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Alt ekstremite amputasyonlu hastalarda uyku kalitesi ve ilişkili faktörlerin değerlendirilmesi
(Türkiye Fiziksel Tıp ve Rehabilitasyon Derneği, 2015) Em, Serda; Batmaz, İbrahim; Karakoç, Mehmet; Aydın, Abdulkadir; Bozkurt, Mehtap; Çağlayan, Mehmet; Nas, Kemal
Amaç: Alt ekstremite amputasyonlu (AEA) hastalarda uyku kalitesini değerlendirmek ve uyku bozukluğu ile ilişkili faktörleri belirlemektir.Gereç ve Yöntemler: Bu çalışmaya AEA'lı 35 hasta ve 35 sağlıklı kontrol alındı. Çalışma grubunun demografik verileri kaydedildi. Uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile değerlendirildi. Amputasyonla ilişkili ağrı, Vizüel Analog Skala kullanılarak ölçüldü. Psikolojik durum Beck Depresyon Ölçeği (BDÖ) ve Beck Anksiyete Ölçeği (BAÖ) ile değerlendirildi.Bulgular: Hastalarda PUKİ'nin uyku süresi alt skoru dışında tüm alt skorları ve total skoru kontrol grubuna göre anlamlı olarak yüksekti. Total PUKİ skoru ile BDÖ (p<0,05) ve BAÖ (p<0,01) skoru korele idi. Multipl regresyon analizi ile yaş ve anksiyetenin uyku kalitesini belirlemede en önemli faktörler olduğu gösterildi (p<0,05). Sonuç: Çalışmamız kontrol grubuna göre AEA'lı hastalarının uyku kalitesinde bozulma olduğunu ve buna ek olarak yaş ve emosyonel durumun uyku kalitesiyle ilişkili olduğunu gösterdi. Bu nedenle ileri yaşta ve emosyonel durumu bozuk olan hastalarda çok yönlü tedavi yaklaşımları uyku bozukluğunu gidermek için gereklidir. Ancak uyku bozukluğunun nedenlerini ve genel sağlık üzerine etkilerini gösteren daha fazla hasta ile yapılmış ileri çalışmalara ihtiyaç vardır.
Ankilozan spondilitli hastalarda komorbit hastalıkların değerlendirmesi
(Dicle Üniversitesi Tıp Fakültesi, 2014) Em, Serda; Bozkurt, Mehtap; Çağlayan, Mehmet; Oktayoğlu, Pelin; Karakoç, Mehmet; Nas, Kemal
Amaç: Bu çalışmanın amacı ankilozan spondilit (AS) hastalarında komorbit hastalıkları ve bulunma oranlarını belirlemektir. Yöntemler: Bu çalışmaya 70 AS’li hasta, 70 romatoid artritli (RA) hasta ve 70 sağlıklı kontrol alındı. Demografik ve klinik özellikler kaydedildi. Tüm gruplar hipertansiyon, Aterosklerotik Kalp Hastalığı (ASKH), kalp yetmezliği, tiroid hastalıkları, akciğer hastalıkları, Tip2 diyabet ve serebrovasküler olay (SVO) açısından sorgulandı ve daha kapsamlı bilgi elde etmek için hasta kayıtları retrospektif olarak incelendi. Bulgular: Hasta ve kontrol grupları yaş, boy ve kilo bakımından benzerdi. AS’li hastalarda hipertansiyon görülme sıklığı, sağlıklı kontrollerden anlamlı olarak yüksekti (p<0.05). Fakat AS ve RA hastaları hipertansiyon açısından karşılaştırıldığında böyle bir farklılık gözlenmedi (p>0.05). AS ve RA’lı hastalarda ASKH ve kalp yetmezliği görülme sıklığı benzerdi ve AS hastaları kontrol grupları ile karşılaştırıldığında anlamlı farklılık yoktu. AS’li hastalarda tiroid hastalıkları %12.8 olarak görülürken, Tip2 diyabet sıklığı %11.4 idi ve sağlıklı kontrollerle AS hastaları karşılaştırıldığında bu iki hastalık açısından iki grup arasındaki fark anlamlıydı (p<0.05). Sonuç: AS’li hastalarda, sağlıklı kontrollere göre hipertansiyon, tiroid hastalıkları ve diyabet görülme sıklığı anlamlı derecede yüksekti. Ancak RA’lı hastalar ve AS’li hastalar arasında komorbit hastalık açısından anlamlı fark tespit edilmedi.
