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Berat Alkan

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Papers by Berat Alkan

The Effect of Obesity on Neuropathic Pain in Female Patients with Fibromyalgia Syndrome

Turkish Journal of Osteoporosis

Amaç: Bu çalışmada fibromiyalji sendromlu (FMS) kadın hastalarda nöropatik ağrının değerlendirilm... more Amaç: Bu çalışmada fibromiyalji sendromlu (FMS) kadın hastalarda nöropatik ağrının değerlendirilmesi ve obezitenin fibromiyalji semptomları, yaşam kalitesi ve nöropatik ağrı üzerine etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: 40 normal kilolu ve 40 obez fibromiyalji sendromlu kadın hasta çalışmaya dahil edildi. Hastaların tümü ACR 1990 VE 2010 ACR sınıflama kriterlerini karşılıyordu. LANSS(Leeds asseessment of neuropathic symptoms and signs) ve DN4(Douleur neuropathique 4 questions) skalaları hastalarda nöropatik ağrı değerlendirmesi için kullanıldı. FIQ(Fibromyalgia impact questionnaire) skalası hastaların sağlık durumu değerlendirmeleri için kullanıldı. Bulgular: Nöropatik ağrı LANSS skalasına göre %56,3, DN4 skalasına göre %78 hastada saptandı. Nöropatik ağrı oranı normal kilolu FMS lu grupta %42,5, obez FMS'lu grupta %70 oranındaydı ve obez grupta istatiksel olarak anlamlı olarak daha yüksekti. FIQ skorları ile yaşam kalitesi skorları açısından iki grup arasında anlamlı farklı saptanmadı. Sonuç: Nöropatik ağrı obez kadın FMS hastalarında normal kilolu kadın FMS hastalarına göre anlamlı daha yüksek çıkmıştır. Bu nedenle FMS'lu kadın hastalarda obez olanlarda nöropatik ağrı açısından daha dikkatli olunmalıdır.

format_quote70% of obese fibromyalgia patients exhibited neuropathic pain according to LANSS scale, compared to 42.5% of normal weight patients.format_quote

The Mediterranean Fever Gene Mutations and Its Association with HRQoL, Depression and Fatigue in Patients with Familial Mediterranean Fever Associated Spondyloarthropathies

Turkish Journal of Osteoporosis

Amaç: Ailevi Akdeniz ateşine (AAA) eşlik eden spondililoartropatisi (SpA) olan hastalarda sağlıkl... more Amaç: Ailevi Akdeniz ateşine (AAA) eşlik eden spondililoartropatisi (SpA) olan hastalarda sağlıkla ilişkili yaşam kalitesi (HRQoL), depresyon, yorgunluk, Akdeniz ateşi geni (MEFV) mutasyonları ve diğer hastalıklarla ilişkili durumların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kırk beş AAA spondilit hastası (41 kadın, 4 erkek) ve 40 sağlıklı kontrol çalışmaya dahil edildi. Metrolojik ölçümler (el parmak-zemin mesafesi, bel Schöber testi, oksiput-duvar mesafesi ve göğüs ekspansiyonu) değerlendirilerek kaydedildi. Aksiyal ve periferik eklem ağrısı görsel ağrı skalası (GAS) ile, hastalık aktivitesi Bath Ankilozan Spondilit Hastalık Aktivite indeksi (BASDAİ) ile, hastalık fonksiyonu Bath Ankilozan Spondilit Fonksiyonel indeksi (BASFİ) ile değerlendirildi. HRQoL, depresyon ve yorgunluk değerlendirilmesinde Kısa Form-36, Beck depresyon indeksi (BDI) ve multidimensiyonel yorgunluk değerlendirme (MAF) ölçekleri kullanıldı. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 43,73±8,7 (24-59) yıl idi. Hem fiziksel hem de mental sağlıkla ilişkili yaşam kalitesi sonuçları kontrol grubuna göre anlamlı derecede kötüydü. On iki hastada (%26,6) BDI 17'nin üzerinde olup klinik olarak depresyon saptandı. Yorgunluk skorları yüksek olarak saptandı. AAA'ya eşlik eden SpA hastalarında en sık rastlanan gen mutasyonları M694V ve E148Q idi. MEFV gen mutasyonlarının QoL, yorgunluk, depresyon, ağrı ve diğer hastalıkla ilişkili değişkenler üzerinde önemli bir etkisi görülmedi. Objective: Our aim was to evaluate the health-related quality of life (HRQoL), depression, fatigue, the Mediterranean fever (MEFV) gene mutations, and other disease-related variables in patients with Familial Mediterranean fever (FMF) associated spondyloarthropathies (SpA). Materials and Methods: Consecutively, 45 patients with FMF associated SpA (41 females, 4 males) and 40 healthy controls were included. Metrological measures (finger-floor distance, dorsal Schober's test, occiput-wall distance and chest expansion) were determined. Axial and peripheral joint pain was evaluated by using visual analog scale (VAS), disease activity by Bath Ankylosing Spondylitis Disease Activity index and function by Bath Ankylosing Spondylitis Functional index. Short Form-36 and the multidimensional assessment of fatigue (MAF) scale, Beck depression index (BDI) and MAF scales were used to evaluate HRQoL, depression and fatigue. Results: Mean ages of the patients was 43.73±8.7 (24-59) years. Both physical and mental HRQoL were found to be significantly worse in FMF associated SpA patients than in controls. Twelve patients (26.6%) had clinical depression with BDI scores ≥17. MAF score was high in patients with FMF associated SpA. The most frequent mutations were M694V and E148Q in patients with FMF associated SpA. No significant effect of MEFV gene mutations was seen on QoL, fatigue, depression, pain and disease-related variables. Conclusion: FMF associated SpA significantly affects the QoL of its sufferers, as other chronic ilnesses. In this study, both physical and mental HRQoL were found to be significantly worse in FMF associated SpA patients than in controls, irrespective of the MEFV gene mutations. Depression was also seen in high rates in patients with FMF associated SpA. Further studies are needed to determine the effects of MEFV gene mutations on disease severity and QoL in FMF patients.

format_quoteFMF associated SpA significantly worsens HRQoL, depression, and fatigue, independent of MEFV gene mutations.format_quote

Musculoskeletal disorders, quality of life and depression in healthcare workers

Ege Tıp Dergisi, 2017

Postpartum Spinal Osteoporoza Bağlı Vertebra Kırıkları: Bel Ağrısının Nadir Bir Nedeni

Postpartum spinal osteoporosis (PPSO) is a rare disease entity presenting with back/low back pain... more Postpartum spinal osteoporosis (PPSO) is a rare disease entity presenting with back/low back pain and is characterized by osteoporosis during late pregnancy or puerperium. It generally leads to one or more vertebral fractures. Herein, we present a young female patient who had multiple vertebral compression fractures due to PPSO in the postpartum period. (Turkish Journal of Osteoporosis 2011;17:21-3)

Osteoartrite Güncel Yaklaşım

Ankara Medical Journal, 2013

Osteoarthritis (OA) is a progressive non-inflammatory joint disease that affects particularly car... more Osteoarthritis (OA) is a progressive non-inflammatory joint disease that affects particularly cartilage within all structures of the joint. Diagnosis of osteoarthritis is confirmed with clinical and radiological findings. Its incidence rises with age. The joints most frequently affected by osteoarthritis are; knees, hips, spine, distal and proximal interphalangial joints of the hands, first carpometacarpal joint and first metatarsophalengial joint. Typically OA is presented with activity related or mechanical joint pain in earlier periods, while pain may also occur during rest in advanced disease. Treatment modalities for OA are pharmacological, non-pharmacological, intra-articular and surgical. The management of OA should be tailored for each patient and treatment guidelines should be taken into consideration.

Incidence of Osteoporosis in Patients Admitted to our Physical Medicine and Rehabilitation Outpatient Clinics

Türk Osteoporoz Dergisi, 2011

Aim: Osteoporosis is a skeletal disease characterized with decreased bone mass and microarchtitec... more Aim: Osteoporosis is a skeletal disease characterized with decreased bone mass and microarchtitectural deterioration of bone tissue which increases bone fragility and fracture risk. Osteoporosis and osteoporotic fractures constitute an important health problem in general population. This study aimed to determine the incidence of osteoporosis, chronic diseases accompanying osteoporosis and incidence of falls in male and female patients admitted to our out patient clinics retrospectively. Material and Methods: Patient records of the 11624 patients admitted to Ankara Atatürk Education and Research Hospital Physical Medicine and Rehabilitation Outpatient clinics between January 2010 and July 2010 were retrospectively reviewed and 644 patients diagnosed as osteoporosis according to femoral neck and/or lumbar dual energy x ray absoptiometry measurements were included in the study. Ages of the patients, sexes, chronic ilnesses, musculoskeletal sytem complaints and fall histories were also ...

Osteoartrite Güncel Yaklaşim Current Approach to Osteoarthritis

Osteoarthritis (OA) is a progressive non-inflammatory joint disease that affects particularly car... more Osteoarthritis (OA) is a progressive non-inflammatory joint disease that affects particularly cartilage within all structures of the joint. Diagnosis of osteoarthritis is confirmed with clinical and radiological findings. Its incidence rises with age. The joints most frequently affected by osteoarthritis are; knees, hips, spine, distal and proximal interphalangial joints of the hands, first carpometacarpal joint and first metatarsophalengial joint. Typically OA is presented with activity related or mechanical joint pain in earlier periods, while pain may also occur during rest in advanced disease. Treatment modalities for OA are pharmacological, non-pharmacological, intra-articular and surgical. The management of OA should be tailored for each patient and treatment guidelines should be taken into consideration.

