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Duruöz MT, Bodur H, Ataman Ş, Gürer G, Akgül Ö, Çay HF, Çapkın E, Sezer İ, Rezvani A, Melikoğlu MA, Yağcı İ, Yurdakul FG, Göğüş FN, Kamanlı A, Çevik R, Altan L. Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry. Rheumatol Int 2024; 44:631-642. [PMID: 38319376 PMCID: PMC10914924 DOI: 10.1007/s00296-023-05523-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/20/2023] [Indexed: 02/07/2024]
Abstract
The association between spondyloarthritis and cardiovascular (CV) diseases is complex with variable outcomes. This study aimed to assess the prevalence rates of CV diseases and to analyze the impact of CV risk factors on CV disease in patients with spondyloarthritis. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461-6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631-7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189-28.810, p = 0.030) were the independent predictors for CV disease. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461-6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631-7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189-28.810, p = 0.030) were the independent predictors for CV disease. The prevalence rate of CV disease was 3.0% in patients with spondyloarthritis. Hypertension, dyslipidemia, and cancer history were the independent CV risk factors for CV disease in patients with spondyloarthritis.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Türkiye.
| | - Hatice Bodur
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Türkiye
| | - Şebnem Ataman
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Türkiye
| | - Gülcan Gürer
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, University School of Medicine, Adnan Menderes University, Aydın, Türkiye
| | - Özgür Akgül
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Manisa Celal Bayar University School of Medicine, Manisa, Türkiye
| | - Hasan Fatih Çay
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University School of Medicine, Trabzon, Türkiye
| | - İlhan Sezer
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, University School of Medicine, Akdeniz University, Antalya, Türkiye
| | - Aylin Rezvani
- Department of Physical Medicine Rehabilitation, Internatonal School of Medicine, İstanbul Medipol University, Istanbul, Türkiye
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine Rehabilitation, School of Medicine, Atatürk University, Erzurum, Türkiye
| | - İlker Yağcı
- Department of Physical Medicine Rehabilitation, University School of Medicine, Marmara University, Istanbul, Türkiye
| | - Fatma Gül Yurdakul
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye
| | - Feride Nur Göğüş
- Department of Physical Medicine Rehabilitation and Rheumatology, Gazi University School of Medicine, Ankara, Türkiye
| | - Ayhan Kamanlı
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Sakarya University, Sakarya, Türkiye
| | - Remzi Çevik
- Department of Physical Medicine Rehabilitation, School of Medicine, Dicle University, Diyarbakır, Türkiye
| | - Lale Altan
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Uludağ University, Bursa, Türkiye
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Duruöz MT, Ataman Ş, Bodur H, Çay HF, Melikoğlu MA, Akgül Ö, Çapkın E, Gürer G, Çevik R, Göğüş FN, Kamanlı A, Yurdakul FG, Yağcı İ, Rezvani A, Altan L. Prevalence of cardiovascular diseases and traditional cardiovascular risk factors in patients with rheumatoid arthritis: a real-life evidence from BioSTAR nationwide registry. Rheumatol Int 2024; 44:291-301. [PMID: 38157014 DOI: 10.1007/s00296-023-05515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030-20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567-13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Marmara University, İstanbul, Türkiye.
| | - Şebnem Ataman
- Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Hatice Bodur
- Department of Physical Medicine and Rehabilitaton, Ankara City Hospital, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Türkiye
| | - Hasan Fatih Çay
- Department of Physical Medicine Rehabilitation and Rheumatology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Türkiye
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Atatürk University, Erzurum, Türkiye
| | - Özgür Akgül
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Manisa Celal Bayar University, Manisa, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitaton, School of Medicine, Karadeniz Technical University, Trabzon, Türkiye
| | - Gülcan Gürer
- Department of Physical Medicine Rehabilitation and Rheumatology, University School of Medicine, Adnan Menderes University, Aydın, Türkiye
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitaton, School of Medicine, Dicle University, Diyarbakır, Türkiye
| | - Feride Nur Göğüş
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Gazi University, Ankara, Türkiye
| | - Ayhan Kamanlı
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Sakarya University, Sakarya, Türkiye
| | - Fatma Gül Yurdakul
- Department of Physical Medicine and Rehabilitaton, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye
| | - İlker Yağcı
- Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Marmara University, İstanbul, Türkiye
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitaton, Internatonal School of Medicine, İstanbul Medipol University, İstanbul, Türkiye
| | - Lale Altan
- Department of Physical Medicine Rehabilitation and Rheumatology, Faculty of Medicine, Uludağ University, Bursa, Türkiye
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Altan L, Metin Ökmen B, Tuncer T, Sindel D, Fatih Çay H, 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, Faruk Şendur Ö, Sezer İ, Taşçı Bozbaş G, Tıkız C, Uğurlu H. Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis. Arch Rheumatol 2023; 38:512-520. [PMID: 38125064 PMCID: PMC10728734 DOI: 10.46497/archrheumatol.2023.9806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 12/23/2023] Open
Abstract
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.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Uludağ University School of Medicine, Bursa, Türkiye
| | - Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Türkiye
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Türkiye
| | - Hasan Fatih Çay
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Atılım University Medical School, Ankara, Türkiye
| | - Ajda Bal
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Meral Bilgilisoy
- Department of Physical Medicine and Rehabilitation, Health Science University, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Lale Cerrahoğlu
- Department of Physical Medicine and Rehabilitation, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
| | - Deniz Dülgeroğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Berrin Durmaz
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Tuncay Duruöz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Gülcan Gürer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Savaş Gürsoy
- Department of Physical Medicine and Rehabilitation, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Sami Hizmetli
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
| | - Cahit Kaçar
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Ece Kaptanoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Başkent University Faculty of Medicine, Zübeyde Hanım Hospital, Izmir, Türkiye
| | - Hilal Ecesoy
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University Faculty of Medicine, Konya, Türkiye
| | - Meltem Melikoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University Faculty of Medicine, Sakarya, Türkiye
| | - Hakan Nur
- Department of Physical Medicine and Rehabilitation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Şüheda Özçakır
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Uludağ University School of Medicine, Bursa, Türkiye
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Özlem Şahin
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
| | - Merih Sarıdoğan
- Department of Physical Medicine and Rehabilitation, Istanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Istanbul, Türkiye
| | - Ömer Faruk Şendur
- Department of Physical Medicine and Rehabilitation and Algology, Medicana International Hospital, Izmir, Türkiye
| | - İlhan Sezer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Gülnur Taşçı Bozbaş
- Department of Physical Medicine and Rehabilitation, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Canan Tıkız
- Department of Physical Medicine and Rehabilitation, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Hatice Uğurlu
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Türkiye
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Altan L. Postoperative rehabilitation of compartment syndrome following fasciotomy. Turk J Phys Med Rehabil 2023; 69:133-139. [PMID: 37671371 PMCID: PMC10475902 DOI: 10.5606/tftrd.2023.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 09/07/2023] Open
Abstract
Compartment syndrome can be defined as an increase in pressure in an anatomical compartment in the body resulting in muscle and nerve damage. Acute compartment syndrome mostly develops after crushing traumas and fractures to the extremities and is a condition that requires urgent intervention. Fasciotomy of the affected extremity segment in the early stage of the compartment syndrome is the gold standard in treatment of crush injury. Rehabilitation after fasciotomy is extremely important in regaining extremity functions. In this review, we discuss current approaches to compartment syndrome and rehabilitation principles following fasciotomy.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Uludağ University, Bursa, Türkiye
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Altan L, Mısırcı S, Yağcı İ, Karacaatlı M, Ünlü Özkan F, Güner A, Aktaş İ. How do COVID-19 vaccines affect rheumatic diseases? Arch Rheumatol 2023; 38:75-81. [DOI: 10.46497/archrheumatol.2023.9530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/24/2022] [Indexed: 03/18/2023] Open
Abstract
Objectives: This study aims to investigate the effects of novel coronavirus disease 2019 (COVID-19) vaccines administered in Türkiye on disease activity and the side effects in the patients with inflammatory rheumatic disease (IRD).
Patients and methods: Between September 2021 and February 2022, a total of 536 patients with IRD (225 males, 311 females; mean age: 50.5±12.6 years; range, 18 to 93 years) who were vaccinated against COVID-19 and followed in the outpatient setting were included in the study. Vaccination status of the patients and whether they had COVID-19 were questioned. All patients were asked to rate their anxiety about the vaccination on a scale of 0-10 before and after the shots. They were asked whether they experienced any side effects and an increase in IRD complaints after vaccination.
Results: A total of 128 (23.9%) patients were diagnosed with COVID-19 before the first vaccination. Totally, 180 (33.6%) patients were vaccinated with CoronaVac (Sinovac) and 214 (39.9%) patients with BNT162b2 (Pfizer-BioNTech). Also, 142 (26.5%) patients were given both vaccines. When the anxiety level of the patients before the first vaccination was questioned, 53.4% reported that they had no anxiety. The rate of patients without any anxiety after vaccination was 67.9%. Comparison of pre- (median Q3=6) and post-vaccine (median Q3=1) anxiety values showed a statistically significant difference (p<0.001). A total of 283 (52.8%) patients reported side effects after vaccination. When both vaccines were compared with each other, the rate of the side effects was higher in the BNT162b2 group (p<0.001) and also in the CoronaVac plus BNT162b2 group (p=0.022). There was no statistically significant difference between BNT162b2 and CoronaVac plus BNT162b2 in terms of side effects (p=0.066). Forty-five (8.4%) patients had increased rheumatic complaints after vaccination.
Conclusion: The lack of a significant increase in disease activity after COVID-19 vaccination in patients with IRD and the absence of serious side effects requiring hospitalization support the safety of vaccines in this patient group.
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Çay HF, Akıncı A, Altan L, Ataman Ş, Aydoğdu S, Dıraçoğlu D, Genç H, Hepgüler S, Ketenci A, Öneş K, Uyar M, Gümrü S, Hacıbedel B, Helvacıoğlu K, Ölmez A, Tuncer T. Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology. Osteoarthr Cartil Open 2022; 5:100332. [PMID: 36605849 PMCID: PMC9807826 DOI: 10.1016/j.ocarto.2022.100332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 11/03/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Objective To get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey. Design 157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor. Results Panellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation. Conclusions These findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts' perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented.
