HATİCE BODUR , Fatma GÜL YURDAKUL,
ŞEBNEM ATAMAN , Yeşim GARİP,
KEMAL NAS , Fikriye Figen AYHAN,
ÖZGÜR AKGÜL ,
AYŞEN AKINCI ,
ZÜHAL ALTAY ,
MURAT BİRTANE , Derya SOY BUĞDAYCI, Erhan ÇAPKIN,
REMZİ ÇEVİK ,
MEHMET TUNCAY DURUÖZ ,
GÜLCAN GÜRER ,
CAHİT KAÇAR ,
AYHAN KAMANLI , Taciser KAYA, Hilal KOCABAŞ,
ÖMER KURU , Ece KAPTANOĞLU,
MELTEM ALKAN MELİKOĞLU , Erhan ÖZDEMİREL, Sumru ÖZEL,
AYLİN REZVANİ ,
İLHAN SEZER , İsmihan SUNAR,
TUFAN GÜRKAN YILMAZ
Objectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloarthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation. Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength. Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific evidence. These recommendations will be updated regularly in accordance with current developments.
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relationships with clinical, functional, and radiological findings of lower extremities. Patients and methods: A total of 81 patients with RA (15 males, 66 females; mean age 48.9±10.4 years; range 22 to 67 years) were compared with 84 age and sex-matched healthy controls (14 males, 70 females; mean age 45.9±12.1 years; range 24 to 70 years). Radiographic assessments of feet were performed to evaluate the presence of pes planus, hallux valgus, metatarsus primus varus, and splaying foot deformities. Foot functions of patients were determined with Foot and Ankle Outcome Score. The balance disorders of the subjects were evaluated with three static (modified clinical test of sensory interaction and balance, unilateral stance, weight bearing squat) and three dynamic (step-up-and-over, sit-to-stand, tandem walk) balance tests via the ‘Neurocom Balance Master’ device. Results: Rheumatoid arthritis patients had significantly higher sway velocity in unilateral stance and modified clinical test of sensory interaction and balance tests, higher step width and lower speed when walking on a line, lower rising index and higher movement time in step-up-and-over test compared to healthy controls (p<0.05). Performances on the sit-to-stand and weight bearing squat tests were comparable between both groups. Of the patients, although 61% had hallux valgus, 52% had metatarsus primus varus, 33% had pes planus, and 26% had splaying foot, these deformities were not correlated with Foot and Ankle Outcome Score or balance disorders. Presence of swollen joint was determined as the most relevant factor for balance disorders of RA patients. Conclusion: Patients with RA may have increased risk for balance disorders due to cumulative effect of the lower extremity impairments seen in the course of disease.
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KEMAL NAS , Erkan KILIÇ,
REMZİ ÇEVİK ,
HATİCE BODUR ,
ŞEBNEM ATAMAN , Figen AYHAN,
ÖZGÜR AKGÜL ,
AYŞEN AKINCI ,
ZÜHAL ALTAY ,
ERHAN ÇAPKIN , Abdullah Zübeyir DAĞLI,
MEHMET TUNCAY DURUÖZ ,
GÜLCAN GÜRER ,
FERİDE NUR GÖĞÜŞ , Yeşim GARİP,
CAHİT KAÇAR ,
AYHAN KAMANLI , Ece KAPTANOĞLU, Taciser KAYA, Hilal KOCABAŞ, Erhan Ali ÖZDEMİREL, Sumru ÖZEL,
İLHAN SEZER , İsmihan SUNAR, Gürkan YILMAZ
Objectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice.
