Browsing by Author "Akinci, A"
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Item Management of Psoriatic Arthritis: Turkish League Against Rheumatism (TLAR) Expert OpinionsNas, K; Kiliç, E; Çevik, R; Bodur, H; Ataman, S; Ayhan, F; Akgül, Ö; Akinci, A; Altay, Z; Çapkin, E; Dagli, AZ; Duruöz, T; Gürer, G; Gögüs, F; Garip, Y; Kaçar, C; Kamanli, A; Kaptanoglu, E; Kaya, T; Kocabas, H; Özdemirel, EA; Özel, S; Sezer, I; Sunar, I; Yilmaz, GObjectives: 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.Item Quality of life and related variables in patients with ankylosing spondylitisBodur, H; Ataman, S; Rezvani, A; Bugdayci, DS; Çevik, R; Birtane, M; Akinci, A; Altay, Z; Günaydin, R; Yener, M; Koçyigit, H; Duruöz, T; Yazgan, P; Çakar, E; Aydin, G; Hepgüler, S; Altan, L; Kirnap, M; Ölmez, N; Soydemir, R; Kozanoglu, E; Bal, A; Sivrioglu, K; Karkucak, M; Günendi, ZTo evaluate quality of life (QoL) and related variables in patients with ankylosing spondylitis (AS), a chronic inflammatory disease of the spine. Nine-hundred and sixty-two patients with AS from the Turkish League Against Rheumatism AS Registry, who fulfilled the modified New York criteria, were enrolled. The patients were evaluated using the Assessment of SpondyloArthritis International Society core outcome domains including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), fatigue (BASDAI-question 1), pain (last week/spine/due to AS), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and two QoL questionnaires (the disease-specific ASQoL and generic the Short Form-36 [SF-36]). The mean ASQoL score was 7.1 +/- A 5.7. SF-36 subscales of general health, physical role and bodily pain had the poorest scores. ASQoL was strongly correlated with disease duration, BASDAI, fatigue, BASFI, BASMI, BASRI, MASES, pain and SF-36 subscales (P < 0.001). SF-36 subscales were also strongly correlated with BASDAI and BASFI. Advanced educational status and regular exercise habits positively affected QoL, while smoking negatively affected QoL. In patients with AS, the most significant variables associated with QoL were BASDAI, BASFI, fatigue and pain. ASQoL was noted to be a short, rapid and simple patient-reported outcome (PRO) instrument and strongly correlated with SF-36 subscales.Item Anthropometric findings from birth to adulthood and their relation with karyotpye distribution in Turkish girls with Turner syndromeSari, E; Bereket, A; Yesilkaya, E; Bas, F; Bundak, R; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Öakan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; Ökten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Demirbilek, H; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Unuvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, Ç; Bas, VN; Fidanci, K; Gül, D; Polat, A; Acikel, C; Cinaz, P; Darendeliler, FTo evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P<0.001). The mean birth length was 1.3cm shorter and mean birth weight was 0.36kg lower than that of the normal population. The mean age at diagnosis was 10.1 +/- 4.4 years. Mean height, weight and body mass index standard deviation scores at presentation were -3.1 +/- 1.7, -1.4 +/- 1.5, and 0.4 +/- 1.7, respectively. Patients with isochromosome Xq were significantly heavier than those with other karyotype groups (P=0.007). Age at presentation was negatively correlated and mid-parental height was positively correlated with height at presentation. Mid-parental height and age at presentation were the only parameters that were associated with height of children with TS. The frequency of SGA birth was found higher in preterm than term neonates but the mechanism could not be clarified. We found no effect of karyotype on height of girls with TS, whereas weight was greater in 46,X,i(Xq) and 45,X/46,X,i(Xq) karyotype groups. (c) 2016 Wiley Periodicals, Inc.Item Growth curves for Turkish Girls with Turner Syndrome: Results of the Turkish Turner Syndrome Study GroupDarendeliler, F; Yesilkaya, E; Bereket, A; Bas, F; Bundak, R; Sari, E; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Mazicioglu, MM; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Özkan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; Ökten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Demirbilek, H; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Ünüvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, Ç; Bas, VN; Saglam, C; Gül, D; Polat, A; Açikel, C; Cinaz, PObjective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS. Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated. Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others. Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients.Item Turkish League Against Rheumatism (TLAR) Recommendations for the Pharmacological management of Rheumatoid Arthritis: 2018 Update Under Guidance of Current RecommendationsAtaman, S; Sunar, I; Yilmaz, G; Bodur, H; Nas, K; Ayhan, FF; Akgül, Ö; Akinci, A; Altay, Z; Birtani, M; Soy Bugdayci, D; Çapkin, E; Çevik, R; Garip Çimen, Y; Duruöz, MT; Elhan, AH; Gürer, G; Kaçar, C; Kamanli, A; Kaptanoglu, E; Kaya, T; Kocabas, H; Kuru, Ö; Alkan Melikoglu, M; Özel, S; Rezvani, A; Sezer, I; Gül Yurdakul, FObjectives: 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.Item Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial SpondyloarthritisBodur, H; Yurdakul, FG; Ataman, S; Garip, Y; Nas, K; Ayhan, FF; Akgül, Ö; Akinci, A; Altay, Z; Birtane, M; Soy Bugdayci, D; Çapkin, E; Çevik, R; Duruöz, T; Gürer, G; Kaçar, C; Kamanli, A; Kaptanoglu, E; Kaya, T; Kocabas, H; Kuru, Ö; Melikoglu, MA; Özdemirel, E; Özel, S; Rezvani, A; Sezer, I; Sunar, I; Yilmaz, GObjectives: 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.Item Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitisRezvani, A; Bodur, H; Ataman, S; Kaya, T; Bugdayci, DS; Demir, SE; Koçyigit, H; Altan, L; Ugurlu, H; Kirnap, M; Gür, A; Kozanoglu, E; Akinci, A; Tekeoglu, I; Sahin, G; Bal, A; Sivrioglu, K; Yazgan, P; Aydin, G; Hepgüler, S; Ölmez, N; Sendur, ÖF; Yener, M; Altay, Z; Ayhan, F; Durmus, O; Duruöz, MT; Günendi, Z; Nacir, B; Öken, Ö; Toktas, H; Delialioglu, SÜ; Evcik, D; Sertpoyraz, FMObjectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 +/- 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.Item Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLARAtaman, S; Sürmeli, ZS; Sunar, I; Özdemirel, E; Akinci, A; Bodur, H; Akgül, Ö; Altan, L; Altay, Z; Ayhan, F; Birtane, M; Soy Bugdayci, D; Çapkin, E; Cerrahoglu, L; Duruöz, MT; Günaydin, R; Günendi, Z; Gürer, G; Bal, A; Kaçar, C; Kaptanoglu, E; Kaya, T; Kocabas, H; Kotevoglu, N; Nas, K; Rezvani, A; Sen, N; Sendur, OF; Yalçin, PObjectives: 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. Materials 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.Item Turner Syndrome and Associated Problems in Turkish Children: A Multicenter StudyYesilkaya, E; Bereket, A; Darendeliler, F; Bas, F; Poyrazoglu, S; Aydin, BK; Darcan, S; Dündar, B; Büyükinan, M; Kara, C; Sari, E; Adal, E; Akinci, A; Atabek, ME; Demirel, F; Çelik, N; Özkan, B; Özhan, B; Orbak, Z; Ersoy, B; Dogan, M; Atas, A; Turan, S; Göksen, D; Tarim, Ö; Yüksel, B; Ercan, O; Hatun, S; Simsek, E; ÖOkten, A; Abaci, A; Döneray, H; Özbek, MN; Keskin, M; Önal, H; Akyürek, N; Bulan, K; Tepe, D; Emeksiz, HC; Demir, K; Kizilay, D; Topaloglu, AK; Eren, E; Özen, S; Abali, S; Akin, L; Eklioglu, BS; Kaba, S; Anik, A; Bas, S; Ünüvar, T; Saglam, H; Bolu, S; Özgen, T; Dogan, D; Çakir, ED; Sen, Y; Andiran, N; Çizmecioglu, F; Evliyaoglu, O; Karagüzel, G; Pirgon, Ö; Çatli, G; Can, HD; Gürbüz, F; Binay, C; Bas, VN; Fidanci, K; Polat, A; Gül, D; Açikel, C; Demirbilek, H; Cinaz, P; Bondy, CObjective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. Results: The most common karyotype was 45, X (50.7%), followed by 45, X/46, XX (10.8%), 46, X, i(Xq) (10.1%) and 45, X/46, X, i(Xq) (9.5%). Mean age at diagnosis was 10.2 +/- 4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45, X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan.