Serpil Tuna - Academia.edu (original) (raw)
Papers by Serpil Tuna
Research Square (Research Square), Feb 29, 2024
Background: It is widely accepted that skin thickness decreases and fragility increases with agin... more Background: It is widely accepted that skin thickness decreases and fragility increases with aging. However, the relationship between skin thickness and sarcopenia, a common condition in the elderly associated with an increased risk of fragility, remains unknown. Objective: We aimed to investigate the presence of skin thinning in sarcopenia patients and explore the relationship between age, sarcopenia, and skin thickness. Methods: This case-control study included a total of 66 individuals (33 individuals with sarcopenia, 33 healthy controls) aged 40 to 80 years. In all patients, total skin (epidermal + dermal) thickness was measured using ultrasound (US) at the leg, hand, forearm, and upper arm. Results: Skin thickness in all regions was signi cantly lower in patients with sarcopenia compared to controls (all p < 0.05). Controlling for potential confounders, including age, sex, and body mass index, revealed a signi cant relationship between sarcopenia and skin thickness. Conclusion: Sarcopenia was found to be associated with skin thinning in all regions and BMI is positively correlated only with leg skin thickness. However, age and gender were not found to be associated with skin thickness. İNTODUCTİON Aging is a complex process in uenced by a multitude of factors such as chronic in ammation, changes in metabolic pathways, and alterations in stress adaptation. It affects numerous organs and systems and serves as a risk factor for geriatric diseases. 1, 2 Sarcopenia is a multifactorial disease characterized by the progressive loss of muscle mass and function, which increases in prevalence with age. 3 Sarcopenia prevalence was reported to vary between 8% and 36% in individuals younger than 60 years and between 10% and 27% in individuals aged 60 or older, according to a meta-analysis. 4 It has also been reported to reach 50% in individuals aged 80 and above. 5 It is one of the most signi cant health issues in elderly adults and is associated with heightened frailty, increased risk of falls, morbidity and mortality. 6 Aging is also linked to increased epidermal fragility, which is associated with an elevated risk of skin disorders. This epidermal fragility is believed to be related to the thinning of the epidermis. 7, 8 Despite the widespread belief that skin thickness decreases with age, research ndings on this topic are contradictory and subject to ongoing debates 8-14. Environmental factors, climate, gender, skin phototypes, and ethnic background have been reported to in uence skin thickness, but it has been indicated that the thinning of the skin, particularly in sun
Parkinson Hastasında Sakatlığa Neden Olan Multifokal Nöropatik Artropati
Abant tıp dergisi, 2015
Miyofasial ağrı sendromu ile kan lipid düzeyleri arasındaki ilişki
Abant tıp dergisi, 2015
Abstracts Accepted for Publication, 2017
previous exposure to anti-TNF agents to which they have either been intolerant or found ineffecti... more previous exposure to anti-TNF agents to which they have either been intolerant or found ineffective. More research into drug survival and persistence should be considered as real world data may not reflect RCT results.
Hipofiz Bezi Hastalıklarında Kas İskelet Sistemi Bulguları
Türkiye Klinikleri Fiziksel Tıp ve Rehabilitasyon - Özel Konular, 2021
Parkinson Hastasında Sakatlığa Neden Olan Multifokal Nöropatik Artropati
Abant Tıp Dergisi, 2015
Diz Osteoartriti ile Osteoporoz Arasindaki İlişki
Objective: The aim of this study was to investigate the association between knee osteoarthritis (... more Objective: The aim of this study was to investigate the association between knee osteoarthritis (OA) and bone mineral density (BMD) in the femur and lumbar vertebrae. Materials and Methods: A total of 74 female patients (mean age 61.9 ±9.1 years, mean body mass index 27.09±4.24) diagnosed with knee OA were included in this study. To assess knee OA, bilateral weight-bearing antero-posterior knee radiographs were taken and graded from 0 to 4 according to Kellgren–Lawrence criteria. The BMD of the subjects was measured using dual-energy X-ray absorptiometry (DEXA). BMD measurements of those with OA were compared with those without OA. Results: While there was no correlation between BMD and the grade of knee OA, a signifi cant negative correlation was found between age and femur BMD. Body mass index was positively correlated with OA and negatively correlated with OP.
The effect of physical therapy and exercise on pain and functional capacity according to the radiological grade of knee osteoarthritis
Journal of Back and Musculoskeletal Rehabilitation, 2021
BACKGROUND: Physical therapy and exercise programs are frequently used in the treatment of knee o... more BACKGROUND: Physical therapy and exercise programs are frequently used in the treatment of knee osteoarthritis (OA). However, it is not known at what stage of knee OA it is more effective. OBJECTIVE: The purpose of this work was to determine the relationship between the effectiveness of the physical therapy and exercise programs and the radiological findings presence/grade of knee OA. MATERIAL AND METHODS: Overall, 92 patients (65F, 27M) with knee OA were enrolled in the retrospective study. Standard knee radiographs were graded according to Kellgren-Lawrence. Pain and functional status were evaluated using a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, at the end of the physical therapy program (first month), and at third-month control visits. The demographic characteristics and VAS/WOMAC scores of the subjects were obtained from patient files. RESULTS: We analyzed 131 knees of 92 patients with knee OA (65F, 2...
