Evaluation of HLA-B51 frequency and its relationship with clinical findings in patients with Behcet's disease: 4-year analysis in a single center

The clinical findings of Behcet's disease (BD) differ according to the country and race investigated. The most important genetic factor known in the pathogenesis of BD is HLA-B51, and this positivity is high in countries on the "Silk Road" where BD is as frequent as it is in Turkey. Although the positivity of HLA B51 is proven to be high in Turkey, there are no studies in the area of the western Black sea demonstrating its relation to the demographic. We aimed to investigate the association of HLA-B51 positivity in Turkish patients diagnosed as having BD and the relationship between the demographic and clinical findings of the patients.ResultsIn this descriptive, cross-sectional study, a convenience sample of adults with BD was obtained from an outpatient clinic of a university hospital in Turkey between January 2018 and January 2022. Patients were diagnosed as having BD according to the criteria of the International BD Study Group, and the patients' sociodemographic and clinical characteristics were recorded retrospectively. Demographic data and the frequency of clinical findings were compared between patients who were HLA-B51-positive and HLA-B51-negative. Sixty patients (55.6%) were HLA-B51-positive. Oral ulceration, genital ulceration, thrombophlebitis, and family history of BD were found to be higher in patients who were HLA-B51-positive. Erythema nodosum, papulopustular eruption, pathergy positivity, arthritis, and ocular involvement were less frequent in patients with HLA-B51 positivity. However, there were no statistically significant differences according to the frequency of clinical findings between the HLA-B51-positive and HLA-B51-negative groups.ConclusionsHLA B51 positivity is not diagnostic of BD; however, it may affect clinical phenotypes. Although oral and genital ulcerations, thrombophlebitis, and positive family history of BD were found to be common in patients with HLA-B51 positivity, this relationship could not reach statistical significance

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

Comparing of the efficacy and effectiveness of isokinetic exercise, laser, pseudoiontophoresis and iontophoresis treatments according to the stage in treatments of subacromial impingement syndrome

Bu çalışmanın amacı, subakromiyal sıkışma sendromlu (SSS) hastaların tedavilerinde izokinetik egzersiz, lazer, iyontoforez, psödoiyontoforez tedavilerinin etkinliklerini araştırmak ve bu etkinlikleri evrelere göre karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya Subakromiyal Sıkışma Sendromu SS tanısı konan 242 hasta alındı. Hastalar 4 gruba ayrıldı. Her grupta 3 evre vardı (evre 2, evre 3 parsiyel yırtık, evre 3 komplet yırtık). Birinci grubun bütün evrelerine izokinetik egzersiz, ikinci gruba iyontoforez yöntemi ile diklofenak jel, üçüncü gruba lazer tedavisi, dördüncü gruba diklofenak jel uygulandı ve iyontoforez cihazı çalıştırılmadı. Tedavilerin tümü haftada 3 kez, 6 hafta süreyle (18 seans) yapıldı. Hastaların tedavi öncesi ve tedavi sonrası ağrıları Visuel Analog Skala, omuz fonksiyonları Constant Skoru ve Omuz Özürlülük Skoru, yaşam kalitesi Nottingham Sağlık Profili ile değerlendirildi. Bulgular: Tedavi öncesine göre tüm gruplarda tüm skorlarda tedavi sonrası düzelme sağlandı. Grupların kendi aralarındaki karşılaştırmada tüm skorlarda en etkin yöntemin izokinetik egzersiz, en az atkili olanın ise psödoiyontoforez yöntemi olduğunu bulduk. Lazer ve iyontoforez tedavileri psödoiyontoforeze göre daha fazla düzelme sağladı. İyontoforez ile lazer karşılaştırıldığında lazer istatistiksel anlamlı olmasa da daha fazla düzelme yaptı. Hastalar evrelere göre karşılaştırıldığında grupların hepsinde tedavi öncesine göre tedavi sonrası iyileşme saptandı. Tüm evrelerde izokinetik tedavi daha etkili bulundu, daha sonra lazer tedavisi en az da psödoiyontoforez tedavisi etkili bulundu. Sonuç: Dört grupta ve 3 evrede de tedaviler, tedavi sonrası etkiydi. Birbirleriyle karşılaştırdığımızda lazer ve iyontoforez yöntemi, izokinetik kadar olmasa da psödoiyontoforezden üstün ve etkindi.Objective: The aim of this study is to investigate effectiveness of isokinetic exercise, laser, pseudoiontophoresis and iontophoresis treatment in subacromial impingement syndrome (SIS) patients, and compare this effectiveness according to the stages. Material and Methods: 242 patients who were diagnosed subacromial impingement syndrome were included to study. Patients divided 4 groups. There were three stages in each group (stage 2, stage 3 partial tear, stage 3 complete rupture). Isokinetic exercise to first group's all stages, diclofenac gel by iontophoresis method to second group, laser treatment to third group, and diclofenac gel to fourth group were applied, and iontophoresis device was not worked. All of the treatment was performed three times a week and was carried out for 6 weeks (18 session). Pre-treatment and post-treatment pain of patients was evaluated by Visual Analogue Scale, shoulder function was evaluated by Constant Score and Shoulder Disability Score, and quality of life was assessed using the Nottingham Health Profile. Results: At the end of our study; in all groups in all scores were improved after treatment compared to pre-treatment. The comparison between the groups we have found that the most effective method in all scores is isokinetic exercise, and the least effective method is pseudoiontophoresis method. Laser and iontophoresis treatments provided greater recovery compared to pseudoiontophoresis. Compared to iontophoresis with laser, laser provided greater recovery although is not statistically important. Compared to patients by stage, revealed recovery after treatment than before treatment in all groups. Isokinetic treatment is the most effective, laser treatment is normal effective and pseudoiontophoresis treatment is the least effective were found in all stages. Conclusion: As a result, treatments in four groups and in three stages were effect of after the treatment. If we compare the methods with each other, laser and iontophoresis methods are more superior and more effective than pseudoiontophoresis method, but not as isokinetic method. © 2015 by Türkiye Klinikleri

