Ali Biçer

Assessment of pain and disability in patients with chronic neck pain: reliability and construct validity of the Turkish version of the neck pain and disability scale.

Objectives: The objective of this study was to test whether a Turkish version of the Neck Pain and Disability Scale retains its reliability and validity of the original English version. Methods: Sixty-one patients with chronic neck pain were enrolled in the study. The Neck Pain and Disability Scale (NPDS), the Pain Disability Index (PDI) and The Hospital Anxiety and Depression Scale (HADS) were filled by all subjects. Reliability was determined by internal consistency. Internal consistency was measured by calculating Cronbachs alpha and item-total correlation. Validity was examined by correlating the NPDS scores to the Visual Analogue Scale (VAS), PDI and HADS scores. Results: Cronbachs alpha value for NPDS was found to be 0.86 and this was statistically significant (p < 0.0001). The item-total correlations of NPDS varied between 0.08 and 0.69. The cross-sectional construct validity coefficients were 0.51 for PDI, 0.45 for VAS, 0.35 and 0.33 for Hospital Anxiety and Depression Scales. Conclusion: Despite its major limitations, our results seem to support previous findings of the English and French versions of the Neck Pain and Disability Scale, indicating that this functional scale is valid and reliable.

Respiratory muscle strength but not BASFI score relates to diminished chest expansion in ankylosing spondylitis

Pulmonary function is altered in ankylosing spondylitis (AS) owing mainly to the restriction of chest wall involvement (limited chest expansion). The objective of this study was to investigate the relationship between chest expansion, respiratory muscle strength (MIP, MEP) maximum voluntary ventilation (MVV), and BASFI score in patients with AS. Twenty-three male patients with definite AS and 21 age-matched healthy male controls were recruited for the study. Patients with AS were assessed for functional status by BASFI. Measurement of chest expansion and lumbar spinal flexion (modified Schober) method was performed in all subjects. Pulmonary function tests were performed by spirometry. Respiratory muscle strength was evaluated by a mouth-pressure meter (MPM). Body mass index (kg/m2) was recorded in all individuals. Chest expansion and modified Schober measurement were significantly lower in AS patients (p<0.05). Pulmonary function tests revealed restrictive lung disease. The mean BASFI score suggested good functional capacity in the AS group. The respiratory muscle strength and MVV were also lower in AS (p<0.05). The chest expansion was correlated with MIP and MEP values (r=0.491; p=0.02, r=0.436; p=0.05). Chest expansion was also correlated negatively with disease duration (r=−0.502; p=0.03). In addition, there was no correlation between chest expansion and BASFI score (r=−0.076; p=0.773). This study demonstrates that functional status (BASFI) is not influenced by the limitation of chest wall movement. It may be as a result of the maintenance of moderate physical activity during active life in patients with AS.

Coexistence of osteopoikilosis and discoid lupus erythematosus: a case report.

Abstract: Osteopoikilosis is an uncommon, benign sclerosing bone dysplasia characterised by typical roentgenographic findings and usually seen in patients with dermatological problems. We report a case of osteopoikilosis and discoid lupus erythematosus presenting with skin and mucosal involvement, an association that has never previously been reported. We also discuss the differential diagnosis and the clinical pathologies accompanying osteopoikilosis in the literature.

Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis

AIM To evaluate the relationship between mean platelet volume (MPV) and red cell distribution width (RDW), and disease activity in rheumatoid arthritis (RA). PATIENTS & METHODS Hundred RA and 100 controls were included. RESULTS MPV and RDW were higher in RA (p < 0.0001). The cut-off levels of RDW and MPV were 14.8 and 10.4. Patients with RDW >14.8 had higher Disease Activity Score 28 (DAS28; p = 0.002) and pain score (p = 0.0007). RDW was positively correlated with DAS28 and pain. But, DAS28 and pain were not different between patients with MPV >10.4 and <10.4. CONCLUSION MPV and RDW were significantly higher in RA. RDW and MPV were similar to erythrocyte sedimentation rate and C-reactive protein to indicate inflammatory activity. RDW was correlated with pain and DAS28, but MPV was not associated with them.

