Bahar Ulubaş

Handgrip strength, pulmonary function tests, and pulmonary muscle strength in fibromyalgia syndrome: is there any relationship?

Objective It has been reported that patients with fibromyalgia syndrome (FMS) have lower maximal respiratory pressures than healthy subjects, indicating reduced pulmonary muscle strength. It has also been reported that patients with FMS have reduced grip strength. In this study, we aimed to examine the possible relationship between handgrip strength as a determinant of peripheral muscle strength and pulmonary muscle strength in patients with FMS by comparing them with healthy controls. Methods Forty-one consecutive women with FMS (diagnosed according to the American College of Rheumatology 1990 criteria) were compared with 40 age- and body mass index-matched healthy female controls. Pulmonary function tests were assessed by spirometry. Maximal pulmonary pressures were evaluated using an oral pressure meter. A dyspnea score was obtained. Pain was scored according to visual analogue scale and chest pain was classified (0–9) in fibromyalgia patients. Chest expansion was also measured in the two groups. Tender points were also evaluated in FMS patients. Grip strength (Jamar handheld dynamometer) was also measured in the two groups. Results The difference in pulmonary function tests was not statistically significant between groups. Maximal respiratory pressures (maximum inspiratory pressure and maximum expiratory pressure) and endurance (maximum ventilatory volume) were significantly lower in patients with FMS than in controls. There was also a statistically significant difference between groups regarding grip strength. There was also significant correlation between maximal inspiratory pressure and maximal expiratory pressure values and handgrip strength in patients with FMS. Conclusion These data indicate that handgrip strength may be a determinant of pulmonary muscle strength in fibromyalgia patients.

Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis

Pulmonary toxicity and blood dyscrasias are rare side effects of sulfasalazine. Pulmonary pathology is variable, the most common being eosinophilic pneumonia with peripheral eosinophilia, and interstitial inflammation with or without fibrosis. We here present the case of a 68-year-old female patient treated for 6 months with sulfasalazine for rheumatoid arthritis. On laboratory examination, eosinophil count was 97×103 mm3. Thorocoscopic biopsy was performed . Histopathologic diagnosis was bronchiolitis obliterans organizing pneumonia (BOOP). This is the first case in the literature to present with sulfasalazine-induced BOOP in a patient with seronegative RA.

Pulmonary function tests, respiratory muscle strength, and endurance of patients with osteoporosis

Background It has been shown that patients with thoracic kyphosis due to osteoporosis have diminished pulmonary function. The aim of this study was to determine the pulmonary function, respiratory muscle strength, and endurance of patients with osteoporosis who did not have compression fractures. Methods The patient group consisted of 88 recently diagnosed postmenopausal osteoporotic women without spinal fractures. They were matched for age and body mass index with 54 healthy women, who formed the control group. Bone mineral density, pulmonary function test (PFT), maximum voluntary ventilation (MVV), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) measurements of both groups were performed. Results There were no significant differences between the two groups regarding PFT parameters and MIP and MEP. However, osteoporotic patients had significantly lower MVV values. Conclusion Women with postmenopausal osteoporosis without spinal compression fractures have normal PFT, MIP, and MEP values, but they have reduced respiratory muscle endurance.

Is chest expansion a determinant of pulmonary muscle strength in primary fibromyalgia

OBJECTIVE To examine the possible relationship between chest expansion and pulmonary muscle strength in patients with primary fibromyalgia (PFM). METHODS Forty-one consecutive women with PFM were compared with age and body mass index matched 40 healthy women concerning pulmonary function tests, chest expansion, and maximum respiratory pressures indicating pulmonary muscle strength, and endurance (MVV). Pain was scored according to a visual analog scale (VAS). Chest pain was scored on a 10 point scale. RESULTS There was no significant difference between the two groups regarding chest expansion (P > 0.05). Maximum inspiratory and expiratory pressures (MIP, MEP) were lower in fibromyalgia patients than controls (P < 0.05). However, chest expansion and dyspnea score were insignificant between groups (P > 0.05). CONCLUSION Reduced maximum respiratory pressures (MIP, MEP) may result from isometric type pulmonary muscle dysfunction as a result of low physical performance in fibromyalgia patients, despite insignificant finding of chest expansion and dyspnea score according to controls.

Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey.

AIM The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. MATERIALS AND METHODS A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5±10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. RESULTS The patient delay was found to be 49.9±96.9 days, doctor delay was found to be 87.7±99.6 days, and total delay was found to be 131.3±135.2 days. The referral delay was found to be 61.6±127.2 days, diagnostic delay was found to be 20.4±44.5 days, and treatment delay was found to be 24.4±54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (p<0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (p<0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (p<0.05). DISCUSSION The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly.

Lung function impairment in women aged over 40 years: The critical role of abdominal obesity

SUMMARY It is known that obesity causes to impairment of pulmonary functions. This impairment worsens with aging. There are studies about obesity showing that the uses of abdominal measurements instead of BMI are more accurate.: PURPOSE The aim of our study is to investigate the correlation of waist circumference in the women aged over 40 years with obesity to the respiratory function tests and chest expansion. MATERIALS AND METHODS In our study, BMI, waist circumference and chest expansion of 64 women over 40-year old were measured and the values obtained were compared with the results of respiratory function tests. RESULTS There was a positive correlation between the age of the patients with waist circumference and DLCO/VA. A negative correlation was found between the age and MVV. The weight increase was associated with an increase in waist circumference and DLCO/VA. It was observed that waist circumference and DLCO/VA were increased and chest expansion was decreased when BMI was increased. A positive correlation was determined between MVV and the other respiratory function parameters, FEV1, FVC, FEV1/FVC and FIVC (p < 0.01). Similarly, the increase in DLCO was found to be correlated with the values of FEV1, FVC and FIVC. FIVC was correlated only with FEV1 and FVC. CONCLUSION In this study, it was observed that respiratory function tests of women over 40-year old with obesity were associated with anthropometric measurements. But, studies with larger sample sizes and prospective studies are needed to provide more accurate information about the importance of DLCO/VA for the assessment of pulmonary function in obese women.

Chest wall pain and related respiratory muscle strength in patients with primary fibromyalgia

AbstractIn this paper, maximum inspiratory pressure, maximum expiratory pressure, pulmonary function tests and maximum voluntary ventilation in primary fibromyalgia patients with chest pain were evaluated. Patients without any complaint of dyspnoea were selected. Fifty-nine fibromyalgia patients and 42 healthy controls were studied. Patients with fibromyalgia had lower maximum inspiratory pressure, maximum expiratory pressure, and maximum voluntary ventilation values than controls. Chest pain was assessed according to visual analog scale (VAS) score. There was no significant difference between groups in spirometric values, age and body mass index. The duration of fibromyalgia was 3.8 ± 4.4 years (1–15 years). Although the exact mechanism is not known, the results indicate that reduced respiratory muscle strength may be related to chest pain in fibromyalgia patients in the absence of dyspnoea.