Journal of Surgery and Medicine, 2019
Aim: Nowadays PPD is the most inexpensive and easy to apply modality of test in identification of... more Aim: Nowadays PPD is the most inexpensive and easy to apply modality of test in identification of latent tuberculosis infection. Isoniazid (INH) prophylaxis must be given before usage of anti-TNF-α agents for patients. We aimed to investigate the change in Tuberculin skin test (TST) levels and Isoniazid (INH) prophylaxis rates in patients with inflammatory rheumatic diseases treated with anti-tumor necrosis factor alpha (TNF-α) agents. Methods: A cross-sectional study was planned. Patients with inflammatory rheumatic diseases treated with anti-TNF agents were included in the study. Demographic data, initial TST level and INH prophylaxis had obtained from patient's files. Control TST tests had done at tuberculosis dispensaries in different time periods such as 1-2 / 2-3 / 3-4 / ≥4 years of anti TNF treatment. INH prophylaxis rates according to initial and control TST tests were compared. The relationship between INH prophylaxis and duration of anti-TNF therapy were examined. Results: A total of 117 patients were included in the study. The mean age of the patients (81 male, 36 female) was 40.4±12.90. The control TST levels was significantly higher than initial TST (p=0.001). INH prophylaxis was given to total 99 (84.6%) of 117 patients (to 63 (53.8%) according to initial and to 36 (30.8%) according to control TST tests). There was no relationship between duration of anti TNF therapy and INH prophylaxis initiation (p=0.180). Conclusion: Anti-TNF treatments may reduce the rates of false-negative TST in patients with rheumatic diseases and latent tuberculosis (LTBI) at any stage of the treatment. Therefore, LTBI, which is not determined with initial TST tests, may be determined with TST test applied in the later stages of anti-TNF treatment, and the risk of active tuberculosis can be reduced by INH prophylaxis in this patients.
Turkiye Klinikleri Journal of Dermatology, 2014
Archives of Rheumatology, 2015
Objectives: This study aims to investigate the separate and cumulative effects of smoking and hum... more Objectives: This study aims to investigate the separate and cumulative effects of smoking and human leukocyte antigen (HLA)-B51 on the severity and clinical manifestations of Behçet's disease (BD). Patients and methods: A total of 209 patients (119 males, 90 females; mean age 42.97±10.44 years; range 23 to 75 years) with BD were included in this retrospective study. The severity and clinical manifestations of BD, smoking habits, and presence of HLA-B51 of patients were obtained from medical records. The severity of BD was evaluated with Behçet's Syndrome Activity Scale (BSAS). Relationship between smoking habits and presence of HLA-B51 with disease severity and clinical manifestations was investigated. Results: Presence of HLA-B51 was effective on BSAS, erythema nodosum (EN), articular, ocular and neurological involvements (p=0.001, p=0.011, p=0.013, p=0.001, p=0.038, respectively). Smoking was also effective on BSAS, EN, articular, ocular and neurological involvements (p=0.001, p=0.001, p=0.013, p=0.042, p=0.027, respectively). There was a strong association between positive HLA-B51 with smoking (p=0.004). Smoking and HLA-B51 were effective on articular involvement, smoking was effective on EN, and HLA-B51 and smoking were effective on ocular and neurological involvements (p=0.039, p=0.040, p=0.001, p=0.028, p=0.037, respectively). Conclusion: Our findings indicate that smoking and HLA-B51 influence severity and systemic involvements of BD with a positive relationship in between. We recommend that smoking and HLA-B51 should be considered simultaneously in BD since this relationship may lead to incorrect inferences.
Abant Medical Journal, 2016
GİRİŞ ve AMAÇ: Biz bu çalışmada, romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan hastal... more GİRİŞ ve AMAÇ: Biz bu çalışmada, romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan hastalarda, tedavi süresince gelişmiş olan dermatolojik yan etkileri (DYE) saptamayı amaçladık. YÖNTEM ve GEREÇLER: Romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan 103 hasta çalışmaya dahil edildi. Hastalarda saptanan tüm cilt lezyonları, tedavi öncesi ve sonrası olarak kaydedildi. TNF-α bloker tedavisi sürecinde gelişen dermatolojik lezyonlar enfeksiyöz ve non-enfeksiyöz olarak gruplandırıldı. Tedavi sürecinde DYE geliştiren hastaların demografik ve kinik özellikleri incelendi. Ayrıca enfeksiyöz ve non-enfeksiyöz DYE gelişen hastaların demografik ve kinik özellikleri karşılaştırıldı. BULGULAR: Bu çalışma da yaşları 18-74 arasında değişen 103 hasta (40 kadın) değerlendirildi. Toplam 50 (% 48,54) hastada TNF-α bloker tedavi sürecinde gelişmiş 63 cilt lezyonu tespit edildi (25 onikomikoz, 7 psoriazis, 1 diskoid lupus eritematozus, 1 basal hücreli karcinom, 1 palmoplantar pustuloz, 28 diğer cilt lezyonu). Anti TNFα tedavi sürecinde DYE gelişmiş 50 hastanın 36 (%72) ' sında enfeksiyöz, 14 (%38)' ünde non-enfeksiyöz cilt lezyonları mevcuttu. Eş zamanlı methotrexate (MTX) kullanan hastalarda DYE anlamlı olarak daha sık bulundu. Bunlar arsında enfeksiyöz DYE' lerin, non-enfeksiyöz olanlardan anlamlı olarak daha yüksek olduğu görüldü. Hastalığın tanısı ve kullanılan TNF-α bloker ile DYE ' ler arasında anlamlı bir fark bulunmadı. TARTIŞMA ve SONUÇ: TNF-α blokerler ile tedavi sürecinde, onikomikoz dan malignitelere kadar değişen yelpazede farklı dermatolojik yan etkiler gelişebilir. Sonuç olarak, TNFα bloker tedavisi alan hastaların, DYE' ler açısından takip edilmesi, erken tanı ve tedavi