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Affiliation(s)
- Hasan Fatih Çay
- Department of Rheumatology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey,Corresponding author. Professor Doctor Hasan Fatih Çay, Address: , Tel.: +90 532 250 91 47
| | - Ayşen Akıncı
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University Medical School, Bursa, Turkey
| | - Şebnem Ataman
- Department of Rheumatology, Ankara University Medical School, Ankara, Turkey
| | - Semih Aydoğdu
- Department of Orthopaedic Surgery, School of Medicine, Ege University, İzmir, Turkey
| | - Demirhan Dıraçoğlu
- Department of Physical Medicine and Rehabilitation, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hakan Genç
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, School of Medicine, Ege University, İzmir, Turkey
| | - Ayşegül Ketenci
- Department of Physical Medicine and Rehabilitation, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Kadriye Öneş
- Department of Physical Medicine and Rehabilitation, İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Meltem Uyar
- Department of Anaesthesiology and Reanimation, Pain Clinic, Ege University, İzmir, Turkey
| | - Salih Gümrü
- Department of Medical Affairs, Pfizer, Istanbul, Turkey
| | - Başak Hacıbedel
- Health Economics and Outcomes Research Department, Pfizer, Istanbul, Turkey
| | - Kerem Helvacıoğlu
- Health Economics and Outcomes Research Department, Pfizer, Istanbul, Turkey
| | - Ayşe Ölmez
- Department of Medical Affairs, Pfizer, Istanbul, Turkey
| | - Tiraje Tuncer
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
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7
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Duruöz MT, Erdem Gürsoy D, Tuncer T, Altan L, Ayhan F, Bal A, Bilgilisoy M, Cerrahoğlu L, Çapkın E, Çay HF, Çevik R, Durmaz B, Dülgeroğlu D, Gürer G, Gürsoy S, Hepgüler S, Hizmetli S, Kaçar C, Kaptanoğlu E, Kaya T, Ecesoy H, Alkan Melikoğlu M, Nas K, Nur H, Özçakır Ş, Sarıdoğan M, Sarıkaya S, Sezer İ, Sindel D, Şahin N, Şahin Ö, Faruk Şendur Ö, Taşçı Bozbaş G, Tıkız C, Uğurlu H. The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study. Arch Rheumatol 2022; 37:375-382. [PMID: 36589604 PMCID: PMC9791555 DOI: 10.46497/archrheumatol.2022.9234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/24/2021] [Indexed: 01/03/2023] Open
Abstract
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 Turkey 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.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Didem Erdem Gürsoy
- Department of Physical Medicine and Rehabilitation, Rheumatology Clinic, Prof. Dr. Cemil Taşcoğlu City Hospital, Istanbul, Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
| | - Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Atılım University School of Medicine, Ankara, Turkey
| | - Ajda Bal
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Meral Bilgilisoy
- Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey
| | - Lale Cerrahoğlu
- Department of Physical Medicine and Rehabilitation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Hasan Fatih Çay
- Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Berrin Durmaz
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey
| | - Deniz Dülgeroğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gülcan Gürer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Savaş Gürsoy
- Department of Physical Medicine and Rehabilitation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey
| | - Sami Hizmetli
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Cahit Kaçar
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ece Kaptanoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Başkent University Zübeyde Hanım Application and Research Center, Izmir, Turkey
| | - Taciser Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Turkey
| | - Hilal Ecesoy
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University School of Medicine, Karaman, Turkey
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Sakarya University School of Medicine, Sakarya, Turkey
| | - Hakan Nur
- Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Şüheda Özçakır
- Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
| | - Merih Sarıdoğan
- Department of Physical Medicine and Rehabilitation, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - İlhan Sezer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Balıkesir University, Balıkesir, Turkey
| | - Özlem Şahin
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ömer Faruk Şendur
- Department of Physical Medicine and Rehabilitation, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Gülnur Taşçı Bozbaş
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Canan Tıkız
- Department of Physical Medicine and Rehabilitation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Hatice Uğurlu
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University School of Medicine, Konya, Turkey
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Chen CH, Elsalmawy AH, Ish-Shalom S, Lim SJ, AlAli NS, Cunha-Borges JL, Yang H, Casas N, Altan L, Belaya Z, Marin F, Moll T, Gurbuz S, Brnabic A, Pavo I, Florez S. The Effect of Teriparatide Treatment on the Risk of Fragility Fractures in Postmenopausal Women with Osteoporosis: Results from the Asian and Latin America Fracture Observational Study (ALAFOS). Calcif Tissue Int 2022; 110:74-86. [PMID: 34415388 PMCID: PMC8732800 DOI: 10.1007/s00223-021-00895-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023]
Abstract
The Asian and Latin America Fracture Observational Study (ALAFOS) is a prospective, observational, single-arm study conducted in 20 countries across Asia, Latin America and the Middle East. ALAFOS evaluated new clinical vertebral and non-vertebral fragility fractures in relation to time on teriparatide, in postmenopausal women with osteoporosis in real-life clinical practice. Clinical fragility fractures, back pain, and health-related quality of life (HRQoL) were recorded in 6-month intervals for ≤ 24 months during teriparatide treatment and up to 12-months post-treatment. Data were analysed with piecewise exponential regression with inverse probability weighting for time to event outcomes and mixed-model repeated measures for back pain and HRQoL. 3054 postmenopausal women started teriparatide and attended ≥ one follow-up visit (mean [SD] age 72.5 [10.4] years). The median (95% CI) time to treatment discontinuation was 22.0 months (21.2, 22.8). During the treatment period, 111 patients (3.6%) sustained 126 clinical fractures (2.98 fractures/100 patient-years). Rates of new clinical fragility fractures were significantly decreased during the > 6-12, > 12-18, and > 18-24-month periods, as compared with the first 6 months of treatment (hazard ratio [HR] 0.57; 95% CI 0.37, 0.88; p = 0.012; HR 0.35; 95% CI 0.19, 0.62; p < 0.001; HR 0.43; 95% CI 0.23, 0.83; p = 0.011; respectively). Patients also reported an improvement in back pain and HRQoL (p < 0.001). These results provide data on the real-world effectiveness of teriparatide in the ALAFOS regions and are consistent with other studies showing reduction of fractures after 6 months of teriparatide treatment. These results should be interpreted in the context of the noncontrolled design of this observational study.
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Affiliation(s)
- Chung-Hwan Chen
- Department of Orthopedics and Orthopedic Research Center, Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Abdulaziz H Elsalmawy
- Department of Trauma and Orthopedic Surgery, Al Noor Specialized Hospital Makkah, Mecca, Saudi Arabia
| | | | - Seung-Jae Lim
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Nadia S AlAli
- Endocrinology Unit, Amiri Hospital, MOH, Kuwait City, Kuwait
| | | | - Huilin Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | | | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
| | - Zhanna Belaya
- Department of Neuroendocrinology and Bone Disease, The National Medical Research Center for Endocrinology, Moscow, Russia
| | | | | | | | | | - Imre Pavo
- Eli Lilly and Company, Indianapolis, USA
| | - Sandra Florez
- Eli Lilly and Company, Indianapolis, USA.
- Pain and Palliative Care Department, Universidad de la Sabana, Chía, Colombia.
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İldemir Doğangün D, Kasapoğlu Aksoy M, Altan L. Serum progranulin levels in axial spondyloarthropathy and relationship with clinical features. Arch Rheumatol 2021; 37:110-118. [PMID: 35949863 PMCID: PMC9326385 DOI: 10.46497/archrheumatol.2022.8542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/16/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives
In this study, we aimed to investigate the serum progranulin (PGRN) levels in patients with axial spondyloarthropathy (AxSpA) and to identify the correlation between disease activity, symptom severity, acute phase reactant (APR), and serum PGNR levels in patients with AxSpA. Patients and methods
This prospective, cross-sectional study included a total of 152 patients (105 males, 47 females; mean age: 41.8±10.3; range 20 to 65 years) with AxSpA according to the 2009 Assessment of SpondyloArthritis Society (ASAS) criteria who received treatment and 100 healthy individuals (61 males, 39 females; mean age 43.4±14.2; range 20 to 65 years) between February 2018 and February 2019. Serum PGRN levels from the venous blood were analyzed in both groups. The clinical AxSpA assessment scales were used in the patient group. Erythrocyte sedimentation rate and C-reactive protein levels were examined. Results
The mean serum PGRN level was 6.9±5.4 ng/mL in the patient group and 11.2±6.0 ng/mL in the control group. Serum PGRN level was significantly higher in the control group (p<0.001). No significant correlation was found between the PGRN levels and disease activity, symptom severity, duration of disease, and age of the patient (p>>0.05). Serum PGRN levels were significantly higher in female patients in the patient group (p<0.01). In the control group, the serum PGRN levels of individuals with a high body mass index were significantly higher (p=0.001). Conclusion
Serum PGRN levels of patients with AxSpA who are under treatment and follow-up are significantly lower than healthy individuals. Serum PGRN levels in female patients with AxSpA are also significantly higher than male patients. Serum PGRN levels do not seem to be related to disease activity.
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Affiliation(s)
- Didem İldemir Doğangün
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University Medicine Faculty, Bursa, Turkey
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10
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Metin Ökmen B, Ayar K, Altan L, Yeşilöz Ö. Central sensitisation in primary Sjögren Syndrome and its effect on sleep quality. Mod Rheumatol 2021; 32:908-914. [PMID: 34918134 DOI: 10.1093/mr/roab075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/05/2021] [Accepted: 08/26/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aim of the present study is to evaluate the presence and frequency of central sensitisation (CS) in primary Sjögren Syndrome (pSS) and to determine the effect of CS on sleep quality. MATERIALS AND METHODS In this cross-sectional study, 50 patients diagnosed with pSS between the ages of 18 and 75 were included. The healthy control group was composed of 43 healthcare workers. Each participant underwent a physical examination, and demographic data and the medications they used were recorded. Central sensitisation inventory and Pittsburgh Sleep Quality Index questionnaires were filled in to garner data on CS and sleep quality, respectively, from all participants. RESULTS While central sensitisation inventory >40 was detected in 74% of pSS patients, it was 25.6% in healthy controls, and there is a statistically significant difference between the groups (p < .05). A correlation analysis of the central sensitisation inventory and Pittsburgh Sleep Quality Index values of all participants revealed a statistically significant correlation between all parameters other than the duration of sleep (p < .05). CONCLUSIONS CS was found to have a negative effect on sleep quality in patients with pSS. We suggest that the cause of widespread pain seen in patients with pSS as the possible development of CS should be considered.
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Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Koray Ayar
- Department of Rheumatology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Özgür Yeşilöz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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11
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Zateri C, Birtane M, Aktaş İ, Sarıkaya S, Rezvani A, Altan L, Dursun N, Dursun E, Taştekin N, Çeliker R, Özdolap Ş, Akgün K. Attitudes of patients with spondylarthritis or rheumatoid arthritis regarding biological treatment during COVID-19 pandemic: A multi-center, phone-based, cross-sectional study. Arch Rheumatol 2021; 36:473-481. [PMID: 35382368 PMCID: PMC8957759 DOI: 10.46497/archrheumatol.2021.8364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives
In this study, we aimed to investigate the medical treatment attitudes of patients with spondylarthritis or rheumatoid arthritis (RA) who were using biological drugs during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods
In this multi-center, cross-sectional study, a total of 277 patients (178 males, 99 females; median age: 45 years; range, 20 to 77 years) who were using biological disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatic diseases and were reached by phone between June 1st, 2020 and June 30th, 2020 were included. Demographic characteristics, working status, type of the rheumatic disease, comorbidities, smoking habits, and type of the bDMARDs were recorded. Disease activity was evaluated using the Visual Analog Scale (VAS). The patients were asked whether they continued the treatment plan, as it was before or changed and, if changed, how they changed the plan and what happened after the change. Results
Of the patients, 229 had spondylarthritis and 48 had RA. A total of 36.1% of the patients were smokers, and the most common comorbidity was hypertension (17.3%). Totally, 5.8% of the patients had a history of contact with a COVID-19 positive person. Only three (1.1%) patients were diagnosed with COVID-19 infection and none of them died. Of the patients, 64.3% continued their treatment, while 35.7% adopted various changes. Most patients made the decision about the treatment plan on their own (n=160, 57.8%), while 38.3% of them consulted their physicians and 13.9% of them consulted any health staff. The only significant parameter for changing the drug course was receiving intravenous bDMARDs (by infusion at hospital) (p=0.001). These patients had also a higher disease activity as measured by VAS, compared to the patients receiving non-infusion therapy (p=0.021). As a result of these changes, severity of the symptoms increased in 91 (32.9%) patients. Disruption of regular biological treatment and prior infusion therapy more likely worsened the complaints (p<0.001 and p=0.024, respectively). Conclusion
Intravenous bDMARD therapy seems to be the main factor affecting the continuity of the treatment in the pandemic period. During the pandemic period, alternative treatment options should be considered other than infusion therapy not to interrupt the treatment of these patients.