Arthropathy, quality of life, depression, and anxiety in Behcet's disease: relationship between arthritis and these factors
(Springer London Ltd, 2006) Gur, Ali; Sarac, Aysegul Jale; Burkan, Yahya Kemal; Nas, Kemal; Cevik, Remzi
We aimed to determine arthritis frequency, quality of life (QoL), anxiety, and depression levels in Behcet's disease (BD) and thereby the effect of joint involvement on QoL, anxiety, and depression. Sixty-three patients diagnosed with BD according to the International Study Group Diagnostic Criteria and 45 healthy subjects as control were included in the study. All patients were evaluated in terms of clinical findings, the number and site of the joints involved, sacroiliac joint involvement, pain intensity, QoL, anxiety, and depression scale. The instruments used were Beck Depression Inventory (BDI) for depression, State-Trait Anxiety Inventory (STAI-T) for anxiety, and Health Assessment Questionnaire (HAQ) and Nottingham Health Profile (NHP) for health status and QoL. Joint involvement was seen in 41.3% of the patients. The most characteristic form was asymmetric oligoarthritis, which was seen in 65.3% of the patients. The joints most commonly involved were found to be in the wrist (53.8%) and knee (50%). Sacroiliitis was found at a rate of 38.1%. In BD patients without arthritis, rates of men (p=0.004) and genital ulcer (p=0.001) were higher, and rates of erythema nodosum (p=0.001) and human leukocyte antigen B5 positivity (p=0.023) were less than those of BD patients with arthritis. Pain intensity (p=0.000), NHP (p=0.004), and HAQ (p=0.003) scores were significantly higher in BD patients with arthritis than those without arthritis. Pain intensity, NHP, BDI, and STAI-T scores were significantly higher in BD patients without arthritis than in healthy controls, while pain intensity, NHP, HAQ, BDI, and STAI-T scores were significantly higher in BD patients with arthritis than in healthy controls (p=0.000). In conclusion, our study establishes that arthropathy is one of the common manifestations of BD. Arthritis in BD affects considerably patients' pain levels and QoL. A multistep approach is required for these patients. We are of the opinion that this approach may also improve the QoL of these patients and prevent the activation of the disease.
THE ASSESMENT OF CARDIAC SEMPATOVAGAL ACTIVITY BY HEART RATE VARIABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS
(Oxford Univ Press, 2011) Cevik, Figen Ceylan; Yazici, Selma; Cil, Habib; Cevik, Remzi; Sarac, Aysegul Jale; Nas, Kemal
[Abstract Not Available]
Assessment of sexual function and quality of life in patients with lower limb amputations
(Ios Press, 2019) Em, Serda; Karakoc, Mehmet; Sariyildiz, Mustafa Akif; Bozkurt, Mehtap; Aydin, Abdulkadir; Cevik, Remzi; Nas, Kemal
BACKGROUND: Diseases causing disabilities lead to sexual dysfunction. However, studies that evaluate sexual functions in patients with traumatic lower limb amputations (LLA) are limited and controversial. OBJECTIVE: The objective is to evaluate sexual functions in male patients with LLA and to identify factors that might contribute to sexual dysfunction. The hypothesis is that male patients with LLA would experience worse sexual and emotional functioning and consequently emotional impairment that consequently influenced the sexual function. METHODS: Sixty men with traumatic LLA and 60 healthy men were assessed according to the International Index of Erectile Function (IIEF) scoring system. Emotional state was assessed by the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and the quality of life by the Short Form-36 Health Survey (SF-36). RESULTS: Patients had significantly lower scores in the IIEF total score and subscores in comparison with the controls. Intercourse satisfaction scores were significantly higher (p < 0.05) in patients with trans-tibial amputation than in those with trans-femoral amputation. BDI and BAI scores negatively correlated with erectile function, sexual desire, intercourse satisfaction, overall satisfaction and total IIEF scores. The mental and physical scores of SF-36 significantly correlated with some of the sub scores and IIEF total scores. The power of statistical analysis for study population was 100% according to the given effect size (alpha = 0.01). CONCLUSION: The present study suggests that the LLA leads to impairments in the sexual function and quality of life in male patients. Also, sexual dysfunction in patients is strongly associated with emotional state, pain, level of amputation and quality of life.
