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Öğe A New Trend in Orthopedics: Radiofrequency Ablation for the Treatment of Intractable Plantar Fasciitis(2024) Savaş, Toktamış; Tekin, Sezgin Bahadır; Gönüllü, Edip; Karabulut, ÇağrıAim: One of the most common causes of pain in the plantar region of the foot is plantar fasciitis (PF), for which there are numerous treatment options. Several invasive and non-invasive treatment modalities have been developed for this condition. One of these options for patients who do not respond to conservative treatment is radiofrequency ablation (RFA). Due to its early functional benefits and minimally invasive nature, RFA is believed to achieve successful clinical outcomes in patients with persistent early-stage PF. This study aims to evaluate the efficacy and clinical outcomes of RFA in the treatment of PF. Methods: A total of 35 patients (46 feet), aged 31-50 years, who were treated with RFA from December 2018 to December 2019 were included in the study. AOFAS (American Orthopaedic Foot & Ankle Society) and Visual Analog Scale (VAS) of patients who received conservative treatment for 3 months or longer and whose complaints persisted were pre-treatment (PrT) of RFA. These scores were re-evaluated after 3 months. Results: Among the patients in the study, 10 (28.57%) were male and 25 (71.43%) were female. The mean age of the patients was 40.43±5.37 years. The PrT and post-treatment (PsT) VAS scores were 8.97±1.36 and 5.89±3.66, respectively. The PrT and PsT AOFAS scores were 48.51±10.67 and 65.86±22.74, respectively. Statistical analyses showed that the clinical outcomes of RFA were significantly improved after treatment for both scores (p<0.05). Conclusion: RFA, which is rapidly and long-term effective without disrupting the plantar fascia anatomy, is an important minimally invasive treatment option that can be preferred in patients with chronic PF.Öğe Deprem sonrası göç eden ergenlerde gerilim tipi baş ağrısı: Kontrollü çalışma(2021) Gönüllü, Edip; Tekin, Hande GazeteciGiriş: Depremzedeler afetlerin akut travmatik etkilerinin yanı sıra aile bireylerini kaybetmek, ikamet ettikleri yeriterk etmek zorunda kalmak, okul değiştirmek gibi ciddi psikolojik stresli durumlarla da karşı karşıya kalmaktadırlar.Doğal afetler sonrası gelişen hastalıklar arasında gerilim tipi baş ağrısı travma sonrası stres bozukluğundan sonraen sık görülen ikinci durumdur.Gereç ve Yöntem: Bu çalışma gerilim tipi baş ağrısı açısından deprem sonrası yer değiştirmek zorunda kalan(Grup 1), deprem geçirip yer değiştirmeyen (Grup 2) ve yıkıma neden olacak bir deprem yaşamamış ergenlerde(Kontrol Grup) yürütüldü. Tüm hasta gruplarının epidemiyolojik ve demografik özellikleri kaydedildi. Baş ağrısıolan hastalar, baş ağrısı nedeniyle okula gelememe, okul ödevlerini yapamama, ev işlerine yardım etme gibigünlük aktiviteleri açısından sorgulandı ve kayıt altına alındı. Grupların karşılaştırılmasında Student's t testi ve kikare testi kullanıldı. P <0.05 değeri istatistiksel olarak anlamlı kabul edildi.Bulgular: 498 lise öğrencisinin yaş ortalaması 15.6 ± 0.67 olup, bu öğrencilerin 287'si erkek, 211'i kızdır. Afetsonrası yerinden olan ergenlerde gerilim tipi baş ağrısı oranı % 64, deprem sonrası göç etmeyen ve bulunduğuyerde kalanlarda ise bu oran % 40 idi. Gerilim tipi baş ağrısı olan Grup 1'deki hastaların% 38,6'sının baş ağrısışiddet skoru yüksek (4-5 puan) olmakla birlikte bu bulgu istatistiksel olarak anlamsızdı. Doksan gün okulagelmeme ve ev işlerine yardımda aksama bakımından karşılaştırıldığında üç grup arasında anlamlı fark bulundu.Sonuç: Depreme maruz kalan ve yerinden edilmiş ergenlerde baş ağrısı sıklığının ve şiddetinin diğer gruplaragöre daha yüksek olması, bu grubun deprem bölgesinden uzaklaşmalarına rağÖğe Does heated erythrocyte suspension transfusion with medical devices containing phthalates increase DEHP and MEHP levels?(Wiley, 2021) Gönüllü, Edip; Bilvanisi, Sevdegul; Tasdogen, Aydin; Gönüllü, Hayriye; Erkin, Yüksel; Kume, Tuncay; Aykac, Mehmet CoşkunAims It is commonly known that stored blood and blood products are heated before transfusion to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate (DEHP) content leaching into the blood and blood products and thereby causes greater conversion of DEHP to mono (2-ethylhexyl) phthalate (MEHP). However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension (ES) transfused via warming. In this study, we aimed to investigate the DEHP and MEHP content in blood following the heated ES transfusions administered by DEHP-containing and DEHP-free infusion sets. Methods The study included 30 patients that were randomly divided into two groups with 15 patients each: group I underwent ES transfusion via DEHP-containing infusion sets warmed with blood-fluid warmers, and group II underwent ES transfusion via DEHP-free infusion sets warmed with blood-fluid warmers. DEHP and MEHP levels were measured both before and after transfusion. Results DEHP-free infusion sets led to no increase in the phthalate content, whereas DEHP-containing infusion sets significantly increased the DEHP and MEHP, where the DEHP level increased almost four times (P = .001). Conclusion DEHP-containing products lead to toxicity. Therefore, using DEHP-free medical devices may prevent toxicity in patients undergoing ES transfusion.