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

Relationship Between Patient’s Age and Bone Mineral Density of Lomber Spine and Femur in Postmenopausal Women

The aim of this study was to examine the relationship between patient’s age and lomber spine, hip regions(femur neck, trochanter, Ward’s triangle) bone mineral density (BMD) and T scores. A total of 85 postmenopausal women whose L2-4 T score was equal to or less than -2.5 with a mean age of 65.72 (50-81) years were included. Bone mineral density of lomber spine and hip was measured by dual energy x-ray absorbtiometry (DEXA) in all patients. Pearson correlation analysis was used to perform the statistical evaluation. There was negative correlation between patient’s age and femoral neck and ward’s triangle BMD and T scores (p 0.05)

The Effect of Tip II Diabetes Mellitus on the Musculoskeletal System in Postmenopausal Women

The aim of this study was to examine the effect of type 2 Diabetes Mellitus on bone mineral density (BMD) and its association with locomotor system diseases compared with healthy postmenopausal women. In this study 31 diabetic and 21 healthy postmenopausal women were included. Locomotor system examination and laboratory evaluations of all subjects were perfermed. The medical treatment of diabetic subjects were recorded. Lumbar vertebrae and femoral BMDs were measured with dual-energy X-ray absorptiometry. L2-L4 total and femoral neck BMD values of subjects showed no statistically significant diffrence between diabetic and control group and between patients using only oral antidiabetic medication and insulin additionally. We detected a negative corrrelation between BMD and serum fasting glucose values of the subjects, but it was not statistically significant. We detected statistically significant higher prevalence of Phalen and Tinel sign, glove and sock type hypoestesia, dupuytren contracture and range of motion limitation of the shoulder in the diabetic group compared with the control group. As a result, type 2 diabetic postmenopausal women had BMD values showing no difference compared with the control group, but prevalence of musculoskeletal diseases were increased in these subjects

Risk Factors in Osteporotic Vertebral Fractures

The aim of this study was to investigate the risk factors for osteoporotic vertebral fractures in postmenopausal women. 44 postmenopausal women whose L 2-L4 T scores were £ -2.5 SD with a mean age of 66.38+ 6.47 years were included in this study. Age, postmenopausal years, body mass index, milk consumption (before and after age 50), family history of osteoporosis and osteoporotic fracture, patient’s previous fracture history, tobacco use, number of pregnancies, surgical menopause were questioned in all patients. DEXA was used to evaluate bone mineral density . Kleerekoper method was used to evaluate the fractures between T4 and L5 vertebra on lateral thoracal and lumbar X rays. When 25 patient with vertebral fractures compared with 19 patients without fracture ,only patient’s age showed statistically significant difference between groups ( p=0.035). Of the 5 risk factors chosen (age, L2-L4 BMD, L2-L4 T score, body weight <57 kg, milk consumption before age 50) only patient’s age was found to be statistically important in estimating vertebral fracture risk (p=0.032).There was statistically significant positive correlation between vertebral deformity score (evaluated according to Kleerekoper method) and patient’s age and postmenopausal years (respectively p=0.001, p=0.006)

Femoral Geometry in Male Patients with Atraumatic Hip Fracture - Original Investigation

Aims: Hip fracture is the most serious complication of osteoporosis and the most disabling type of fracture. In this study, we aimed to compare femoral geometry in hip fractured male patients aged more than 65 years old with age matched controls. Patients and Methods: 20 male patients with a history of nontraumatic hip fracture and 19 age-matched healthy controls were included in this study. Bone mineral density of neck and trochanter of hip were measured by DEXA. In addition to BMD, an experienced radiologist measured proximal femur geometric parameters potentially involved in bone strength. Results: Mean BMDs of trochanteric region were not significantly different between groups, but mean BMDs of neck region were statistically significantly lower in the hip fractured group. Neck shaft angle and femur shaft width were the geometric parameters found to be significantly higher in the hip fractured group. The correlation between femur geometric and the anthropometric measurements was present only in the kontrol group. Conclusion: We concluded that besides femur geometric measurements, correlation between these measurements might be an important factors for the fracture risk. (From the World of Osteoporosis 2007;13:15-8

Türkiye'deki romatoid artritli hastaların özellikleri: Türkiye romatizma araştırma ve savaş derneği romatoid artrit kayıt sistemi sonuçları

