BibTex RIS Kaynak Göster

Nutritional approach in treatment of fibromyalgia

Yıl 2015, Cilt: 6 Sayı: 3, 126 - 130, 11.03.2016

Öz

Fibromyalgia with unknown etiology and medical treatment, chronic widespread pain condition and many of symptoms that comes with it such as chronic fatigue, depression, sleep disorders, cognitive dysfunction significantly affects quality of life. Some of applications developed for treatment of patients are cardio exercises, cognitive behavioral therapy, patient training, acupuncture, antidepressant, dietary changes and supplements. With increase of studies supporting hypothesis that oxidative stress plays an active role in etiology of fibromyalgia, improvement of dietary antioxidant content was considered. Studies that evaluate effects of nutritional status in patients with symptoms are among issues of current researches. In this study, nutritional status of fibromyalgia patients and effects of dietary changes on symptoms of the disease had been compiled.

Kaynakça

  • Arranz LI, Canela MA, Rafecas M. Fibromyalgia and nutrition, what do we know? Rheumatol Int 2010; 30:1417– 1427.
  • Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum 1990; 33: 160–172.
  • 3.Wolfe F, Clauw DJ, FitzCharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62: 600-10.
  • 4.Jones GT, Atzeni F, Beasley M, Flüβ E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population. Arthritis Rheum 2015; 67(2): 568-575.
  • 5. Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Delgado-Fernandez M. Analysis of the body composition of Spanish women with fibromyalgia. Rheumatol Clin 2011;7(1):7–12.
  • Segura-Jimenez V, Álvarez-Gallardo IC, Carbonell-Baeza A, Aparicio VA, Ortega FB, Casimiro AJ, et al. Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: The al-Ándalus project Semin Arthritis Rheum 44 (2015) 563–570.
  • Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M, et al. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 2010;39:448–53.
  • Clauw DJ, Arnold LM, McCarberg BH. The science of fibromyalgia. Mayo Clin Proc 2011;86:907–11.
  • Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol 2005; 34: 140-4.
  • Finan PH, Okun MA, Kruszewski D, Davis MC, Zautra AJ, Tennen H. Interplay of concurrent positive and negative interpersonal events in the prediction of daily negative affect and fatigue for rheumatoid arthritis patients. Health Psychol 2010; 29: 429–37.
  • Toussaint LL, Vincent A, McAllister SJ, Oh TH, Hassett AL. A comparison of fibromyalgia symptoms in patients with healthy versus depressive, low and reactive affect balance styles. L.L. Toussaint et al. Scand J Pain 2014; 5: 161-166.
  • Finan PH, Quartana PJ, Smith MT. Positive and negative affect dimensions in chronic knee osteoarthritis: effects on clinical and laboratory pain. Psychosom Med 2013; 75: 463– 70.
  • Schneider M, Vemon H, Ko G, Lawson G, Perera J. Chiropractic management of fibromyalgia syndrome: a systematic review of the literature. J Manipulative Physiol Ther 2009; 32: 25-40.
  • Ramon S, Gleitz M, Hernandez L, Romero L. Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia. Int J Surg 2015; doi: 10.1016/j.ijsu.2015.08.083.
  • Perrot S, Dickenson AH, Bennett RM. Fibromyalgia: harmonizing science with clinical practice considerations. Pain Practice 2008; 8(3): 177–189.
  • Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med 2008; 121: 555–561.
  • Sakarya ST, Akyol Y, Bedir A, Canturk F. The relationship between serum antioxidant vitamins, magnesium levels, and clinical parameters in patients with primary fibromyalgia syndrome. Clin Rheumatol. 2011;30:1039–43.
  • Mustafa N, Selami A, Feray S, Kadir Y, Omer C, Sevilay E, et al. Vitamins C and E treatment combined with exercise modulates oxidative stress markers in blood of patients with fibromyalgia: a controlled clinical pilot study. Inf Healthc USA. 2010;13(6):498–505.
  • Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord 2007; 8: 27.
  • Cordero MD, de Miguel M, Moreno-Fernandez AM. Mitochondrial dysfunction in fibromyalgia and its implication in the pathogenesis of disease. Med Clin (Barc) 2011; 136(6): 252–6.
  • Cordero MD, de Miguel M, Moreno-Fernández AM. Mitochondrial dysfunction in fibromyalgia and its implication in the pathogenesis of disease. Med Clin (Barc). 2011;136:252–6.
  • Menzies V, Lyon DE. Integrated review of the association of cytokines with fibromyalgia and fibromyalgia core symptoms. Biol Res Nurs. 2010;11: 387–94.
