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Öğe Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study(SPRINGER HEIDELBERG, 2020) Sunar, İsmihan; Ataman, Şebnem; Nas, Kemal; Kılıç, Erkan; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Şahin, Nilay; Cengiz, Gizem; Cüzdan, Nihan; Gezer, İlknur Albayrak; Keskin, Dilek; Mülkoğlu, Cevriye; Resorlu, Hatice; Bal, Ajda; Duruöz, Mehmet Tuncay; Küçükakkaş, Okan; Yurdakul, Ozan Volkan; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Ayhan, F. Figen; Bodur, Hatice; Çalış, Mustafa; Çapkın, Erhan; Devrimsel, Gül; Gök, Kevser; Hizmetli, Sami; Kamanlı, Ayhan; Keskin, Yaşar; Kocabaş, Hilal; Kutluk, Öznur; Şen, Nesrin; Şendur, Ömer Faruk; Tekeoğlu, İbrahim; Tolu, Sena; Toprak, Murat; Tuncer, TirajePsoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.Öğe Fiziatristlerin Antiosteoporotik İlaç Tercihleri: Çok Merkezli Tanımlayıcı Araştırma(Galenos Yayıncılık, 2012) Kutsal, Yeşim Gökçe; Özdemir, Oya; Çalışkan, Aslı; İnanıcı, Fatma; Karahan, Sevilay; Doğan, Asuman; Hizmetli, Sami; Kamanlı, Ayhan; Kuran, Banu; Öncel, Sema; Sarıkaya, Selda; Savaş, Serpil; Şenel, Kazım; Uğurlu, Hatice; Yazgan, PelinAim: The purpose of this multicenter descriptive study is to determine the preferences of physiatrists in our country for anti-osteoporotic drugs in patients with primary and secondary osteoporosis. Materials and Methods: This study was carried out in 10 provinces of Turkey. The diagnosis of osteoporosis was based on World Health Organization criteria using dual-energy x-ray absorptiometry. Patients with a spine and/or hip T-score ?-2.5 were considered as osteoporotic. 714 patients over 18 years old with primary or secondary osteoporosis were included in the study. In addition to socio-demographic characteristics and chronic use of medications and/or additional systemic diseases that cause secondary osteoporosis were questioned and antiosteoporotic drugs that are recommended by their physicians were recorded. Results: The physicians' preferred vitamin D and calcium as the prior treatment both in primary and secondary osteoporosis. The most commonly used anti-osteoporotic agent was alendronate from the biphosphonate group. It was followed by ibandronate, risedronate, strontium ranelate, calcitonin, zoledronate, raloxifene, parathyroid hormone (PTH) and hormone replacement therapy (HRT) in the primary osteoporosis and risedronate, ibandronate, calcitonin, strontium ranelate, zoledronate, PTH, HRT and raloxifene in the secondary osteoporosis, respectively. Conclusion: The physician should choose the most suitable treatment for the patient based on fracture risk, medical history, previous treatments for osteoporosis, concomitant diseases, treatment-induced risks and benefits, and the relation between financial cost and potential benefit.Öğe Fiziatristlerin antiosteoporotik ilaç tercihleri: Çok merkezli tanımlayıcı araştırma(2012) Kutsal, Yeşim Gökçe; Özdemir, Oya; Çalışkan, Aslı; İnanıcı, Fatma; Karahan, Sevilay; Doğan, Asuman; Hizmetli, SamiAmaç: Bu çok merkezli tanımlayıcı araştırmanın amacı ülkemizdeki fiziatristlerin birincil ve ikincil osteoporozu olan hastalarda anti-osteoporotik ilaç tercihlerini saptamaktır. Gereç ve Yöntemler: Çalışma Türkiye’nin 10 ilinde yürütüldü. Osteoporoz tanısı; dual-energy x-ray absorptiometry kullanılarak Dünya Sağlık Örgütü kriterlerine göre konuldu. Omurga ve–veya kalçada T skoru -2,5 olan hastalar osteoporotik olarak kabul edildi. Çalışmaya 18 yaş üstünde birincil veya ikincil osteoporozu olan 714 hasta alındı. Hastaların sosyodemografik özelliklerinin yanı sıra olarak ikincil osteoporoza neden olan kronik ilaç kullanımı ve-veya ek sistemik hastalıkları sorgulandı ve hekimleri tarafından önerilen anti-osteoporotik ilaçları kaydedildi. Bulgular: Hem birincil hem de ikinci osteoporozu olan hastalarda hekimlerin öncelikli tedavi seçeneği olarak vitamin D ve kalsiyum kullandıkları, medikal tedavi seçenekleri içinde ise ilk tercihlerinin bifosfonat grubundan alendronat olduğu saptandı. Bunları birincil osteoporoz grubunda ibandronat, risedronat, stronsiyum ranelat, kalsitonin, zoledronat, raloksifen, paratiroid hormon (PTH) ve hormon replasman tedavisinin (HRT) izlediği, ikincil osteoporoz grubunda ise risedronat, ibandronat, kalsitonin, stronsiyum ranelat, zoledronat, PTH, HRT ve raloksifenin izlediği belirlendi. Sonuç: Hekimler hastanın kırık riskini, tıbbi öyküsünü, osteoporoz için uygulanan önceki tedavilerini, diğer hastalıklarını, tedavi kaynaklı riskleri ve yararları, finansal maliyet ve potansiyel yarar ilişkisini de göz önüne alarak hasta için en uygun tedaviyi seçmelidir. (Türk Osteoporoz Dergisi 2012;18: 42-6)Öğe The Frequency of the Clinical Risk Factors in Postmenopausal Osteoporosis(TURKISH LEAGUE AGAINST RHEUMATISM, 2013) Kutsal, Yesim Gokce; Savas, Serpil; Inanici, Fatma; Ozdemir, Oya; Karahan, Sevilay; Dogan, Asuman; Hizmetli, SamiObjectives: This study aims to identify the frequency of clinical risk factors associated with osteoporosis in postmenopausal women. Patients and methods: In this cross-sectional, observational, multicenter study, a total of 730 postmenopausal women were assessed for risk factors associated with osteoporosis. The assessment included a standardized questionnaire which recorded the following clinical risk factors: family and personal histories of fractures, prolonged immobilization, sun exposure, lifelong sedentary lifestyle, smoking history, low calcium intake in childhood and adulthood, excessive caffeine intake, high sodium intake, inadequate protein intake, number of pregnancies, age at menopause, the presence of premature menopause, primary and secondary amenorrhea, medical conditions, and chronic use of prescription drugs. Results: The most frequent clinical risk factors for osteoporosis were inadequate sun exposure (53.3%), current sedentary lifestyle (52.9%), low calcium intake in adulthood (45.1%) and childhood (41.9%), and sedentary lifestyle in adolescence (27.9%). A total of 707 patients (96.5%) described more than one risk factor, while 74.3% of the patients reported one clinical risk factor at least for secondary osteoporosis. Conclusion: Adequate sun exposure and proper intake of dietary calcium beginning in childhood combined with lifelong daily physical activity may play a role in preventing osteoporosis in postmenopausal women. In addition, physicians should be aware of the high probability of secondary osteoporosis in this patient group.