Musculoskeletal Findings in Behcet's Disease

Behcets disease is a multisystem disease characterized by recurrent oral and genital ulcers, relapsing uveitis, mucocutaneous, articular, gastrointestinal, neurologic, and vascular manifestations. Rheumatologic manifestations may also occur in Behcets disease, and arthritis and arthralgia are the most common musculoskeletal findings followed by enthesopathy, avascular necrosis, myalgia, and myositis. Although the main pathology of Behcets disease has been known to be the underlying vasculitis, the etiology and exact pathogenesis of the disease are still unclear. Musculoskeletal findings of Behcets disease, the relationship between Behcets disease and spondyloarthropathy disease complex, and the status of bone metabolism in patients with Behcets disease were discussed in this paper.

Prevalence of dermatophytosis in patients with rheumatoid arthritis

Abstract Objective. The prevalence of dermatophytic infections in rheumatoid arthritis is unknown. This study investigated the prevalence of dermatophytosis in patients with rheumatoid arthritis and the relationship between sulfasalazine, low-dose methotrexate and steroid therapy. Methods. We examined 53 consecutive patients with rheumatoid arthritis for evidence of dermatophytosis and compared them 55 with age- and sex-matched, nonimmunocompromised controls recruited from the low back pain population. Nail scrapings were obtained from the subjects, and the clinical diagnosis of dermatophytosis was confirmed with a potassium hydroxide preparation. Results. In 32% of the rheumatoid arthritis population we found dermatophytosis, compared with 16% of the control group, although statistical significant was only borderline. Tinea pedis was the most frequent type of dermatophytosis in both groups. The prevalence of dermatophytosis in patients receiving sulfasalazine, low-dose methotrexate, and steroid therapy was not found to be significantly increased. Conclusions. This study shows a slightly higher prevalence of dermatophytosis in rheumatoid arthritis population than in controls. Sulfasalazine, low-dose methotrexate, and steroid therapy had no effect on the prevalence of dermatophytic infections in patients with rheumatoid arthritis.

Assessment of pain and disability in patients with chronic low back pain: Reliability and construct validity of the Turkish version of the Quebec Back Pain Disability Scale and Pain Disability Index

Objectives: The objective of this study was to test the reliability and validity of the Turkish version of the Quebec Back Pain Disability Scale (QBPDS) and Pain Disability Index (PDI) as well as the retainment of the psychometric properties of the original versions. The importance of the region-specific functional measures on patients with chronic low back pain was also assessed. Methods: Eighty-three patients with chronic low back pain were enrolled in the study. The QBPDS, the PDI and The Hospital Anxiety and Depression Scale (HADS) were filled by all subjects. Reliability was determined by internal consistency. Internal consistency was measured by calculating Cronbachs alpha and item-total correlation. Validity was examined by correlating the QBPDS and PDI scores to external criteria scores at a single point in time, defined as cross-sectional construct validity. Results: Cronbachs alpha value for QBPDS and PDI was found 0.93 and 0.84 respectively, which were both statistically significant ( p< 0.0001). The item-total correlations of QBPDS varied between 0.28 and 0.76, and that of PDI varied between 0.30 and 0.73. The cross-sectional construct validity coefficients of QBPDS were 0.63 for PDI, 0.46 for Visual Analogue Scale (VAS), 0.28 and 0.16 for HADS. Correlation coefficients of PDI were 0.49, and those of VAS and HADS were 0.36 and 0.24 respectively. Conclusion: Our results are in accordance with the previous findings of the English and French versions of the QBPDS and English version of the PDI, indicating that these functional scales are valid and reliable. However, due to the considerable overlap between generic and region-specific functional instruments, the use of both scales is not necessary. We conclude that the QBPDS and PDI both measure predominantly functional status in patients with chronic low back pain.

Fixed drug eruption due to tiaprofenic acid

Tiaprofenic acid is a propionic acid derivative with analgesic, anti-inflammatory and antipyretic properties. Fixed drug eruption induced by tiaprofenic acid has not been reported previously. Described in this paper is a 57-year-old female patient with tiaprofenic acid-associated fixed drug eruption, which occurred shortly after starting tiaprofenic acid therapy for her osteoarthritis. Upon establishment of the diagnosis, tiaprofenic acid therapy was stopped and topical corticosteroids and systemic antihistamines were administered. The eruption resolved, leaving post-inflammatory hyperpigmentation within 5 days. The rash returned folloiwng tiaprofenic acid rechallenge. It is proposed that fixed drug eruption is a new side effect of tiaprofenic acid.