with aphasia, and those with left-sided brain damage (p=0.002, p=0.045, respectively). There was no difference in the magnitude of improvement between the risk factors. Conclusion: This study showed that the rehabilitation program applied without a specific cognitive rehabilitation program in patients with chronic stroke can improve cognitive functions, although it does not cause a significant improvement compared to BMRS and FAC. Therefore, we believe that rehabilitation without specific cognitive rehabilitation will improve patients' daily activities and increase their participation in treatment.

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis, is a considerable part of the spectrum of chronic autoimmune thyroid gland disorders which is pathologically associated with various degrees of lymphocytic infiltration. The purpose of the present study was to evaluate whether cartilage thickness is affected in patients with Hashimoto's thyroiditis or not in thyroidology. A total of 61 individuals had been evaluated in this case-control study, including 32 euthyroid Hashimoto's thyroiditis patients and 29 healthy subjects comparable in age, sex, and body mass index. The patients with a history of knee trauma or knee surgery, an additional systemic disease such as diabetes mellitus, or an inflammatory disease like rheumatoid arthritis, systemic lupus erythematosus, and scleroderma had not been included in the study. The thickness of the femoral articular cartilage was measured using B-mode ultrasonography, and the right lateral condyle, right intercondylar area, right medial condyle, left medial condyle, left intercondylar area, and left lateral condyle were also measured. No statistically significant difference between patients with Hashimoto's thyroiditis diagnosis and healthy controls in terms of age, age groups, gender, and body mass index (p>0.05). As a consequence, no obvious connection between autoimmune markers and cartilage thickness in patients with Hashimoto's thyroiditis was recognized. Although the diverse manifestation of Hashimoto's thyroiditis could be observed, it seems to be no liaison between thyroid autoimmunity and cartilage thickness.

OBJECTIVE: Long-term ocular effects of tumor necrosis factor-alpha inhibitors remain to be elucidated. This study aimed to examine the long-term effects of adalimumab use on neural tissue of the anterior visual pathways using optical coherence tomography in patients with ankylosing spondylitis.METHODS: This was a single-center, open-label, cross-sectional study conducted at the Giresun University Faculty of Medicine, Physical Medicine and Rehabilitation Department, between November 2019 and August 2020. This study included 26 ankylosing spondylitis patients receiving adalimumab for at least 1 year and 21 healthy controls. All subjects underwent a full ophthalmological examination and optical coherence tomography examination with the following measurements: peripapillary retinal nerve fiber layer thickness, peripapillary retinal thickness, peripapillary choroidal thickness, ganglion cell complex thickness, and the optic head properties.RESULTS: Peripapillary retinal nerve fiber layer thickness and retinal thickness measurements were lower in the adalimumab group. In addition, ganglion cell complex thickness was significantly lower and the cup-to-disc ratio was significantly higher in the adalimumab group (p0.05).CONCLUSION: Although tumor necrosis factor-alpha inhibitors have some favorable effects on the ocular involvement of patients with ankylosing spondylitis, they may also have paradoxical detrimental effects as evidenced by structural changes observed by optical coherence tomography. Future studies with better design, probably including a large number of patients with a range of rheumatological diseases and tumor necrosis factor-alpha inhibitors, are warranted.