Cihat Öztürk

The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey: a multicenter study

Abstract. The purpose of this study was to investigate the associations of tooth loss with skeletal bone mass, years since menopause, educational level, current smoking status, dietary calcium intake, and number of pregnancies in postmenopausal osteoporotic women in Turkey. The study population consisted of 1171 postmenopausal women aged 40–86 years (mean age, 61.19 ± 7.28 years). A detailed history was obtained from all women, including relevant lifestyle parameters, risk factors, and measurements of weight and height. Women were separated into three groups according to the number of teeth remaining as group 1 (edentulous, 457 women), group 2 (10 or fewer teeth, 232 women), and group 3 (more than 10 teeth remaining, 482 women). There was no significant difference among the three groups in mean age and menopausal age (P < 0.05). Body mass index of group 1 was significantly higher than that of group 2 (P < 0.01). Educational level was significantly different between three groups: groups 1 and 2 (P < 0.001), groups 1 and 3 (P < 0.0001), and groups 2 and 3 (P < 0.001). Educational level was lowest in group 1 and highest in group 3. Despite a low ratio of cigarette smoking in general, a smoking habit was most prevalent in group 3 and least in group 2. The ratio of women receiving adequate calcium was significantly lower in group 1 than in other groups (P < 0.001); mean calcium intake was similar in all groups. The number of pregnancies was significantly higher in group 1 than in other groups (P < 0.001). Lumbar bone mineral density (BMD) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001). Although no significant difference was found between groups 1 and 3, femoral neck BMD of group 2 was less than in others, and differences between groups 1 and 2 and between groups 2 and 3 (P < 0.001) were significant. Lumbar bone mineral content (BMC) of group 1 was significantly lower than that of groups 2 and 3 (P < 0.001), and lumbar BMC in group 2 was significantly higher than in group 3 (P < 0.05). Femoral neck BMC in group 1 was significantly higher than in groups 2 and 3 (P < 0.001). In conclusion, lumbar BMD and BMC in the edentulous group were significantly lower, whereas femoral neck BMD and BMC were significantly higher in edentulous group compared with the others. Our findings indicated that improvement in lifestyle factors and nutritional strategies for the treatment and prevention of osteoporosis may have additional benefit in reducing tooth loss.

EFFICACY OF NECK STABILIZATION EXERCISES FOR NECK PAIN: A RANDOMIZED CONTROLLED STUDY

OBJECTIVE To determine the efficacy of neck stabilization exercises in the management of neck pain. PATIENTS AND METHODS Sixty patients with neck pain were randomized to 3 groups, as follows: group 1--physical therapy agents including transcutaneous electrical nerve stimulation, continuous ultrasound and infra-red irradiation; group 2--physical therapy agents + isometric and stretching exercises; and group 3--physical therapy agents + neck stabilization exercises. The exercises were performed as a home training programme following a 3-week supervised group exercise. The patients were evaluated with a visual analogue scale, by intake of paracetamol, Neck Disability Index, Beck Depression Scale and range of motion in the 3 planes at baseline and at months 1, 3, 6, 9 and 12. RESULTS Compared with baseline, all groups showed a significant decrease in visual analogue scale scores during the first 6 months. However, this improvement was maintained only in group 3 at 9 and 12 months, with a significant difference among the groups (p<0.05). During the study, the improvement in disability was marked in group 3 with respect to Neck Disability Index, Beck Depression Scale and range of motion in the frontal plane (p<0.05). CONCLUSION This study demonstrates the superiority of the neck stabilization exercises, with some advantages in the pain and disability outcomes, compared with isometric and stretching exercises in combination with physical therapy agents for the management of neck pain.

Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.

ObjectiveThe aim of this study was to compare whether the effectiveness of continuous ultrasound (US) was superior against pulsed US and against sham US in knee osteoarthritis. DesignA randomized controlled study was carried out on 60 patients diagnosed with knee osteoarthritis according to American College of Rheumatology. The patients were randomized into the following three treatments: (1) continuous US (at a frequency of 1 MHz with intensity of 1 W/cm2), (2) pulse US (same frequency and intensity on 1:4 pulse ratio), and (3) sham US. All treatments were applied with 5-cm2 head US device five times a week for 2 weeks in addition to home exercise program including quadriceps isometric exercise, muscle strength exercises, and stretching exercises of the lower extremity muscles for at least three times per week. Assessments were performed at baseline, at the end of the treatment, and at the end of the treatments and at the sixth month using the following measurements: Western Ontario and McMaster University Osteoarthritis Index–pain, stiffness, function, visual analog scale–pain at rest, visual analog scale–pain on movement, visual analog scale–disease severity, and 20-m walking time. Among these parameters, the Western Ontario and McMaster University Osteoarthritis Index–pain was the primary outcome. ResultsAll groups showed a significant improvement in all parameters in both following visits (P < 0.05). However, there was no significant difference between the groups. Although the mean reduction percent in Western Ontario and McMaster University Osteoarthritis Index–pain was significantly higher in group I (continuous US) when compared to sham group (46.5% vs 28.9%, P < 0.05) at the end of the treatment, this result was not found in other pain parameters. ConclusionsThe present study demonstrated that all assessment parameters significantly improved in all groups without a significant difference. This result suggested that therapeutic US provided no additional benefit in improving pain and functions in addition to exercise training.