  • Zhang Z, Cherryholmes G, Mao A, Marek C, Longmate J, Kalos M, et al. High plasma levels of MCP-1 and eotaxin provide evidence for an immunological basis of fibromyalgia. Exp Biol Med 2008; 2333: 1171–1180.
  • Wallace DJ, Linker-Israeli M, Hallegua D, Silverman S, Silver D, Weisman MH. Cytokines paly an aetiopathogenetic role in fibromyalgia: a hypothesis and pilot study. Rheumatology 2001; 40: 74–749.
  • Menzies V, Lyon DE. Integrated review of the association of cytokines with fibromyalgia and fibromyalgia core symptoms. Biol Res Nurs. 2010;11: 387–94.
  • Kaartinen K, Lami K, Hypen M, Nenonen M, Hanninen O, Rauma AL. Vegan diet alleviates fibromyalgia symptoms. Scand J Rheumatol 2000; 29(5): 308–313.
  • Bennet RM. A raw vegetarian diet for patients with fibromyalgia. Curr Rheumatol Rep 2002; 4(4): 284.
  • Azad KA, Alam MN, Hag SA, Nahar S, Chowdhury MA, Ali SM, et al. Vegetarian diet en the treatment of fibromyalgia. Bangladesh Med Res Counc Bull 2000; 26(2): 41–47.
  • Hanninen O, Kaartinen K, Rauma AL, Nenonen M, Törrönen R, Hakkinen S, et al. Antioxidants in vegan diet and rheumatic disorders. Toxicology 2000; 155: 45-53.
  • Michalsen A, Riegert M, Lüdtke R, Bäcker M, Langhorst J, Schwickert M, et al. Mediterranean diet or extended fasting’s influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study. BMC Complement Altern Med 2005; 5: 22.
  • Paiva ES, Jones KD. Rational treatment of fibromyalgia for a solo practitioner. Best Pract Res Clin Rheumatol 2010; 24: 341-352.
  • Castrillon EE, Cairns BE, Wang K, Arendt-Nielsen L, Svensson P. Comparison of glutamate-evoked pain between the temporalis and masseter muscles in men and women. Pain 2012; 153(4): 823-829.
  • Ursini F, Naty S, Grembiale RD. Fibromyalgia and obesity: the hidden link. Rheumatol Int 2011; 31: 1403-8.
  • Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trondelag Health Study. Arthritis Care Resarch (Hoboken) 2010; 62: 611-7.
  • Silva SGL, Sarni ROS, Souca FIS, Molina J, Terreri MTRA, Hilario MOE, et al. J Adolesc Health 2012; 51: 524– 527.
  • ). Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. J Pain 2010;11:1329-1337.
  • Aparicio VA, Ortega FB, Carbonell-Baeza A, Gatto- Cardia C, Sjöströn M, Ruiz JR, et al. Fibromyalgia’s key symptoms in normal-weight, overweight, and obese female patients. Pain Manag Nurs 2013; 14(4): 268-276.
  • Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and fibromyalgia features. Scand J Rheumatol 2002; 31: 27-31.
  • Lobo MMMT, Paiva ES, Andretta A, Schieferdecker MEM. Body composition by dual-energy x-ray absorptiometry in women with fibromyalgia. Rev Bras Reumatol 2014; 54(4): 273–278.
  • Douchi T, Yonehara Y, Kawamura Y, Kuwahata A, Kuwahata T, Iwamoto I. Difference in segmental lean and fat mass components between pre- and postmenopausal women. Menopause 2007; 14: 875-8.
  • Kim C-H, Luedtke CA, Vincent A, Thompson JM, Oh TH. Association of body mass index with symptom severity and quality of life in patients with fibromyalgia. Arthritis Care Res 2012;64:222-228.
  • Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Delgado-Fernández M. Analisis de la composición corporal em mujeres con fibromialgia. Reumatol Clin 2011; 7: 7-12.
  • Chaitow L. Fibromyalgia Syndrome. Lowe JC. Chapter Ten–The metabolic rehabilitation of fibromyalgia patients. United Kingdom: Churchill Livingstone. 2010; 247-262.
  • Verheesen RH, Schweitzer CM. Iodine deficiency, more than cretinism and goiter. Med Hypotheses 2008; 71: 645– 648.
  • Pamuk GE, Pamuk ON, Set T, Harmandar O, Yeşil N. An increased prevalence of fibromyalgia in iron deficiency anemia and thalassemia minör and associated factors. Clin Rheumatol 2008; 27: 1103–1108.
  • Al-Allaf AW, Mole PA, Paterson CR, Pullar T. Bone health in patients with fibromyalgia. Rheumatology 2003; 42: 1202–1206.
  • Armstrong DJ, Meenagh GK, Bickle I. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol 2007; 26: 551–554.
  • Seferoglu B, Baykal T, Altas EU, Senel K. Trace element profile in patients with fibromyalgia syndrome. 2014; 57 Supp1: 261.
  • Engen DJ, McAllister SJ, Whipple MO, Cha SS, Dion LJ, Vincent A, Bauer BA, Wahner-Roedler DL. Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. J Integr Med 2015; 13(5): 306-313.
  • Chaitow L. Fibromyalgia Syndrome. Chapter Two– Fibromyalgia’s symptom patterns: causes or effects? United Kingdom: Churchill Livingstone. 2010; 25-46.
  • Chaitow L. Fibromyalgia Syndrome. Chapter Fourteen– Integration: what seems to be helping? United Kingdom: Churchill Livingstone. 2010; 303-328.

