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Öğe A Cross-Sectional Study on Elevated Serum Calcitonin Gene-Related Peptide Levels in Rheumatoid Arthritis Patients and Their Relationship with Disease Activity(Aves, 2026) Akpinar, Merve Dede; Ataoglu, Safinaz; Cangur, SengulBackground/Aims: This study aims to assess serum levels of calcitonin gene-related peptide (CGRP) in patients with rheumatoid arthritis (RA), compare these levels with those of healthy controls, and analyze their correlation with disease activity. Materials and Methods: This cross-sectional, case-controlled study involved 80 individuals diagnosed with RA based on the American College of Rheumatology/The European Alliance of Associations for Rheumatology (ACR/EULAR) 2010 criteria and 40 healthy individuals serving as the control group. Demographic data, along with clinical and laboratory findings of the participants, were documented for analysis. C-reactive protein (CRP), CGRP, and erythrocyte sedimentation rate (ESR) levels were measured in both the RA and control groups. Disease activity among patients with RA was assessed using the Visual Analog Scale (VAS), Disease Activity Score-28 (DAS-28), and Health Assessment Questionnaire (HAQ). Logistic regression was performed to identify significant predictors, and the optimal cut-off value was established through receiver operating characteristic (ROC) analysis. Results: The median serum CGRP level in patients with RA (91.1 pg/mL) was significantly higher than that of the control group (40.8 pg/mL) (P < .001). The median serum CGRP level was significantly greater in seropositive patients with RA (118.7 pg/mL) compared to seronegative patients (66.1 pg/mL) (P = .017). The ROC analysis identified 61.78 pg/mL as the optimal CGRP cut-off to distinguish patients with RA from controls, with 70% sensitivity and 87.5% specificity (Area Under the Curve (AUC): 0.839, P < .001). A significant correlation was observed between CGRP levels in patients with RA and the scores of DAS-28, HAQ, VAS-Patient, and VAS-Physician (P = .001, P = .006, P < .001, P = .001). Logistic regression analyses demonstrated that increases in CGRP (P = .002) and CRP (P = .011), aswell as CGRP (P = .001) and ESR (P < .001), were each significantly associated with higher odds of active disease. Conclusion: The findings suggest that higher serum CGRP levels may contribute to the pathophysiology of RA, potentially indicating disease progression, joint damage, and supporting prognosis in the management of RA.Öğe AWARENESS AND APPROACHES OF FAMILY PHYSICIANS ABOUT CHRONIC PAIN(Dokuz Eylul Univ Inst Health Sciences, 2021) Sultanoglu, Tuba Erdem; Gamsizkan, Zerrin; Ataoglu, Safinaz; Sultanoglu, HasanPurpose: We aimed to investigate family physicians' awareness and approaches to chronic pain in its management. Methods: This study was planned as a descriptive, crosssectional study to investigate family physicians' awareness and approaches to chronic pain between September and November 2020.A questionnaire were used as data collection tools.The physicians sociodemographic characteristics, the number of registered patients, the percentage of patients with chronic pain, the status of participation in training activities on pain management, the most common cause of chronic pain, initial approach to chronic pain management were recorded. They were also questioned about the medical treatment option that they preferred for the treatment of patients with chronic pain, the most commonly demanded medication group by their patients and their practice of prescribing those medications, their views on traditional and complementary medicine, and the most effective treatment option for chronic pain. Results: 81 family physicians participated in the study. The mean age was 34.2 +/- 7.3.58% of the participants are women;42% of them were male.Half of the family physicians participating reported that low back pain was the most common cause of chronic pain. In our country, the responses given to the question about the most common causes of chronic pain were psychiatric problems and low back pain. Initial approach to a patient presenting with chronic pain, the most the physicians responsed 'I treat the patient'.66.7% of the physicians agreed with multidisciplinary approach. Conclusion: Developing algorithms for chronic pain management, structuring specialist training and planning continuous training after graduation will contribute significantly to increasing awareness of chronic pain.Öğe Duzce University Faculty of Medicine Department of Physical Medicine and Rehabilitation in the COVID-19 Pandemic Process(Duzce Univ, 2020) Sultanoglu, Tuba Erdem; Ataoglu, SafinazCOVID-19 is one of the extraordinary periods in Wuhan, China, which affect the whole world, and protective measures must be taken quickly. Coronavirus Disease (COVID-19) is a highly contagious disease that causes physical, psychological and widespread systemic dysfunction in patients, causing a rapid change in our social life. In this review, we aimed to explain the pandemic process in the Department of Physical Medicine and Rehabilitation.