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  • Küçük Resim
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    ANKİLOZAN SPONDİLİTLİ HASTALARDA NÖROPATİK AĞRININ HASTALIK AKTİVİTE SKORLARI İLE İLİŞKİSİ VE ANTİ- TNF? KULLANIMININ ETKİSİ
    (2021) Kimyon, Gezmiş; Güneş, Ümran Gezici; Gümüşay, Meryem; Karadağ, Mehmet; Bay, Feyyaz; Melek, İsmet Murat
    AMAÇ: Bu çalışmada ankilozan spondiliti olan hastalarda nöropatik ağrının hastalık aktivite indekslerine etki edip etmediği ve aynı zamanda tedavide kullanılan anti-TNF? gibi ajanların bununla ilişkili olup olmadığını araştırmayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya modifiye New York kriterlerine göre ankilozan spondilit tanıs konan 98 hasta ve yaş ve cinsiyet uyumlu 99 sağlıklı kontrol alındı. Her iki grupta nöropatik ağrı painDETECT skorlamasına göre yapıldı. Ankilozan spondilit hastalarının hastalık aktiviteleri BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), BASFI (Bath ankylosing spondylitis functional ındex), VAS ağrı (Visual Analog Scale) ve Leeds entezit indeksi ile değerlendirildi. Ayrıca herikigrubaHAQ(HealthAssesmentQuestionnaire)veBeckdepresyon ölçeği uygulandı. Ayrıca ankilozan spondilit hastaları anti-TNF? ilaç kullanan ve kullanmayan şeklinde iki grup olarak karşılaştırıldı. BULGULAR: PainDETECT hasta grubunda kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksekti. Ankilozan spondilit grubunda ortalama painDETECT 22,10 kontrol grubunda ise 9,95 idi (p<0,001). Hasta grubunda VAS, HAQ ve Beck depresyon ölçeği kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek saptandı. Anlilozan spondilit hastaları anti-TNF? ilaç kullanan ve kullanmayan olarak incelendiğinde painDETECT ile anti-TNF? kullanmak arasında istatistiksel anlamlı bir fark saptanmadı. Anti- TNF? kullanan grupta painDETECET ortalama 20,30 kullanmayan grupta 17,80 (p=0,135) idi. Kolerasyon analizi yapıldığında ise painDETECT ile BASDAI, VAS ağrı ve Beck depresyon ölçeği arasında orta düzeyde pozitif yönde kolerasyon saptandı. SONUÇ: Ankilozan spondilitte nöropatik ağrı hastalık aktivite göstergeleri ile paralellik gösterir. Dolayısıyla nöropatik ağrı nedeniyle AS hastalık aktivitesinin yüksek saptanması, AS için verilecek aşırı tedavinin önüne geçebilir.Anti-TNF? ilaçlar ile nöropatik ağrı arasında herhangi bir ilişki saptamadık.
  • [ N/A ]
    Öğe
    Covid-19 and rheumatic diseases
    (Duzce University Medical School, 2020) Kimyon, Gezmiş; Duman, Taşkın
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19. © 2020, Duzce University Medical School. All rights reserved.
  • Küçük Resim
    Öğe
    COVID-19 and rheumatic diseases
    (Düzce Üniversitesi, 2020) Kimyon, Gezmiş; Duman, Taşkın
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19.
  • [ N/A ]
    Öğe
    CPPD-related pseudoneuroarthropathy in a patient with myelodysplastic syndrome
    (Galenos Publishing House, 2022) Pekdiker, Mete; Kimyon, Gezmiş
    The calcium pyrophosphate deposition (CPPD) disease is a common form of crystal arthropathy. It usually affects elderly patients. The clinical and radiological features of CPPD vary widely, so CPPD is a great mimicker of other musculoskeletal conditions. Asymptomatic and destructive forms can present at the same time in the same patients. Several diseases have been proposed to be related to CPPD, but hematologic disorders have not been reported to occur concurrently. Charcot arthropathy (CA) is associated with neuropathy and is characterized by erosive joint disease. Here, we report an interesting CPPD case presenting as pseudo-CA in a patient with myelodysplastic syndrome. © 2022 by the Turkish Society for Rheumatology / Journal of Turkish Society for Rheumatology published by Galenos Publishing House.
  • Küçük Resim
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    CPPD-related pseudoneuroarthropathy in a patient with myelodysplastic syndrome
    (2022) Pekdiker, Mete; Kimyon, Gezmiş
    The calcium pyrophosphate deposition (CPPD) disease is a common form of crystal arthropathy. It usually affects elderly patients. The clinical and radiological features of CPPD vary widely, so CPPD is a great mimicker of other musculoskeletal conditions. Asymptomatic and destructive forms can present at the same time in the same patients. Several diseases have been proposed to be related to CPPD, but hematologic disorders have not been reported to occur concurrently. Charcot arthropathy (CA) is associated with neuropathy and is characterized by erosive joint disease. Here, we report an interesting CPPD case presenting as pseudo-CA in a patient with myelodysplastic syndrome.
