The relationship between bisphosphonate use and demographic characteristics of male osteoporosis patients

INTRODUCTION: This study aimed to investigate a number of demographic characteristics in males with osteoporosis (OP) treated with bisphosphonate and determine whether any of these measures could act as an effective indicator of medication persistence and compliance. MATERIAL AND METHOD: Among the patients with OP who applied to our clinic and were prescribed weekly oral bisphosphonate treatment, 89 patients over 50 years of age were included in this study. The demographic characteristics of these patients were evaluated. The number of medications used by the patients over the past 1 and 3 years were counted, and the persistence and compliance with bisphosphonate treatment was estimated. The patients were divided into two groups: fully compliant and noncompliant subjects. The two groups of patients were compared separately for 1 and 3 years while considering their demographic characteristics. RESULTS: The mean age of the 89 patients included in the study was 62.43 + 9.41 years. Comparisons among the studied demographic characteristics during the 1-year period of medication use indicated that the educational status of the fully compliant patients was higher. During the 3-year period of medication use, educational status was the only demographic characteristic that was determined to be significantly lower in the noncompliant patients than in the fully compliant group. CONCLUSION: Although deficiencies in medication persistence and compliance during osteoporosis treatment can lead to serious health and social problems in both genders, the causes of these deficiencies have not been thoroughly clarified. We suggest that the educational status of the patient may contribute to these deficiencies

The Value of Calcaneal Bone Mass Measurement Using a Dual X-Ray Laser Calscan Device in Risk Screening for Osteoporosis

OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA). MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO), dual energy X-ray laser calcaneal measurements showed that 13% of the subjects had osteoporosis, while another 56% had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05). A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001), body mass index (BMI) (r=0.223, p=0.001), number of live births (r=-0.229, p=0.001), breast feeding time (r=-0.064, p=0.001), and age at menarche (r=-0.050, p=0.008). The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001) at the spine, and calcaneal DXL and DXA T- scores (r=0.28, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.33, p=0.001) at the femoral neck were statistically significant. CONCLUSION: Bone mineral density measurements in the calcaneus using a dual energy X-ray laser are valuable for screening Turkish women over 40 years of age for the risk of osteoporosis

Sensory disturbance and polyneuropathy in rheumatoid arthritis patients with foot deformity

Abstract Introduction Our aim in this study was to present the results of sensory evaluation tests and electrophysiological evaluations in rheumatoid arthritis (RA) patients with foot deformity and to determine their relation with general health status and lower extremity functionality. Materials and methods Fifty-one patients with RA diagnosis and foot deformity were included in the study. Demographic and disease characteristics of the patients were recorded, and a detailed neurological examination was performed. Superficial sensation, pain, heat, vibration, and two-point discrimination sensation were evaluated in each foot, and their sum was used to determine the sensory deficits index (SDI) of 0&#8211;10. The presence of polyneuropathy was evaluated with electrophysiological methods. The Health Assessment Questionnaire and mobility and walking subscales of the Arthritis Impact Measurement Scales-2 were used to assess general health status and lower extremity functionality, respectively. According to the sensory examination and electromyography results, patients were compared in terms of their general health status and lower extremity functional status. Results Sensory disturbance was detected in 39 patients (74%) during the examination; however, 27 patients (52.9%) had polyneuropathy determined electrophysiologically. In patients with sensory deficits, statistically significant deterioration was detected in general health and foot functionality, including mobility and walking, when compared to patients with a normal sensory evaluation. Conclusions Even in the presence of normal electrophysiological tests, sensory dysfunction alone seems to be associated with severe disability in general health status and foot functionality when compared to patients with a normal sensory examination

Outcomes of Botulinum Toxin Type A Injection Followed by Rehabilitation in Cases of Cerebral Palsy With Upper Extremity Involvement

