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Öğe Beyond expectations: disease duration and psychological burden in psoriatic arthritis(Springer Heidelberg, 2023) Kilic, Gamze; Kilic, Erkan; Tekeoglu, Ibrahim; Sargin, Betul; Cengiz, Gizem; Balta, Nihan Cüzdan; Alkan, HakanThis study aims to investigate the relationship between disease duration and psychological burden in PsA and to identify the risk factors associated with psychological distress. Patients with PsA who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism (TLAR)-Network. Patients were categorized into three groups based on disease duration: early stage (< 5 years), middle stage (& GE; 5, < 10 years), and late stage (& GE; 10 years). All patients underwent clinical and laboratory assessment using standardized protocol and case report forms. The associations between psychological variables and clinical parameters were assessed by a multivariate analysis. Of the 1113 patients with PsA (63.9% female), 564 (%50.7) had high risk for depression and 263 (%23.6) for anxiety. The risk of psychological burden was similar across all PsA groups, and patients with a higher risk of depression and anxiety also experienced greater disease activity, poorer quality of life, and physical disability. Multivariate logistic regression revealed that female gender (OR = 1.52), PsAQoL (OR = 1.13), HAQ (OR = 1.99), FiRST score (OR = 1.14), unemployment/retired (OR = 1.48) and PASI head score (OR = 1.41) were factors that influenced the risk of depression, whereas the current or past enthesitis (OR = 1.45), PsAQoL (OR = 1.19), and FiRST score (OR = 1.26) were factors that influenced the risk of anxiety. PsA patients can experience a comparable level of psychological burden throughout the course of their disease. Several socio-demographic and disease-related factors may contribute to mental disorders in PsA. In the present era of personalized treatment for PsA, evaluating psychiatric distress can guide tailored interventions that improve overall well-being and reduce disease burden.Öğe Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H(Korean Geriatric Soc, 2022) Umay, Ebru; Eyigor, Sibel; Bahat, Gulistan; Halil, Meltem; Giray, Esra; Unsal, Pelin; Unlu, ZelihaBackground: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.Öğe Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up(Springer, 2022) Umay, Ebru; Eyigor, Sibel; Ertekin, Cumhur; Ünlü, Zeliha; Selçuk, Barin; Bahat, Gülistan; Karahan, Ali YavuzDysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.Öğe Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study(Elsevier, 2023) Karaağaç, Ali; Arslan, Saniye Aydoğan; Keskin, Esra DilekIntroduction: This study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. Method: 40 individuals who applied to Kirikkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. Result: Pain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). Conclusion: As a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.Öğe Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye(Turkish League Against Rheumatism, 2024) Kılıç, Erkan; Kılıç, Gamze; Tekeoğlu, İbrahim; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Sahin, NilayObjectives: The study aimed to investigate and compare clinical features, disease activity, and the overall disease burden among psoriatic arthritis (PsA) patients across seven distinct geographic regions in T & uuml;rkiye. Patients and methods: A multicenter cross-sectional study involving 1,134 PsA patients from 25 referral centers across seven regions was conducted. Demographic and clinical characteristics, comorbidities, joint involvement, extra-articular manifestations, and disease activity measures were evaluated across regions. Results: A total of 1134 PsA patients from seven different geographic regions in T & uuml;rkiye participated in this study. The highest number of participants was from the Marmara