Fibromiyalji tedavisinde beslenme yaklaşımı

Yıl 2015, Cilt: 6 Sayı: 3, 126 - 130, 11.03.2016

Öz

Tıbbi tedavisi ve etiyolojisi henüz bilinmeyen fibromiyalji, yaygın ağrı durumu ve beraberinde getirdiği kronik yorgunluk, depresyon, uyku bozuklukları, bilişsel disfonksiyon gibi pek çok semptomla birlikte hastaların yaşam kalitesini önemli düzeyde etkilemektedir. Hastalarda tedaviye yönelik geliştirilen uygulamalardan bazıları, kardiyo egzersizleri, bilişsel davranışçı terapi, hasta eğitimi, akupunktur, antidepresan kullanımı, besin desteği kullanımı ve diyet değişiklikleridir. Fibromiyalji etiyolojisinde oksidatif stresin etkin rol oynadığı hipotezini destekleyen çalışmaların artmasıyla birlikte diyetin antioksidan içeriğinin geliştirilmesi görüşü ortaya çıkmıştır. Hastalarda beslenme durumunun semptomlar üzerine etkilerinin değerlendirildiği çalışmalar güncel araştırma konuları arasında yer almaktadır. Bu çalışmada, fibromiyalji hastalarının beslenme durumları ve yapılan diyet değişikliklerinin hastalık semptomları üzerine etkileri derlenmiştir.