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Affiliation(s)
- Coskun Zateri
- Department of Physical Medicine and Rehabilitation, Çanakkale Onsekiz Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Murat Birtane
- Department of Physical Medicine and Rehabilitation, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - İlknur Aktaş
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, Medipol University, International Faculty of Medicine, Istanbul, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Nigar Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Erbil Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Nurettin Taştekin
- Department of Physical Medicine and Rehabilitation, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - Reyhan Çeliker
- Department of Physical Medicine and Rehabilitation, Acıbadem University, Faculty of Medicine, Istanbul, Turkey
| | - Şenay Özdolap
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
| | - Kenan Akgün
- Department of Physical Medicine and Rehabilitation, Istanbul University, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
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Metin Ökmen B, Şengören Dikiş Ö, Ökmen K, Altan L, Yildiz T. Investigation of the effect of kinesiotaping on the respiratory function and depression in male patients with chronic obstructive pulmonary disease: a prospective, randomized, controlled, and single-blind study. Aging Male 2020; 23:648-654. [PMID: 30739540 DOI: 10.1080/13685538.2019.1567703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES We aimed to investigate the effect of kinesiotaping (KT) on the respiratory parameters as measured by spirometry and depression in the chronic obstructive pulmonary disease (COPD) patients. METHODS In this prospective, randomized, controlled, single-blind study 42 male patients with COPD diagnosis were randomized into two groups. In Group1 (n = 21) routine COPD medical treatment plus kinesiotaping and in Group2 (n = 21) only routine COPD medical treatment was given. KT was changed on every fifth day (for a total of three times and 15 days). The patients were assessed using Visual Analog Scale (VAS) for difficulty experienced by the patients during respiration, respiratory function test (RFT), modified medical research council (mMRC) dyspnea scale and beck depression inventory (BDI). The data were obtained before treatment and posttreatment. RESULTS In Group 1; statistically significant improvement was found in all parameters except for FVC and FVC % following treatment compared to pretreatment values. Comparison of the difference scores (the amount of recovery between posttreatment and pretreatment) of the two groups showed significantly superior improvement in Group1 for all parameters except for FVC, FVC % and FEV1% following the treatment (p < .05). CONCLUSIONS The results of this study showed that supplementary kinesiotaping improved respiratory function and depression significantly compared to only routine medical treatment in COPD patients who were in stable condition.
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Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Özlem Şengören Dikiş
- Department of Pulmonary Diseases, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Korgün Ökmen
- Department of Anesthesiology and Reanimation, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Pulmonary Diseases, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Anesthesiology and Reanimation, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Tekin Yildiz
- Department of Pulmonary Diseases, Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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Aksoy MK, Altan L, Karlıbel İA. Associations between Handgrip Strength and Vitamin 25(OH)D Levels in Geriatric Patients. Folia Med (Plovdiv) 2020; 61:397-403. [PMID: 32337926 DOI: 10.3897/folmed.61.e39346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/27/2019] [Indexed: 11/12/2022] Open
Abstract
Introduction: Thirty percent of the muscle mass is lost between the third and eighth decades of life. Vitamin D may have different roles in different aspects of the muscle cell function.
Aim: To assess the correlation between vitamin 25(OH)D levels, handgrip strength (HGS), and finger pinch strength (FPS) in elderly.
Materials and methods: This was a clinical observational study. It included a total of 92 patients of 65 years and over with good general health status and 66 young healthy volunteers. They all underwent HGS and FPS measurements. Study groups were further stratified into those with a serum 25(OH)D levels higher than 30 ng/dl and those with lower than 30 ng/dl.
Results: When geriatric patients were divided into two groups based on 25(OH)D levels, no statistically significant intergroup differences were found in FPS (p>0.05) while statistically significant differences were found in HGS (p<0.05). The analysis of the correlations between HGS and 25(OH)D concentrations revealed a positive, statistically significant correlation between these two parameters at r= 0.330 (p<0.05).
Conclusions: This study demonstrated that serum vitamin 25(OH)D levels have an impact on HGS in both geriatric group and control group.
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Affiliation(s)
- Meliha Kasapoğlu Aksoy
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - İlknur Aykurt Karlıbel
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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Abstract
OBJECTIVES In this study, we aimed to evaluate the level of central sensitization (CS) and its relationship with health profile, including neuropathic pain and sleep quality in Behçet's disease (BD). METHOD Eighty-eight patients with BD and 60 healthy controls (HCs) were included in the study between May 2018 and February 2019. Nottingham health profile (NHP), pain DETECT, Pittsburgh sleep quality index (PSQI) questionnaires and the central sensitization inventory (CSI) were administered to all participants. To evaluate the correlations of the NHP, PSQI, and PDQ scores with the CSI score, the CSI was modified for each questionnaire. The activity of BD was determined by the Behçet's disease current activity form (BDCAF). RESULTS CSI scores were significantly higher in patients with BD than HCs (BD: 41.2 ± 21.1 vs HCs: 20.4 ± 16.9, p < .001). Clinical CS was detected in 69.3% of patients with BD and 28.3% of HCs (p < .001). Severe or extreme CS (CSI score ≥ 50) was present in 37.5% of patients with BD and 5.0% of HCs (p < .001). There were high correlations between the modified CSI scores and the NHP, PDQ and PSQI scores in patients with BD (R = 0.804; p < .001, Rho = 0.698; p < .001, and Rho = 0.734; p < .001, respectively). There was significant correlation between CSI and BDCAF scores (Rho= 0.470, p < .001). CONCLUSION CS is more frequent and more severe in patients with BD than in HCs. There is a strong correlation between the severity of CS and poor health profile in patients with BD.
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Affiliation(s)
- Koray Ayar
- Department of Rheumatology, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Burcu M Ökmen
- Department of Physical Medicine and Rehabilitation, Bursa Yüksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University Medicine Faculty, Bursa, Turkey
| | - Esra K Öztürk
- Department of Physical Medicine and Rehabilitation, Bursa Yüksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
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Çelik A, Altan L, Ökmen BM. The Effects Of Extracorporeal Shock Wave Therapy On Pain, Disability And Life Quality Of Chronic Low Back Pain Patients. Altern Ther Health Med 2020; 26:54-60. [PMID: 31221949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Low back pain is the most common form of pain related to the musculoskeletal system disorders. ESWT has been suggested as a new treatment modality in CLBP and its effectiveness has been investigated in a small number of studies. OBJECTIVE The aim of this study is to investigate the effect of Extracorporeal Shockwave Therapy (ESWT) on pain, functional status, and quality of life compared to placebo in chronic low back pain (CLBP) patients. METHODS/DESIGN Prospective, randomized, placebo-controlled, double-blind study. SETTING The study occurred at the University Of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation (Bursa, Turkey). PARTICIPANTS Participants were 45 patients with CLBP. INTERVENTIONS Participants were randomized into 2 groups. Group 1 (n = 25) received ESWT and Group 2 (n = 20) received placebo ESWT. PRIMARY OUTCOME MEASURES The patients were assessed by using Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), Short-form 36 (SF-36). The data were obtained before treatment (W0), at sixth (W6) and twelfth week (W12). RESULTS In Group 1, statistically significant improvement was found in all parameters of rest and movement NRS, ODI, HADS and SF-36 except for emotional role at both W6 and W12 compared to W0(P < .05). Comparison of the difference scores of the two groups showed significantly superior improvement in Group 1 for all parameters at both W6 and W12 (P < .05). CONCLUSIONS The results of our study have shown that ESWT had a statistically significant superiority over placebo for improvement in the parameters of pain, disability, depression, anxiety, and quality of life in the patients with CLBP.
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Ayhan FF, Sunar İ, Umay E, Keskİn D, Altan L, DİnÇer F, DuruÖz T, Karalezlİ N, Kuran B, Tuncer T. The Turkish League Against Rheumatism Recommendations for the Management of Hand Osteoarthritis Under Guidance of the Current Literature and 2018 European League Against Rheumatism Recommendations. Arch Rheumatol 2020; 35:309-320. [PMID: 33458653 PMCID: PMC7788652 DOI: 10.46497/archrheumatol.2020.7693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/14/2019] [Indexed: 01/17/2023] Open
Abstract
Objectives
This study aims to explore the accordance to the 2018 European League Against Rheumatism (EULAR) recommendations for the management of hand osteoarthritis (OA) among the Turkish League Against Rheumatism (TLAR) expert panel and composition of TLAR recommendations for the management of hand OA under guidance of the current literature. Materials and methods
The TLAR convener designated an expert panel of 10 physicians experienced in hand OA for this process. The 2018 EULAR recommendations for the management of hand OA and the systematic review of the literature were sent to the expert panel via e-mails. The e-mail process which included Delphi round surveys was completed. The EULAR standard operational procedure Appraisal of Guidelines for Research and Evaluation II was followed. The level of agreement was calculated for each item and presented as mean, standard deviations, minimum and maximum and comparisons of 2018 EULAR recommendations were performed. Results
Five overarching principles and 10 recommendations were discussed. Revisions were held for the sixth, seventh, and ninth recommendations with lowest level of agreements. These recommendations were revised in accordance with suggestions from the experts and re-voted. The revised forms were approved despite the lack of statistically significant difference between these forms (p=0.400, p=0.451, p=0.496, respectively). Except for the ninth recommendation about surgery (p=0.008), no significant difference in level of agreements was observed between the EULAR and TLAR hand OA recommendations. The 11th recommendation about paraffin bath was added. Conclusion The optimal treatment of hand OA consists of personalized non-pharmacological (self-management, exercise, splint), pharmacological (topical non-steroidal anti-inflammatory drugs as the first choice), and interventional procedures (only for refractory cases) based on shared decision between the patient and physician. TLAR hand OA recommendations were created mainly based on the most recent literature and the last EULAR hand OA management recommendations, which are widely approved among the TLAR experts.
