Huzurevinde yaşayan bir grup kadında Üriner Enkontinans

Bu çalışmanın amacı huzurevinde yaşayan bir grup kadında üriner enkontinansın (ÜE) sıklığını, özelliklerini, günlük yaşam aktiviteleri ve psikososyal fonksiyonlar ile ilişkisini araştırmaktır. Çalışma bir huzurevinde fiziatrist tarafından uygulanan sorgulama formları ile yapıldı. Önce huzurevinde yaşayan ve ambulatuar olan 500 kişiye mental bakımdan intakt olanları belirlemek için Mini Mental State Examination (MMSE) testi uygulandı. MMSE skoru≥23 olan ve mental olarak intakt kabul edilen 260 kişi arasından rastgele yöntemle 100 kişi seçildi. Bu 100 kişiden kadın olan 87 si çalışmaya alındı. ÜE olan 26 kişi hasta grubunu, ÜE olmayan 61 kişi de kontrol grubunu oluşturdu. 87 kadında ÜE varlığı, demografik özellikler, ÜE ile ilişkili olan ve ÜE yi etkileyen çeşitli faktörler sorgulandı. ÜE grubunda ÜE sıklığı, tipi, kaçırılan idrar miktarı, günlük yaşam aktivitelerine etkisi, visual analog scale (VAS) ile ciddiyeti ve Incontinence Impact Questionnaire (IIQ) ile günlük yaşam aktiviteleri(GYA) ve psikososyal fonksiyonlara etkisi değerlendirildi. İki grup tüm değişkenler açısından karşılaştırıldı . 87 kadının 26`sında ÜE (% 30)olduğu , 61`inde (%70) ise olmadığı saptandı. ÜE grubundan 18 kadında (%72) stres, 2 kadında (%8) urge , 6`sında(%20) ise mikst tip enkontinans olduğu belirlendi. Pelvik operasyon, solunum sistemi hastalığı, gece ve gündüz idrara çıkma sayısı, idrar yaparken yanma, ağrı ve idrar yaptıktan sonra doluluk hissi ÜE grubunda anlamlı derecede fazla bulundu. Yaşlılıkta kaçınılmaz ve tedavisi olanaksız olarak kabul edilen bir problem olan ÜE ye; sık görülmesi, yaşam kalitesini olumsuz yönde etkilemesi, konservatif ve cerrahi tedavi yöntemlerinin oldukça başarılı olması nedeniyle bilimsel , pratik , hasta ve tedavi yaklaşımı yönlerinden hakettiği önem verilmelidir

Bone Loss in Ankylosing Spondylitis: A Controlled Study - Original Investigation

Osteoporosis is common in ankylosing spondylitis (AS), which is a chronic inflammatory rheumatic disease.The aim of this study was to assess the bone loss and the effects of disease activity on bone mineral density in patients with AS. Thirty-three (29 men ,4 women ) patients with AS were included in the study. All of the patients were evaluated as their age, sex, height, weight, history, physical examination, laboratory and AP-lateral thoracic and lumbar vertebrae radiographic findings. Control group was consisted of 35 (31 men 4 women) age and sex-matched healthy person. Mean age and disease duration of the patient group were 43.2 ± 9.9 and 13.18 ± 10.6 years, respectively. Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry (DXA) at lumbar spine and proximal femur regions. BMD did not show statistically significant difference at lumbar region between two groups. However BMD values were 10% lower at femur neck in patient group than controls. The rate of osteopenia and osteoporosis was 42.8 % at the femur neck region in the patient group and 22.8 % in the control group. BMD values at femur neck correlated with age and disease duration. There was no correlation between BMD and BASDAI and BASMI, BASFI, BASGI scores. In conclusion, bone loss is common in AS. Ligament calcification and syndesmophytes may lead to higher BMD values at lumbar region in AS .Thus proximal femur BMD is valuable in the patients with long disease duration. Disease activity has no negative effect on bone density in our study. (Osteoporoz Dünyasından 2006;12:81-3

Quality of Life in the Patients With Osteoporosis: Is There A Difference Between Sexes?

