Turkish Journal of Rheumatology - 2004; 19(3)

ADAPTATION AND VALIDATION OF THE TURKISH VERSION OF THE BATH ANKYLOSING SPONDYLITIS DISEASE ACTIVITY INDEX (BASDAI)

Saime Ay, �ehim Kutlay, Ye�im Kurtai�, Burcu Yan�k — 2004-06-01

The aim of this study was to adapt the Bath Ankylosing Spondylitis Disease Index (BASDAI) questionnaire for use in Turkey and to test its reliability and validity. Following standart adaptation procedure of BASDAI, we performed the Turkish version. A total of 76 patients with ankylosing spondylitis were assessed with the BASDAI, the Turkish version of the Bath Ankylosing Spondylitis Functional �ndex (BASFI), the Bath Ankylosing Spondylitis Metrology �ndex (BASMI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G). Reliability of the adapted version was good, with high internal consistency (cronbach's alpha 0.76) and test-retest reliability (spearman's Rho 0.88) as was the distribution of scores across the scale (score range:0.1-8.9; md:3.3). The correlation coefficient between the BASDAI and the BASFI was rs=0.61, between the BASDAI and the BASMI rs=0.21 and between the BASDAI and the BAS-G rs=0.46. Conclusions: Adaptation of the BASDAI for use in Turkey is succesful. The results of the present study indicate that the Turkish version of BASDAI is reliable and valid. It is a comprehensive self-administered instrument for assessing disease activity.

EVALUATION OF BONE MINERAL DENSITY IN PATIENTS WITH PLAQUE PSORIASIS WITHOUT ARTHROPATHY

2004-06-01

Psoriasis is a chronic, recurrent, inflammatory and hyperproliferative skin disease. Osteoporosis is characterized by decrease of bone mineral density (BMD) and bone matrix. Reduced BMD is a major risk factor for osteoporotic fracture. The aim of this study is to investigate BMD (using Z score) in patients with moderate and severe plaque psoriasis without arthropathy. Forty-three patients (12 males, 31 females and mean age 38.2) diagnosed as plaque psoriasis without joint involvement and 30 healthy subjects (9 males, 21 females and mean age 38.6) were included to this study. BMD was measured with dual X-ray absorptiometry at the lumbar spine (L2-4), femur and left forearm of all patients and healthy subjects. There were no significant differences in the mean BMD of L2-4, femur and left forearm between patients and healthy subjects (for each region p>0.05). Both groups were divided into two subgroups according to the age of the subjects as a younger and older than 40-year-old. No significant differences were detected in comparisons between these subgroups (p>0.05). Furthermore, we have not found significant differences in BMD between patients and healthy subjects which were postmenopausal (p>0.05). As a result, this study indicoted that cortical or trabecular bone density was not affected in patients with moderate and severe plaque psoriasis without joint involvement.

SACROILIITIS IN PATIENTS WITH ANKYLOSING SPONDYLITIS: THE FINDINGS OF MAGNETIC RESONANCE IMAGING

L.Oktay Erdem, C. Zuhal Erdem, Selda Sar�kaya — 2004-06-01

Objective: To determine the characteristic findings of sacroiliitis using by magnetic resonance (MR) imaging. Material and Method: 13 consecutive patients with AS (mean age: 44� 10years) and 4 volunteers (mean age:40� 7 years) were enrolled in the study. Mean disease duration of AS patients was 10.4� 8.3 years (4- 30 years). MR images were performed with the sequences of the coronal T1 weighted turbo spin-echo (TSE) image, T2 weighted FFE image and STIR image using a 1.5-T imager for all volunteers and patients. 26 sacroiliac (SI) joints in 13 patients with AS were examined with MR examination. Erosions, ankylosis, and type 1-3 findings in the SI joints were recorded on MR imaging. MR image set was interpreted by consensus of two radiologist who blinded clinical data. Results: MR imaging findings were normal in 4 volunteers (8 SI joints ). The most common abnormalities detected by MR imaging in 13 AS patients were as follows, type 3 lesions (46%), type 2 lesions (31%), type 1 lesions (19%), erosions (38%) and ankylosis (35%). Conclusion: We belived that MR imaging is an useful diagnostic modality in the diagnosis of sacroiliitis which can demonstrate detailed anatomy of the SI joint and the changes of sacroiliitis and the lack of radiation exposure.

COMPARISON OF THE EFFECTS OF ALENDRONATE AND CALCITONIN ON BONE DENSITY AND BONE TURNOVER IN THE TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS

Serpil Sava�, Abdullah Cinda�, Berna Okudan, Mustafa �zt�rk — 2004-06-01

The aim of this study is to compare the effects of 10 mg daily oral alendronate and intranasal calcitonin at a daily dose of 200 IU on bone density and bone turnover in the treatment of postmenopausal osteoporosis. Forty-seven patients with postmenopausal osteoporosis received alendronate therapy and thirty patients received salmon calcitonin nasal spray for 12 months. Spine and hip bone mineral density (BMD) and markers of bone turnover were measured at baseline and at 12 months. Alendronate produced greater increases in BMD than calcitonin at 12 months at the spine (p=0,05) , greater trochanter (p= 0,04) , femoral neck (p=0,05) . Alendronate produced greater decreases in serum osteocalcin levels than calcitonin (p=0,0001) and urinary deoxypridinoline (p=0,01) . We conclude that in postmenopausal women with osteoporosis, 10 mg daily alendronate produced significantly greater increases in BMD of the lumbar spine and hip and greater decreases in bone turnover than intranasal calcitonin at daily dose of 200 IU at 12 months.

