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Background:: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes.Objective:: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis.Study Design:: Randomized controlled trial.Methods:: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force.Results:: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints ( p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores ( p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values ( p > 0.05).Conclusion:: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements.Clinical Relevance: Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice. [ABSTRACT FROM AUTHOR]

Background/aim: Systemic sclerosis (SSc) is an autoimmune disease characterized by microvascular injury, excessive extracellular matrix deposition, and fibrosis in the skin and internal organs. Bacterial and viral infectious agents have been suspected to be contributing factors in the development and progression of the pathologic features of SSc. Materials and methods: In this study, 30 SSc patients who were admitted to the rheumatology unit of the Konya Training and Research Hospital and 30 healthy controls were included. The presence of 9 different antibodies (IgM and IgG) against Helicobacter pylori, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and parvovirus B19 were investigated in sera samples obtained from the 60 participants using an enzyme-linked immunosorbent assay method. The characteristics of current and past infections with H. pylori, CMV, EBV, and parvovirus B19 were evaluated by determining the seropositivity of the tested bacterial and viral agents. Results: The prevalences of H. pylori, CMV, EBV, and parvovirus B19 were determined to be higher in patients with SSc than in the control group. Conclusion: SSc is associated with a higher rate of certain infections, which deserves further investigation in order to assess the role of infections in disease etiology/pathogenesis. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population.The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle).RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses.CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Rheumatology is the property of Turkish League Against Rheumatism / Turkiye Romatizma Arastirma ve Savas Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Polyarthritis and panniculitis can be the presenting manifestations of pancreatitis. Early recognition of this triad is critical because of the high mortality rate from pancreatic disease when the diagnosis is delayed. Although this association can be seen at any age, its frequency peaks around the fifth decade of life. We report this case because of the rarity of the association and the high morbidity and mortality in these patients. [ABSTRACT FROM AUTHOR]

Objective: In recent years, increasing attention has been given to the role of reactive oxygen metabolites in the pathogenesis of inflammatory diseases such as rheumatoid arthritis (RA). The aim of this study was to elucidate plasma and especially erythrocyte oxidant and antioxidant status in RA patients and to assess the relationship between disease activity scores (evaluated by Disease Activity Score (DAS) 28 as mild, moderate and severe) and antioxidant status. Materials and Methods: Fasting blood samples were obtained from 50 RA patients and 26 control subjects. DAS28 was used to evaluate the activity. Plasma and erythrocyte levels of malondialdehyde (MDA), xanthine oxidase (XO) and superoxide dismutase (SOD) were investigated in both groups. Results: The plasma levels of MDA and XO and erythrocyte levels of MDA and SOD were significantly higher in RA patients than in control subjects. Although increases in plasma MDA levels in mild and moderate and erythrocyte MDA levels in mild activity groups of RA were not significant (p>0.05), plasma MDA levels in severe (p=0.001) and erythrocyte MDA levels in moderate and severe activity groups of RA were significantly higher (p<0.001). Whereas plasma SOD levels showed no significant change (p=0.241), erythrocyte SOD levels were significantly increased in RA patients (p<0.001). Although increase in erythrocyte SOD activity in mild RA was not significant, it was significant in moderate and severe RA (p=0.002 and p<0.001, respectively). Conclusion: These results suggest that increased plasma and erythrocyte MDA levels in RA patients, especially in those with severe activity, indicate an increased oxidative stress due to inflammation. Nonetheless, an increase particularly in erythrocyte SOD activity in moderate and severe RA patients suggests that the cellular antioxidant system might counterbalance the oxidant status in RA patients. [ABSTRACT FROM AUTHOR]

Copyright of Romatizma/Rheumatism is the property of Turkish League Against Rheumatism / Turkiye Romatizma Arastirma ve Savas Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Fibromyalgia (FM) is a nonarticular rheumatic disorder with an unknown etiology which is characterized by diffuse musculoskeletal pain, tenderness on specific anatomical points and psychological discomfort. There isn't any standardized treatment regime. In recent years some nonpharmacological applications have been come in prominence. These are, hydrotherapy, balneotherapy and massage. In this study, we compared effectiveness and side effects of amitriptyline and hydrotherapy which were used in the treatment of fibromyalgia. Patients and Methods: A total of 51 female patients with FM were included. They were randomly divided into two groups. Group 1 (n=20) took 15 session hydrotherapy along three weeks, group 2 took (n=31) 10 mg/day amitriptyline for eigth weeks. Both groups were examined at the beginning and at the end of the treatment, third and sixth month. The number of tender points (NTP) were evaluated by digital pressure. Likert scoring system were used to assess pain intensity, morning stiffness, skin sensitivity, sleep disturbances, fatigue and muscle spasm. Hamilton Depression Scale (HDRS) and Fibromyalgia Impact Questionnaire (FIQ) were used to evaluate psychologic condition and physical and functional capacity, respectively. Results: In group 2, significant improvement was found in pain, sleep disturbance, fatigue, NTP, FIQ and HDRS values at the end of the treatment. In group 1 significant improvement was obtained in all measurements except skin sensitivity and HDRS. This improvement prolonged up to 3 months in pain, morning stiffness, fatigue, NTP and FIQ. When the two groups were compared there was a significant improvement in hydrotherapy group in pain, sleep disturbance and FIQ at the end of the treatment. Conclusion: Effectiveness of hydrotherapy is more and longer than amitriptyline. When the adverse effects of tricyclic antidepressants are considered, it will be useful to prefer any regimen which has no advers effect. (Rheumatism 2007; 22: 91-6). [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey., Methods: Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria., Results: A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) ( p  < .002), fatigue ( p  < .001), ESR ( p  < .001), DAS28 ( p  < .001), BASDAI score ( p  < .001), PsAQoL ( p  < .001), HAQ score ( p  < ,01), HAQ-S score ( p  < .001), anxiety ( p  < .001), depression ( p  < .024), FACIT ( p  < .001) and FiRST ( p  < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better ( p  < .001) and PASI score ( p  < .005) were statistically worse in male patients than in female patients with axial involvement., Conclusion: This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.

Objectives: 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., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Objectives: 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., Patients 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., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.