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Öğe Clinical characteristics of and services provided for patients with lymphedema referred to a physiotherapy program during the years 2009 through 2019(Mary Ann Liebert, Inc, 2021) Keser, İlke; Özdemir, Kadirhan; Ertürk, Burak; Haspolat, Miray; Duman Özkan, Tuğçe; Cam, Yağmur; Suner Keklik, SinemBackground: Lymphedema is a chronic and progressive disease whose diagnosis involves determination of clinical and demographic characteristics. The aim of this retrospective study was to analyze the clinical characteristics of patients with lymphedema and their various diagnoses. We studied patients who were referred for physiotherapy services at any point during the years 2009 through 2019. Methods: Retrospective data were collected from the files of 430 lymphedema patients. The type, cause, localization, stage, and severity of lymphedema and physiotherapy needs were analyzed and reported. Results: Primary and secondary lymphedema were observed in 18 (4.2%) and 412 (95.8%) patients, respectively. The patients' mean body mass index score was 30.66 kg/m(2). The data indicated that the most common cause of secondary lymphedema was breast cancer and its treatments (n = 196, 47.6%). Other causes were chronic venous insufficiency (CVI) (n = 140, 34%), lipolymphedema (n = 11, 2.7%), and other types of cancers (n = 65, 15.7%). According to the affected body regions, 416 patients had unilateral/bilateral upper and lower extremity lymphedema and 14 had head and neck lymphedema. The patients were followed with a home-based physiotherapy program (n = 353, 82.1%) or they underwent treatments through an outpatient program (n = 77, 17.9%). Conclusions: Most patients admitted to the clinic had a diagnosis of breast cancer and CVI. The severity and stages of lymphedema were variable. The data indicated that most patients were followed through a home-based physiotherapy program. These results may set a frame for understanding the treatment and care needs of patients with lymphedema.Öğe Comparison of trace element (selenium, iron), electrolyte (calcium, sodium), and physical activity levels in COVID-19 patients before and after the treatment(Elsevier Gmbh, 2022) Özdemir, Kadirhan; Saruhan, Ercan; Benli, Tuba Kaya; Kaya, Gözde; Meral, Orhan; Yavuz, Melike Yüksel; Şen, TeomanObjective: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), a worldwide health problem, is the cause of 2019 coronavirus disease. This study aimed to compare the trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of COVID-19 patients before and after COVID-19 treatment. Method: This prospective study was conducted in patients diagnosed with COVID-19 (n = 15). Trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of the patients were compared before and after the treatment. Result: Most of patients had selenium deficiency (86.7 %), iron deficiency (73.3 %), calcium deficiency (66.7 %) and sodium deficiency (46.7 %) before COVID-19 treatment. The most important improvements were seen in iron deficiency (from 73.3 % to 26.7 %) and sodium deficiency (from 46.7 % to 13.3 %) after the treatment. Selenium, iron, calcium, and sodium levels of the patients were significantly higher after the treatment (p < 0.05). The patients had low physical activity before and after COVID-19 treatment. In addition, no statistically significant difference was found in the comparison of physical activity levels (p > 0.05). Conclusion: This study indicated that selenium, iron, calcium, and sodium levels and deficiencies might improve after treating patients with COVID-19. However, the results of this study showed that the physical activity levels of COVID-19 patients might remain stable and low throughout the treatment process.Öğe Determination of serum trace elements (Se, Fe, Zn), macrominerals (Ca, Na, Cl), and physical activity levels in COVID-19 patients(Dustri-Verlag Dr Karl Feistle, 2022) Özdemir, Kadirhan; Saruhan, Ercan; Meral, Orhan; Kaya, Gözde; Benli, Tuba Kaya; Bakar, Yeşim; Kızıloğlu, İlkerObjective: This study mainly aims to determine serum trace elements, macrominerals, and physical activity levels in COVID-19 patients compared to healthy con-trols. Materials and methods: This prospec-tive study was conducted among COVID-19 patients (group I, n = 20) and healthy con-trols (group II, n = 20). Serum trace element levels (Se, Fe, and Zn), macrominerals (Ca, Na, and Cl), vitamin D, ferritin, and physical activity levels were determined. Results: Of the participants in group I, 90% had Se defi-ciency, 65% had Fe deficiency, and 35% had Zn deficiency. In addition, 45% of the par-ticipants in group II had Se deficiency. There was Ca deficiency (60%), Na