Türkiye Romatizma Araştırma ve Savaş Derneği ankilozan spondilit ulusal tedavi önerileri

Objectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group(ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and non-pharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments.Türkiye Romatizma Araştırma ve Savaş Derneği᾽nin (TRASD) Ankilozan Spondilit (AS) için ulusal tedavi önerilerinin oluşturulmasıdır. Gereç ve yöntemler: TRASD tarafından altı Romatoloji ve 19 Fiziksel Tıp ve Rehabilitasyon uzmanı olmak üzere toplam 25 kişiden oluşan bir bilimsel kurul oluşturuldu. Önerilerde 2006 yılında yayınlanan Ankilozan Spondilit Değerlendirme Uluslararası Çalışma Grubu (ASAS)/Romatizmaya karşı Avrupa Ligi (EULAR) önerileri ve Ocak 2005 - Eylül 2010 arasında yayınlanmış olan ilişkili yayınlar konusundaki sistematik bir inceleme temel alındı. Öneriler oluşturulurken Delphi süreci kullanıldı. Ankilozan spondilit tedavisi ile ilgili 12 ana öneri oluşturuldu. Oylama yapılarak önerilerin güçlülük düzeyi bir nümerik derecelendirme skalası ile belirlendi. Bulgular: On iki öneri hasta değerlendirilmesini, hasta takibini ve farmakolojik ve non-farmakolojik yöntemleri içermektedir. ASAS/EULAR önerilerine bazı ilaveler ve önerilerde bazı küçük değişiklikler yapılmıştır. Tüm öneriler yeterli kuvvete sahipti. Sonuç: Bilimsel kanıtlar ve uzmanların görüş birliği ile AS tedavisine yönelik ulusal öneriler oluşturulmuştur. Bu öneriler, yeni gelişmeler doğrultusunda düzenli olarak güncellenmelidi

Transcutaneus Electrical Muscle Stimulation'ın (TEMS) cellülit üzerine etkileri

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.-62- VI. ÖZET Bu çalışmada E.Ü. Tip fakültesi fiziksel Tıp ve Rehabilitasyon Kliniği ayaktan tedavi bölününe başvuran 20 Gellülit vak'ası üzerin de yapıldı. Hastaların hepsi kadındı ve genellikle menapoz dönemin de olup çor-u obes kişilerdi. Hastalara 3

Peak Bone Mass. The Role of Heredity and Modifiable Factors

Osteoporosis is a metabolic bone disease that is characterized by low bone mineral density and increase in fragility of bone. Low peak bone mass has been considered as a risk factor for osteoporosis. Heredity, physical activity level and diet are of importance in the determination of variations in peak bone mass. Investigations have been continuing on numerous candidate genes playing a role in the genetic programming of peak bone mass. It has been suggested that heredity may account for about 50-85% of the variation in peak bone mass. However, negative consequences of genetic factors may be changed by the modification of some environmental factors such as diet and physical activity

Biomechanical Properties of Bone and Biomechanics of Age - Related Fractures - Review

From a biomechanical viewpoint, fractures are due to a structural failure of the bone. This failure occurs when the forces applied to the bone exceed its load – bearing capacity. The load – bearing capacity of a bone depends on the geometry (its size, shape and distribution of bone mass), and the material properties of a bone as well as the direction and magnitude of applied load. Bone fragility can be defined by biomechanical parameters such as strength, brittleness and work to failure. Strategies to reduce fracture risk must be based on a sound understanding of the cellular, molecular and biomechanical mechanisms that underlie the increased risk of fractures while aging. In this review biomechanics of bone and the etiology of age – related fractures from a biomechanical viewpoint have been discussed in the view of current literature. (From the World of Osteoporosis 2007;13:44-8

Relationship Between Patient’s Age and Bone Mineral Density of Lomber Spine and Femur in Postmenopausal Women

The aim of this study was to examine the relationship between patient’s age and lomber spine, hip regions(femur neck, trochanter, Ward’s triangle) bone mineral density (BMD) and T scores. A total of 85 postmenopausal women whose L2-4 T score was equal to or less than -2.5 with a mean age of 65.72 (50-81) years were included. Bone mineral density of lomber spine and hip was measured by dual energy x-ray absorbtiometry (DEXA) in all patients. Pearson correlation analysis was used to perform the statistical evaluation. There was negative correlation between patient’s age and femoral neck and ward’s triangle BMD and T scores (p 0.05)

The Effect of Tip II Diabetes Mellitus on the Musculoskeletal System in Postmenopausal Women

The aim of this study was to examine the effect of type 2 Diabetes Mellitus on bone mineral density (BMD) and its association with locomotor system diseases compared with healthy postmenopausal women. In this study 31 diabetic and 21 healthy postmenopausal women were included. Locomotor system examination and laboratory evaluations of all subjects were perfermed. The medical treatment of diabetic subjects were recorded. Lumbar vertebrae and femoral BMDs were measured with dual-energy X-ray absorptiometry. L2-L4 total and femoral neck BMD values of subjects showed no statistically significant diffrence between diabetic and control group and between patients using only oral antidiabetic medication and insulin additionally. We detected a negative corrrelation between BMD and serum fasting glucose values of the subjects, but it was not statistically significant. We detected statistically significant higher prevalence of Phalen and Tinel sign, glove and sock type hypoestesia, dupuytren contracture and range of motion limitation of the shoulder in the diabetic group compared with the control group. As a result, type 2 diabetic postmenopausal women had BMD values showing no difference compared with the control group, but prevalence of musculoskeletal diseases were increased in these subjects

Risk Factors in Osteporotic Vertebral Fractures

The aim of this study was to investigate the risk factors for osteoporotic vertebral fractures in postmenopausal women. 44 postmenopausal women whose L 2-L4 T scores were £ -2.5 SD with a mean age of 66.38+ 6.47 years were included in this study. Age, postmenopausal years, body mass index, milk consumption (before and after age 50), family history of osteoporosis and osteoporotic fracture, patient’s previous fracture history, tobacco use, number of pregnancies, surgical menopause were questioned in all patients. DEXA was used to evaluate bone mineral density . Kleerekoper method was used to evaluate the fractures between T4 and L5 vertebra on lateral thoracal and lumbar X rays. When 25 patient with vertebral fractures compared with 19 patients without fracture ,only patient’s age showed statistically significant difference between groups ( p=0.035). Of the 5 risk factors chosen (age, L2-L4 BMD, L2-L4 T score, body weight <57 kg, milk consumption before age 50) only patient’s age was found to be statistically important in estimating vertebral fracture risk (p=0.032).There was statistically significant positive correlation between vertebral deformity score (evaluated according to Kleerekoper method) and patient’s age and postmenopausal years (respectively p=0.001, p=0.006)

Pregnancy-Associated Osteoporosis: Case Report - Case Report

Pregnancy associated osteoporosis is a rare complication manifested with back, low back pain after gestation, or in lactation period. The entity has been first described by Nordin and Roper in 1955. The etiology and pathogenesis has not been thoroughly understood. Preexisting osteoporosis which grows harder in gestation, or genetic tendency and idiosyncrasy have been suggested as etiologic factors. In this article the current literature was reviewed on the basis of a patient diagnosed and treated in our department. (Osteoporoz Dünyasından 2006; 12 (2): 39-42