region (n=409), with subsequent representation from Central Anatolia (n=370), Aegean (n=139), Mediterranean (n=60), Black Sea (n=60), Eastern Anatolia (n=60), and Southeastern Anatolia (n=36) regions. There were significant variations in demographic profile, including age, body mass index, age of disease onset, educational status, comorbidities, and family history of both psoriasis and PsA. Clinical features, such as enthesitis, dactylitis, uveitis, and joint involvement, demonstrated significant variation across regions. Additionally, disease activity measures, including pain, patient and physician global assessments, acute phase reactants, disease activity indices, quality of life, and functional status, displayed considerable regional differences. Conclusion: This nationwide study revealed substantial regional diversity in demographic data, clinical characteristics, disease activity, and quality of life among PsA patients in T & uuml;rkiye. These findings stress the need to customize treatment approaches to address regional needs and to conduct further research to uncover reasons for disparities. It is crucial to enhance region-specific approaches to improve patient care and outcomes for PsA.Öğe What awaits us after COVID-19? Musculoskeletal system involvement in the elderly population in Turkey and its aftermath(Turkish Geriatrics Soc, 2024) Gökçe-Kutsal, Yeşim; Ordu-Gökkaya, Nilufer Kutay; Karahan, Sevilay; Irdesel, Fatma Jale; Paker, Nurdan; Ay, Saime; Binay-Safer, VildanIntroduction: Although COVID-19 primarily affects the respiratory system, one of the most frequently effected areas is the musculoskeletal system. COVID-19 associated musculoskeletal problems can cause disability in patients >= 65 years. The aim of the study was to define the musculoskeletal problems after the COVID-19 infection and to examine the relationship with the accompanying comorbidities in geriatric population. Materials and Method: The study was conducted by the members of Geriatric Rehabilitation Study Group of Turkish Physical Medicine and Rehabilitation Society at 11 different hospitals from 7 provinces (Ankara, stanbul, zmir, Gaziantep, Adana, Bursa, and Kirikkale) of Turkiye. Individuals aged 65 years and over who had a history of COVID-19 within the last 12 months and experienced persistent/continuous musculoskeletal complaints were included into the study. COVID-19 diagnoses were confirmed from electronic hospital records and the e-Nabiz system. Data were collected by face-to-face interviews and after recruiting the first 50 patients from each center, patient recruitment was terminated. Results: A total of 457 cases in which all questions were answered completely (without any missing data) were included in this observational study. The cases were mainly 65-75 years old, married, and non-smoking women. The most common musculoskeletal involvement was widespread pain (81%), followed by myalgia (63.7%) and arthralgia (44.4%). Other rare involvements (osteonecrosis, myositis, steroid myopathy, arthritis) were significantly more frequent in patients older than 75 years, regardless of gender. Analysis showed that musculoskeletal pain immediately after infection is observed more in cases with comorbid diseases (p<0.001), hypertension (p<0.001), pulmonary involvement (p=0.002) and hospitalization due to COVID-19 (p<0.001). It was determined that the incidence of pain seen immediately after infection increased as the number of comorbidities increased (p<0.001). In conjunction with this, persistent pain after COVID-19 infection were more common in those with osteoarthritis (p=0.039). Conclusion: Elderly patients may develop musculoskeletal pain in multiple body sites after COVID-19, which is primarily related to presence and number of comorbidities, hospitalization and pulmonary involvement. The long-term consequences of COVID-19 on musculoskeletal health are still being studied, and further research is needed to fully understand the extent and duration of these effects.