EFFECT OF VENTILATORY MUSCLE TRAINING AND AEROBIC EXERCISE PROGRAM IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON RESPIRATORY FUNCTIONAL TEST AND ARTERIAL BLOOD GASES

�lk� Sarpkaya, Hakan Tuna, G�ndeniz Alt�ay, Erhan Tabako�lu — 2004-06-01

The main aim of pulmonary rehabilitation is to improve life quality, strength and endurance; additionally prevent dyspnea as well. Our study designed for evaluation the effectiveness of pulmonary rehabilitation was conducted in 19 COPD patients (16/3 men/women) whose mean (SD) age was 61,00 (9,6) years and mean forced expiratory volume in one second (FEV1) was 1,46 (0,60). After completion of 6-8 weeks homebased threshold IMT ventilatory muscle training program, hospital-based 3 weeks intensive bicycle ergometer exercise training was conducted for each patient. There were statistically significant improvements in FEV1, forced vital capacity (FVC), maximum inspiratory-expiratory pressure (PImax- PEmax), arterial oxygen pressure and oxygen saturation (PO2, SaO2), 6 minute walk distance (p<0,05). These results confirm our thought that pulmonary rahabilitation could be separated confidently and additional benefits could be more powerful with preparing the respiratory system before aerobic exercise training.

RESULTS OF INTRA-ARTICULAR HYALURONIC ACID INJECTION IN OSTEOARTHRITIS OF THE KNEE

Sel�uk KESER, Ahmet BAYAR , �brahim TUNCAY, Ahmet EGE, Nurettin DEM�REL — 2004-06-01

In this prospective study, the outcome of intraarticular hyaluronic acid injections in patients with gonarthrosis, that were classified according to radiologic grade, were analysed. Forty female patients with the diagnosis of gonarthrosis according to the criteria of American College of Rheumatology and with a mean age of 59 (40-73), were treated with weekly intraarticular injections of hyaluronic acid for three weeks. Radiologic assessment was made according to the Kellgren-Lawrence classification. The results were evaluated according to the values of visual analoque scale on walking painrest pain, patient satisfaction and the Lequesne Functional Index that were examined at baseline, 3rd and 6th months. Patients with grade I and II gonarthrosis had significantly decreased scores of walking pain, rest pain and Lequesne index at 3rd and 6th months (p<0.05). Seventy two percent of these patients were satisfied with the treatment. While the patients with grade III gonarthrosis also had significantly decreased scores of walking and rest pain at 3rd month (p<0.05), Lequesne index values were not significantly altered. The only significant difference at 6th month was the lowered resting pain. Sixty percent of grade III patients were satisfied with the treatment. Intraarticular hyaluronic acid injection is a useful medical treatment option for patients with radiologic grade I,II gonarthrosis. It may be used for palliative treatment of pain for patients with advanced age, grade III gonarthrosis and for those rejecting an operation.

NECROTIZING MYELOPATHY: A CASE REPORT

2004-06-01

Necrotizing myelopathy, although very rare, is a neurological paraneoplastic complication of various malignancies, it may certainly be seen in non-cancer patients. It is a slowly progressing disease characterized with lower motor neuron involvement. Preservation of sensory nerve action potentials and severe denervation seen in electromyography. In this case, we present a necrotizing myelopathy case with electrophysiological findings and rehabilitation outcomes. A discussion of the case and a brief review of the literature on the subject were presented.

HAND DEFORMITY IN PARKINSON'S DISEASE: CASE REPORT

Ece Aydo�, Emel Ek�io�lu, Ayt�l �akc�, �zge Y�lmaz — 2004-06-01

Hand and foot deformities were originally described in Parkinson's disease in 1864, although its pathogenesis still remains to be clarified. Typical hand deformities are flexion in metacarpopharyngeal joints and hyperextension in interphalangial joints, sometimes accompanied by ulnar deviation. Unlike Rheumatoid arthritis, there is no swelling and stiffness in joints. In this report, a case that was previously misdiagnosed as Rheumatoid arthritis due to deformities in hand and whose Parkinson's disease was detected upon presentation to our clinic is presented and the differential diagnosis of the disease is discussed.

CARDIOVASCULAR INVOLVEMENT IN RHEUMATOID ARTHRITIS

Elif Berber Menek�e, Ferhan Cant�rk, Gamze Alayl� — 2004-06-01

Rheumatoid arthritis (RA) is a chronic, systemic and inflammatory joint disease. Cardiac involvement is common in RA. Although cardiac involvement is clinically silent, many studies revealed that the mortality rate was increased in RA and cardiovascular disease was the most common reason of mortality in RA. In this review cardiac involvement in RA and the pathogenesis of cardiovascular disease in RA were briefly summarized.

SHOULDER ARTHROPLASTY REHABILITATION

Burcu Yan�k, G�lay Din�er — 2004-06-01

The glenohumeral joint has the greatest amount of motion of any joint in the body. The first aim of the shoulder arthroplasty is to decrease the pain. The loss of joint motion and function are the other indications. Rehabilitation after shoulder arthroplasty depends on multiple factors, including the status of the soft tissues around the shoulder (intact or torn rotator cuff, size of tear), the quality of the bone, the stability of the implant and the fixation technique used, any concomitant injuries or systemic illness, and the expectations of the patient.