Kaynakça

  • Arranz LI, Canela MA, Rafecas M. Fibromyalgia and nutrition, what do we know? Rheumatol Int 2010; 30:1417– 1427.
  • Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum 1990; 33: 160–172.
  • 3.Wolfe F, Clauw DJ, FitzCharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62: 600-10.
  • 4.Jones GT, Atzeni F, Beasley M, Flüβ E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population. Arthritis Rheum 2015; 67(2): 568-575.
  • 5. Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Delgado-Fernandez M. Analysis of the body composition of Spanish women with fibromyalgia. Rheumatol Clin 2011;7(1):7–12.
  • Segura-Jimenez V, Álvarez-Gallardo IC, Carbonell-Baeza A, Aparicio VA, Ortega FB, Casimiro AJ, et al. Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: The al-Ándalus project Semin Arthritis Rheum 44 (2015) 563–570.
  • Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M, et al. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 2010;39:448–53.
  • Clauw DJ, Arnold LM, McCarberg BH. The science of fibromyalgia. Mayo Clin Proc 2011;86:907–11.
  • Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol 2005; 34: 140-4.
  • Finan PH, Okun MA, Kruszewski D, Davis MC, Zautra AJ, Tennen H. Interplay of concurrent positive and negative interpersonal events in the prediction of daily negative affect and fatigue for rheumatoid arthritis patients. Health Psychol 2010; 29: 429–37.
  • Toussaint LL, Vincent A, McAllister SJ, Oh TH, Hassett AL. A comparison of fibromyalgia symptoms in patients with healthy versus depressive, low and reactive affect balance styles. L.L. Toussaint et al. Scand J Pain 2014; 5: 161-166.
  • Finan PH, Quartana PJ, Smith MT. Positive and negative affect dimensions in chronic knee osteoarthritis: effects on clinical and laboratory pain. Psychosom Med 2013; 75: 463– 70.
  • Schneider M, Vemon H, Ko G, Lawson G, Perera J. Chiropractic management of fibromyalgia syndrome: a systematic review of the literature. J Manipulative Physiol Ther 2009; 32: 25-40.
  • Ramon S, Gleitz M, Hernandez L, Romero L. Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia. Int J Surg 2015; doi: 10.1016/j.ijsu.2015.08.083.
  • Perrot S, Dickenson AH, Bennett RM. Fibromyalgia: harmonizing science with clinical practice considerations. Pain Practice 2008; 8(3): 177–189.
  • Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med 2008; 121: 555–561.
  • Sakarya ST, Akyol Y, Bedir A, Canturk F. The relationship between serum antioxidant vitamins, magnesium levels, and clinical parameters in patients with primary fibromyalgia syndrome. Clin Rheumatol. 2011;30:1039–43.
  • Mustafa N, Selami A, Feray S, Kadir Y, Omer C, Sevilay E, et al. Vitamins C and E treatment combined with exercise modulates oxidative stress markers in blood of patients with fibromyalgia: a controlled clinical pilot study. Inf Healthc USA. 2010;13(6):498–505.
  • Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord 2007; 8: 27.
  • Cordero MD, de Miguel M, Moreno-Fernandez AM. Mitochondrial dysfunction in fibromyalgia and its implication in the pathogenesis of disease. Med Clin (Barc) 2011; 136(6): 252–6.
  • Cordero MD, de Miguel M, Moreno-Fernández AM. Mitochondrial dysfunction in fibromyalgia and its implication in the pathogenesis of disease. Med Clin (Barc). 2011;136:252–6.
  • Menzies V, Lyon DE. Integrated review of the association of cytokines with fibromyalgia and fibromyalgia core symptoms. Biol Res Nurs. 2010;11: 387–94.
  • Zhang Z, Cherryholmes G, Mao A, Marek C, Longmate J, Kalos M, et al. High plasma levels of MCP-1 and eotaxin provide evidence for an immunological basis of fibromyalgia. Exp Biol Med 2008; 2333: 1171–1180.
  • Wallace DJ, Linker-Israeli M, Hallegua D, Silverman S, Silver D, Weisman MH. Cytokines paly an aetiopathogenetic role in fibromyalgia: a hypothesis and pilot study. Rheumatology 2001; 40: 74–749.
  • Menzies V, Lyon DE. Integrated review of the association of cytokines with fibromyalgia and fibromyalgia core symptoms. Biol Res Nurs. 2010;11: 387–94.
  • Kaartinen K, Lami K, Hypen M, Nenonen M, Hanninen O, Rauma AL. Vegan diet alleviates fibromyalgia symptoms. Scand J Rheumatol 2000; 29(5): 308–313.
  • Bennet RM. A raw vegetarian diet for patients with fibromyalgia. Curr Rheumatol Rep 2002; 4(4): 284.
