Is there an association between two-STAT4 gene polymorphisms and rheumatoid arthritis in turkish population?

[No Abstract Available

EVALUATION OF THE PRE AND POST-OPERATIVE CARDIAC AND PULMONARY FUNCTIONS IN CHILDREN WITH ADENOTONSILLARY HYPERTROPHY

Amaç: Üst solunum yolu obstrüksiyonu, çocuklarda çoğu geri dönüşümlü olan kardiyak ve pulmoner fonksiyon bozukluklarına yol açabilmektedir. Bu çalışmada hipertrofik tonsil ve/ veya adenoid nedeniyle ameliyat kararı alınan, üst solunum yolu obstrüksiyonu olan çocukların kardiyak ve pulmoner fonksiyonlarının değerlendirilmesi amaçlanmıştır. Yöntem: Haziran 2000 - Nisan 2001 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları AD tarafından izlenen, klinik olarak tonsil ve/veya adenoid hipertrofisi tanısı konulan, bu nedenle ameliyat edilen, 5 ile 12 yaşları arasındaki üst solunum yolu obstrüksiyonlu 25 hasta, kardiyak ve pulmoner fonksiyonlar açısından ameliyat öncesi ve ameliyattan 3 ay sonra değerlendirildi. Bulgular: Olguların yaş ortalaması 8,1 ± 2,0 yıl olup, 14'ü (%56) erkek, 11'i (%44) kız idi. Hiçbirinde ameliyat öncesinde klinik olarak kardiyopulmoner sisteme ait herhangi bir patoloji saptanmamıştır. Tüm olgularda elektrokardiyografi ve telekardiyografi bulguları normal olarak değerlendirilmiştir. Ekokardiyografi ile ameliyat öncesi sağ ventrikül preejeksiyon periyodu / sağ ventrikül ejeksiyon zamanına oranı, sağ ventrikül sistolik basıncı ve sağ ventrikül diyastolik boyutu değerleri, bir olgu hariç normal sınırlarda olup, ameliyat sonrasında bu değerlerde istatistiksel olarak anlamlı bir azalma saptanmıştır (p=0,001). Ameliyat öncesi %88'inde solunum fonksiyon testlerinde hafif obstrüktif bozukluk bulgusu saptanan hastaların ameliyat sonrası bu değerleri normale dönmüştür. Sonuç: Üst solunum yolu obstrüksiyonu bulguları olan çocuklarda pulmoner fonksiyonlardaki obstrüktif bozulma, klinik bulgular henüz ortaya çıkmadan solunum fonksiyon testleri ile saptanabilir. Bu çalışmada klinik bulgu vermeyen ancak laboratuvar bulgularla gösterilebilen kardiyopulmoner fonksiyonlardaki değişikliklerin çoğunun geriye dönüşümlü olduğu ve obstrüksiyon ameliyat ile giderildikten kısa süre sonra normale döndüğü gösterilmiştir. Objective: In this study, evaluation of cardiac and pulmonary functions were aimed in the children who underment tonsillectomy due to upper airway obstruction secondary to hypertrophic tonsils and / or adenoids. Methods: Twenty five children who have been followed up due to hypertrophic tonsils and / or adenoids in Dokuz Eylül University Medical Faculty, Department of Ear-Nose &Throat in, between June 2000 and April 2001 were enrolled in the study. All of the patients were decided to be operated due to significant upper airway obstruction. Cardiac and pulmonary functions of these children were evaluated before and three months after the operation. Results: Mean age of the patients were 8.1 ± 2.0 years. None of the patients had any pathology related to cardiopulmonary system before the operation. The ratio of right ventricular preejection period / right ventricular ejection time, right ventricle systolic pressure and diastolic dimensions were within normal ranges, except one patient, echocardiographically before the operation. However, all of these parameters decreased statistically significant after operation (p=0.001 for all of these parameters). Pulmonary function tests were compatible with mild obstructive disorders in 88 % of the patients preoperatively. On the other hand, all of the patients had normal pulmonary function tests postoperatively. Conclusion: This study demonstrated that clinically undetectable cardiopulmonary function changes were reversible and returns to normal shorty time after the relief of airway obstruction