Assessment of the presence of carpal tunnel syndrome in patients with diabetes mellitus, hypothyroidism and acromegaly
(Journal of Clinical and Diagnostic Research, 2015) Oktayoğlu, Pelin; Nas, Kemal; Kılınç, Faruk; Taşdemir, Nebahat; Bozkurt, Mehtap; Yıldız, İsmail
ABSTRACT Introduction: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. Aim: The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population. Materials and Methods: Patients were assigned into three groups as follows: patients with type II DM n: 100, patients with hypothyroidism n:48 and patients with acromegaly n:36. In addition, 50 healthy individuals were included in the study as control subjects. Patients were asked if they had any pain, symptoms of paraesthesia and numbness. Patients with peripheral neuropathy were excluded from the study. Boston Symptom Severity Scale and Functional Capacity Scale were used to assess symptom severity and functional capacity. CTS was investigated by performing electrophysiological study for both hands. Results: The incidence of CTS was significantly higher in all three groups compared to the control group (p>0.05). In addition, the incidence of CTS was significantly higher in the DM group compared to the hypothyroid and acromegaly groups (p<0.001). The incidence of bilateral CTS in the DM group was significantly higher compared to both hypothyroid and acromegaly groups and the control group (p<0.001). Conclusion: CTS has a higher incidence in DM, hypothyroid and acromegaly patients compared to healthy individuals. Clinicians should be careful about development of CTS in DM, hypothyroidism and acromegaly. They should adopt a multidisciplinary approach and co-operate with the psychiatrist.
Association of Neuron-Specific Enolase with Sleep Quality, Cognitive Function And Quality of Life in Patients with Fibromyalgia Syndrome
(Clinical & Exper Rheumatology, 2014) Verim, Sabahattin; Cavas, Husamettin; Nas, Kemal; Yazmalar, Levent; Batmaz, Ibrahim; Cevik, Remzi
[Abstract Not Available]
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.
Benign eklem hipermobilite sendromlu hastalarda emosyonel durum ve ilişkili faktörler
(Dicle Üniversitesi Tıp Fakültesi, 2014) Em, Serda; Çağlayan, Mehmet; Oktayoğlu, Pelin; Bozkurt, Mehtap; Ceylan, Veysi; Nas, Kemal
Amaç: Benign eklem hipermobilite sendromlu (BEHS) hastalarda emosyonel durumu değerlendirmek ve emosyonel durum üzerine etkili hastalıkla ilgili faktörleri belirlemektir. Yöntemler: Beighton tanı kriterlerine göre BEHS tanısı konan 63 kadın hasta ve 60 sağlıklı kontrol bu çalışmaya dahil edildi. Hastalar sorgulandıktan sonra kas-iskelet sistem muayeneleri yapılarak elde edilen bulgular kaydedildi. Hastaların kronik ağrılarını değerlendirmek için Vizüel Analog skala (VAS) kullanıldı. BEHS’li hastalar ve kontrollerin anksiyete ve depresyon durumları Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ile değerlendirildi. Bulgular: Hasta ve kontrol grubu, yaş ortalaması bakımından benzerdi. Hastaların Beighton toplam skor ortalaması (6.64 ± 1.28) kontrol grubundan (0.65±0.86) anlamlı olarak yüksekti (p<0.001). Ortalama anksiyete ve depresyon oranları açısından hasta ve kontroller arasındaki fark anlamlıydı (sırasıyla, p<0.05; p<0.01). HADÖ anksiyete skoru, hem Beighton skoru ile hem de VAS ağrı skoru ile korele iken, depresyon skoru sadece VAS ağrı skoru ile ilişkiliydi. Sonuç: BEHS’li hastalarda, sağlıklı kontrollere göre anksiyete ve depresyon oranı anlamlı derecede yüksekti. Aynı zamanda hastalardaki hipermobilite derecesi ve ağrı şiddeti ile emosyonel durum arasında bir ilişki vardı. Bu nedenle BEHS’li hastaların takip ve tedavisinde emosyonel durum göz önüne alınmalıdır
Bone mineral density and cytokine levels during interferon therapy in children with chronic hepatitis B: does interferon therapy prevent from osteoporosis?