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Affiliation(s)
- Fikriye Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Uşak University, School of Medicine, Uşak, Turkey
| | - İsmihan Sunar
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara University, School of Medicine, Ankara, Turkey
| | - Ebru Umay
- Department of Physical Therapy and Rehabilitation, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Dilek Keskİn
- Department of Physical Medicine and Rehabilitation, Kırıkkale University, School of Medicine, Kırıkkale, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Uludağ University, School of Medicine, Bursa, Turkey
| | - Fitnat DİnÇer
- Department of Physical Medicine and Rehabilitation, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Tuncay DuruÖz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University, School of Medicine, İstanbul, Turkey
| | - Nazım Karalezlİ
- Department of Orthopedics, Division of Hand Surgery, Muğla Sıtkı Koçman University, School of Medicine, Muğla, Turkey
| | - Banu Kuran
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University, School of Medicine, Antalya, Turkey
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Ayar K, Metİn Ökmen B, Altan L, KÖsegİl ÖztÜrk E. The Frequency of Fibromyalgia and its Relationship With Disease Activity in Female Patients With Behçet's Disease: A Cross Sectional Study. Arch Rheumatol 2020; 35:401-408. [PMID: 33458664 PMCID: PMC7788660 DOI: 10.46497/archrheumatol.2020.7729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/28/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to determine the incidence of fibromyalgia (FM) in female patients with Behçet's disease (BD) and to investigate whether disease activity changes in the presence of FM in female patients with BD. Patients and methods This cross-sectional study included 72 female patients with BD (mean age 39.7±10.5 years; range, 22 to 74 years) between June 2018 and February 2019. The frequency of FM was evaluated according to the American College of Rheumatology alternative criteria. Active clinical features and BD activity were evaluated with the Behçet's disease activity form (BDCAF). Results The prevalence of FM was 29.2% in the BD patients. BD clinical activity index, patients' perceptions of disease activity and clinicians' overall perceptions of disease activity scores were significantly higher in BD patients with FM (p=0.003, p<0.001 and p=0.025, respectively). The active clinical features of BD were not different between the groups except for genital ulcer. The prevalence of active genital ulcers was higher in BD patients with FM than in BD patients without FM (38.1% vs. 13.7%, respectively). Conclusion Disease activity is higher in female BD patients with FM than those without FM. High disease activity in female BD patients with FM may be associated with the presence of genital ulcers.
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Affiliation(s)
- Koray Ayar
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Burcu Metİn Ökmen
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Therapy and Rehabilitation, Uludağ University Medical Faculty, Bursa, Turkey
| | - Esra KÖsegİl ÖztÜrk
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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Kasapoğlu Aksoy M, Altan L, Görükmez O, Güner A, Ayar K. The relationship between CRP gene polymorphism (rs2794521, rs3091244), ASDAS-CRP and ASDAS-ESR in ankylosing spondylitis. Mod Rheumatol 2019; 30:715-720. [PMID: 31267817 DOI: 10.1080/14397595.2019.1639916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: We aimed to investigate the haplotypes and alleles of two variants (rs2794521 and rs3091244) in AS patients and to examine their relationship with ASDAS-CRP and ASDAS-ESR values.Methods: We evaluated 160 AS patients diagnosed according to the ASAS criteria. ASDAS-CRP and ASDAS-ESR values were calculated. ESR and CRP were examined. The restriction fragment length polymorphism (RFLP) method was used for detecting the rs2794521 and rs3091244 regions on the CRP gene.Results: As a result of the evaluation of rs2794521 gene polymorphism using PCR, TT, TC and CC genotypes were observed in 90, 81 and 9 individuals, respectively. As a result of the evaluation of rs3091244 gene polymorphism, CC, AC and TT genotypes were observed in 104, 51 and 5 individuals, respectively. T allele and C allele were found in rs2794521 gene by 75% and 25%, respectively. In addition, T allele, C allele and A allele were found in rs3091244 gene by 80%, 17% and 3%, respectively. With the help of regression equation, ASDAS-CRP level was 0.34 units higher in cases with rs3091244 C allele than cases without rs3091244 C alleles.Conclusion: CRP rs3091244 C allele may be associated with the increased relative risk for ASDAS-CRP.
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Affiliation(s)
- Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey.,Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Orhan Görükmez
- Department of Genetics, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Altuğ Güner
- Department of Physical Medicine and Rehabilitation, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Koray Ayar
- Department of Romatology, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
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Aykurt Karlıbel İ, Dülger S, Kasapoğlu Aksoy M, Güzelsoy M, Türkoğlu AR, Altan L, Yıldız T. Effect of cigarette smoking on sexual functions, psychological factors, and disease activity in male patients with ankylosing spondylitis. Aging Male 2019; 22:109-115. [PMID: 29863428 DOI: 10.1080/13685538.2018.1477935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study aims to investigate the effect of smoking on sexual functions in AS patients. PATIENTS AND METHODS A total of 67 male AS patients with a median age of 34 years (range: 18-57) reporting sexual activity at least for the past 4 weeks period were included. Patients were divided into smokers (Group 1, n = 47) and non-smokers (Group 2, n = 20). Fagerström test for nicotine dependence, smoking history, exhaled carbon monoxide test were recorded for smoking AS patients. Visual analogue scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI) were filled for both groups. RESULTS There was no significant difference between smokers and non-smokers in all evaluation parameters. BASMI scores were significantly lower in the mild dependency subgroup as compared to those with moderate or severe dependency (p = .005 and p = .007, respectively). Total IIEF score and IIEF categories correlated significantly with BASDAI, BASFI, BASMI, ASQoL, pain, fatigue, and cumulative smoking. BDI showed an inverse correlation with the IIEF score and IIEF category (p < .001 r = -0.520, p < .001 r = -0.508, respectively). CONCLUSIONS Sexual function in AS patients is associated with the pain, fatigue, disease activity, functional status, quality of life, depression as well as the cumulative exposure to smoking, and that sexual functions tend to decline with increasing degree of cigarette dependency.
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Affiliation(s)
- İlknur Aykurt Karlıbel
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Seyhan Dülger
- b Department of Pulmonology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Meliha Kasapoğlu Aksoy
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Muhammet Güzelsoy
- c Department of Urology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Ali Rıza Türkoğlu
- c Department of Urology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
| | - Lale Altan
- a Department of Physical Medicine and Rehabilitation , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
- d Department of Physical Medicine and Rehabilitation , Uludağ University Medicine Faculty , Bursa , Turkey
| | - Tekin Yıldız
- b Department of Pulmonology , University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey
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Chen CH, Elsalmawy AH, Ish-Shalom S, Lim SJ, Al-Ali NS, Cunha-Borges JL, Yang H, Casas N, Altan L, Moll T, Gurbuz S, Brnabic AJM, Burge RT, Marin F. Study description and baseline characteristics of the population enrolled in a multinational, observational study of teriparatide in postmenopausal women with osteoporosis: the Asia and Latin America Fracture Observational Study (ALAFOS). Curr Med Res Opin 2019; 35:1041-1049. [PMID: 30474449 DOI: 10.1080/03007995.2018.1552576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the study design and baseline patient characteristics of the Asia and Latin America Fracture Observational Study (ALAFOS) to better understand the profile of patients receiving teriparatide during the course of routine clinical practice in Asia, Latin America, the Middle East and Russia. METHODS Prospective, observational, non-interventional study in postmenopausal women with osteoporosis who are prescribed teriparatide for up to 24 months, according to local medical standards, with a 12 month post-treatment follow-up. MEASURES Demographics, risk factors for osteoporosis and fractures, history of fracture, prior osteoporosis medications, comorbidities, physical function, back pain and quality of life (QoL). RESULTS In total 3031 postmenopausal women (mean age 72.5 years) recruited at 152 sites in 20 countries were analyzed; 62.9% had a history of fragility fracture after age 40 (33.0% of patients with spinal, 14.2% with hip fractures). The mean (SD) bone mineral density T-scores at baseline were -3.06 (1.40) and -2.60 (1.05) at the lumbar spine and femoral neck, respectively. At entry, 43.7% of patients were naïve to prior osteoporosis treatments; 40.5% of patients reported ≥1 fall in the past year. The median (Q1; Q3) EuroQoL Visual Analog Scale (EQ-VAS) for perceived overall health status was 60 (50; 80). The mean (SD) worst back pain Numeric Rating Scale in the last 24 hours was 4.6 (3.3). CONCLUSIONS Our data indicates that patients who were prescribed teriparatide in the ALAFOS participant countries had severe osteoporosis, high prevalence of fractures, disabling back pain and poor QoL. The frequency of patients receiving prior osteoporosis medications was lower than in previous observational studies conducted in other locations.
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Affiliation(s)
- Chung-Hwan Chen
- a Department of Orthopedics , College of Medicine and Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung City , Taiwan
| | - Abdulaziz H Elsalmawy
- b Department of Trauma and Orthopedic Surgery , Al Noor Specialized Hospital Makkah , Mecca , Saudi Arabia
| | | | - Seung-Jae Lim
- d Department of Orthopedic Surgery , Sungkyunkwan University School of Medicine , Seoul , South Korea
| | | | - Joao L Cunha-Borges
- f Faculty of Medicine , Universidade Católica de Brasília , Brasilia , Brazil
| | - Huilin Yang
- g Department of Orthopedics , The First Affiliated Hospital of Soochow University , Suzhou , China
| | - Noemí Casas
- h Riesgo de Fractura CAYRE , Bogotá , Colombia
| | - Lale Altan
- i Department of Physical Medicine and Rehabilitation , Uludağ University School of Medicine , Bursa , Turkey
| | - Thomas Moll
- j Lilly Research Center , Windlesham , United Kingdom
| | - Sirel Gurbuz
- k Lilly Research Laboratories , Indianapolis , IN , USA
| | | | - Russel T Burge
- k Lilly Research Laboratories , Indianapolis , IN , USA
- l Winkle College of Pharmacy , University of Cincinnati , Cincinnati , OH , USA
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Altan L, Kasapoğlu Aksoy M, Kösegil Öztürk E. Efficacy of diclofenac & thiocolchioside gel phonophoresis comparison with ultrasound therapy on acute low back pain; a prospective, double-blind, randomized clinical study. Ultrasonics 2019; 91:201-205. [PMID: 30139568 DOI: 10.1016/j.ultras.2018.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/29/2018] [Accepted: 08/12/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To investigate the effect of Phonophoresis (PP) with the combination of nonsteroidal anti-inflammatory drugs (NSAID's) and myorelaxant versus routine Ultrasound (US) treatment with non-therapeutic gel on the patients with acute low back pain (ABP). METHODS Sixty patients with ABP were randomly assigned into 2 groups. In Group 1 (n = 30) US was applied using diclofenac + Thiocolchicoside gel for 10 min and for a total of 10 sessions. In Group 2 (n = 30) the same US protocol was applied with the same setting and timing with Group 1 using US gel that does not contain any pharmaceutical ingredient. Evaluation parameters were Visual numeric scale (VNS), Oswestry Disability Index (ODI), and Shober test. RESULTS Comparison of the results obtained from the two groups before treatment and at second (W2) and sixth weeks (W6) posttreatment showed significant improvement in all parameters in both groups (p < 0.05). Comparison of the groups showed significantly superior improvement in Group 1 for ODI while there was no difference in other parameters at W2. At W6, there was significantly superior improvement in all parameters (p < 0.05) except for Shober test in Group1. CONCLUSION Our results showed that PP treatment is superior than conventional US therapy at short term in ABP patients.