Öğe 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(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2022) Bagcier, Fatih; Kibar, Sibel; Evcik, Deniz; Ketenci, Aysegul; Sindel, Dilsad; Tur, Birkan Sonel; Unlu, ZelihaObjectives: 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.Öğe The Relationship Between Hand Function and Activities of Daily Living in Patients with Hypothyroidism(Aves, 2023) Hepsen, Sema; Keskin, Dilek Baday; Çakal, ErmanObjective: This study aimed to evaluate hand function and hand function-related factors in patients with hypothyroidism and to investigate the relationship between hand function and activities of daily living. Methods: This cross-sectional study included 103 patients with hypothyroidism (53 with Hashimoto thyroiditis, 50 with postoperative hypothyroidism) and 50 controls. Hand function was evaluated with the Duruoz Hand Index, and the Nottingham Extended Activities of Daily Living Scale was used to assess activities of daily living. Results: The mean Duruoz Hand Index scores were higher in the Hashimoto group (1.70 +/- 4.71) (P =.02) and postsurgical group (2.16 +/- 4.37) (P =.002) than in the control group (0.24 +/- 1.02). The median Nottingham Extended Activities of Daily Living Scale score was 65 (45-66) in patients with Hashimoto thyroiditis, 63 (43-66) in patients with postsurgical hypothyroidism, and 66 (46-66) in the control group (P =.009). The difference was statistically significant between the control group and Hashimoto (P =.037) and postsurgical (P =.001) groups. The cut-off value of the Nottingham Extended Activities of Daily Living Scale determined with receiver operating characteristics analysis for poor and good activities of daily living status was 63.5 with a sensitivity of 70% and a specificity of 54% (area under the curve: 0.643, 95% Cl: 0.553-0.733, P =.004) for this study. Logistic regression analysis showed that Duruoz Hand Index (B = -0.695, P =.011) and female gender (B = -2.477, P =.028) were predictive variables for activities of daily living (R-2 = 0.43). Conclusion: Hand function was worse, and activities of daily living were lower in patients with hypothyroidism. Since poor hand function may affect activities of daily living, clinicians should routinely assess hand function and activities of daily living in patients with hypothyroidism. A multidisciplinary approach including rehabilitation programs, must be considered if hand dysfunction is detected.Öğe Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut OrkunObjective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.Öğe Acute Spinal Cord Injury After Delivery Induced byGiant Cell Tumor of T12 Vertebrae DuringPregnancy: A Case Report(2011) Arslan, Ayşe; Sarp, Ümit; Başaran, Pınar; Yavuzer, Melek GüneşDoğumdan 2 hafta sonra dev hücreli tümör nedeni ile oluşan akut spinal kord travmalı nadir bir vaka raporu.Yirmialtı yaşında bayan hasta flask parapleji ve üriner inkontinans nedeniyle rehabilitasyon kliniğimizekabul edildi. Hastanın hikayesinde yaklaşık 6 ay önce gebeliğinin 21. haftasından itibaren progresif olarakartan bel ağrısı şikayeti vardı. Torasik manyetik rezonans görüntülemede T12 vertebra korpusunda kompresyon/çökme ve spinal kordu basılayan geniş paraspinal ve intraspinal tümör görüldü. Acil cerrahidekompresyon ve tümör dokusu eksizyonu yapıldı. Materyalin histopatolojik incelemesinde dev hücrelitümör olduğu ortaya çıktı. Hasta cerrahiden 10 gün sonra rehabilitasyon ünitemize başvurdu. On haftalıkyatarak rehabilitasyon programı sonrası ASIA motor skorunda 50/100'den 100/100'e, FIM skorunda54/128'den 111/128'e, ASIA impairment skalada ASIA B'den ASIA E'ye iyileşme gözlendi. Gebeliksüresince herhangi bir spinal ağrı veya uyuşukluğun kemik tümörü sonucu olabileceği akılda tutulmalıdırÖğe Differences in pain, fatigue, and quality of