Öğe The Frequency of the Clinical Risk Factors in Postmenopausal Osteoporosis Postmenopozal Osteoporozda Klinik Risk Faktörlerinin Sıklığı(2013) Kutsal, Yeşim Gökçe; Savaş, Serpil; İnanıcı, Fatma; Özdemir, Oya; Karahan, Sevilay; Doğan, Asuman; Hizmetli, SamiAmaç: Bu çalışmada postmenopozal kadınlarda osteoporoz ile ilişkilendirilen klinik risk faktörlerinin sıklığı belirlendi.Hastalar ve yöntemler: Bu kesitsel, gözlemsel, çokmerkezli çalışmada toplam 730 postmenopozal kadın osteoporozun klinik risk faktörleri açısından değerlendirildi. Değerlendirmede şu klinik risk faktörlerinin kaydedildiği standart bir sorgulama formu kullanıldı: ailesel ve kişisel kırık öyküsü, uzamış hareketsizlik, güneş maruziyeti, yaşam boyu hareketsiz yaşam biçimi, sigara kullanımı, çocukluk ve erişkinlik döneminde düşük kalsiyum alımı, aşırı kafein alımı, yüksek sodyum alımı, yetersiz protein alımı, gebelik sayısı, menopoz yaşı, prematür menopoz varlığı, primer ve sekonder amenore, tıbbi hastalıklar ve kronik reçeteli ilaç kullanımı.Bulgular: Osteoporoz açısından en sık rastlanan klinik risk faktörleri, yetersiz güneş maruziyeti (%53.3), mevcut hareketsiz yaşam biçimi (%52.9), erişkin (%45.1) ve çocukluk çağında (%41.9) düşük kalsiyum alımı ve ergenlik döneminde hareketsiz yaşam biçimi (%27.9) idi. Toplam 707 hasta (%96.5) birden fazla klinik risk faktörü tanımlarken, hastaların %74.3'ü sekonder osteoporoz açısından en az bir klinik risk faktörü bildirdi.Sonuç: Yeterli güneş maruziyeti, çocukluktan itibaren beslenmede yeterli kalsiyum alımı ve hareketli bir yaşam biçimi, postmenopozal kadınların osteoporozdan korunmasında rol oynayabilir. Buna ilave olarak, hekimler bu hasta grubundaki yüksek sekonder osteoporoz olasılığının farkında olmalıdırlar.Öğe FRI0456 The effect of gender on disease activity, functional index and quality of life in patients with axial SPA. The data of Tlar-Network PsA study(BMJ PUBLISHING GROUP, 2019) Nas, Kemal; Kılıç, Erkan; Tekeoğlu, İbrahim; Çevik, Remzi; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Şahin, Nilay; Cengiz, Gizem; Cüzdan, Nihan; Gezer, İlknur Albayrak; Keskin, Dilek; Mülkoğlu, Cevriye; Resorlu, Hatice; Ataman, Şebnem; Bal, Ajda; Duruöz, Mehmet Tuncay; Küçükakkaş, Okan; Yurdakul, Ozan Volkan; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Ayhan, Figen; Bodur, Hatice; Çalış, Mustafa; Çapkın, Erhan; Devrimsel, Gül; Gök, Kevser; Hizmetli, Sami; Kamanlı, Ayhan; Keskin, Yaşar; Kocabaş, Hilal; Kutluk, Öznur; Şen, Nesrin; Şendur, Ömer Faruk; Toprak, Murat; Tolu, Sena; Tuncer, TirajeBackground PsA is a chronic musculoskeletal disease. The prevalence of axial involvement in PsA varies according to the duration of the disease. In early stage the incidence varies between 5% and 28%, but it increases up to 25-70% in later stages of the disease. In the literature, there is limited data on the differences in disease activity, functional status and quality of life of men and women with axial PsA.