Öğe Effects of Endogen Erythropoietin on Parathormone Secretion(2021) Kılıç, Esat; Gönüllü, Edip; Adanaş, Cihan; Atmaca, Murat; Özbay, Mehmet Fatih; Özkan, SezaiObjective: We hypothesize that tissue hypoxia would increase erythropoietin, as well as parathormone (PTH), secretion. To verify this hypothesis, patients who had undergone orthopedic surgery with a pneumatic tourniquet were evaluated for endogenous tissue hypoxia. Methods: This study included 20 patients who underwent orthopedic surgery with a pneumatic tourniquet, wherein, 6 had diagnostic arthroscopy and 14 had anterior cruciate ligament reconstruction. All operations were performed under spinal anesthesia. The paired t-test was used to detect the differences between serial concentrations of parathyroid hormone, erythropoietin, calcium, and phosphorus levels before and after ischemia, where “p values” of <0.05 were considered significant. Results: The average duration of ischemia that patients were exposed to during surgery was 57.40±22.65 min. After ischemia, parathyroid hormone and erythropoietin levels were significantly elevated (p<0.001; p<0.001). No significant difference was found in calcium and phosphorus levels in patients before and after ischemia. A positive correlation was found between parathyroid hormone and erythropoietin levels (p<0.05). Conclusion: Our study is the first to show that the increase in erythropoietin levels in response to tissue hypoxia and increases the release of PTHÖğe Efficacy of greater occipital nerve and supraorbital nerve blockade in the treatment of acute migraine attack(Van Yüzüncü Yıl Üniversitesi, 2021) Gönüllü, Edip; Şentürk, İlteriş Ahmet; Gönüllü, HayriyeObjective: Migraine is the most common neurological disorder among primary headaches that can cause loss of quality of life. Medical agents are generally used for the treatment and prophylaxis of acute migraine attack. However, the effectiveness of pericranial nerve blocks in the treatment and prophylaxis of acute attacks has been experienced for many years. In this study, we investigated the effectiveness of bilateral greater occipital nerve (GON) and supraorbital nerve (SON) blockade in terminating acute migraine attacks that did not improve with medical treatment. Material and Method: In this retrospective study, 191 patients with acute migraine attacks resistant to medical treatment were evaluated. First GON block was applied to all patients, SON block was applied to patients whose visual analog scale (VAS) did not fall below ‘5’ at the fifth minute after GON block. The zero, fifth and 30th mi-nute VAS results were evaluated. Results: 76.96 % of the patients were women. Subraorbital nerve blockade (22.51%) was applied in addition to those with a VAS value above 5 at the 5th minute after bilateral greater occipital nerve blockade. Pericranial nerve blockade including bilateral GON and SON blockade improved the VAS level in 97.4% of our cases (mean VAS; fifth min: 1.3769±1.9746, 30th min: 0.3979±1.3013). Conclusion: The results of our study show that pericranial nerve blockages are beneficial in the treatment of acute migraine attacksÖğe Herbal Product/Drug Usage Habits of Patients Applying to the Pain Clinic(2023) Özduran, Erkan; Erkin, Yüksel; Hancı, Volkan; İyilikci, Leyla; Gönüllü, Edip; Tertemiz, Oktay Faysal; Kara, Müge MercanAim: In recent years, the use of herbal products and drugs has been increasing all over the world. During irrational use, herbal product-drug interaction and side-effect rates also pose a risk. The aim of this study is to evaluate the effects of patients on herbal/product drug use habits and other sociodemographic characteristics by gender during their application to the Pain (Algology) outpatient clinic. Methods: In this cross-sectional study, which was created by using face-to-face questionnaire method on 200 patients between February and June 2022, after ethics committee approval, the herbal product/drug use habits and sociodemographic characteristics of the participants were questioned. Results: 71.5% of the participants were female and 28.5% were male. 29% of the participants were using herbal products. There was no significant relationship between the use of herbal products by gender (p = 0.419). It was determined that the users most frequently (32.8%) used these products to strengthen the immune system. It was determined that 36.2% of the users had knowledge about side effects and there was a significant difference between gender and knowledge about side effects (p = 0.035). Conclusions: It was determined that 29% of the patients used herbal products and the most frequently used herbal product was