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Öğe Characteristics of Patients With Rheumatoid Arthritis in Turkey: Results From the Turkish League Against Rheumatism Rheumatoid Arthritis Registry(TURKISH LEAGUE AGAINST RHEUMATISM, 2015) Bal, Ajda; Ataman, Sebnem; Bodur, Hatice; Rezvani, Aylin; Paker, Nurdan; Tastekin, Nurettin; Karatepe, Altinay Goksel; Borman, Pinar; Yener, Mahmut; Nas, Kemal; Sezgin, Melek; Yazgan, Pelin; Tekeoglu, Ibrahim; Dogu, Beril; Altay, Zuhal; Kirnap, Mehmet; Gurgan, Alev; Gur, Ali; Hizmetli, Sami; Gunendi, Zafer; Erdem, Rana; Ugurlu, Hatice; Inal, Elem; Olmez, Nese; Kozanoglu, Erkan; Oken, Oznur; Ozel, Sumru; Dundar, Umit; Akinci, Aysen; Ozturk, Cihat; Sivrioglu, Koncuy; Duruoz, Mehmet Tuncay; Aydog, Ece; Capkin, Erhan; Altan, Lale; Evcik, Deniz; Durmus, Oguz; Yagci, Ilker; Sendur, Omer Faruk; Sertpoyraz, Filiz Meryem; Ozgul, Ahmet; Senel, Kazim; Capaci, KazimObjectives: This study investigates the demographic and clinical characteristics of patients with rheumatoid arthritis (RA) in Turkey, and attempts to identify strategies for the prevention, treatment, and support of RA. Patients and methods: A total of 2,359 patients (1,966 females, 393 males; mean age 51.6 +/- 12.5 years; range 18 to 75 years) with RA from 36 centers across Turkey, who were recorded in the Turkish League Against Rheumatism (TLAR) RA Registry between September 2007 and March 2011, were evaluated. Patients' demographic and clinical data were recorded. Disease activity, functional status, and radiographic damage were measured using the Disease Activity Score 28, the Health Assessment Questionnaire, and van der Heijde modified Sharp scoring method. Results: The mean duration of academic education received was 5.2 +/- 3.8 years, and 74.6% of the patients were homemakers. Non-biological disease-modifying anti-rheumatic drugs were used by 91.0% of the patients, while 10.2% used biological disease-modifying anti-rheumatic drugs. The mean Disease Activity Score 28, Health Assessment Questionnaire, and Sharp scores were 4.0 +/- 1.4, 0.38 +/- 0.37, and 31.2 +/- 57.1, respectively. Of the patients, 17.8% were in remission and 14.1% had low disease activity rates, while 42.7% and 25.5% had moderate and high disease activity rates. Conclusion: The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently.Öğe THE EFFECT OF GENDER ON DISEASE ACTIVITY, FUNCTIONAL INDEX AND QUALITY OF LIFE IN PATIENTS WITH AXIAL SPA. THE DATA OF TLAR-NETWORK PSA STUDY(BMJ PUBLISHING GROUP, 2019) Nas, Kemal; Kilic, Erkan; Tekeoglu, Ibrahim; Cevik, Remzi; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, Nilay; Cengiz, Gizem; Cuzdan, Nihan; Gezer, Ilknur Albayrak; Keskin, Dilek; Mulkoglu, Cevriye; Resorlu, Hatice; Ataman, Sebnem; Bal, Ajda; Duruoz, Mehmet Tuncay; Kucukakkas, Okan; Yurdakul, Ozan Volkan; Melikoglu, Meltem Alkan; Aydin, Yildiray; Ayhan, Figen; Bodur, Hatice; Calis, Mustafa; Capkin, Erhan; Devrimsel, Gul; Gok, Kevser; Hizmetli, Sami; Kamanli, Ayhan; Keskin, Yasar; Kocabas, Hilal; Kutluk, Oznur; Sen, Nesrin; Sendur, Omer Faruk; Toprak, Murat; Tolu, Sena; Tuncer, Tiraje…Öğe The effect of heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis(WILEY-BLACKWELL PUBLISHING, INC, 2010) Yildirim, Nurcan; Ulusoy, Mehlika Filiz; Bodur, HaticeAims and objectives. The aim in this study was to evaluate the effect of local heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis. Background. Local heat application is used as a non-pharmacological practice for the treatment of knee osteoarthritis. On the other hand, literature reveals limited information on the effects of heat application. Design. The study was a comparative study. Methods. The patients with knee osteoarthritis were divided into two groups (23 patients in each) as intervention and control groups, and patients in the control group were applied with the routine medication of the physician. The intervention group received 20-minute heat application every other day for four weeks in addition to the routine medication. The data were collected using data collection form, Western Ontario and McMaster Universities Index and SF-36. Results. The Western Ontario and McMaster Universities pain and Western Ontario and McMaster Universities disability scores of the patients with knee osteoarthritis in control and intervention groups before and after the intervention were compared, and the differences for both scores in the change were found to be statistically significant (p < 0 center dot 05). Moreover, statistically significant differences were found between the control and intervention group patients in terms of changes in the scores for physical function, pain and general health perception (p < 0 center dot 05). Conclusions. It was found that heat application every other day decreased pain and disability of the patients with knee osteoarthritis. Also, heat application was found to improve the subdimensions of quality of life scores of physical function, pain and general health perception of patients. Relevance to clinical practice. The data obtained in this study on the efficiency of heat application on pain, stiffness, physical function and general health perception of patients with knee osteoarthritis may offer an insight into decision-making process for appropriate intervention.Öğe Familial mediterranean fever: assessment of clinical manifestations, pregnancy, genetic mutational analyses, and disease severity in a national cohort(Springer Heidelberg, 2020) Bodur, Hatice; Yurdakul, Fatma Gul; Cay, Hasan Fatih; Ucar, Ulku; Keskin, Yasar; Sargin, Betul; Gurer, GulcanThe aims of this study were to investigate the main clinical and laboratory features, including pregnancy and genetic analysis, of Turkish Familial Mediterranean Fever (FMF) patients and to analyze the relationships between genotypic features, age of disease onset, clinical findings, and disease severity. A study was planned within a national network of 22 different centers. Demographics, clinical and laboratory findings, attack characteristics, drugs, pregnancy and birth history, disease severity, and gene mutation analyses were evaluated. Disease severity, assessed using a scoring system developed by Pras et al., was evaluated in relation to gene mutations and age of disease onset. A total of 979 patients (643 females and 336 males; mean age: 35.92 +/- 11.97 years) with FMF were included in the study. Of a total of 585 pregnancies, 7% of them resulted in preterm birth and 18.1% resulted in abortions. During pregnancy, there was no FMF attack in 61.4% of patients. Of the MEditerranean FeVer (MEFV) mutations, 150 (24.3%) cases were homozygous, 292 (47.3%) cases were heterozygous, and 175 (28.4%) were compound heterozygous. Patients with homozygous gene mutations had more severe disease activity, earlier age of disease onset, higher rates of joint and skin involvement, sacroiliitis, and amyloidosis. Patients with compound heterozygous genotype displayed severe disease activity in close resemblance to patients with homozygous mutation. In addition, patients with compound heterozygous mutations had higher rates of protracted febrile myalgia and elevated fibrinogen levels. In 63.9% of compound heterozygous patients, age of onset was < 20 years, with greater disease severity, and high rates of attack frequency and colchicine resistance. Our results suggest that indicators for disease severity include early onset of disease and homozygous gene mutations. Furthermore, patients with compound heterozygous mutations displayed significant presentations of severe disease activity.Öğe Familial Mediterranean fever: Health-related quality of life and associated variables in a national cohort(Turkish League Against Rheumatism, 2021) Bodur, Hatice; Yurdakul, Fatma Gul; Duruoz, Mehmet Tuncay; Cay, Hasan Fatih; Ucar, Ulku; Keskin, Yasar; Sargin, BetulObjectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$<300), smoking, late-onset FMF (>20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale.Öğe Familial Mediterranean fever: perspective on female fertility and disease course in pregnancy from a multicenter nationwide network(Springer Heidelberg, 2023) Yurdakul, Fatma Gul; Bodur, Hatice; Cay, Hasan Fatih; Ucar, Ulku; Keskin, Yasar; Sargin, Betul; Gurer, GuelcanThe aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine.Öğe Management of rheumatoid arthritis: Consensus recommendations from the Turkish league against rheumatism(Turkish League Against Rheumatism (TLAR), 2011) Ataman, Şebnem; Borman, Pinar; Evcik, Deniz; Aydo?, Ece; Ayhan, Figen; Yildizlar, Derya; Bodur, HaticeObjectives: 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.Öğe Neuropathic Pain in Carpal Tunnel Syndrome: Association with Electrophysiological Findings and Functional Status(2023) Ağadayı, Sıtkı; Eser, Filiz; Agadayı, Ezgi; Bodur, HaticeAims of the present study are to determine the presence of neuropathic pain according to The Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) in patients with electrophysiologically confirmed carpal tunnel syndrome (CTS) and investigate the association of neuropathic pain with clinical and electrophysiological findings and hand functionality. Material and Methods: One hundred and seventy five patients (234 hands) whose electrophysiological test results were compatible with CTS were included. Standard electrophysiological tests, LANSS and Quick Disability of the Arm, Shoulder, and Hand (Q-DASH) were applied to each patient. Patients with LANSS score 12 formed Group 1 and <12 formed Group 2. Results: Of patients, 58.11% (136 hands) had a LANSS score ?12 (Group 1) and 41.89% (98 hands) had a LANSS score <12 (Group 2). Female sex, symptom duration, sensory loss detected in the hand innervated by the median nerve, abductor pollicis muscle strength, thenar atrophy, phalen sign positivity and Q-DASH scores were higher in Group 1 (p<0.05). Electrophysiological severity was found to be higher in Group 1 (p<0.005). Median nerve motor distal latency and median nerve 2nd digit-wrist sensory distal latency were longer (p<0.05) in Group 1. Median nerve 2nd digit-wrist sensory amplitude and median nerve 2nd digit-wrist sensory velocity were found to be significantly lower in Group 1 (p<0.05). Conclusion: It has been shown that median nerve motor distal latency and sensory nerve conduction studies can be used to determine the presence of neuropathic pain in patients with CTS. Knowing the presence and mechanism of neuropathic pain in patients with CTS will guide the clinician in determining the appropriate treatment strategy.Öğe Polypharmacy in the Elderly: A Multicenter Study(ELSEVIER SCIENCE INC, 2009) Kutsal, Yesim Gokce; Barak, Anil; Atalay, Ayce; Baydar, Terken; Kucukoglu, Selcuk; Tuncer, Tiraje; Hizmetli, Sami; Dursun, Nigar; Eyigor, Sibel; Saridogan, Merih; Bodur, Hatice; Canturk, Ferhan; Turhanoglu, Ayse; Arslan, Sule; Basaran, AynurObjective: The aim of this study was to evaluate the polypharmacy issue and its correlations with socio-economic variables in Turkish elderly patients. Design: Cross-sectional Setting: Outpatient clinics of the medical schools, departments of physical medicine and rehabilitation from 12 provinces. Participants: A total of 1430 elderly in different geographical regions of Turkey during January 2007 to January 2008 were included. Measurements: Patients were interviewed using a questionnaire that included demographic characteristics, current medical diagnosis, and pharmaceuticals that are used by elderly. Demographical parameters were gender, age, marital status, number of children, level of education, province, and status of retirement. Results: The mean number of drugs was found to be higher in the females. There was a significant difference among age groups, marital status groups, and the number of children categories. The distribution of the number of drugs among education levels did not differ significantly, whereas the distribution of the number of drugs between the status of retirement and presence of chronic disease differed significantly. Conclusions: Polypharmacy is correlated with various factors including age, sex, marital status, number of children, status of retirement, and presence of chronic medical conditions but not educational status in our study group. (J Am Med Dir Assoc 2009; 10: 486-490)Öğe POSSIBLE POTENTIAL INTERACTIONS BETWEEN OBESITY, QUALITY OF LIFE, PSYCHOLOGICAL STATUS AND CLINICAL PARAMETERS IN PSORIATIC ARTHRITIS(BMJ PUBLISHING GROUP, 2019) Gok, Kevser; Nas, Kemal; Kilic, Erkan; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, Nilay; Cengiz, Gizem; Cuzdan, Nihan; Gezer, Ilknur Albayrak; Keskin, Dilek; Mulkoglu, Cevriye; Resorku, Hatice; Sunar, Ismihan; Hasturk, Ajda Bal; Duruoz, Mehmet Tuncay; Kucukakkas, Okan; Yurdakul, Ozan Volkan; Melikoglu, Meltem Alkan; Aydin, Yildiray; Ayhan, Figen; Bodur, Hatice; Calis, Mustafa; Capkin, Erhan; Devrimsel, Gul; Hizmetli, Sami; Kamanli, Ayhan; Keskin, Yasar; Kocabas, Hilal; Kutluk, Oznur; Sen, Nesrin; Sendur, Omer Faruk; Tekeoglu, Ibrahim; Toprak, Murat; Tolu, Sena; Tuncer, Tiraje…Öğe Validity, reliability, and factor structure of the Istanbul Low Back Pain Disability Index in axial spondyloarthritis(Taylor & Francis Ltd, 2021) Duruoz, Mehmet Tuncay; Acer Kasman, Sevtap; Sahin, Nilay; Sezer, Ilhan; Bodur, Hatice; Ketenci, Aysegul; Hizmetli, SamiObjective: To investigate the validation and reliability of Istanbul Low Back Pain Disability Index (ILBPDI) in axial spondyloarthritis (Ax-SpA). Methods: Patients with Ax-SpA according to The Assessment of SpondyloArthritis International Society criteria were recruited. The validation was assessed by face, content, and construct (convergent and divergent) validities, whereas the reliability was assessed by internal consistency and test-retest reliability. Factor analysis was performed. Convergent validity was assessed by correlations of ILBPDI with functional parameters (The Bath Ankylosing Spondylitis Functional Index, The Dougados Functional Index, and The Health Assessment Questionnaire). Divergent validity was assessed by correlations of ILBPDI with non-functional parameters. Results: Two hundred forty patients were recruited. Cognitive debriefing showed ILBPDI to be clear, relevant, and comprehensive. Cronbach's alpha coefficient was 0.953. The test-retest reliability was good with the intraclass correlation coefficient of 0.870. ILBPDI was represented by three-factor groups of activity: axial bending, sitting/rest, and standing activities. ILBPDI had good correlations with the functional parameters (rho changes between 0.809 and 0.580), and it had poor or non-significant correlations with the non-functional parameters (absolute rho changes between 0.669 and 0.001). Conclusion: ILBPDI is a practical, accurate, and non-time-consuming scale which is valid and reliable to evaluate the functional disability in patients with Ax-SpA.