life in patients with chronic venous insufficiency based on physical activity level(2020) Keser, İlke; Özdemir, Kadirhan; Erer, Dilek; Onurlu, İlknur; Bezgin, SabihaBackground: This study aims to compare the effect of different physical activity levels on pain, fatigue, and quality of life in patients with chronic venous insufficiency. Methods: Between October 2018 and February 2019, a total of 69 patients (4 males, 65 females; mean age 50 years; range, 19 to 73 years) who were diagnosed with chronic venous insufficiency and consulted for physiotherapy were included in the study. The physical activity level of the patients was determined using the International Physical Activity Questionnaire in three groups as light, moderate, or vigorous. Fatigue, pain, and QoL were assessed using the Fatigue Severity Scale, visual analog scale (during the night, activity, and rest), and Venous Insufficiency Epidemiological and Economic Study Quality/Symptom Scale, respectively. Results: Of a total of 69 patients, 17 were in the light-intensity physical activity group, 32 in the moderate-intensity physical activity group, and 20 in the vigorous-intensity physical activity group. Perceived pain during activity and fatigue were significantly different between the light- and moderate-intensity physical activity groups (p<0.05). There was no significant difference in pain, fatigue, and quality of life scores between the vigorous-intensity physical activity group and the other two groups (p>0.05). Conclusion: Our study results suggest that a moderate level of physical activity may be helpful to overcome symptoms such as pain and fatigue in patients with chronic venous insufficiency and to improve quality of lifeÖğe Üriner İnkontinansın Kadın Hastalarda Yaşam Kalitesi Ve Duygu Durum Üzerine Etkisi Ve Hastaların Egzersiz Farkındalık Düzeyleri(2019) Karaca, Şahika Burcu; Demir, Ayşe NurAMAÇ: Üriner inkontinans (Üİ); kadınlarda ve yaşlılarda oldukça sık görülen, objektif olarak gösterilebilen istemsiz idrar kaçırma durumu olarak tanımlanmaktadır. Tedavisi planlanırken mutlaka pelvik taban kas egzersizini (PTKE) içermelidir. Biz bu çalışmada Üİ’ı olan hastaların yaşam kalitesi, duygu durumu ve etkileyen faktörler ile egzersiz farkındalıklarını ortaya koymayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya Üİ’ı olan 40 kadın hasta dahil edildi. Hastaların demografik özellikleri, İnkontinans Şiddet İndeksi (İŞİ), Beck Depresyon Ölçeği (BDÖ) ve İnkontinans Yaşam Kalitesi Ölçeği (İYKÖ) formları dolduruldu. BULGULAR: Hastaların yaş ortalaması 57,2 (36-79) idi. Hastaların %5’inin tedavisi PTKE içeriyordu. İŞİ skorları, %12,5 hafif, %45 orta, %25 şiddetli %17,5 çok şiddetli olarak saptandı. BDÖ skorlarına göre hastaların %32,5’inin skorları normalken, %30’unda hafif, %32,5’inde orta, %5’inde ağır depresyon saptandı. İYKÖ total skor medyan değerleri 66.3 iken, davranışların sınırlanması (DS) alt skoru 57.5, psikososyal etkilenme (PS) alt skoru 81.1, sosyal izolasyon (SI) alt skoru 66 olarak saptandı. İnkontinanslı hastalarda yaşam kalitesi ile inkontinans şiddeti arasında istatistiksel olarak anlamlı korelasyon saptandı (p<0,05). BDÖ ile İYKÖ arasında istatistiksel olarak anlamlı korelasyon saptandı (p <0,05). SONUÇ: Üriner inkontinans kadın hastaların yaşam kalitesini ve duygu durumunu olumsuz olarak etkilemektedir. Hastaların büyük bir kısmı egzersiz ile tedaviden haberdar değildir. Pelvik rehabilitasyonun önemi ve gerekliliği konusunda interdisipliner bakış açısıyla daha başarılı sonuçlar alınacağına inanmaktayız.