(BioMed Central, 2005) Gür, Ali; Dikici, Bünyamin; Nas, Kemal; Boşnak, Mehmet; Haspolat, Yusuf Kenan; Saraç, Ayşe Jale
Background: Our aim was to determinate bone mineral density (BMD), levels of biochemical markers and cytokines in children with chronic hepatitis B treated with interferon (IFN)-alpha and to investigate effect of IFN-alpha therapy on these variables. To the best of our knowledge, this is first study carried out about BMD and cytokine levels in pediatric patients with chronic hepatitis B treated with IFN-alpha. Methods: BMD, levels of parathyroid hormone (PTH), osteocalcin, C-terminal cross-linking telopeptide of type I collagen (CTX), calcium, alkaline phosphates (ALP), cytokines as TNF-alpha, interleukin (IL)-1beta, IL-2r, IL-6, and IL-8 were studied in 54 children with chronic hepatitis B (4-15 years old) treated with interferon alone (n = 19) or in combination with lamivudine (n = 35) for six months and as controls in 50 age-matched healthy children. Results: There was no significant difference in respect to serum IL-1beta, TNF-alpha and osteocalcin levels while serum IL-2r (p = 0.002), IL-6 (p = 0.001), IL-8 (p = 0.013), PTH (p = 0.029), and CTX (p = 0.021) levels were higher in children with chronic hepatitis B than in healthy controls. BMD of femur neck (p = 0.012) and trochanter (p = 0.046) in patients were higher than in healthy controls. There was a statistically significant correlation between serum IL-1beta and osteocalcin (r = -0.355, p < 0.01); between serum IL-8 and CTX levels (r = 0.372, p = 0.01), and ALP (r = 0.361, p = 0.01); between serum ALP and femur neck BMD (r = 0.303, p = 0.05), and trochanter BMD (r = 0.365, p = 0.01); between spine BMD and IL-2R (r = -0.330, p < 0.05). Conclusion: In conclusion, our study suggest that BMD of femur, serum IL-2r, IL-6, IL-8, PTH, and CTX levels were higher in children with chronic hepatitis B treated with IFN-alpha alone or combination with lamivudine than in healthy children. High femur BMD measurements found in patients may suggest that IFN-alpha therapy in children with chronic hepatitis B could contribute indirectly to prevent from hip osteoporosis. Additionally, further investigations on effects of IFN-alpha for bone structure in children should be performed in the future.
A case of brucellar spondylodiscitis involving the cervical spine
(Ios Press, 2009) Nas, Kemal; Bukte, Yasar; Ustun, Cemal; Cevik, Remzi; Geyik, Mehmet Faruk; Batmaz, Ibrahim
We have presented a patient of 71-year-age with brucellar spondylodiscitis, involving the cervical spine, especially the C3-C4 segment. The patient had painful percussion of the cervical spine and passive mobilization of the neck, decreased range of motion, and cervical paravertebral tenderness; but no abnormalities observed on neurological examination. Wright agglutination test for brucella was positive at 1/320. Cervical localization for brucellar spondylodiscitis is an unusual case and should be detected and treated as early as possible. In endemic regions, spinal involvement of brucellosis should be considered in cases with fever, neck and low back pain.
A Case of Tibialis Anterior Muscle Herniation Diagnosed by Ultrasonography
(Galenos Yayincilik, 2013) Ulu, Mehmet Ali; Cakmak, Muharrem; Nas, Kemal
Muscle hernia is a focal muscular protrusion through a fascial defect and the tibialis anterior muscle is the most commonly affected site in the lower leg. It is usually an asymptomatic bulge which changes in size with the patient's position. In this article, we report a patient who presented with a swelling on his leg and was diagnosed with tibialis anterior muscle herniation by ultrasonographic examination. Turk J Phys Med Rehab 2013;59:73-5.
