Yasemin Yumusakhuylu

Bone mineral changes during pregnancy and lactation

Abstract Objective: Significant calcium transfer from the mother to the fetus and infant occurs during pregnancy and lactation, theoretically placing the mother at an increased risk for osteoporosis. The relationship between pregnancy, breast-feeding and low bone mass is controversial. In this study we aimed to elucidate the relationship between pregnancy, breast-feeding and bone mass in third trimester pregnants, at least 3 months lactating mothers, and healthy young nulliporous women by using quantitative ultrasonometry. Method: The study included 120 women divided in three groups: third trimester pregnants, at least 3 months lactating mothers and healthy young nulliporous women. Demographics, total lactation time, number of pregnancies, births and miscarriages-abortions were recorded. Study groups underwent quantitative ultrasonometry measurement at midtibial shaft. Values of the ultrasonometry variables were calculated and compared for groups. Results: There were no significant differences among the groups with respect to parameters of age, age at menarche, smoking, alcohol intake and physical exercise in all of the three groups (p > 0.05). No differences were found among the three groups in analyzed variables, when comparing SOS, T- and Z-scores mid-tibial shaft quantitative ultrasonometry. Conclusion: No statistically significant associations were found between ultrasonometry variables and pregnancy, breast-feeding or nulliparity.

A case of caudal regression syndrome: walking or sitting?

Caudal regression syndrome (CRS) is a congenital disorder which is seen vertebral anomalies in varying degrees from lower thoracic spineto the level of the coccyx. We present a case of CRS which is not intended operation for orthopedic deformities considering functionality. 2, 5 year-old girl referred to our clinic with complaints about walking disability, knee and foot deformities. Patients mother with unregulated diabetes did not have a history of drug use, radiation exposure and serious illness during pregnancy. Diagnosis had been put during antenatal follow-ups. On physical examination, her lower extremities were hypoplastic and had no muscle activity. Her hips were flexed and abducted, but did not have contractures. Her knees had 75 degrees of flexion contractures with popliteal webs and feet had equinovarus deformity. Frog belly was present due to abdominal muscles weakness. Also hypoplasic labia majora has been identified. In lumbar MRI, spinal cord was terminated at 6th thoracic (T6) vertebrae and the last solid vertebrae level was at T10. Patient who has been following by urology with clean intermittent catheterization had also severe urological problems including horseshoe kidney, neurologic bladder, vesico-ureteral reflux and grade 2 hydronephrosis. Orthopedic consultation was made for her deformities. They decided that ambulation unexpected patients knee flexion contractures were helping sitting balance. Because of this operation was not considered. Prognosis, treatment options, strength exercises for upper extremities, skin care were told to parents and patient was taken to follow. CRS is a rare congenital abnormality which is associated with orthopedic deformities, as well as urological, anorectal and cardiac malformations. Treatment requires a multidisciplinary approach. It should not be forgotten that purpose of rehabilitation is not to correct all deformities but increase the functionality of everyday life.

A preliminary study showing that ultrasonography cannot differentiate between psoriatic arthritis and nodal osteoarthritis based on enthesopathy scores

Author(s): Yumusakhuylu, Yasemin; Kasapoglu-Gunal, Esen; Murat, Sadiye; Kurum, Esra; Keskin, Havva; Icagasioglu, Afitap; McGonagle, Dennis; Zehra Aydin, Sibel

Musculoskeletal Pain and Quality of Life in Obese Patients

Abstract Objectives: The aim of this study is to investigate the impact of obesity on frequency and severity of musculoskeletal pain and quality of life. Methods: Demographic data of 230 patients that presented to the Physical Medicine and Rehabilitation Department because of musculoskeletal pain were acquired and analyzed. Patients were randomized into two groups according to body mass index [BMI] values: obese group [BMI ≥ 30 kg/m2] and normal-weighted group [BMI < 25 kg/m2]. Patients were asked for localization and duration of muskuloskeletal pain. Severity of pain was evaluated by using a visual analog scale. Information on difficulties of daily movements within the last month was obtained and quality of life was evaluated by using the Short-Form 36. Results: There was a statistically significant increase in frequency of neck pain [p = 0.049], shoulder pain [p = 0.001], elbow pain [p = 0.006], wrist and hand pain [p = 0.012], arm pain [p = 0.017], low back pain [p = 0.001], hip pain [p = 0.001], knee pain [p = 0.001], ankle-foot pain [p = 0.001], and leg pain [p = 0.001] in the obese group when compared with the normal-weighted group. There was a statistically significant increase in visual analog scale scores of the all body parts in the obese group when compared with in the normal-weighted group [p < 0.01]. There was a statistically significant difference between groups in difficulties of daily movements within last month [p < 0.01]. All the parameters of Short-Form 36 were found statistically significant lower in the obese group [p = 0.001]. Conclusions: Obesity is a multifactorial, chronic disease which causes many complications and pain on the musculoskeletal system. Difficulty of daily movements also decreases quality of life.