Coskun Zateri

Single-nucleotide polymorphism in Turkish patients with adolescent idiopathic scoliosis: Curve progression is not related with MATN-1, LCT C/T-13910, and VDR BsmI

The role of genetics in the etiopathogenesis of adolescent idiopathic scoliosis (AIS) is unclear. In this study, we investigated the relationship between AIS and polymorphisms in MATN‐1, LCT C/T‐13910, and VDR BsmI genes. 53 Turkish adolescents with diagnosed AIS and 54 healthy adult individuals were included in the study. MATN‐1, LCT C/T‐13910, and VDR BsmI gene mutations were analyzed with real‐time PCR. We did not detect a statistically significant difference between AIS and control groups in respect to those three different gene polymorphisms (p < 0.05). We next evaluated the associations of all three SNPs with scoliosis curve severity. There was no significant difference between curve severity and gene polymorphisms (p < 0.05). In terms of gene polymorphisms, AIS patients with a family history of AIS did not significantly differ from AIS patients who did not have history (p < 0.05). AIS might be caused by many different gene mutations, biomechanical mechanisms that have been modified by environmental factors, different biological interactions, modulation of growth, or a synergy of different factors causing abnormal control of growth. However, the existing knowledge is still not enough to explain the etiopathogenesis of AIS.

Probable osteosarcoma risk after prolonged teriparatide treatment: Comment on the article by Saag et al

To the Editor: Teriparatide is known to be effective in increasing levels of bone turnover biomarkers in institutionalized, mostly nonambulatory adults with severe developmental disabilities. Its use has been approved by the US Food and Drug Administration (FDA) only for adults (1). Contraindications to the use of teriparatide include the following: any hypercalcemic disorder, osteosarcoma, metastatic bone disease, Paget’s disease of bone, pregnancy, and radiation therapy to the skeleton or to soft tissue in which a skeletal port is exposed. A toxicity that appears to be unique to animals and not applicable to human subjects is osteosarcoma; osteosarcoma has developed in rats that have been given very high doses of either teriparatide or parathyroid hormone 1–84 for prolonged periods of time (2–4). It is unlikely that this animal toxicity is related to human skeletal physiology (5,6), but the FDA issued a black box warning with the approval of teriparatide. Treatment with teriparatide is approved by the FDA for a limited duration of 18–24 months, and in many European countries approval is limited to 18 months. In some recent studies, the period of treatment with teriparatide was prolonged to 24–30 months (1,7). It has been reported that a longer treatment period may have a role in the development of various pathologies in animals, one of which is osteosarcoma (3). Although this has not been observed in humans to date, longer-term use of teriparatide, especially in the young population that makes up a great proportion of patients with glucocorticoid-induced osteoporosis, may cause risks. Because the exact relationship between the occurrence of osteosarcoma and the duration of treatment has not been clearly elucidated, it is difficult to determine an exact duration of treatment after which risk might develop. The most significant problem that patients will experience is not drug tolerance, but malignancy. In the study by Saag et al published in the November 2009 issue of Arthritis & Rheumatism (8), teriparatide was used for up to 36 months in a patient population with a short duration of osteoporosis, which carries more prominent risks. We believe this prolonged treatment may have increased the risk of osteosarcoma occurrence. Although it has been reported that the teriparatide-related risk of osteosarcoma development is low (9), there are still no clear scientific data, and the general recommendation about this treatment is to closely follow up patients who have risk factors (10). Therefore, we have the following questions about the study by Saag et al: How was the treatment duration planned? Were the patients evaluated for risk of osteosarcoma development before the study? Did the authors experience difficulties with the ethical approval process? And how will the study patients be followed up prospectively in terms of osteosarcoma risk? Nurettin Tastekin, MD Trakya University Edirne, Turkey Coskun Zateri, MD On Sekiz Mart University Canakkale, Turkey

Prevalence of adolescent idiopathic scoliosis among primary school children in Canakkale, Turkey

Materials and methods The universe of our study was chosen from primary school students. The sample size was calculated separately for provinces and districts, 1321 and 1420, respectively. We chose 12 schools totally by cluster sampling method. Presence of AIS was evaluated with scoliometre and posture analysis. Students who have skeletal deformity or major skeletal surgery history were excluded. SPSS 15.0 was used for analysis.

Reliability and validity of the Turkish version of the fibromyalgia rapid screening tool (FiRST)

[Purpose] An easy-to-use, psychometrically validated screening tool for fibromyalgia is needed. This study aims to evaluate the reliability and validity of the Turkish version of the Fibromyalgia Rapid Screening Tool by correlating it with 2013 American College of Rheumatology alternative diagnostic criteria and the Hospital Anxiety and Depression Scale. [Subjects and Methods] Subjects were 269 Physical Medicine and Rehabilitation clinic outpatients. Patients completed a questionnaire including the Fibromyalgia Rapid Screening Tool (twice), 2013 American College of Rheumatology alternative diagnostic criteria, and the Hospital Anxiety and Depression Scale. Scale reliability was examined by test-retest. The 2013 American College of Rheumatology alternative diagnostic criteria was used for comparison to determine criterion validity. The sensitivity, specificity, and positive and negative likelihood ratios were calculated according to 2013 American College of Rheumatology alternative diagnostic criteria. Logistic regression analysis was conducted to find the confounding effect of the Hospital Anxiety and Depression Scale on Fibromyalgia Rapid Screening Tool to distinguish patients with fibromyalgia syndrome. [Results] The Fibromyalgia Rapid Screening Tool was similar to the 2013 American College of Rheumatology alternative diagnostic criteria in defining patients with fibromyalgia syndrome. Fibromyalgia Rapid Screening Tool score was correlated with 2013 American College of Rheumatology alternative diagnostic criteria subscores. Each point increase in Fibromyalgia Rapid Screening Tool global score meant 10 times greater odds of experiencing fibromyalgia syndrome. [Conclusion] The Turkish version of the Fibromyalgia Rapid Screening Tool is reliable for identifying patients with fibromyalgia.

