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Öğe Comorbidities in patients with psoriatic arthritis: a comparison with rheumatoid arthritis and psoriasis(Wiley-Blackwell, 2015) Nas, Kemal; Karkucak, Murat; Durmus, Bekir; Karatay, Saliha; Capkin, Erhan; Kaya, Arzu; Ucmak, DeryaAimPsoriatic arthritis (PsA) is a chronic, inflammatory disease. The purpose of this study was to examine the association between PsA and comorbid conditions. This is the first study to investigate comorbid diseases in PsA in Turkey. MethodsThis study was performed under the auspices of the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) and involved participation by six university research hospitals. Patients diagnosed with and treated for PsA on the basis of clinical, radiological and laboratory findings and expert opinion were monitored using standardized examination methods and jointly prepared forms. Clinical status, accompanying systemic diseases and surgical history were recorded. ResultsOne hundred and seventy-three patients with PsA (75 male, 98 female, mean age 41.8) and 138 patients with rheumatoid arthritis (RA) (17 male, 121 female, mean age 48.6) and 67 with psoriasis (PsO) (43 male, 24 female, mean age 36.1) were included in the study. No accompanying disease was determined in 72.8% of PsA, 50.0% of RA and 80.6% of PsO groups. In regression analysis, patients with PsA had higher risk for cataract/glaucoma surgery (odds ratio [OR]=11.99; 95% CI 1.36-105.4, P=0.025) compared to patients with RA, and higher risk for hypertension (HT) (OR=4.26; 95% CI 1.27-14.23, P=0.018) compared to the patients with PsO. ConclusionPatients with PsA have relatively lower frequency of comorbidities like diabetes mellitus, HT and cataract/glaucoma surgery compared to the patients with RA. The increased risk for having cataract/glaucoma surgery in RA compared to PsA may be particularly attributed to the more prevalent glucocorticoid use in RA.Öğe Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis(Springer London Ltd, 2015) Kilic, Gamze; Kilic, Erkan; Nas, Kemal; Karkucak, Murat; Capkin, Erhan; Dagli, Abdullah Zubeyir; Cevik, RemziThe aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA.Öğe Comparison of clinical outcomes of ultrasonography-guided and blind local injections in facet syndrome: A 6-week randomized controlled trial(Ios Press, 2020) Karkucak, Murat; Batmaz, Ibrahim; Kerimoglu, Servet; Ayar, AhmetBACKGROUND: Facet syndrome is defined as pain that arises from any structure of the facet joints, including the fibrous capsule, synovial membrane, hyaline cartilage, and bone. OBJECTIVES: To compare the effectiveness of US-guided and blind injections on clinical outcome in facet syndrome. MATERIALS AND METHODS: Forty-seven patients with the diagnosis of facet syndrome were included. Patients were consecutively randomized into one of the two groups. The patient's history, physical examination and routine laboratory parameters were obtained and diagnose was established based on physical findings. Two injections (mixture of 2 ml of 1% lidocaine hydrochloride and 20 mg of triamcinolone, to a single or maximum two sites depending on the clinical characteristics of the facet joint) were performed with 15 days apart, as blinded or US-guided manner. Clinical outcome assessments were carried out at 0, 2nd and 6th weeks, using Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and State-Trait Anxiety Inventory (STAI). RESULTS: The patients' initial VAS and ODI were not significantly different. When the two groups were compared in the 6th week in terms of VAS scores, improvement was more pronounced in the US-guided injection group (US-guided group (n = 23) before 7.6 (2.2) cm, after 3.0 (1.7) cm, P = 0.0001 vs blind group (n = 24) before 7.2 (1.3) cm, after 5.2 (2.0) cm, P = 0.0001). The improvement in initial and 6th week ODI was statistically significant in the US-guided injection group ( P = 0.006). Except STAI I for US-group, trait anxiety scale scores were significant in both groups. CONCLUSION: The US-guided local injections offer better clinical outcome in the treatment of facet syndrome.