Romatoid artritli hastalarda sosyal rol katılımının yaşam kalitesine etkisi

Objective: The aim of this study was to explore the impact of social role participation on quality of life in rheumatoid arthritis (RA) patients. Material and Methods: This study was conducted on 100 RA patients who applied to our outpatient clinic and 95 healthy controls. The outcome measures included Visual Analogue Scale (VAS) (rest and activity pain), Disease Activity Score (DAS-28) Scale, Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL), and Social Role Participation Questionnaire (SRPQ) (role limitations, salience, satisfaction). Results: There were statistically significant differences in SRPQ role salience, SRPQ role limitation, and SRPQ role satisfaction scores between the RA patients and the healthy individuals (p<0.001). The RAQoL scores were positively correlated with SRPQ limitation scores and negatively correlated with SRPQ role satisfaction and SRPQ role salience scores (all, p<0.001). Negative correlations were found between SRPQ scores (salience, satisfaction) and DAS-28 and VAS (rest and activity pain) scores (all, p<0.05). Positive correlations were found between SRPQ role limitations scores and DAS-28 and VAS (rest and activity pain) scores (all, p<0.05). There was no correlation between SRPQ domains scores and age or disease duration in RA patients (all, p>0.05). RAQoL was positively correlated with VAS (rest and activity pain) and DAS-28 scores (all, p<0.001). Conclusion: This study showed that there is an association between social role participation and quality of life in RA patients. So, it may be useful to take into account the evaluation of social role participation in the management of RA patients.Amaç: Çalışmamızda, romatoid artrit (RA) hastalarında sosyal rol katılımının yaşam kalitesi üzerindeki etkisini araştırmayı amaçladık. Gereç ve Yöntemler: Bu çalışma polikliniğimize başvuran 100 RA hastası ve 95 sağlıklı kontrol üzerinde gerçekleştirildi. Sonuç ölçütlerinde Vizüel Analog Skalası (VAS) (istirahat ve aktivite ağrısı), Hastalık Aktivite Skoru [Disease Activity Score-28 (DAS-28)] Ölçeği, Romatoid Artrit Yaşam Kalitesi Ölçeği [Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL)] ve Sosyal Rol Katılım Anketi [Social Role Participation Questionnaire (SRPQ)] (rol sınırlamaları, belirginlik, memnuniyet) kullanıldı. Bulgular: RA hastaları ve sağlıklı bireyler arasında SRPQ rol belirginliği, SRPQ rol sınırlaması ve SRPQ rol memnuniyetinde istatistiksel olarak anlamlı farklılıklar vardı (p<0,001). RAQoL ile SRPQ rol sınırlama arasında pozitif korelasyon ve RAQoL ile SRPQ rol memnuniyeti ve SRPQ rol belirginliği arasında ise negatif korelasyon bulundu (hepsi, p<0,001). SRPQ (belirginlik, memnuniyet) ile DAS-28 ve VAS (istirahat ve aktivite ağrısı) arasında negatif korelasyon tespit edildi (hepsi, p<0,05). SRPQ rol sınırlılıkları ile DAS28 ve VAS (istirahat ve aktivite ağrısı) arasında pozitif korelasyon tespit edildi (hepsi, p<0,05). RAQoL ile VAS (istirahat ve aktivite ağrısı) ve DAS-28 arasında pozitif korelasyon bulundu (hepsi, p<0,001). Sonuç: Bu çalışma, RA hastalarında sosyal rol katılımı ile yaşam kalitesi arasında bir ilişki olduğunu göstermiştir. Bu nedenle RA hastalarının tedavi yönetiminde, sosyal rol katılımının değerlendirilmesini dikkate almak faydalı olabilir

Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis

Serdaroglu Beyazal, Munevver/0000-0001-5903-5708WOS: 000368605500030PubMed: 26834345[Purpose] This study aimed to determine and compare the effectiveness of extracorporeal shock wave therapy and local corticosteroid injection in patients with lateral epicondylitis. [Subjects and Methods] Sixty-four patients with lateral epicondylitis were randomly divided into extracorporeal shock wave therapy and steroid injection groups. Patients were evaluated using hand grip strength, visual analog scale, and short-form McGill pain questionnaire at baseline and at 4 and 12 weeks post-treatment. [Results] Both groups showed statistically significant increase in hand grip strength and decreases on the visual analog scale and short form McGill pain questionnaire overtime. There was no statistically significant difference in the percentage of improvement in hand grip strength and on the short-form McGill pain questionnaire between groups at 4 weeks post-treatment, whereas the extracorporeal shock wave therapy group showed better results on the visual analog scale. the percentages of improvements in all 3 parameters were higher in the extracorporeal shock wave therapy group than in the injection group at 12 weeks post-treatment. [Conclusion] Both the extracorporeal shock wave therapy and steroid injection were safe and effective in the treatment of lateral epicondylitis. However, extracorporeal shock wave therapy demonstrated better outcomes than steroid injection at the long-term follow-up

The association of anti-CCP antibodies with disease activity in rheumatoid arthritis

Antibodies to citrullinated proteins have been described in patients with rheumatoid arthritis (RA) and these appear to be the most specific markers of the disease. Our objective was to determine the frequency of antibodies to cyclic citrullinated peptides (CCPs) in patients with RA and the association of anti-CCP antibodies with disease activity, radiological erosions and HLA DR genotype. Forty patients with RA and 38 patients with fibromyalgia were included in this study. Serum samples were collected from both patient groups with RA and fibromyalgia. Anti-CCP was measured by the corresponding enzyme-linked immunosorbent assay. Additionally, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), disease activity score (DAS), visual analog scala (VAS), HLA genotype and radiographic information were determined in patients with RA. The rate of sensitivity and specificity of anti-CCP reactivity for the diagnosis RA were measured (sensitivity 50%, specificity100%). There is no significant difference between anti-CCP (+) and anti-CCP (−) RA patients for DAS28, VAS, ESR, CRP, disease duration, HLA genotype, and radiological assessment of hand. However, there was a significant difference between anti-CCP (+) and anti-CCP (−) RA patients for RF and the radiological assessment of left and right wrists (respectively, P < 0.05, P = 0.04, P = 0.01). There was no significant correlation between anti-CCP antibody and ESR, CRP, VAS, DAS 28 or radiological assessment. A small but significant correlation was found between RF and anti-CCP antibody (P = 0.02, r = 0.35)

The Relationship of Hand Grip Strength with Bone Mineral Density and Vitamin D in Postmenopausal Women

Objective: The aim of the present study was to evaluate the relationship of hand grip strength (HGS) with bone mineral density (BMD) and vitamin D levels in postmenopausal women. Materials and Methods: One hundred thirty one postmenopausal women were included in this study. HGS was measured by Jamar hand dynamometer. BMD was measured by dual energy X-ray absorptiometry at lumbar spine and femoral neck sites. Serum 25-hydroxyvitamin D (25OHD) levels were measured. Results: The mean age of patients was 61.2±9.2 years. The mean HGS was 22.9 kg and 32 patients (24.4%) had low HGS. Thirty seven patients (28.2%) were osteoporotic and 62 (47.3%) were osteopenic. The mean 25OHD level was 17 ng/mL and 101 (77.1%) patients having vitamin D insufficiency. There was a significant difference in HGS values among groups with osteoporosis, osteopenia, and normal BMD (p=0.016). HGS values demonstrated a positive correlation with T-scores and BMD values at lumbar spine and femoral neck sites (p<0.001, r=0.340; p<0.001, r=0.300; p<0.001, r=0.320; p=0.001, r=0.298, respectively) and negative correlation with age and duration of menopause (p<0.001, r=-0.344; p<0.001, r=-0.318; respectively). However, no significant association was observed between 25OHD levels and HGS (p=0.860, r=0.016). Conclusion: Postmenopausal women with osteoporosis had lower HGS than postmenopausal women with normal BMD, and HGS was significantly correlated with BMD, but not with vitamin D in this population. The patients should be encouraged to increase muscle strength for the risk management of osteoporosis in postmenopausal wome

