Browsing by Author "Altay Z."
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Item Gain in visual acuity after cataract surgery improves postural stability and mobility(2011) Durmus B.; Emre S.; Cankaya C.; Baysal O.; Altay Z.Objectives: Vision plays an important role in postural stability. It has also been shown that visual information from the environment and visual cues significantly contribute to balance skills. The aim of this study was to investigate the effects of visual acuity on postural stability and mobility before and after cataract surgery. Methods: The study group was composed of 25 male and 11 female patients (age 57-84, mean 66.6±4.7) who had been operated for age-related cataract. Postural stability and mobility were assessed before and four weeks after the surgery by means of Biodex stability system (BSS), Tinetti, Time up and go (TUG) and Functional reach (FR) tests, as well as by gait analysis (gait velocity, step length, step width, cadence, stride length). Results: Postoperative visual acuity was significantly improved. Gait velocity and cadence increased significantly but step length, stride length, and step width did not change significantly. Postoperative improvement of Tinetti balance, TUG and FR tests were significant. Similarly, antero-posterior stability index (APSI), medio-lateral stability index (MLSI) and overall stability index (OSI) that were examined with BSS improved significantly after the cataract surgery. Conclusion: These results demonstrated that gain in visual acuity after cataract surgery improves the postural stability and mobility of patients.Item Turkish League Against Rheumatism National recommendations for the management of ankylosing spondylitis; [Türkiye romatizma araştırma ve savaş derneǧi ankilozan spondilit ulusal tedavi önerileri](Turkish League Against Rheumatism (TLAR), 2011) Bodur H.; Sivas F.; Yilmaz O.; Özgöçmen S.; Günaydin R.; Kaya T.; Ataman S.; Altan L.; Altay Z.; Aydoǧ E.; Birtane M.; Borman P.; Buǧdayci D.S.; Bütün B.; Çakirbay H.; Duruöz T.; Gürer G.; Hepgüler S.; Kamanli A.; Kuru O.; Küçükdeveci A.; Nacir B.; Ölmez N.; Rezvani A.; Yanik B.C.Objectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group (ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and nonpharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments. ©2011 Turkish League Against Rheumatism. All rights reserved.Item Management of rheumatoid arthritis: Consensus recommendations from the Turkish league against rheumatism; [Romatoid artritin tedavisi: Türkiye romatizma araştırma ve savaş derneǧi uzlaşı önerileri](Turkish League Against Rheumatism (TLAR), 2011) Ataman S.; Borman P.; Evcik D.; Aydoǧ E.; Ayhan F.; Yildizlar D.; Bodur H.; Altay Z.; Birtane M.; Bütün B.; Duruöz T.; Erdem H.R.; Günendi Z.; Günaydin R.; Gürer G.; Kaçar C.; Kaptanoǧlu E.; Kaya T.; Ölmez N.; Paker N.; Rezvani A.; Sonel Tur B.; Yener M.; Özgöçmen S.Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions. Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope "Recommendations for the Management of RA in Turkey" based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated. Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon. Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated. © 2011 Turkish League Against Rheumatism. All rights reserved.Item Femoral cartilage thickness measurements in healthy individuals: Learning, practicing and publishing with TURK-MUSCULUS(IOS Press, 2014) Özçakar L.; Tunç H.; Öken O.; Ünlü Z.; Durmuş B.; Baysal O.; Altay Z.; Tok F.; Akkaya N.; Doʇu B.; Çapkin E.; Bardak A.; Çarli A.B.; Buʇdayci D.; Toktaş H.; Diraçoʇlu D.; Gündüz B.; Erhan B.; Kocabaş H.; Erden G.; Günendi Z.; Kesikburun S.; Omaç O.K.; Taşkaynatan M.A.; Şenel K.; Uʇur M.; Yalçinkaya E.Y.; Öneş K.; Atan C.; Akgün K.; Bilgici A.; Kuru O.; OzgocmenBACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population. The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle). RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses. CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard. © 2014 - IOS Press and the authors. All rights reserved.Item Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis(Informa Healthcare, 2014) Rezvani A.; Bodur H.; Ataman Ş.; Kaya T.; Buǧdayci D.S.; Demir S.E.; Koçyiǧit H.; Altan L.; Uǧurlu H.; Kirnap M.; Gür A.; Kozanoǧlu E.; Akinci A.; Tekeoǧlu I.; Şahin G.; Bal A.; Sivrioǧlu K.; Yazgan P.; Aydin G.; Hepgüler S.; Ölmez N.; Şendur Ö.F.; Yener M.; Altay Z.; Ayhan F.; Durmuş O.; Duruöz M.T.; Günendi Z.; Nacir B.; Öken Ö.; Toktaş H.; Delialioǧlu S.Ü.; Evcik D.; Sertpoyraz F.M.Objectives. 