  • [ N/A ]
    Öğe
    Factors associated with frequency and severity of COVID-19 in patients with axial spondyloarthritis
    (Pamukkale University, 2023) Pekdiker, Mete; Kara, Mete; Koç, Emrah; Kimyon, Gezmiş
    Purpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in managing rheumatic diseases during the pandemic; therefore, we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials and methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa-associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% of them had ankylosing spondylitis, 35.5% had non-radiographic axSpa, and 59.4% of patients were treated with a biologic agent. The frequency of COVID-19 was 23% (n:192); only five patients (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high-resolution computed tomography (HRCT) (p:0.02, p:0.01, and p<0.001). In hospitalized individuals, female gender, HT, DM, and disease lasting longer than 10 years were significantly higher (p:0.03, p:0.011, p<0.001, and p:0.014). Only DM was found as an independent risk factor for both pulmonary involvement in HRCT (p:0.029) and hospitalization (p:0.001). Conclusion: We conducted our study with a homogenous study population and our results suggested that biological agents did not affect poor COVID-19 outcomes; only DM was associated with a more severe COVID-19 course in patients with axSpa. © 2023, Pamukkale University. All rights reserved.
  • Küçük Resim
    Öğe
    Factors associated with frequency and severity of COVID-19 in patients with axial spondyloarthritis
    (2023) Pekdiker, Mete; Kara, Mete; Koç, Emrah; Kimyon, Gezmiş
    Purpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in managing rheumatic diseases during the pandemic; therefore, we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials and methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa-associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% of them had ankylosing spondylitis, 35.5% had non-radiographic axSpa, and 59.4% of patients were treated with a biologic agent. The frequency of COVID-19 was 23% (n:192); only five patients (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high-resolution computed tomography (HRCT) (p:0.02, p:0.01, and p<0.001). In hospitalized individuals, female gender, HT, DM, and disease lasting longer than 10 years were significantly higher (p:0.03, p:0.011, p<0.001, and p:0.014). Only DM was found as an independent risk factor for both pulmonary involvement in HRCT (p:0.029) and hospitalization (p:0.001). Conclusion: We conducted our study with a homogenous study population and our results suggested that biological agents did not affect poor COVID-19 outcomes; only DM was associated with a more severe COVID-19 course in patients with axSpa.
  • Küçük Resim
    Öğe
    Romatoid Artrit Tanısı Almış Bireylerde Serum D Vitamini Seviyelerinin Hastalık Aktivitesi İle İlişkisi: Retrospektif Bir Çalışma
    (2021) Gürün, Enes; Kimyon, Gezmiş; Ayık, Derya Bıçak
    Amaç: Bu araştırmanın amacı, romatoid artrit tanısı almış bireylerde serum D vitamini seviyelerinin hastalık aktivitesi üzerindeki etkisini saptamaktır. Materyal ve Metod: Tanımlayıcı, kesitsel ve retrospektif olarak planlanan bu çalışma, Ekim 2019- Mart 2020 tarihleri arasında 337 romatoid artritli bireyin medikal dosyaları incelenerek tamamlandı. Araştırmaya, Romatoloji polikliniğinde takip edilen, hekim tarafından romatoid artrit tanısı konmuş ve en az 1 yıldır romatoid artrit rahatsızlığı olan bireyler dahil edildi. Veriler, araştırmacılar tarafından oluşturulan “Sosyodemografik ve Laboratuvar Tahlil Formu” ve “Hastalık Aktive Skoru-28” kullanılarak elde edildi. Verilerin analizi tanımlayıcı istatistikler, Kruskal Wallis ve Mann-Whitney U testi ile Sperman korelasyon analizi ile yapıldı. Bulgular: Araştırmaya katılan 337 romatoid artritli bireyin %83,4’ü kadın, yaş ortalaması 54,38±13,0, hastalık yılı ortalaması 4,08±3,67 ve hastalık akivitesi skor ortalaması 3,14±0,82 idi. Bireylerin %73,3’ünün D vitamini seviyesi ?20 ng/mL’nin altındaydı. Romatoid artritli bireylerin D vitamini seviyesi ile yaş değişkeni arasında pozitif yönde zayıf bir ilişki, hastalık aktive skoru ile negatif yönde zayıf bir ilişki olduğu belirlendi (p<0,05). Sonuç: Bu çalışmada romatoid artritli bireylerin büyük çoğunluğunda D vitamini eksikliği ve yetersizliği olduğu saptanmıştır. Romatoid artritli bireylerin D vitamini seviyelerinin değerlendirilip eksikliğin giderilmesine yönelik girişimlerin yapılması önerilmektedir.