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Uzuner B, Ketenci S, Durmus D, Atay HM. The frequency of sarcopenia in haemophilia patients: Effects on musculoskeletal health and functional performance. Haemophilia 2024; 30:505-512. [PMID: 38353986 DOI: 10.1111/hae.14945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION In patients with haemophilia A, chronic arthropathy develops over time as a result of recurrent joint bleeds, which leads to restricted mobility and disability in the affected joints. There are limited studies in the literature evaluating sarcopenia in patients with haemophilia. The present study aims to determine the prevalence of sarcopenia in severe haemophilia-A patients and to evaluate musculoskeletal health and functional performance. METHODS Thirty haemophilia-A patients and 26 adult male volunteers were enrolled in the study. For detection of sarcopenia, the appendicular skeletal muscle mass (ASM) obtained by bioelectrical impedance analysis (BIA) was divided by height squared (m2 ) to obtain the appendicular skeletal muscle mass index (ASMI) value. The thighs of both lower extremities were measured using the Modified Sonographic Tight Adjustment Ratio (STAR) method, which was obtained by adding the bilateral rectus femoris and vastus intermedius muscle thicknesses measured by ultrasound. Hand and quadriceps muscle strength (MS) were measured with a dynamometer. Physical performance was determined using the walking speed (WS), timed up-and-go test (TUGT), 5-repetition sit-to-stand test (5RSTS), and 6-min walk test (6MWT). Haemophilia Joint Health Score (HJHS) and Haemophilia Early Arthropathy Detection-Ultrasonography (HEAD-US) were also used to assess the musculoskeletal system. RESULTS According to the modified STAR values calculated based on body mass index, sarcopenia was present in 15 (50%) of 30 patients. However, based on the ASMI-BIA values, sarcopenia was present in only two (6.6%) patients. A weak correlation was found between ASMI and HJHS, HEAD-US, WS, TUGT, and hand MS (left), while a moderate correlation was found with knee MS (right), knee MS (left), and 5RSTS. A strong correlation was found between the modified STAR score and HEAD-US, HJHS, knee MS (left), 5RSTS, TUGT, and WS, while a moderate correlation was found with hand MS (left), hand MS (right), and knee MS (right). CONCLUSION This study showed muscle loss, joint mobility restrictions, and decreased functional capacity in haemophilia patients and demonstrated the presence of sarcopenia in these patients. The STAR measurement method showed stronger relationships with MS and functional performance values than ASMI measurements in terms of evaluating sarcopenia.
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Affiliation(s)
- Bora Uzuner
- Department of Physical Medicine and Rehabilitation and Department of Algology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Sertaç Ketenci
- Department of Physical Medicine and Rehabilitation and Department of Rheumatology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Durmus
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Hilmi Memis Atay
- Department of Internal medicine, Hematology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Ketenci S, Uzuner B, Durmuş D, Polat M. Frequency of idiopathic intracranial hypertension with ultrasound in patients with fibromyalgia: Relation with function, central sensitization, and neuropathic pain. Int J Rheum Dis 2024; 27:e15066. [PMID: 38334253 DOI: 10.1111/1756-185x.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The purpose of this study was to evaluate the prevalence of idiopathic intracranial hypertension (IIH) in fibromyalgia (FMS) patients by utilizing ultrasound to measure the optic nerve sheath diameter (ONSD), a marker of elevated intracranial pressure and also to investigate the relationship with function, fatigue, quality of life (QOL), central sensitization (CS) and neuropathic pain. METHODS The study encompassed 80 female FMS patients and 75 healthy controls. Ultrasound was employed to measure the average ONSD in both groups. Conditions potentially elevating intracranial pressure were ruled out following neurological assessments. Pain (via visual analog scale, VAS), function (revised Fibromyalgia Impact Questionnaire, r-FIQ), QOL (Short Form-36, SF-36), fatigue (fatigue severity scale, FACIT), CS (Central Sensitization Scale), and neuropathic pain (Douleur Neuropathique-4) were evaluated. RESULTS The average ONSD was significantly higher in the patient group than the control group. Patients with ONSD >5.5 mm consistent with IIH were categorized as Group 1 (n = 54, 67.5%), while those with a diameter of 5.5 mm and below-formed Group 2. VAS pain (p = .033) and FIQ-R scores (p = .033) were significantly higher in Group 1 than Group 2. Headache was found more common in Group 1. CONCLUSION This study unveils a substantial occurrence (67.5%) of IIH in FMS patients, suggesting shared pathophysiological mechanisms contributing to symptoms like fatigue, headache, and cognitive dysfunction. Additionally, these findings implicate heightened functional impairment, CS, headache, and fatigue in FMS patients with IIH.
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Affiliation(s)
- Sertaç Ketenci
- Department of Physical Medicine and Rehabilitation and Department of Rheumatology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Bora Uzuner
- Department of Physical Medicine and Rehabilitation and Department of Algology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Durmuş
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Murat Polat
- Department of Neurology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Seçgin A, Eyigor S, Eyigör C, Uzuner B, Köken İŞ, Uyar M. Comparison of the efficacy of continuous radiofrequency thermocoagulation, pulsed radiofrequency denervation applications, and TENS therapies for lumbar facet syndrome: A single-blind randomized controlled trial. Agri 2024; 36:53-63. [PMID: 38239113 DOI: 10.14744/agri.2022.37108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVES We aimed to compare the effectiveness of TENS, used in physical therapy departments, and continuous radiofrequency thermocoagulation (CRF) and pulsed radiofrequency denervation (PRF), used in algology departments, in patients with lumbar facet syndrome (LFS). METHODS Subjects were selected from patients with LFS visiting outpatient clinics of physical therapy and algology departments at Ege University School of Medicine, whose pain was refractory to medical treatment for at least 3 months. Subjects were randomized into 3 groups. A total of 60 patients, with 20 in each group, were enrolled. The first group received CRF, the second group received TENS for 30 minutes a day for 15 days, and the third group received PRF. Patients were assessed at baseline, at the end of the first and sixth months, for a total of three times. RESULTS Improvements at month 1 and month 6 were found to be statistically significant in all three treatment groups with respect to their pain scores, Oswestry Disability Indexes, hand-floor distance measurements, 20-meter walking times, 6-min walking distances, Beck Depression Inventory, and most of the SF-36 domain scores (p<0.05). A comparison of the treatment groups showed no superiority of any group over the others in any assessment parameters (p>0.05). CONCLUSION We suggest that it might be more appropriate to use TENS, a non-invasive treatment, before trying more invasive procedures like CRF and PRF in these patients. However, it has been stated that further studies involving a larger patient sample are needed.
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Affiliation(s)
- Atilla Seçgin
- Department of Physical Therapy and Rehabilitation, Muş State Hospital, Muş, Türkiye
| | - Sibel Eyigor
- Department of Physical Therapy and Rehabilitation, Ege University Faculty of Medicine, İzmir, Türkiye
| | - Can Eyigör
- Department of Algology, Ege University Faculty of Medicine, İzmir, Türkiye
| | - Bora Uzuner
- Department of Physical Therapy and Rehabilitation, Ondokuz Mayıs University Faculty of Medicine, Samsun Türkiye
| | - İdris Şevki Köken
- Department of Algology, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
| | - Meltem Uyar
- Department of Algology, Ege University Faculty of Medicine, İzmir, Türkiye
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Abstract
The internal iliac artery is the main vascular supply of pelvic visceral structures. All pelvic surgeons must know the anatomic landmarks and basic steps of internal iliac artery ligation in order to stop massive pelvic hemorrhage. This cadaveric demonstration and clinical review of the internal iliac artery shows the anatomic landmarks and basic steps of internal iliac artery ligation.
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Affiliation(s)
- İlker Selçuk
- Clinic of Gynecologic Oncology, Health Sciences University, Zekai Tahir Burak Woman’s Health Training and Research Hospital, Ankara, Turkey
| | - Bora Uzuner
- Department of Anatomy, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Erengül Boduç
- Department of Anatomy, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Yakup Baykuş
- Department of Obstetrics and Gynecology, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Bertan Akar
- Clinic of Obstetrics and Gynecology, VM Medical Park Kocaeli Hospital, Kocaeli, Turkey
| | - Tayfun Güngör
- Clinic of Gynecologic Oncology, Health Sciences University, Zekai Tahir Burak Woman’s Health Training and Research Hospital, Ankara, Turkey
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Abstract
Pelvic lymph node dissection is one of the leading surgical procedures in gynecologic oncology practice. Learning the proper technique with anatomic landmarks will improve surgical skills and confidence. This video demonstrates a right-side systematic pelvic lymphadenectomy in a cadaveric model.