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. © 2014 Japan College of Rheumatology.Item Isokinetic evaluation of knee extensor/flexor muscle strength in Behcet's patients(Sociedade Portuguesa de Reumatologia, 2015) Durmus B.; Emre S.; Sahin N.; Karincaoglu Y.; Dogan E.; Baysal O.; Ersoy Y.; Altay Z.Background: Behçet's disease (BD) is an idiopathic, multisystemic, progressive disease. The purpose of this study is to compare the knee flexor and extensor isokinetic muscle strengths of Behcet's patients with that of healthy subjects. Methods: Twenty-five (13 male and 12 female) patients with BD and 25 (15 male and 10 female) healthy individuals were included in the study. Velocities of 90°/sec, 120°/sec, and 150°/sec were used for the isokinetic muscle strength testing. Patients with active inflammatory knee arthritis were excluded. Peak torque (Nm) and peak torque adjusted to body weight (%) were taken into consideration for comparison between study groups. Results: Compared to healthy controls, there was a statistically significant decrease in both the bilateral knee extensor and flexor muscle isokinetic peak torques (Nm) as well as the peak torques adjusted to body weight (%) at velocities of 90°/sec, 120°/sec and 150°/sec in patients with BD (p < 0.05). However, there was no significant difference in the agonist-antagonist ratio of the isokinetic peak torques of knee muscles between the two groups. Conclusion: In light of these findings, we have concluded that both knee flexor and extensor isokinetic muscle strengths are lower in BD. We therefore recommend careful monitoring of patients with BD in terms of muscle strength.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 TLAR(Turkish League Against Rheumatism (TLAR), 2015) Ataman Ş.; Sari Sürmeli Z.; Sunar İ.; Özdemirel E.; Akinci A.; Bodur H.; Akgül Ö.; Altan L.; Altay Z.; Ayhan F.; Birtane M.; Soy Buğdayci D.; Çapkin E.; Cerrahoğlu L.; Duruöz M.T.; Günaydin R.; Günendi Z.; Gürer G.; Bal A.; Kaçar C.; Kaptanoğlu E.; Kaya T.; Kocabaş H.; Kotevoğlu N.; Nas K.; Rezvani A.; Şen N.; Şendur Ö.F.; Yalçin P.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. 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. © 2015 Turkish League Against Rheumatism. All rights reserved.Item Prevalence of rheumatoid arthritis and spondyloarthritis in Turkey: A nationwide study(Turkish League Against Rheumatism (TLAR), 2018) Tuncer T.; Gilgil E.; Kaçar C.; Kurtaiş Y.; Kutlay Ş.; Bütün B.; Yalçin P.; Akarirmak Ü.; Altan L.; Ardiç F.; Ardiçoğlu Ö.; Altay Z.; Cantürk F.; Cerrahoğlu L.; Çevik R.; Demir H.; Durmaz B.; Dursun N.; Duruöz T.; Erdoğan C.; Evcik D.; Gürsoy S.; Hizmetli S.; Kaptanoğlu E.; Kayhan Ö.; Kirnap M.; Kokino S.; Kozanoğlu E.; Kuran B.; Nas K.; Öncel S.; Sindel D.; Orkun S.; Sarpel T.; Savaş S.; Şendur Ö.F.; Şenel K.; Uğurlu H.; Uzunca K.; Tekeoğlu İ.; Guillemin F.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. © 2018 Turkish League Against Rheumatism. All rights reserved.Item Management of psoriatic arthritis: Turkish League Against Rheumatism (TLAR) expert opinions(Turkish League Against Rheumatism (TLAR), 2018) Nas K.; Kiliç E.; Çevik R.; Bodur H.; Ataman Ş.; Ayhan F.; Akgül Ö.; Akinci A.; Altay Z.; Çapkın E.; Dağli A.Z.; Duruöz T.; Gürer G.; Göğüş F.; Garip Y.; Kaçar C.; Kamanli A.; Kaptanoğlu E.; Kaya T.; Kocabaş H.; Özdemirel E.A.; Özel S.; Sezer İ.; Sunar İ.; Yilmaz G.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. © 2018 Turkish League Against Rheumatism. All rights reserved.Item Turkish league against rheumatism (TLAR) recommendations for the pharmacological management of rheumatoid arthritis: 2018 update under guidance of current recommendations(Turkish League Against Rheumatism (TLAR), 2018) Ataman Ş.; Sunar İ.; Yilmaz G.; Bodur H.; Nas K.; Ayhan F.F.; Akgül Ö.; Akinci A.; Altay Z.; Birtane M.; SOY Buğdayci D.; Çapkin E.; Çevik R.; Garİp Çimen Y.; Duruöz M.T.; Elhan A.H.; Gürer G.; Kaçar C.; Kamanli A.; Kaptanoğlu E.; Kaya T.; Kocabaş H.; Kuru Ö.; Alkan Melikoğlu M.; Özel S.; Rezvani A.; Sezer İ.; Yurdakul F.G.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. © 2018 Turkish League Against Rheumatism. All rights reserved.Item Turkish league against rheumatism consensus report: Recommendations for management of axial spondyloarthritis(Turkish League Against Rheumatism (TLAR), 2018) Bodur H.; Yurdakul F.G.; Ataman Ş.; Garıp Y.; Nas K.; Ayhan F.F.; Akgül Ö.; Akinci A.; Altay Z.; Birtane M.; Soy Buğdayci D.; Çapkin E.; Çevık R.; Duruöz T.; Gürer G.; Kaçar C.; Kamanli A.; Kaptanoğlu E.; Kaya T.; Kocabaş H.; Kuru Ö.; Melikoğlu M.A.; Özdemırel E.; Özel S.; Rezvani A.; Sezer İ.; Sunar İ.; Yilmaz G.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. © 2018 Turkish League Against Rheumatism. All rights reserved.