Karaman Merkez

Researchers are studying the role of Doppler ultrasound in evaluating breast masses to help distinguish between benign and malignant tumors in female patients. This observational study focuses on analyzing differences in the resistive index RI values between the mass and surrounding healthy breast tissue. The study also explores vascular index values using a newer Doppler Microvascular Flow method to improve differentiation based on pathology results. Participants will undergo Doppler ultrasound scans where minimum, maximum, and average RI values from the breast mass and normal tissue will be recorded. The relative differences in these RI values between the mass and healthy tissue will be calculated and compared. Cases will be grouped into benign or malignant categories according to pathology, and threshold values for these measurements will be evaluated. During the study, participants will have their breast masses assessed with Doppler ultrasound. Researchers will collect data on resistive index values and vascular flow patterns. The main outcome measure is the percentage change in resistive index between the mass and surrounding normal tissue over a 3 to 4 month period. This helps determine how well these ultrasound measures distinguish between benign and malignant breast masses, supporting diagnostic accuracy and patient care.

This research aims to evaluate the safety, performance, and usability of several Occlutech accessory medical devices used in heart disease treatment. These devices include the Occlutech Delivery Set ODS, Occlutech Pistol Pusher OPP, Occlutech Occlusions-Pusher OOP, and Occlutech Sizing Balloon OSB. The study is international, multicenter, non-randomized, and non-invasive, focusing on catheter-based implantation procedures for cardiac implants. The study involves physicians experienced in cardiac catheterization using these accessories during implantation procedures. Investigators complete detailed surveys to assess each devices safety, including success of implantation, adverse events during or after the procedure, user harm, and any device deficiencies. The surveys also evaluate the performance, usability, and compatibility of these accessories with other devices. Subjects receive treatment following standard clinical routines and specific instructions for use. Participants who have undergone implantation with an Occlutech accessory and cardiac implant are included. Researchers monitor safety events and assess device performance and usability over a 6-month period. Data is collected via investigator questionnaires, focusing on implantation outcomes and any related complications. The total participation duration varies depending on individual follow-up but includes at least 6 months of monitoring for safety and performance.

Parkinsons disease PD is a progressive neurological disorder that often causes freezing, balance issues, and walking difficulties, which can increase the risk of falls and reduce independence and quality of life. Researchers are evaluating whether adding action observation AO and motor imagery MI therapies to standard rehabilitation programs can improve balance, functional status, and quality of life in people with PD. In this trial, participants receive either AO and MI therapy alongside conventional rehabilitation or a sham version of these therapies with the same rehabilitation. AO involves watching videos of specific exercises accompanied by music, while MI involves visualizing those movements. Sessions include watching, imagining, and performing exercises focusing on upper and lower limb movements, with therapies conducted repeatedly over six weeks. Participants will be assessed before and after the six-week rehabilitation period using several tests measuring balance, movement, functional status, and quality of life. These include the Berg Balance Scale, Movement Disorder Societys Parkinsons rating scale, Timed Up and Go Test, and questionnaires on freezing of gait and Parkinsons quality of life. The study is randomized and single-blinded to monitor effects safely and carefully.

Stroke is a common neurological disorder causing long-term disability in adults by impairing motor and sensory skills, which limits daily activities and reduces independence and quality of life. This trial evaluates whether adding action observation AO and motor imagery MI therapies to usual rehabilitation improves motor recovery, daily functioning, and quality of life in stroke patients. Participants receive either AO and MI therapy combined with conventional rehabilitation or a sham version alongside usual care. The AO therapy involves watching videos of specific upper and lower limb exercises with music, imagining those movements, and then performing them while watching the video. The sham therapy involves watching static nature photos with music and limited exercise practice. Both therapies are delivered in a structured manner over the study period. Participants are assessed before and after 6 weeks of rehabilitation using motor function scales like the Fugl-Meyer Assessment and Brunnstrom stages, as well as daily living and quality of life measures including the Barthel Index and Stroke-Specific Quality of Life Scale. The study monitors changes in these scores to evaluate therapy effects, with the total participation lasting around 6 weeks of treatment plus assessments.

The trial investigates the relationship between blood pressure response during exercise and aortic stiffness in adults with Cardiovascular-Kidney-Metabolic CKM syndrome, a condition involving cardiovascular disease, chronic kidney disease, and metabolic disorders like diabetes and obesity. The study aims to clarify whether blood pressure changes during routine exercise testing can serve as a simple, non-invasive marker to better assess cardiovascular risks in these patients. Participants are adults diagnosed with CKM syndrome who are referred for a routine exercise stress test by a cardiologist. During the single study visit, blood pressure will be measured immediately before and after the exercise test. Aortic stiffness will be assessed through transthoracic echocardiography by calculating the aortic stiffness index using measurements of the aortas size and blood pressure taken during the test. During the study visit, data on demographics, body measurements, cardiovascular risk factors, medications, lifestyle, and clinical history will be collected. The main outcome measured is the association between the change in blood pressure before and after exercise and aortic stiffness. This observational study lasts for one visit, with no additional treatments or long-term follow-up involved.