Öğe Postural balance in women with osteoporosis and effective factors(2011) Ünlüsoy, Duygu; Aydoğ, Ece; Tuncay, Reyhan; Eryüksel, Rahime; Ünlüsoy, İhsan; Çakcı, AytülAmaç: Osteoporozlu hastalarda düşme sonucu oluşan kemik fraktürleri mortalite ve morbiditenin en sık nedenidir.Düşme riskiyle ilişkili faktörler arasında zayıf postural denge ve kas kuvvetsizliği de bulunmaktadır. Bu çalışmanın amacı osteoporotik kadın hastalarda postural dinamik dengeyi değerlendirmek ve denge üzerine etkili faktörleri araştırmaktır. Gereç ve Yöntem: Çalışmaya osteoporozlu 50, osteoporoz ve kifozlu 20 ve sağlıklı 30 hasta alındı.Biodeks stabilite sistem ile antero-posterior( AP), mediolateral(ML) ve genel(OA) stabilite indeksleri değerlendirildi. Hastalar göz açık ve göz kapalı olarak test edildi. 60-180-300°/ sn açısal hızlarda quadriceps-hamstring kas güçlerinin ölçümleri izokinetik sistemle yapıldı. Bulgular: Göz açık OA,AP,ML değerleri osteoporozlu hastalarda anlamlı olarak yüksek bulundu.Tüm osteoporoz hastaları arasında korelasyon analizi yapıldığında denge stabilite indeksleriyle 60 °/sn açısal hızdaki diz fleksiyon ve ekstansiyonu ve 300°/sn açısal hızdaki diz fleksiyonu kas kuvvetleri arasında negatif anlamlı bir ilişki saptandı.Multivariable regresyon analizinde 60 °/sn açısal hızdaki quadriceps kas gücünün osteoporoz hastalarında denge ile en fazla ilişkili faktör olduğu saptandı. Sonuç: Sağlıklı kadınlara göre osteoporotik kadınlarda postural denge önemli derecede bozulmuştur ve dengeyi etkileyen en önemli faktör quadriceps kas gücüdür. Bu yüzden osteoporotik kadınlarda düşmeleri önlemek için denge ve quadriceps kuvvetlendirme egzersizlerine önem verilmelidir. (Türk Os te opo roz Dergisi 2011;17:37-43)Öğe Kas-iskelet sistemi tutulumu olan brusellozisli hastalarda klinik ve laboratuvar özellikler(2005) Aydın, Gülümser; Keleş, Işık; Atalar, Ebru; Açıkgöz, Ergin Ayaşlıoğlu; Tosun, Aliye; Orkun, SevimAmaç: Kırıkkale ve kırsalında kas-iskelet sistemi tutulumu olan brusellozisli hastalarda demografik, klinik ve laboratuvar özellikleri incelemek. Gereç ve Yöntemler: Çalışmaya kas-iskelet sistemi tutulumu olan brusellozis tanısı konulmuş 28 hasta dahil edildi. Hastaların demografik özellikleri, yakınmasının süresi, şekli, olası enfeksiyon kaynağı sorgulandı. Ayrıntılı sistemik ve kas-iskelet sistemi muayene bulguları not edildi. Rutin biyokimya, tam kan sayımı, eritrosit sedimentasyon hızı, C-reaktif protein, romatoid faktör, antinükleer antikor, kan kültürü ve standart tüp aglütinasyon testleri yapıldı. Hastaların tümünde sakroiliak, lumbosakral ve gerekli görülen durumlarda periferik eklem radyografileri değerlendirildi. Klinik ve radyografik olarak derin eklemlerin tutulumundan şüphede kalındığı durumlarda magnetik rezonans görüntüleme yönteminden faydalanıldı. Bulgular: Hastaların yaş ortalaması 39.4 ± 14.4 yıl, hastalık süreleri 10.1 ± 12.7 aydı ve %64.3’ü erkekti. En sık izlenen semptom artralji (%85.7), bulgu ise splenomegaliydi (%32.1). Kan kültürü %39.3 hastada pozitifti. Eklem tutulumu olarak periferik artrit %71 oranı ile ilk sıradaydı ve en sık tutulan periferik eklemler %35 ile kalça ve dizdi. Sakroiliit %32 hastada tespit edildi ve %89’u unilateraldi. Spondilit %14 hastada ve en sık lomber segmentte (%75) izlendi. Her bir kas-iskelet sistemi tutulumunun tipi tüm parametreler açısından diğerleri ile kıyaslandığında sakroiliit grubunda sadece sakroiliak testleri pozitifliği, spondiliti olan grupta yaş, perküsyonla vertebra hassasiyeti ve spinal hareketlerle ağrının varlığı, diğerlerinden anlamlı düzeyde farklıydı (p< 0.05). Sonuç: Bölgemizde brusellozis saptanan ve aynı zamanda kas-iskelet sistemi tutulumu olan olgularda en sık tutulum periferik eklemlerde izlenmektedir. Sakroiliak ekleme yönelik özel testler sakroiliit için yol gösterici olabilir. Özellikle spinal hareketleri ağrılı ve perküsyonla hassasiyet saptanan brusellozisli yaşlı hastalarda omurga tutulumu olabileceği akılda tutulmalıdır. Spinal ya da periferik eklem ağrısı olan ve yumuşak doku romatizmasına bağlı şikayeti bulunan hastalarda brusellozis ayırıcı tanıda yer almalıdır.