deficiency (40%), and Cl deficiency (30%) in COVID-19 patients. Healthy controls did not have any macromineral deficiencies. The trace ele-ment levels including Se, Fe, and Zn were not statistically significant (p > 0.05); how-ever, the micromineral levels including Ca, Na, and Cl were significantly lower between groups (p < 0.05). There were vitamin D de-ficiencies in 90% and 70% of the participants in group I and group II, respectively. Ferritin levels were significantly higher in group I than group II (p < 0.05). All the participants had low physical activity levels in group I, and 40% of the participants had low physi-cal activity levels in group II. Conclusion: This study showed that COVID-19 patients might have lower Ca, Na, and Cl levels than healthy adults. In addition, high rates of Se, Fe, Ca and vitamin D deficiencies, and ferritin lev-els may be seen in COVID-19 patients. More-over, COVID-19 patients may have low levels of physical activity.Öğe Does venipuncture increase lymphedema by triggering inflammation or infection? An experimental rabbit ear lymphedema model study(Mary Ann Liebert, Inc, 2022) Özdemir, Kadirhan; Çıtaker, Seyit; Diker, Şeyda; Keser, İlke; Kurukahvecioglu, Osman; Uyar Göçün, Pinar; Gülbahar, ÖzlemBackground: Recent guidelines recommend avoiding venipuncture to prevent lymphedema for breast cancer patients. This study investigated whether single or multiple sterile venipuncture procedures develop a systemic inflammation or infection and increase lymphedema in the rabbit ear lymphedema model.Methods and Results: Eighteen New Zealand white female rabbits were included. The right ear lymphedema model was created by surgical procedure; then, rabbits were divided into three randomized groups. Single and multiple venipuncture procedures were applied at least the 60th day after surgery for Group I and II, respectively. Group III was a control group. C-reactive protein (CRP) and procalcitonin (PCT) levels were analyzed to determine inflammation and infection. Ear thickness measurements were applied using a vernier caliper to assess the differences in lymphedema between the ears. All rabbits were euthanized on the 90th day after surgery. Histopathological analysis was performed to evaluate lymphedema by measuring tissue thicknesses. Ear thickness measurements showed that ear lymphedema was developed and maintained with surgical operation in all groups (p < 0.05). There was no difference in the ear thickness measurements between and within-groups results (p > 0.05). CRP and PCT levels were below the lower detection levels in all groups. According to the differences of histopathological ear distances, there were significant differences within-groups for all groups (p < 0.05), and no differences were identified between groups (p > 0.05).Conclusion: This experimental study demonstrated that single or multiple sterile venipuncture procedures did not trigger infection or inflammation and did not exacerbate ear lymphedema in the rabbit ear lymphedema model.Öğe The effects of clinical and home-based physiotherapy programs in secondary head and neck lymphedema(Wiley, 2021) Özdemir, Kadirhan; Keser, İlke; Düzlü, Mehmet; Erpolat, Özge P.; Saranli, Uluc; Tutar, HakanObjectives/Hypothesis To determine the effects of complex decongestive physiotherapy (CDP) and home programs on external lymphedema, staging of lymphedema, fibrosis, and three-dimensional (3D) surface scanning and volume evaluation in head and neck lymphedema. Study Design A prospective randomized controlled study. Methods Twenty-one patients were randomly divided into three groups: CDP (n:7), home program (n:7), and control (n:7). Assessment methods were applied at baseline and 4 weeks later for all groups. MD. Anderson Cancer Center Head and Neck Lymphedema Protocol was implemented to evaluate head and neck external lymphedema, staging of lymphedema, and fibrosis. A 3D scanner and a software were used to determine and calculate the volume of the head and neck region via 3D surface scanning. Head and neck external lymphedema and fibrosis assessment criteria were performed to evaluate visible soft tissue edema and the degree of stiffness. Results The severity and volume of lymphedema decreased in the CDP program group (P < .05). Besides, external lymphedema and fibrosis at submental region were decreased in both CDP program and home program groups (P < .05). Conclusions While the benefits of home program are limited, a CDP program may be more effective in the management of lymphedema and fibrosis in patients diagnosed with head and neck cancer. The clinical trial registration number: NCT04286698, date: 02/25/2020, retrospectively registered. Level of Evidence 4 Laryngoscope, 2020