Evaluación de la homeostasis de tiol-disulfuro en pacientes con espondilitis anquilosante activa

Introduction and objectives: The etiopathogenesis of ankylosing spondylitis (AS), which is a chronic, progressive, inflammatory, systemic disease, has not been fully elucidated yet. Thiol-disulfide homeostasis, a component of antioxidant defense, is thought to play a role in the etiology of inflammatory diseases. We aimed to evaluate the existence of oxidative stress in active AS patients with thiol-disulfide homeostasis. Materials and methods: Patients who were found to have high (n: 27) and very-high (n: 18) activity levels with ASDAS-ESR and 40 healthy controls participated in the study. Serum native-thiol (NT), total-thiol (TT), and disulfide levels were analyzed by an automated colorimetric method. Results: While TT and NT levels were significantly decreased in patients compared to the control group, the disulfide levels were increased. There was a significant negative correlation between ESR, and NT, TT in both groups and also between hsCRP and NT, TT in very-high active AS patients.TT and NT levels were significantly higher in the nonsteroidal anti-inflammatory drug (NSAID) users compared to those using biological agents. Conclusions: The deterioration of thiol-disulfide homeostasis in favor of disulfide; correlations between ESR, CRP, and NT, TT support the use of thiol-disulfide variables in determining the disease activity level

Fibromiyaljinin Migrenli Hastalarda Dizabilite, Anksiyete, Depresyon, Uyku Bozukluğu ve Yaşam Kalitesi Üzerine Etkisi