açısından önemlidir. In this study, we aimed to investigate dermatological side effects (DSE) seen in patients with rheumatic diseases taking TNF-α blocker. METHODS: A total number of 103 patients with chronic inflammatory rheumatic diseases on TNF-α blocker treatment were included into the study. All cutaneous leisons in patients were recorded as before and after TNF-α blocker treatment. TNF-α blockers-related DSE were grouped as infectious and non-infectious. The demographic and clinical characteristics of patients with DSE examined. In addition, demographic and clinical characteristics of the patients with infectious and noninfectious DSE were compared. RESULTS: 103 patients (40 female) between the age of 18-74 were included into the study. Totally 63 cutaneous leisons occured during TNF-α blocker treatment were determined in 50 (% 48.54) patients. (25 onychomycosis, 7 psoriasis, 1 diskoid lupus eritematozus, 1 basal cell carcinoma, 1 palmoplantar pustulosis, 28 other cutaneous lesions.) 36 (72%) of patients with DSE had infectious skin lesions. 14 (38%) of patients with DSE had non-infectious skin. DSE were significantly higher in patients receiving concomitant methotrexate (MTX). İnfectious DSE were significantly higher than non infectious DSE in patients receiving concomitant MTX. There was no relationship between DSE with the type of TNF-α blocker and rheumatic diseases. DISCUSSION AND CONCLUSION: As a result, DSE ranging from onychomycosis to malignancies can be seen during be seen during TNF-α blocker therapy. Monitoring for DSE of the patients receiving TNF-α blocker treatment is important for early diagnosis and treatment.
Clinical rheumatology, Jan 18, 2016
To explore whether femoral cartilage thickness is related (and changes) with muscle strength in s... more To explore whether femoral cartilage thickness is related (and changes) with muscle strength in subjects with knee osteoarthritis (OA). Forty patients (27 F, 13 M) with knee OA-who were under quadriceps muscle strengthening program-were enrolled in the study. Isokinetic/isometric knee muscle strength measurements (at 30-60° angles and 60-180° velocity) were performed at baseline, end of the muscle strengthening program, and third month control visit using a biodex dynamometer. Femoral cartilage thicknesses (at medial/lateral condyle and intercondylar area) were measured using ultrasonography. Seventy-nine knees of 40 patients (27 F, 13 M) aged 52.03 ± 11.72 years (range, 26-71) were analyzed. Mean VAS scores on the first and third months were significantly lower than the initial values (p < 0.001, p = 0.049). Isometric peak torque and total work values at 180 °/s were significantly higher than the baseline measurements at first and third month controls (all p < 0.05). Cartilag...
Journal of clinical and diagnostic research : JCDR, 2016
Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus p... more Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus pulposus, and causes non specific symptoms like low back pain, back pain, muscle spasms and radiculopathy. It is frequently confused with vertebral fracture, infection, schmorl nodule or tumour because it has not a spesific symptom. It usually causes mechanical low back pain rather than inflammatory low back pain. We reported a patient presented with inflammatory low back pain and diagnosed with anterior limbus vertebra because it is rare and the patient has atypical clinical presentation.
Journal of Korean Medical Science, 2016
Restless legs syndrome (RLS) is a disease characterized by the urge to move the legs and sleep di... more Restless legs syndrome (RLS) is a disease characterized by the urge to move the legs and sleep disturbances. Similarly, chronic spontaneous urticaria (CSU) is a dermatological disease characterized by pruritus and sleep disorders. In this study, we aimed to determine the prevalence and severity of RLS in patients with chronic spontaneous urticaria (CSU) and to compare the quality of sleep of patients with and without RLS in the CSU group using the Pittsburgh Sleep Quality Index. A total of 130 patients with CSU and 100 healthy controls were included in this study. The frequency of RLS, frequency of sleep disturbances, and average score of RLS in patients with CSU were statistically significantly higher than control groups (respectively P = 0.008, P = 0.009, P = 0.004). Subjective sleep quality, sleep latency and habitual sleep efficiency scores in patients with RLS were statistically significantly higher than patients without RLS (respectively P = 0.016, P = 0.007, P = 0.035). We claimed that pruritus of urticaria may decrease the quality of sleep in patients with RLS and it may trigger and worsen the restless legs syndrome. Furthermore, RLS and CSU may share a common etiology.
Abant Medical Journal, 2015
Nöropatik artropati ya da diğer adıyla Charcot eklemi, genellikle periferik sensorial nöropatinin... more Nöropatik artropati ya da diğer adıyla Charcot eklemi, genellikle periferik sensorial nöropatinin neden olduğu ilerleyici dejeneratif bir artropatidir. Biz burada bir Parkinson hastasında, nadir ve alışılmadık bir durum olarak idiyopatik polinöropatiye sekonder gelişen ve hastayı tekerlekli sandalyeye bağımlı hale getiren multifokal tutulumlu nöropatik artropati olgusu sunduk. Neuropathic arthropathy in other words Charcot joint is a progressive degenerating arthropathy which is generally caused by peripheral sensory neuropathy. Here, we present a multifocal neuropathic arthropathy secondary to idiopathic polyneuropathy patient with Parkinson disease as a rare and unusual presentation, who has become wheelchair-dependent.
