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Association of pain and clinical factors on disability and quality of life in systemic sclerosis: A cross-sectional study from Turkish League Against Rheumatism Network
(Bayçınar Tıbbi Yayıncılık, 2023) Çevik, Remzi; Em, Serda; Nas, Kemal; Toprak, Murat; Cengiz, Gizem; Çalış, Mustafa; Sezer, İlhan; Enginar, Ayşe Ünal; Karslı, Pınar Bora; Sağ, Sinem; Sargın, Betül; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Duruöz, Mehmet Tuncay; Gezer, Halise Hande; Ecesoy, Hilal
Objectives: In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc). Patients and methods: Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9±12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruöz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients. Results: All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p=0.001 and p=0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p<0.001) as HAQ (β=0.397, 0.386, 0.452), SHAQ (β=0.397, 0.448, 0.372), DHI (β=0.446, 0.536, 0.389), PCS (β=-0.417,-0.499, -0.408) and MCS (β=-0.478, -0.441, -0.370) in combined, lcSSc and dcSSc patients respectively. The factors associated with high disability and low QoL scores were forced vital capacity for HAQ (β=-0.172, p=0.002) and SF-36 PCS (β=0.187, p=0.001); disease duration for HAQ (β=0.208, p<0.001), DHI (β=0.147, p=0.006), and SF-36 PCS (β=-0.134, p=0.014); 6-minute walk test for HAQ (β=-0.161, p=0.005) and SF-36 PCS (β=0.153, p=0.009); and modified Rodnan skin score for SHAQ (β=0.250, p<0.001) and DHI (β=0.233, p<0.001) in SSc patients. Diffusing capacity of the lungs for carbon monoxide for HAQ (β=-0.189, p=0.010) and SHAQ (β=-0.247, p=0.002); erythrocyte sedimentation rate for DHI (β=0.322, p<0.001); age for SF-36 PCS (β=-0.221, p=0.003) and body mass index for SF-36 PCS (β=-0.200, p=0.008) and MCS (β=-0.175, p=0.034) were the other variables associated with high disability or low QoL scores in SSc subsets. Conclusion: Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc.
Candida arthritis in a patient diagnosed with spondyloarthritis
(Sociedade Brasileira de Medicina Tropical, 2016) Çevik, Remzi; Tekin, Recep; Gem, Mehmet
Candida arthritis is an unusual manifestation that usually affects the knees. A 35-year-old man presented with a 2-month history of pain and swelling in the right knee. Swelling persisted after anti-inflammatory treatment. Peripheric spondyloarthritis was considered, but methotrexate, sulfasalazine, and methylprednisolone did not reduce the swelling. Direct examination of synovial fluid and a culture were positive for Candida albicans. Intravenous and intra-articular amphotericin-B were administered. The arthritis regressed and a culture and direct staining showed negative results. Candida arthritis should be considered in patients with arthritis that is resistant to treatment and prolonged, even if risk factors are absent.
Complications of brucellosis in different age groups: A study of 283 cases in Southeastern Anatolia of Turkey
(Yonsei University College of Medicine, 2003) Gür, Ali; Geyik, Mehmet Faruk; Dikici, Bünyamin; Nas, Kemal; Çevik, Remzi; Saraç, Jale; Hoşoğlu, Salih
We carried out a retrospective analysis of 283 patients diagnosed with brucellosis in our hospital, which serves almost 5.5 million inhabitants in Southeastern Anatolia in Turkey. Our study focuses on the frequency of complications in cases with brucellosis across different age groups. Patients were classified into three groups according to age: less than 15 years old (group A), 15-45 years old (group B) and over 45 years old (group C). Of 283 patients, 138 (49%) were female and 145 (51%) male. Fifty-three (19%) were younger than 15 years old (group A), 178 (63%) were 15-45 (group B), and 52 (18%) were over 45 (group C). When the distribution of all cases was examined according to months of the year, an increase was seen in June. Osteoarticular complications were the most frequent, found in 195 (69%) cases, followed by cutaneous (17%), genitourinary (8%), nervous (7%), respiratory (5%) and hematological (4%) complications. Treatment failed in 15 patients (5%), owing to true relapse in ten and to non-compliance and drug side effects in the other five. Two hundred seventy-two patients received medical treatment alone and 11 required medical and surgical treatment as well (9 spondylitis and 2 carditis). Complications in brucellosis were frequent because 25% of all patients with brucellosis had more than one complication, more so in group C (38%) than in group A (28%) or B (20%). Cutaneous, hematological and respiratory complications in childhood; osteoarticular and cardiac complications in adults; and genitourinary, neurological and gastrointestinal complications in middle aged were more prominent. In conclusion, the frequency of brucella complications was variable in different age groups in Southeastern Anatolia of Turkey. Since brucellosis is a preventable disease, knowledge and early diagnosis of the complications are especially important. Therefore, population education and medical precautions are necessary to prevent the harmful effects of brucella and its complications. In addition, primary health care physicians should be alerted regarding the clinical and laboratory findings of brucella complications.
Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis
(Turkish League Against Rheumatism (TLAR), 2023) Altan, Lale; Ökmen, Burcu Metin; Tuncer, Tiraje; Sindel, Dilşad; Çay, Hasan Fatih; Hepgüler, Simin; Çevik, Remzi
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.
Cross-sectional analysis of cardiovascular disease and risk factors in patients with spondyloarthritis: a real-life evidence from biostar nationwide registry
(Springer Science and Business Media Deutschland GmbH, 2024) Duruöz, Mehmet Tuncay; Bodur, Hatice; Ataman, Şebnem; Gürer, Gülcan; Akgül, Özgür; Uçar, Ülkü; Çay, Hasan Fatih; Çevik, Remzi
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.
Demographic and clinical characteristics of patients with sustained and switching treatments using biological and targeted synthetic disease-modifying antirheumatic drugs: A Multicenter, observational cross-sectional study for rheumatoid arthritis
(Springer, 2022) Ataman, Şebnem; Sunar, İsmihan; Bodur, Hatice; Melikoğlu, Meltem Alkan; Çay, Hasan Fatih; Çapkın, Erhan; Çevik, Remzi
Introduction Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results The study included a total of 565 patients. The mean age was 53.7 +/- 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment.
Depression and anxiety levels in patients with ankylosing spondylitis
(1999) Sır, Aytekin; Nas, Kemal; Karakoç, Mehmet; Saraç, A. Jale; Gür, Ali; Çevik, Remzi; Erdoğan, Ferda
Ankilozan spondilit aksiyal iskelet sistemini tutmaya eğilimli ancak kalça ve omuzlar gibi büyük eklemleri de tutabilen bir hastalıktır. Hastaların yaşam kalitesini etkilemesinden dolayı ankilozan spondilitli hastalarda depresyon ve anksiyete semptomlarının ortaya çıktığı görülmektedir. Bu çalışmanın amacı, modifiye New York kriterlerine göre ankilozan spondilit tanısı konulmuş hastalarda anksiyete ve depresyonun sıklığını araştırmaktır. 25 kadın ve 8 erkek olmak üzere toplam 33 ankilozan spondilitli hastada Beck Depresyon Skalası ve Durumluk - Sürekli Anksiyete Ölçeği kullanılarak depresyon ve anksiyete durumu belirlendi. Her iki skala da hastaların kendileri tarafından doldurulan skalalardır. Hastaların yaş ortalamaları 30.46±3.25 di. Hastaların 11'inde (3 erkek, 8 kadın) depresyon mevcuttu. Hastaların sürekli anksiyete ölçek sonuçları ortalaması 47.69'du. Bu sonuçlar toplumda bulunan normal seviyelerden .daha yüksekti. Bu bulgular, ankilozan spondilit tedavisinde psikiyatrik değerlendirmenin faydalı olabileceğini ortaya koymaktadır.
Diyarbakır bölgesinde özürlülük prevalansı
(2000) Nas, Kemal; Turhanoğlu, Atlı A. Dicle; Erdoğan, Ferda; Gür, Ali; Saraç, A. Jale; Çevik, Remzi
[Abstract Not Available]
Effectiveness of training about kinesiotaping in myofascial pain syndrome: A prospective, single-blind,randomized-controlled study
(Bayçınar Medical Publications, 2021) Dilek, Banu; Batmaz, İbrahim; Sarıyıldız, Mustafa Akif; Şahin, Ebru; Bulut, Deniz; Akalın, Elif; Çevik, Remzi; Nas, Kemal
Abstract Objectives: In this study, we aimed to investigate whether there was any difference in kinesiotaping (KT) application on the upper trapezius muscle between a trained and untrained physiatrist in the management of patients with myofascial pain syndrome (MPS). Patients and methods: Between April 2013 and July 2015, a total of 45 patients (44 females, 1 males; mean age 31.9 +/- 8.0 years; range, 18 to 55 years) with MPS were included in this prospective, single-blind, randomized-controlled study. The patients were randomly divided into two groups. The first group (intervention group, n=24) was administered KT band with the muscle in a tense condition according to the muscle technique performed by a trained physiatrist, from the muscle origo toward its insertion point. The second group (control group, n=21) received no technique and KT was applied to the painful area by an untrained physiatrist using a randomly selected method. Primary outcome measures were pain at rest, during activity (0-10 cm visual analog scale), and threshold measurement with algometry (kg/cm(2)). Secondary outcome measures were function (Neck Pain and Disability Scale), degree of palpable muscle spasm, and quality of life (Nottingham Health Profile). All evaluations were performed at baseline, at three and six weeks after the treatment. Results: There were significant improvements in all parameters in both groups. There were no significant differences in any parameters at six weeks. We demonstrated that KT, which was applied on active trigger points on the upper trapezius muscle by trained and untrained physiatrists, improved pain, palpable muscle spasm, neck function, quality of life, and patient satisfaction degree in patients with MPS. Conclusion: Our study results show that KT, which is applied by trained and untrained physiatrists, improves pain, palpable muscle spasm, neck function, quality of life in patients with MPS.
The effects of alendronate and calcitonin on cytokines in postmenopausal osteoporosis: A 6-month randomized and controlled study
(Yonsei University College of Medicine, 2003) Gür, Ali; Denli, Aziz; Çevik, Remzi; Nas, Kemal; Karakoç, Mehmet; Saraç, Aysegül Jale
The present study was designed to determine if levels of serum cytokines, such as interleukin (IL)-1 ?, IL-2, IL-2r, IL-6, IL-6r, IL-8, IL-10, and TNF- ? are different in osteoporotic and non-osteoporotic postmenopausal women, and to evaluate the effects of calcitonin and alendronate therapies over a six month period on serum cytokine levels in postmenopausal osteoporotic women. Serum levels of IL-2, TNF- ? and IL-8 were found to be significantly higher (p<0.05), and serum IL-10, and IL-6r significantly lower in the calcitonin (N=60) and the alendronate (N=60) treatment groups than in the control group (N=50) (p<0.05). But, no significant difference was apparent between the calcitonin and alendronate treated groups before treatment. Statistically significant changes occurred in patients, with respect to the levels of serum IL-6r, and IL-8 after one month (p<0.05), in IL-2r, IL-6r, IL-8, IL-10 after three months, and in IL-1 ?, IL-6r, IL-8, IL-10 and TNF- ? after six months of calcitonin therapy (p<0.05). No significant difference was observed in IL-6r after one month, in IL-8 and IL-10 after three months, and in TNF- ? after six months in the calcitonin treated group and in the control group, whereas these parameters were significantly different at baseline. In the alendronate treated group, statistically significant changes occurred in the levels of serum IL-1 ? and IL-6 after three months, and in IL-1 ?, IL-6, 1L-6r and TNF- ? after six months (p<0.05). No significant difference was observed in IL-6r after one month, in IL-10 after three months or in TNF-? after six months between the alendronate treatment group and the control group, whereas these parameters were significantly different at baseline. In conclusion, we suggest that; 1) not only IL-1, IL-6, TNF-? and IL-11 but also IL-2, IL-8 and IL-10 may have roles in the etiopathogenesis of osteoporosis, 2) calcitonin therapy have a more distinct influence on serum levels of some cytokines and have an earlier effect than alendronate therapy (especially upon IL-2r, IL-8, and IL-10). Nevertheless, further longitudinal studies are needed to identify the cytokines involved in the pathogenesis of postmenopausal osteoporosis and to evaluate the influence of different treatments on these cytokines.