Öğe Yoğun Bakım Ve Ameliyathane Çalışanlarında Kas İskelet Sistem Ağrıları(2019) Karaca, Şahika Burcu; Aydın, GülçinAmaç: Kas iskelet sistemi bozuklukları (KİSB) hastane çalışanlarında mesleğe bağlı görülen en önemli sağlık sorunlarından birisidir. Biz bu çalışmada ameliyathane ve yoğun bakım çalışanlarında eklem, ekstremite ve omurga bozukluklarını değerlendirip; bu bireylerin günlük yaşam aktivitelerini, ilaç kullanım sıklıklarını ve dizabilitelerini ortaya koymayı amaçladık. Gereç Ve Yöntem: Ameliyathane ve yoğun bakımda çalışan 65 personelin demografik özellikleri, mesleği, çalıştığı birim, çalışma süresi, çalışma yılı, vücut kitle indeksi ve ayakta kalma süresi sorgulanmış ve katılımcılar tarafından Genişletilmiş Nordic Kasiskelet Sistemi Anketi doldurulmuştur. Bulgular: Çalışanlarda en sık bel, diz, boyun ve sırt ağrıları en sık saptanmıştır (sırasıyla %66.2, %63.1, %53.8, %53.8). Hastaneye yatış sıklığı değerlendirildiğinde boyun, sırt ve kalça/uyluk ağrıları ön plandadır (sırasıyla %8.6, %8.6, %8.3). Bel, boyun ve diz ağrısı nedeniyle son 12 ay içinde ev veya ev dışı aktivitelerde kısıtlılık ve ağrı kesici kullanımı daha sık saptanmıştır. Son 12 ay içinde istirahat raporu kullanımında ise ayak/ayak bileği, bel ve kalça/uyluk ağrıları ön plana çıkmaktadır. Sonuç: Yoğun bakım ve ameliyathane çalışanlarında KİSB özellikle bel, diz, boyun ve sırt ağrıları; ev ve iş aktivitelerinde kısıtlılık, doktora başvuru, ağrı kesici kullanımında artış ve istirahat raporu kullanımında artışla beraber önemli bir dizabilite kaynağıdır.Öğe Evaluation of the effect of chiropractic manipulative treatment on oxidative stress in sacroiliac joint dysfunction(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020) Kultur, Turgut; Ciftci, Aydin; Okumus, Muyesser; Dogan, Murat; Durmaz, Senay Arikan; Neselioglu, Salim; Erel, OzcanObjectives: This study aims to investigate the effect of chiropractic manipulative treatment on sacroiliac joint dysfunction (SIJD) and its relationship to oxidative stress (OXS) parameters. Patients and methods: Thirty-three patients diagnosed with SIJD (20 males, 13 females; mean age 36.3 +/- 9.7 years; range, 18 to 60 years) and 30 healthy volunteers (20 males, 10 females; mean age 36.4 +/- 12.2 years; range, 20 to 57 years) were included in this cross-sectional, case-control study conducted between February 2017 and September 2017. Manipulation was applied to the patients once a week for a duration of four weeks. The patients were evaluated at pre-treatment and one month after treatment with visual analog scale, SIJD test, and total thiol, native thiol, disulphide, and ischemia-modified albumin (IMA) as OXS indicators. Results: Prior to treatment, we demonstrated that serum native thiol (mu mol/L) and total thiol (mu mol/L) levels in the patient group were lower compared to control subjects (p=0.03 and p=0.02, respectively). Serum IMA levels were higher in the patient group (p=0.01). There was no change in OXS parameters after manipulative treatment in the patient group. Conclusion: Manipulation is useful in SIJD. Thiol/disulphide homeostasis and serum IMA levels may be used to measure the OXS in patients with SIJD.Öğe Reply to the Letter to the Editor for "Evaluation of the effect of chiropractic manipulative treatment on oxidative stress in sacroiliac joint dysfunction"(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020) Kultur, Turgut; Ciftci, Aydin; Okumus, Muyesser; Dogan, Murat; Durmaz, Senay Arikan; Neselioglu, Salim; Erel, Ozcan[Özet Yok]Öğe The effect of aerobic exercise training on postmenopausal patients with knee osteoarthritis(IOS PRESS, 2020) Kılıç, Filiz; Demirgüç, Arzu; Arslan, Saniye Aydoğan; Keskin, Esra Dilek; Aras, MüyesserBACKGROUND: Knee osteoarthritis (OA) is a common musculoskeletal problem encountered in the postmenopausal period. OBJECTIVE: This study aimed to determine the impact of aerobic exercise on functional limitation, exercise tolerance, and performance tests in postmenopausal women with knee OA. METHODS: A total of 50 women (aged between 48-78) with grade 2-3 knee OA according to the Kellgren-Lawrence radiographic