Prevalence of symptomatic knee, hand and hip osteoarthritis among individuals 40 years or older: a study conducted in İzmir city

OBJECTIVE This cross-sectional study was conducted to determine the prevalence of symptomatic knee, hand and hip osteoarthritis among men and women at or over 40 years of age, living in the Bayraklı Adalet district of İzmir. METHODS The study included a sample size of 522 people calculated using the Epi Info™ software. Demographic information, weight, height and body mass index were recorded. Patients were physically examined for evidence of osteoarthritis, such as joint tenderness, range of motion deficiency, deformity, 1st carpometacarpal joint involvement and Heberdens and/or Bouchards nodes. One hundred and ninety-one individuals were suspected of having knee/hand/hip osteoarthritis and 152 of these were called in for radiographs. RESULTS The prevalence of symptomatic knee, hand and hip osteoarthritis of adults aged ≥40 years was 20.9%, 2.8% and 1.0%, respectively. Symptomatic knee and hand osteoarthritis was significantly higher among women (p<0.05). However, there was no significant difference between two genders regarding symptomatic hip osteoarthritis. CONCLUSION Knee osteoarthritis is frequent in the region in which the study was conducted. An effective health policy regarding osteoarthritis can be created following further studies with larger samples representing the entire country.

Design of orthopedic support material containing diclofenac sodium microparticles: preparation and characterization of microparticles and application to orthopedic support material

The aim of this study is preparation and characterization of diclofenac sodium microparticles and their application to the orthopedic support materials. The microparticles were obtained using spray drying method involving ethyl cellulose as shell material. The morphology, particle size, drug loading capacity and in vitro release characteristics of the drug microparticles were optimized for impregnation diclofenac sodium microparticles onto the orthopedic support materials. Scanning electron microscopy (SEM) was used to characterize the drug microparticles and the treated fabrics with microparticles. SEM images illustrated that the microparticles were spherical in shape and also fixed onto the orthopedic support materials. Furthermore, the resistance of materials containing microparticles to washing were also investigated. Finally, in vitro drug release studies of microparticles and textile impregnated with microparticles were done. This study suggested that textile systems containing diclofenac sodium microparticles could have a potential for long-term therapy for rheumatic disorders.

Preparation of naproxen–ethyl cellulose microparticles by spray-drying technique and their application to textile materials

Abstract The objective of this study is to develop a new textile-based drug delivery system containing naproxen (NAP) microparticles and to evaluate the potential of the system as the carrier of NAP for topical delivery. Microparticles were prepared by spray-drying using an aqueous ethyl cellulose dispersion. The drug content and entrapment efficiency, particle size and distribution, particle morphology and in vitro drug release characteristics of microparticles were optimized for the application of microparticles onto the textile fabrics. Microparticles had spherical shape in the range of 10–15 μm and a narrow particle size distribution. NAP encapsulated in microparticles was in the amorphous or partially crystalline nature. Microparticles were tightly fixed onto the textile fabrics. In vitro drug release exhibited biphasic release profile with an initial burst followed by a very slow release. Skin permeation profiles were observed to follow near zero-order release kinetics.

Is QUALIOST Appropriate for the Patients With Orthotopic Liver Transplantation in Measuring Quality of Life

The quality of life questionnaire in osteoporosis (QUALIOST) measures the impact of this condition. The purpose of this study was to assess the psychometric properties of QUALIOST among 38 orthotopic liver transplantation (OLT) patients who had been diagnosed with osteoporosis or osteopenia versus 42 control subjects with osteoporosis or osteopenia associated with other conditions. Bone mineral density (gr/cm(2)) measurements were performed by dual-energy X-ray absorptiometry as well as thoracic and lumbar spine radiographs to assess fractures. Reliability studies evaluated by intraclass correlation coefficients (ICC) and internal consistency (Cronbach α). For the validity studies, correlation analysis was performed between this scale and Short Form-36 (SF-36) results. The questionnaire was filled out completely by all the patients with 0.9% and 1.3% of omitted answer rates for OLT and control patients. ICC and Cronbachs α values were good for all domains with values above .90. In both groups we observed significant negative high correlations between the domains of the questionnaire and all SF-36 dimensions (P < .001). At least one vertebral fracture was diagnosed in 17 (44.7%) and 20 (47.6%) patients with OLT and control respectively. The comparison analysis revealed that the scores of QUALIOST of patients with vertebral fracture were significantly higher than those without a fracture in both groups (P < .05). In conclusion, we evaluated the validity and reliability of a scale measuring quality of life in patients who had osteoporosis secondary to OLT. The results showed that the Turkish QUALIOST showed acceptable validity and reliability in these patients.