Effects of Extracorporeal Shock Wave Therapy on the Quality of Life and Pain in Patients with Lateral Epicondylitis
(2018) Atiç, Ramazan; Çevik, Remzi; Alemdar, Celil; Aydın, Abdulkadir; Çelepkolu, Tahsin; Aydın, Zekiye Sevinç
Aim: We aimed to evaluate the effects of extracorporeal shock wave therapy (ESWT) on clinical and functional status, quality of life and level of pain for short and long terms in patients with lateral epicondylitis. Methods: In total, 34 patients with lateral epicondylitis were included in the study. The patients received three sessions of ESWT administered 1day apart. The Short Form (SF-36) Health Survey evaluating the quality of life, the Turkish version of the patient-rated tennis elbow evaluation (PRTEET) evaluating the level of pain during various activities of daily living, the Nirschl pain phase scale evaluating pain during activity of the affected arm and patient-rated visual analogue scale (VAS) evaluating pain localised in the affected arm were used before andafter therapy and at 6 and 12 weeks after therapy. Results: There were significant decreases in the PRTEE-T, Nirschl and VAS scores at 6 and 12 weeks and significant increases in the SF-36 survey scores. There was a significant decrease in the total PRTEE-T,Nirschl and VAS scoresat 6 and 12 weeks. There were significant increases in all subscale scores of the SF-36 survey. Furthermore, there was a sustained decrease in the PRTEE-T, Nirschl and VAS scores and increase in the SF-36 score from 6 to 12 weeks. Conclusion: This study revealed that ESWT is effective in treating lateral epicondylitis by improving the quality of life, reducing pain during activity, decreasing pain during activities of daily living and reducing pain localised in the arm.
Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double-blind and randomize-controlled trial
(Wiley, 2004) Gür, Ali; Saraç, Ayşegül Jale; Çevik, Remzi; Altındağ, Özlem; Saraç, Serdar
Background and Objectives: A prospective, doubleblind, randomized, and controlled trial was conducted in patients with chronic myofascial pain syndrome (MPS) in the neck to evaluate the effects of infrared low level 904 nm Gallium-Arsenide (Ga-As) laser therapy (LLLT) on clinical and quality of life (QoL). Study Design/Patients and Methods: The study group consisted of 60 MPS patients. Patients were randomly assigned to two treatment groups: Group I (actual laser; 30 patients) and Group II (placebo laser; 30 patients). LLLT continued daily for 2 weeks except weekends. Follow-up measures were evaluated at baseline, 2, 3, and 12 weeks. All patients were evaluated with respect to pain at rest, pain at movement, number of trigger points (TP), the Neck Pain and Disability Visual Analog Scale (NPAD), Beck depression Inventory (BDI), and the Nottingham Health Profile (NHP). Results: In active laser group, statistically significant improvements were detected in all outcome measures compared with baseline (P < 0.01) while in the placebo laser group, significant improvements were detected in only pain score at rest at the 1 week later of the end of treatment. The score for self-assessed improvement of pain was significantly different between the active and placebo laser groups (63 vs. 19%) (P < 0.01). Conclusion: This study revealed that short-period application of LLLT is effective in pain relief and in the improvement of functional ability and QoL in patients with MPS.
Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: A double-blind and randomized-controlled trial
(Wiley, 2003) Gür, Ali; Coşut, Abdullkadir; Saraç, Ayşegül Saraç; Çevik, Remzi; Nas, Kemal; Uyar, Aşur; 0000-0001-9680-6268; 0000-0001-8099-097X; 0000-0002-5845-0851; 0000-0002-4124-1586
Background and Objectives: A prospective, double-blind, randomized, and controlled trial was conducted in patients with knee osteoarthritis (OA) to evaluate the efficacy of infrared low-power Gallium-Arsenide (Ga-As) laser therapy (LPLT) and compared two different laser therapy regimes. Study Design/Materials and Methods: Ninety patients were randomly assigned to three treatment groups by one of the nontreating authors by drawing 1 of 90 envelopes labeled 'A' (Group I: actual LPLT consisted of 5 minutes, 3 J total dose + exercise; 30 patients), 'B' (Group II: actual LPLT consisted of 3 minutes, 2 J total dose + exercise; 30 patients), and 'C' (Group III: placebo laser group + exercise; 30 patients). All patients received a total of 10 treatments, and exercise therapy program was continued during study (14 weeks). Subjects, physician, and data analysts were unaware of the code for active or placebo laser until the data analysis was complete. All patients were evaluated with respect to pain, degree of active knee flexion, duration of morning stiffness, painless walking distance and duration, and the Western Ontario and Me Master Universities Osteoarthritis Index (WOMAC) at week 0, 6, 10, and 14. Results: Statistically significant improvements were indicated in respect to all parameters such as pain, function, and quality of life (QoL) measures in the post-therapy period compared to pre-therapy in both active laser groups (P < 0.01). Improvements in all parameters of the Group I and in parameters, such as pain and WOMAC of the Group II, were more statistically significant when compared with placebo laser group (P < 0.05). Conclusions: Our study demonstrated that applications of LPLT in different dose and duration have not affected results and both therapy regimes were a safe and effective method in treatment of knee OA.
Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain
(Wiley, 2003) Gür, Ali; Karakoç, Mehmet; Çevik, Remzi; Nas, Kemal; Saraç, Ayşegül Jale; Karakoç, Meral; 0000-0001-9680-6268; 0000-0002-9511-7070; 0000-0002-4124-1586; 0000-0002-5845-0851
Background and Objectives: The aim of this study was to determine whether low power laser therapy (Gallium-Arsenide) is useful or not for the therapy of chronic low back pain (LBP). Study Design/Materials and Methods: This study included 75 patients (laser+exercise-25, laser alone-25, and exercise alone-25) with LBP. Visual analogue scale (VAS), Schober test, flexion and lateral flexion measures, Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the clinical and functional evaluations pre and post therapeutically. A physician, who was not aware of the therapy undertaken, evaluated the patients. Results: Significant improvements were noted in all groups with respect to all outcome parameters, except lateral flexion (P < 0.05). Conclusions: Low power laser therapy seemed to be an effective method in reducing pain and functional disability in the therapy of chronic LBP.
Genç yaştaki fibromiyaljili hastalarda solunum fonksiyon testleri
(2001) Şenyiğit, Abdurrahman; Saraç, Ayşegül Jale; Karakoç, Mehmet; Gür, Ali; Çevik, Remzi; Nas, Kemal; Erdoğan, Ferda
Fibromiyalji; nonartiküler orijinli, etyolojisi bilinmeyen, jeneralize kas iskelet sistemi ağrısı, karekteristik bölgelerde hassas noktalar, yorgunluk, tutukluk, uyku bozuklukları ve anksiyete ile karakterize, ağrılı bir sendromdur. Bu çalışmanın amacı, genç fibromiyaljili hastalarda solunum fonksiyon testlerini değerlendirmektir. Çalışmaya Amerikan Romatoloji Birliği (ARA) kriterlerine göre Fibromiyalji Sendromu (FMS) tanısı konan 38 hasta ile benzer yaş ve cinsiyette 23 kişilik kontrol grubu alındı. Vakaların hiçbiri sigara içmemekteydi. Hastalarda zorlu vital kapasite (FVC), birinci saniye zorlu ekspirasyon hacmi (FEV1), FEV1/FVC, ekspiryum ortası akım hızı (FEF25-75), ekspiryum en yüksek akım hızı(PEF), ekspire edilen vital kapasitenin ilk %25, %50 ve %75'inde atılan hava volümü (FEF25,FEF50 ve FEF75) değişkenleri ölçüldü. Tüm spirometrik ölçümler kontrol grubuna göre hasta grubunda düşük bulunmasına rağmen, sadece FEV1, FVC, FEF25 ve PEF değerlerindeki düşüklük anlamlıydı (p<0.05). Bu bulgular restriktif tip solunum fonksiyon bozukluğunu göstermekteydi. Çalışmamız; fibromiyaljili hastalarda şiddetli ağrı, yorgunluk, fiziksel inaktiviteye ve solunum kaslarının etkilenmesine bağlı olarak restriktif tipte solunum fonksiyon bozukluğu gelişebileceğini göstermiştir.