Dermatologica Sinica, 2016
Background: Nailfold videocapillaroscopy (NVC) is a diagnostic method for evaluating the microvas... more Background: Nailfold videocapillaroscopy (NVC) is a diagnostic method for evaluating the microvasculature. Behçet's disease (BD) can affect vessels of all types and sizes. Methods: We performed NVC in 82 randomly selected patients with BD. NVC was performed for eight fingers (excluding the thumbs) with a 200Â magnification. Results: Of the 82 patients with BD, 75 had at least one capillaroscopic change, including tortuosity in 75 (91.5%), bizarre capillaries in eight (9.8%), microhemorrhages in four (4.9%) and mega capillary in two (2.4%). The mean number of capillaries/mm length of nailfold in the group with BD was 10.17 ± 1.23 and was 11.45 ± 0.99 in the healthy controls (p < 0.001). Conclusion: In this study, the BD group had significantly more capillaroscopic pathological findings than did the healthy control group. However, the detected capillaroscopic pathology rate in BD patients was significantly lower than that of three previously published studies. Further studies are needed to clarify the diagnostic and prognostic value of capillaroscopy in BD.
Türk Oftalmoloji Dergisi, 2015
Sjögren's syndrome secondary to various autoimmune diseases. Ma te ri als and Met hods: This pros... more Sjögren's syndrome secondary to various autoimmune diseases. Ma te ri als and Met hods: This prospective study included 22 eyes of 22 patients with Sjögren's syndrome who began treatment with Index (OSDI) scores were recorded before treatment and in the 3 rd and 6 th months of treatment. Re sults: In the 3 rd or OSDI scores (p=0.260, p=0.357, p=0.190 and p=0.07, respectively). In the 6 th disease, ulcerative colitis, and ankylosing spondylitis, did not show a positive effect on ocular surface and tear function tests. (
AB0724 Isotretinoin Induced Bilateral Sacroiliitis: CASE Report
Annals of the Rheumatic Diseases, 2014
Background Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been a... more Background Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been associated with adverse effects,including musculoskeletal symptoms. Reported here is a case of bilateral sacroiliitis related to isotretinoin use. Isotretinoin may cause sacroiliitis development or trigger it in healthy people. We advise rheumatologists to be aware of this side effect. Objectives Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been associated with adverse effects,including musculoskeletal symptoms. Reported here is a case of bilateral sacroiliitis related to isotretinoin use which completely resolved following discontinuation of the medication. Methods A 18 year old man was treated for acne affecting the back and face with oral isotretinoin. He had no previous medical problems apart from the onset with puberty of severe acne vulgaris of the face and back. Isotretinoin was commenced 10 weeks later he experienced back and sacroiliiac pain, restricting his participation in sporting activities. There was no history of psoriasis, uveitis or inflammatory bowel disease. The patient was taking no other medications. On examination he had decrease lomber schober,sacroiliac tenderness. MRI showed moderate to severe relatively symmetrical sacroiliitis with moderate joınt effusions and florid bone marrow oedema in the anterosuperior aspect of the sacroiliac joints. The isotretinoin was ceased and the patient responded to slow release naproxen 1000 mg daily and physiotherapy. Eight weeks later he was free of symptoms. A repeat MRI performed 10 weeks later showed no evidence of sacroiliitis – no effusions, synovitis or abnormal one marrow signal. Results Bilateral symmetrical sacroiliitis can be seen in seronegative spondyloarthropathies. The patient had no infectious conditions capable of initiating reactive arthritis and lacked both a history and symptoms of inflammatory bowel disease psoriasis, uveitis, conjunctivitis or perıpheral arthritis inconsistent with ankyilosing spodylitis, enteropathic arthropathies and psoriatic arthropathy. Synovial and/or bone inflammatory symptoms may develop in closely related conditions featuring acne or acral pustules. These symptoms may appear spontaneously or be triggered by isotretinoin. Previous cases of sacroiliitis in patients treated with isotretinoin for acne have not been able to conclusively attribute the condition to either isotretinoin or the patients' acne. We report here that isotretinoin treatment is usually used in acne treatment, may cause sacroiliitis development or trigger it in healthy people. We advise rheumatologists to be aware of this side effect. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5208
Dicle Medical Journal / Dicle Tip Dergisi, 2014
Complex regional pain syndrome type 1 (CRPS-1) is a chronic pain syndrome characterized by severe... more Complex regional pain syndrome type 1 (CRPS-1) is a chronic pain syndrome characterized by severe pain, swelling, autonomic dysfunction and dystrophic changes in affected extremity. RSDS is a rare disease in children and usually occurs after trauma, however, without trauma may also occur. We were detected CRPS-1 activated by cold and stress and characterized by recurrent attacks in the bilateral upper extremities in 14 year-old girl, which is similar to Raynaud's phenomenon. We present this case with the literature because of its rarity and atypical course.
