Browsing by Author "Nas, K"
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Item THE RELATIONSHIP BETWEEN MRI FINDINGS, PAIN AND DISABILITY IN THE PATIENTS WITH CERVICAL OSTEOARTHRITISAltan, L; Ökmen, BM; Tuncer, T; Akarirmak, U; Ayhan, F; Bal, A; Bozbas, G; Cerrahoglu, L; Cevik, R; Durmaz, B; Duruöz, T; Dülgeroglu, D; Gürer, G; Gürsoy, S; Hepgüler, S; Hizmetli, S; Kaçar, C; Kaptanoglu, E; Kocabas, H; Nas, K; Nur, H; Özçakir, S; Özdolap, S; Sindel, D; Sahin, O; Sendur, F; Tikiz, C; Ugurlu, HItem THE FREQUENCY AND ASSOCIATION OF KNEE, HIP, HAND AND SPINE OSTEOARTHRITIS IN TURKISH POPULATION: A PRELIMINARY RE PORT OF MULTICENTER LONGITUDINAL STUDYTuncer, T; Ugur, S; Nur, H; Kacar, C; Akarimak, U; Altan, L; Ayhan, F; Bal, A; Basaran, S; Bilgilisoy, M; Bozbas, G; Cerrahoglu, L; Cevik, R; Coskun, N; Dagli, Z; Durmaz, B; Duruoz, T; Dulgeroglu, D; Gurer, G; Gursoy, S; Hepguler, S; Hizmetli, S; Kaplanoglu, E; Kaya, T; Kocabas, H; Kuran, B; Melikoglu, M; Nas, K; Oncu, J; Ozcakir, S; Ozdolap, S; Saridogan, M; Sarikaya, S; Sindel, D; Sahin, O; Sendur, OF; Tikiz, C; Ugurlu, H; Yilmaz, FItem THE RADIOLOGICAL, CLINICAL AND FUNCTIONAL PROPERTIES OF HAND OSTEOARTHRITIS AND THEIR RELATION WITH RADIOLOGICAL FINDINGS IN A TURKISH POPULATION: TLAR-OA STUDYDuruöz, MT; Erdem, D; Tuncer, T; Altan, L; Ayhan, F; Bal, A; Cerrahoglu, L; Capkin, E; Cevik, R; Dulgeroglu, D; Gursoy, S; Hizmetli, S; Kacar, C; Kaptanoglu, E; Kaya, T; Kocabas, H; Nas, K; Ozcakir, S; Sindel, D; Sahin, O; Bozbas, GT; Tikiz, C; Ugurlu, HItem Gastrointestinal side effect profile due to the use of alendronate in the treatment of osteoporosisAki, S; Eskiyurt, N; Akarirmak, Ü; Tüzün, F; Eryavuz, M; Alper, S; Arpacioglu, O; Atalay, F; Kavuncu, V; Kokino, S; Kuru, O; Nas, K; Özerbil, Ö; Savas, G; Sendur, ÖF; Soy, D; Akyüz, GThe aim of our study was to evaluate the upper gastrointestinal (GI) tract side effect profile in 759 female patients that had taken alendronate (10 mg/day), for at least 6 months, for the treatment of osteoporosis, in relation to the safety of alendronate and the compliance of patients to its absorption rules. This study was a multicentered retrospective, clinical, non-placebo controlled, study of 759 female subjects carried out at 26 centres in 6 different regions of Turkey. The mean age of our patients was 62.6 +/- 8.6, with 51.2% in the age range 60 to 69 years. 158 patients (20.8%) were considered to have upper GI tract complaints with nausea as the most often encountered symptom. Of the subjects with upper GI tract complaints, 20% reported discontinued drug use, and 30% reported the requirement of an additional drug in order to abolish their complaints. Approximately 537 (71%) of the patients stated they had been given written information about the administration of the drug, and at least 93 patients (12%) and 73 patients (18.4%) acknowledged non compliance with the safety and absorption rules, respectively. In our study, no significant difference was found between the adherence to the safety measures and upper GI tract complaints (p>0.05), but that upper GI tract complaints were higher in patients taking additional medication to alendronate (p<0.05).Item Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosisAltan, L; Ökmen, BM; Tuncer, T; Sindel, D; Çay, HF; Hepgüler, S; Sarikaya, S; Ayhan, F; Bal, A; Bilgilisoy, M; Çapkin, E; Cerrahoglu, L; Çevik, R; Dülgeroglu, D; Durmaz, B; Duruöz, T; Gürer, G; Gürsoy, S; Hizmetli, S; Kaçar, C; Kaptanoglu, E; Ecesoy, H; Melikoglu, M; Nas, K; Nur, H; Özcakir, S; Sahin, N; Sahin, O; Saridogan, M; Sendur, ÖF; Sezer, I; Bozbas, GT; Tikiz, C; Ugurlu, HObjectives: 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.