AB0927 Reliability and validity of turkish version of fibromyalgia participation questionnaire

Background Fibromyalgia (FMS) is a chronic health problem characterized by a wide range of physical and psychological symptoms. There are few high-quality instruments to evaluate the participation and social functioning of fibromyalgia patients. Farin et al. designed the Fibromyalgia Participation Questionnaire (FPQ) as an instrument for measuring the participation and social functioning of FMS patients. The original version of FPQ has been demonstrated to have acceptable internal consistency, reliability and criterion validity. Objectives To test reliability and validity of Turkish version of Fibromyalgia Participation Questionnaire (FPQ-T) Methods One hundred and eighty-four female fibromyalgia syndrome patients were included in the study. All patients filled FPQ-Turkish (FPQ-T) questionnaire which was obtained by translation from German according to the guideline for the cross-cultural adaptation process. The patients filled the revised Fibromyalgia Impact Questionnaire (FIQ) and reevaluated FPQ-T two hours later. Internal consistency reliability of FPQ-T was assessed by calculating “if item deleted” using Cronbach alpha and “item-total correction” coefficient for each item of the questionnaire. Consistency of sub-scales and correlation of test-retest values were assessed. Test-retest values were compared using Wilcoxon test. Criterion validity was measured using FIQ scales by Spearmans rho correlation coefficient. Results For internal reliability, Cronbach alpha coefficient was calculated as 0.957 for non-working and 0.958 for working patients. Cronbach alpha values of 0.939, 0.871, and 0.914 were obtained for daily, social, and work life, respectively. Correlation coefficients were 0.888 for daily life, 0.859 for social life, and overall 0.901 in non-working group versus 0.896 in working group. Comparison of scores obtained from test-retest measurements showed no significant difference except for Item-3. Correlation of symptom severity score (SSS) and FPQ-T were r=0.385 (p<0.001) and r=0.390 (p<0.001) for the non-working and working sub-groups, respectively. Construct validity evaluation showed significant correlation between SSS and FPQ-T. Conclusions The results of our study showed that FPQ-T is reliable and valid for assessing participation and social functioning in fibromyalgia patients in our society. References Williams DA, Clauw DJ (2009) Understanding fibromyalgia: Lessons from the broader pain research community. J Pain 10:777–791. Farin E, Ullrich A, Hauer J (2013) Participation and social functioning in patients with fibromyalgia: development and testing of a new questionnaire. Health Qual Life Outcomes 11:135. Disclosure of Interest None declared

The relationship between C-reactive protein rs3091244 polymorphism and ankylosing spondylitis.

Previous studies have shown that C‐reactive protein (CRP) gene polymorphism can be related to inflammatory changes. The present study aimed to examine the association between CRP gene polymorphism and clinical and laboratory findings in ankylosing spondylitis (AS) patients.

Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review.

Abstract Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Epidural abscess may occur as a rare complication of spondylitis. Spinal brucellosis and development of epidural abscess in the cervical region are rare. Development of epidural abscess affects the duration and success of treatment. Spinal brucellosis should be considered in patients presenting with fever and lower back-neck pain in endemic regions, and treatment must be initiated with early diagnosis in order to prevent potential complications.

THU0557 Reliability and Validity of Turkish Version of The fibromyalgia Rapid Screening Tool (First)

Background Fibromyalgia is a challenging chronic pain condition accompanied by several comorbidites. Since patients are encountered in various health care settings, there is a need for short, easy to use, psychometrically validated screening tool Objectives This study aims to evaluate reliability and validity of Turkish version of Fibromyalgia Rapid Screening Tool (FiRST) by correlating this tool with 2013 American College of Rheumatology alternative diagnostic criteria (ACR AltCr) and Hospital Anxiety and Depression Scale (HADS). Methods A convenience sample of 269 subjects recruited from outpatient Physical Medicine and Rehabilitation clinics were included in the study. Patients were asked to complete the questionnaire including FiRST (twice), 2013 AltCr and HADS. The reliability of the FiRST scale was examined by test-retest method. For criterion validity of FiRST scale, we used ACR 2013AltCr for comparison. The concordance between ACRAltCr and FiRST and the relationships between variables were evaluated. The sensitivity, specificity, positive and negative likelihood ratios of FiRST was calculated according to ACR 2013 AltCr criteria. Logistic regression analysis was carried out to find the confounding effect of HADS on FiRST to discriminate the patients with FMS Results The test-retest reliability coefficient of FiRST scale was r=0.875. FiRST was similar to ACR 2013 AltCr in defining patients with FMS. FiRST score was correlated with subscores of ACR 2013AltCr. Each point increase in FiRST global score increased odds of suffering FM approximately 10 times compared to HADS Conclusions Turkish version of FiRST is a reliable instrument for identifying patients with FMS Disclosure of Interest None declared