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    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, Kazim
    Objectives: 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.
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    Results Muscle Strength and Thickness After Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: An Ultrasonographic and Isokinetic Evaluation
    (Galenos Publ House, 2021) Suner-Keklik, Sinem; Guzel, Nevin A.; Cobanoglu, Gamze; Gunendi, Zafer; Kafa, Nihan; Ataoglu, Muhammed Baybars
    BACKGROUND/AIMS: This study aimed to compare the muscle strength and thickness of individuals who underwent anterior cruciate ligament (ACL) reconstruction using a hamstring tendon graft for at least 12 months with uninvolved limbs and healthy controls. MATERIALS and METHODS: This study included 25 individuals who underwent ACL reconstruction [age: 29.56 +/- 8.25 years; Body Mass Index (BMI): 27.27 +/- 3.89 kg/cm(2)] and 25 healthy participants (age: 27.12 +/- 5.94 years; BMI: 24.70 +/- 3.03 kg/cm2). Muscle thicknesses of the vastus medialis oblique (VMO), rectus femoris (RF), biceps femoris (BF), and semitendinosus-semimembranosus (SS) muscles were evaluated by ultrasonographic measurement. Muscle strength measurements using an isokinetic system were performed. RESULTS: VMO (p<0.001) and RF (p<0.001) muscle thickness were higher in the uninvolved limb than in the surgical limb. The concentric quadriceps muscle (p=0.029), eccentric quadriceps muscle (p=0.012), and eccentric hamstring muscle strengths (p=0.001) were significantly higher in uninvolved limb, which was similar concentric hamstring muscle strength (p>0.05). Muscle thickness and muscle strength of the control group and the surgical limbs were similar (p>0.05). CONCLUSION: An average of 3 years has passed since the operation; however, VMO and RF muscle atrophy and decreased hamstring and quadriceps muscle strength continued. These results revealed that the use of the limb, which has not fully achieved its functionality, is limited, and individuals try to compensate for this situation by the uninvolved limb.
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    The role of ultrasonographic synovial assessment in rheumatoid arthritis patients with concomitant fibromyalgia
    (Turkish League Against Rheumatism, 2023) Polat, Musa; Kahveci, Abdulvahap; Tecer, Duygu; Gunendi, Zafer; Gogus, Feride
    Objectives: This study aimed to compare the prevalence and musculoskeletal ultrasonography (US) findings of rheumatoid arthritis (RA) patients with concomitant fibromyalgia (FM) according to the 1990 American College of Rheumatology (ACR) FM classification criteria or the 2016 ACR FM diagnostic criteria. Patients and methods: This cross-sectional study included 63 patients (17 males, 46 females; mean age: 48.2 +/- 7.1 years; range, 18 to 62 years) with RA. Medical history and laboratory data were obtained from electronic records. Clinical examination, composite disease activity measures, functional status, and the German 7-joint ultrasound score were assessed to evaluate disease activity and synovial inflammation. The patients were divided into three groups: patients who met only the 2016 ACR criteria, patients who met only the 1990 ACR criteria, and patients who met both criteria. Results: In patients with RA, concomitant FM prevalence was 34.9% according to the 2016 ACR FM diagnostic criteria versus 23.8% according to the 1990 ACR FM classification criteria. Rheumatoid arthritis patients with FM had high tender joint count and disease activity scores, while musculoskeletal US findings were similar. Patients who met only the 2016 ACR FM diagnostic criteria had significantly higher gray-scale US and power Doppler US synovitis scores than patients who satisfied only ACR 1990 FM classification criteria (p=0.03 and p=0.02, respectively). Conclusion: Synovial inflammation is a prominent sign in RA patients diagnosed with FM according to the 2016 ACR FM diagnostic criteria. The higher disease activity seen in the presence of FM in RA patients is associated with FM rather than synovitis.