Karaca, Burcu/0000-0003-2401-5445WOS: 000370429700014PubMed: 26239492We evaluated the efficiency of botulinum toxin type A injection followed by a rehabilitation program including individual therapy, group therapy, and occupational therapy in cases of cerebral palsy with upper extremity involvement. A total of 29 injections were performed on 25 patients, and the patients were placed on rehabilitation program. At 3-month and 6-month assessments, there was a significant improvement in lateral grip strength, 9 Hole Peg test, Upper Limb Physician's Rating Scale and pediatric functional independence measure total scores. There were significant decreases in active range of motion in elbow extension, supination, and wrist extension, and Modified Ashworth Scale in elbow flexion, elbow pronation, and wrist flexion at 6-week, 3-month, and 6-month assessments. Combination of group therapy with traditional therapy methods after injection is effective in cases of cerebral palsy with upper extremity involvement

Importância do período de silêncio cutâneo na fibromialgia e sua relação com as características da doença, distúrbios psicológicos e qualidade de vida dos pacientes

INTRODUÇÃO: O período de silêncio cutâneo (PSC) é um reflexo protetor inibitório da coluna vertebral e seus aferentes consistem em fibras nervosas A-delta. Nosso objetivo foi avaliar pacientes com fibromialgia (FM) e controles saudáveis para determinar as diferenças entre os grupos em relação à duração e latência do PSC, e quando presente, determinar se há alguma relação com as características da doença, distúrbios psicológicos e qualidade de vida. MATERIAIS E MÉTODOS: Trinta e dois pacientes com FM e 32 voluntários saudáveis foram incluídos no estudo. Os dois grupos foram comparados em relação à latência e duração do PSC em ambos os membros superiores e inferiores. Características da doença, distúrbios psicológicos e qualidade de vida dos pacientes foram avaliados utilizando o Fibromyalgia Impact Questionnaire (FIQ), e o Short Form-36 (SF-36). Os pacientes com medida de PSC igual ou inferior às do grupo controle foram comparados com aqueles com valores mais elevados do que os controles em termos de características da doença, estado psicológicos e qualidade de vida. RESULTADOS: Latências significativamente prolongadas de PSC nos membros superiores e inferiores foram determinadas em pacientes comparados com os controles. Observou-se que a prolongamento da latência do PSC no membro inferior estava associado com a gravidade da doença e incapacidade funcional. CONCLUSÕES: Latências do PCS nos membros superiores e inferiores em pacientes com FM são mais longas do que em voluntários saudáveis. Além disso, o prolongamento da latência do PSC no membro inferior está associado com a gravidade da doença e incapacidade funcional física

Comparing The Effectiveness Of Ultrasound-Guided Versus Blind Steroid Injection In The Treatment Of Severe Carpal Tunnel Syndrome

Background/aim: This study aimed to compare the effectiveness of ultrasound (US)-guided injection versus blind injection of corticosteroids in the treatment of carpal tunnel syndrome (CTS). Materials and methods: This prospective, randomized clinical trial included patients with severe CTS based on clinical and electrophysiological criteria. The patients were evaluated for clinical and electrophysiological parameters at baseline and 4 weeks after treatment. Symptom severity and hand function were assessed by the Boston questionnaire. The patients underwent blind injection or US-guided injection. Results: When compared with baseline, both groups showed significant improvement in Boston questionnaire scores and all electrophysiological parameters. Significant differences were observed between the groups for clinical parameters (Boston Symptom Severity Scale: P = 0.007; Functional Status Scale: P < 0.001) in favor of the US-guided group. Conclusion: This study demonstrated that both US-guided and blind injections were effective in reducing symptoms and improving hand function. US-guided injections may yield more effective clinical results in the short-term than blind injections in the treatment of patients with severe CTS.WoSScopu

An unusual late complication in traumatic brain injury: Persistent dysphagia due to tracheoesophageal fistula

Traumatic brain injury (TBI), which leads to cognitive, physical, emotional and behavioral deficits according to the severity of trauma, is a disability with high morbidity and mortality. In addition to primary effects of TBI, direct trauma to the face, neck, and chest also contributes to increased morbidity. Recovery in swallowing functions in TBI patients is often parallel with recovery in functional daily activities. Herein, contrary to that expectation, we present a TBI case with persistent dysphagia symptoms lasting for even 1.5 years after trauma, despite the fact that she gained independence in dailylife activities under supervision