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 Neuropathic Pain in Patients with Knee Osteoarthritis and Related Factors: A Multicenter Longitudinal Study-Preliminary ReportKaptanoglu, E; Sahin, O; Tuncer, T; Hizmetli, S; Altan, L; Ayhan, F; Bal, A; Bilgilisoy, M; Bozbas, G; Cerrahoglu, L; Cevik, R; Duruoz, T; Dulgeroglu, D; Gurer, G; Gursoy, S; Hepguler, S; Kacar, C; Kaya, T; Melikoglu, M; Nas, K; Ozcakir, S; Ozdolap, S; Saridogan, M; Sarikaya, S; Sindel, D; Sendur, OF; Tikiz, C; Ugurlu, HItem The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort studyDuruöz, MT; Gürsoy, DE; Tuncer, T; Altan, L; Ayhan, F; Bal, A; Bilgilisoy, M; Cerrahoglu, L; Çapkin, E; Çay, HF; Çevik, R; Durmaz, B; Dülgeroglu, D; Gürer, G; Gürsoy, S; Hepgüler, S; Hizmetli, S; Kaçar, C; Kaptanoglu, E; Kaya, T; Ecesoy, H; Melikoglu, MA; Nas, K; Nur, H; Özçakir, S; Saridogan, M; Sarikaya, S; Sezer, I; Sindel, D; Sahin, N; Sahin, Ö; Sendur, ÖF; Bozbas, GT; Tikiz, C; Ugurlu, HObjectives: 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 Turkiye 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 Duruoz 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.Item Description of the registry of patients with ankylosing spondylitis in Turkey: TRASD-IPBodur, H; Ataman, S; Bugdayci, DS; Rezvani, A; Nas, K; Uzunca, K; Emlakcioglu, E; Karatepe, AG; Durmuus, B; Sezgin, M; Ayhan, F; Yazgan, P; Duruöoz, T; Yener, M; Gürgan, A; Kirnap, M; Çakar, E; Altan, L; Soydemir, R; Çapkin, E; Tekeoglu, I; Aydin, G; Günendi, Z; Nacir, B; Salli, A; Öztürk, C; Memis, A; Turan, Y; Kozanoglu, E; Sivrioglu, KA web-based application patient follow-up program was developed to create a registry of patients with ankylosing spondylitis (AS) by the Turkiye Romatizma Arastirma Savas Dernegi (TRASD) AS Study Group. This study describes the methodological background and patient characteristics. The patient follow-up program is a web-based questionnaire, which contains sections on socio-demographic data, anamnesis, personal and family history, systemic and musculoskeletal examination, laboratory and imaging data and treatment. Between October 1, 2007 and February 28, 2009, 1,381 patients from 41 centers were included in the registry (1,038 males [75.2%]; mean age 39.5 +/- A 10.7 years). Mean disease duration was 12.1 +/- A 8.5 years, and mean time from initial symptom to diagnosis was 5 +/- A 6.8 years (median 2 years). HLA-B27 positivity was detected in 73.7% of 262 patients tested. Manifestations of extraarticular involvement were anterior uveitis (13.2%), psoriasis and other skin and mucous membrane lesions (6%) and inflammatory bowel disease (3.8%). The prevalence of peripheral arthritis was 11.2%. In 51.7% of patients, the Bath AS Disease Activity Index was a parts per thousand yen4. But since our patients consisted of the ones with more severe disease who referred to the tertiary centers and needed a regular follow-up, they may not represent the general AS population. Disease-modifying anti-rheumatic drugs were being used by 41.9% of patients, with 16.4% using anti-TNF agents. TRASD-IP (Izlem Programi: Follow-up program) is the first AS registry in Turkey. Such databases are very useful and provide a basis for data collection from large numbers of subjects. TRASD-IP gives information on the clinical and demographic profiles of patients, and the efficacy and safety of anti-TNF drugs, examines the impact on quality of life, and provides real-life data that may be used in cost-effectiveness analyses.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 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 Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide StudyTuncer, T; Gilgil, E; Kaçar, C; Kurtais, Y; Kutlay, S; Bütün, B; Yalçin, P; Akarirmak, Ü; Altan, L; Ardiç, F; Ardiçoglu, Ö; Altay, Z; Cantürk, F; Cerrahoglu, L; Çevik, R; Demir, H; Durmaz, B; Dursun, N; Duruöz, T; Erdogan, C; Evcik, D; Gürsoy, S; Hizmetli, S; Kaptanoglu, E; Kayhan, Ö; Kirnap, M; Kokino, S; Kozanoglu, E; Kuran, B; Nas, K; Öncel, S; Sindel, D; Orkun, S; Sarpel, T; Savas, S; Sendur, OF; Senel, K; Ugurlu, H; Uzunca, K; Tekeoglu, I; Guillemin, FObjectives: 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.