Türkiye Romatizma Araştırma ve Savaş Derneği ankilozan spondilit ulusal tedavi önerileri

Objectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group(ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and non-pharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments.Türkiye Romatizma Araştırma ve Savaş Derneği᾽nin (TRASD) Ankilozan Spondilit (AS) için ulusal tedavi önerilerinin oluşturulmasıdır. Gereç ve yöntemler: TRASD tarafından altı Romatoloji ve 19 Fiziksel Tıp ve Rehabilitasyon uzmanı olmak üzere toplam 25 kişiden oluşan bir bilimsel kurul oluşturuldu. Önerilerde 2006 yılında yayınlanan Ankilozan Spondilit Değerlendirme Uluslararası Çalışma Grubu (ASAS)/Romatizmaya karşı Avrupa Ligi (EULAR) önerileri ve Ocak 2005 - Eylül 2010 arasında yayınlanmış olan ilişkili yayınlar konusundaki sistematik bir inceleme temel alındı. Öneriler oluşturulurken Delphi süreci kullanıldı. Ankilozan spondilit tedavisi ile ilgili 12 ana öneri oluşturuldu. Oylama yapılarak önerilerin güçlülük düzeyi bir nümerik derecelendirme skalası ile belirlendi. Bulgular: On iki öneri hasta değerlendirilmesini, hasta takibini ve farmakolojik ve non-farmakolojik yöntemleri içermektedir. ASAS/EULAR önerilerine bazı ilaveler ve önerilerde bazı küçük değişiklikler yapılmıştır. Tüm öneriler yeterli kuvvete sahipti. Sonuç: Bilimsel kanıtlar ve uzmanların görüş birliği ile AS tedavisine yönelik ulusal öneriler oluşturulmuştur. Bu öneriler, yeni gelişmeler doğrultusunda düzenli olarak güncellenmelidi

Factors affecting the efficacy of treatment and recurrence in intravitreal ranibizumab applications in neovascular age-related macular degeneration

Objective: To evaluate the efficacy of intravitreal ranibizumab treatment and factors affecting the treatment in neovascular type age-related macular degeneration Methods: Ranibizumab injected 60 eyes of 60 patients with the diagnosis of neovascular age-related macular degeneration in our clinic were analyzed retrospectively. After three consecutive 3-month follow-up dose injection, decision to perform re-injections was according to best corrected visual acuity, fundus fluorescein angiography and optical coherence tomography findings in consecutive month follow-up. Patients were evaluated in terms of number of ranibizumab injections, pre-treatment and follow-up best-corrected visual acuity, central macular thickness, factors affecting the treatment and recurrence. Results: 30 (50%) of patients were male and 30 (50%) were women with a mean age of 67 ± 9.14 (50-84). While pre-treatment visual acuity average of the cases was 1.12 ± 0.69 logMAR, at the end of 12th month was 0.92 ± 0.63 logMAR. While pre-treatment mean central macular thickness was 343.1 ± 97 µm, in the 12th month was 286 ± 75.5 µm. While the first 3 injections were enough in 20 (33.3%) eyes, but 40 (66.7%) eyes had to be re-injected. Average number of injections was 4.23 ± 1.21. While there was no significant correlation between recent functional and anatomical success with age, gender, type of lens and membrane type, more vision gain was obtained in patients with initial lower visual acuity. The age of patients, pre-treatment visual acuity, membrane type were found to have no significant effect on recurrence rate. Membranes with classic component required more injection than occult type. Conclusion: After intravitreal injection of ranibizumab which is safe and effective in neovascular type of age-related macular degeneration more vision gain was obtained in patients with initial lower visual acuity and presence of classic component initial higher visual acuity, lower age required more injection

Boron concentrations in tap water in many cities of Turkey

Boron concentrations in 335 tap water samples collected from 75 cities in Turkey have been determined by inductively coupled plasma-mass spectrometry. Boron levels ranged between 0.001 and 5.5 mg/L. The lowest boron levels were in Trabzon, the highest in Kayseri. Boron levels in tap water from cities of the Aegean, Eastern, and Central Anatolian Regions were higher than those from cities of the Marmara, Black Sea, South East, and Mediterranean Regions. The overall mean value was around 0.2 mg/L, lower than the limit levels given by the WHO and the European Union, and also the limit level established by Turkish regulations. In some cities, these limit values were exceeded, generally in the tap water of cities where the drinking water based on groundwater or of those located in the vicinity of hot springs, volcanic areas, or boron production regions. This is the most detailed study evaluating boron levels in the drinking water of Turkey. To conclusion, since the boron intake is being mainly with nutrients and drinking water it may effect public health. To know boron levels in drinking waters is also very important for epidemiologic studies and for establishment of database of boron level in drinking waters in Turkey

Clinical Features of Patients with Post-Traumatic Canalicular Laceration and the Effectiveness of Surgical Repair with Monoka Tube Intubation

Objectives: Evaluation of the clinical characteristics of patients with post-traumatic canalicular laceration and the results of surgical repair of these patients with Monoka® tube intubation. Materials and Methods: Medical records of 15 patients who underwent surgical repair with Monoka® tube implantation due to canalicular laceration in our clinic between 2009 and 2013 years were analyzed retrospectively. Patients were analyzed in terms of their demographic characteristics, leading cause of injury, accompanying ocular injuries along with anatomical and functional success. Results: The mean age was 25 (1-56) years. Twelve patients (80%) were males and 3 (20%) were female. Twelve (80%) eyes presented with lower canalicular laceration, 1 (6.7%) eye-with upper canalicular laceration, and 2 (13.3%) eyes had bicanalicular laceration. Five of injuries (33%) were due direct sharp objects and 10 of injuries (66%) occurred due to blunt trauma. Six of patients were operated under general anesthesia and 9 of patients were operated under local anesthesia. The mean time duration between canalicular injury and surgery was found to be 14 hours (4-39 hours). The mean duration of the tubes’ residence time was 5.26 months (1-6 months). Patients were followed averagely 14 months (6-32 months) in the postoperative period. The open status of lavage was considered as anatomical success, and the absence of fluorescein dye pooling and epiphora was considered as functional success. Except for 1 patient with tube protrusion in the early postoperative first month, anatomical and functional success was achieved in 14 patients (93.3%) during the follow-up period. Conclusion: After traumatic canalicular lacerations, Monoka® tube intubation is an easily applicable and effective method with low risk of damage. (Turk J Ophthalmol 2015; 45: 14-17