Amaç: Bu çalışmanın amacı Türkiye’deki romatoid artrit hastalarının demografik ve klinik özelliklerini ortaya koyarak bu hastalar için oluşturulabilecek önlem, tedavi ve destek stratejilerine ışık tutmaktır. Hastalar ve yöntemler: Bu çalışma kapsamında Eylül 2007 - Mart 2011 tarihleri arasında Türkiye’nin farklı bölgelerindeki toplam 36 merkezden Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) kayıt sistemine kaydedilen 2.359 hasta (1.966 kadın, 393 erkek; ort. yaş 51.6±12.5 yıl; dağılım 18-75 yıl) değerlendirildi. Hastaların demografik ve klinik verileri kaydedildi. Hastalık aktivitesi, fonksiyonel durum ve radyografik hasar sırasıyla hastalık aktivite skoru 28, sağlık değerlendirme anketi ve van der Heijde modifiye Sharp puanlama yöntemi ile ölçüldü. Bulgular: Akademik eğitim süresi ortalama 5.2±3.8 yıldı ve hastaların %74.6’sı ev hanımıydı. Hastaların %91.0’ı biyolojik olmayan hastalık modifiye edici ilaçlar, %10.2’si biyolojik hastalık modifiye edici ilaçlar kullanıyordu. Ortalama hastalık aktivite skoru 28, sağlık değerlendirme anketi ve Sharp puanları sırasıyla, 4.0±1.4, 0.38±0.37 ve 31.2±57.1 idi. Hastaların %17.8’i remisyonda ve %14.1’i düşük hastalık aktivitesinde iken %42.7’si orta hastalık aktivitesinde ve %25.5’i yüksek hastalık aktivitesinde idi. Sonuç: Türkiye’de romatoid artrit hastalarının çoğunluğu orta yaşlı ev hanımlarıdır. Her ne kadar hastalık modifiye edici ilaç kullanımı yüksek oranda ise de hastaların büyük bölümü orta ve yüksek hastalık aktivite düzeyinde idi. Bu bulgular romatoid artritli hastaların tedavi gereksinimlerinin yeterli olarak karşılanmadığını düşündürmektedir.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. Results: The mean duration of academic education received was 5.2±3.8 years, and 74.6% of the patients were homemakers. Non-biological disease modifying anti-rheumatic drugs were used by 91.0% of the patients, while 10.2% used biological disease-modifying anti-rheumatic drugs. The mean Disease Activity Score 28, Health Assessment Questionnaire, and Sharp scores were 4.0±1.4, 0.38±0.37, and 31.2±57.1, respectively. Of the patients, 17.8% were in remission and 14.1% had low disease activity rates, while 42.7% and 25.5% had moderate and high disease activity rates. Conclusion: The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently

Türkiye'deki romatoid artritli hastaların özellikleri: Türkiye romatizma araştırma ve savaş derneği romatoid artrit kayıt sistemi sonuçları

Amaç: Bu çalışmanın amacı Türkiye’deki romatoid artrit hastalarının demografik ve klinik özelliklerini ortaya koyarak bu hastalar için oluşturulabilecek önlem, tedavi ve destek stratejilerine ışık tutmaktır. Hastalar ve yöntemler: Bu çalışma kapsamında Eylül 2007 - Mart 2011 tarihleri arasında Türkiye’nin farklı bölgelerindeki toplam 36 merkezden Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) kayıt sistemine kaydedilen 2.359 hasta (1.966 kadın, 393 erkek; ort. yaş 51.6±12.5 yıl; dağılım 18-75 yıl) değerlendirildi. Hastaların demografik ve klinik verileri kaydedildi. Hastalık aktivitesi, fonksiyonel durum ve radyografik hasar sırasıyla hastalık aktivite skoru 28, sağlık değerlendirme anketi ve van der Heijde modifiye Sharp puanlama yöntemi ile ölçüldü. Bulgular: Akademik eğitim süresi ortalama 5.2±3.8 yıldı ve hastaların %74.6’sı ev hanımıydı. Hastaların %91.0’ı biyolojik olmayan hastalık modifiye edici ilaçlar, %10.2’si biyolojik hastalık modifiye edici ilaçlar kullanıyordu. Ortalama hastalık aktivite skoru 28, sağlık değerlendirme anketi ve Sharp puanları sırasıyla, 4.0±1.4, 0.38±0.37 ve 31.2±57.1 idi. Hastaların %17.8’i remisyonda ve %14.1’i düşük hastalık aktivitesinde iken %42.7’si orta hastalık aktivitesinde ve %25.5’i yüksek hastalık aktivitesinde idi. Sonuç: Türkiye’de romatoid artrit hastalarının çoğunluğu orta yaşlı ev hanımlarıdır. Her ne kadar hastalık modifiye edici ilaç kullanımı yüksek oranda ise de hastaların büyük bölümü orta ve yüksek hastalık aktivite düzeyinde idi. Bu bulgular romatoid artritli hastaların tedavi gereksinimlerinin yeterli olarak karşılanmadığını düşündürmektedir.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. Results: The mean duration of academic education received was 5.2±3.8 years, and 74.6% of the patients were homemakers. Non-biological disease modifying anti-rheumatic drugs were used by 91.0% of the patients, while 10.2% used biological disease-modifying anti-rheumatic drugs. The mean Disease Activity Score 28, Health Assessment Questionnaire, and Sharp scores were 4.0±1.4, 0.38±0.37, and 31.2±57.1, respectively. Of the patients, 17.8% were in remission and 14.1% had low disease activity rates, while 42.7% and 25.5% had moderate and high disease activity rates. Conclusion: The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently