Search

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2006.06.008 Byline: M. Yurtkuran (a), A. Alp (a), M. Yurtkuran (b), K. Dilek (b) Keywords: End-stage renal disease; Exercise; Hemodialysis; Yoga Abstract: To evaluate the effects of a yoga-based exercise program on pain, fatigue, sleep disturbance, and biochemical markers in hemodialysis patients. Author Affiliation: (a) Uludag University Medical Faculty, Physical Therapy and Rehabilitation Department, Ataturk Balneotherapy and Rehabilitation Center, PK 16080 Kukurtlu, Bursa, Turkey (b) Uludag University Medical Faculty, Internal Medicine Nephrology Department, Gorukle, Bursa, Turkey

OBJECTIVE: In this prospective, controlled study, the effects of weight bearing and aquatic exercises on the calcaneal ultrasonic scores of postmenopausal sedentary women was investigated. DESIGN: A total of 62 postmenopausal sedentary women (mean age, 54.1 +/- 7 yrs) with broadband ultrasound attenuation (BUA) T-score variables less than -1 were admitted to Ataturk Balneotherapy and Rehabilitation Center and randomized into aquatic exercise (n = 21), weight-bearing exercise (n = 21), and control (n = 20) groups. The subjects were told to perform the aerobic exercises according to the Borg scale. Quantitative ultrasound variables, BUA, and speed of ultrasound were evaluated after the 6-mo training study. RESULTS: Calcaneal BUA increased in aquatic exercise and weight-bearing exercise groups by 3.1% and 4.2% (P < 0.05, P < 0.05) respectively. There was a decrease in BUA by 1.3% in the control group (P > 0.05). Speed of ultrasound did not change in the aquatic exercise, weight-bearing exercise, or the control groups. There were no statistically significant differences between the exercise groups for BUA and speed of ultrasound. The percentage changes in the aquatic exercise and weight-bearing exercise groups were statistically significant when compared with the control group for BUA (P < 0.01, P < 0.01) and speed of ultrasound (P < 0.05, P < 0.05). CONCLUSIONS: Although weight-bearing physical activity is known to be superior to non-weight-bearing activity to increase the bone mass, our present evidence shows that aquatic and weight-bearing exercises both can increase calcaneal BUA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study is based on whether moderate increased physical activity as aquatic exercise has anabolic effects on bone and evaluates this in terms of quantitative ultrasound and hormonal variables. DESIGN: In this study, 41 postmenopausal sedentary women were admitted to Atatürk Balneotherapy and Rehabilitation Center, according to T scores of broadband ultrasound attenuation. Subjects were followed for 6 mos in aquatic exercise and control groups. The subjects were told to perform the aerobic exercises according to the Borg Scale. Ultrasonic and hormonal evaluation was done before and after the 6-mo training study. RESULTS: In the exercise group, there were 36%, 75%, and 54% increases in the serum levels of insulin-like growth factor-1, growth hormone, and calcitonin, respectively. In addition, a 31% decrease was found in the serum levels of parathormone compared with the initial values. In the control group, serum levels of growth hormone decreased by 61%, but there were no statistically significant changes in the serum levels of insulin-like growth factor-1, calcitonin, or parathormone. T scores of broadband ultrasound attenuation and speed of sound increased by 19% and 63% in the exercise group, respectively, whereas there were decreases in the control group for the same variables. There were statistically significant differences between the control and the aquatic exercise groups for the 6-mo percentage of changes in broadband ultrasound attenuation and speed-of-sound T scores, insulin-like growth factor-1, growth hormone, parathormone, and calcitonin. CONCLUSIONS: Aquatic exercise was determined to be effective to make an anabolic effect on the bone of the postmenopausal, sedentary subjects. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the efficacy and possible side effects of Methotrexate (MTX) treatment in patients with ankylosing spondylitis.Methods: A total of 51 patients with a diagnosis of AS according to NewYork criteria were randomly distributed into 2 groups. In Group I (n = 25) only Naproxen (1000 mg/day) and in Group II (n = 26) oral MTX (7.5 mg/week) combined with Naproxen were given for 12 months. The patients were evaluated at 3, 6, and 12 months after the start of the treatment according to a number of clinical parameters using objective and subjective variables. Data were analysed using ki-square and Mann-Whitney U tests.Results and Conclusions: The comparison of the values using the percent changes and difference scores with respect to pretreatment values showed significant improvement in the "global evaluation of the physician" in Group II compared to Group I while no other parameter was found to be significantly different between the two groups. Those results have led us to conclude that a combination of MTX with Naproxen did not prove to be superior to Naproxen-alone treatment in terms of statistical significance. Further trials with MTX employing larger doses and different patient populations, mainly comprised of peripheral arthritis are necessary for delineation of the role of MTX in AS treatment. [ABSTRACT FROM AUTHOR]

