The effects of restless legs syndrome on sleep and quality of life during pregnancy: a comparative descriptive study

Objective: The study aimed to identify the effects of restless legs syndrome (RLS) on sleep quality and quality of life in pregnant women.Methods: This comparative and descriptive study was conducted with 109 pregnant women between the 24 and 39 weeks of gestation. The presence and severity of RLS were investigated using the International Restless Legs Syndrome Study Group’s Diagnostic Criteria Scale and Severity Rating Scale, and the effects of the syndrome on sleep and quality of life were evaluated. Results: The prevalence of RLS in pregnant women was found to be 47.7%. In the RLS group, 22.0% of the pregnant women had severe RLS symptoms and 20.2% had moderate RLS symptoms. The mean score for Restless Legs Syndrome Severity Rating Scale was determined 20.75±6.38. The mean score for quality of life scale was determined 17.75±3.73 in RLS group and 26.46±2.67 in non-RLS group. Conclusion: The difference between the mean scores for Pittsburgh Sleep Quality Index of the pregnant women with RLS and those without the syndrome was found to be statistically significant. While the mean score for Quality of Life Scale in pregnant women with RLS was lower in general health, physical health and psychological health sub-dimensions, no statistically significant difference was found in social relations and environment sub-dimensions. It is recommended that nurses investigate RLS complaints of pregnant women and include non-pharmacological methods in their nursing practices

Accelerated hand bone mineral density loss is associated with progressive joint damage in hands and feet in recent-onset rheumatoid arthritis

Introduction: To investigate whether accelerated hand bone mineral density (BMD) loss is associated with progressive joint damage in hands and feet in the first year of rheumatoid arthritis (RA) and whether it is an independent predictor of subsequent progressive total joint damage after 4 years. Methods: In 256 recent-onset RA patients, baseline and 1-year hand BMD was measured in metacarpals 2-4 by digital X-ray radiogrammetry. Joint damage in hands and feet were scored in random order according to the Sharp-van der Heijde method at baseline and yearly up to 4 years. Results: 68% of the patients had accelerated hand BMD loss (>-0.003 g/cm(2)) in the first year of RA. Hand BMD loss was associated with progressive joint damage after 1 year both in hands and feet with odds ratios (OR) (95% confidence intervals [CI]) of 5.3 (1.3-20.9) and 3.1 (1.0-9.7). In univariate analysis, hand BMD loss in the first year was a predictor of subsequent progressive total joint damage after 4 years with an OR (95% CI) of 3.1 (1.3-7.6). Multivariate analysis showed that only progressive joint damage in the first year and anti-citrullinated protein antibody positivity were independent predictors of long-term progressive joint damage. Conclusions: In the first year of RA, accelerated hand BMD loss is associated with progressive joint damage in both hands and feet. Hand BMD loss in the first year of recent-onset RA predicts subsequent progressive total joint damage, however not independent of progressive joint damage in the first year.Pathophysiology and treatment of rheumatic disease

Early changes in bone mineral density measured by digital X-ray radiogrammetry predict up to 20 years radiological outcome in rheumatoid arthritis

ABSTRACT: INTRODUCTION: Change in bone mineral density (BMD) in the hand, as evaluated by digital X-ray radiogrammetry (DXR) of the II-IV metacarpal bones, has been suggested to predict future joint damage in rheumatoid arthritis (RA). This study's objective was to investigate if DXR-BMD loss early in the disease predicts development of joint damage in RA patients followed for up to 20 years. METHODS: 183 patients (115 women and 68 men) with early RA (mean disease duration 11 months) included from 1985 to 1989 were followed prospectively (the Lund early RA cohort). Clinical and functional measures were assessed yearly. Joint damage was evaluated according to the Larsen score on radiographs of hands and feet taken in years 0 to 5, 10, 15 and 20. These radiographs were digitized and BMD of the II-IV metacarpal bones was evaluated by DXR (Sectra, Linkoping. Sweden). Early DXR-BMD change rate (bone loss) per year calculated from the first 2 radiographs taken on average 9 months apart (SD 4.8) were available for 135 patients. Mean values of right and left hand were used. RESULTS: Mean early DXR-BMD loss during the first year calculated was -0.023 g/cm2 (SD 0.025). Patients with marked bone loss, i.e. early DXR-BMD loss above the median for the group, had significantly worse progression of joint damage at all examinations during the 20-year period. CONCLUSIONS: Early DXR-BMD progression rate predicted development of joint damage evaluated according to Larsen at year one and further onwards up to 20 years in this cohort of early RA patients

Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis

<p>Abstract</p> <p>Objective</p> <p>To determine the prevalence of vertebral fractures (VFs) after 5 years of disease activity score (DAS)-steered treatment in patients with early rheumatoid arthritis (RA) and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD) over time.</p> <p>Methods</p> <p>Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4). A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ) scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined.</p> <p>Results</p> <p>VFs were observed in 41/275 patients (15%). No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36), and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2). Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09), mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively).</p> <p>Conclusion</p> <p>After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression.</p

Organik Sultani Çekirdeksiz Üzüm Yetiştiriciliği

Bu projede, organik ürün olarak, talebi oldukça fazla Sultani Çekirdeksiz kuru üzüm üretimi ele alınmıştır. Çalışma, iki alt projeden oluşturulmuştur. I. Alt projede organik tarımda istenen minimum toprak işlemesi yanında ülkemizde bulunan ve birçok olumlu özelliklere sahip Zeolit (Klinoptilolitie mineral [Agro-clıno (NMF 900)]) kullanımı da denemede yer almıştır. II. Alt proje de ise Ege Bölgesi bağlarının ana hastalığı olan külleme mücadelesinde NaHCO3’ (içme sodasının) mevcut koşullardaki kullanım olanakları projede ele alınmıştır Bağlardaki ana zararlı da salkım güvesi olup her iki alt projede, salkım güvesi mücadelesinde tuzaklar asılarak zararlının ergin populasyonu bu tuzaklarla ilk ergin çıkışından uçuşlar sona erinceye kadar haftalık olarak izlenmiştir. Uçuş eğrileri ile tahmin-uyarı istasyonlarından elde edilen meteorolojik veriler ışığında gerekli uygulamalar yapılmıştır. Çalışmanın sonucunda, KULTIVATOR ile toprak işleme sisteminin toprağa olumsuz etkisinin de en az düzeyde olduğu da dikkate alınarak önerilebileceği ortaya çıkmıştır. Yeşilyurt yöresi topraklarındaki mikrobiyal aktiviteyi arttırmada malç uygulaması önerilmesine karşın, bu uygulama diğer disiplinler tarafından uygun görülmediğinden alternatif olarak KULTIVATOR uygulaması tercih edilmektedir. Kükürt ve içme sodası uygulanan parsellerde külleme hastalık şiddeti konvansiyonel olan şahit parsele göre istatistiki öneme sahip düzeyde azalma kaydetmiştir. Konvansiyonel koşullardaki hastalığın daha fazla görülmesini uygun koşulları yaratacak yoğun vejetatif gelişmenin yaratmış olduğu düşünülmektedir. Kükürdün zararlıları baskılayıcı etkisi de bilindiğinden organik yetiştiricilikte Külleme mücadelesinde içme sodasına nazaran özellikle kükürdün tercih edilmesi uygun bulunmaktadır. Denemenin başladığı 2003 yılı baz alındığında Zeolit (Klinoptilolitie mineral [Agro-clıno (NMF 900)]) uygulamalarında verim ve kalite kriterlerinde artış olduğu tespit edilmiştir. Toprak işleme uygulamalarından toprağı çizerek işleme salkım sayısı ve verim bakımından önemli bulunurken pulluk+ diskharow ile işleme salkım ağırlığını; malç uygulamasının ise kuru maddeyi ve tane tutumunu arttırdığı görülmektedir. Yaprak alma uygulamalarından, 6 adet yaprak alınması kontrole nazaran verim, salkım sayısı ve salkım ağırlığını nispeten arttırmıştır. Proje konusu çalışma birimleri itibarıyla değerlendirildiğinde toprağın çizilerek işlenmesi (KULTIVATOR sistemi) ön plana çıkmaktadır

COVID-19 in pediatric nephrology centers in Turkey

Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage