Fikret Tüzün

Bone mineral density in women with sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Almost any organs of the body, but mostly the lungs, are involved. Bone mineral density (BMD) can be affected directly or indirectly in chronic granulomatous systemic diseases such as sarcoidosis. The aim of our study was to evaluate BMD in premenopausal and postmenopausal sarcoidosis patients with or without prednisone treatment and to compare their BMD values with those of a control group having the same menopausal status. Thirty-five premenopausal women (18 untreated, 8 treated, and 9 controls) and 21 postmenopausal women (5 untreated, 5 treated, and 11 controls) were included in the study. All of the patients had a histologically proven diagnosis and were being followed-up at the Sarcoidosis Outpatient Clinic of our unit. BMD of the lumbar (L) spine and femoral neck was measured by dual-energy absorptiometry (DEXA). The subgroups of premenopausals and postmenopausals were compared separately. Comparison among the groups was performed by using analysis of variance. Age, duration of the disease, and body mass index were comparable in treated, untreated, and control subgroups of the pre- and postmenopausal groups, and the subgroups of postmenopausals had comparable durations since menopause. For premenopausals, BMD values at L1–4 were not significantly different among the subgroups (0.920 ± 0.08 g/cm2, 0.801 ± 0.09 g/cm2, and 0.910 ± 0.05 g/cm2, for untreated, treated, and controls, respectively). However, the BMD value at the femoral neck in treated patients (0.921 ± 0.1 g/cm2) was significantly lower than the values in untreated patients (1.080 ± 0.2 g/cm2; P ≪ 0.01) and in controls (1.028 ± 0.17 g/cm2; P ≪ 0.05). For postmenopausals, the BMD value at L1–4 in controls (1.019 ± 0.07 g/cm2) was significantly higher than the values in untreated patients (0.783 ± 0.01 g/cm2) and in treated patients (0.751 ± 0.08 g/cm2; P ≪ 0.001 for both). The BMD value at the femoral neck in controls (0.890 ± 0.1 g/cm2) was higher than the values in untreated patients (0.745 ± 0.08 g/cm2) and treated patients (0.747 ± 0.1 g/cm2), but the difference was not statistically significant (P = 0.06). We concluded that sarcoidosis patients, especially postmenopausal patients with corticosteroid treatment, may have an increased risk of bone mineral loss. Large-scale studies are warranted in order to delineate the exact roles of the disease itself, menopausal status, and corticosteroid treatment in this bone mineral loss.

Melorheostosis: Report of a new case with linear scleroderma

Melorheostosis is a very rare bone disease of unknown etiology characterised by linear hyperostosis and associated with fibrosis of soft tissues and the skin. This uncommon sclerosing bone dysplasia was first described by Leri and Joanny in 1922, and since then, until 1993, approximately 300 cases were reported in the literature. Linear scleroderma is a localised proliferation of connective tissue and has rarely been associated with melorheostosis.In this paper, we present a new case of melorheostosis with linear scleroderma which, to the best of our knowledge, is the first case reported in Turkey.

The effect of flurbiprofen and tiaprofenic acid on serum cytokine levels of patients with osteoarthrosis

39 patients with active knee osteoarthrosis, chosen according to ACR criteria, were assigned to receive flurbiprofen (n 12, 2 2 100 mg), tiaprofenic acid (n 14, 2 2 300 mg) and placebo (n 13) in a 3-week, placebo-controlled study. All patients completed the study, and both medications were found to be effective: improvement occurred in the clinical signs. These drugs reduced the TNF- f levels. Flurbiprofen especially affected the IL-6 levels. Our findings indicate that NSAIDs may be effective in the etiopathogenesis of osteoarthrosis.

Étude multicentrique, randomisée, en double aveugle, contrôlée versus placebo évaluant l'efficacité de la thiocolchicoside au cours de la lombalgie aiguë

Resume Objectif de l’etude. – Evaluer l’efficacite d’injections intramusculaire de thiocolchicoside (4 mg–2 ml) par rapport a un placebo, administrees deux fois par jour pendant 5 jours chez des patients souffrant de lombalgie aigue. Patients et Methodes. – Etude multicentrique, randomisee, en double aveugle, controlee versus placebo. L’etude a ete menee de juillet 1998 a mars 2000 dans cinq centres. Ont ete inclus les patients hospitalises pour lombalgie aigue. Le principal critere d’evaluation etait la diminution des douleurs spontanees au repos evaluee par une echelle visuelle analogique (EVA). Les criteres secondaires etaient la distance main–sol, l’intensite de la contracture musculaire, l’appreciation globale du patient et la consommation d’antalgiques (paracetamol). Resultats. – Cent quarante-neuf (149) patients ont ete inclus. Les douleurs spontanees evaluees par l’EVA ont diminue dans les deux groupes a la fin de la premiere journee ; cependant l’amelioration etait significativement plus importante dans le groupe thiocolchicoside au troisieme jour ( p p p Conclusion. – L’administration biquotidienne de 4 mg de thiocolchicoside pendant 5 jours constitue un traitement efficace et sur de la lombalgie aigue avec contracture musculaire.