The Comparison of the Effect of Risedronate and Strontium Ranelate on Bone Mineral Density in Postmenopausal Women

Aim: The purpose of our study is to compare the changes in bone mineral density (BMD) in postmenopausal women who had uninterrupted risedronate sodium and strontium ranelate treatment for 3 years. Material and Methods: Eighty-five postmenopausal women with primer osteoporosis who had uninterrupted risedronate sodium (A) (35 mg/week), strontium ranelate (P) (2 g/day) and calcium (1000 mg/day) - vitamin D (880 IU/day) supplementation for 3 years were included in our retrospective study. The demografic data and the yearly BMD measurements (lumbar spine, femur neck and femur total BMD and t scores) were recorded. Results: Group A had 34, and Group P had 51 patients. The mean age of the patients were 62.06±9.16 years and 60.30±7.68 years; and duration of menopause was 16.32±7.81 years and 16.78±8.34 years, respectively. There was statistically no significant difference between the groups regarding age, weight, body mass index, duration of menopause, menarche and menopause age, the lumbar spine, femur neck and total BMD and t scores at the beginning. At the end of uninterrupted 3 years of treatment, statistically significant increase was detected in lumbar spine and femur BMD measurements in Groups A and P (p<0.0001). Statistically significant increase was detected also in lumbar spine t scores in both groups. However, the femur t scores were found not to improve significantly in Group A, while in P, there was significant improvement. When the differences of improvement were compared, there was no difference between Group A and P regarding lumbar spine and femur BMD improvements. Conclusion: There was significant improvement in lumbar spine and femur BMD for Groups A and P at the end of 3 years of treatment for both medical agents, and improvement is similar for both agents. (Turkish Journal of Osteoporosis 2012;18: 58-62

Evaluation of Risk Factors Associated with Osteoporotic Hip Fractures - Original Investigation

Aim: Hip fractures are the most serious and economically most important complication of osteoporosis. Therefore in our study we examined risk factors associated with osteoporotic hip fractures. Material and Methods: Patients (Group 1; n=35) with osteoporotic hip fractures were compared with patients aged ≥70 years without osteoporotic hip fractures (Group 2; n=35). Age and sex distribution of the patients were recorded. From all patients bone mineral density measurements (BMD) of their L1-L4 vertebras and femurs (total and femoral head) were obtained using dual energy X-Ray absorptiometry (DXA) techniques. Their walking distances, presence and location of any previous fracture(s), usage of any assisted device, concomitant disease(s), laboratory values, creatinine clearance (ml/min), and recurrent falling episodes were documented. Results: Any significant difference could not be found as for sex, BMD measurements of relevant regions, presence of any previous fracture(s), history of recurrent falls and creatinine clearance (p >0.05). The mean age of the patients in Group 1 was more advanced (p>0.05). Although walking distances in Group 2 were longer, the difference was not statistically significant (p>0.05).The usage of asisted device and the presence of concomitant disease(s) were more frequently observed in Group 1 (p<0.05). Conclusion: The association of many risk factors with hip fracture has been demonstrated. Determination of these risk factors and their detailed examination are quite important in the prevention of hip fractures and related disabilities. (From the World of Osteoporosis 2010;16:31-4

Comparison of the Effects of Strontium Ranelate and Raloxiphene on Bone Mineral Density in Postmenopausal Osteoporosis - Original Investigation

Aim: To compare the effects of one year- long strontium ranelate (SR) and raloxiphene ( R) therapies on bone mineral densities (BMDs) in postmenopausal osteoporotic women. Material and Methods: Female patients diagnosed as postmenopausal osteoporosis who received SR 2 gr/d (Group 1) or R 60 mg/d (Group 2) were analysed retrospectively.. All the patients also received calcium 1000 mg/d, vitamin D 880 IU/d supplementations. Patients also underwent BMD measurements from L2-4, femoral neck and femur total with Lunar-DXA before and after the treatment. Intragroup changes in yearly BMD and t values were calculated and compared with each other. Results: Both groups contained 22 patients without any significant inter-group differences between age, menarche age, duration of postmenopausal period, weight, height, body mass indexes, baseline BMDs and t values (p>0.05). After a year-long treatment, a significant improvement in BMD of L2-4 in Group 1 was detected (p<0.0001). In posttreatment t values of the same group a significant improvement was seen for all three regions examined (p<0.05). In Group 1, none of these regions showed significant improvements as for BMD and t values. Conclusion: After a year-long treatment, strontium ranelate demonstrated significant improvements as for BMDs of L2-4, and t values in L2-4, femoral neck, and femur total. An increase in BMDs of femoral neck and femur total was seen which didn’t attain significance. However raloxiphene didn’t lead to significant improvement in BMDs and t values of the three regions examined. After a year-long treatment strontium ranelate was found to be more effective than raloxiphene in terms of improvements in BMDs. (From the World of Osteoporosis 2009;15:16-20