There have been several studies which show the impact of postmenopausal osteoporosis on the patients’ quality of life (QOL). The aim of this study was to investigate the differences in the various domains of QOL between the women and men with osteoporosis. The patients consisted of 30 women and 28 men who hadosteoporosis. Bone mineral density (BMD) was measured by using Dual-Energy X-Ray Absorptiometry (DEXA). Mean age for women and men with osteoporosis was 61.80 (9.13) years and 62.86(11.48) years respectively. QOL was measured by using the Short Form 36 (SF-36). The SF-36 physical function scores were significantly lower in patients with osteoporosis. The impairment in the physical function , physical role and pain domains in women with osteoporosis was significantly greater than those in men. General health score was lowered in men who had fractures. In conclusion, QOL shows different characteristics in men and women with osteoporosis

Assesment of Osteoporosis in Medulla Spinalis Injured Patients

Aim: To investigate the relationship between osteoporosis and demographic features, clinical characteristics,risk factors in younger SCI patients. Materials and Methods: Between January-June 2009, all SCI patients admitted to our hospital evaluated and 58 patients who were younger than 50 years who had osteoporosis were enrolled.Patients age, gender, educational status, duration of injury, smoking, sunlight exposure and dietary habits were questioned. Neurological level, completeness, ambulation status and spasticity were assessed. Relationship between these findings with the severity of osteoporosis has been viewed. Results: There were 19 women. Mean age was 35,7 years. The mean time since injury were 117.7 months. 42 patients were paraplegia (17 complete), 16 were tetraplegia (4 complete).The most common osteoporotic site where the legs. There was no correlation between BMD values with age. In men, the legs and total body BMD were significantly lower.The effect of educational level on BMD was not found. No significant correlation was found between time since injury and BMD. In paraplegics, femoral neck and total femur Z-scores were significantly lower. In tetraplegics, Z scores of the arms were lower, but was not significant. Lumbar BMD values of complete patients were significantly lower than incompletes. Sunlight exposure and consumption of milk/milk products had not a significant positive effect on BMD. 8 patients had therapeutic ambulation, whereas 23 of them had community ambulation. Ambulation status of patients and the presence of spasticity was no effect on BMD. There was no significant correlation between BMD and the severity of spasticity. Smokers (n=19), bone density was lower in all regions except for femoral neck but were not significantly. Conclusion: Male gender, paraplegia, and incompleteness negatively effects the bone density. Age, time since injury, education level, spasticity, ambulation level, smoking, sunlight exposure and dietary habits has no significant effect on bone density. (Turkish Journal of Osteoporosis 2011;17:71-6

Assessment of the Relationship Between Vitamin D Level and Non-specific Musculoskeletal System Pain: A Multicenter Retrospective Study (Stroke Study Group)

Objective: In this study, it was aimed to evaluate the relationship between vitamin D level and pain severity, localization and duration in patients with non-specific musculoskeletal pain. Materials and Methods: Patients who applied to physical medicine and rehabilitation outpatient clinics due to non-specific muscle pain in 19 centers in Turkey were retrospectively screened. Three thousand four hundred fourpatients were included in the study, whose pain level was determined by visual analog scale (VAS) and the painful region, duration of pain and vitamin D level were reached. D group was found to be D deficient (group 1) when 25 (OH)D level was 20 ng/mL or less and group D 2 (vitamin D deficiency) was higher than 30 ng/mL (group 3). The groups were compared in terms of pain duration, localization and severity. In addition, the correlations of pain localization, severity and duration with vitamin D levels were examined. Results: D vitamin deficiency was detected in 2202 (70.9%) of 3 thousand four hundred and four registered patients, and it was found that vitamin D deficiency in 516 (16.6%) and normal vitamin D in 386 (12.4%). The groups were similar in terms of age, body mass index, income level, duration of complaint, education level, family type and working status (p>0.05). There was no statistically significant difference between groups in terms of VAS, pain localization and duration scores (p>0.05). Conclusion: Our study shows that vitamin D deficiency in patients with nonspecific musculoskeletal pain is not associated with the severity and duration of pain