V Kavuncu

Afyon Kocatepe University, Kara Hissar Sahib, Afyonkarahisar, Turkey

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Publications (9)11.87 Total impact

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    ABSTRACT: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p < 0.05). Comparison of the percentage changes of parameters both at week 4 and week 12 relative to pretreatment values showed that improvement in VAS (p < 0.001) and bodily pain (p < 0.001), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role limitations due to emotional problems (p < 0.001), and general mental health (p < 0.001) subparts of SF-36 were better in aquatic exercise group. It is concluded that a water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise.
    Rheumatology International 03/2014; · 2.21 Impact Factor
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    ABSTRACT: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p < 0.01). Speech discrimination scores were also significantly different (p < 0.01). No significant difference was found between DPOE responses of the patients and controls (p > 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss.
    Clinical Rheumatology 04/2012; 31(7):1103-8. · 2.04 Impact Factor
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    ABSTRACT: The main cause of lichen simplex chronicus (LSC) is not known but there is evidence to suggest that neurological abnormalities may be implicated in its aetiology. To investigate neuropathy in patients with LSC on the limbs. In total, 23 consecutive patients [15 women (65.2%) and 8 men (34.8%); mean +/- SD age 48.2 +/- 14.03 years, range 20-71] with LSC on the limbs were included in the study. Mean +/- SD duration of disease was 22.86 +/- 21.38 months (range 1-60). Radiography, magnetic resonance imaging (MRI) and electrophysiological studies were performed for all patients. In total, 8 patients (34.8%) had LSC on the arms and 15 patients (65.2%) had LSC on the legs; 3 (37.5%) of the 8 patients with LSC on the arms and 6 (40%) of the 15 patients with LSC on the legs had radiculopathy in the electrophysiological studies. The prevalence of radiculopathy in patients with LSC on the limbs was higher than in asymptomatic subjects in the electrophysiological studies. Damage to the peripheral nervous system, such as radiculopathy and neuropathy, can play a critical role in the aetiology of LSC on the limbs. Both nerve-root compression in MRI scans and radiculopathy in nerve-conduction studies are common findings in asymptomatic subjects, but they seem to be more common in patients with LSC on the limbs. Therefore, these patients should be evaluated for the possibility of underlying neuropathy.
    Clinical and Experimental Dermatology 12/2008; 34(4):476-80. · 1.33 Impact Factor
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    ABSTRACT: Screening studies indicate a prevalence of celiac disease (CD) of up to 1% in populations of European ancestry, yet the majority of cases remain undiagnosed. One of the common complication of CD is intestinal osteopathy or osteoporosis [bone mineral density (BMD) based diagnosis]. Available data regarding the prevalence of CD in the patients with osteoporosis are limited and controversial. The objective of this study was to perform serological testing to screen for CD among postmenopausal women with osteoporosis. We studied 192 postmenopausal women with low BMD with a mean age of 62.75 +/- 8.58 years. Among the patients, a total of 137 had osteoporosis and 55 had osteopenia. Venous blood samples were obtained for serological screening of CD and evaluation of bone metabolism. The serological screening protocol consisted of determining serum level of IgA antigliadin antibodies (AGA), IgG-AGA, IgA endomysial antibody (EMA), IgG-EMA. Subjects who were positive for both IgA-AGA and IgA-EMA were classified as having CD. Bone metabolism was evaluated by serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, 25 (OH) vitamin D, osteocalcin, serum C-telopeptide cross-linked collagen type I levels. Of the 192 patients evaluated, only one (0.5%) was found to have positive for both IgA-AGA and IgA EMA tests and accepted as having CD. Prevelance of CD in postmenopausal women with low BMD (0.5%) did not differ from prevelance of CD in normal healthy population (0.3-1%). BMD values at proximal femur level were significantly lower in IgA-AGA (+) patients when compared to IgA-AGA (-) patients. However, the mean levels of bone metabolism markers were found similiar in both IgA-AGA (+) and (-) patients. In conclusion, the results of our study suggest that there is no need for routine screening of CD in postmenopausal women with osteoporosis.
    Rheumatology International 12/2008; 29(7):841-5. · 2.21 Impact Factor
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    ABSTRACT: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic, progressive, systemic inflammatory rheumatic diseases that lead to serious disability. The objective of this study was to investigate the demographic and clinical characteristics of the patients with RA and AS who were treated in tertiary hospitals in Turkey and to analyze their current medical management. A total of 562 RA and 216 AS patients were evaluated. The mean age of RA patients was 52.1 +/- 12.6 years. The female to male ratio was 3.7:1. Of the RA patients, 72.2% had positive rheumatoid factor (RF), 62.9% had high C-reactive protein, and 75.2% had radiological erosion. The ratio of patients with Disease Activity Score (DAS) 28 >3.2 was 73.9% and of those with Health Assessment Questionnaire (HAQ) > or =1.5 was 20.9%. There was a statistically significant increase in RF positivity and HAQ scores in the group with higher DAS 28 score. Frequency of extraarticular