Introduction: The aim of the present study was to assess the impact of fibromyalgia (FM) comorbidity on disability, anxiety, depression, sleep disturbance, and quality of life in patients with migraine. Methods: Eighty-six consecutive migraine patients (age, 35.4±10.3 years; 69 women and 17 men) were enrolled in the study. The headache characteristics of the patients were recorded. FM was diagnosed based on the 1990 American College of Rheumatology classification criteria for the diagnosis of FM. All patients were asked to complete selfreport questionnaires, including the Fibromyalgia Impact Questionnaire (FIQ), Headache Impact Test (HIT-6), Migraine Disability Assessment Questionnaire (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the 36- Item Short Form Survey (SF-36) to assess their pain-related disability, migraine-related disability, depression, anxiety, sleep disturbance, and quality of life. Results: Of the migraine patients, 28 (32.6%) met the criteria for FM. Migraine patients with FM showed significantly increased migraine frequency and BDI, BAI, and PSQI scores and decreased quality of life scores for all eight domains of the SF-36 compared to patients with migraine alone, whereas the mean HIT-6 and MIDAS values did not differ between the groups. FIQ score showed statistically significant positive correlations with BDI, BAI, PSQI, and MIDAS scores and with headache frequency (p<0.001, r=0.657; p<0.001, r=0.730; p<0.001, r=0.754; p=0.005, r=0.300; p=0.008, r=0.286, respectively); FIQ score showed negative correlations with scores for all domains of the SF36. In multivariate linear regression analysis, BDI, BAI, and PSQI scores independently predicted FIQ score. Conclusion: Our study results demonstrate the significant impact of FM comorbidity on anxiety, depression, sleep disturbance, and quality of life in this population. FM evaluation and treatment should be considered in the routine care of patients with migraine to globally improve the patient’s quality of life.Amaç: Sunulan bu çalışmanın amacı migrenli hastalarda fibromiyalji (FM) birlikteliğinin dizabilite, anksiyete, depresyon, yaşam kalitesi ve uyku bozukluğu üzerindeki etkilerini değerlendirmek idi. Yöntem: Seksenaltı ardışık migren hastası çalışmaya dahil edildi. Hastaların migren baş ağrısı karakteristikleri kaydedildi. FM tanısı 1990 Amerikan Romatizma Cemiyeti’nin FM tanı kriterlerine göre koyuldu. Ağrı ve migren ile ilişkili dizabilite, depresyon, anksiyete, uyku bozukluğu ve yaşam kalitesi tespiti için tüm hastaların Migren Dizabilite Değerlendirme Ölçeği (MDDÖ), Fibromiyalji Etki Sorgulaması (FES), Baş Ağrısı Etki Testi-6 (BET-6), Pittsburgh Uyku Kalite Indeksi (PUKİ), Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE) ve Kısa Form 36’yı (KF-36) içeren hasta bildirimli sorgulama formlarını tamamlamaları istendi. Bulgular: Migren hastalarının 28’i (%32,6) FM tanı kriterlerini karşıladı. Ortalama BET-6 ve MDDÖ değerleri gruplar arasında farklı değilken, migrenle birlikte FM’ye sahip olan hastalar yalnızca migrene sahip olan hastalara göre artmış baş ağrısı sıklığı ve artmış BDE, BAE, PUKİ ve MDDÖ skorları ve KF-36’nın tüm alt grupları için azalmış yaşam kalitesi skorları gösterdiler. FES skorları BDE, BAE, PUKİ, MDDÖ skorları ve baş ağrısı sıklığı ile istatiksel olarak anlamlı pozitif korelasyon (p<0,001, r=0,657; p<0,001, r=0,730; p<0,001, r=0,754; p=0,005, r=0,300; p=0,008, r=0,286, sırasıyla) ve KF-36’nın tüm alt grupları ile negatif korelasyon gösterdi. Çok değişkenli lineer regresyon analizinde BDE, BAE ve PUKİ skorları FES skorlarını bağımsız şekilde tespit etti. Sonuç: Çalışmamızın sonuçları migrenli hastalarda FM birlikteliğinin anksiyete, depresyon, uyku bozukluğu ve yaşam kalitesi üzerindeki önemli etkilerini açığa çıkardı. Hastaların yaşam kalitesinde tümüyle iyileşme sağlamak için, FM incelemesi ve tedavisi migrenli hastaların rutin takibinde dikkate alınmalıdır

Assoziation von serum-interleukin-17- und interleukin-23- spiegeln mit krankheitsaktivität, funktion, mobilität, enthesitis index bei patienten mit ankylosierender apondyl

Aim: More and more studies have demonstrated that the interleukin (IL)-23/IL-17 axis is highly associated with immune dysfunction and activated autoimmune inflammation. The purposes of this study were to determine the serum levels of IL-17 and IL-23 in ankylosing spondylitis (AS) patients compared with healthy controls and evaluate these cytokine levels based on disease-related characteristics. Material and Methods: Eighty-six consecutive AS patients and 70 sex and age-matched healthy controls were included in the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), ASDAS-C reactive protein, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index, the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and Achilles pain VAS scores were recorded. Serum IL-17 and IL-23 levels were examined by enzyme-linked immunosorbent assay. Results: The serum levels of IL-17, IL-23 and CRP as well as ESR values were significantly increased in AS patients compared with controls (1.94 vs. 0.28 pg/mL p 0.05). Serum IL-23 levels demonstrated a significant correlation with Achilles pain VAS, but not with other disease-related parameters (all p>0.05). Conclusions: AS patients had increased serum IL-17 and IL-23 levels compared with healthy controls, and serum IL-17 levels were associated with disease activity. Our study results support the hypothesis that the IL17/23 pathway plays an important role in the pathogenesis of AS

The Evaluation of Paraspinal Markers in the Numbering of the Lumbosacral Transitional Vertebrae

