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Öğe Obesity Associated With Active, But Preserved Joints in Rheumatoid Arthritis: Results From our National Registry(Turkish League Against Rheumatism, 2016) Ayhan, Fikriye Figen; Ataman, Sebnem; Rezvani, Aylin; Paker, Nurdan; Tastekin, Nurettin; Kaya, Taciser; Bodur, HaticeObjectives: This study aims to investigate the prevalence of obesity in patients with rheumatoid arthritis (RA) and associations with disease outcomes. Patients and methods: The study population comprised of 1,038 patients with RA (198 males, 840 females; mean age 56.1 +/- 12.6 years; range 19 to 94 years) who had been included in National RA-Registry. RA disease activity measures, physical function, quality of life, joint destruction, laboratory tests, as well as pain, fatigue, general health, and patient and physician global health assessments on a visual analog scale were collected. Results: Our patients had established RA with mean disease duration of 10.2 +/- 8.8 years and moderate disease activity (disease activity score in 28 joints: mean 3.7 +/- 1.6). According to the body mass index (BMI), 70% of the patients were overweight (n= 362, 34.9%) or obese (n= 364, 35.1%). These patients had higher disease activity scores in 28 joints, visual analog scale-pain and visual analog scale-patient global scores, and higher levels of fasting blood glucose; however, they had lower radiographic scores than normal-BMI patients (p< 0.05). Regression analyses showed that the BMI was independently and inversely associated with disease activity scores in 28 joints and Sharp/van der Heijde scores after the adjustments for biologic and treatment-related factors (p< 0.05). Conclusion: Our findings indicate that obesity is more common in patients with RA than the general population. High disease activity and low radiographic damage were associated with high BMI in this National RA-Registry.Öğe SARS-CoV-2 (COVID-19) Sonrası Pulmoner Rehabilitasyon Prensipleri: Akut ve Subakut Sürecin Yönetimi İçin Rehber(2020) Tur, Birkan Sonel; Genç, Aysun; Delialioğlu, Sibel Ünsal; Köseoğlu, Belma; Ayhan, Fikriye Figen; Sarıkaya, Selda; Aytür, Yeşim KurtaişCoronavirus Hastalığı 2019 (COVID-19) solunumsal, fiziksel, psikolojikve yaygın sistemik işlev bozukluğuna yol açabilen bulaşıcı bir hastalıktır. Hastalığınciddiyeti asemptomatik enfeksiyondan, hafif hastalık, pnömoni, ciddi pnömoni,akut solunum sıkıntısı sendromu, solunum yetmezliği ve ölüme kadardeğişebilmektedir. COVID-19 solunum sistemi önemli şekilde etkilenmektedir.Hastalığın uzun dönem sonuçları ve muhtemel sekellerine ilişkin yeterli bilgi olmadığıgibi, rehabilitasyonu konusunda da henüz kanıt yoktur. Bu klinik uygulamarehberi erişkin COVID-19 hastaları için pulmoner rehabilitasyon önerileriiçermektedir ve Dünya Sağlık Örgütü ile T.C. Sağlık Bakanlığı Halk SağlığıGenel Müdürlüğü tarafından hazırlanan COVID-19 tanı ve tedavi rehberleri,yakın zamanlı bilimsel yayınlar, uzman görüşü olarak yayınlanan COVID-19 içinpulmoner rehabilitasyon önerileri ışığında ve pulmoner rehabilitasyonun temelprensipleri doğrultusunda hazırlanmıştır Bu öneriler geliştirilirken, COVID-19’unbulaşıcılığı, sınırlı sayıda personelin hasta ile teması ilkeleri ile pulmoner rehabilitasyonunsağlayacağı yararların düzeyi göz önünde bulundurulmuştur.Öğe Turkish League Against Rheumatism (TLAR) Recommendations for the Pharmacological management of Rheumatoid Arthritis: 2018 Update Under Guidance of Current Recommendations(Turkish League Against Rheumatism, 2018) Ataman, Sebnem; Sunar, Ismihan; Yilmaz, Gurkan; Bodur, Hatice; Nas, Kemal; Ayhan, Fikriye Figen; Akgul, OzgurObjectives: 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 Turkish League Against Rheumatism Consensus Report: Recommendations For Management of Axial Spondyloarthritis(Turkish League Against Rheumatism, 2018) Bodur, Hatice; Yurdakul, Fatma Gul; Ataman, Sebnem; Garip, Yesim; Nas, Kemal; Ayhan, Fikriye Figen; Akgul, OzgurObjectives: 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.