Öğe Education and Visual Information Improves Effectiveness of Ultrasound-Guided Local Injections on Shoulder Pain and Associated Anxiety Level A Randomized Controlled Study(Lippincott Williams & Wilkins, 2016) Karkucak, Murat; Cilesizoglu, Nurce; Capkin, Erhan; Can, Ipek; Batmaz, Ibrahim; Kerimoglu, Servet; Onder, Mustafa AvniObjective Local injections are widely used in patients with a painful shoulder. The aim of this study was to evaluate the possible impact of patients' visual information on the effectiveness of ultrasound (US)-guided local injections on anxiety levels and shoulder pain. Design A total of 151 patients, scheduled for local injection owing to shoulder pain, were randomly assigned into two groups in a consecutive order. Patients in group I (n = 72) were provided information related to US findings and allowed to watch the procedures from the monitor, whereas patients in group II (n = 79) received the injection only without any collaboration. Data were collected from both groups immediately before and after injections through visual analog scale and questionnaire (the State-Trait Anxiety Inventory [STAI] forms 1 and 2). Results US-guided local injections provided significant improvement of anxiety and pain in both groups, irrespective of providing visual information. Group I and group II comparisons with respect to the visual analog scale, STAI 1, and STAI 2 yielded significant difference only for postinjection STAI 2 in group I (P = 0.006). Intragroup comparisons revealed significant differences between preinjection and postinjection values (group I: visual analog scale, P = 0.001; STAI form 1, P = 0.001; STAI form 2, P = 0.002; group II: visual analog scale, P = 0.001; STAI form 1, P = 0.002; STAI form 2, P = 0.042). There was no significant difference between the groups in terms of postinjection satisfaction levels from the procedures (P = 0.824). Conclusions Performing US-guided shoulder injections with patient visual information provides positive contributions to coping with pain and anxiety. In particular, the patient collaboration-based US-guided injections have positive consequences on patients' long-standing trait-anxiety levels.Öğe Gender specific differences in patients with psoriatic arthritis(Taylor & Francis Ltd, 2017) Nas, Kemal; Capkin, Erhan; Dagli, Abdullah Zubeyir; Cevik, Remzi; Kilic, Erkan; Kilic, Gamze; Karkucak, MuratObjectives: To assess gender related differences in a cohort of patients with psoriatic arthritis (PsA).Methods: Consecutively recruited patients were included and underwent clinical, radiological and laboratory evaluation by using standardized protocol and case report forms.Results: Women (n=115) with PsA had higher symptom duration and body mass index (BMI), tender and swollen joint counts, disease activity score-28 joints (DAS28), Erythrocyte sedimentation rate (ESR) and poorer physical activity and fatigue than men (n=72) with PsA. Psoriasis area and severity index (PASI) were higher in male patients. However quality of life (SF36 physical and mental component scores), articular pattern, extra-articular features (including uveitis, iritis) and family history for psoriasis, spondyloarthritis (SpA) (PsA and ankylosing spondylitis [AS]) were quite similar between men and women.Conclusions: Some of the clinical and laboratory variables tend to be different between men and women with PsA. The extent of quality of life and articular pattern seem to be similar in both genders. Men with PsA are more likely to have higher PASI scores and longer duration to develop arthritis after the onset of psoriasis, while women are more likely to have higher disease activity and report more fatigue and physical activity limitations.Öğe Local steroid injection accompanied by ultrasonographic imaging in the treatment of facet syndrome(2014) Çapkın, Erhan; Batmaz, İbrahim; Karkucak, Murat; Can, İpek; Önder, Avni Mustafa; Baki, Mehmet EmreUltrasonografi (US) muskuloskeletal system görüntülemesinde gittikçe önemli bir yer tutmaktadır. Lokal enjeksiyon uygulamalarında tanısal rehber olarak kullanılmakla birlikte, derin eklemlerin görüntülenmesi ve enjeksiyonunda daha az sıklıkta kullanılmaktadır. Bu çalışmanın amacı faset sendromu tanısı ile bir yıldır devam eden bel ağrısı olan 19 yaşında erkek hastada, US eşliğinde yapılan faset eklem enjeksiyonu sonucunu literatür derlemesi ile birlikte sunmaktır.