Amaç: Lumbosakral geçiş vertebra (GV) yaygın bir konjenital anomali olup kronik bel ağrısı ile ilişkili olduğu bilinmektedir. Bu çalışmanın amacı bilgisayarlı tomografi (BT) görüntülerde lumbosakral GV’nin doğru numaralandırılmasında çölyak arter (ÇA), süperior mezenterik arter (SMA), sağ renal arter (SRA) orijinleri, abdominal aort bifurkasyonu (AAB) ve iliolumbar ligament (İL) gibi paraspinal belirteçlerin değerini ortaya koymaktır. Gereç ve Yöntem: Ocak 2015 ile Aralık 2017 tarihleri arasında tüm vücut BT görüntülemesi yapılan 18-65 yaşları arasındaki olgular retrospektif olarak değerlendirildi. Bulgular: Çalışmaya 380 olgu (yaş, 53,4±10,8 yıl; 164 kadın ve 216 erkek) dahil edildi, 51 olguda (%13,4) GV vardı. Normal spinal segmentasyonlu ve GV’li olgular arasında ÇA, SMA, SRA orijini, AAB ve İL düzeyleri açısından anlamlı farklılık saptandı (p<0,001). Sonuç: Normal spinal segmentasyonlu ve GV’li bireyler arasında ÇA, SMA, SRA orijinleri, AAB ve İL düzeylerinin lokalizasyonu açısından anlamlı farklar vardır. Dolayısıyla, bu belirteçlerin kullanımı, vertebral numaralandırmanın belirlenmesinde yanlışlıklara neden olabilir.Objective: Lumbosacral transitional vertebrae (TV) are a common congenital anomaly and known to be associated with chronic low back pain. The purpose of this study is to reveal the value of the paraspinal markers such as celiac artery (CA), superior mesenteric artery (SMA), right renal artery (RRA) origins, abdominal aorta bifurcation (AAB), and iliolumbar ligament (IL) in the correct numbering of lumbosacral TV on computed tomography (CT) imaging. Materials and Methods: The cases with aged from 18-65 years who underwent the whole-body CT imaging between the dates January 2015 and December 2017 were assessed retrospectively. Results: Of the 380 cases (age 53.4±10.8 years; 164 women and 216 men) included in the study, 51 (13.4%) had TV. A significant difference was determined in terms of the level of CA, SMA, RRA origin, AAB, and IL between the cases with TV and normal spinal segmentation (p<0.001). Conclusion: There are significant differences in terms of the localization of the CA, SMA, RRA origins, AAB, and IL levels between the subjects with normal spinal segmentation and TV. Therefore, the use of these marks may result in inaccuracy of the vertebral numbering

The association of achilles sonoelastography findings with disease activity, functional status and enthesitis index in patients with axial spondyloarthritis

Background Sonoelastography (SE) is a new ultrasound (US)-based technique able to assess tissue elasticity. Using conventional US, it is sometimes difficult or even impossible to distinguish pathologic tissue because it often presents with the same echogenicity as the surrounding healthy tissue. This study aimed to evaluate SE findings in Achilles tendons of patients with axial spondyloarthritis (axSpA) and to assess how these findings are associated with disease-related parameters. Material and Methods Sixty-four consecutive patients (37 men, 27 women; mean age 39.7 years; range 20-65 years) with axSpA and 30 sex and age-matched healthy controls were enrolled in the study. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index were recorded. All participants underwent an SE examination of the Achilles tendon and measurement of the strain index (SI). Results The mean right and left SI were significantly higher in axSpA patients than in controls (2.96 +/- 0.94 vs. 1.90 +/- 0.45; p<0.001; 2.95 +/- 0.95 vs. 1.92 +/- 0.48, p<0.001, respectively). In axSpA patients, both right and left SI were significantly correlated with the BASDAI, BASFI and SPARCC enthesitis indices, but not with ESR or CRP. Conclusion AxSpA patients had an increased SI compared with healthy subjects and these values were associated with disease activity, functional capacity and the enthesitis index. SE may be a useful tool for the evaluation of Achilles tendons in patients with axSpA