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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 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 Hemiplejik hastalarda ağrılı omuz(Selçuk Üniversitesi Tıp Fakültesi, 2003) Kocabaş, Hilal; Özerbil, Önder M.Omuz ağrısı, hemiplejik hastalarda % 5-84 oranında saptanan yaygın ve ciddi bir problemdir. Bu çalışmada hemiplejik hastalardaki omuz ağrısı insidansmı, nedenlerini ve oranlarını araştırdık. Bu amaçla kliniğimizde rehabilite ettiğimiz 82 hasta takip edildi. Herbirinin ayrıntılı sorgulaması ve fizik muayenesi yapıldı. Tüm hastaların antero-posterior omuz grafıleri ve 54 hastanın da etkilenen taraf omzunun manyetik rezonans görüntülemesi yapıldı. Cinsiyet, etkilenen taraf, etyoloji, ihmal varlığı, duyuda azalma, spastisite, Brunnstrom evresi, motor güç, fonksiyonel durum, depresyon varlığı, ve eklem hareket açıklığı ile omuz ağrısı, subluksasyon, ve omuz el sendromu arasındaki ilişki araştırıldı. Hastalar ilk kez serebrovasküler olay geçirdikten sonra 2. haftada, daha sonra 6., 14. ve 28. haftalarda değerlendirildi. Hastaların yaşları 35-82 arasındaydı (ort 63,96 ± 9,88). 35'i sağ, 47'si sol hemiplejikti. Hastaların 79'unun (% 96,3) omuz ağrısı vardı. Ağrısı olan 79 hastanın 46'smda (% 56,0) subluksasyon vardı ve 40'mda (% 48,7) omuz el sendromu gelişti. Subluksasyonu olan 46 hastanın 27'sinde omuz el sendromu oluştu. Subluksasyonu olanlarda olmayanlara göre omuz el sendromu gelişimi odds risk oranına göre 2,5 kat daha fazla idi. Hemiplejik hastalarda omuz el sendromu gelişiminde etkili tüm parametreler göz önüne alındığında omuz eksternal rotasyonundaki kısıtlanma ile omuz el sendromu gelişimi arasında kuvvetli bir ilişki tespit edilmiştir. Brunnstrom evresi, kas gücü ve omuz eklem açıklığı ile omuz ağrısı arasında anlamlı ilişki bulundu (p<0,05). Sonuç olarak özellikle dış rotasyonda olmak üzere eklem hareket açıklığındaki kısıtlanma ve kas güçsüzlüğü yüksek oranda omuz ağrısına yol açmaktadır. Bu nedenle erken dönemde rehabilitasyona başlanması ile omuz ağrısının önlenebileceği sonucuna varıldı.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 Primer Fibromyaljide El Kavrama Kuvvetinin İzokinetik Omuz Abduksiyon-Adduksiyon Kuvveti ile İlişkisi(2008) Sallı, Ali; Yılmaz, Halim; Kocabaş, Hilal; Uğurlu, HaticeAmaç: Primer Fibromyalji’li (FM) hastalarda el kavrama kuvveti (EKK) ve izokinetik omuz abduksiyon-adduksiyon maksimal kas kuvvetinin sağlıklı kontrollerle karşılaştırılması ve EKK ile omuz kuvveti arasındaki ilişkinin araştırılması. Hastalar ve Yöntem: Çalışmaya primer FM tanısı almış 100 kadın hasta ve 50 sağlıklı kadın kontrol grubu olarak alındı. Hastalar muayene edilerek şikâyet süreleri, Hassas Nokta Sayıları (HNS) kaydedildi. Ağrı düzeyi için Vizüel Analog Skala (VAS) kullanıldı. Beck depresyon ölçeği (BDÖ) ve Fibromyalji etki sorgulama (FES) skoru hesaplandı. EKK ölçümü için Bar cinsinden ölçüm yapan bir el manometresi ile dominant tarafa 3 ölçüm yapıldı ve en yüksek değer kaydedildi. İzokinetik omuz abduksiyon-adduksiyon maksimal kas kuvveti ölçümü için 60 0/sn ve 180 0/sn açısal hızlarda, dominant tarafa befler maksimal konsantrik izokinetik hareket yaptırıldı. Bulgular: FM ve kontrol grupları arasında yaş ve vücut kitle indeksleri (VKİ) açısından anlamlı fark yoktu. FM grubunda ortalama EKK 0,410,10 bar, kontrol grubunda ise 0,620,13 bardı ve kontrol grubuna göre anlamlı düzeyde düşüktü (p0,001). İzokinetik maksimal omuz abduksiyon-adduksiyon kuvvetleri FM grubunda anlamlı düzeyde düşüktü (p0,001). EKK ile yaş, VKİ, izokinetik omuz maksimal abduksiyon-adduksiyon kas kuvvetleri ile pozitif korelasyon varken şikayet süresi, VAS ve FES skorları ile negatif korelasyon saptandı. Sonuç: FM hastalarında üst ekstremite kas performansının tespitinde el kavrama kuvveti basit ve etkin bir yöntem olarak kullanılabilir. (Romatizma 2008; 23: 5-8)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 Relationship of Cellular Oxidant and Antioxidant Status with Disease Activity in Patients with Rheumatoid Arthritis(2010) Kocabaş, Hilal; Kocabaş, Volkan; Büyükbaş, Sadık; Sallı, Ali; Uğurlu, HaticeIn recent years, increasing attention has been given to the role of reactive oxygen metabolites in the pathogenesis of inflammatory diseases such as rheumatoid arthritis (RA). The aim of this study was to elucidate plasma and especially erythrocyte oxidant and antioxidant status in RA patients and to assess the relationship between disease activity scores (evaluated by Disease Activity Score (DAS) 28 as mild, moderate and severe) and antioxidant status. Materials and Methods: Fasting blood samples were obtained from 50 RA patients and 26 control subjects. DAS28 was used to evaluate the activity. Plasma and erythrocyte levels of malondialdehyde (MDA), xanthine oxidase (XO) and superoxide dismutase (SOD) were investigated in both groups.Results: The plasma levels of MDA and XO and erythrocyte levels of MDA and SOD were significantly higher in RA patients than in control subjects. Although increases in plasma MDA levels in mild and moderate and erythrocyte MDA levels in mild activity groups of RA were not significant (p>0.05), plasma MDA levels in severe (p0.001) and erythrocyte MDA levels in moderate and severe activity groups of RA were significantly higher (p<0.001). Whereas plasma SOD levels showed no significant change (p0.241), erythrocyte SOD levels were significantly increased in RA patients (p<0.001). Although increase in erythrocyte SOD activity in mild RA was not significant, it was significant in moderate and severe RA (p0.002 and p<0.001, respectively). Conclusion: These results suggest that increased plasma and erythrocyte MDA levels in RA patients, especially in those with severe activity, indicate an increased oxidative stress due to inflammation. Nonetheless, an increase particularly in erythrocyte SOD activity in moderate and severe RA patients suggests that the cellular antioxidant system might counterbalance the oxidant status in RA patients.Öğe Relationship of Cellular Oxidant and Antioxidant Status With Disease Activity in Patients With Rheumatoid Arthritis(Turkish League Against Rheumatism, 2010) Kocabaş, Hilal; Kocabaş, Volkan; Büyükbaş, Sadık; Sallı, Ali; Uğurlu, HaticeObjective: In recent years, increasing attention has been given to the role of reactive oxygen metabolites in the pathogenesis of inflammatory diseases such as rheumatoid arthritis (RA). The aim of this study was to elucidate plasma and especially erythrocyte oxidant and antioxidant status in RA patients and to assess the relationship between disease activity scores (evaluated by Disease Activity Score (DAS) 28 as mild, moderate and severe) and antioxidant status Materials and Methods: Fasting blood samples were obtained from 50 RA patients and 26 control subjects. DAS28 was used to evaluate the activity. Plasma and erythrocyte levels of malondialdehyde (MDA), xanthine oxidase (XO) and superoxide dismutase (SOD) were investigated in both groups. Results: The plasma levels of MDA and XO and erythrocyte levels of MDA and SOD were significantly higher in RA patients than in control subjects Although increases in plasma MDA levels in mild and moderate and erythrocyte MDA levels in mild activity groups of RA were not significant (p>0.05), plasma MDA levels in severe (p=0.001) and erythrocyte MDA levels in moderate and severe activity groups of RA were significantly higher (p<0.001). Whereas plasma SOD levels showed no significant change (p=0.241), erythrocyte SOD levels were significantly increased in RA patients (p<0.001). Although increase in erythrocyte SOD activity in mild RA was not significant, it was significant in moderate and severe RA (p=0.002 and p<0.001, respectively). Conclusion: These results suggest that increased plasma and erythrocyte MDA levels in RA patients, especially in those with severe activity, indicate an increased oxidative stress due to inflammation. Nonetheless, an increase particularly in erythrocyte SOD activity in moderate and severe RA patients suggests that the cellular antioxidant system might counterbalance the oxidant status in RA patients.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]Öğe The Serum Levels of Resistin in Ankylosing Spondylitis Patients: A Pilot Study(SPRINGER HEIDELBERG, 2012) Kocabaş, Hilal; Kocabaş, Volkan; Büyükbaş, Sadik; Melikoğlu, Meltem Alkan; Sezer, İlhan; Bütün, BülentResistin is a recently described adipokine which is a member of cysteine-rich secretory protein family. Although it has been primarily defined in human adipocytes, it has been identified that its level was higher in mononuclear leukocytes, macrophages, spleen, and bone marrow cells. Because ankylosing spondylitis is an inflammatory disease, it is suspected that upregulation of proinflammatory cytokines is effective in its immunopathogenesis. The aim of our study is to determine the serum resistin levels in patients with AS and to research the relationship with disease activity markers. A total of 30 patients with AS and 30 healthy controls were included in this study. Serum resistin concentrations, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath AS Disease Activity Index (BASDAI) were evaluated. In results resistin levels in ankylosing spondylitis group were significantly higher than in control group. But, there was no correlation between resistin and ESR, CRP, BASDAI. In conclusion, higher serum resistin levels in patients with AS compared to healthy subjects give clues that resistin could have a role in the pathogenesis of AS.