  • Azad KA, Alam MN, Hag SA, Nahar S, Chowdhury MA, Ali SM, et al. Vegetarian diet en the treatment of fibromyalgia. Bangladesh Med Res Counc Bull 2000; 26(2): 41–47.
  • Hanninen O, Kaartinen K, Rauma AL, Nenonen M, Törrönen R, Hakkinen S, et al. Antioxidants in vegan diet and rheumatic disorders. Toxicology 2000; 155: 45-53.
  • Michalsen A, Riegert M, Lüdtke R, Bäcker M, Langhorst J, Schwickert M, et al. Mediterranean diet or extended fasting’s influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study. BMC Complement Altern Med 2005; 5: 22.
  • Paiva ES, Jones KD. Rational treatment of fibromyalgia for a solo practitioner. Best Pract Res Clin Rheumatol 2010; 24: 341-352.
  • Castrillon EE, Cairns BE, Wang K, Arendt-Nielsen L, Svensson P. Comparison of glutamate-evoked pain between the temporalis and masseter muscles in men and women. Pain 2012; 153(4): 823-829.
  • Ursini F, Naty S, Grembiale RD. Fibromyalgia and obesity: the hidden link. Rheumatol Int 2011; 31: 1403-8.
  • Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trondelag Health Study. Arthritis Care Resarch (Hoboken) 2010; 62: 611-7.
  • Silva SGL, Sarni ROS, Souca FIS, Molina J, Terreri MTRA, Hilario MOE, et al. J Adolesc Health 2012; 51: 524– 527.
  • ). Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. J Pain 2010;11:1329-1337.
  • Aparicio VA, Ortega FB, Carbonell-Baeza A, Gatto- Cardia C, Sjöströn M, Ruiz JR, et al. Fibromyalgia’s key symptoms in normal-weight, overweight, and obese female patients. Pain Manag Nurs 2013; 14(4): 268-276.
  • Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and fibromyalgia features. Scand J Rheumatol 2002; 31: 27-31.
  • Lobo MMMT, Paiva ES, Andretta A, Schieferdecker MEM. Body composition by dual-energy x-ray absorptiometry in women with fibromyalgia. Rev Bras Reumatol 2014; 54(4): 273–278.
  • Douchi T, Yonehara Y, Kawamura Y, Kuwahata A, Kuwahata T, Iwamoto I. Difference in segmental lean and fat mass components between pre- and postmenopausal women. Menopause 2007; 14: 875-8.
  • Kim C-H, Luedtke CA, Vincent A, Thompson JM, Oh TH. Association of body mass index with symptom severity and quality of life in patients with fibromyalgia. Arthritis Care Res 2012;64:222-228.
  • Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Delgado-Fernández M. Analisis de la composición corporal em mujeres con fibromialgia. Reumatol Clin 2011; 7: 7-12.
  • Chaitow L. Fibromyalgia Syndrome. Lowe JC. Chapter Ten–The metabolic rehabilitation of fibromyalgia patients. United Kingdom: Churchill Livingstone. 2010; 247-262.
  • Verheesen RH, Schweitzer CM. Iodine deficiency, more than cretinism and goiter. Med Hypotheses 2008; 71: 645– 648.
  • Pamuk GE, Pamuk ON, Set T, Harmandar O, Yeşil N. An increased prevalence of fibromyalgia in iron deficiency anemia and thalassemia minör and associated factors. Clin Rheumatol 2008; 27: 1103–1108.
  • Al-Allaf AW, Mole PA, Paterson CR, Pullar T. Bone health in patients with fibromyalgia. Rheumatology 2003; 42: 1202–1206.
  • Armstrong DJ, Meenagh GK, Bickle I. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol 2007; 26: 551–554.
  • Seferoglu B, Baykal T, Altas EU, Senel K. Trace element profile in patients with fibromyalgia syndrome. 2014; 57 Supp1: 261.
  • Engen DJ, McAllister SJ, Whipple MO, Cha SS, Dion LJ, Vincent A, Bauer BA, Wahner-Roedler DL. Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. J Integr Med 2015; 13(5): 306-313.
  • Chaitow L. Fibromyalgia Syndrome. Chapter Two– Fibromyalgia’s symptom patterns: causes or effects? United Kingdom: Churchill Livingstone. 2010; 25-46.
  • Chaitow L. Fibromyalgia Syndrome. Chapter Fourteen– Integration: what seems to be helping? United Kingdom: Churchill Livingstone. 2010; 303-328.
Toplam 51 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derlemeler
Yazarlar

Hande Yılmaz Bu kişi benim

Hilal Yıldıran

Yayımlanma Tarihi 11 Mart 2016
Gönderilme Tarihi 9 Nisan 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 6 Sayı: 3

Kaynak Göster

Vancouver Yılmaz H, Yıldıran H. Fibromiyalji tedavisinde beslenme yaklaşımı. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2016;6(3):126-30.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.