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Öğe Lipocalin 2 as a clinical significance in rheumatoid arthritis(Termedıa publıshıng house ltd, kleeberga st 2, poznan, 61-615, poland, 2017) Yıldırım, TülayAim of the study: In this study, serum lipokalin 2 (LCN-2) levels and its clinical and radiological significance in patients with rheumatoid arthritis was evaluated. Material and methods: The study enrolled 37 patients with RA and 34 healthy controls. Serum LCN-2 level was measured using ELISA method. Patients with DAS 28 scores <= 3.2, and > 3.2 were allocated into lower and high/moderate disease activity groups, respectively. Additionally patients were divided into 2 groups as early RA (disease duration <= 2 years) and established RA (duration of the disease >= 2 years). Functional disability was evaluated using Health Assessment Questionnaire (HAQ). Radiographs were scored using the modified Larsen score. Results: Serum LCN-2 (p = 0.029) levels were significantly higher in patients with RA than in the controls. Serum LCN-2 level did not correlate with laboratory and clinical parameters of disease activity like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAS 28, Health Assessment Questionnaire Score (HAQ) and Nottingham Health Profile (NHP). Similarly, any correlation could not be found between structural joint damage and serum LCN2 levels. Conclusions: These results indicate that serum LCN-2 levels may be used as an indicator for structural damage like erosions in the early stage of the disease but do not able to be used to monitor disease activity.Öğe Turkish league against rheumatism consensus report: recommendationsfor management of axial spondyloarthritis(Turkısh league agaınst rheumatısm, talatpasa bulvarı dumlupınar cad 40 3 cebecı dortyol, ankara, 06100, turkey, 2018) Altay, ZuhalObjectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloarthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation. Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength. Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific evidence. These recommendations will be updated regularly in accordance with current developments.Öğe Turkish league against rheumatism (tlar) recommendations for the pharmacological management of rheumatoid arthritis: 2018 update under guidance of current recommendations(Turkısh league agaınst rheumatısm, talatpasa bulvarı dumlupınar cad 40 3 cebecı dortyol, ankara, 06100, turkey, 2018) Altay, ZuhalObjectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining >= 70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected. Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.Öğe A comparison of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients(Kare publ, kare yayıncılık, sogutlucesme cad, no 76-103, ıstanbul, 34000, turkey, 2017) Acet, Gunseli; Kaya, Arzu; Akturk, Semra; Akgol, GurkanOBJECTIVE: The present study is a comparison of the effectiveness of amitriptyline and pregabalin on the symptoms of fibromyalgia patients. METHODS: A total of 71 female patients aged >= 18 years were included in this study. The patients were divided into 2 groups. Pregabalin (n=36) or amitriptyline (n=35) treatment was initiated at daily oral dose of 450 mg and 25 mg, respectively for the indicated number of patients. The patients were evaluated at the start of treatment and at the end of 12 weeks. The Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety Depression Scale, Nottingham Health Profile, Mini Mental State Test, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were administered to all study participants. Pain at all tender points was measured using a pressure algometer. RESULTS: Significant improvement was observed in both groups after 12 weeks of treatment (p<0.05). Percent change in LANSS was greater in the pregabalin group compared with the amitriptyline group. Tender point pressure pain thresholds and total myalgic score improved significantly in both groups (p<0.05); however higher percentage change in these parameters was achieved in the amitriptyline group when compared with the pregabalin group (p<0.05). CONCLUSION: Both drugs improved pain, fatigue, sleep disorder, disability, psychological evaluation, and cognitive function; however, amitriptyline was more effective at reducing experimentally measured pain than neuropathic pain. According to these results, preference for pregabalin may be recommended in fibromyalgia patients whose primary complaint is neuropathic pain.Öğe Proprioceptive force-reproduction of the rotator cuff in healthy subjects before and after muscle fatigue(Ios press, nıeuwe hemweg 6b, 1013 bg amsterdam, netherlands, 2018) Talu, BurcuOBJECTIVE: To examine the effects of fatigue on force reproduction during internal and external rotation of the shoulder using a single group repeated measure design. METHODS: Seventeen healthy male subjects who did not regularly compete in overhand sports and had no history of glenohumeral complaints took part in the study. Force reproduction was measured in the dominant shoulder. A target force had to be reproduced in three consecutive trials before and after a fatigue protocol. Maximal voluntary contraction was assessed to determine the target force. Measured data before and after fatigue were analyzed as well as error scores to examine the effect of fatigue. RESULTS: Repeated-measures analysis of variance revealed a significant influence only in the testing direction. No difference was found with the target value before or after the fatiguing repetitions. The inter-trial intra-class correlation coefficient showed high reliability. CONCLUSIONS: Force reproduction towards external rotation is more accurate than for internal rotation.