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Affiliation(s)
- L Altan
- Uludağ University Medicine Faculty, Department of Physical Medicine and Rehabilitation, Turkey; University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey
| | - M Kasapoğlu Aksoy
- University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey.
| | - E Kösegil Öztürk
- University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey
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Aykurt Karıbel I, Kasapoglun Aksoy M, Altan L. Familial Transient Osteoporosis of the Hip? On Account of Three Cases from the Same Family. Erciyes Med J 2018. [DOI: 10.5152/etd.2018.17093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tuncer T, Cay FH, 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 OF, Ugurlu H, Unlu Z. 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis. Rheumatol Int 2018; 38:1315-1331. [PMID: 29777340 DOI: 10.1007/s00296-018-4044-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/05/2018] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Tiraje Tuncer
- School Of Medicine, Physical Medicine Rehabilitation, Akdeniz University, Antalya, Turkey
| | - Fatih Hasan Cay
- Antalya Training and Research Hospital, Physical Medicine Rehabilitation and Rheumatology, University of Health Sciences, Antalya, Turkey.
| | - Lale Altan
- School of Medicine, Physical Medicine Rehabilitation, Uludağ University, Bursa, Turkey
| | - Gulcan Gurer
- School of Medicine, Physical Medicine Rehabilitation and Rheumatology, Adnan Menderes University, Aydın, Turkey
| | - Cahit Kacar
- School Of Medicine, Physical Medicine Rehabilitation and Rheumatology, Akdeniz University, Antalya, Turkey
| | - Suheda Ozcakir
- School of Medicine, Physical Medicine Rehabilitation, Uludağ University, Bursa, Turkey
| | - Sahap Atik
- School of Medicine, Orthopaedics and Traumatology, Gazi University, Ankara, Turkey
| | - Figen Ayhan
- Ankara Training and Research Hospital, Physical Medicine Rehabilitation, University Of Health Sciences, Ankara, Turkey
| | - Berrin Durmaz
- School of Medicine, Physical Medicine Rehabilitation, Ege University, Izmir, Turkey
| | - Nurten Eskiyurt
- Istanbul School of Medicine, Physical Medicine Rehabilitation (Retired), İstanbul University, Istanbul, Turkey
| | - Hakan Genc
- Ankara Training and Research Hospital, Physical Medicine Rehabilitation, University Of Health Sciences, Ankara, Turkey
| | - Yesim GokceKutsal
- School of Medicine, Physical Medicine Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Rezzan Gunaydin
- Physical Medicine Rehabilitation, Medical Park İzmir Hospital, Izmir, Turkey
| | - Simin Hepguler
- School of Medicine, Physical Medicine Rehabilitation, Ege University, Izmir, Turkey
| | - Sami Hizmetli
- School of Medicine, Physical Medicine Rehabilitation and Rheumatology Physical Medicine Rehabilitation, Cumhuriyet University, Sivas, Turkey
| | - Taciser Kaya
- Bozyaka Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Izmir, Turkey
| | - Yesim Kurtais
- School of Medicine, Physical Medicine Rehabilitation, Ankara University, Ankara, Turkey
| | - Merih Saridogan
- Cerrahpaşa School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey
| | - Dilsad Sindel
- İstanbul School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey
| | - Serap Sutbeyaz
- Kayseri Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Kayseri, Turkey
| | - Omer Faruk Sendur
- School of Medicine, Physical Medicine Rehabilitation, Adnan Menderes University, Aydın, Turkey
| | - Hatice Ugurlu
- School of Medicine, Physical Medicine Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Zeliha Unlu
- School of Medicine, Physical Medicine Rehabilitation, Celal Bayar University, Manisa, Turkey
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Metin Ökmen B, Ökmen K, Altan L. Comparison of the Efficiency of Ultrasound-Guided Injections of the Rhomboid Major and Trapezius Muscles in Myofascial Pain Syndrome: A Prospective Randomized Controlled Double-blind Study. J Ultrasound Med 2018; 37:1151-1157. [PMID: 29048132 DOI: 10.1002/jum.14456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES We aimed to investigate the effect of ultrasound (US)-guided injections of the rhomboid major (deep) and trapezius (superficial) muscles on pain, disability, and quality of life in patients with myofascial pain syndrome. METHODS In this prospective randomized controlled double-blind study, 65 patients with a diagnosis of myofascial pain syndrome were randomized into 2 groups. In group 1 (n = 33), US-guided rhomboid major muscle injection was performed, and in group 2 (n = 32), US-guided trapezius muscle injection was performed. The patients were assessed by a visual analog scale for pain, the Pressure Pain Threshold, the Neck Pain and Disability Scale, and Short Form 12. Data were obtained before treatment (week 0), the second week after treatment, and the fourth week after treatment. RESULTS In both groups, significant improvements were observed for all parameters at both weeks 2 and 4 compared to pretreatment values (P < .05). A comparison of the groups showed significantly superior results in group 1 for all parameters at week 2 (P < .05) and for all parameters but the Physical Component Scale of Short Form 12 at week 4 (P < .05). CONCLUSIONS We think that US-guided deep injection of the rhomboid major muscle was more effective than superficial injection of the trapezius muscle for pain, disability, and quality of life in patients with myofascial pain syndrome.
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Affiliation(s)
- Burcu Metin Ökmen
- Departments of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Korgün Ökmen
- Departments of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Departments of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Departments of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
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Altan L, Çeliker R, Ercan İ, Birtane M, Akgün K, Zateri C, Taştekin N, Rezvani A, Aktaş İ, Özdolap Ş, Dursun E, Dursun N, Sarıkaya S. The reliability and validity of the Turkish version of the Fibromyalgia Participation Questionnaire. Eur J Rheumatol 2018; 5:40-44. [PMID: 29657874 DOI: 10.5152/eurjrheum.2017.16090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The objective of this study was to test the reliability and validity of the Turkish version of the Fibromyalgia Participation Questionnaire (FPQ). Methods One hundred and eighty-four female patients with fibromyalgia syndrome were included in the study. All patients filled out the Turkish FPQ (FPQ-T) questionnaire, which was obtained by translation from German according to the guideline for the process of cross-cultural adaptation The patients filled out the revised Fibromyalgia Impact Questionnaire (FIQ) and reevaluated the FPQ-T two hours later. Internal consistency reliability of the FPQ-T was assessed by calculating the "if item deleted" using Cronbach's alpha and the "item-total correction" coefficient for each item of the questionnaire. The consistency of the subscales and the correlation of the test-retest values were assessed. The test-retest values were compared using the Wilcoxon test. Criterion validity was measured using FIQ scales by Spearman's rank correlation coefficient. Results For internal reliability, Cronbach's alpha coefficient was calculated as 0.957 for nonworking patients and 0.958 for working patients. Cronbach's alpha values of 0.939, 0.871, and 0.914 were obtained for daily, social, and work life, respectively. Correlation coefficients were 0.888 for daily life, 0.859 for social life, and 0.901 overall in the nonworking group versus 0.896 the in working group. The comparison of scores obtained from test-retest measurements showed no significant difference except for Item 3. The correlation of the symptom severity score (SSS) and the FPQ-T was r=0.385 (p<0.001) and r=0.390 (p<0.001) for the nonworking and working subgroups, respectively. The evaluation of construct validity showed a significant correlation between the SSS and FPQ-T. Conclusion The results of our study showed that the FPQ-T is reliable and valid for assessing participation and social functioning in fibromyalgia patients in Turkish society.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludag University School of Medicine, Bursa, Turkey
| | - Reyhan Çeliker
- Department of Physical Medicine and Rehabilitation, Acibadem University, School of Medicine, İstanbul, Turkey
| | - İlker Ercan
- Department of Biostatistics, Uludag University School of Medicine, Bursa, Turkey
| | - Murat Birtane
- Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
| | - Kenan Akgün
- Department of Physical Medicine and Rehabilitation, Istanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Coşkun Zateri
- Department of Physical Medicine and Rehabilitation, Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Nurettin Taştekin
- Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, Bezmialem University School of Medicine, İstanbul, Turkey
| | - İlknur Aktaş
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Şenay Özdolap
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Erbil Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Nigar Dursun
- Department of Physical Medicine and Rehabilitation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
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Güner A, Altan L, Kasapoğlu Aksoy M. The effectiveness of the low-power laser and kinesiotaping in the treatment of carpal tunnel syndrome, a pilot study. Rheumatol Int 2018; 38:895-904. [DOI: 10.1007/s00296-018-4020-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 03/26/2018] [Indexed: 05/29/2023]
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Kasapoğlu Aksoy M, Altan L, Eröksüz R, Metin Ökmen B. The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study. Int J Biometeorol 2017; 61:2145-2152. [PMID: 28779304 DOI: 10.1007/s00484-017-1419-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion (ROM), and joint stiffness, leading to impaired hand function and difficulty in performance of daily living activities. Mud bath therapy has been reported to play a primary role in the prevention and management of OA. Thus, we planned to conduct a study aimed at investigating the effects of peloid therapy on pain, functional state, grip strength, and the quality of life and performing a comparative analysis of the outcomes of peloid therapy. In this randomized, controlled, single-blind, pilot study, patients (n = 33) underwent peloid therapy over 2 weeks, 5 sessions a week, for a total of 10 sessions and home exercise program in group 1. Patients in group 2 (control, n = 30) received only the same home exercise program as in group 1. Patients were evaluated just before, and 2 and 6 weeks after the start of the study with Visual Analogue Scale (VAS), Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Health Assessment Questionnaire (HAQ), hand grip strength (HGS), and pinch strength (PS). Statistically significant improvements were observed in all parameters assessed at week 2 and week 6 in the group 1 (p < 0.05). Statistically significant differences were observed in HGS scores in the group 2 at week 2 and in AUSCAN scores at week 6 (p < 0.05). Intergroup comparisons of the scores revealed significant differences between the peloid therapy group and control group in VAS, HAQ, AUSCAN, HGS, and PS scores at week 2 and week 6 (p < 0.05). This study demonstrates that peloid therapy might be an effective and confident treatment modality in the management of symptomatic osteoarthritis of the hand and may provide effective pain control and improvements in the hand functions, quality of life, and grip strength.
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Affiliation(s)
- Meliha Kasapoğlu Aksoy
- Department of Physical Therapy and Rehabilitation, Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Rıza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Burcu Metin Ökmen
- Department of Physical Therapy and Rehabilitation, Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Ökmen BM, Eröksüz R, Altan L, Aksoy MK. Efficacy of peloid therapy in patients with chronic lateral epicondylitis: a randomized, controlled, single blind study. Int J Biometeorol 2017; 61:1965-1972. [PMID: 28620677 DOI: 10.1007/s00484-017-1386-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/02/2017] [Accepted: 05/27/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to assess the effect of peloid on pain, functionality, daily life activities, and quality of life of lateral epicondylitis (LE) patients. In this randomized, controlled, single-blind study, 75 patients who were diagnosed with chronic LE were enrolled to the study. Patients were randomized into two groups using the random number table. The patients in the first group (group 1) (n = 33), were given lateral epicondylitis band (LEB) (during the day for 6 weeks) + peloid therapy (five consecutive days a week for 2 weeks), and the second group (group 2) (n = 32), received LEB treatment alone. The patients were assessed by using Patient Rated Tennis Elbow Evaluation (PRTEE) and Nottingham Health Profile (NHP). The data were obtained before treatment (W0), immediately after treatment (W2), and 1 month after treatment (W6). In analysis of the collected data, the Wilcoxon signed rank test for intra-group comparisons and Mann-Whitney U test for comparisons between groups were used. Both in groups 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0 (p < 0.05). In comparison of difference scores between groups, although there was no statistically significant difference between the two groups at W2 when compared to W0 (p > 0.05), a statistically significant difference was found in favor of group 1 for all the evaluation parameters at W6 (p < 0.05). Our results have shown that peloid treatment could be effective in providing improvement in pain relief, function, daily life activities, and quality of life in LE patients.