Demographic and clinical characteristics of patients with sustained and switching treatments using biological and targeted synthetic disease-modifying antirheumatic drugs: A multicenter, observational cross-sectional study for rheumatoid arthritis

Introduction Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results The study included a total of 565 patients. The mean age was 53.7 +/- 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment.Turkish Medicine and Medical Devices Agency ; Ankara Numune Egitim ve Arastirma Hastanes

Five-Years Tigecycline Experience an Analysis of Real-Life Data

Aim: Tigecycline has been approved by the Food and Drug Administration for the treatment of complicated intra-abdominal infections, skin and soft tissue infections and community-acquired pneumonia. In our study, we examined the efficacy of tigecycline in clinical practice and reported real life data from our hospital over a period of five years. Methods: The study was conducted between 2008 and 2013 on patients who received tigecycline for longer than 48 hours in Ankara Training and Research Hospital. Clinical success was defined as clinical recovery and microbiological cure in patients who used tigecycline. Any reason for discontinuation of tigecycline treatment was considered a clinical failure. Results: In our hospital, 320 patients were administered tigecycline between 2008 and 2013. Tigecycline was mainly used for pneumonia and skin and soft tissue infections. Tigecycline was used as monotherapy in 174 patients (54.1%). The most frequently isolated agent in tigecycline-treated patients was Acinetobacter baumannii (43.4%) followed by Enterococcus (6.9%). A change in treatment was not considered necessary in 243 (75.9%) patients who received tigecycline, while it was changed in 77 patients (24.1%). Conclusion: In conclusion, the use of tigecycline can be an effective treatment choice, either as monotherapy or as a combination antibiotic therapy

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

Romatoid Artritin Tedavisi: Türkiye Romatizma Araştırma ve Savaş Derneği Uzlaşı Önerileri

Amaç: Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) romatoid artrit tedavisindeki yeni gelişmeleri ve ülkemizin ekonomik koşullarını göz önünde bulundurarak, RA tedavisine yönelik ulusal tedavi önerileri geliştirmeyi amaçlamıştır ve bu amaçla, fikirlerini almak için ulusal uzmanlara danışmıştır.Gereç ve yöntemler: Bu alanda deneyimli olan sekiz romatolog ve 15 fizik tedavi uzmanı TRASD'nin RA tedavisi önerilerinin geliştirilmesine katkıda bulunmuştur. Uzmanlar kurulu, EULAR 2010'da yer alan RA'nın sentetik ve biyolojik hastalık modifiye edici antiromatizmal ajanlarla (DMARD'ler) tedavi önerilerini baz alarak, uzman görüşlerinin de yer aldığı bir "Türkiye RA Tedavi Önerileri" oluşturulmasını planlamıştır. Toplantının ardından, Medline ve Cochrane, Embase ve Türk Tıp Dizini veritabanlarında farmakolojik tedavi önerileri için 2009 ile 2010 yılları arasını, non-farmakolojik tedavi için ise 2007 ile 2010 yılları arasını kapsayan aramalar gerçekleştirilerek sistematik bir literatür taraması yürütülmüştür. Bu işlem EULAR 2010 önerilerine dahil edilen çalışmalara ilave olarak yapılmıştır. Tüm makaleler incelenmiştir, içerikler özetlenmiştir, kanıt seviyeleri belirlemiştir ve Delphi işlemi başlatılmıştır.Bulgular: Beş ana prensip ve bir non-farmakolojik tedavi yöntemiyle birlikte 16 genel öneri sıralanmıştır. Tüm öneriler konusunda uzlaşıya varılmıştır ve önerilerin kuvvet seviyeleri oylanmıştır.Sonuç: Türkiye'deki RA tedavisine yönelik öneriler oluşturulmuştur. Bu ulusal önerilerin fizik tedavi ve rehabilitasyon uzmanlarına (fizyatri uzmanlarına) romatologlara ve aile hekimlerine yönelik bir kılavuz olarak işlev görmesi amaçlanmıştır ve önerilerin düzenli şekilde güncellenmesi gerekmektedir.Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions. Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope &quot;Recommendations for the Management of RA in Turkey&quot; based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated. Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon. Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated

Romatoid Artritin Tedavisi: Türkiye Romatizma Araştırma ve Savaş Derneği Uzlaşı Önerileri

Amaç: Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) romatoid artrit tedavisindeki yeni gelişmeleri ve ülkemizin ekonomik koşullarını göz önünde bulundurarak, RA tedavisine yönelik ulusal tedavi önerileri geliştirmeyi amaçlamıştır ve bu amaçla, fikirlerini almak için ulusal uzmanlara danışmıştır.Gereç ve yöntemler: Bu alanda deneyimli olan sekiz romatolog ve 15 fizik tedavi uzmanı TRASD'nin RA tedavisi önerilerinin geliştirilmesine katkıda bulunmuştur. Uzmanlar kurulu, EULAR 2010'da yer alan RA'nın sentetik ve biyolojik hastalık modifiye edici antiromatizmal ajanlarla (DMARD'ler) tedavi önerilerini baz alarak, uzman görüşlerinin de yer aldığı bir "Türkiye RA Tedavi Önerileri" oluşturulmasını planlamıştır. Toplantının ardından, Medline ve Cochrane, Embase ve Türk Tıp Dizini veritabanlarında farmakolojik tedavi önerileri için 2009 ile 2010 yılları arasını, non-farmakolojik tedavi için ise 2007 ile 2010 yılları arasını kapsayan aramalar gerçekleştirilerek sistematik bir literatür taraması yürütülmüştür. Bu işlem EULAR 2010 önerilerine dahil edilen çalışmalara ilave olarak yapılmıştır. Tüm makaleler incelenmiştir, içerikler özetlenmiştir, kanıt seviyeleri belirlemiştir ve Delphi işlemi başlatılmıştır.Bulgular: Beş ana prensip ve bir non-farmakolojik tedavi yöntemiyle birlikte 16 genel öneri sıralanmıştır. Tüm öneriler konusunda uzlaşıya varılmıştır ve önerilerin kuvvet seviyeleri oylanmıştır.Sonuç: Türkiye'deki RA tedavisine yönelik öneriler oluşturulmuştur. Bu ulusal önerilerin fizik tedavi ve rehabilitasyon uzmanlarına (fizyatri uzmanlarına) romatologlara ve aile hekimlerine yönelik bir kılavuz olarak işlev görmesi amaçlanmıştır ve önerilerin düzenli şekilde güncellenmesi gerekmektedir.Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions. Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope &quot;Recommendations for the Management of RA in Turkey&quot; based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated. Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon. Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated

Turkish Compliance and Adaptation of EULAR 2013 Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: Expert Opinion of TLAR

Objectives: This study aims to report Turkish League Against Rheumatism s assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of Interest The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial Disclosure The authors received no financial support for the research and/or authorship of this article

Characteristics of patients with rheumatoid arthritis in Turkey: results from the Turkish league against rheumatism rheumatoid arthritis registry

İstanbul Bilim Üniversitesi, Sağlık Yüksekokulu.Objectives: This study investigates the demographic and clinical characteristics of patients with rheumatoid arthritis (RA) in Turkey, and attempts to identify strategies for the prevention, treatment, and support of RA. Patients and methods: A total of 2,359 patients (1,966 females, 393 males; mean age 51.6±12.5 years; range 18 to 75 years) with RA from 36 centers across Turkey, who were recorded in the Turkish League Against Rheumatism (TLAR) RA Registry between September 2007 and March 2011, were evaluated. Patients’demographic and clinical data were recorded. Disease activity, functional status, and radiographic damage were measured using the Disease Activity Score 28, the Health Assessment Questionnaire, and van der Heijde modified Sharp scoring method