The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study

Alcelik, Aytekin/0000-0002-3156-1076WOS: 000292798400018PubMed: 22295033Introduction: In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life. Material and methods: The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA). They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD), and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were considered as having low bone mass (LBM). Results: We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = -0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM. Conclusions: In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life

Relationship between blood pressure levels and bone mineral density in postmenopausal Turkish women

WOS: 000290915100012PubMed: 22291766Introduction: We investigated the association between bone mineral density (BMD) detected by dual-energy X-ray absorptiometric (DXA) method and blood pressure (BP) in a large sample of postmenopausal women. Material and methods: The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 +/- 8.8 years, who were screened for osteopenia or osteoporosis by DXA. Patients with hypertension (HT, n = 306) were compared with normotensive (NT, n = 290) individuals. Bone mineral density results for the femur neck and spine were classified into 3 groups according to World Health Organization criteria: normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD) and osteoporosis (T score <-2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were grouped as having low bone mass (LBM). Results: There were no significant differences in femur T score, femur BMD, femur Z score, spinal T score, spinal BMD and spinal Z score between hypertensive and normotensive groups. The group of patients with low bone mass calculated from femur T scores had higher age, systolic BP, duration of hypertension and duration of menopause, but lower BMI. Similarly, patients with low spine BMD had higher age and duration of menopause, but lower BMI. Linear regression analysis showed a significant correlation between systolic BP and femur BMD and T score values. Furthermore, logistic regression analysis revealed that hypertension is an independent predictor of spinal osteopenia and osteoporosis. Conclusions: The presence of hypertension is an independent predictor of spinal low bone density in Turkish women after menopause

The contribution of vacuum-assisted modified Menghini type needle to diagnosis of US-guided fine needle aspiration biopsy of the thyroid

PURPOSEWe aimed to determine the contribution of vacuum-assisted modified Menghini type needle to diagnosis of ultrasound-guided fine needle aspiration biopsy (FNAB) of the thyroid evaluated by a pathologist at the bedside.METHODSA total of 147 thyroid nodules in 138 patients (122 women, 16 men) were included in this prospective study. Sonographic features of nodules, number of aspirations, pain and pain severity during the process, hemorrhage, and presence of sample obtained for cell block analysis were recorded and analyzed with the results of aspiration biopsy.RESULTSUsing the 21G modified Menghini type needle, a diagnosis could not be reached in 14.3% of nodules. Adequate samples for cell block analysis were obtained in 47 nodules (32%), 17 of which contributed to the diagnosis. While the difference between diagnostic cytopathology results and the contribution of the cell block were statistically significant, obtainability of cell block samples was not significantly correlated with the number of aspirations or the presence of a cystic component in the nodule.CONCLUSIONFNAB with 21G vacuum-assisted modified Menghini type needle is a safe procedure with very low complication rates. In addition to the cytologic smear samples, microtissue fragments obtained with this method help pathologists in the diagnosis of thyroid nodules

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

The effects of the statins on skeletal muscle, anxiety, depression and quality of life