cinnamon. There was no significant relationship between the use of herbal products and gender. It has been determined that patients most frequently get advice from doctors about the use of herbal products, and the most common reason for using them is to strengthen the immune system. It is important for health care providers to have knowledge about herbal products and to question patients about possible herb-drug interactionÖğe Port catheterization: Our clinical experience with 156 diseases(2021) Aycan, Abdurrahman; Doğan, Erkan; Gönüllü, Edip; Koca, Doğan; Yeşıltaş, SerdarObjective: Port catheterization, which can be practically applied by various clinical and surgical branches in our country, is an extremely comfortable procedure in patient groups requiring long-term parenteral treatment, especially malignancy patients. Method: In this study, 156 patients who underwent port catheterization by an anesthesiologist after the approval of the local ethics committee were evaluated retrospectively. Results: The procedure was performed in 98.1% of the patients due to malignancy (originated esophagus: 37.3%, stomach: 24.8%). The most common application part was the right internal jugular vein (65.4%). Sixty-two patients required two or more punctures. Port was removed due to port pocket infection in 1.9% of the patients. Conclusion: In this study, we presented our port catheterization experience and aimed to contribute to the national literature.Öğe Protective effect of polyethylene glycol (PEG) 3350 on a cisplatin-induced rat model of neuropathy(Asian Network Scientific Information-Ansinet, 2022) Gönüllü, Edip; Dağıstan, Gözde; Erdoğan, Mümin Alper; Erbaş, OytunBackground and Objective: Peripheral neuropathy is the most important side effect, leading to a decrease in the dose of cisplatin or its complete cessation in the early period. For this purpose, the study aimed to investigate the therapeutic potential of PEG in cisplatin-induced neuropathy and to measure the levels of MDA, GSH, IL-6 and TNF-alpha, which are key markers of lipid peroxidation and antioxidant capacity. Materials and Methods: Cisplatin was given to 16 rats twice a week for 4 weeks at a rate of 2.5 mg/kg/day. Cisplatin-treated rats were split into two groups. For 4 weeks, the rats in Group 1 (n = 8) received 1 mL/kg/day of 0.9% NaCl intraperitoneally, while the rats in Group 2 received 30 mg/kg/day of PEG. The control group consisted of the eight surviving rat specimens. The motor abilities of all the animals were assessed after the research. Blood samples were collected for the measurement of plasma lipid peroxidation malondialdehyde (MDA), Tumour Necrosis Factor (TNF-alpha), glutathione (GSH) and IL-6 levels. Results: Electromyography findings revealed that compound muscle action potential (CMAP) amplitude was significantly higher in the cisplatin-PEG group than in the cisplatin-saline group. Also, cisplatin-PEG treated group showed significantly lower TNF-alpha, MDA and IL-6 levels and hig her GSH levels than the cisplatin-saline group (p<0.01, p<0.001). In addition, while the CMAP latency was decreased in the PEG-treated group, the CMAP amplitude was increased and a significant improvement was observed in the Inclined test scores. Besides, histological examinations showed an increase in axon diameter and NGF expression with PEG treatment. Conclusion: This study demonstrated that PEG exerts protective activity against cisplatin-induced neurotoxicity by increasing endogenous antioxidants and reducing lipid peroxidation and inflammation.Öğe Use of ultrasound guided single shot costotransverse block (intertransverse process) in breast cancer surgery: a prospective, randomized, assessor blinded, controlled clinical trial(Bmc, 2022) Aygün, Hakan; Kızıloğlu, İlker; Öztürk, Nilgün Kavrut; Öcal, Haydar; İnal, Abdullah; Kutlucan, Leyla; Gönüllü, EdipBackground: Ultrasound guided costotransverse block (CTB) is a relatively newperi-paravertebral block that has been described recently. It has been previously reported that CTB, administered with a single high-volume injection, provides effective analgesia in breast conserving surgery. In this study we evaluated the effect of CTB when used in breast cancer surgery. Methods: Seventy patients due to undergo breast cancer surgery were included in this blinded, prospective, randomized, efficiency study. Patients were randomized into two equal groups (CTB group and control group) using the closed envelope technique. All patients underwent general anesthesia. In addition to standard analgesia methods, patients in group CTB also received CTB block while the remaining (control group) did not. Numeric rating (pain) scores and opioid consumption was compared between the two groups. Results: Opioid consumption in all time frames and pain scores at 1st and 3rd hours only were found to be significantly lower in Group CTB when compared to the control group. Conclusions: Ultrasound guided CTB improves analgesia quality in breast cancer surgery.
