Browsing by Author "Sindel D."

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    Evidence-based recommendations for the management of knee osteoarthritis: A consensus report of the Turkish league against rheumatism; [Diz osteoartrit tedavisinde kanıta dayalı öneriler: Türkiye romatizma araştırma ve savaş derneǧi uzlaşı raporu]
    (Turkish League Against Rheumatism (TLAR), 2012) Tuncer T.; Çay H.F.; Kaçar C.; Altan L.; Atik O.S.; Aydin A.T.; Figen Ayhan F.; Çorekçi Yanik B.; Durmaz B.; Eskiyurt N.; Genç H.; Gokçe Kutsal Y.; Günaydin R.; Hepgüler S.; Hizmetli S.; Kaya T.; Kurtaiş Y.; Ölmez N.; Saridoǧan M.; Sindel D.; Sonel Tur B.; Sütbeyaz S.; Şendur O.F.; Uǧurlu H.; Ünlü Z.
    Objectives: Knee osteoarthritis (OA) is a common disease which causes pain, disability and great socioeconomic burden as a result. Turkish League Against Rheumatism (TLAR) initiated a project to prepare national, "evidence-based recommendations for the management of knee osteoarthritis" supported by expertopinion in order to assist the physicians who are interested in knee OA in their daily clinical practice. Materials and methods: The expert committee was composed of 25 academicians, 23 of whom were physical medicine and rehabilitation (PM&R) specialists (three also had rheumatology subspeciality) and two were orthopedic surgeons. At the first meeting, the previous guidelines were discussed, and 2008 Osteoarthritis Research Society International (OARSI) recommendations were decided to be taken as the fundamental template for national recommendations. Databases of the Pubmed, Embase, Cochrane, and Turkish Medical Index were used to search the literature, and this was carried out for the period between 2009-2010 for international publications since studies up to 2009 were present in the 2010 OARSI update. No limit was applied for searching of national publications. The selected relevant publications were graded according to evidence level and quality, and were sent to the members who were then asked to suggest propositions according to their experiences, knowledge, and review of the literature. After amalgamation and editing of new proposals, Delphi rounds were started. After five Delphi rounds, the propositions on which the members were in consensus, were discussed with regard to evidence and the "strength of recommendation" was determined by measuring on visual analog scale (VAS) for each proposal at the final meeting. Results: Nineteen propositions (one for general principles, nine for nonpharmacologic treatments, seven for pharmacologic treatments, and two for surgical treatments) were accepted as the "TLAR Evidence-Based Recommendations for the Management of Knee OA" in consensus as a result of Delphi rounds. Conclusion: Evidence-based recommendations for the management of knee OA were developed by TLAR for the first time in our country. The recommendations should be updated regularly according to new evidence and insights. It is expected that physicians who are interested in knee OA will benefit greatly from this report in their daily clinical practice. © 2012 Turkish League Against Rheumatism. All rights reserved.
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    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.
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    2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis
    (Springer Verlag, 2018) Tuncer T.; Cay F.H.; Altan L.; Gurer G.; Kacar C.; Ozcakir S.; Atik S.; Ayhan F.; Durmaz B.; Eskiyurt N.; Genc H.; GokceKutsal Y.; Gunaydin R.; Hepguler S.; Hizmetli S.; Kaya T.; Kurtais Y.; Saridogan M.; Sindel D.; Sutbeyaz S.; Sendur O.F.; Ugurlu H.; Unlu Z.
    In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
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    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.
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    Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study
    (Turkish Society of Physical Medicine and Rehabilitation, 2022) Bagcier F.; Kibar S.; Evcik D.; Ketenci A.; Sindel D.; Tur B.S.; Ünlü Z.; Tıkız C.; Keskin D.; Alp A.; Ay S.; Yanık B.; Külcü D.G.; Karakaş M.; Ural Nazlıkul F.G.; Kurt Oktay K.N.; Aksoy M.K.; Fındıkoğlu G.; Eser F.; Atıcı A.; Yurdakul O.V.; Koçak F.A.; Kurt E.E.; Özkan Y.; Doğan Ş.K.; Sultanoğlu T.E.; Ordahan B.; Umay E.K.; Demirhan E.; Yağcı H.Ç.; Balbaloğlu Ö.; Tezel N.; Satış S.; Atar S.; Akaltun M.S.
    Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS. ©2022 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.
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    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.