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Author: search.filters.author.Karabudak, RanaHas files: No

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    Differences Between General Neurologists and Multiple Sclerosis Specialists in the Management of Multiple Sclerosis Patients: A National Survey
    (AVES, 2019-01-01) Kurtuncu, Murat; Tuncer, Asli; Uygunoglu, Ugur; Caliskan, Zeynep; Kokenli Paksoy, Aysenur; Efendi, Husnu; Sagduyu Kocaman, Ayse; Ozcan, Cemal; Terzi, Murat; Turan, Omer Faruk; Saip, Sabahattin; Karabudak, Rana; Siva, Aksel
    Introduction: The management of multiple sclerosis (MS) has become more complicated after the introduction of new diagnostic and treatment options. Despite the abundance of guidelines, the experience of physicians still plays a major role in the management of patients. This study aimed to define differences in behavior patterns between general neurologists (GNs) and MS specialists (MSSs). Methods: We conducted a survey of 36 questions to 318 neurologists, including 33 MSSs. The survey covered topics including laboratory investigations, pregnancy, and treatment. Results: Our study found many differences between GNs and MSSs in terms of management, the most important being treatment initiation and switching. GNs had a tendency to initiate treatment later than MSSs however, they tended to switch treatment faster. Our study also showed that GNs ordered magnetic resonance imaging (MRI) more frequently than MSSs, even if patients were clinically stable. Moreover, although GNs more frequently relied on MRI, they did not consider brain atrophy as an important measure in the follow-up of their patients. Furthermore, GNs considered replacement therapy less often than MSSs, even in patients with vitamin D deficiency. Discussion: Our study revealed important discrepancies between the management patterns of GNs and MSSs in MS patients. These findings suggest the need for a national education program for GNs on MSSs.
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    Cumulative Corticosteroid Doses and Osteoporosis in Patients with Multiple Sclerosis
    (TURKISH LEAGUE AGAINST RHEUMATISM, 2010-01-01) Arslan, Sule; Celiker, Reyhan; Karabudak, Rana
    Objective: Multiple sclerosis (MS) is an inflammatory demyelinating disorder and corticosteroids used for the treatment of attacks are known to cause osteoporosis. Although osteoporosis is a known potential complication, many patients do not receive treatment to prevent bone loss. The aim of this study was to assess the relationship between cumulative doses of corticosteroids and bone mineral density (BMD) in MS patients. Materials and Methods: Twenty-two patients with MS (15 women, 7 men) and 22 age-and sex-matched subjects were enrolled into the study. Lumbar and femoral BMDs were measured using dual energy X-ray absorptiometry (DXA). Mobility and ambulation scales were also evaluated. Corticosteroid use was determined from an interviewer-administered questionnaire and patient records. Result: Lumbar and femoral BMDs were significantly lower in MS patients compared to the control group (p<0.05). 18.2\% of the MS patients had no restriction in activities of normal employment and domestic life when assessed with Kraft Mobility Scale. Only 22.7\% of the MS patients were fully ambulant when evaluated with Scranton Ambulation Scale. Cumulative dose was negatively correlated with lumbar BMD measurements (r=-0.505, p=0.017). Conclusion: Corticosteroids are an important part of the MS therapy and their use results in osteoporosis. Thus, cumulative corticosteroid dose should be determined and BMD measurements of the patients should be taken before treatment to determine those at high risk of osteoporosis, and preventive measures should be undertaken. (Turk J Rheumatol 2010