Research Square (Research Square), Feb 29, 2024
Background: It is widely accepted that skin thickness decreases and fragility increases with agin... more Background: It is widely accepted that skin thickness decreases and fragility increases with aging. However, the relationship between skin thickness and sarcopenia, a common condition in the elderly associated with an increased risk of fragility, remains unknown. Objective: We aimed to investigate the presence of skin thinning in sarcopenia patients and explore the relationship between age, sarcopenia, and skin thickness. Methods: This case-control study included a total of 66 individuals (33 individuals with sarcopenia, 33 healthy controls) aged 40 to 80 years. In all patients, total skin (epidermal + dermal) thickness was measured using ultrasound (US) at the leg, hand, forearm, and upper arm. Results: Skin thickness in all regions was signi cantly lower in patients with sarcopenia compared to controls (all p < 0.05). Controlling for potential confounders, including age, sex, and body mass index, revealed a signi cant relationship between sarcopenia and skin thickness. Conclusion: Sarcopenia was found to be associated with skin thinning in all regions and BMI is positively correlated only with leg skin thickness. However, age and gender were not found to be associated with skin thickness. İNTODUCTİON Aging is a complex process in uenced by a multitude of factors such as chronic in ammation, changes in metabolic pathways, and alterations in stress adaptation. It affects numerous organs and systems and serves as a risk factor for geriatric diseases. 1, 2 Sarcopenia is a multifactorial disease characterized by the progressive loss of muscle mass and function, which increases in prevalence with age. 3 Sarcopenia prevalence was reported to vary between 8% and 36% in individuals younger than 60 years and between 10% and 27% in individuals aged 60 or older, according to a meta-analysis. 4 It has also been reported to reach 50% in individuals aged 80 and above. 5 It is one of the most signi cant health issues in elderly adults and is associated with heightened frailty, increased risk of falls, morbidity and mortality. 6 Aging is also linked to increased epidermal fragility, which is associated with an elevated risk of skin disorders. This epidermal fragility is believed to be related to the thinning of the epidermis. 7, 8 Despite the widespread belief that skin thickness decreases with age, research ndings on this topic are contradictory and subject to ongoing debates 8-14. Environmental factors, climate, gender, skin phototypes, and ethnic background have been reported to in uence skin thickness, but it has been indicated that the thinning of the skin, particularly in sun
Parkinson Hastasında Sakatlığa Neden Olan Multifokal Nöropatik Artropati
Abant tıp dergisi, 2015
Miyofasial ağrı sendromu ile kan lipid düzeyleri arasındaki ilişki
Abant tıp dergisi, 2015
Abstracts Accepted for Publication, 2017
previous exposure to anti-TNF agents to which they have either been intolerant or found ineffecti... more previous exposure to anti-TNF agents to which they have either been intolerant or found ineffective. More research into drug survival and persistence should be considered as real world data may not reflect RCT results.
Hipofiz Bezi Hastalıklarında Kas İskelet Sistemi Bulguları
Türkiye Klinikleri Fiziksel Tıp ve Rehabilitasyon - Özel Konular, 2021
Parkinson Hastasında Sakatlığa Neden Olan Multifokal Nöropatik Artropati
Abant Tıp Dergisi, 2015
Diz Osteoartriti ile Osteoporoz Arasindaki İlişki
Objective: The aim of this study was to investigate the association between knee osteoarthritis (... more Objective: The aim of this study was to investigate the association between knee osteoarthritis (OA) and bone mineral density (BMD) in the femur and lumbar vertebrae. Materials and Methods: A total of 74 female patients (mean age 61.9 ±9.1 years, mean body mass index 27.09±4.24) diagnosed with knee OA were included in this study. To assess knee OA, bilateral weight-bearing antero-posterior knee radiographs were taken and graded from 0 to 4 according to Kellgren–Lawrence criteria. The BMD of the subjects was measured using dual-energy X-ray absorptiometry (DEXA). BMD measurements of those with OA were compared with those without OA. Results: While there was no correlation between BMD and the grade of knee OA, a signifi cant negative correlation was found between age and femur BMD. Body mass index was positively correlated with OA and negatively correlated with OP.
The effect of physical therapy and exercise on pain and functional capacity according to the radiological grade of knee osteoarthritis
Journal of Back and Musculoskeletal Rehabilitation, 2021
BACKGROUND: Physical therapy and exercise programs are frequently used in the treatment of knee o... more BACKGROUND: Physical therapy and exercise programs are frequently used in the treatment of knee osteoarthritis (OA). However, it is not known at what stage of knee OA it is more effective. OBJECTIVE: The purpose of this work was to determine the relationship between the effectiveness of the physical therapy and exercise programs and the radiological findings presence/grade of knee OA. MATERIAL AND METHODS: Overall, 92 patients (65F, 27M) with knee OA were enrolled in the retrospective study. Standard knee radiographs were graded according to Kellgren-Lawrence. Pain and functional status were evaluated using a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, at the end of the physical therapy program (first month), and at third-month control visits. The demographic characteristics and VAS/WOMAC scores of the subjects were obtained from patient files. RESULTS: We analyzed 131 knees of 92 patients with knee OA (65F, 2...
