Turkish Journal of Rheumatology - 2003; 18(1)

THE EFFECTS OF PULMONARY REHABILITATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

�zlem Levent, Ye�im Kurtai� G�rsel — 2003-06-01

The purpose of this study was to compare the effects of pulmonary rehabilitation (PR) on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease (COPD) with thase of education alone. Twentythree patients with COPD were randomly assigned to either a 3 days per week for 8 weeks comprehensive pulmonary rehabilitation program (exercise group) or to 8 weeks education program (control group ). Compared with education alone, pulmonary rehabilitation produced a greater improvement in exercise endurance, 6-minute walking test, exertional dyspnea and depression. Measures of lung function and arterial blood gases did not differ between groups, whereas diffusion capacity significantly improved in the exercise group. There was a significant improvement in the quality of life in both groups. These findings suggest that 8-week pulmonary rehabilitation program may be beneficial for COPD patients. Improvement in functional exercise capacity, even without an increase in maximal exercise capacity, are helpful for reducing dyspnea and depression, improving quality of life parameters in patients with COPD.

TREATMENT OF POSTRAVMATIC REFLEX SYMPATHETIC DYSTROPHY SYNDROME WITH CALCITONIN

D. Ofluo�lu, G. Aky�z, �. Kayhan, F. Dede, H.T. Turo�lu, TY Erdinc, S. �nan�r — 2003-06-01

Reflex sympathetic dystrophy syndrome (RSDS) is a common but often unrecognized entity. It usually affects extremities after a certain trauma. The purpose of this study was to investigate the effects of calcitonin on pain and symptoms in upper limb RSDS which was seen after a certain trauma. The study included 15 patients with stage I RSDS. Three of 15 were men and 12 were women. Their mean age was 55�15 (25-72). All patients were treated with 200 IU/day intranasal salmon calcitonin for 3 months, and with whirlpool, TENS (Trancutaneous Electrical Nerve Stimulation), 1.5 watt/cm² ultrasound therapy for 15 days following diagnosis. Range of motion (ROM) exercies were prescribed in warm water and continued for 3 months. Before and after treatment, we measured joint ROM and grasp strength with a goniometer and dinamometer respectively. Patients' pain level was evaluated by using 10 cm visual analogue scale (VAS). Finally, physicians' global assessment was utilized at the end of the study. At the end of the study, ROM, pain scores and grasp strength improved (p<0.05). As a result, we suggested that intranasal salmon calcitonin decreased pain scores and increased functional activity in traumatic reflex sympathetic dystrophy syndrome.

SOMATOTYPE DISTRIBUTION IN STUDENTS OF SPORTS ACADEMY AND MEDICAL SCHOOL

2003-06-01

Objective: The purpose of this study was to investigate the difference in somatotype, % fat, body mass index (BMI) between Sports Academy students (SAS) who were actively engaged in sports and Medical School students (MSS) Design and Material: Sixty (30 male, 30 female) Sports Academy students and twenty four (14 male, 10 female) Medical School students participated in this study as volunteers. Body composition was estimated from skinfold and somatotype was determined using the Heath-Carter method. Data analysis included antropometric measures and three somatotype variables (endomorphy, mesomorphy, ectomorphy), were compared between groups and sexes, and the level of significance was set at 0.05. Results: Thorax, abdominal and hip circumference of sports academy students were significantly higher (p<0.05). Suprailiac, abdominal, upper arm triceps and subscapular skinfold of medical school students were found significantly higher (p<0.01). Between the groups the mean mesomorphic (SAS: 2,42�1,24 and MSS: 2,29�1,24) and ectomorphic components (SAS: 3,01�0,93 and MSS: 2,79�1,02) and diameter of bicondylar of femur and humerus were not significantly different (p>0.05). The endomorphic component was found significantly different (SAS: 2,15�0,75, MSS: 2,69�0,74) (p<0.05). The amount of endo-ectomorphs were higher in both groups. SAS were mainly classified as endo-ectomorph, meso-ectomorph and ekto-mesomorph. The average values of mesomorphy and endomorphy were found different from sex point of view (p<0.001). In both groups, mean percent body fat and endomorphy was found significantly higher (p<0.05, p<0.001 respectively) in the females. Conclusion: The amount of endomorphy and % fat was higher in the MSS group than SAS group. The endomorphic component of females was found higher than males in both groups. The endo-ectomorphic, meso-ectomorphic and ekto-mesomorphic somatotypes were significantly higher in SAS. It may be concluded that amount of endomorphic component of active people decreases significantly.

CLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC FATIGUE SYNDROME

Remzi �evik, Ali G�r, Kemal Nas, Suat Acar, A. Jale Sara� — 2003-06-01

Purpose: Chronic fatigue syndrome (CFS) consists of a range of symptoms including fatigue, headache, sleep disturbances, difficulties in concentration, and muscle pain. Our aim was to describe the clinical and demographical features of the patients with CFS and to compare them with the control group. Methods. Sixty-eight women with CFS (mean age: 31�8) and 52 healthy women (mean age: 29�6) were included in the study. Clinical findings and demographical data of the patients with CFS were evaluated and compared with control group. Results: Most commonly detected symptoms were fatigue (100%), myalgia (97%), adenopathy (87%), pharyngitis (84%), arthralgia (84%), sleep disturbances (73.5%) and sore throat (69%) in women with CFS. Depression level and tender point count were higher than controls. Conclusions: These data demonstrate that depression level is higher, and fatigue, myalgia, adenopathy, sore throat, and athralgia are the most commonly symptoms that occurred in patients with CFS. In addition CFS should be taken into consideration in patients with such complaints for long time.