Öğe The performance of psoriatic arthritis classification criteria in Turkish patients with psoriatic arthritis(Wiley, 2017) Nas, Kemal; Karkucak, Murat; Durmus, Bekir; Ulu, Mehmet Ali; Karatay, Saliha; Capkin, Erhan; Ulusoy, HasanObjectivesTo investigate performance of some of the published psoriatic arthritis (PsA) classification criteria as well as Assessment of Spondyloarthritis International Society (ASAS) criteria for peripheral spondyloarthritis (SpA) in Turkish patients with PsA (in early and late disease subgroups). MethodsPatients were recruited using case report forms and physical examination methods proposed by the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD). The Moll and Wright (MW), modified Fournie (MF), modified McGonagle (mMG), Vasey and Espinoza (VE), classification of PsA (CASPAR) criteria and ASAS criteria were assessed in patients with PsA who were diagnosed based on expert opinion. ResultsOne hundred and twenty-eight patients with PsA (58 male, 70 female, mean age 41.8years) were included. Thirty patients were in the early PsA and 98 patients were in the late PsA groups. Diagnostic delay was 2.6years. In the 15.6% of patients arthritis developed before the skin findings. The proportion of patients fulfilling the MW, MF, mMG, VE, CASPAR and ASAS criteria were at a ratio of 90.6%, 82.8%, 62.5%, 84.4%, 96.1% and 76.5%, respectively. In early PsA (< 12months disease duration) the proportions were 93.4%, 83.3%, 76.7%, 76.7%, 96.7% and 66.6%, respectively. On the other hand, in late PsA the proportions were 89.8%, 82.6%, 57.1%, 86.7%, 95.9%, 79.5%, respectively. ConclusionsEven though the sensitivity of PsA classification criteria in Turkish patients changes, the CASPAR criteria seems to be more prominent among all criteria for both early and late cases with its high sensitivity.Öğe Ultrasonographic evaluation of femoral cartilage thickness in patients with psoriatic arthritis(Ios Press, 2016) Batmaz, Ibrahim; Sariyildiz, Mustafa Akif; Cilesizoglu, Nurce; Karkucak, Murat; Yazmalar, Levent; Serdar, Omer Faruk; Capkin, ErhanBACKGROUND: Psoriatic arthritis (PsA) is a common form of arthritis that may vary from asymmetric oligoarthritis to symmetric polyarthritis and spondyloarthritis. OBJECTIVES: To evaluate femoral cartilage thickness using ultrasonography in patients with PsA. METHODS: Thirty-three patients (24 female, 9 male) with a diagnosis of PsA and 31 age-, sex- and body mass index-similar healthy subjects were enrolled in this study. Demographic and clinical characteristics of the patients were recorded, including disease duration, morning stiffness and medications. The femoral cartilage thicknesses of both knees (while held in maximum flexion) were measured with a 7-12 MHz linear probe. Three mid-point measurements were taken from both knees (at the lateral condyle, intercondylar area and medial condyle). RESULTS: Cartilage thicknesses were similar between PsA patients and healthy control subjects. However, there were significant correlations between cartilage thickness and the Maastricht Ankylosing Spondylitis Enthesitis Score, Bath AS functional index and Bath AS disease activity index scores. CONCLUSION: Femoral cartilage thickness is similar between PsA patients and healthy controls. The femoral cartilage thickness in PsA patients is associated with disease activity, functional inadequacy, and enthesopathy scores.Öğe Ultrasonographic measurement of femoral cartilage thickness in acromegalic patients(Springer London Ltd, 2015) Karkucak, Murat; Batmaz, Ibrahim; Civan, Nadim; Kilinc, Fatih; Capkin, Erhan; Sariyildiz, Mustafa Akif; Garipoglu, Melek AslanJoint involvement is one of the most frequent clinical complications of acromegaly. The aim of this study was to evaluate the femoral cartilage thicknesses of acromegalic patients using ultrasound (US). Sixty-two patients diagnosed with acromegaly (30 F, 32 M) were included. Patients' demographic and clinical characteristics were recorded. The thickness of the femoral articular cartilage was measured using a 6- to 18-MHz linear probe. Measurements were performed bilaterally from three points (medial condyle, intercondylar area, and lateral condyle). Of the patients, 14 (22.5 %) reported pain in the knee joints. A significantly higher femoral articular cartilage thickness was determined in the patients compared with the controls (all parameters, p < 0.001). US measurements results from all points were consistent, but these values were not correlated with levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Analysis of acromegaly patients as active (n = 37) or inactive (n = 25) revealed no significance with respect to femoral cartilage thickness. Acromegalic patients seem to have thicker femoral articular cartilages irrespective of disease activity state.