YÖK Tez No: 306229Hiperlipidemi tedavisinde özellikle de LDL kolesterolün düşürülmesinde en etkili, en yaygın kulanılan Hidroksimetilglutaril-koenzim A inhibitörlerin (statinler)çok sayıda çalışmada koroner arter hastalığında mortalite ve morbiditeyi azalttığı,son çalışmalarda da inmeyi önlemede faydalı olduğu bulunmuştur. Kontrollü klinik çalışmalara göre statinler oldukça iyi tolere edilebilmekle birlikte, miyalji, kramp,güçsüzlük gibi semptomlardan kas kuvvet kaybı, rabdomiyolize kadar ilerleyebilen miyopatiye neden olabilmektedir. Ancak statin tedavisi alan hastalarda müskülerperformansın incelendiği çok az sayıda çalışma vardır.Çalışmamızın amacı iki farklı statin tedavisinin diz izokinetik kas gücü,anksiyete, depresyon, yaşam kalitesi üzerine ve müsküler yan etkilerini araştırmaktır. Hiperkolesterolemi tanılı 63 hasta üç ay süreyle 20 mg/gün atorvastatin ve 20mg/gün rosuvastatin tedavisi almak üzere iki gruba randomize edildi. Tedavi öncesi ve sonrası hastaların dominant dizin izokinetik kas kuvvet ölçümleri yapıldı. Müsküler yan etkiler, serum kreatin kinaz, karaciğer fonksiyon testleri, anksiyete,depresyon ve yaşam kalitesi ölçekleri değerlendirildi.Atorvastatin grubunda %12.5, rosuvastatin grubunda %9.6 oranında müsküler yan etki saptadık. Diz izokinetik kas gücü ölçümlerinde; atorvastatin grubunda 60°/s hızda fleksiyonda ve ekstansiyonda total iş ve 180°/s hızda ekstansiyon pik torkdeğerlerinde, rosuvastatin grubunda ise 60°/s hızda fleksiyonda ve ekstansiyonda total iş değerlerinde istatistiksel anlamlılıkta azalma belirledik. Her iki grupta diz izokinetik kas gücünde azalma saptanan hastaların % 8-10'unda müsküler semptom bulduk. Beck Anksiyete, Beck Depresyon ve Nottingham Sağlık Profili ölçekleri ile değerlendirilen her iki grup hastalarda tedavi öncesi ve tedavi sonrası arasındaistatistiksel anlamlılıkta fark yoktu. Sonuç olarak statin tedavisi alan hastalarda risk faktörleri, müsküler şikayetler ve serum kreatin kinaz yüksekliği olmasa da düzenli kontrollerle kas gücü değerlendirmesi yapılmasının faydalı olacağı bu nedenle statin tedavisi alan hastaların tedavileri başlamadan önce ve tedavileri devam ederken en az üçer aylıkperiyotlarla fiziyatristler tarafından da takip edilmesi gerektiği sonucuna vardık.Statins are the most effective medications for reducing elevatedconcentrations of lowdensity lipoprotein cholesterol. Numerous studies have demonstrated that cholesterol lowering with statin therapy reduces morbidity and mortality from coronary heart disease and also useful in preventing stroke. Statins have been extremely well-tolerated in controlled clinical trails but can produce a skeletal myopathy with symptoms ranging from mild complaints such as myalgia,cramps, and weakness to rhabdomyolysis. Muscle performance has not been carefully examined in statin users.The aim of the study was to investigate the effects of different two statins on knee isokinetic skeletal muscle strength, patients anxiety, depression, quality of life and also muscle adverse effects of statins. We conducted the study on 63 patients who had been randomly assigned to treatment with 20 mg/day atorvastatin or rosuvastatin for three months. Patients dominant knee isokinetic muscle strength was tested and also their liver and creatine kinase measurements, muscle-related adverse reactions, anxiety, depression and quality of life levels were evaluated before and after treatment.Muscle related adverse reactions were reported by 12.5% of atorvastatin group and 9.6% ofrosuvastatin group. After treatment; in both group total work values in flexion and extension by 60°/s speed, and extension peak torque by 180°/s speed in atorvastatin group statistically reduced compared to values before treatment. İn both groupmuscle symptoms were found in 8-10% of the patients who had reduction in knee isokinetic muscle strength after treatment. There was no statistically difference in both groups anxiety, depression and life quality questionnaire between before andafter treatment. As a result, the muscle strenght of patients treated with statins should be evaluated regularly although they had no muscle complain, elevated creatine kinaselevels and also risk factor. So patients who received statin therapy should be concluded by physiatrists before starting and continued treatment for at least three months following periods

EFFECT OF GAME BASED EXERCISE PROGRAMS ON PAIN, FUNCTIONAL MOBILITY AND BALANCE IN PATIENTS WITH KNEE OSTEOARTHRITIS: RANDOMIZED CONTROLLED STUDY

Annual European Congress of Rheumatology (EULAR) -- JUN 12-15, 2019 -- Madrid, SPAINWOS: 000472207101328European League Against Rheumatis

Bilateral Fifth-Finger Camptodactyly

WOS: 000305624100013PubMed: 22019975