Evaluation of dexamethasone suppression test in fibromyalgia patients with or without depression

WOS: 000183769800004PubMed: 12811674Objective: While in most healthy persons dexamethasone administration suppresses cortisol synthesis from the adrenal cortex, such suppression is not usually observed in patients with depression. We set out to investigate whether the dexamethasone suppression test (DST) reveals any neurobiological relationship between fibromyalgia (FM) and depression related to the hypothalamic-pituitary-adrenal (HPA) axis. Method. To discover a relationship between depression and FM we performed the DST in 2 0 FM patients with depression, 26 FM patients without depression and 20 healthy subjects serving as a control group. Results: Compared with the control group the cortisol level was found to be significantly higher in response to the DST in FM patients with depression (p = 0.03; z: -2.165), but not in those without depression (p = 0.15 3 ; z: -1.429). The cortisol level was not found to be statistically significant when patients with FM without depression were compared with the control group (p = 0.249 z: -1.152). In 7 FM patients with depression the DST failed to suppress cortisol; this was statistically significant compared with FM patients without depression (p = 0.014) and the control group (p = 0.008). Among FM patients without depression cortisol was not suppressed in one case. Cortisol was suppressed in all the controls. There was no statistically significant difference in cortisol suppression between FM patients without depression and the control group (p = 1.00). Conclusion: Our findings show that the DST reveals no neurobiological relationship between FM and depression related to the HPA axis

Meslek hastalığı olarak brusella saptanan ve kas-iskelet sistemi bulguları olan aynı köyde yaşayan iki olgu

Brucellosis is a systemic and infectious disease which spreads all around the world but mostly Mediterranean and Middle Asian countries. Brucellosis begins with non-specific symptoms such as fewer, night sweating, anorexia, weight loss, weakness, severe headache and polialtralgia. Appearance of symptoms is connected with duration of disease. One of the systems which brucellosis holds onto is the musculoskeletal system. Peripheral arthritis, sacroiliitis, spondylitis, tenosynovitis, bursitis and osteomyelitis can be seen on musculoskeletal system. In two case, brucellosis spondylitis, olecranon bursitis and arthritis which is detected as industrial illness on two men living in the same village, having arthralgia, backache, elbow pain and swelling is reported. © 2018, Duzce University Medical School. All rights reserved

Evaluation of medication adherence and medication beliefs and their relation with quality of life in osteoporotic patients with and without vertebral fractures: a path analysis

Abstract Background Osteoporosis (OP) is a public health problem that causes morbidity and mortality with various complications, especially fractures, negatively affects quality of life (QoL) and creates an economic burden on society. The aim of this study was to investigate the relationships among medication adherence, medication beliefs, QoL in Turkish patients with OP. Results The Medication Adherence Report Scale (MARS) total score was 17 in those with vertebral fractures and 18 in those without vertebral fractures. The total Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41) score was 48.7 in those with vertebral fractures and 35.1 in those without vertebral fractures. Visual analog scale (VAS) of pain scores showed a moderate correlation with every domain of the Qualeffo-41 scores (r = 0.401, r = 0.412, r = 0.391, r = 0.402, r = 0.380, r = 0.387 respectively, P =  0.05) of statistically significant. Conclusions Enhancing positive medication beliefs are a promising approach to improve medication adherence, and in turn, improved diseases self management and better QoL, in OP patients

A Case of primary erythromelalgia treated with pregabalin

Erythromelalgia (EM) is defined as the clinical syndrome characterized by erythema, an increased skin temperature, and burning pain in the affected extremities. Symptoms are relieved by cooling and aggravated in warm temperatures. The pain is often very severe, and treating is generally difficult. The therapeutic guidelines are also not well-established yet; a number of very different treatments were advised. We present a case of a 19-year-old male with primary erythromelalgia treated with pregabalin. The diagnosis of primary EM was based on his medical history, clinical findings, and laboratory tests. The frequency, duration, and intensity of the pain episodes decreased after pregabalin therapy. Pregabalin seems to be a proper option in controlling the pain in erythromelalgia. Copyright © 2010 by Türk Tibbi Rehabilitasyon Kurumu Derne?i

A Comparison of the Measuring Instruments to Assess Quality of Life in Patients with Fibromyalgia Syndrome

Amaç: Kompleks ve çok boyutlu bir klinik sendrom olan fibromiyalji sendromu (FMS), birçok somatik ve psikolojik yakınmalara neden olduğu için yaşam kalitesini bozmaktadır. Çalışmanın amacı, FMS tanısı almış kişilerin, yaşam kalitesini en kısa sürede ve en verimli şekilde değerlendiren ölçeği belirlemektir. Yanı sıra SF-12, SF-8 ve SF-6D formlarının güvenilirliği ve geçerliliğinin de incelenmesi amaçlandı.Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon AD'de tanı almış, çalışmaya katılmayı kabul etmiş ve formları tam doldurmuş olan 59 FMS hastası değerlendirildi. Hastaların yaşam kalitesi SF-36, WHOQOL-BREF, QuickDASH, SF-12, SF-8 ve SF-6D ölçekleri ile incelendi. Bulgular: Elde edilen veriler doğrultusunda ölçeklerin iç tutarlılığı ve ölçek puanlarının tekrarlama derecesi yüksek bulundu. SF-36 ölçek puanları ile diğer üç kısa formdan (SF) elde edilen puanlar arasındaki ilişki incelendiğinde, SF-12 ve SF-6D ölçekleri geçerlilik bakımından SF-8'den üstün bulundu. Tartışma ve Sonuç: Geçerlilik için yapılan bütün hesaplamalar değerlendirildiğinde, FMS'de SF12 ve SF-6D ölçekleri yaşam kalitesini ölçmede SF-36 yerine kullanabilir. SF-8'in ise bütün alt boyutlarda SF-12 ve SF-6D kadar etkili olmaması ve mental sağlık alt boyutunun bulunmaması nedenleriyle FMS'de yaşam kalitesini ölçmek amacıyla kullanımı önerilmemektedir.Aim: Fibromyalgia syndrome (FMS), a complex and multidimensional clinical syndrome, disrupts quality of life, causing many somatic and psychological problems. In this study we aimed to determine which measuring instrument should be chosen for the fastest and most efficient assessment of life quality in patients diagnosed with FMS. The reliability and validity of the SF12, SF-8, and SF-6D were also assessed concurrently.Materials and Methods: Fifty-nine patients diagnosed with FMS at Department of Physical Medicine and Rehabilitation, Medical Faculty of Duzce University, who consented to participate in the study and filled out the forms fully were evaluated. Life quality of the patients was investigated by using the instruments SF-36, WHOQOL-BREF, QuickDASH, SF-12, SF-8, and SF-6D.Results: The internal consistency and repeatability of these scales were found to be high in light of the obtained data. When the relation between the SF-36 scores and the scores obtained from the other three short forms (SF) was investigated, the SF-12 and SF-6D scales were found superior to the SF-8 in terms of validity.Discussion and Conclusion: In light of the entire data resulted from our assessment of validity, we suggest that the SF-12 and SF-6D might be preferred over the SF-36 in measuring life quality in patients with FMS. Because its lower efficiency than the SF-12 and SF-6D in all subdimensions and its lack of a mental health-related sub-dimension, the SF-8 is not an appropriate tool for this purpose in FMS