Generalize nodal osteoartritte eklem tutulumlarının özellikleri ve yaşam kalitesi üzerine etkili faktörler
(1999) Saraç, Jale; Gür, Ali; Nas, Kemal; Erdoğan, Ferda; Çevik, Remzi
Generalize nodal osteoartrit, heberden nodülleri ile belirgin bir birliktelik gösteren primer osteoartritin iyi tanımlanmış bir formudur. Klinik teşhis zor değildir ve hastalık sıklıkla fazla bir problem oluşturmaz. Bununla birlikte Heberden nodülleri hastaların çoğunda günlük aktivitelerini yapmayı zorlaştırarak, yaşam kalitesinde değişiklik oluşturabilir. Çalışmamızın amacı generalize nodal osteoartritin tutulum özelliklerini ve yaşam kalitesini etkileyen faktörleri belirlemekti. 43 bayan ve 11 erkek olmak üzere toplam 54 generalize nodüler osteoartritli hastada; klinik, yaşam kalitesi ve hastalığın süresi açısından değerlendirme yapıldı. Bütün hastalar el parmak eklemlerinde klinik ve radyolojik değişiklikleri kapsayan yumuşak doku değişiklikleri gösteriyorlardı. Yaşam kalitesi (Health Assessment Questionnaire) (HAQ) skalasının 8 alt başlığı kullanılarak değerlendirildi. İstatistiksel analizde student's t ve pearson korelasyon testleri kullanılarak; hastalık süresi, el tutulumu, cinsiyet ve HAQ skoru arasında karşılaştırmalar yapıldı. İlk tutulan eklem çoğunlukla sol elin ikinci (işaret) parmağıydı. Tutulan parmak sayısı ve HAQ skoru arasında negatif bir korelasyon mevcuttu. Bu çalışma, yaşam kalitesini etkileyen faktörün tutulan parmak sayısından ziyade hastalığın ilk yıllarının olduğu ve sağ el tutulumunun fonksiyonel olarak daha kısıtlayıcı olduğunu ortaya koymaktadır.
High frequency of fibromyalgia in patients with acne vulgaris
(Turkish League Against Rheumatism, 2016) Yazmalar, Levent; Çelepkolu, Tahsin; Batmaz, İbrahim; Sarıyıldız, Mustafa Akif; Sula, Bilal; Alpaycı, Mahmut; An, İsa; Burkan, Yahya Kemal; Uçak, Haydar; Çevik, Remzi
ABSTRACT: Objectives: This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Patients and methods: Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age, sexand body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included. Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Results: Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulgaris patients than controls. Conclusion: This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21.6% versus 5.3%, respectively).
