Hasan Elden

The prevalence of diffuse idiopathic skeletal hyperostosis in patients with diabetes mellitus

ObjectiveThe relation of diffuse idiopathic skeletal hyperostosis (DISH) and diabetes mellitus (DM) has been frequently reported. However, there is little knowledge about its prevalence in DM. The purpose of this study was to determine that prevalence and whether it differs from that of controls.MethodsThe prevalence of DISH was investigated in 133 patients with DM and 133 nondiabetic controls matched for sex, age, and weight. Radiologic criteria were used for diagnosis. Erythrocyte sedimentation rate, fasting blood glucose levels, glycolized hemoglobin, triglyceride, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein, calcium, uric acid, alkaline phosphatase, phosphorus, insulin, and insulin-like growth factor-1 (IGF1) levels of both groups were compared.ResultsThe prevalence of DISH (12%) was higher in patients with DM than the control group (6.8%), but there was no statistically significant difference. The average age of the patients diagnosed with DISH (63.36±9.27) was significantly higher than that of the others (54.21±12.12) (P<0.05). There was no significant difference between the DISH patients and the others in other parameters examined.ConclusionWe found no statistically significant difference in the prevalence of DISH between patients with DM and controls. We suggest that the factors thought to be responsible for the etiopathogenesis of DISH such as DM, insulin, and insulin-like growth factor-1 be investigated further.

Prevalence of atopy in rheumatoid arthritis in Sivas, Turkey. A prospective clinical study

Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism.

Relapsing significant bacteriuria : Effect on urinary tract infection in patients with spinal cord injury

OBJECTIVE To evaluate whether there is a relation between relapsing significant asymptomatic bacteriuria (ASB) and symptomatic urinary tract infection (UTI), and to determine the frequency rate of UTI in patients with spinal cord injury (SCI) using indwelling catheters (IC). DESIGN Cohort study. Patients were followed up for 24 to 270 days (mean, 66.3 +/- 42.2). SETTING A department of physical therapy and rehabilitation in a research hospital of a university referral center. PATIENTS Fifty patients with SCI using IC. Patients with severe concurrent illness, known vesicouretheral reflux, urinary calculi, and severely disturbed renal function were excluded. MAIN OUTCOME MEASURE Symptomatic UTI, relapsing ASB, and recurrent significant ASB. RESULTS There was significant difference between relapsing ASB and recurrent ASB with regard to occurring symptomatic UTI (chi 2, 4.92; p < .03). Symptomatic UTI was observed at a rate of 9.35, relapsing ASB 35.59, and recurrent ASB 55.80 per 1,000 patient-days. CONCLUSION Relapsing ASB is an important factor in the development of symptomatic UTI.

Acute spinal cord injury: A review of pathophysiology and potential of non-steroidal anti-inflammatory drugs for pharmacological intervention

Acute spinal cord injury (SCI) is one of the serious central nervous system injuries, which can lead to significant neurological impairments and a reduction in quality of life with loss in sensory and motor functions. Although recent advancements contribute to the understanding of the underlying pathophysiological processes developed after SCI, currently, there is limited innovative and effective treatment options besides conventional rehabilitation and management of SCI to alleviate the condition. Improvements in neurological functions of the individuals with SCI depend mainly on the mechanical damage occurring in the primary injury and on pathophysiological alterations associated with secondary damage. Since in the treatment of SCI, there are no therapeutic strategies for neurological alterations caused by primary injury, all innovative treatments utilize treatment strategies targeting to the secondary damage. Non-steroidal anti-inflammatory drugs (NSAIDs) have become the focus of various experimental SCI models as these may be expected to reduce inflammation in secondary damage due to their potent anti-inflammatory effects. Experimentally, they exhibit neuro-protective and apoptotic effects by suppressing axonal re-growth, thus inhibiting the RhoA pathway, which leads to apoptotic cell death, in addition to the recovery of motor functions along with histological improvement. However, histological improvement is not significantly associated with improvement of motor function. The main target of SCI research should not only focus on histological improvement of lesion, but also on its potential for contribution to effective clinical therapies targeting improvements in sensory and motor functions. In the present review, we have summarized the current knowledge about pathophysiologic mechanisms working after SCI and discussed the potential of NSAIDs as promising agents in the management of SCI.

Additional Therapeutic Effect of Balneotherapy in Low Back Pain

Objectives: Balneotherapy has been widely used for treatment of chronic low back pain recently. However there are only a few clinical controlled trials on balneotherapy. The aim of the present study was to evaluate the effects of balneotherapy in patients with chronic low back pain. Methods: Sixty patients with lumbar spondylosis were included in the study. In Group 1, patients received both balneotherapy and physiotherapy and in Group 2, patients received only physiotherapy for three weeks. The intensity of the pain was evaluated by Visual Analog Scale (VAS) and functional disability was scored according to Revised Oswestry Index (ROI). Spinal mobility was assessed by the Schober and lateral flexion tests. Variables were evaluated before and after the three weeks of treatment. Results: The groups were comparable regarding age (P = 0.970) and sex (P = 0.357). There was no statistically significant difference between the two groups for baseline VAS (P = 0.838), Schober test (P = 0.226), and right (P = 0.642) and left (P = 0.674) lateral flexion measurements, and ROI scores (P = 0.798). At the end of the therapy, all clinical parameters significantly improved in patients in both of the groups (P < 0.05). VAS, Schober test, and ROI scores after the therapy were clearly superior in Group 1 in comparison to Group 2 (P < 0.05). Conclusion: The results of the present study reiterate that besides conventional physiotherapy, balneotherapy may be effective in the treatment of patients with chronic low back pain.