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TİRAJE TUNCER , Erdal GİLGİL,
CAHİT KAÇAR , Yeşim KURTAİŞ,
ŞEHİM KUTLAY , Bülent BÜTÜN, Peyman YALÇIN,
ZEYNEP ÜLKÜ AKARIRMAK ,
LALE ALTAN İNCEOĞLU ,
FÜSUN ARDIÇ , Özge ARDIÇOĞLU,
ZÜHAL ALTAY , Ferhan CANTÜRK,
AYŞE BEYHAN LALE CERRAHOĞLU ,
REMZİ ÇEVİK ,
HÜSEYİN DEMİR ,
BERRİN DURMAZ ,
NİGAR DURSUN ,
MEHMET TUNCAY DURUÖZ , Canan ERDOĞAN, Deniz EVCİK,
SAVAŞ GÜRSOY ,
SAMİ HİZMETLİ , Ece KAPTANOĞLU, Önder KAYHAN,
MEHMET KIRNAP , Siranuş KOKİNO,
MUSTAFA ERKAN KOZANOĞLU ,
KADRİYE BANU KURAN ,
KEMAL NAS , Sema ÖNCEL,
DİLŞAD SİNDEL , Sevim ORKUN,
TUNAY SARPEL ,
SERPİL SAVAŞ ,
ÖMER FARUK ŞENDUR , Kazım ŞENEL,
HATİCE UĞURLU , Kaan UZUNCA,
İBRAHİM TEKEOĞLU , Francis GUILLEMIN
Objectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range, 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range, 16 to 97 years) by trained general practitioners across the country, in 25 provinces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.
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Objectives: This study aims to assess the validity and reliability of the Jenkins Sleep Evaluation Scale (JSS) when applied to a Turkish population with rheumatoid arthritis (RA). Patients and methods: The Turkish version of JSS (JSS-TR) was obtained after translation from English into Turkish, according to standard guidelines. The study included 61 patients of RA (13 males, 48 females; mean age 50.5 years; range 19 to 72 years) as defined by the American College of Rheumatology 2010 criteria. The internal consistency (Cronbach’s alpha) was assessed for reliability. Content and construct validity (convergent and divergent validities) were evaluated. The relationships between the JSS-TR and the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue scale, subgroups of the Nottingham Health Profile, and the Stanford Health Assessment Questionnaire were assessed for convergent validity. In addition, the relationships between the JSS-TR and age, disease duration, visual analog scale patient global score, and disease activity score 28 were assessed for divergent validity. Results: The Cronbach’s alpha of JSS-TR was 0.80. All questions and the answer choices for the scale were understood well and related to some dimension of sleep demonstrating good content validity. The JSS-TR had good correlations with functional parameters (which are convergent), and poor or insignificant correlations with non-functional parameters (which are divergent). This implies that the JSS-TR had good construct validity in the context of this study. Overall, the JSS-TR had the best correlation with the PSQI (Spearman’s rank correlation coefficient=0.76). Conclusion: The JSS-TR is a valid and reliable instrument. It is a simple and effective tool which can be used to evaluate sleep disturbances in RA patients in both daily practice and clinical research.
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ŞEBNEM ATAMAN , Zühre SÜRMELİ SARI, İsmihan SUNAR, Erhan ÖZDEMİREL, Ayşen AKINCI, Hatice BODUR,
ÖZGÜR AKGÜL ,
LALE ALTAN İNCEOĞLU , Zuhal ALTAY, Figen AYHAN,
MURAT BİRTANE , Derya BUĞDAYCI SOY, Erhan ÇAPKIN,
AYŞE BEYHAN LALE CERRAHOĞLU ,
MEHMET TUNCAY DURUÖZ , Rezzan GÜNAYDIN,
ZAFER GÜNENDİ , Gülcan GÜRER,
AJDA BAL HASTÜRK , Cahit KAÇAR, Ece KAPTANOĞLU, Taciser KAYA, Hilal KOCABAŞ, Nurdan KOTEVOĞLU,
KEMAL NAS , Aylin REZVANİ, Nesrin ŞEN,
ÖMER FARUK ŞENDUR , Peyman YALÇIN
Objectives: This study aims to report Turkish League Against Rheumatism s assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of Interest The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial Disclosure The authors received no financial support for the research and/or authorship of this article.