Polymyalgia rheumatica (PMR) is an inflammatory disease of individuals aged over 50 years. Because of the concomitant malignancy possibility and the high prevalence of constitutional symptoms seen in this condition, patients with classical clinical picture often experience delay in diagnosis and treatment and are exposed to a wide list of laboratory and imaging procedures. In this study, we aimed to explore the adventure these patients experience from symptom onset to rheumatology clinic. A total of 106 PMR patients (84 women, 22 men) mean age 70.1 ± 8 were analyzed retrospectively. The time period from the onset of symptoms and referral to rheumatology specialists was explored. Diagnostic methods applied to these patients, antibiotic use and hospitalization during this period were recorded. The interval between the onset of the symptoms and admission to rheumatology unit was 13 ± 13 months. In this period, abdominal computed tomography (29.2 %), chest computed tomography (21.7 %), cranial magnetic resonance imaging (18.9 %) and whole-body scintigraphy (3.8 %) were applied to the patients. About 30 % of the patients were hospitalized for a mean period of 7 ± 3 days before referral to rheumatology unit, and 30 % of the patients were given antibiotics. In order to reduce the delay in the diagnosis of PMR and prevent unnecessary and expensive diagnostic methods, education of clinicians about the diagnosis of PMR may be beneficial.

Objective: To evaluate the effectiveness of magnetotherapy in the treatment of hand osteoarthritis (HO)., Methods: In this randomized controlled single-blind follow-up study, patients with HO were randomly assigned into 2 groups (G1 and G2). The subjects in G1 (n=25) received 25Hz, 450 pulse/s, 5-80G, magnetotherapy of totally 10 days and 20 min/day combined with active range of motion/strengthening exercises for the hand. G2 (n=25) received sham-magnetotherapy for 20 min/day for the same duration combined with the same hand exercises. Outcome measures were pain and joint stiffness evaluation, handgrip and pinchgrip strength (HPS), Duruöz and Auscan Hand Osteoarthritis Indexes (DAOI) and Short Form-36 Health Questionnaire (SF-36) administered at baseline, immediately after treatment and at the follow up., Results: When the groups were compared with each other, improvement observed in SF-36 Pain (p<0.001), SF-36 Social Function (p=0.030), SF-36 Vitality (p=0.002), SF-36 General Health (p=0.001), Pain at rest (p<0.001), Pain at motion (p<0.001), Joint stiffness (p<0.001), DAOI (p<0.001) were in favor of G1., Conclusions: Changes in pain, function and quality of life scores showed significant advantage in favor of the applied electromagnetic intervention in patients with HO., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2(nd), 5(th), 8(th), and 11(th) months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3(rd), 6(th), 9(th), and 12(th) months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire. Of 448 patients (mean age 62.4±7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7±25.4 vs. 34.0±14.6, p<0.001); however, the difference was not significant between AT and PT groups both in visit 1 and visit 5. In conclusion, in addition to active training, passive training provided at the 1(st) visit did not improve the persistence and compliance of the patients for bisphosphonate treatment.

Introduction: Systemic lupus erythematosus is an autoimmune disease that may affect almost all organ systems. Renal involvement is the most significant prognostic factor. Renal biopsy findings play an important role in treatment decision. Ki-67 is a monoclonal antibody that is only found in proliferative cells. This study aimed to investigate the proliferative activity in renal biopsy specimens of patients with lupus nephritis using the Ki-67 monoclonal antibody, and to compare the proliferative index between different subgroups of patients., Materials and Methods: Renal biopsy specimens of 29 patients with systemic lupus erythematosus were retrospectively evaluated. Type of lupus nephritis and activity and chronicity indexes were determined. Ki-67 immunostaining was performed. For each patient, 1000 cells were counted and the number of Ki-67 positive cells was determined. The Ki-67 activity index was compared between different subgroups of lupus nephritis and correlated with systemic lupus erythematosus disease activity index, serum creatinine, proteinuria, anticardiolipin antibodies, and complement levels., Results: A positive correlation between Ki-67 proliferation index, serum creatinine levels, and systemic lupus erythematosus disease activity index were found. Although conventional activity indexes were low, in 3 of 9 patients with class II lupus nephritis, Ki-67 proliferation indexes were high, indicating proliferation., Conclusions: Ki-67 can be used as a proliferation marker in renal biopsy specimens for patients diagnosed with systemic lupus erythematosus.

Objectives: This study aimed to evaluate the incidence and the time course of methotrexate (MTX)-associated gastric intolerance in patients with rheumatoid arthritis and psoriatic arthritis., Methods: Four hundred twenty subjects undergoing MTX treatment for rheumatoid arthritis (n = 346) and psoriatic arthritis (n = 74) were retrospectively assessed. The incidence and time course of gastric MTX intolerance resulting in treatment discontinuation were investigated. In addition, the relations between gastric intolerance and patient characteristics, including gender, age, diagnosis, and rheumatoid factor (RF) positivity, were examined., Results: Overall, oral MTX discontinuation rate due to gastric intolerance was 28.6 %. The time to discontinuation for oral MTX was 8.1 ± 11.5 months on average, with more than half of the discontinuations occurring within the first three months of treatment. Discontinuation was not associated with gender, age, diagnosis, or RF positivity. More than half of the patients that switched to a parenteral treatment regimen (52.6 %, 20/38) could tolerate the agent., Conclusions: Gastric MTX intolerance usually develops within the first year of treatment and presents a major obstacle to long-term treatment retention in patients with rheumatologic disease. However, parenteral MTX appears to be a good alternative for patients intolerant of oral MTX.