manifestations was 22.4%. The ratio of the patients receiving disease modifying antirheumatic drugs (DMARD) was 93.1%, and 6.9% of the patients were using anti-tumor necrosis factor (TNF) blocking agents. In AS, the mean age of the patients was 38.1 +/- 10.6, and the female to male ratio was 1:2.5. The time elapsed between the first symptom and diagnosis was 4.3 years. The ratio of peripheral joint involvement was 29.4%. Major histocompatibility complex, class I, B 27 was investigated in 31.1% of patients and the rate of positivity was 91%. In 52.4% of the patients, Bath AS Disease Activity Index (BASDAI) was > or =4. The erythrocyte sedimentation rate, Bath AS Functional Index, and peripheral involvement were significantly higher in the group with BASDAI > or =4. Frequency of extraarticular involvement was 21.2% in AS patients. In the treatment schedule, 77.5% of AS patients were receiving sulphasalazine, 15% methotrexate, and 9.9% anti-TNF agents. Despite widespread use of DMARD, we observed high disease activity in more than half of the RA and AS patients. These results may be due to relatively insufficient usage of anti-TNF agents in our patients and therefore these results mostly reflect the traditional treatments. In conclusion, analysis of disease characteristics will inform us about the disease severity and activity in RA and AS patients and could help in selecting candidate patients for biological treatments.
    Clinical Rheumatology 03/2008; 27(9):1119-25. · 2.04 Impact Factor
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    ABSTRACT: Background: Chronic post-thoracotomy pain (CPTP) consists of different types of pain. Some characteristics of CPTP are the same as those of recognized neuropathic pain syndromes. Objective: We aimed to determine the safety and efficacy of gabapentin (GP) in comparison to naproxen sodium (NS) in patients with CPTP. Methods: Forty consecutive patients with CPTP after posterolateral/lateral thoracotomy were prospectively evaluated. Twenty patients were given GP and another 20 were given NS treatment. Visual Analogue Scale (VAS) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scorings were performed pretreatment (day 0) and on the 15th, 30th, 45th and 60th days. Adverse events were questioned. The mean ages were 45.7 +/- 14.9 and 49.8 +/- 15.2 years and the mean durations of pain were 3.8 +/- 0.9 and 3.8 +/- 1.1 months, respectively. Results: The mean pretreatment VAS scores (VAS0) were 6.4 +/- 0.6 and 6.8 +/- 0.6, the mean pretreatment LANSS scores (LANSS0) were 18.85 +/- 1.6 and 20.75
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 07/2007; 32:9-12.
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    ABSTRACT: The efficacy of low-level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. A prospective, double-blind, randomized controlled trial was conducted in patients with chronic MPS in the neck to evaluate the effects of low-level 830-nm gallium arsenide aluminum (Ga-As-Al) laser therapy. The study group consisted of 64 MPS patients. The patients were randomly assigned into two groups. In group 1 (n = 32), Ga-As-Al laser treatment was applied over three trigger points bilaterally for 2 min over each point once a day for 15 days during a period of 3 weeks. In group 2 (n = 32), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups performed daily isometric exercise and stretching exercises for cervical region. Parameters were measured at baseline and after 4 weeks. All patients were evaluated with respect to pain (at rest, movement, and night) and assessed by visual analog scale, measurement of active range of motion using an inclinometer and a goniometer, and the neck disability index. In both groups, statistically significant improvements were detected in all outcome measures compared with baseline (p < 0.05). However, no significant differences were obtained between the two groups (p > 0.05). In conclusion, although the laser therapy has no superiority over placebo groups in this study, we cannot exclude the possibility of effectivity with another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval).
    Clinical Rheumatology 06/2007; 26(6):930-4. · 2.04 Impact Factor
  • U Dundar, O Solak, I Yigit, V Kavuncu
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    ABSTRACT: Bilateral symmetric calcification involving striatum pallidum with or without deposits in the dentate nucleus, thalamus and white matter is commonly referred to as Fahr′s syndrome. Symptoms of the disorder may include deterioration of motor function, spasticity, spastic paralysis, dysarthria, dementia, seizures, headache and athetosis. The clinical and imaging abnormalities are restricted to the central nervous system (CNS). We report an unusual association of Fahr′s syndrome with polyarticular juvenile idiopathic arthritis in a girl.
    Journal of Pediatric Neurosciences. 01/2007;
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    ABSTRACT: Alkaptonuria is a rare hereditary disorder which may result with arthropathy in multiple joints. Clinical findings are similar to degenerative joint diseases. It mostly involves the spine and extremities especially large joints. There is no consensus in the treatment of the disease. In this case we present the effect of physical therapy program in the treatment of back pain and a four year follow up results. ÖZET: Alkaptonüre bir çok eklemde artropatiye yol aça-bilen, nadir görülen herediter bir hastalıktır. Klinik bulgu-lar dejeneratif hastalıklarla benzerlik göstermektedir. Ço-ğunlukla omurga ve ekstremitelerde büyük eklemleri tutar. Hastalığın tedavisinde kesinleşmiş bir görüş birliği mevcut değildir. Bu olguda, bel ağrısı tedavisinde fizik tedavinin etkinliğini ve dört yıllık takip sonuçlarını bildirmekteyiz.