The impact of COVID-19 on familial Mediterranean fever: a nationwide study
(Springer Science and Business Media Deutschland GmbH, 2021) Günendi, Zafer; Yurdakul, Fatma Gül; Bodur, Hatice; Cengiz, Ahmet Kıvanç; Uçar, Ülkü Gürbüz; Çay, Hasan Fatih; Şen, Nesrin; Keskin, Yaşar; Gürer, Gülcan; Melikoǧlu, Meltem Alkan; Altıntaş, Duygu; Deveci, Hülya Mutlu; Baykul, Merve; Nas, Kemal; Çevik, Remzi; Karahan, Ali Yavuz; Toprak, Murat M.; Ketenci, Sertaç; Nayimoğlu, Mehmet; Sezer, İlhan; Demir, Ali Nail; Ecesoy, Hilal; Duruöz, Tuncay; Volkan Yurdakul, Ozan; Sarıfakıoğlu, Ayşe Banu; Ataman, Şebnem
The study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) in patients with familial Mediterranean fever (FMF) and to assess the relationships between FMF characteristics and severe COVID-19 outcomes such as hospitalization. The study was planned within a national network of 21 different centers. Demographics, FMF-related clinical and genetic characteristics, and COVID-19 outcomes were obtained. A total of 822 patients with FMF (mean age of 36 years) were included in the study. Fifty-nine of them (7%) had a COVID-19 diagnosis confirmed by real-time PCR test or chest CT findings. Most FMF patients with COVID-19 (58) had mild and moderate disease activity. All patients were on colchicine treatment. However, 8 of them (13.6%) were not compliant with colchicine use and 9 of them (15.3%) were colchicine resistant. Twelve FMF patients with COVID-19 were hospitalized. There were 4 patients requiring oxygen support. COVID-19 related complications were observed in 2 patients (1 thromboembolism, 1 acute respiratory distress syndrome). Hospitalized COVID-19 patients with FMF were older than non-hospitalized patients (median ages: 51 and 31 years, respectively; p: 0.002). Other FMF-related characteristics were similar between the groups. FMF-related characteristics were not found to be associated with poor outcomes in COVID-19. Thus, FMF may not be a risk factor for poor COVID-19 outcomes.
Influence of patient training on persistence, compliance, and tolerability of different dosing frequency regimens of bisphosphonate therapy: An observational study in Turkish patients with postmenopausal osteoporosis
(Turkish Association of Orthopaedics and Traumatology, 2016) Akarırmak, Ülkü; Koçyiğit, Hikmet; Eskiyurt, Nurten; Esmaeilzadeh, Sina; Kuru, Ömer; Yalçınkaya, Ebru Yılmaz; Peker, Özlen; Çevik, Remzi
Objective: In our study, we aimed to evaluate the influence of training on compliance and persistence with bisphosphonate treatment given on a weekly vs. monthly basis in postmenopausal osteoporosis patients. Methods: A total of 979 patients with postmenopausal osteoporosis (mean age: 63.2 ± 7.2 years) were included in this national, multicenter, prospective non-interventional observational cohort registry study. Patients were randomized into training (n = 492, 50.3%, mean age: 63.4 ± 7.2 years) and control (n = 487, 49.7%, mean age: 63.0 ± 7.1 years) groups. Patients in each intervention group were given weekly (44.9% and 44.6% for training and control subjects, respectively) or monthly (55.1% and 55.4%, respectively) bisphosphonate regimens. After the initial visit, patients were followed up at three-month intervals throughout 12 months of treatment for evaluation of persistence, compliance and adverse events. Results: On average, 79.4% of the patients were persistent with the treatment with a mean of 350.4 days of duration during the 12-month follow-up period. The mean compliance in the compliant and fully compliant group remained at an average of 86.6%. No significant difference was detected between the training and control groups in terms of compliance and persistence. Significantly longer persistence (360.0 ± 89.0 vs. 345.0 ± 108.0 days; p = 0.035), higher percentage of persistent patients (83.4% vs. 74.2%; p = 0.012) and higher compliance rates (88.8% vs. 83.3%; p = 0.002) were noted in monthly regimen patients in comparison to those given weekly regimen.
Intramedullary tuberculoma of the cones medullaris
(Nature Publishing Group, 2001) Kemaloǧlu, Serdar; Gür, A; Nas, Kemal; Çevik, Remzi; Büyükbayram, Hüseyin; Saraç, Ayşegül Jale
Objective: To illustrate the dilemmas in the diagnosis and management of intramedullary tuberculomas of the spinal cord. Methods: Case report of a 32 year-old man with tuberculous meningitis. The presence of unexplained urinary retention and progressive weakness in the legs led to the discovery of an additional tuberculoma of the conus medullaris. Setting: Dicle University Diyarbakir, Turkey. Results: The patient was on a 1-year course of isoniazid, pyrazinamide and rifampicin, and responded well to conservative treatment. Our patient's unique features were represented by the worsening of neurological symptoms while being treated with adequate anti-tuberculous medication. Conclusion: We present a case of intramedullary tuberculoma of the conus medullaris to illustrate the dilemmas in the diagnosis and management of this curable disease, and review of the literature to date.

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