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Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Rıza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Metin Ökmen B, Kasapoğlu Aksoy M, Güneş A, Eröksüz R, Altan L. Effectiveness of PELOID therapy in carpal tunnel syndrome: A randomized controlled single blind study. Int J Biometeorol 2017; 61:1403-1410. [PMID: 28210859 DOI: 10.1007/s00484-017-1317-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/09/2017] [Accepted: 01/26/2017] [Indexed: 06/06/2023]
Abstract
Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)(n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)(n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0(p < 0.05). Comparison of the groups with each other revealed significantly better results for VAS, BCTSQ, mSNCV, SF-12 in Group 1 than in Group 2 at W2(p < 0.05). There was also a statistically significant difference in favor of Group 1 for VAS, BCTSQ, FGS and MCS at W6 when compared to W0 (p < 0.05). The results of our study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS.
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Affiliation(s)
- Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Aygül Güneş
- Department of Neurology, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Riza Eröksüz
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
- Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey
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Celiker R, Altan L, Rezvani A, Aktas I, Tastekin N, Dursun E, Dursun N, Sarıkaya S, Ozdolap S, Akgun K, Zateri C, Birtane M. Reliability and validity of the Turkish version of the fibromyalgia rapid screening tool (FiRST). J Phys Ther Sci 2017; 29:340-344. [PMID: 28265170 PMCID: PMC5333001 DOI: 10.1589/jpts.29.340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] An easy-to-use, psychometrically validated screening tool for fibromyalgia is
needed. This study aims to evaluate the reliability and validity of the Turkish version of
the Fibromyalgia Rapid Screening Tool by correlating it with 2013 American College of
Rheumatology alternative diagnostic criteria and the Hospital Anxiety and Depression
Scale. [Subjects and Methods] Subjects were 269 Physical Medicine and Rehabilitation
clinic outpatients. Patients completed a questionnaire including the Fibromyalgia Rapid
Screening Tool (twice), 2013 American College of Rheumatology alternative diagnostic
criteria, and the Hospital Anxiety and Depression Scale. Scale reliability was examined by
test-retest. The 2013 American College of Rheumatology alternative diagnostic criteria was
used for comparison to determine criterion validity. The sensitivity, specificity, and
positive and negative likelihood ratios were calculated according to 2013 American College
of Rheumatology alternative diagnostic criteria. Logistic regression analysis was
conducted to find the confounding effect of the Hospital Anxiety and Depression Scale on
Fibromyalgia Rapid Screening Tool to distinguish patients with fibromyalgia syndrome.
[Results] The Fibromyalgia Rapid Screening Tool was similar to the 2013 American College
of Rheumatology alternative diagnostic criteria in defining patients with fibromyalgia
syndrome. Fibromyalgia Rapid Screening Tool score was correlated with 2013 American
College of Rheumatology alternative diagnostic criteria subscores. Each point increase in
Fibromyalgia Rapid Screening Tool global score meant 10 times greater odds of experiencing
fibromyalgia syndrome. [Conclusion] The Turkish version of the Fibromyalgia Rapid
Screening Tool is reliable for identifying patients with fibromyalgia.
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Affiliation(s)
- Reyhan Celiker
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Acibadem University, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Uludag University, Turkey
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem University, Turkey
| | - Ilknur Aktas
- Physical Medicine and Rehabilitation Clinic, Fatih Sultan Mehmet Teaching and Research Hospital, Turkey
| | - Nurettin Tastekin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Trakya University, Turkey
| | - Erbil Dursun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kocaeli University, Turkey
| | - Nigar Dursun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kocaeli University, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bulent Ecevit University, Turkey
| | - Senay Ozdolap
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bulent Ecevit University, Turkey
| | - Kenan Akgun
- Department of Physical Medicine and Rehabilitation, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Coskun Zateri
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Murat Birtane
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Trakya University, Turkey
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Yeğin T, Altan L, Kasapoğlu Aksoy M. The Effect of Therapeutic Ultrasound on Pain and Physical Function in Patients with Knee Osteoarthritis. Ultrasound Med Biol 2017; 43:187-194. [PMID: 27727020 DOI: 10.1016/j.ultrasmedbio.2016.08.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/11/2016] [Accepted: 08/29/2016] [Indexed: 06/06/2023]
Abstract
Osteoartritis (OA) is one of the most frequent causes of pain, loss of function and disability in adults. The prevalence of OA is expected to increase substantially in the future. Knee OA is the most common subset of OA. Therapeutic ultrasound (US) is one of several physical therapy modalities suggested for the management of pain and loss of function due to OA. The purpose of our study was to investigate the efficacy of US therapy in reducing pain and functional loss and improving the quality of life in patients with knee OA in comparison to sham US therapy. The study involved 62 patients. The patients were randomly divided into two groups. The patients in group 1 (n = 30) were administered 1 W/cm2, 1 MHz continuous US, and the patients in group 2 (n = 32) were administered sham US. The US treatment was applied for 8 min to each knee, 16 min in total, 5 d a wk, for a total of 10 sessions during 2 wk. The patients were evaluated immediately after treatment and 1 mo after therapy according to the visual analog scale (VAS), night pain, range of motion, morning stiffness, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne and Short Form-36 (SF-36) scales and 6 min walking distance. Improvement in pain and joint functions was observed in both groups according to the evaluation immediately after treatment and at 1 mo after the therapy. According to the evaluation results immediately after treatment, there was significant improvement in all pain scales (VAS, WOMAC, Lequesne, SF-36), morning stiffness and 6 min walking distance in patients receiving real US treatment (p < 0.05), but only in some pain scales (VAS, WOMAC) and functions in the group receiving sham US (p < 0.05). Significantly better improvement was observed in some pain scales (SF-36), functions (WOMAC, SF-36) and 6 min walking distance in the real US group. At 1 mo after therapy, no significant difference was observed between groups except for improvement in night pain in the real US group. In conclusion, US therapy has been found to be effective in reducing pain and improving physical function in the short term, but this positive effect was not persistent in the long term. However, we believe that the results of our study may contribute to ongoing research for the treatment of patients with knee OA, and further systematic investigation on larger patient populations may delineate the role of US in knee OA treatment.
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Affiliation(s)
- Tuğba Yeğin
- Department of Physical Medicine and Rehabilitation, BursaYüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, BursaYüksek Ihtisas Training and Research Hospital, Bursa, Turkey; Department of Physical Medicine and Rehabilitation, Uludağ University Medicine Faculty, Bursa, Turkey
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, BursaYüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
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Abstract
INTRODUCTION Fibromyalgia syndrome (FMS) is a chronic disease characterized by diffuse pain of unknown cause, fatigue, sleep disorders, cognitive dysfunction, and sensitivity. Fibromyalgia was shown to be associated with balance problems and increased incidence of falls. There are many theoretical mechanisms related to the impact of vitamin D on postural control. The aim of the current study was to investigate the relationship between vitamin 25(OH)D levels and pain, balance and daily activities in patients with FMS. METHOD Patients aged 35-65 years who were diagnosed with FMS according to 1990 ACR diagnostic criteria were screened. Seventy patients diagnosed with FMS and 60 healthy controls with comparable age and gender were included in the study. Fibromyalgia impact scale (FIQ), Berg Balance Scale (BBS), the Nottingham Health Profile (NHP), and visual analog scale (VAS) were applied to the subjects. The subjects were divided into two groups by vitamin 25(OH)D level being above or below 30 ng/ml. RESULTS A statistically significant difference was established between VAS, BBS value and all NHP subscale and NHP total values of FMS patients and those of healthy control group. The relationship between BBS and the level of vitamin 25(OH)D of all participants was investigated, a positive statistically significant relationship was found with Vit-D at r = 0.481 level (p < 0.05). CONCLUSION It was observed that low vitamin D levels affected balance in both FMS group and healthy control group. It should be kept in mind that vitamin D level is likely to negatively affect balance and VAS values in FMS.
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Affiliation(s)
- Meliha Kasapoğlu Aksoy
- a Department of Physical Medicine and Rehabilitation , Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital , Bursa , Turkey and
| | - Lale Altan
- a Department of Physical Medicine and Rehabilitation , Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital , Bursa , Turkey and.,b Department of Physical Medicine and Rehabilitation , Uludağ University Medicine Faculty , Bursa , Turkey
| | - Burcu Ökmen Metin
- a Department of Physical Medicine and Rehabilitation , Sağlık Bilimleri University Bursa Yüksek Ihtisas Training and Research Hospital , Bursa , Turkey and
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Çeliker R, Altan L, Rezvani A, Aktaş I, Taştekin N, Dursun E, Dursun N, Sarıkaya S, Özdolap S, Akgün K, Zateri C, Birtane M. THU0557 Reliability and Validity of Turkish Version of The fibromyalgia Rapid Screening Tool (First). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yeğin T, Altan L, Kasapoğlu Aksoy M. SAT0460 The Effect of Therapeutic Ultrasound on Pain and Physical Function in The Patients with Knee Osteoartritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Karadeniz PG, Bekiroglu N, Ercan I, Altan L. Application of Rasch analysis to Turkish version of ECOS-16 questionnaire. J Appl Meas 2014; 15:302-312. [PMID: 24992253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this study is to reevaluate validity of Turkish version of the ECOS-16 questionnaire by using Rasch analysis in post-menopausal women with osteoporosis. ECOS-16 (Assessment of health related quality of life in osteoporosis) is a quality of life questionnaire, which is convenient for measuring the quality of life of post-menopausal women with osteoporosis. 132 post-menopausal women with osteoporosis who attended Uludag Universtity, Atatürk Rehabilitation and Research Center between January 2010 and March 2011 were included in this study. The subjects filled out Turkish version of ECOS-16 questionnaire by themselves. The Rasch model was used for assessing construct validity of ECOS-16 data. Internal consistency was assessed by Cronbach's alpha coefficient. The mean infit and outfit mean square (z std) were found as 1.08 (0.1) and 1.02 (-0.1), respectively. The separation indices for the item and person were found as 7.72 and 3.13; the separation reliabilities were 0.98 and 0.91, respectively. Cronbach's alpha coefficient was found as 0.90. The construct validity of ECOS-16 questionnaire was assessed by Rasch analysis.
