Browsing by Author "Birlik, Ahmet Merih"

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Citation - WoS: 15
Citation - Scopus: 18
Effects of Supervised Exercise Program and Home Exercise Program in Patients With Systemic Sclerosis: a Randomized Controlled Trial
(Wiley, 2021) Yakut, Hazal; Ozalevli, Sevgi; Aktan, Ridvan; Alpaydin, Aylin Ozgen; Birlik, Ahmet Merih; Can, Gercek
Aim To compare the effects of supervised exercise and home exercise program in patients with systemic sclerosis (SSc). Methods Thirty-seven SSc patients were included. Patients with SSc were allocated into 2 groups as supervised and home exercise. Breathing, aerobic and resistance exercises were performed with a physiotherapist for 12 weeks in the supervised exercise group. Breathing, posture and aerobic exercises were given to the home exercise group as a home program for 12 weeks. All patients were assessed at baseline and 12 weeks later in terms of functional capacity, pulmonary functions, respiratory-peripheral muscle strength, dyspnea severity, health-related quality of life (HRQoL) and fatigue level. Results Significant improvements were observed in the functional capacity, measured by 6 minute walking test in the supervised exercise group (before = 376.21 +/- 65.50, after = 518.78 +/- 75.84 m) and home exercise group (before = 384.44 +/- 68.14, after = 432.7 +/- 70.8 m; (P < .05). Respiratory-peripheral muscle strength (with the exception of inspiratory muscle strength and upper limb strength in the home exercise group) and HRQoL were significantly increased and fatigue level was significantly decreased in the supervised exercise and home exercise groups (P < .05). However, pulmonary functions and dyspnea severity were significantly improved only in the supervised exercise group (P < .05). The supervised exercise program was found superior to the home exercise program for change in all parameters (P < .05). Conclusion This study suggests that exercise interventions should be applied in addition to the medical treatments of patients with SSc as supervised and home exercise programs play an important role in the functionality and health status of these patients.
Citation - WoS: 4
Citation - Scopus: 4
Vitamin D Attenuates Elevated Oxidative Dna Damage in Scleroderma Patients With Organ Involvement: a Prospective Study
(Pergamon-Elsevier Science Ltd, 2023) Dal-Bekar, Nazlı Ecem; İşlekel, Gül Huray; Köken-Avşar, Aydan; Yarkan-Tuğsal, Handan; Tuna, Gamze; Zengin, Berrin; Birlik, Ahmet Merih
Scleroderma is a rare autoimmune disease characterized by progressive fibrosis of the skin and internal organs. Oxidative damage to macromolecules has been reported to occur in scleroderma. Among the macromolecular damages, oxidative DNA damage is a sensitive and cumulative marker of oxidative stress and is of particular interest because of its cytotoxic and mutagenic effects. Vitamin D supplementation is an important part of treatment, as vitamin D deficiency is a common problem in scleroderma. Furthermore, the antioxidant role of vitamin D has been demonstrated in recent studies. In light of this information, the present study aimed to comprehensively investigate oxidative DNA damage in scleroderma at baseline and to evaluate the contribution of vitamin D supplementation to the attenuation of DNA damage in a prospectively designed study. In accordance with these objectives, oxidative DNA damage in scleroderma was evaluated by measurement of stable damage products (8-oxo-dG, S-cdA, and R-cdA) in urine by liquid chromatography-tandem mass spectrometry (LC-MS/ MS); serum vitamin D levels were determined by high-resolution mass spectrometry (HR-MS); VDR gene expression and four polymorphisms in the VDR gene (rs2228570, rs1544410, rs7975232, and rs731236) were analyzed by RT-PCR and compared with healthy subjects. In the prospective part, the DNA damage and the VDR expression of the patients who received vitamin D were re-evaluated after the replacement. As a result of this study, we demonstrated that all DNA damage products were increased in scleroderma patients compared to healthy controls, whereas vitamin D levels and VDR expression were significantly lower (p < 0.05). After sup-plementation, statistical significance (p < 0.05) was reached for the decrease in 8-oxo-dG and the increase in VDR expression. Attenuated 8-oxo-dG after replacement in patients with lung, joint, and gastrointestinal system involvement demonstrated the efficacy of vitamin D in scleroderma patients with organ involvement. To the best of our knowledge, this is the first study to examine oxidative DNA damage in scleroderma comprehensively and to evaluate the effects of vitamin D on DNA damage using a prospective design.