Öğe Prevalence of rheumatoid arthritis and spondyloarthritis in turkey: A nationwide study(TURKISH LEAGUE AGAINST RHEUMATISM, TALATPASA BULVARI DUMLUPINAR CAD 40 3 CEBECI DORTYOL, ANKARA, 06100, TURKEY, 2018) Altay, ZuhalObjectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0 +/- 13.1 years; range, 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5 +/- 16.8 years; range, 16 to 97 years) by trained general practitioners across the country, in 25 provinces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.Öğe management of psoriatic arthritis: turkish league against rheumatism (tlar) expert opinions(Turkısh league agaınst rheumatısm, talatpasa bulvarı dumlupınar cad 40 3 cebecı dortyol, ankara, 06100, turkey, 2018) Nas, Kemal; Capkin, Erhan; Kilic, Erkan; Cevik, Remzi; Bodur, HaticeObjectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice.Öğe Evaluating the functional outcomes of ultrasound-guided botulinum toxin type A injections using the Euro-musculus approach for upper limb spasticity treatment in post-stroke patients: an observational study(EDIZIONI MINERVA MEDICA, CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY, 2018) Büyükavcı, Raikan; Aktürk, Semra; Ersoy, YükselBACKGROUND: Ultrasound-guided botulinum toxin type A injection is an effective treatment for spasticity. Euro-musculus spasticity approach is a new method for administering injections to the correct point of the correct muscle. The clinical outcomes of this practical approach are not vet available in the literature. AIM: The purpose of this study was to evaluate the effects on spasticity and the functional outcomes of ultrasound guided botulinum toxin type A injections via the Euro-musculus spasticity approach to treat upper limb spasticity in post-stroke patients. DESIGN: Observational study. SETTING: Inpatient post-stroke patients. POPULATION: Twenty-five post-stroke patients with post-stroke upper limb spasticity were recruited. METHODS: The ultrasound-guided botulinum toxin type A injections were administered into the spastic target muscles using the Euro-musculus spasticity approach, and all of the patients were enrolled in rehabilitation programs after the injections. This research included the innervation zone and injection site figures and ultrasound images of each muscle in the upper limb. The degree of spasticity was assessed via the Modified Ashworth Scale and the upper limb motor function via the Fugl Meyer Upper Extremity Scale at the baseline and 4 and 12 weeks after the botulinum toxin type A injection. RESULTS: Significant decreases in the Modified Ashworth Scale scores of the upper limb flexor muscle tone measured 4 and 12 weeks after the botulinum toxin type A injection were found when compared to the baseline scores (P<0.025). When compared with the baseline Fugl Meyer Upper Extremity subgroup scores, the sitting position, wrist and total scores at 4 and 12 weeks were significantly improved (P<0.025). However, only the Fugl Meyer Upper Extremity hand scores were significantly improved 12 weeks after the injection (P<0.025). CONCLUSIONS: Ultrasound-guided botulinum toxin type A injection via the Euro-musculus spasticity approach is a practical and effective method for administering injections to the correct point of the correct muscle. Ultrasound-guided botulinum toxin type A injections combined with rehabilitation programs decrease spasticity and improve the upper extremity motor functions in stroke patients. CLINICAL REHABILITATION IMPACT: This new approach for ultrasound-guided botulinum toxin type A injection is very practical and effective method for upper extremity spasticity.Öğe Functional outcomes following ultrasound-guided botulinum toxin type A injections to reduce spastic equinovarus in adult post-stroke patients(Pergamon-elsevıer scıence ltd, the boulevard, langford lane, kıdlıngton, oxford ox5 1gb, england, 2018) Akturk, Semra; Buyukavci, Raikan; Ersoy, YukselObjective: The aim of this study is to identify the effect on spasticity and walking of US-guided botulinum toxin type A (BoNT-A) injections administered to improve equinovarus walking pattern commonly observed in patients after stroke. Material and method: Twenty-three patients with post-stroke spastic equinovarus deformity were recruited. The US-guided BoNT-A injections were administered into the spastic muscles (including gastrocnemius; GK, soleus; S and tibialis posterior; TP) using a specific approach, and all of the patients were enrolled in rehabilitation programmes after the injections. Modified Ashworth Scale (MAS), Brunnstrom stage of lower limb, Functional Ambulation Score (FAS), Preferred Gait Speed (PGS) and the six-minute walk test (6MWT) were assessed at the baseline, 4 