Journal of Surgery and Medicine, 2019
Aim: Nowadays PPD is the most inexpensive and easy to apply modality of test in identification of... more Aim: Nowadays PPD is the most inexpensive and easy to apply modality of test in identification of latent tuberculosis infection. Isoniazid (INH) prophylaxis must be given before usage of anti-TNF-α agents for patients. We aimed to investigate the change in Tuberculin skin test (TST) levels and Isoniazid (INH) prophylaxis rates in patients with inflammatory rheumatic diseases treated with anti-tumor necrosis factor alpha (TNF-α) agents. Methods: A cross-sectional study was planned. Patients with inflammatory rheumatic diseases treated with anti-TNF agents were included in the study. Demographic data, initial TST level and INH prophylaxis had obtained from patient's files. Control TST tests had done at tuberculosis dispensaries in different time periods such as 1-2 / 2-3 / 3-4 / ≥4 years of anti TNF treatment. INH prophylaxis rates according to initial and control TST tests were compared. The relationship between INH prophylaxis and duration of anti-TNF therapy were examined. Results: A total of 117 patients were included in the study. The mean age of the patients (81 male, 36 female) was 40.4±12.90. The control TST levels was significantly higher than initial TST (p=0.001). INH prophylaxis was given to total 99 (84.6%) of 117 patients (to 63 (53.8%) according to initial and to 36 (30.8%) according to control TST tests). There was no relationship between duration of anti TNF therapy and INH prophylaxis initiation (p=0.180). Conclusion: Anti-TNF treatments may reduce the rates of false-negative TST in patients with rheumatic diseases and latent tuberculosis (LTBI) at any stage of the treatment. Therefore, LTBI, which is not determined with initial TST tests, may be determined with TST test applied in the later stages of anti-TNF treatment, and the risk of active tuberculosis can be reduced by INH prophylaxis in this patients.
Turkiye Klinikleri Journal of Dermatology, 2014
Archives of Rheumatology, 2015
Objectives: This study aims to investigate the separate and cumulative effects of smoking and hum... more Objectives: This study aims to investigate the separate and cumulative effects of smoking and human leukocyte antigen (HLA)-B51 on the severity and clinical manifestations of Behçet's disease (BD). Patients and methods: A total of 209 patients (119 males, 90 females; mean age 42.97±10.44 years; range 23 to 75 years) with BD were included in this retrospective study. The severity and clinical manifestations of BD, smoking habits, and presence of HLA-B51 of patients were obtained from medical records. The severity of BD was evaluated with Behçet's Syndrome Activity Scale (BSAS). Relationship between smoking habits and presence of HLA-B51 with disease severity and clinical manifestations was investigated. Results: Presence of HLA-B51 was effective on BSAS, erythema nodosum (EN), articular, ocular and neurological involvements (p=0.001, p=0.011, p=0.013, p=0.001, p=0.038, respectively). Smoking was also effective on BSAS, EN, articular, ocular and neurological involvements (p=0.001, p=0.001, p=0.013, p=0.042, p=0.027, respectively). There was a strong association between positive HLA-B51 with smoking (p=0.004). Smoking and HLA-B51 were effective on articular involvement, smoking was effective on EN, and HLA-B51 and smoking were effective on ocular and neurological involvements (p=0.039, p=0.040, p=0.001, p=0.028, p=0.037, respectively). Conclusion: Our findings indicate that smoking and HLA-B51 influence severity and systemic involvements of BD with a positive relationship in between. We recommend that smoking and HLA-B51 should be considered simultaneously in BD since this relationship may lead to incorrect inferences.
Abant Medical Journal, 2016
GİRİŞ ve AMAÇ: Biz bu çalışmada, romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan hastal... more GİRİŞ ve AMAÇ: Biz bu çalışmada, romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan hastalarda, tedavi süresince gelişmiş olan dermatolojik yan etkileri (DYE) saptamayı amaçladık. YÖNTEM ve GEREÇLER: Romatizmal hastalığı nedeniyle TNF-α bloker tedavisi alan 103 hasta çalışmaya dahil edildi. Hastalarda saptanan tüm cilt lezyonları, tedavi öncesi ve sonrası olarak kaydedildi. TNF-α bloker tedavisi sürecinde gelişen dermatolojik lezyonlar enfeksiyöz ve non-enfeksiyöz olarak gruplandırıldı. Tedavi sürecinde DYE geliştiren hastaların demografik ve kinik özellikleri incelendi. Ayrıca enfeksiyöz ve non-enfeksiyöz DYE gelişen hastaların demografik ve kinik özellikleri karşılaştırıldı. BULGULAR: Bu çalışma da yaşları 18-74 arasında değişen 103 hasta (40 kadın) değerlendirildi. Toplam 50 (% 48,54) hastada TNF-α bloker tedavi sürecinde gelişmiş 63 cilt lezyonu tespit edildi (25 onikomikoz, 7 psoriazis, 1 diskoid lupus eritematozus, 1 basal hücreli karcinom, 1 palmoplantar pustuloz, 28 diğer cilt lezyonu). Anti TNFα tedavi sürecinde DYE gelişmiş 50 hastanın 36 (%72) ' sında enfeksiyöz, 14 (%38)' ünde non-enfeksiyöz cilt lezyonları mevcuttu. Eş zamanlı methotrexate (MTX) kullanan hastalarda DYE anlamlı olarak daha sık bulundu. Bunlar arsında enfeksiyöz DYE' lerin, non-enfeksiyöz olanlardan anlamlı olarak daha yüksek olduğu görüldü. Hastalığın tanısı ve kullanılan TNF-α bloker ile DYE ' ler arasında anlamlı bir fark bulunmadı. TARTIŞMA ve SONUÇ: TNF-α blokerler ile tedavi sürecinde, onikomikoz dan malignitelere kadar değişen yelpazede farklı dermatolojik yan etkiler gelişebilir. Sonuç olarak, TNFα bloker tedavisi alan hastaların, DYE' ler açısından takip edilmesi, erken tanı ve tedavi