Araştırma Çıktıları | TR-Dizin | WoS | Scopus | PubMed
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Item Radiographic Ischial Enthesopathy in Patients with Psoriatic Arthritis(2022) Bitik, Berivan; Dalgic, Gunay Sahin; Kanbur, Aysenur Yalcintas; Ok, Mehtap Akcil; Yucel, Ahmet Eftal; https://orcid.org/0000-0001-5803-915X; AAI-9195-2021Background To investigate the prevalence of radiographic ischial entheseal lesions in patients with psoriatic arthritis (PsA) compared to patients with rheumatoid arthritis (RA). Patients and Methods Thirty-eight patients with PsA and 46 patients with RA were included. Anteroposterior radiographs of the pelvis and lateral foot were evaluated for entheseal lesions. The following entheseal sites were reviewed: os ischium, bilateral Achilles tendon and inferior calcaneus. Abnormalities such as cortical erosions and enthesophytes (irregular bony proliferation) were recorded. Results The frequency of enthesopathic changes in the ischial region was found to be statistically significantly higher in PsA patients compared with RA patients (50 and 28.3%, respectively, p=0.04). Enthesopathic changes of the calcaneus and Achilles tendon also occurred more frequently in PsA patients than in RA patients. Conclusion Radiographic entheseal lesions in the ischial region are more prevalent in PsA patients compared with RA patients with symptoms in that region. Furthermore, such enthesopathic changes in the ischium are observed as frequently as changes in the Achilles tendon. These findings regarding structural entheseal lesions in the pelvic region contribute to the knowledge of entheseal involvement in PsA.Item Effect of subcutaneous high-dose methotrexate treatment on the management of rheumatoid arthritis(2021) Tufan, Muge Aydin; Ersozlu, Emine Duygu; Koseoglu, Hamide Kart; Yucel, Ahmet EftalPurpose: Methotrexate (MTX) is still the main treatment option for rheumatoid arthritis (RA). There is no consensus on drug administration routes and dosage when administered alone or in combination with other drugs. This study aims to identify the effects of early administration of a combination therapy containing high dose subcutaneous (SC) MTX on RA management. Materials and Methods: Forty-five patients with RA who newly diagnosed were divided into two groups randomly. The patients who took 12.5 mg SC MTX per week in the first 4 weeks defined as a "low dose group". The patients who took 25 mg SC MTX per week in the first 4 weeks defined as a "high dose group". Then, patients of both groups continued with 12.5 mg oral MTX per week. Clinical and laboratory findings, disease activity scores and response rates of the patients were recorded at the beginning, 3rd months and 6th months. Results: There was no significant difference between the two groups at 3rd month's values. There were statistically significant improvements at 6th month's values. Values were as follows in low and high dose groups: mean DAS28-CRP (3.5 vs 2.7), VAS pain score (3.3 vs 1.6), and TJC28 (3 vs 1.5), respectively. Conclusion: Early administration of high-dose SC MTX effectively controls disease activity and increases the quality of life in RA patients.Item The effectiveness of intra-articular bleomycin versus methotrexate in a chronic synovitis model(2020) Maralcan, Gokhan; Inan, Ulukan; Kuru, Ilhami; Aktepe, Fatma; Isik, Cengiz; 0000-0002-1268-1451; AAJ-4341-2021Objective: To compare the effectiveness of methotrexate which was proven to be effective for rheumatoid arthritis and bleomycin in a synovitis model. Our aim was to show whether bleomycin could be used for chemical synovectomy purposes. Design: Experimental study Setting: Department of Orthopedics and Traumatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey Subjects: Fifteen mature New Zealand rabbits were studied. Synovitis was induced by repeated injections of lambda carrageenan. Interventions: Knees of the subjects were grouped as sham, bleomycin and methotrexate. After synovitis occurred, sterile saline injected knees formed the sham group, bleomycin and methotrexate injected knees composed the study groups. In the 9th week of the study, animals were euthanised. Standard specimens were harvested from all knees. Immunoperoxidase staining was performed. Main outcome measures: The intensity of synovitis was evaluated with thickness of the synovial cell layers, intensity of inflammatory infiltrate and iNOS expression in cells. Results: Thickness of the synovial cell layers was greater in the sham group than in the study groups (p<0.05). Intensity of inflammatory infiltrate, lymphoplasmacytoid infiltrate, and histiocytes in the sham group were greater than in the study groups (p<0.05). iNOS expression in histocytes and plasma cells was significantly decreased in the study groups compared to sham operated group (p<0.05). There was no statistically significant difference between bleomycin and methotrexate groups with respect to synovial cell layer thickness and lymphoplasmacytoid infiltrate. Conclusions: According to these results, intraarticular bleomycin seems as effective as methotrexate in experimental synovitis model.Item Anti-Tumor Necrosis Factor Alpha Treatment and Tuberculin Skin Test(2015) Bozkirli, Emine Duygu Ersozlu; Tufan, Muge Aydin; Ozisik, Lale; Sen, Nazan; Yucel, Ahmet EftalPurpose: The use of anti-tumor necrosis factor alpha (anti-TNF) drugs has been a milestone in the treatment of rheumatic diseases. Despite their strong efficacy, there are some factors restricting the use of anti-TNF agents. We must be careful especially for the granulomatous diseases which can be seen endemic in our country such as tuberculosis and leishmaniasis. In our country according to the RAED 2005 Consensus Meeting Reports, patients candidate for anti-TNF treatment are evaluated for both active and inactive tuberculosis before treatment and prophylaxis with isoniazid (INH) has been performed where indicated. Material and Methods: Tuberculin skin tests (TST) of 43 patients followed up in the Rheumatology Clinic and receiving anti-TNF therapy were repeated under treatment. Patients' pretreatment first TST results, drugs they used, INH prophylaxis state, smoking status and the duration of anti-TNF treatment were evaluated. Results: 14 patients (32.6%) were women, while 29 (67.4%) were men. The mean of first TST values were 11.72 +/- 90.3 mm (0-30) and the mean of second TST values were 12.06 +/- 12.4 mm (0-45). 48.8% of the patients were smoking and 74.4% of the patients had received INH prophylaxis for 9 months. The mean total duration of anti-TNF drug use was found as 22.67 +/- 19.11 (5-68) months. No statistically significant difference (p=0.888) was observed between the first pretreatment and second under treatment TST results of the patients. Discussion: Tuberculosis remains to be a serious public health problem for both our country and the whole world. For this reason in our country, a detailed assessment is performed for all patients before anti-TNF treatment. In our study patients who are planned to start anti-TNF therapy were assessed with their first TST values and INH prophylaxis were given to 32 patients (74.4%) before treatment. No statistically significant difference was observed between pre and post-treatment TST values when control TST were performed with the earliest after five months of treatment. These findings may suggest that there is no evident increase in the risk of tuberculosis for patients receiving anti-TNF treatment with appropriate INH prophylaxis.