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Affiliation(s)
- Pinar Gunel Karadeniz
- Marmara University Medical School, Department of Biostatistics and Bioinformatics, Selimiye, Tbbiye Street 34668, Haydarpasa, Istanbul, Turkey,
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Rezvani A, Bodur H, Ataman Ş, Kaya T, Buğdaycı DS, Demir SE, Koçyiğit H, Altan L, Uğurlu H, Kırnap M, Gür A, Kozanoğlu E, Akıncı A, Tekeoğlu I, Şahin G, Bal A, Sivrioğlu K, Yazgan P, Aydın G, Hepgüler S, Ölmez N, Şendur ÖF, Yener M, Altay Z, Ayhan F, Durmuş O, Duruöz MT, Günendi Z, Nacır B, Öken Ö, Toktaş H, Delialioğlu SÜ, Evcik D, Sertpoyraz FM. Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis. Mod Rheumatol 2013; 24:651-6. [DOI: 10.3109/14397595.2013.850182] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, Bezmialem Vakif University, Faculty of Medicine,
Istanbul, Turkey
| | - Hatice Bodur
- Physical Medicine and Rehabilitation Clinic, Ankara Numune Training and Research Hospital,
Ankara, Turkey
| | - Şebnem Ataman
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Ankara University, Faculty of Medicine,
Ankara, Turkey
| | - Taciser Kaya
- Physical Medicine and Rehabilitation Clinic, Izmir Bozyaka Training and Research Hospital,
Izmir, Turkey
| | - Derya Soy Buğdaycı
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital,
Istanbul, Turkey
| | - Saliha Eroğlu Demir
- Department of Physical Medicine and Rehabilitation, Bezmialem Vakif University, Faculty of Medicine,
Istanbul, Turkey
| | - Hikmet Koçyiğit
- Physical Medicine and Rehabilitation Clinic, Izmir Katip Celebi University Atatürk Training and Research Hospital,
Izmir, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University, Faculty of Medicine,
Bursa, Turkey
| | - Hatice Uğurlu
- Department of Physical Medicine and Rehabilitation, Selcuk University, Meram Faculty of Medicine,
Konya, Turkey
| | - Mehmet Kırnap
- Department of Physical Medicine and Rehabilitation, Erciyes University, Faculty of Medicine,
Kayseri, Turkey
| | - Ali Gür
- Department of Physical Medicine and Rehabilitation, Gaziantep University, Faculty of Medicine,
Gaziantep, Turkey
| | - Erkan Kozanoğlu
- Department of Physical Medicine and Rehabilitation, Çukurova University, Faculty of Medicine,
Adana, Turkey
| | - Ayşen Akıncı
- Department of Physical Medicine and Rehabilitation, Hacettepe University, Faculty of Medicine,
Ankara, Turkey
| | - Ibrahim Tekeoğlu
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Sakarya University, Faculty of Medicine,
Sakarya, Turkey
| | - Günşah Şahin
- Department of Physical Medicine and Rehabilitation, Mersin University, Faculty of Medicine,
Mersin, Turkey
| | - Ajda Bal
- Physical Medicine and Rehabilitation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital,
Ankara, Turkey
| | - Konçuy Sivrioğlu
- Department of Physical Medicine and Rehabilitation, Uludağ University, Faculty of Medicine,
Bursa, Turkey
| | - Pelin Yazgan
- Department of Physical Medicine and Rehabilitation, Harran University, Faculty of Medicine,
Urfa, Turkey
| | - Gülümser Aydın
- Department of Physical Medicine and Rehabilitation, Kırıkkale University, Faculty of Medicine,
Kırıkkale, Turkey
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, Ege University, Faculty of Medicine,
Izmir, Turkey
| | - Neşe Ölmez
- Physical Medicine and Rehabilitation Clinic, Atatürk Training and Research Hospital,
Izmir, Turkey
| | - Ömer Faruk Şendur
- Department of Physical Medicine and Rehabilitation, Adnan Menderes University, Faculty of Medicine,
Aydın, Turkey
| | - Mahmut Yener
- Department of Physical Medicine and Rehabilitation, Süleyman Demirel University, Faculty of Medicine,
Isparta, Turkey
| | - Zühal Altay
- Department of Physical Medicine and Rehabilitation, İnönü University, Faculty of Medicine,
Malatya, Turkey
| | - Figen Ayhan
- Physical Medicine and Rehabilitation Clinic, Ankara Training and Research Hospital,
Ankara, Turkey
| | - Oğuz Durmuş
- Physical Medicine and Rehabilitation Clinic, GATA Haydarpaşa Training and Research Hospital,
İstanbul, Turkey
| | - Mehmet Tuncay Duruöz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Celal Bayar University, Faculty of Medicine,
Manisa, Turkey
| | - Zafer Günendi
- Department of Physical Medicine and Rehabilitation, Gazi University, Faculty of Medicine,
Ankara, Turkey
| | - Barış Nacır
- Physical Medicine and Rehabilitation Clinic, Ankara Training and Research Hospital,
Ankara, Turkey
| | - Öznur Öken
- AnkaraPhysical Medicine and Rehabilitation Training and Research Hospital,
Ankara, Turkey
| | - Hasan Toktaş
- Department of Physical Medicine and Rehabilitation, Kocatepe University, Faculty of Medicine,
Afyon, Turkey
| | | | - Deniz Evcik
- Department of Therapy and Rehabilitation, Ankara University, Haymana Vocational School; Department of Physical Medicine and Rehabilitation, Ufuk University, Faculty of Medicine Ankara,
Ankara, Turkey
| | - Filiz Meryem Sertpoyraz
- Physical Medicine and Rehabilitation Clinic, Tepecik Training and Research Hospital,
Izmir, Turkey
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Dursun N, Sarikaya S, Ozdolap S, Dursun E, Zateri C, Altan L, Birtane M, Akgun K, Revzani A, Aktas I, Tastekin N, Celiker R. SAT0238 Risk of Falls in Patients with Ankylosing Spondylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Demir-Göçmen D, Altan L, Korkmaz N, Arabacı R. Effect of supervised exercise program including balance exercises on the balance status and clinical signs in patients with fibromyalgia. Rheumatol Int 2012; 33:743-50. [DOI: 10.1007/s00296-012-2444-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
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Altan L, Korkmaz N, Dizdar M, Yurtkuran M. Effect of Pilates training on people with ankylosing spondylitis. Rheumatol Int 2011; 32:2093-9. [DOI: 10.1007/s00296-011-1932-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/27/2011] [Indexed: 02/05/2023]
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Bodur H, Ataman S, Buğdaycı DS, Rezvani A, Nas K, Uzunca K, Emlakçıoğlu E, Karatepe AG, Durmuş B, Sezgin M, Ayhan F, Yazgan P, Duruöz T, Yener M, Gürgan A, Kırnap M, Cakar E, Altan L, Soydemir R, Capkın E, Tekeoğlu I, Aydın G, Günendi Z, Nacır B, Sallı A, Oztürk C, Memiş A, Turan Y, Kozanoğlu E, Sivrioğlu K. Description of the registry of patients with ankylosing spondylitis in Turkey: TRASD-IP. Rheumatol Int 2010; 32:169-76. [PMID: 20711591 DOI: 10.1007/s00296-010-1599-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 07/28/2010] [Indexed: 11/25/2022]
Abstract
A web-based application patient follow-up program was developed to create a registry of patients with ankylosing spondylitis (AS) by the Turkiye Romatizma Arastirma Savas Dernegi (TRASD) AS Study Group. This study describes the methodological background and patient characteristics. The patient follow-up program is a web-based questionnaire, which contains sections on socio-demographic data, anamnesis, personal and family history, systemic and musculoskeletal examination, laboratory and imaging data and treatment. Between October 1, 2007 and February 28, 2009, 1,381 patients from 41 centers were included in the registry (1,038 males [75.2%]; mean age 39.5 ± 10.7 years). Mean disease duration was 12.1 ± 8.5 years, and mean time from initial symptom to diagnosis was 5 ± 6.8 years (median 2 years). HLA-B27 positivity was detected in 73.7% of 262 patients tested. Manifestations of extraarticular involvement were anterior uveitis (13.2%), psoriasis and other skin and mucous membrane lesions (6%) and inflammatory bowel disease (3.8%). The prevalence of peripheral arthritis was 11.2%. In 51.7% of patients, the Bath AS Disease Activity Index was ≥4. But since our patients consisted of the ones with more severe disease who referred to the tertiary centers and needed a regular follow-up, they may not represent the general AS population. Disease-modifying anti-rheumatic drugs were being used by 41.9% of patients, with 16.4% using anti-TNF agents. TRASD-IP (Izlem Programi: Follow-up program) is the first AS registry in Turkey. Such databases are very useful and provide a basis for data collection from large numbers of subjects. TRASD-IP gives information on the clinical and demographic profiles of patients, and the efficacy and safety of anti-TNF drugs, examines the impact on quality of life, and provides real-life data that may be used in cost-effectiveness analyses.
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Affiliation(s)
- Hatice Bodur
- Ankara Numune Training & Research Hospital, Mürsel Uluç M, 937 S, No: 35/17, 06450 Ankara, Turkey.
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Altan L, Korkmaz N, Bingol U, Gunay B. Effect of pilates training on people with fibromyalgia syndrome: a pilot study. Arch Phys Med Rehabil 2010; 90:1983-8. [PMID: 19969158 DOI: 10.1016/j.apmr.2009.06.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 05/29/2009] [Accepted: 06/05/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Altan L, Korkmaz N, Bingol U, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study. OBJECTIVE To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder. DESIGN Randomized, prospective, controlled, and single-blind trial. SETTING Physical medicine and rehabilitation department. PARTICIPANTS Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria. INTERVENTION The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation. MAIN OUTCOME MEASURES Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile. RESULTS Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24. CONCLUSIONS We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, University of Uludag, Bursa, Turkey.
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Altan L, Ercan İ, Konur S. Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatol Int 2009; 30:1049-54. [DOI: 10.1007/s00296-009-1101-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 08/07/2009] [Indexed: 11/24/2022]
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Altan L, Bingol U, Karakoc Y, Aydiner S, Yurtkura M, Yurtkuran M. Clinical investigation of methotrexate in the treatment of ankylosing spondylitis. Scand J Rheumatol 2009. [DOI: 10.1080/03009740410005089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Altan L, Kurtoğlu Z, Yalçinkaya U, Aydinli U, Ertürk E. Brown tumor of the sacral spine in a patient with low-back pain. Rheumatol Int 2007; 28:77-81. [PMID: 17569048 DOI: 10.1007/s00296-007-0380-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 05/22/2007] [Indexed: 10/23/2022]
Abstract
We present a case of a 44-year-old woman with an unusual location of a brown tumor in the sacral vertebrae due to parathyroid adenoma. She was admitted to our clinic with the complaint of low-back pain and was later diagnosed to have a brown tumor. The patient underwent surgery and partial sacrectomy and iliac wing resection was performed in Orthopedic Surgery Department. Subsequently the patient underwent parathyroid adenoma excision in General Surgery Department. On her control examination at postoperative 3 months, she had no pain and was able to perform daily activities without any problem. We believe it is an interesting clinical case both because it shows a very rare localization of brown tumor and points out the importance of employing a wide clinical scope in the differential diagnosis of back pain.
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Affiliation(s)
- Lale Altan
- Department of Physical Therapy and Rehabilitation, Rheumatic Disease and Hydrotherapy Section, Uludağ University Medical Faculty, Atatürk Rehabilitation Center, Kükürtlü cad. No. 98, 16080, Cekirge, Bursa, Turkey.
