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Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining ≥70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected.Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.

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Objective: The objective of this study was to test the reliability and validity of the Turkish version of the Fibromyalgia Participation Questionnaire (FPQ). Methods: One hundred and eighty-four female patients with fibromyalgia syndrome were included in the study. All patients filled out the Turkish FPQ (FPQ-T) questionnaire, which was obtained by translation from German according to the guideline for the process of cross-cultural adaptation The patients filled out the revised Fibromyalgia Impact Questionnaire (FIQ) and reevaluated the FPQ-T two hours later. Internal consistency reliability of the FPQ-T was assessed by calculating the “if item deleted” using Cronbach’s alpha and the “item-total correction” coefficient for each item of the ques- tionnaire. The consistency of the subscales and the correlation of the test-retest values were assessed. The test-retest values were compared using the Wilcoxon test. Criterion validity was measured using FIQ scales by Spearman’s rank correlation coefficient. Results: For internal reliability, Cronbach’s alpha coefficient was calculated as 0.957 for nonworking patients and 0.958 for working patients. Cronbach’s alpha values of 0.939, 0.871, and 0.914 were ob- tained for daily, social, and work life, respectively. Correlation coefficients were 0.888 for daily life, 0.859 for social life, and 0.901 overall in the nonworking group versus 0.896 the in working group. The com- parison of scores obtained from test-retest measurements showed no significant difference except for Item 3. The correlation of the symptom severity score (SSS) and the FPQ-T was r=0.385 (p<0.001) and r=0.390 (p<0.001) for the nonworking and working subgroups, respectively. The evaluation of construct validity showed a significant correlation between the SSS and FPQ-T. Conclusion: The results of our study showed that the FPQ-T is reliable and valid for assessing participa- tion and social functioning in fibromyalgia patients in Turkish society.

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Chronic obstructive pulmonary disease is a major public health problem. In the present study, we aimed to investigate the possible effects of upper extremity exercises and neuromuscular electrical stimulation therapy applied to auxiliary respiratory muscles on arterial blood gases, blood pressure, heart rate values, and quality of life in patients with chronic obstructive pulmonary disease. Material and Methods: Thirty patients who were diagnosed with stage 4 severe chronic obstructive pulmonary disease by a pulmonologist and who needed intensive care were included in the study. The patients were equally allocated into two groups containing 15 patients each: control and intervention. Both groups were given an unassisted upper extremity exercise program for four weeks, and only one group was given neuromuscular electrical stimulation on auxiliary respiratory muscles for 10 days. Arterial blood gas measurements, peak heart rate, and breathing frequency were recorded. St. George’s Respiratory Questionnaire and short form-36 were performed for the evaluation of the quality of life. Functional capacity was determined by functional independent measurement. Evaluations of the patients were performed on the 1st, 8th, 15th, and 30th days of the study. Results: There were statistically significant improvements in peak heart rate, breathing frequency per minute, and functional independency scores in the group where exercise and neuromuscular electrical stimulation had been concomitantly applied (p<0.05). Conclusion: This study revealed positive effects of neuromuscular electrical stimulation in addition with therapeutic exercises on the cardiorespiratory system in the short run.

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Meningiomlar; araknoid hücrelerden köken alan, tipik olarak selim karakterde, yavaş büyüyen tümörlerdir. Tüm meningiomlar içerisinde spinal meningiomlar %12 sıklıkta görülmektedir. Genellikle yavaş büyüme eğiliminde olmaları ve bulundukları bölgeye göre farklı semptom oluşturmaları nedeniyle semptomların başlamasıyla tanı konulması arasında geçen süre değişkendir. Manyetik rezonans (MR) görüntüleme öncesinde bazı spinal meningiomlu olguların lomber disk hernisi veya diz cerrahisi geçirdikleri bildirilmiştir. Burada 67 yaşında uzun süredir bel ağrısı ve alt ekstremitede ilerleyici kas gücü kaybı olan, lomber spinal stenoz tanısıyla opere edildikten sonra dorsal meningiom tanısı alan bir hastayı sunduk. Ameliyat sonrası tarafımıza başvuran hastayı rehabilitasyon amacıyla servisimizde takip ettik.