scale were enrolled. OA-specific physical performance tests (40 m Fast-Paced Walk Test (40mFPWT), 30 s Chair Stand Test (30sCST), Stair Climb Test (9-step SCT)), six-minute walk test (6MWT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS) were performed. Fifty patients were randomized to either the treatment or control groups. The treatment group received an additional aerobic exercise training along with a combined physiotherapy program for six weeks. The aerobic exercise program was carried out by the same physiotherapist every weekday (five days) for six weeks. The control group only received a combined physiotherapy program for six weeks. RESULTS: The post-treatment comparisons of the two groups yielded similar SCT results (p > 0.05), while VAS scores, the results of all performance tests, WOMAC scores, and the distance covered in 6MWT were significantly higher in the treatment group (p < 0.05). CONCLUSIONS: Consequently, this study provides an insight into the efficacy of the aerobic exercise program applied along with a combined physiotherapy program in postmenopausal women with knee OA.Öğe Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study(SPRINGER HEIDELBERG, 2020) Sunar, Ismihan; Ataman, Sebnem; Nas, Kemal; Kilic, Erkan; Sargin, Betul; Kasman, Sevtap Acer; Alkan, HakanPsoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.Öğe The impact of fatigue on patients with psoriatic arthritis: a multi-center study of the TLAR-network(SPRINGER HEIDELBERG, 2020) Duruoz, Mehmet Tuncay; Gezer, Halise Hande; Nas, Kemal; Kilic, Erkan; Sargin, Betul; Acer Kasman, Sevtap; Alkan, HakanFatigue is a substantial problem in patients with psoriatic arthritis (PsA) that needs to be considered in the core set of domains. This study aimed to evaluate fatigue and its relationship with disease parameters, functional disability, anxiety, depression, quality of life, and correlation with disease activity as determined by various scales. A total of 1028 patients (677 females, 351 males) with PsA who met the CASPAR criteria were included [Turkish League Against Rheumatism (TLAR) Network multicenter study]. The demographic features and clinical conditions of the patients were recorded. Correlations between fatigue score and clinical parameters were evaluated using the Disease Activity Score 28 (DAS28), Disease Activity in Psoriatic Arthritis (DAPSA), Clinical DAPSA (cDAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Fibromyalgia Rapid Screening Tool (FiRST), minimal disease activity (MDA), and very low disease activity (VLDA). Fatigue was assessed with the Functional Assessment of Chronic Illness Therapy (FACIT-F) and a 10-point VAS (VAS-F). The mean age of the patients was 47 (SD: 12.2) years, and the mean disease duration was 6.4 (SD: 7.3) years. The mean VAS-F score was 5.1 (SD: 2.7), with fatigue being absent or mild, moderate, and severe in 12.8%, 24.6%, and 62.5% of the patients, respectively. Fatigue scores were significantly better in patients with DAS28 remission, DAPSA remission, cDAPSA remission, MDA, and VLDA (p < 0.001). Fatigue scores significantly increased with increasing disease activity levels on the DAS28, DAPSA, and cDAPSA (p < 0.001). VAS-F scores showed correlations with the scores of the BASDAI, BASFI, PsAQoL, HAD-A, FiRST, pain VAS, and PtGA. FiRST scores showed fibromyalgia in 255 (24.8%) patients. FACIT-F and VAS-F scores were significantly higher in patients with fibromyalgia (p < 0.001). In regression analysis, VLDA, BASDAI score, FiRST score, high education level, HAD-Anxiety, and BMI showed independent associations with fatigue. Our findings showed that fatigue was a common symptom in PsA and disease activity was the most substantial predictor, with fatigue being less in patients in remission, MDA, and VLDA. Other correlates of fatigue were female gender, educational level, anxiety, quality of life, function, pain, and fibromyalgia.