and 12 weeks after the BoNT-A injection. Results: Significant decreases in the MAS scores of the lower limb muscle (GK, S and TP) tone were measured 4 and 12 weeks after the BoNT-A injection when compared to the baseline scores (p < 0.05). In parallel with a reduction in spasticity there was an increase in 6MWT and PGS in the 4th and 12th weeks. Increases in motor improvement and functional ambulation score were ensured in the 12th week (p <0.05). Conclusion: Spastic equinovarus deformity observed in patients after stroke creates significant limitations in the patient's functional walking speed and distance. As a result, when BoNT-A injections accompanied by ultrasound to improve equinovarus deformity considering the innervation zones of the muscles with a specific approach are administered directly into the muscle at the correct point, we can say it provides hopeful results from a functional point of view. (C) 2018 Elsevier Ltd. All rights reserved.Öğe Determine the relationship between abdominal muscle strength, trunk control and urinaryıncontinence in children with diplegic cerebral palsy(Urol & nephrol res ctr-unrc, no 44, 9th boustan st, pasadaran ave, tehran, 00000, ıran, 2018) Talu, BurcuPurpose: The aim of this study is to determine the relationship between abdominal muscle strength, trunk control and urinary incontinence in children with diplegic cerebral palsy. Materials and methods: The current study had a cross-sectional design using analytical study as well as an observational research model. Fifty children between the ages of 5 and 18 years who were diagnosed with diplegic clinical type of cerebral palsy were included in this study using improbable-random sampling method. After patients' demographic information were obtained, Dysfunctional Voiding and Incontinence Symptoms Score Questionnaire (DVISS), Dysfunctional Voiding Symptom Score (DVSS), the manual muscle test of the muscles, Trunk Control Test (TCT) and Trunk Control Measurement Scale (TCMS) were completed in order to evaluate trunk control. Also, Gross Motor Function Classification System (GMFCS) was performed in order to define the functional level. Results: In this study, a highly correlated negative relationship was found between DVISS and DVSS scores with muscle abdominal strength, TCMS and TCT. In addition, a highly correlated positive relationship was found between both GMFCS and DVISS and GMFCS and DVSS. Conclusion: This is the first study that describes the effect of trunk control and muscle strength on urinary incontinence in children with diplegic cerebral palsy. This study showed that there is a correlation between trunk control, muscle strength and urinary incontinence.Öğe Comparison of high-intensity laser therapy and combination of transcutaneous nerve stimulation and ultrasound treatment in patients with chronic lumbar radiculopathy: A randomized single-blind study(PROFESSIONAL MEDICAL PUBLICATIONS, PANORAMA CENTRE, RM 522, 5TH FLOOR, BLDG 2, RAJA GHAZANFAR ALI RD, PO BOX 8766, SADDAR, KARACHI 00000, PAKISTAN, 2018) Kolu, Emine; Büyükavcı, Raikan; Aktürk, Semra; Eren, Fatma; Ersoy, YükselObjective: To compare the effects of high-intensity laser therapy (HILT) and a combination of transcutaneous nerve stimulation (TENS) with ultrasound (US) therapy on pain and functionality in patients with chronic lumbar radiculopathy. Methods: This prospective randomized comparative study was conducted in Department of physical medicine and rehabilitation, Turgut Ozal Medicine Center, Malatya, Turkey from April 2016 to September 2016. A total of 54 patients with chronic lumbar radiculopathy were enrolled in this study. The patients were randomly divided into two groups: Group 1 (n:27) received 10 sessions of a combination of hot pack, TENS, US and exercise, and Group 2 (n:27) received hot pack, HILT and exercise. The outcomes measured were low back with unilateral leg pain level measured by visual analog scale (VAS) and functionality measured with the Oswestry Disability Index (ODI) at the end of the therapy and four weeks later. p-value less than 0.05 considered statistically significant. Results: In two groups, VAS (low back with unilateral leg pain) and ODI scores showed significant changes. At the end of the 2 weeks intervention, participants in Group-1 showed a significantly greater decrease in pain than participants in Group-2. Statistically significant differences in pain variation and functionality (VAS and ODI) were observed four weeks after treatment sessions for participants in the TENS+US therapy group compared with participants in the HILT group. Conclusion: HILT and TENS+US combined with exercise were effective treatment modalities in decreasing the VAS and ODI scores. TENS+US combined with exercises were more effective than HILT combined with exercise.