Öğe Electrophysiological evaluation of upper extremity entrapment neuropathies in rheumatic diseases(Lippincott Williams & Wilkins, 2025) Erdem Sultanoglu, Tuba; Ataoglu, SafinazSystemic inflammation in rheumatic diseases (RDs) can affect the peripheral nervous system, leading to neuropathic and myopathic complications. This study aimed to assess the frequency of upper extremity entrapment neuropathies in patients with RDs and identify associated predictive variables. A secondary objective was to highlight the role of electroneuromyography (ENMG) in early diagnosis and awareness about these issue. In this cross-sectional study, 102 patients diagnosed with RDs were evaluated. Demographic and clinical data, including disease duration, medications, joint involvement, and comorbidities, were recorded. Laboratory parameters such as rheumatoid factor, cyclic citrullinated peptide, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were recorded. Patients were referred for nerve conduction studies performed according to the American Academy of Neurology standards. Disease activity was measured using the Disease Activity Score 28 for rheumatoid arthritis (RA), Disease Activity Score for psoriatic arthritis (PsA), and European League Against Rheumatism Sj & ouml;gren Syndrome Disease Activity Index for Sj & ouml;gren syndrome. The frequency of carpal tunnel syndrome was 50% in RA, 47.4% in PsA, and 22.2% in Sj & ouml;gren syndrome patients. Additionally, 9.5% of RA patients had cubital tunnel syndrome. Positive ENMG findings were weakly correlated with age (r = 0.234; P = .018), RD (r = 0.221; P = .026), ESR (r = 0.216; P = .029), CRP (r = 0.229; P = .02), disease activity (r = 0.354; P < .001), and comorbidities (r = 0.229; P = .02). Moderate correlations were observed with disease duration (r = 0.432; P = .037) and the side affected by the lesion (r = 0.447; P < .001). In ordinal regression analysis, age and CRP had a nonsignificant positive effect on abnormal ENMG results. Disease duration, ESR, diagnosis (RA/PsA), disease activity, and comorbidities showed a nonsignificant negative effect on the likelihood of normal ENMG findings. The affected side was significantly associated with ENMG results; compared to bilateral involvement, right-sided neuropathy had a 1.5% and left-sided 4.3% chance of normal ENMG results. In RD patients with symptoms such as wrist or elbow pain, tingling, or numbness, peripheral neuropathies should be considered. ENMG is a critical tool for early diagnosis, as it offers detailed insights into lesion localization, severity, and prognosis.Öğe Evaluation of medication adherence and medication beliefs and their relation with quality of life in osteoporotic patients with and without vertebral fractures: a path analysis(Springernature, 2023) Sultanoglu, Tuba Erdem; Ataoglu, SafinazBackgroundOsteoporosis (OP) is a public health problem that causes morbidity and mortality with various complications, especially fractures, negatively affects quality of life (QoL) and creates an economic burden on society. The aim of this study was to investigate the relationships among medication adherence, medication beliefs, QoL in Turkish patients with OP.ResultsThe Medication Adherence Report Scale (MARS) total score was 17 in those with vertebral fractures and 18 in those without vertebral fractures. The total Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41) score was 48.7 in those with vertebral fractures and 35.1 in those without vertebral fractures. Visual analog scale (VAS) of pain scores showed a moderate correlation with every domain of the Qualeffo-41 scores (r = 0.401, r = 0.412, r = 0.391, r = 0.402, r = 0.380, r = 0.387 respectively, P = < 0.001). MARS total score, Beliefs about Medicines Questionnaire (BMQ), and Qualeffo-41 parameters were compared between patients with osteoporotic fractures and without fractures. In patients with a vertebral fracture, the patients Qualeffo-41 scores were higher with every domain and their QoL was more impaired (p < 0.001); but there were no significant differences between patients with osteoporotic fractures and without fractures in terms of MARS total score and BMQ domains. The pathway analysis results showed that general beliefs about drugs is associated with the physical function and social function of statistically significant and general overuse is associated with the pain (& beta; = 1.781; p < 0.001), and general health (& beta; = 1,832; p = 0.039). However, self-reported medication adherence and specific beliefs is not associated with the pain, physical function, social function, general health, and mental function (p > 0.05) of statistically significant.ConclusionsEnhancing positive medication beliefs are a promising approach to improve medication adherence, and in turn, improved diseases self management and better QoL, in OP patients.