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    Assessment of Temperament and Character of Rheumatoid Arthritis Patients
    (Georg Thieme Verlag Kg, 2015) Gokmen, F.; Altinbas, K.; Akbal, A.; Celik, M.; Resorlu, H.; Gokmen, E.; Savas, Y.
    Objective: It is widely known that perception of disease affects clinical course and treatment response in patients with rheumatoid arthritis (RA). In this study we aim to define temperament and character properties of RA patients and to discuss the relation between these specific temperament and character properties and clinic variables. Methods: Study involved 93 RA patients. Temperament and character properties of patients were evaluated using Temperament and Character Inventory. Associations of clinical variables and specific temperament characteristics were evaluated using correlation and association analyses. Approval was obtained from institutional ethical commitee. Results: 74 (79.6 %) of study subjects were females and 19 (20.4 %) were males. Mean age of the patients was 53.3 +/- 11.5 years. There wasn't any difference between sociodemographic and clinical variables and temperament scores of patients according to gender (p > 0.05). Comparison of temperament features and clinical variables showed that there was a weak correlation between harm avoidance and Anticitrullinated Peptide Antibodies (p = 0.04, r = 0.22) and between reward dependance and Disease Activity Score (DAS 28). Regression analysis showed an association between reward dependance and DAS-28. Conclusion: Our findings indicated that there is an association between harm avoidance and reward dependance temperament properties of RA patients and disease activation, and disease course is more severe in patients who have high scores in these temperament dimensions. Therefore, adding assessment of temperament and character properties will help clinicians while evaluating treatment compliance and motivation of patients at initial and later stages of disease.
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    Evaluation of the temperament and character properties of patients with ankylosing spondylitis
    (Springer Heidelberg, 2014) Gokmen, F.; Altinbas, K.; Akbal, A.; Celik, M.; Savas, Y.; Gokmen, E.; Resorlu, H.
    Purpose. The aim of this study was to evaluate temperament and character of ankylosing spondylitis (AS) patients and to examine the association between these specific temperament and character properties and clinical variables. Patients and methods. This study involved 73 AS patients. Temperament properties of patients were evaluated using Cloninger's Temperament and Character Inventory (TCI). Association between clinical variables and specific temperament features were evaluated using correlation and regression analyses. Results. Forty eight (65.8%) of the study participants were men and the mean age was 42+/-11.4 years. There was slight negative correlations between self directedness (S) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores (p=0.01, r=-0.30), and between the Visual Analog Scale (VAS) and reward dependence (RD) scores (p=0.03, r=-0.26). Regression analysis showed that correlations between BASDAI and S, and between VAS and RD scores were statistically significant. Conclusion. Our study showed that the dimensions temperament and character are related to disease activation, and disease course is more severe in patients who have low scores in these TCI dimensions. Therefore, we suggest that evaluating temperament and character properties of AS patients will help clinicians to predict treatment compliance and motivation of patients during disease course.
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    The level of termination of the dural sac by MRI and its clinical relevance in caudal epidural block in adults
    (Springer France, 2013) Senoglu, N.; Senoglu, M.; Ozkan, F.; Kesilmez, C.; Kizildag, B.; Celik, M.
    Caudal epidural block (CEB) is a reliable and effective technique commonly used in pain practice. Having accurate knowledge of sacral anatomy and its anatomical variations is very important for avoiding complications, especially as may occur during dural puncture. This study was undertaken to delineate the anatomical features of the sacrococcygeal region relevant to dural sac (DS) puncture. We reviewed magnetic resonance (MRI) images of 1,000 adult patients to determine of the level of termination of the DS, the distance between the upper margin of the sacrococcygeal membrane and the DS, and the presence of incidental dural cystic lesions. Each sacral vertebra was divided into three equal portions (upper, middle, and lower thirds), was defined as a separate region. The level (26.7 % of all patients) of termination of the DS was most commonly the upper one-third of S2. The DS terminated below the 3rd sacral vertebra in 0.1 % of all patients. No posterior sacral meningocele was seen, but 13 (1.3 % of all patients) had a sacral Tarlov cyst. In three of 13 patients (23 %), the Tarlov cysts terminated below 3rd sacral vertebra level (0.3 % of all patients). Knowledge of the level of termination of the DS, the distance between the upper margin of the sacrococcygeal membrane and the DS, and the presence of Tarlov cysts on MRI images of before CEB is very important and might decrease the risk of dural puncture.