açısından önemlidir. In this study, we aimed to investigate dermatological side effects (DSE) seen in patients with rheumatic diseases taking TNF-α blocker. METHODS: A total number of 103 patients with chronic inflammatory rheumatic diseases on TNF-α blocker treatment were included into the study. All cutaneous leisons in patients were recorded as before and after TNF-α blocker treatment. TNF-α blockers-related DSE were grouped as infectious and non-infectious. The demographic and clinical characteristics of patients with DSE examined. In addition, demographic and clinical characteristics of the patients with infectious and noninfectious DSE were compared. RESULTS: 103 patients (40 female) between the age of 18-74 were included into the study. Totally 63 cutaneous leisons occured during TNF-α blocker treatment were determined in 50 (% 48.54) patients. (25 onychomycosis, 7 psoriasis, 1 diskoid lupus eritematozus, 1 basal cell carcinoma, 1 palmoplantar pustulosis, 28 other cutaneous lesions.) 36 (72%) of patients with DSE had infectious skin lesions. 14 (38%) of patients with DSE had non-infectious skin. DSE were significantly higher in patients receiving concomitant methotrexate (MTX). İnfectious DSE were significantly higher than non infectious DSE in patients receiving concomitant MTX. There was no relationship between DSE with the type of TNF-α blocker and rheumatic diseases. DISCUSSION AND CONCLUSION: As a result, DSE ranging from onychomycosis to malignancies can be seen during be seen during TNF-α blocker therapy. Monitoring for DSE of the patients receiving TNF-α blocker treatment is important for early diagnosis and treatment.
Clinical rheumatology, Jan 18, 2016
To explore whether femoral cartilage thickness is related (and changes) with muscle strength in s... more To explore whether femoral cartilage thickness is related (and changes) with muscle strength in subjects with knee osteoarthritis (OA). Forty patients (27 F, 13 M) with knee OA-who were under quadriceps muscle strengthening program-were enrolled in the study. Isokinetic/isometric knee muscle strength measurements (at 30-60° angles and 60-180° velocity) were performed at baseline, end of the muscle strengthening program, and third month control visit using a biodex dynamometer. Femoral cartilage thicknesses (at medial/lateral condyle and intercondylar area) were measured using ultrasonography. Seventy-nine knees of 40 patients (27 F, 13 M) aged 52.03 ± 11.72 years (range, 26-71) were analyzed. Mean VAS scores on the first and third months were significantly lower than the initial values (p < 0.001, p = 0.049). Isometric peak torque and total work values at 180 °/s were significantly higher than the baseline measurements at first and third month controls (all p < 0.05). Cartilag...
Journal of clinical and diagnostic research : JCDR, 2016
Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus p... more Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus pulposus, and causes non specific symptoms like low back pain, back pain, muscle spasms and radiculopathy. It is frequently confused with vertebral fracture, infection, schmorl nodule or tumour because it has not a spesific symptom. It usually causes mechanical low back pain rather than inflammatory low back pain. We reported a patient presented with inflammatory low back pain and diagnosed with anterior limbus vertebra because it is rare and the patient has atypical clinical presentation.
Journal of Korean Medical Science, 2016
Restless legs syndrome (RLS) is a disease characterized by the urge to move the legs and sleep di... more Restless legs syndrome (RLS) is a disease characterized by the urge to move the legs and sleep disturbances. Similarly, chronic spontaneous urticaria (CSU) is a dermatological disease characterized by pruritus and sleep disorders. In this study, we aimed to determine the prevalence and severity of RLS in patients with chronic spontaneous urticaria (CSU) and to compare the quality of sleep of patients with and without RLS in the CSU group using the Pittsburgh Sleep Quality Index. A total of 130 patients with CSU and 100 healthy controls were included in this study. The frequency of RLS, frequency of sleep disturbances, and average score of RLS in patients with CSU were statistically significantly higher than control groups (respectively P = 0.008, P = 0.009, P = 0.004). Subjective sleep quality, sleep latency and habitual sleep efficiency scores in patients with RLS were statistically significantly higher than patients without RLS (respectively P = 0.016, P = 0.007, P = 0.035). We claimed that pruritus of urticaria may decrease the quality of sleep in patients with RLS and it may trigger and worsen the restless legs syndrome. Furthermore, RLS and CSU may share a common etiology.
Abant Medical Journal, 2015
Nöropatik artropati ya da diğer adıyla Charcot eklemi, genellikle periferik sensorial nöropatinin... more Nöropatik artropati ya da diğer adıyla Charcot eklemi, genellikle periferik sensorial nöropatinin neden olduğu ilerleyici dejeneratif bir artropatidir. Biz burada bir Parkinson hastasında, nadir ve alışılmadık bir durum olarak idiyopatik polinöropatiye sekonder gelişen ve hastayı tekerlekli sandalyeye bağımlı hale getiren multifokal tutulumlu nöropatik artropati olgusu sunduk. Neuropathic arthropathy in other words Charcot joint is a progressive degenerating arthropathy which is generally caused by peripheral sensory neuropathy. Here, we present a multifocal neuropathic arthropathy secondary to idiopathic polyneuropathy patient with Parkinson disease as a rare and unusual presentation, who has become wheelchair-dependent.