Öğe Investigation of incidental findings of temporomandibular joint disorders on brain magnetic resonance imaging in three-dimensional T2-weighted SPACE sequence performed for brain imaging(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2024) Samancı, Rümeysa; Ogul, Hayri; Gökce, Ayşe; Kaya, Abdulkadir; Ataoglu, SafinazObjectives: The study aimed to determine the temporomandibular joint (TMJ) findings, to investigate the prevalence contribution of this sequence on cases in which cranial magnetic resonance examination was performed and three-dimensional (3D) T2-SPACE (T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions) sequence was used by retrospectively scanning the magnetic resonance imaging (MRI) archive of our hospital, and to reveal the advantages of the 3D-T2 SPACE sequence in patients with TMJ disorders. Patients and methods: The cross-sectional retrospective study was conducted with 499 patients (289 females, 210 males; mean age: 50.1 +/- 17.7 years; range, 8 to 92 years) who underwent brain MRI and had 3D-T2 SPACE between March 1, 2021 and March 1, 2022. Two radiologists analyzed the TMJs of the subjects included in the study in 3D-T2 SPACE sequences. Results: At least one incidental finding was detected in the TMJ in 37.1% (n=185) of the patients included in our study. In our study, the most common (13.6%) MRI findings were osteoarthritic changes and synovial cysts. Joint effusion (13.2%) and disc displacement (9%) were less frequent. When the relationship between the age of the patients and the presence of incidental findings, degeneration, effusion, disc displacement, and cyst was examined, the age of the patients with incidental findings (p=0.001) and osteoarthritic changes (p<0.001) was statistically significantly higher. Conclusion: Incidental findings, particularly osteoarthritic changes and synovial cysts, can be seen quite commonly in the TMJ in brain MRI using 3D T2-SPACE sequences in the general population. The 3D T2-SPACE sequence provides valuable information in the recognition of TMJ disorders.Öğe Investigation of the effect of subacromial corticosteroid injections on intraocular pressure(Lippincott Williams & Wilkins, 2023) Engin, Onur; Engin, Ceren Durmaz; Samanci, Rumeysa; Teberik, Kuddusi; Ataoglu, SafinazBackground:Subacromial corticosteroid injection is one of the most commonly used procedures to treat subacromial impingement syndrome. Despite their significant efficacy, corticosteroids have several serious adverse effects, including increased intraocular pressure (IOP) and visual loss. The purpose of this study is to determine the effect of subacromial corticosteroid injections on IOP.Materials and Methods:42 patients with impingement syndrome, who received subacromial corticosteroid injection, were included in the study. Patients received a single dose of betamethasone. IOP was monitored using a tonometer prior to injection, 24 hours after injection, and one week following injection.Results:The average age of the patients was 52.1 +/- 9.0, and 31 (74%) of them were female. Patients' mean IOP values were 16.0 +/- 2.6 mmHg, 16.4 +/- 2.4 mmHg, and 16.1 +/- 2.31 mmHg before injection, one day after injection, and one week after injection, respectively. Repeated ANOVA tests revealed no statistically significant difference between the three measurements (P=0.386). Age, gender, history of diabetes, and history of hypertension didn't have a significant effect on IOP change after corticosteroid injection. Those with a family history of glaucoma had a significantly greater increase in IOP on day 1 post-injection than those without (P=0.05).Conclusions:This is the first study to examine the effect of subacromial corticosteroid injections on IOP change. While a single subacromial steroid injection has no statistically significant effect on IOP change, care should be taken, particularly in susceptible individuals and those who need repeated injections.Öğe A Rare Condition in the Differential Diagnosis of Arthritis, Preiser's Disease: A Case Report and Review of the Literature(Knowledge E, 2025) Sultanoglu, Tuba Erdem; Bozkurt, Gokce Gizem; Ataoglu, SafinazChronic wrist pain is a common clinical condition that negatively affects daily activities. Many diseases are involved in the etiology of chronic wrist pain. Identification of specific causes of pain increases treatment success and prevents disability. Detailed evaluation and necessary imaging methods for differential diagnosis of multiple clinical entities with similar history and examination findings are essential for accurate diagnosis and treatment success. Avascular necrosis is a progressive disorder resulting in partial or complete death of bone tissue cells due to impaired blood circulation of the bone, usually caused by nontraumatic or idiopathic etiology. Preiser's disease, avascular necrosis of the carpal scaphoid, is a rare disorder generally occurring on the dominant side and in women. This case report presents an uncommon disease that should be considered in the differential diagnosis while searching for the etiologic cause of chronic wrist pain.