Browsing by Author "Cerrahoğlu L."
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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 Ankle pain in hereditary multiple exostoses: A case report(Springer Verlag, 2015) Cerrahoğlu L.; Ulusoy A.; Akgül Ö.[No abstract available]Item 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 The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study(Turkish League Against Rheumatism (TLAR), 2022) Duruöz M.T.; Gürsoy D.E.; Tuncer T.; Altan L.; Ayhan F.; Bal A.; Bilgilisoy M.; Cerrahoğlu L.; Çapkın E.; Çay H.F.; Çevik R.; Durmaz B.; Dülgeroğlu D.; Gürer G.; Gürsoy S.; Hepgüler S.; Hizmetli S.; Kaçar C.; Kaptanoğlu E.; Kaya T.; Ecesoy H.; Melikoğlu M.A.; Nas K.; Nur H.; Özçakır Ş.; Sarıdoğan M.; Sarıkaya S.; Sezer İ.; Sindel D.; Şahin N.; Şahin Ö.; Şendur Ö.F.; Bozbaş G.T.; Tıkız C.; Uğurlu H.Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Türkiye by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results: The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades. © 2022 Turkish League Against Rheumatism. All rights reserved.Item The clinical and demographical characteristics of Turkish pediatric lymphedema patients: a multicenter study(Turkiye Klinikleri, 2022) Borman P.; Balcan A.; Eyigör S.; Coşkun E.; Ayhan F.; Çakit B.D.; Vural S.; Vural M.; Çakir E.D.P.; Çağdaş D.; Yaman A.; Cerrahoğlu L.; Doğan S.C.Background/aim: Reducing lymphedema-associated burden and disability in the pediatric setting requires improved awareness and understanding clinical properties of the lymphedema. The aim of this study was to evaluate the clinical and demographic characteristics of patients with pediatric lymphedema presented to different lymphedema centers in Turkey. Materials and methods: The socio-demographic and clinical characteristics of the children including age, gender, presence of genetic syndromes, duration of edema, site and stage of lymphedema and the received therapies were determined. Parental and children education on self-management techniques were recorded. Results: A total of 122 children (female: 66, male: 56) with a mean age of 120.7 ± 71.2 months were included from 7 centers. Of them; 92% had primary, 8% had secondary lymphedema mostly due to infection and trauma. Lymphedema was part of a syndrome in 18% of the children. The most common site of involvement was the lower extremity, followed by upper extremity and genital involvement. Lymphedema was complicated in 17 % of children, mainly with a clinical picture of cellulitis, infection, and pain. The median duration of lymphedema was 41 (5–216) months. Although most of the children had stage 2 lymphedema, only 40% of them received treatment. The most commonly received treatment was compression therapy. No family or child was educated for self-care management before. Conclusion: In conclusion, pediatric lymphedema has a comparable gender distribution and usually involves the lower extremities. Although most of the children had advanced disease, more than half of the patients did not receive any treatment indicating the unmet need for management of lymphedema. The education of patients and/or children about self-management methods were lacking. We suggest educational activities for both families of children with lymphedema and health care providers, in order to facilitate early reference to lymphedema units and to receive prompt preventive and therapeutic approaches for this suffering condition. © TÜBİTAK.Item Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis(Turkish League Against Rheumatism (TLAR), 2023) Altan L.; Metin Ökmen B.; Tuncer T.; Sindel D.; Çay H.F.; Hepgüler S.; Sarıkaya S.; Ayhan F.; Bal A.; Bilgilisoy M.; Çapkın E.; Cerrahoğlu L.; Çevik R.; Dülgeroğlu D.; Durmaz B.; Duruöz T.; Gürer G.; Gürsoy S.; Hizmetli S.; Kaçar C.; Kaptanoğlu E.; Ecesoy H.; Melikoğlu M.; Nas K.; Nur H.; Özçakır Ş.; Şahin N.; Şahin Ö.; Sarıdoğan M.; Şendur Ö.F.; Sezer İ.; Bozbaş G.T.; Tıkız C.; Uğurlu H.Objectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain. © 2023, Turkish League Against Rheumatism (TLAR). All rights reserved.Item Additional contribution of phonophoresis and low-level laser therapy to exercise in the treatment of carpal tunnel syndrome: A clinical, electrophysiological, and ultrasonographic evaluation; [Karpal tünel sendromunun tedavisinde fonoforez ve düşük seviyeli lazer tedavisinin egzersize ek katkısının klinik, elektrofizyolojik ve ultrasonografik olarak değerlendirilmesi](Turkish Society of Algology, 2024) Karaman N.; Ünlü Z.; Selçuki D.; Cerrahoğlu L.Objectives: Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve compression syndrome. This study aims to evaluate the additive contribution of phonophoresis and low-level laser therapy (LLLT) to tendon and nerve gliding exercises electrophysiologically, ultrasonographically, and clinically in the treatment of moderate CTS. Methods: The sample consisted of 45 patients with moderate CTS, randomized into three groups. Group 1 received phonophoresis and exercise, Group 2 received LLLT and exercise, and Group 3 received exercise alone. Participants were evaluated electrophysiologically, clinically, and ultrasonographically before treatment and at the 6th and 12th weeks after the treatment. Results: An improvement was observed in clinical parameters (Boston Functional Status Scale, Boston Symptom Severity Scale, visual analog scale at rest, and visual analog scale during activity) for all groups at the 6th and 12th weeks after the treatment (p<0.05). An improvement was also noted in the ultrasonographic parameter (cross-sectional area) for all groups at the 12th week after the treatment (p=0.017). Conclusion: Phonophoresis and LLLT do not provide additional effects to exercise therapy. Exercise therapy alone may positively contribute to ultrasonographic and clinical outcomes in the treatment of moderate CTS. © 2024 Turkish Society of Algology.