Objectives: This study aims to explore the accordance to the 2018 European League Against Rheumatism (EULAR) recommendations for
the management of hand osteoarthritis (OA) among the Turkish League Against Rheumatism (TLAR) expert panel and composition of TLAR
recommendations for the management of hand OA under guidance of the current literature.
Materials and methods: The TLAR convener designated an expert panel of 10 physicians experienced in hand OA for this process. The 2018 EULAR
recommendations for the management of hand OA and the systematic review of the literature were sent to the expert panel via e-mails. The e-mail
process which included Delphi round surveys was completed. The EULAR standard operational procedure Appraisal of Guidelines for Research
and Evaluation II was followed. The level of agreement was calculated for each item and presented as mean, standard deviations, minimum and
maximum and comparisons of 2018 EULAR recommendations were performed.
Results: Five overarching principles and 10 recommendations were discussed. Revisions were held for the sixth, seventh, and ninth recommendations
with lowest level of agreements. These recommendations were revised in accordance with suggestions from the experts and re-voted. The revised
forms were approved despite the lack of statistically significant difference between these forms (p=0.400, p=0.451, p=0.496, respectively). Except
for the ninth recommendation about surgery (p=0.008), no significant difference in level of agreements was observed between the EULAR and TLAR
hand OA recommendations. The 11th recommendation about paraffin bath was added.
Conclusion: The optimal treatment of hand OA consists of personalized non-pharmacological (self-management, exercise, splint), pharmacological
(topical non-steroidal anti-inflammatory drugs as the first choice), and interventional procedures (only for refractory cases) based on shared decision
between the patient and physician. TLAR hand OA recommendations were created mainly based on the most recent literature and the last EULAR
hand OA management recommendations, which are widely approved among the TLAR experts.
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Objectives: This study aims to determine the preferences of physical and rehabilitation medicine (PRM) residents in Turkey for future career choices,
subspecialty training plans, and practice location and to identify the factors that influence those preferences.
Materials and methods: Using a cross-sectional study design, a survey was sent to all PRM residents enrolled in the Turkish Society of Physical
Medicine and Rehabilitation and the Turkish League Against Rheumatism (n=500). A total of 181 residents (36%) (74 males, 107 females; mean
age 28.8 years; range 24 to 40 years) responded to the survey. Data were collected about demographic profile of respondents and PRM clinics,
respondents’ experiences in rheumatology education and injection skills, preferences for fellowship training, and future practice location.
Results: Thirty-five percent of residents intended to pursue fellowship training. Rheumatology was more preferred than algology. Male sex was
positively associated with the decision to pursue fellowship training and also having an algology division in the PRM department was positively
associated with planning to pursue algology fellowship training. For those planning to pursue fellowship training, the most influential factors were
prestige, interest in an academic career and the possibility of performing compulsory service in a better location. Thirty-four percent of residents
preferred to work in university hospitals after residency while 57% of residents who planned to pursue fellowship training preferred to practice at
university hospitals after their fellowship. Thus, an academically oriented career was the most desirable career choice.
Conclusion: One-third of residents training in Turkey chose to pursue fellowship training and work in university hospitals. Performing compulsory
service was the top factor affecting the decisions of both undecided and reluctant residents; thus, career plans of PRM residents in Turkey are not
based solely on personal and professional desires, but require consideration of compulsory service.
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OBJECTIVE: To determine the validity and reliability of the Turkish version of the Trunk impairment scale (TIS), used in the
evaluation of somatic, motor, and coordination disturbances in stroke patients, and provide a culturally adapted version for
use in the Turkish population.
METHODS: A total of 80 patients who were either hospitalized at our facility and rehabilitated for stroke or admitted at our
outpatient clinics were included in this study. Reliability was evaluated by the internal consistency (Cronbach α) and test
reproducibility [intra-class correlation coefficient (ICCC)] methods, and validity was evaluated by the correlation between
subgroups and the total scores of the TIS and Berg Balance Scale (BBS), Brunnstrom phases, Barthel index (BI), Rivermead
mobility index (RMI), and Short Form-36 (SF-36) scores.
RESULTS: The mean age of the patients was 63.00±12.1 years. Out of a total of 80 subjects, 34 were female and 46 were
male. The reliability of the scale was evaluated by the internal consistency, inter- and intra-observer reliability, and test reproducibility. The findings showed that the Turkish form of the scale was reliable at a good level. The test values were as follows;
Cronbach α: >0.70, ICCC: 0.969–1, subgroups and total score comparison: 0. The correlation between TIS and BBS was
considerably high in the validity analysis (p<0.001). Further, significant associations among the BI, RMI, KF-36, Brunnstrom,
and TIS scores were found (p<0.001), which indicate the structural validity of this scale.
CONCLUSION: TIS is a scale used in measuring the motor derangement that develops after a stroke. It has sufficient reliability, internal consistency, and validity for use in clinical practice and stroke investigations. Our study has shown that TIS
used for the evaluation of body balance is valid and reliable for the Turkish population.
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Schwannomlar ‘nörilemma’ olarak da adlandırılan schwann hücrelerinden kaynaklanan periferik sinirlerin en sık görülen benign
tümörüdür. Sıklıkla baş ve boyun bölgesinden kaynaklanan soliter lezyonlardır. Tanı esasında ultrasonografi, manyetik
rezonans görüntüleme ve histopatolojik incelemelere dayanır. Kapsüllü olduğundan dolayı cerrahi eksizyon sonrasında nüks
ihtimali düşüktür ve iyi bir prognoza sahiptir. Bu yazıda, ilk bakışta ganglion kistini taklit eden bir schwannom olgusu sunuldu.
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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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Selda ÇİFTCİ,
KADRİYE BANU KURAN , Zehra DUMAN, Figen YILMAZ, Cansu MERT, Gülgün DURLANIK, Jülide ÖNCÜ, Bilge DÜDEN, Hüseyin BERTAN,
CEM ERÇALIK ,
BERİL DOĞU , Rana TERLEMEZ
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Topuk ağrısı ayak ağrılarının %15'ini oluşturur. Ağrı, plantar fasiit, kalkaneal kırık, kalkaneal apofizit, topuk yastığının atrofisi, enflamatuar hastalıklar gibi nedenlere bağlı olabildiği gibi sinir kökenli de olabilir. Tibial, plantar ve/veya medial kalkaneal sinir sıkışması ağrının nöral nedenlerindendir. Medial kalkaneal sinir topuktaki yumuşak dokuların çoğunun duysal innervasyonunu sağlar. Topuk ağrısının nöral kaynaklı olduğunu teşhis etmek için öykü ve dikkatli bir fizik muayene gerekir. Topuk ağrısının diğer nedenleri dışlanmadan önce cerrahi girişim için acele edilmemeli, konservatif tedavi sonrasında tanı yeniden gözden geçirilmelidir.
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Selda ÇİFTCİ, Jülide ÖNCÜ ALPTEKİN, Zehra DUMAN, Cansu MERT, Rana TERLEMEZ, Figen YILMAZ,
KADRİYE BANU KURAN
Selda ÇİFTCİ, Jülide ÖNCÜ ALPTEKİN, Zehra DUMAN, Cansu MERT, Rana TERLEMEZ, Figen YILMAZ,
... Devamını oku
Glukokortikoid kullanımı sırasında pek çok yan etkiyle karşılaşılmaktadır. Osteoporoz kemik metabolizması üzeri sık görülen yan etkisidir. Yüksek dozda ve uzun süreli steroid kullanımı sırasında yan etki artar. Bu yazımızda, Behçet hastalığına bağlı göz tutulumu nedeniyle yaklaşık 6 yıldır kontrolsüz glukokortikoid ve 3 yıldır siklosporin kullanımı sonucu dorsal ve lomber vertebralarda osteoporotik fraktür gelişen genç erkek bir olgu sunulmuştur. Sonuç olarak bu olgu, steroidlerin ve kombinasyon tedavilerinin gerekli endikasyonlarda, uygun doz ve süreyle kullanılmasını, hastaların düzenli takip edilmelerinin gerektiğini göstermiştir
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Türk Halk Sağlığı Kurumu verilerine göre prostat kanseri, ülkemizde erkeklerde en sık görülen 2. kanser türüdür. İleri evrede olgular karşımıza bel, kalça, uyluk ağrısı gibi şikayetlerle başvurabilirler. Bu olgu sunumunda, 66 yaşında kalça ağrısı olan ve romatoloji polikliniğimize sakroileit nedeni ile refere edilmiş bir olgu sunulmuştur. Olgunun ileri tetkiklerinde kalça ağrısının, osteoblastik kemik metastazı sonucu gelişen asetabular kırığa bağlı olduğu anlaşılmıştır. Primer prostat kanseri tanısı konan olguda radyoterapi sonrasında belirgin ağrı palyasyonu sağlanmıştır
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