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Affiliation(s)
- İlker Selçuk
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Dr. Zekai Tahir Burak Woman’s Health Training and Research Hospital, Ankara, Turkey
| | - Bora Uzuner
- Department of Anatomy, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Erengül Boduç
- Department of Anatomy, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Yakup Baykuş
- Department of Obstetrics and Gynecology, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Bertan Akar
- Clinic of Obstetrics and Gynecology, İstinye University, WM Medical Park Hospital, Kocaeli, Turkey
| | - Tayfun Güngör
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Dr. Zekai Tahir Burak Woman’s Health Training and Research Hospital, Ankara, Turkey
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Çetin E, Daldal İ, Eren A, Akarca Dizakar SÖ, Ömeroğlu S, Uzuner B, Çelik HH, Saygılı HH, Koçkar B, Şenköylü A. Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats. Acta Orthop Traumatol Turc 2019; 53:134-139. [PMID: 30738625 PMCID: PMC6506815 DOI: 10.1016/j.aott.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/30/2018] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
Abstract
Objective The aim of this study was to investigate the effects of human recombinant epidermal growth factor (EGF) on posterolateral lumbar fusion in a rat model. Methods 36 male Sprague Dawley rats underwent posterolateral fusion at L4-5 level. They were randomly assigned to 3 groups: 1- Sham control group where no local augmentation was made, 2- Local Hydoxyapatite β-tricalcium phosphate (HA/β-TCP) augmentation group and 3- Local HA/β-TCP + EGF augmentation group. Rats were euthanized at 8 weeks post-surgery. 6 rats from each group were selected for manual palpation examination, micro-computed tomography analysis and histologic analysis; and the rest was used for biomechanical analysis. Results Based on manual palpation, there was no fusion in the sham control group. Fusion rate was 33.3% in the HA/β-TCP group and 66.7% in the HA/β-TCP + EGF group (p = 0.085). Micro-CT results revealed that new bone formation was higher in the HA/β-TCP + EGF group (BV/TV: 40% vs. 65%) (p = 0.004). Histologically newly formed bone tissue was more pronounced in the EGF group and compacted and bridging bone spicules were observed. The median maximum bending moment values were 0.51 Nmm (0.42–0.59), 0.73 Nmm (0.49–0.88) and 0.91 Nmm (0.66–1.03) in the sham control, HA/β-TCP and HA/β-TCP + EGF groups, respectively (p = 0.013). The median stiffness values were 1.69 N/mm (1.12–2.18), 1.68 N/mm (1.13–2.74) and 3.10 N/mm (1.66–4.40) as in the previous order (p = 0.087). Conclusion This study demonstrates that EGF enhances posterolateral lumbar fusion in the rat model. EGF in combination with ceramic grafts increased the fusion rates. Our findings may provide insights to further studies, investigating EGF's clinical usage as an alternative fusion enhancer.
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Affiliation(s)
- Engin Çetin
- Department of Orthopaedics and Traumatology, Gaziosmanpaşa Taksim Training and Research Hospital, Istanbul, Turkey.
| | - İsmail Daldal
- Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Ali Eren
- Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
| | | | - Suna Ömeroğlu
- Department of Histology and Embryology, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Bora Uzuner
- Department of Anatomy, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Hakan Hamdi Çelik
- Department of Anatomy, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | | | - Benat Koçkar
- Department of Mechanical Engineering, Hacettepe University, Ankara, Turkey.
| | - Alpaslan Şenköylü
- Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
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Kenan S, Onur ÖD, Solakoğlu S, Kotil T, Ramazanoğlu M, Çelik HH, Ocak M, Uzuner B, Fıratlı E. Investigation of the effects of semaphorin 3A on new bone formation in a rat calvarial defect model. J Craniomaxillofac Surg 2018; 47:473-483. [PMID: 30616935 DOI: 10.1016/j.jcms.2018.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/18/2018] [Accepted: 12/17/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study investigates the effects of semaphorin 3A on new bone formation in an experimental rat model. MATERIALS AND METHODS Cortical bone defects, 5 mm, were created in the calvaria of 40 Wistar rats, which were then separated into three groups: empty defect (control) group, collagen group, collagen + semaphorin 3A group. The bone blocks were harvested after 4 and 8 weeks. New bone formation was assessed by micro-computed tomography (micro-CT), histology, histomorphometry, transmission electron microscope (TEM) and immunohistochemistry. RESULTS Increased bone formation was observed in collagen + semaphorin 3A groups both histologically and with micro-CT. In the histomorphometic analysis, the control group had significantly less bone formation compared to both the collagen and collagen + semaphorin 3A group at 4 weeks (p = 0.0001) and 8 weeks (p = 0.0001). The collagen group had significantly less bone formation compared to collagen + semaphorin 3A group both at 4 weeks (p = 0.002) and 8 weeks (p = 0.005). Immunohistochemical analysis revealed that semaphorin 3A inhibited receptor activator of nuclear factor-kB ligand (RANKL) expression and increased the expressions of osteoblastic bone markers at 4 weeks. In TEM analysis, the collagen + semaphorin 3A group had an increased proliferation and bone formation rate at 4 weeks, whereas bone quantity and maturation were enhanced at 8 weeks. CONCLUSION Locally applied semaphorin 3A increases callus formation at 4 weeks and bone formation at 8 weeks. Semaphorin 3A prevents bone resorption by inhibiting osteoclasts and increases bone formation by inducing osteoblasts.