Öğe Possible potential interactions between obesity, quality of life, psychological status and clinical parameters in psoriatic arthritis(BMJ PUBLISHING GROUP, 2019) Gök, Kevser; Nas, Kemal; Kılıç, Erkan; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Şahin, Nilay; Cengiz, Gizem; Cüzdan, Nihan; Gezer, İlknur Albayrak; Keskin, Dilek; Mülkoğlu, Cevriye; Resorku, Hatice; Sunar, İsmihan; Hastürk, Ajda Bal; Duruöz, Mehmet Tuncay; Küçükakkaş, Okan; Yurdakul, Ozan Volkan; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Ayhan, Figen; Bodur, Hatice; Çalış, Mustafa; Çapkın, Erhan; Devrimsel, Gül; Hizmetli, Sami; Kamanlı, Ayhan; Keskin, Yaşar; Kocabaş, Hilal; Kutluk, Öznur; Şen, Nesrin; Şendur, Ömer Faruk; Tekeoğlu, İbrahim; Toprak, Murat; Tolu, Sena; Tuncer, TirajeBackground: Psoriatic arthritis (PsA), a chronic rheumatic disease associated with reduced quality of life. Obesity is an important clinical problem which may interfere with loss of functioning and quality of life. Obesity is usually an overlooked entity in patients with PsA. Several studies were invastigated prevalence and the impact of obesity on disease activity in patients with PsA, however relationship between psychological status and quality of life have not been evaluated comparatively. Objectives: To assess the impact of obesity on quality of life, psychological status and clinical parameters in patients with PsA.Öğe Regional difference in disease burden among patients with psoriatic arthritis: A multi-center study(WILEY, 2019) Kılıç, Erkan; Kılıç, Gamze; Nas, Kemal; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Şahin, Nilay; Cengiz, Gizem; Cüzdan, Nihan; Gezer, İlknur Albayrak; Keskin, Dilek; Mülkoğlu, Cevriye; Resorlu, Hatice; Sunar, İsmihan; Bal, Ajda; Duruöz, Mehmet Tuncay; Küçükakkaş, Okan; Yurdakul, Ozan Volkan; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Ayhan, Fikriye Figen; Bodur, Hatice; Calış, Mustafa; Çapkın, Erhan; Devrimsel, Gül; Gök, Kevser; Hizmetli, Sami; Kamanlı, Ayhan; Keskin, Yaşar; Kocabaş, Hilal; Kutluk, Öznur; Şen, Nesrin; Şendur, Ömer Faruk; Tekeoğlu, İbrahim; Tolu, Sena; Toprak, Murat; Tuncer, TirajeBackground/Purpose : Psoriatic arthritis (PsA) has been de? ned as an in? ammatory arthritis associated with pso-riasis. The disease activity can be evaluated using many scales in patients with PsA. There is a great temperature difference between geographic region in Turkey. For example,the average annual air temperature in Erzurum (one of the Eastern Anatolian cities) is 5.7° C whereas in Antalya (one of the Mediterranean region cities) average temperature is 18.7° C. Furthermore, altitude of Eastern Anatolian cities is higher than Mediterranean cities.Öğe The risk factors related to mental health problems in patients with psoriatic arthritis in a large multicenter study; data from tlar-network(BMJ PUBLISHING GROUP, 2019) Kılıç, Gamze; Nas, Kemal; Kılıç, Erkan; Tekeoğlu, İbrahim; Sargın, Betül; Kasman, Sevtap Acer; Alkan, Hakan; Şahin, Nilay; Cengiz, Gizem; Cüzdan, Nihan; Gezer, İlknur Albayrak; Keskin, Dilek; Mülkoğlu, Cevriye; Resorlu, Hatice; Ataman, Şebnem; Bal, Ajda; Duruöz, Mehmet Tuncay; Küçükakkaş, Okan; Yurdakul, Ozan Volkan; Melikoğlu, Meltem Alkan; Aydın, Yıldıray; Ayhan, Figen; Bodur, Hatice; Çalış, Mustafa; Çapkın, Erhan; Devrimsel, Gül; Hizmetli, Sami; Kamanlı, Ayhan; Gök, Kevser; Keskin, Yaşar; Kocabaş, Hilal; Kutluk, Öznur; Şen, Nesrin; Şendur, Ömer Faruk; Toprak, Murat; Tolu, Sena; Tuncer, Tiraje[Abstract not Available]