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Abstract
OBJECTIVE To compare the effect of balneotherapy on physical activity and quality of life as well as the symptoms of pain and stiffness with exercise alone in ankylosing spondylitis (AS) patients. METHODS A total of 60 patients who had a diagnosis of AS according to the modified New York criteria were included in the study. The patients were randomly assigned to two groups. In Group I (n = 30) the patients received balneotherapy in a therapeutic pool for 30 min once a day for 3 weeks. All patients received instructions on the exercise programme, which they were requested to repeat once a day for 30 min during the study. The patients in this group continued the same exercise programme after the end of the balneotherapy protocol to complete a course of 6 months. In Group II the patients were given the same exercise protocol but did not receive balneotherapy. Patients were evaluated before the start of the study and at 3 weeks and 24 weeks. Evaluation parameters were daily and night pain, morning stiffness, the patient's global evaluation and the physician's global evaluation (according to a scoring system of 1 to 5), the Bath Ankylosing Spondilitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Dougados Functional Index (DFI), tragus-wall distance, chest expansion, modified Shober test (MST), fingertip-fibula head distance, and Nottingham Health Profile (NHP). RESULTS Evaluations were completed in 54 patients in the two groups. Comparison of the groups showed significantly superior results for Group I for parameters of BASDAI, NHP total, pain, physical activity, tiredness and sleep score, patient's global evaluation and the physician's global evaluation at 3 weeks, but only for the parameters of patient's global evaluation and MST at 24 weeks. CONCLUSION Balneotherapy has a supplementary effect on improvement in disease activity and functional parameters in AS patients immediately after the treatment period. However, in the light of our medium-term evaluation results, we suggest that further research is needed to assess the role of balneotherapy applied for longer durations in AS patients.
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Affiliation(s)
- L Altan
- Uludağ University Medical Faculty, Rheumatic Disease and Hydrotherapy Section, Atatürk Rehabilitation Centre, Kükürtlü cad. No. 98, 16080 Cekirge, Bursa, Turkey.
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Yurtkuran M, Yurtkuran M, Alp A, Nasircilar A, Bingöl U, Altan L, Sarpdere G. Balneotherapy and tap water therapy in the treatment of knee osteoarthritis. Rheumatol Int 2006; 27:19-27. [PMID: 16832639 DOI: 10.1007/s00296-006-0158-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2005] [Accepted: 06/16/2006] [Indexed: 10/24/2022]
Abstract
To investigate if spa water is superior to tap water (TW) in relieving the symptoms of pain, joint motion, life quality in knee osteoarthritis (KOA) patients. In this randomized placebo-controlled trial, 52 patients with KOA were followed in two groups. In group I (n = 27), patients were treated in the pool full of spa water at 37 degrees C for 20 min a day, 5 days a week, for a period of 2 weeks. In group II (n = 25), the same protocol was used but spa water was replaced by TW heated to 37 degrees C. Patients in both groups were given a home-based standardized exercise program. Evaluation parameters were pain (pVAS), tenderness score (TS), 50-ft walking duration, quadriceps muscle strength (QMS), active flexion degree (AFD), WOMAC OA index, and Nottingham Health Profile (NHP). The first evaluation was done after the informed consent was obtained. Second and third evaluations were done at the 2nd and 12th week. PVAS, 50-ft walking duration, AFD, TS, WOMAC, and NHP variables improved in group I. Same variables except QMS improved also in group II. Comparison of the groups just after treatment showed that only pVAS (P = 0.015), NHP pain score (P = 0.020), and TS (P = 0.002) differed significantly in favor of group I at the 2nd or 12th week. Both of the thermal treatment modalities were found to be effective in the management of the clinical symptoms and quality of life in KOA patients. However, pain and tenderness improved statistically better with balneotherapy. There were no significant differences between the groups for the other variables.
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Affiliation(s)
- Merih Yurtkuran
- Uludag University Atatürk Rehabilitation Center, 16080, Bursa, Turkey.
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Abstract
OBJECTIVE The objective of this study is to investigate the effect of low-power gallium-arsenide laser treatment on the patients with shoulder pain. BACKGROUND DATA Low-energy laser therapy has recently been popularized in the treatment of various rheumatologic, neurologic, and musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, fibromyalgia, carpal tunnel syndrome, rotator cuff tendinitis, and chronic back pain syndromes. METHODS A total of 40 patients who applied to our clinic with shoulder pain and complied with the selection criteria were included in the study. The patients were randomly assigned into Group I (n = 20, laser treatment) and Group II (n = 20, control). In Group I, patients were given laser treatment and an exercise protocol for 10 sessions during a period of 2 weeks. Laser was applied over tuberculum majus and minus, bicipital groove, and anterior and posterior faces of the capsule, regardless of the existence of sensitivity, for 1 min at each location at each session with a frequency of 2000 Hz using a GaAs diode laser instrument (Roland Serie Elettronica Pagani, wavelength 904 nm, frequency range of 5-7000 Hz, and maximum peak power of 27 W, 50 W, or 27 x 4 W). In Group II, placebo laser and the same exercise protocol was given for the same period. Patients were evaluated according to the parameters of pain, palpation sensitivity, algometric sensitivity, and shoulder joint range of motion before and after treatment. RESULTS Analysis of measurement results within each group showed a significant posttreatment improvement for some active and passive movements in both groups, and also for algometric sensitivity in Group I (p < 0.05-0.01). Posttreatment palpation sensitivity values showed improvement in 17 patients (85%) for Group I and six patients (30%) for Group II. Comparison between two groups showed superior results (p < 0.01 and p < 0.001) in Group I for the parameters of passive extension and palpation sensitivity but no significant difference for other parameters. CONCLUSIONS The results of our study have shown better results in palpation sensitivity and passive extension, but no significant improvement in pain, active range, and algometric sensitivity in laser treatment group compared to the control group in the patients with shoulder pain.
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Affiliation(s)
- Umit Bingöl
- Faculty of Medicine, Atatürk Rehabilitation Center, Rheumatic Disease and Hydrotherapy Section, Uludaà University, Cekirge, Bursa, Turkey.
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Ozkan N, Altan L, Bingöl U, Akln S, Yurtkuran M. Investigation of the Supplementary Effect of GaAs Laser Therapy on the Rehabilitation of Human Digital Flexor Tendons. ACTA ACUST UNITED AC 2004; 22:105-10. [PMID: 15165384 DOI: 10.1089/104454704774076154] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the effect of laser photostimulation in rehabilitation of human digital flexor tendons with a placebo-controlled double-blind prospective study model. BACKGROUND DATA Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with a varying rate of success and it has also been shown to have a positive effect on tendon healing in animal experiments, but no clinical study on laser photostimulation in the treatment of human tendons has been reported to date. MATERIALS AND METHODS This study was performed in a total of 25 patients with 41 digital flexor tendon injuries in five anatomical zones. In Group I (21 digits in 13 patients), whirlpool and infrared GaAs diode laser with a frequency of 100 Hz. was applied between the 8th and 21st days postoperatively and all patients were given the Washington rehabilitation program until the end of the 12th week. In Group II (20 digits in 12 patients), the same treatment protocol was given but the laser instrument was switched off during applications. RESULTS The results of the study showed a significant improvement in the laser-treated group only for the parameter of edema reduction (p < 0.01) but the difference between the two groups was non-significant for pain reduction, hand grip strength, and functional evaluation performed according to Strickland and Buck-Gramcko systems using total active motion and fingertip-to distal palmar crease distance parameters (p > 0.05). CONCLUSIONS Significant improvement obtained in edema reduction both immediately and 12 weeks after supplementary GaAs laser application in our study has been interpreted as an important contribution to the rehabilitation of human flexor tendon injuries because edema is known to have a detrimental effect on functional recovery during both early and late stages of tendon healing. However, our study has failed to show a significant positive effect of supplementary GaAs laser application on the other functional recovery parameters of human flexor tendon injury rehabilitation and we suggest further clinical study in this topic be done using different laser types and dosages in order to delineate the role of this promising treatment modality.
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Affiliation(s)
- Neslihan Ozkan
- Atatürk Rehabilitation Center, Rheumatic Disease and Hydrotherapy Section, Uludağ University Medical Faculty, Bursa, Turkey
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Altan L, Akin S, Bingöl U, Ozbek S, Yurtkuran M. [The prognostic value of the Hand Injury Severity Score in industrial hand injuries]. ULUS TRAVMA ACIL CER 2004; 10:97-101. [PMID: 15103567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND We evaluated the value of the "Hand Injury Severity Score" (HISS) in determining the prognosis of industrial hand injuries. METHODS Hand injury severity scores of 112 patients (17 females, 95 males; mean age 31 years; range 15 to 54 years) were calculated following surgery for industrial hand injuries. During the course of rehabilitation program, the patients were followed-up regularly. Pearson correlation coefficients were used to determine the relationship between the HISS scores and the time intervals from injury to healing and return to work. RESULTS The mean HISS score was 37.1+/-27 (range 6 to 116). The time to healing ranged from 12 to 210 days (mean 73.7+/-40.7 days). All the patients returned to work after a mean of 80.4+/-52.9 days (range 7 to 300 days), mainly to previous working places with (12%) or without (79%) changing job activities. Nine per cent of the workers had to change their jobs. The HISS scores were found to be correlated with the healing period and the time to work (p<0.05 and p<0.000, respectively). CONCLUSION The results of this study indicated that HISS was a useful system in predicting the prognosis in the early stages of industrial hand injuries.
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Affiliation(s)
- Lale Altan
- Atatürk Applied Research Center for Rehabilitation, Medicine Faculty of Uludağ University, Bursa, Turkey.
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Altan L, Bingöl U, Aykaç M, Yurtkuran M. Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome. Rheumatol Int 2003; 25:23-7. [PMID: 14673617 DOI: 10.1007/s00296-003-0396-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2003] [Accepted: 08/22/2003] [Indexed: 11/26/2022]
Abstract
Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with varying rates of success. The objective of our study was to investigate the effect of laser therapy on cervical myofascial pain syndrome with a placebo-controlled double-blind prospective study model. It was performed with a total of 53 patients (35 females and 18 males) with cervical myofascial pain syndrome. In group 1 (n = 23), GaAs laser treatment was applied over three trigger points bilaterally and also one point in the taut bands in trapezius muscle bilaterally with a frequency of 1000 Hz for 2 min over each point once a day for 10 days during a period of 2 weeks. In group 2 (n = 25), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups were instructed to perform daily isometric exercises and stretching just short of pain for 2 weeks at home. Evaluations were performed just before treatment (week 0), immediately after (week 2), and 12 weeks later (week 14). Evaluation parameters included pain, algometric measurements, and cervical lateral flexion. Statistical analysis was done on data collected from three evaluation stages. The results were evaluated in 48 patients (32 females, 16 males). Week 2 and week 14 results showed significant improvement in all parameters for both groups. However, comparison of the percentage changes both immediately and 12 weeks after treatment did not show a significant difference relative to pretreatment values. In conclusion, the results of our study have not shown the superiority of GaAs laser therapy over placebo in the treatment of cervical myofascial pain syndrome, but we suggest that further studies on this topic be done using different laser types and dosages in larger patient populations.
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Affiliation(s)
- Lale Altan
- Rheumatic Disease and Hydrotherapy section, Atatürk Rehabilitation Center, Uludağ University Medical Faculty, Bursa, Turkey.
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