Öğe Relationship between Serum Homocysteine Levels and Disease Activity in Patients with Fibromyalgia(Duzce Univ, Fac Medicine, 2025) Samanci, Rumeysa; Akpinar, Merve Dede; Samanci, Volkan Murat; Ataoglu, Safinaz; Sultanoglu, Tuba ErdemObjective: Fibromyalgia syndrome (FMS) is a rheumatic disorder characterized by a wide spectrum of symptoms. Elevated homocysteine (Hcy) levels have been associated with a variety of conditions including renal dysfunction, cardiovascular disease, vitiligo, cancer, diabetes, ischemic stroke, epilepsy, dementia, autism, and various neurological disorders. This retrospective study aimed to evaluate the role of Hcy in the etiology of FMS and its relationship with disease activity. Method: This study included 42 female patients diagnosed with FMS according to the American College of Rheumatology 2010 criteria, along with 20 age-matched healthy female controls. Detailed medical history and sociodemographic data were collected from all participants. Hemogram, routine biochemical tests, vitamin B12, folic acid, thyroid function tests, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), 25-hydroxy vitamin D, and serum Hcy levels were recorded from medical files in both groups. Results: Serum Hcy, CRP, and ESR levels were significantly higher in the FMS group compared to controls (p=0.003, p=0.004, and p=0.011, respectively). However, no statistically significant correlation was found between Hcy levels and Fibromyalgia Impact Questionnaire, Visual Analog Scale, Beck Depression Inventory, Pittsburgh Sleep Quality Index, or Short Form-36 scores. Conclusions: FMS is a complex disease with an unclear etiology. Considering that FMS affects multiple systems and that Hcy plays a role in various physiological processes, further comprehensive studies are warranted to elucidate the relationship between FMS and Hcy.Öğe Retinal microvascular changes in patients with ankylosing spondylitis receiving biologic therapy: a cross-sectional OCTA study(Bmc, 2026) Samanci, Rumeysa; Meydan, Bayram; Teberik, Kuddusi; Meydan, Sumeyye Ucar; Ataoglu, SafinazBackground To evaluate retinal microcirculation in biologic-treated ankylosing spondylitis (AS) using optical coherence tomography angiography (OCTA) and its association with disease activity. Methods Fifty-seven AS patients (31 active, 26 inactive) under biologic therapy and 57 age- and sex-matched healthy controls were included. Right eyes underwent 10 degrees & times;10 degrees macular OCTA imaging (Heidelberg Spectralis). Vessel area density (VAD), foveal avascular zone (FAZ) metrics, and vessel density within a 300-& micro;m-wide ring surrounding the FAZ (FD-300) were quantified for the superficial and deep vascular complexes (SVC and DVC). Structural OCT provided foveal and parafoveal retinal thickness, peripapillary retinal nerve fiber layer (RNFL), and subfoveal choroidal thickness. Biologic therapy details and disease activity indices (Ankylosing Spondylitis Disease Activity Score-C-reactive protein [ASDAS-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI]) were obtained from records. OCTA and structural parameters were compared among active AS, inactive AS, and control groups. Results Parafoveal SVC VAD was reduced only in the active AS group (p = 0.007), whereas DVC total/parafoveal VAD and FD-300 values were lower in both AS groups compared with controls (all p < 0.01). Retinal thickness, RNFL, and choroidal thickness were similar across groups (all p > 0.05). For distinguishing AS patients from controls, DVC metrics showed the highest performance (AUC approximate to 0.70-0.73; 0.63 for SVC), while the combined model including age, sex, and OCTA parameters achieved an AUC of 0.77. For differentiating disease activity, DVC-FAZ alone showed limited performance (AUC = 0.67). A parsimonious multivariable model including age, sex, BASFI, and DVC FAZ area yielded an AUC of 0.88 (95% CI: 0.80-0.97). Conclusions In AS patients receiving biologic therapy, retinal microcirculatory alterations were detected-particularly within the DVC-while retinal and choroidal structural measurements appeared to remain largely preserved. Further studies are warranted to confirm these findings.Öğe The Relationship Between Lipid Levels And Bone Mineral Density in Postmenopausal Women(Düzce Üniversitesi, 2010) Çalık, Yalkın; Yazıcı, Selma; Baş, Ersun; Ataoglu, SafinazObjective: The aim of this study is to investigate the relationship between lipid levels and bonemineral density in postmenopausal womenMethods: We studied 276 postmenopausal women aged 45- 65 years (mean 54 years) whoattended Duzce University faculty of medicine physical medicine and rehabilitation polyclinic.Bone mineral density in the lumbar spine and femur neck were measured by dual energy X-rayabsorptiometry. Serum cholesterol, lipoproteins and triglyceride were assessed on a bloodsample obtained after a 12-hour fast. All participants were given a questionnaire to answer onvarious risk factors for osteoporosis. Participants who reported the use of hormone replacementtherapy and lipid lowering therapy were excluded. Statistically significant associations werefound by SPSS 11.0 and p0,05)higher body mass index is associated with higher bone mineral density at femur neck and lumbarspine (both p values