A Case With Type I Gaucher Primarily Involved Pelvis
(Elmer Press Inc, 2012) Dilek, Banu; Aydin, Fatma; Dag, Ilknur Sevin Buluttekin; Batmaz, Ibrahim; Nas, Kemal; Cevik, Remzi
Type 1 Gaucher disease is the most common lysosomal storage disorder which also affects the musculoskeletal system with various organ manifestations. Here, we aimed to present a case diagnosed Type 1 Gaucher disease which mainly involved pelvis.
Cervical intramedullary granuloma of Brucella: a case report and review of the literature
(Springer, 2007) Nas, Kemal; Tasdemir, Nebahat; Cakmak, Erkan; Kemaloglu, Mustafa Serdar; Bukte, Yasar; Geyik, Mehmet Faruk
The aim of this study was to present a unique case of intramedullary brucellar granuloma (IBG) and to discuss the diagnosis and management. To our knowledge, only one case of thoracic IBG has been reported previously, and our case is the first in cervical spine. A 35-year-old female patient was admitted with headache, pain and weakness in her four extremities. She had no gastrointestinal symptoms and fever. She had been diagnosed with Brucella meningitis 3 months ago and a triple therapy of doxycyclin, rifampicin and trimetoprim/sulfametoxazol (TMP/SMZ) had been started. Medical history revealed that she had ingested raw cheese and taken her medication improperly. Loss of strength was detected in her four extremities, which led us to assume the formation of a mass lesion at cervical level. Therefore, we performed a magnetic resonance imaging scan and found enhancement of an intramedullary mass lesion at cervical 1-2 level. Diagnosis of neurobrucellosis was confirmed by titer of > 1/160 Brucella antibodies both in blood and cerebrospinal fluid. Based on these findings, brucellar granuloma of cervical spine was diagnosed and a combination therapy of doxycyclin, TMP/SMZ and rifampicin was administered for additional 6 months. At the ninth month of treatment, the patient recovered both radiologically and clinically. Our case is unique, in terms of cervical IBG formation. The excellent response to antimicrobial therapy in our patient suggests that, a trial of medical treatment for 6 months may be effective in such cases.
Cervical intramedullary granuloma of Brucella: A case report and review of the literature (European Spine Journal DOI: 10.1007/s00586-006-0252-3)
(2007) Nas, Kemal; Taşdemir, Nebahat; Çakmak, Erkan; Kemaloğulu, Mustafa Serdar; Bükte, Yaşar; Geyik, Mehmet Faruk; 0000-0002-0906-0902
[No abstract available]
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, Derya
AimPsoriatic 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.
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, Remzi
The 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.
Comparison of imaging techniques in the early diagnosis of sacroiliitis
(2000) Erdoğan, Ferda; Gür, Ali; Ataoğlu, Safinaz; Nas, Kemal; Saraç, A. Jale; Özateş, Mustafa; Satıcı, Ömer
Seronegatif spondiloartropatilerin başlıca ilk görüntüsü genellikle sakroiliitistir. Fakat sakroiliak eklemlerin derin lokalizasyonları ve az hareketli oluşları, tanı açısından bir problem oluşmasına neden olmaktadır. Bu zorluklar, bu eklem hastalıklarının tanısı için görüntüleme teknikleri üzerinde yoğunlaşılmasına neden olmuştur. Bu nedenle bilgisayarlı tomografi(BT), tek foton bilgisayarlı tomografi (SPECT) ve manyetik rezonans görüntüleme(MRG) gibi çeşitli görüntüleme teknikleri üzerinde çalışılmıştır. Bizim çalışmamızda, sakroiliitisin klinik bulgularına sahip 48 hastada MRG çekildi. MRG bulguları, BT ve SPECT sonuçlarıyla karşılaştırıldı. Bu hastaların 35(%73)'inde anormal BT, 36(%75)'sında anormal SPECT ve 44(%91,6)'ünde anormal MRG görüntüleri mevcuttu. MR görüntüleme yönteminin, inflamatuvar spinal hastalığın klinik bulguları olan hastalarda, sakroiliitisin tanısında en objektif ve tanımlayıcı kanıtlar sağladığı sonucuna vardık.
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.
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.

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