Evaluation of Risk Factors Associated with Osteoporotic Hip Fractures - Original Investigation

Aim: Hip fractures are the most serious and economically most important complication of osteoporosis. Therefore in our study we examined risk factors associated with osteoporotic hip fractures. Material and Methods: Patients (Group 1; n=35) with osteoporotic hip fractures were compared with patients aged ≥70 years without osteoporotic hip fractures (Group 2; n=35). Age and sex distribution of the patients were recorded. From all patients bone mineral density measurements (BMD) of their L1-L4 vertebrae and femurs (total and femoral head) were obtained using dual energy X-Ray absorptiometry (DXA) techniques. Their walking distances, presence and location of any previous fracture(s), usage of any assisted device, concomitant disease(s), laboratory values, creatinine clearance (ml/min), and recurrent falling episodes were documented. Results: Any significant difference could not be found as for sex, BMD measurements of relevant regions, presence of any previous fracture(s), history of recurrent falls and creatinine clearance (p>0.05). The mean age of the patients in Group 1 was more advanced (p>0.05). Although walking distances in Group 2 were longer, the difference was not statistically significant (p>0.05). The usage of assisted device and the presence of concomitant disease(s) were more frequently observed in Group 1 (p<0.05). Conclusion: The association of many risk factors with hip fracture has been demonstrated. Determination of these risk factors and their detailed examination are quite important in the prevention of hip fractures and related disabilities. (From the World of Osteoporosis 2010;16:13-6

Comparative the effectiveness of occlusal splint and TENS treatments on clinical findings and pain threshold of temporomandibular disorders secondary to bruxism

Amaç: Bu çalışmada bruksizme eşlik eden miyofasyal ağrı sendromlu ve temporomandibuler eklem rahatsızlığı olan hastalarda oklüzal splint ve TENS tedavilerinin klinik bulgular ve ağrı eşiği üzerine olan etkinliklerini karşılaştırdık. Gereç ve Yöntem: Çalışmaya katılan 30 hasta randomize olarak oklüzal splint ve TENS grubu olmak üzere ikiye ayrıldı. Hastaların ağrıları (tetik nokta üzerine algometrik ölçümle saptanan basınç ağrı eşiği, görsel analog ölçek üzerinden istirahat ve fonksiyon halindeki ağrı derecesi), eklem hareket açıklığı (cetvel ile ölçülerek), yaşam kaliteleri (çene ile ilişkili spesifik yaşam kalitesi formu ve genel yaşam kalitesi ölçeği Kısa Form-36 kullanılarak) değerlendirildi. Bu değerlendirmeler tedavi öncesi, tedavi sonu ve tedaviden sonraki 1. ayda olmak üzere toplam üç kez yapıldı. Bulgular: Tetik noktalar üzerine yaptığımız algometrik ölçümlerde, tedavi sonrası hem splint hem TENS tedavisi etkiliydi (p0,05). Her iki grubun ağrı skorlarında azalma mevcuttu (p<0,05). Hastalarımızın çene hareketlerindeki artış splint grubunda daha belirgindi (p<0,05). Temporomandibuler eklem patolojilerine yönelik spesifik yaşam kalitesi ölçeğinde tedavi sonrası ve 1. ay kontrollerinde yine hem splint hem TENS grubunda yaşam kalitesinde artış tespit ettik (p<0,05). Kısa Form-36 değerlendirmesinde ise ağrı kategorisinde etkilenim olup, düzelme TENS grubunda daha belirgindi (p<0,05). Sonuç: Bruksizme bağlı miyofasyal ağrı sendromunda kısa dönemde hem splint hem TENS tedavileri etkin olup, splinte göre TENS’in etkinliğinin daha çabuk kaybolduğu görülmektedir. Bu nedenle TENS’in analjezik etkisinden dolayı diğer tedavi modaliteleri ile kombine olarak uygulanmasının daha uygun olacağını düşünmekteyiz.treatments with respect to clinical findings and pain threshold in patients with myofascial pain syndrome and temporomandibular disorders. Material and Methods: Thirty patients included in the study were randomized into occlusal splint and TENS groups. The severity of pain of the patients (pressure-pain threshold determined with algometric measurements of the trigger point, the degree of pain during rest and functional activities measured with visual analogue, range of motion of joints (measured with a ruler), quality of lives questionnaire specific to masticatory functions and general quality of life scale Short Form-36) were evaluated. These evaluations were repeated three times namely once before, during and after the therapies. Results: Our post-treatment algometric measurements of trigger points pain scores showed that both splint and TENS treatments had been effective (p&lt;0,05). However effectiveness in the TENS group decreased in the first month controls (p&gt;0,05). In both groups pain scores were improved (p&lt;0,05). Improvement in mandibular movements in the patients who applied splint treatment was more significant (p&lt;0,05). We obtained an increase in quality of life measurement scores which is specific to temporomandibular disorders both in TENS group and splint group in post treatment and one month after controls. (p&lt;0,05). However in Short Form-36 evaluations, the pain category was positively influenced and improvement in the TENS group was more apparent (p&lt;0,05). Conclusion: In myofascial pain syndrome secondary to bruxism both splint and TENS treatments are effective in the short term. However the effectiveness of TENS is observedly short lived when compared with TENS treatments. Therefore we suggested that, due to the analgesic properties, usage of TENS in combination with other treatment modalities would be more appropriate