Researchers are investigating the effects of combining femoral triangle block with either popliteal plexus block or distal IPACK block to manage pain after total knee arthroplasty TKA. The study compares these two nerve block techniques, which target nerves supplying the back of the knee, as part of a multimodal pain relief approach. This research addresses an important question about which combination may better reduce pain and opioid use after knee replacement surgery. The trial involves two groups receiving different combinations of nerve blocks one group gets femoral triangle block with popliteal plexus block, and the other gets femoral triangle block with distal IPACK block. Each block is given as a single dose bolus of 10 ml of 5% bupivacaine. These procedures are applied during spinal anesthesia before the knee replacement surgery. Participants will be monitored for opioid consumption during the first 24 hours after surgery, which is the main outcome measured. Secondary assessments include pain scores, knee movement range, patient mobilization, muscle strength tests before and after blocks, incidence of rebound pain, and quality of recovery over 48 hours. Muscle strength is evaluated at several time points using standardized tests. The study lasts through the early postoperative period to understand pain control and function following the nerve blocks.

This research aims to compare the amplitude settings of three different frequency modes of Transcutaneous Electrical Nerve Stimulation TENS Conventional TENS, Low Frequency LF TENS, and High Frequency HF TENS in patients who have undergone total knee arthroplasty. It investigates whether the electrical resistance of swollen edematous tissue affects the TENS amplitude settings. Participants are evaluated both before surgery and in comparison with their opposite knee to understand how edema may influence the adjustment of TENS amplitude. Participants will receive assessments of TENS amplitude settings for all three modes, documenting levels at which tingling is felt, current is clearly noted, and the maximum tolerated amplitude or muscle contraction occurs. Measurements are taken preoperatively and 2 to 3 days after surgery. The study also considers the effects of edema amount and anesthesia type on these amplitude settings. During the study, participants will be evaluated before and shortly after surgery, with assessments focusing on TENS amplitude settings and edema impact. The main outcomes measured include differences in TENS amplitudes for each mode between pre- and post-arthroplasty states. Secondary measures examine how edema and anesthesia type influence amplitudes. The study is observational and continues until December 2026, with participant involvement primarily around the surgery period.

Ventilator-associated pneumonia VAP is a lung infection that can occur in critically ill patients who are on mechanical ventilation for at least 48 hours. This research aims to study how a constructivist education program for nurses and cleaning staff affects the prevention of VAP in intensive care units ICUs. The study compares two ICUs one where staff receive both constructivist and routine training, and another where staff only receive routine training. The goal is to see if the education approach can reduce VAP cases and associated complications.

Chronic plantar fasciitis is a frequent cause of heel pain, marked by sharp discomfort during the first steps after rest and tenderness in the foot. This condition affects about 10% of people and is linked to factors like limited ankle movement, obesity, and unsuitable footwear. Researchers are studying whether adding knee strengthening or proprioception exercises to a standard stretching treatment can better reduce pain and disability and improve foot, ankle, and knee function in affected patients. The trial involves three groups one performing only plantar fascia and calf stretching twice daily for six weeks, another adding supervised proprioception exercises three times weekly, and a third adding supervised knee strengthening exercises three times weekly, both over six weeks. Proprioception exercises include balance tasks with increasing difficulty, and all interventions are supervised by physiotherapists. Participants will be assessed at the start, after six weeks of intervention, and again at 12 weeks for pain levels, foot function, pressure pain thresholds, and foot and ankle outcomes. Researchers will also measure biomechanical features, joint range of motion, muscle strength, and balance. These evaluations help determine the effects of added exercises on pain relief and functional improvement over the study period.

This research aims to find out if adding Pain Neuroscience Education PNE to conventional rehabilitation improves pain control, physical function, and mental health in adults aged 40 to 75 who have medium-sized rotator cuff tears and are undergoing mini-open surgical repair. It also compares the effects of delivering PNE before surgery versus after surgery. Rotator cuff tears commonly cause shoulder pain and disability, and recovery can be slowed by pain and fear of movement. Understanding pain better through education may help improve outcomes. Participants are randomly assigned to one of three groups conventional rehabilitation alone, rehabilitation plus PNE before surgery, or rehabilitation plus PNE after surgery. The PNE sessions educate about how pain works in the nervous system and ways to reduce fear and negative thoughts about pain. Rehabilitation includes exercises, manual therapy, and functional training tailored for rotator cuff repair recovery. The study lasts about 12 weeks with assessments before surgery, right after PNE if given, and at 6 and 12 weeks after surgery. During the study, participants will have their pain levels, shoulder function, and fear of movement measured, along with assessments of depression, sleep quality, pressure pain threshold, and other physical and psychological factors. These evaluations occur at set times before and after surgery to track progress. The study monitors how well participants follow the program and any discomfort during testing or exercises. The goal is to learn if PNE can enhance recovery and when it is best given to support patients after rotator cuff surgery.