Öğe Comparison of blood platelet distribution width and neutrophil-lymphocyte ratio in patients withdifferent grades of knee osteoarthritis(Ios press, nıeuwe hemweg 6b, 1013 bg amsterdam, netherlands, 2018) Buyukavci, Raikan; Akturk, Semra; Sag, SinemOBJECTIVE: The aim of this study was to compare platelet distribution width (PDW) and neutrophil to lymphocyte ratio (NLR) values in mild-to-moderate and severe knee osteoarthritis (OA). METHODS: This was a retrospective study of patients with knee OA according to the Kellgren-Lawrence (KL) grading system. Of 465 patients, 231 were excluded (62 due to not meeting the inclusion criteria and 169 due to the lack of simultaneous haemogram and radiographic evaluations). Demographic characteristics and PDW and NLR values were recorded. The patients were then divided into two groups: KL grade 1-3 (mild-to-moderate OA) and KL grade 4 (severe OA). RESULTS: In severe knee OA patients, blood PDW (13.44 +/- 2.58, p = 0.01) and NLR values (2.16 +/- 0.84, p = 0.04) were elevated as compared with those in mild-to-moderate knee OA patients. Blood PDW and NLR values of >= 12.5 and >= 2.1, respectively, were taken as cut-offs based on a receiver operating characteristics (ROC) curve analysis. In the ROC curve analysis, blood NLR >= 2.1 had 60% sensitivity and 64.8% specificity, and PDW >= 12.5 had 61% sensitivity and 58% specificity in predicting severe knee OA. In a univariate analysis, age (p < 0.001), PDW >= 12.5 (p = 0.029) and blood NLR >= 2.1 (p = 0.030) emerged as significant predictors of the severe knee OA. CONCLUSION: The results suggested that the blood PDW and NLR are novel inflammatory markers that can predict the radiographic severity of knee OA in clinical practice.Öğe A systematic literature review of physiotherapy and rehabilitation approaches to lower-limbamputation(Taylor & francıs ınc, 530 walnut street, ste 850, phıladelphıa, pa 19106 usa, 2018) Ulger, Ozlem; Sahan, Tezel Yildirim; Celik, Seher ErolBackground: Successful use of prostheses after lower-limb amputation (LLA) depends on undergoing physiotherapy and rehabilitation both physically and psychologically. The aim of this systematic literature review is to systematically review the scientific evidence regarding prosthetic rehabilitation and physiotherapy after LLA. Methods: A systematic literature search was conducted using PubMed, Web of Science, Cochrane, CINAHL, EMBASE, SCOPUS, and EMB Reviews databases on December 31, 2015. Studies with the search keywords were identified and independently assessed by reviewers. The search yielded 403 potentially relevant articles after the removal of duplicates. Of these, only nine articles met the inclusion criteria. All studies were original articles, one of which was a randomized controlled study. Different measurement methods were used and positive results in terms of functional status, weight-lifting capacity with prosthesis, walking and balance ability, and acute care process were gained with a physiotherapy program. Conventional methods still possess high importance; however, it is safe to say that virtual reality and software-based programs for rehabilitation are increasingly being developed and getting more and more support. Discussion: LLA rehabilitation is a topic that requires the focus of current and future studies; evidence-based studies are required on the approaches to rehabilitation for specific LLA groups.Öğe Analysis of the influence of somatotype difference on motoric parameters such as vertical jump, sit and reach flexibility and 30-m sprint(EDIZIONI MINERVA MEDICA, CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY, 2018) Senol, Deniz; Ozbağ, Davut; Kafkas, Muhammed E.; Acak, Mahmut; Baysal, Özlem; Şahin Kafkas, Armağan; Taşkıran, Celal; Özen, GökmenBACKGROUND: The purpose of this study is to show the somatotype features of young people with no symptoms and to find out whether motoric parameters such as vertical jump, flexibility and 30-m sprint were influenced by somatotype differences. METHODS: The study included 146 participants (88 males, 58 females) who had no symptoms. The Heath-Carter formula was used to find out the somatotypes of the participants and each participant's anthropometric measurements were found. Vertical jump, flexibility and 30-meter sprint test were measured to evaluate motoric parameters of male and female. RESULTS: In men, athletes with central type somatotype had the best score in vertical jump test with 53 cm, athletes with endomorphic mesomorph somatotype had the best score in sit and reach flexibility test with 30 cm, and athletes with balanced mesomorph somatotype had the best score in 30-m sprint test with 4.36 s. In women, athletes with endomorphic mesomorph somatotype had the best score in vertical jump test with 40 cm, athletes with Endomorphic Mesomorph somatotype had the best score in sit and reach flexibility test with 33.5 cm, and athletes with mesomorph endomorph somatotype had the best score in 30-m sprint test with 5.22 s. No statistically significant difference was found in male and female between different somatotypes and motoric parameters (P>0.05). CONCLUSIONS: Although there were no statistically significant differences, it emerged that different somatotypes were more successful than others. An anatomic body structure specific for the sport branch influences performance greatly.Öğe Determination of in vitro cytotoxic activity of new chalcone-phosphazene compounds bearing ındole and ımidazole hetero groups as side groups on a2780 and pc-3 cancer cell lines(Acta physıologıca, 2018) Sandal, Süleyman; Tekin, Suat; Kur'an, Kenan; Görgülü, A. Orhan