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Affiliation(s)
- Sevinç Kenan
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Hülya Koçak Berberoğlu), Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Özen Doğan Onur
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Hülya Koçak Berberoğlu), Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Seyhun Solakoğlu
- Department of Histology and Embryology (Head: Prof. Dr. Seyhun Solakoğlu), Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tuğba Kotil
- Department of Histology and Embryology (Head: Prof. Dr. Seyhun Solakoğlu), Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Ramazanoğlu
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Hülya Koçak Berberoğlu), Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Hakan Hamdi Çelik
- Department of Anatomy (Head: Prof. Dr. M. Fevzi Sargon), Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mert Ocak
- Department of Anatomy (Head: Prof. Dr. M. Fevzi Sargon), Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bora Uzuner
- Department of Anatomy (Head: Prof. Dr. M. Fevzi Sargon), Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erhan Fıratlı
- Department of Periodontology (Head: Prof. Dr. Serdar Çintan), Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Selçuk İ, Uzuner B, Boduç E, Baykuş Y, Akar B, Güngör T. Step by step ligation of internal iliac artery. J Turk Ger Gynecol Assoc 2018. [DOI: 10.4274/jtgga.2018.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ozturk O, Yavuz E, Yazicioglu B, Uzuner B. Treatment of resistant idiopathic hiccups with pulse radio frequency on phrenic nerve and gabapentin: A case report. Niger J Clin Pract 2017; 20:910-913. [PMID: 28791989 DOI: 10.4103/1119-3077.212438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hiccups affect life quality, career and family life when they become persistent. We present here a 54-year-old man who worked as a mason and a blacksmith with hiccups complaint for nearly one and a half years. In this period, he was admitted to emergency service ten times with fainting or almost fainting, cold sweating and hand stretching complaints. The patient expressed that he frequently threw up when he had hiccups and his social life was negatively affected. He reported that he was treated with baclofen, esomeprazole and hyoscine-n-butyl bromur without relief. He used escitalopram and chlorpromazine for a short time and quit because they negatively affected his sleeping. As he did not have any relief from medications, he refused any oral medical therapy including gabapentin and started to seek remedy from paramedical treatments resulted with no benefit. The patient was referred to algology department and an intervention on phrenic nerve with pulse radio frequency (8 minutes, 45 Volts, 20 milliseconds wavelength) was performed. Symptoms stopped immediately after the procedure but one week later, although the patient reported a significant decline in symptoms he still had hiccups. The patient was offered oral medical therapy again. With considerable relief from symptoms, the patient accepted oral therapy this time. Gabapentin 300 mg bid was prescribed. The symptoms were completely recovered and the patient reported no hiccups after 30 days of Gabapentin administration. Our case suggests that administration of gabapentin after pulsed radiofrequency might be effective for the treatment of persistent hiccups.
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Affiliation(s)
- O Ozturk
- Family Medicine Specialist, Asarcık Meydan Healthcare Center, Samsun, Turkey
| | - E Yavuz
- Department of Family Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - B Yazicioglu
- Department of Family Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - B Uzuner
- Department of Algology, Samsun Training and Research Hospital, Samsun, Turkey
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Durmus D, Uzuner B, Durmaz Y, Bilgici A, Kuru O. Michigan Hand Outcomes Questionnaire in rheumatoid arthritis patients: relationship with disease activity, quality of life, and handgrip strength. J Back Musculoskelet Rehabil 2014; 26:467-73. [PMID: 23948837 DOI: 10.3233/bmr-130408] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to investigate the clinical relevance of Michigan Hand Outcomes Questionnaire (MHQ) in patients with rheumatoid arthritis (RA) and to evaluate the relationship between MHQ and disease activity, quality of life (QL), and handgrip strength separately. MATERIAL AND METHOD Eighty RA were included in the study. Disease activity is evaluated with Disease Activity Score 28 (DAS28), pain is evaluated with Visual Analog Scale (VAS). The Disabilities of Arm, Shoulder and Hand (DASH), MHQ, Short-Form 36 (SF-36), and Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scales-hand and finger function scale-2 (AIMS-2) were completed by all patients. Hand muscle strength (HMS) was measured with a hand-held dynamometer. RESULTS The MHQ moderately correlated with DAS28. When the patients were grouped according to three disease activity measurements, DASH scores were significantly higher with higher disease activity and MHQ scores were significantly lower with higher disease activity. A high correlation was found between MHQ total and HAQ, AIMS-2. The SF-36 scores were correlated with MHQ scores. CONCLUSIONS The MHQ scores correlate with disease activity indices, functional disability, QL and DASH. The clinical relevance of MHQ, like DASH, is high and both questionnaires can be used effectively.
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Affiliation(s)
- Dilek Durmus
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Bilgici A, Uzuner B, Kuru O, Bedir A. AB0082 The efficacy of anti-tnf treatment on urinary type-ii collagen c-telopeptyde levels in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bilgici A, Uzuner B, Kuru O, Bedir A. AB0451 The efficacy of anti-tumor necrosis factor therapy and the factors which contribute to fatigue in rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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