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AJDA BAL HASTÜRK , Şebnem ATAMAN,
HATİCE BODUR , Aylin REZVANİ, Nurdan PAKER,
NURETTİN TAŞTEKİN ,
ALTINAY GÖKSEL KARATEPE ,
PINAR BORMAN , Mahmut YENER,
KEMAL NAS ,
MELEK SEZGİN , Pelin YAZGAN, İbrahim TEKEOĞLU,
BERİL DOĞU , Zuhal ALTAY,
MEHMET KIRNAP , Alev GÜRGAN,
ALİ GÜR ,
SAMİ HİZMETLİ ,
ZAFER GÜNENDİ , Rana ERDEM,
HATİCE UĞURLU , Elem İNAL, Neşe ÖLMEZ,
MUSTAFA ERKAN KOZANOĞLU , Öznur ÖKEN, Sumru ÖZEL, Ümit DÜNDAR, Ayşen AKINCI, Cihat ÖZTÜRK,
KAZIM ÇAPACI ,
KONÇUY SİVRİOĞLU ,
LALE ALTAN İNCEOĞLU ,
MEHMET TUNCAY DURUÖZ ,
İLKER YAĞCI , Ece AYDOĞ, Erhan ÇAPKIN, Deniz EVCİK, Oğuz DURMUŞ, Ömer Faruk ŞENDUR, Filiz Meryem SERTPOYRAZ, Ahmet ÖZGÜL, Kazım ŞENAL
Amaç: Bu çalışmanın amacı Türkiyedeki romatoid artrit hastalarının demografik ve klinik özelliklerini ortaya koyarak bu hastalar için oluşturulabilecek önlem, tedavi ve destek stratejilerine ışık tutmaktır. Hastalar ve yöntemler: Bu çalışma kapsamında Eylül 2007 - Mart 2011 tarihleri arasında Türkiyenin farklı bölgelerindeki toplam 36 merkezden Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) kayıt sistemine kaydedilen 2.359 hasta (1.966 kadın, 393 erkek; ort. yaş 51.6±12.5 yıl; dağılım 18-75 yıl) değerlendirildi. Hastaların demografik ve klinik verileri kaydedildi. Hastalık aktivitesi, fonksiyonel durum ve radyografik hasar sırasıyla hastalık aktivite skoru 28, sağlık değerlendirme anketi ve van der Heijde modifiye Sharp puanlama yöntemi ile ölçüldü. Bulgular: Akademik eğitim süresi ortalama 5.2±3.8 yıldı ve hastaların %74.6sı ev hanımıydı. Hastaların %91.0ı biyolojik olmayan hastalık modifiye edici ilaçlar, %10.2si biyolojik hastalık modifiye edici ilaçlar kullanıyordu. Ortalama hastalık aktivite skoru 28, sağlık değerlendirme anketi ve Sharp puanları sırasıyla, 4.0±1.4, 0.38±0.37 ve 31.2±57.1 idi. Hastaların %17.8i remisyonda ve %14.1i düşük hastalık aktivitesinde iken %42.7si orta hastalık aktivitesinde ve %25.5i yüksek hastalık aktivitesinde idi. Sonuç: Türkiyede romatoid artrit hastalarının çoğunluğu orta yaşlı ev hanımlarıdır. Her ne kadar hastalık modifiye edici ilaç kullanımı yüksek oranda ise de hastaların büyük bölümü orta ve yüksek hastalık aktivite düzeyinde idi. Bu bulgular romatoid artritli hastaların tedavi gereksinimlerinin yeterli olarak karşılanmadığını düşündürmektedir.
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Camptodactyly is defined as a permanent flexion contracture at the proximal interphalangeal (PIF) joints with mostly the fifth finger involvement. The incidence of camptodactyly is approximately 1% 2% in the general population. Camptodactyly is usually overlooked unless it causes discomfort either cosmetically or functionally. Camptodactyly is generally isolated; however, it may also accompany other anomalies or a number of very rare syndromes. Because the condition can also be mistaken for some rheumatologic diseases, such as rheumatoid arthritis, early diagnosis with a detailed musculoskeletal examination is vital for both prevention of deformity and unnecessary anxiety.
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Amaç: Karpal tünel sendromunda (KTS) düşük enerjili lazer (DEL) ve kesikli ultrason (US) tedavilerinin etkinliklerini değerlendirmek ve karşılaştırmaktır. Gereç ve Yöntem: KTS tanısı alan toplam 60 hasta rastgele yöntemle dört gruba ayrıldı: Grup 1e kesikli US, Grup 2ye plasebo US, Grup 3e DEL, Grup 4e ise plasebo lazer tedavisi üç hafta boyunca haftada beş gün uygulandı. Hastalar tedavi öncesi ve tedavi sonrası 3, 6 ve 12. aylarda klinik ve elektrofizyolojik olarak değerlendirildi. Klinik değerlendirmede ağrı, uyuşukluk, el kavrama gücü ve Boston anketi ile semptom şiddet ve fonksiyonel kapasite değerlendirildi. Bulgular: Çalışma 52 hasta ve toplam 101 el ile tamamlandı. Hastaların genel özellikleri ve bazal elektrofizyolojik değişkenleri dört grupta da benzerdi. Ağrı, duyu kaybı, semptom şiddet skoru ve fonksiyonel kapasite skorlarında hem US hem de DEL gruplarında tedavi öncesine göre anlamlı düzelmeler saptandı (p<0,05). Her iki plasebo grubunda da anlamlı tedavi etkinliği saptanmadı (p>0,05). Elektronörofizyolojik değişkenlerde, dört grupta da tedavi öncesine göre anlamlı değişimler saptanmadı (p>0,05). Klinik parametreler bakımından kesikli US tedavisinin DEL tedavisinden üstün olduğu tespit edildi (p<0,05). Sonuç: KTSde US ve DEL tedavisinin subjektif klinik semptomlar üzerine etkili, ancak elektrofizyolojik parametreler üzerine etkili olmadığı, kesikli US tedavisinin klinik parametreler göz önüne alındığında DEL tedavisinden daha üstün olduğu gösterilmiştir. Türk Fiz T p Rehab Derg 2013;59:201-8.
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Hatice BODUR, Filiz SİVAS, Özlem YILMAZ, Salih ÖZGÖÇMEN, Rezzan GÜNAYDIN, Taciser KAYA,
ŞEBNEM ATAMAN ,
LALE ALTAN İNCEOĞLU , Zuhal ALTAY, Ece AYDOĞ,
MURAT BİRTANE ,
PINAR BORMAN , Bülent BÜTÜN, Haşim ÇAKIRBAY,
MEHMET TUNCAY DURUÖZ , Gülcan GÜRER, Simin HEPGÜLER,
AYHAN KAMANLI ,
ÖMER KURU ,
AYŞE ADİLE KÜÇÜKDEVECİ ,
BARIŞ NACIR , Neşe ÖLMEZ, Aylin REZVANİ, Burcu ÇÖREKÇİ YANIK
Hatice BODUR, Filiz SİVAS, Özlem YILMAZ, Salih ÖZGÖÇMEN, Rezzan GÜNAYDIN, Taciser KAYA,
... Devamını oku
Amaç: Türkiye Romatizma Araştırma ve Savaş Derneği?nin (TRASD) Ankilozan Spondilit (AS) için ulusal tedavi önerilerinin oluşturulmasıdır.Gereç ve yöntemler: TRASD tarafından altı Romatoloji ve 19 Fiziksel Tıp ve Rehabilitasyon uzmanı olmak üzere toplam 25 kişiden oluşan bir bilimsel kurul oluşturuldu. Önerilerde 2006 yılında yayınlanan Ankilozan Spondilit Değerlendirme Uluslararası Çalışma Grubu (ASAS)/Romatizmaya karşı Avrupa Ligi (EULAR) önerileri ve Ocak 2005 - Eylül 2010 arasında yayınlanmış olan ilişkili yayınlar konusundaki sistematik bir inceleme temel alındı. Öneriler oluşturulurken Delphi süreci kullanıldı. Ankilozan spondilit tedavisi ile ilgili 12 ana öneri oluşturuldu. Oylama yapılarak önerilerin güçlülük düzeyi bir nümerik derecelendirme skalası ile belirlendi.Bulgular: On iki öneri hasta değerlendirilmesini, hasta takibini ve farmakolojik ve non-farmakolojik yöntemleri içermektedir. ASAS/EULAR önerilerine bazı ilaveler ve önerilerde bazı küçük değişiklikler yapılmıştır. Tüm öneriler yeterli kuvvete sahipti.Sonuç: Bilimsel kanıtlar ve uzmanların görüş birliği ile AS tedavisine yönelik ulusal öneriler oluşturulmuştur. Bu öneriler, yeni gelişmeler doğrultusunda düzenli olarak güncellenmelidir
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