AN USEFUL AND SIMPLE METHOD IN DIAGNOSIS OF CARPAL TUNNEL SYNDROME: HAND DIAGRAM

�znur �ken, Sema Atalay �atal, Esma Ceceli, Z. Rezan Yorganc�o�lu — 2003-06-01

The most common pathology in patients with upper limb paresthesia is Carpal Tunnel Syndrome (CTS). Most valuable clue for diagnosis is obtained from patient's history. Hand diagram developed by Katz and Stirrat has been used for evaluation of patients with upper limb numbness, pins-needles sensation in some of the hand clinics. We also tested hand diagram on patients who were complaining paresthesia in upper extremities. We concluded that, this diagram is an extremely easy to apply and inexpensive method and, it can be used in hand clinics in addition to other diagnostic tests.

RELATIONSHIP BETWEEN HAND OSTEOARTHRITIS AND BENIGN JOINT HYPERMOBILITY

2003-06-01

Hand OA is a common condition mostly affecting postmenopausal women and causing considerable morbidity. The aim of this study was to determine the association between radiological grades, involved joints, hand-grip strength, and pinch strength in hand osteoarthritis and benign joint hypermobility. One hundred-six postmenopausal female patients with hand osteoarthritis and sixty healthy postmenopausal women were included in this study. Patients' ages, body mass index (BMI), number of Heberden and Bouchard nodules, proximal interphalengeal (PIP), distal interphalengeal (DIP) and carpometacarpal joint (CMC) involvement, pain scales and Beighton scores were recorded. Our results did not reveal any significant correlation between Beighton scores and radiological grades, involvement localizations, hand-grip strength and pinch strength. In conclusion we may say that, our hand osteoarthritis patients did not show any relationship between benign joint hypermobility and hand osteoarthritis. This result may be also due to joint limitation caused by osteoarthritis.

A CASE OF OSTEOMALACIA SHOWING THE CHARACTERISTICS OF SPONDYLOARTHROPATHY

G�ldal Funda Nakipo�lu, Ay�e Karamercan, Aynur Karag�z, Ne�e �zgirgin — 2003-06-01

Osteomalacia is a metabolic bone disease that results from defective bone mineralization and may present with a variety of clinical and radiographic manifestations mimicking other musculoskeletal disorders. In this article a case of osteomalacia showing the characteristics of spondyloarthropaty was presented.

BILATERAL REFLEX SYMPATHETIC DYSTROPHY SYNDROME : A Case Report

Duygu Geler, Birkan Sonel Tur, �ehim Kutlay — 2003-06-01

Reflex sympathetic dystrophy is a syndrome characterized by swelling, pain and vasomotor changes of the affected extremities. Diagnosis is usually based on clinical signs and symptoms. Successful treatment depends on early diagnosis as well as prevention of secondary complications. 56 year old man with severe pain in his both feet (pronounced in right foot) was admitted to the hospital. He complained of burning pain, hyperalgesia, paresthesia, swelling and occasionally discoloration of the lower ekstremities. Eight months ago, all of his symptoms commenced after the onset of low back pain which showed radiation to the right foot. Occurence of reflex sympathetic dystrophy syndrome (RSDS) secondary to low back pain and bilateral involvement is very rare. Since effective treatment of RSDS largely depends on early diagnosis, clinicians should get suspicious about this syndrome whenever they confront with vazomotor changes accompanying low back pain.

AMYLOIDOSIS

Rah�an Kamilo�lu, Ye�im Kurtai� G�rsel — 2003-06-01

Amyloidosis is a disease presenting with accumulation of protein-like materials that are not soluble in extracellular fluid of tissues. This accumulation can be localized to a single organ or it can be systemic. Amyloidosis is usually subclinical, but many different manifestations may also be observed. Sometimes the disease resembles the clinical characteristics of rheumatologic diseases. Amyloidosis may also appear as a result of long lasting inflammatory conditions including rheumatological diseases. There are no specsific treatment modalities eliminating the amyloid deposits, but therapies that reduce the amyloid fibril precursor proteins and support the functions of organs that are involved can improve survival and preserve function.

SJ�GREN'S SYNDROME

�zlem Deren, �ehim Kutlay — 2003-06-01

Sj�gren's syndrome is characterized by dry eyes and dry mouth due to lymphocytic infiltrates of the lacrimal and salivary glands resulting in decreased production of saliva and tears. Females are affected 10 times more frequently than males. Sj�gren's syndrome is divided into a primary form ( sicca complex) and a secondary form accompanying rheumatoid arthritis or occasionally another connective tissue disease. It has been suggested that the increased risk of lymphoma is particularly associated with primary Sj�gren ‘s syndrome, especially of non-Hodgkin's type.