Dermatologica Sinica, 2016
Background: Nailfold videocapillaroscopy (NVC) is a diagnostic method for evaluating the microvas... more Background: Nailfold videocapillaroscopy (NVC) is a diagnostic method for evaluating the microvasculature. Behçet's disease (BD) can affect vessels of all types and sizes. Methods: We performed NVC in 82 randomly selected patients with BD. NVC was performed for eight fingers (excluding the thumbs) with a 200Â magnification. Results: Of the 82 patients with BD, 75 had at least one capillaroscopic change, including tortuosity in 75 (91.5%), bizarre capillaries in eight (9.8%), microhemorrhages in four (4.9%) and mega capillary in two (2.4%). The mean number of capillaries/mm length of nailfold in the group with BD was 10.17 ± 1.23 and was 11.45 ± 0.99 in the healthy controls (p < 0.001). Conclusion: In this study, the BD group had significantly more capillaroscopic pathological findings than did the healthy control group. However, the detected capillaroscopic pathology rate in BD patients was significantly lower than that of three previously published studies. Further studies are needed to clarify the diagnostic and prognostic value of capillaroscopy in BD.
Türk Oftalmoloji Dergisi, 2015
Sjögren's syndrome secondary to various autoimmune diseases. Ma te ri als and Met hods: This pros... more Sjögren's syndrome secondary to various autoimmune diseases. Ma te ri als and Met hods: This prospective study included 22 eyes of 22 patients with Sjögren's syndrome who began treatment with Index (OSDI) scores were recorded before treatment and in the 3 rd and 6 th months of treatment. Re sults: In the 3 rd or OSDI scores (p=0.260, p=0.357, p=0.190 and p=0.07, respectively). In the 6 th disease, ulcerative colitis, and ankylosing spondylitis, did not show a positive effect on ocular surface and tear function tests. (
AB0724 Isotretinoin Induced Bilateral Sacroiliitis: CASE Report
Annals of the Rheumatic Diseases, 2014
Background Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been a... more Background Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been associated with adverse effects,including musculoskeletal symptoms. Reported here is a case of bilateral sacroiliitis related to isotretinoin use. Isotretinoin may cause sacroiliitis development or trigger it in healthy people. We advise rheumatologists to be aware of this side effect. Objectives Isotretinoin, a retinoid indicated for the treatment of severe cystic acne, has been associated with adverse effects,including musculoskeletal symptoms. Reported here is a case of bilateral sacroiliitis related to isotretinoin use which completely resolved following discontinuation of the medication. Methods A 18 year old man was treated for acne affecting the back and face with oral isotretinoin. He had no previous medical problems apart from the onset with puberty of severe acne vulgaris of the face and back. Isotretinoin was commenced 10 weeks later he experienced back and sacroiliiac pain, restricting his participation in sporting activities. There was no history of psoriasis, uveitis or inflammatory bowel disease. The patient was taking no other medications. On examination he had decrease lomber schober,sacroiliac tenderness. MRI showed moderate to severe relatively symmetrical sacroiliitis with moderate joınt effusions and florid bone marrow oedema in the anterosuperior aspect of the sacroiliac joints. The isotretinoin was ceased and the patient responded to slow release naproxen 1000 mg daily and physiotherapy. Eight weeks later he was free of symptoms. A repeat MRI performed 10 weeks later showed no evidence of sacroiliitis – no effusions, synovitis or abnormal one marrow signal. Results Bilateral symmetrical sacroiliitis can be seen in seronegative spondyloarthropathies. The patient had no infectious conditions capable of initiating reactive arthritis and lacked both a history and symptoms of inflammatory bowel disease psoriasis, uveitis, conjunctivitis or perıpheral arthritis inconsistent with ankyilosing spodylitis, enteropathic arthropathies and psoriatic arthropathy. Synovial and/or bone inflammatory symptoms may develop in closely related conditions featuring acne or acral pustules. These symptoms may appear spontaneously or be triggered by isotretinoin. Previous cases of sacroiliitis in patients treated with isotretinoin for acne have not been able to conclusively attribute the condition to either isotretinoin or the patients' acne. We report here that isotretinoin treatment is usually used in acne treatment, may cause sacroiliitis development or trigger it in healthy people. We advise rheumatologists to be aware of this side effect. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5208
Dicle Medical Journal / Dicle Tip Dergisi, 2014
Complex regional pain syndrome type 1 (CRPS-1) is a chronic pain syndrome characterized by severe... more Complex regional pain syndrome type 1 (CRPS-1) is a chronic pain syndrome characterized by severe pain, swelling, autonomic dysfunction and dystrophic changes in affected extremity. RSDS is a rare disease in children and usually occurs after trauma, however, without trauma may also occur. We were detected CRPS-1 activated by cold and stress and characterized by recurrent attacks in the bilateral upper extremities in 14 year-old girl, which is similar to Raynaud's phenomenon. We present this case with the literature because of its rarity and atypical course.