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Öğe 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis(SPRINGER HEIDELBERG, 2018) Tuncer, Tiraje; Cay, Fatih Hasan; Altan, Lale; Gurer, Gulcan; Kacar, Cahit; Ozcakir, Suheda; Atik, Sahap; Ayhan, Figen; Durmaz, Berrin; Eskiyurt, Nurten; Genc, Hakan; GokceKutsal, Yesim; Gunaydin, Rezzan; Hepguler, Simin; Hizmetli, Sami; Kaya, Taciser; Kurtais, Yesim; Saridogan, Merih; Sindel, Dilsad; Sutbeyaz, Serap; Sendur, Omer Faruk; Ugurlu, Hatice; Unlu, ZelihaIn 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.Öğe Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis(Turkish League Against Rheumatism, 2023) Altan, Lale; Okmen, Burcu Metin; Tuncer, Tiraje; Sindel, Dilsad; Cay, Hasan Fatih; Hepguler, Simin; Sarikaya, SeldaObjectives: 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.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 Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism(TURKISH LEAGUE AGAINST RHEUMATISM, 2012) Tuncer, Tiraje; Cay, Hasan Fatih; Kacar, Cahit; Altan, Lale; Atik, Osman Sahap; Aydin, Ahmet Turan; Ayhan, F. Figen; Yanik, Burcu Corekci; Durmaz, Berrin; Eskiyurt, Nurten; Genc, Hakan; Kutsal, Yesim Gokce; Gunaydin, Rezzan; Hepguler, Simin; Hizmetli, Sami; Kaya, Taciser; Kurtais, Yesim; Olmez, Nese; Saridogan, Merih; Sindel, Dilsad; Tur, Birkan Sonel; Sutbeyaz, Serap; Sendur, Omer Faruk; Ugurlu, Hatice; Unlu, ZelihaObjectives: 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 expert-opinion 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 non-pharmacologic 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.Öğe Neuropathic Pain in Patients with Knee Osteoarthritis and Related Factors: A Multicenter Longitudinal Study-Preliminary Report(WILEY, 2017) Kaptanoglu, Ece; Sahin, Ozlem; Tuncer, Tiraje; Hizmetli, Sami; Altan, Lale; Ayhan, Figen; Bal, Ajda; Bilgilisoy, Meral; Bozbas, Gulnur; Cerrahoglu, Lale; Cevik, Remzi; Duruoz, Tuncay; Dulgeroglu, Deniz; Gurer, Gulcan; Gursoy, Savas; Hepguler, Simin; Kacar, Cahit; Kaya, Taciser; Melikoglu, Meltem; Nas, Kemal; Ozcakir, Suheda; Ozdolap, Senay; Saridogan, Merih; Sarikaya, Selda; Sindel, Dilsad; Sendur, Omer F.; Tikiz, Canan; Ugurlu, Hatice…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 The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study(Turkish League Against Rheumatism, 2022) Duruoz, Mehmet Tuncay; Gursoy, Didem Erdem; Tuncer, Tiraje; Altan, Lale; Ayhan, Figen; Bal, Ajda; Bilgilisoy, MeralObjectives: 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.