Nadir Bir Trombositopeni Sebebi: Primer Sjögren Sendromu

Sjögren Sendromu (SS) başta gözyaşı, tükürük bezi olmak üzere ekzokrin bezlerin lenfosit hücre infiltrasyonu, destrüksiyonu ve disfonksiyonu sonucu gelişen kronik, sistemik ve otoimmün bir hastalıktır (2). Bu inflamasyona B lenfositlerin neden olduğu düşünülmektedir (5). Kuru göz (kseroftalmi, keratokonjonktivitis sikka), kuru ağız (kserostomi), parotis bezi büyümesi ile karakterizedir (2). Anemi, lökopeni, trombositopeni ve lenfoproliferatif hastalıklar SS’ nda ekstraglanduler hematolojik tutulum olarak görülebilir (6). Burada 3 aydır rutin tetkiklerinde izole trombositopeni (33.000/mm3) tespit edilen ve romatolojik hastalık araştırılması için tarafımıza konsülte edilen, kliniğimizce SS tanısı konulan ve hidroksiklorokin 200 mg 1x1/ gün ve prednizolon 4 mg 1x1/gün tedavisi ile birinci ayda trombosit sayısında (195.000/ mm3) düzelme, eklem şikayetlerinde gerileme meydana gelen bir olgu sunulmuştur. Sjögren Sendromunun trombositopeninin nadir bir sebebi olabileceği akılda tutulmalı, ayırıcı tanısında romatolojik değerlendirme yapılmalıdır

Amiloidoz Gelişen Bir Juvenil Artrit ve Ailevi Akdeniz Ateşi Olgusu: Olgu Sunumu

Erçalık, Cem (Arel Author)AA amiloidoz, kronik inflamatuar hastalıklardaki amiloidoz türüdür. Günümüzde en sık nedeni romatizmal hastalıklardır. Amiloidoz, Romatoid artritte (RA) % 3-6, Ailevi Akdeniz Ateşinde (AAA) % 11- 3, İnflamatuar Barsak Hastalığında %1-3 oranında saptanmıştır. Burada AAA ve Juvenil İdiopatik Artrit (JİA) olan amiloidozlu bir olgunun tedavisi güncel literatür eşliğinde tartışılmıştır

Epigenetic approach to early-onset Parkinson's disease: Low methylation status of SNCA and PARK2 promoter regions

Background and aim: The effect of epigenetic modifications in the genes related to Parkinson's disease (PD) is still unclear. In the present study, we investigated methylation status of SNCA and PARK2 genes in patients with early-onset Parkinson's disease (EOPD). Materials and methods: The promoter region methylation status of SNCA and PARK2 genes was evaluated by methylation specific-PCR (MSP) in 91 patients with EOPD and 52 healthy individuals. Results: The methylation of SNCA and PARK2 promoter regions were significantly lower in EOPD patients compared to the control group (P = 0.013 and P = 0.03, respectively). We also found that the methylation status of the SNCA might be associated with positive family history of PD (P = 0.042). Conclusion: Although it should be supported by further analysis, based on the results of the present study, the methylation status of SNCA and PARK2 genes might contribute to EOPD pathogenesis