The Frequency of Spontaneous Vertebral Fracture in Geriatric Patients and the Relationship of Vertebral Fractures with Age: A Retrospective Study

Turkish Journal of Osteoporosis, 2021

Amaç: Vertebral kırıklar geriatrik hastalarda yaşam kalitesini bozmakta ve ekonomik maliyeti artı... more Amaç: Vertebral kırıklar geriatrik hastalarda yaşam kalitesini bozmakta ve ekonomik maliyeti artırmaktadır. Bu çalışmada, geriatrik hastalarda spontan vertebral fraktür oranlarını ve risk faktörlerini belirlemeyi amaçladık. Gereç ve Yöntem: 1 Ocak-30 Haziran 2018 tarihleri arasında fiziksel tıp ve rehabilitasyon polikliniğine dorsalji şikayeti ile başvuran 65 yaş üstü hastaların verileri retrospektif olarak incelendi. Torakal ve lomber omurga grafilerinde kırık saptanan 136 hasta çalışmaya alındı. Hastaların vitamin D düzeyi, osteoporoz tedavileri, diabetes mellitus, kronik böbrek yetersizliği ve tiroid disfonksiyonları kaydedildi. Bulgular: Hastaların (kadın/erkek: 119/17) yaş ortalaması 73,9±6,6 idi. Yetmiş dört kişide (%54,4) spontan vertebra kırığı saptandı. Vertebral kırıklar, alt torasik ve üst lomber bölgede yoğunlaşmaktaydı. Hastalar grup 1; 65-74 yaş arası, grup 2; 75 yaş ve üstü hastalar olarak gruplara ayrıldı. Grup 2'deki spontan vertebra fraktür oranları istatistiksel olarak anlamlı derecede yüksekti (p˂0,05). Regresyon analizine göre yaş, kadın cinsiyet ve osteoporoz varlığı vertebral fraktür açısından belirgin risk faktörüydü. Sonuç: Geriatrik hastalarda vertebral kırıklar dramatik şekilde artmaktadır. İleri yaş (>75 yıl) vertebral kırıklar için majör ve bağımsız risk faktörüdür. Maliyetinin yüksek olması ve yaşam kalitesini olumsuz etkilemesi nedeniyle geriatrik hastalarda kemik kalitesine yönelik tanı ve tedavilerin zamanında yapılması gerekmektedir.

Benefits, Treatment Compliance, Awareness and Expectation Levels Related to Treatment of Patients Taking Physical Therapy Program

Turkish Journal of Osteoporosis, 2019

Objective: In our study, we aimed to determine the expectations, treatment compliance, benefit st... more Objective: In our study, we aimed to determine the expectations, treatment compliance, benefit status, and satisfaction levels of patients who had applied physical therapy (PT) outpatient clinic in our hospital. Materials and Methods: Five hundred patients aged 18 years and over who were admitted in the PT program were included in the study. A questionnaire consisting of 21 questions about demographic specifications, PT history, expectation, satisfaction, adaptation to home program, and opinions about PT was given to the patients. The demographic data in the questionnaire form and the questionnaires of the patients who left five or more of the questions unanswered were not included in the study. Patients who had previous experience with PT in another hospital, illiterate, had a neurological disease, joint contracture, and patients treated after musculoskeletal surgery were excluded in the study. Results: The questionnaire form of 362 patients was accepted as valid. Two hundred sixty-three of the patients were female, 99 were male and the mean age was 55.26±12.07. 69.10% of the patients were in the expectation of complete recovery, 89.75% reported that their expectations were met, and 88.60% reported that they benefited from the treatment. The level of satisfaction from PT practitioners was 78.10%. It was determined that 67.40% of the patients applied the given exercises and 76.66% of the patients complied with their daily life suggestions. When the patients who did and did not benefit from PT were compared; it was found that those did not have a systemic disease history, who did exercises along with the treatment, and who complied daily activity suggestions were benefited significantly higher (p<0.05). Conclusion: Assessment of patients' expectations, awareness and satisfaction status from treatment will contribute to increasing the quality of health care services.

The Effect of Bolus Vitamin D Supplementation

Ankara Medical Journal, 2019

Objectives: Vitamin D plays an important role in musculoskeletal and nervous system health. Altho... more Objectives: Vitamin D plays an important role in musculoskeletal and nervous system health. Although, the prevalence of vitamin D deficiency is fairly high and it may lead to bone abnormalities and muscle weakness, it is a preventable condition. The aim of this prospective study was to assess the effects of vitamin D supplementation on balance, mobility, grip strength, fatigue, depression and quality of life. Materials and Methods: Between October 1, 2015 and December 31, 2015, a total of 92 patients with vitamin D insufficiency/deficiency were included in the study. Demographic characteristics of age, gender, height, weight, serum 25-hydroxyvitamin [25-(OH)D], parathyroid hormone, alkaline phosphatase (ALP), calcium, and phosphorus levels were recorded. The primary outcome was assessed the [25-(OH) D] levels at 1 month and 3 month post-treatment. The secondary outcomes were the efficacy of vitamin D administration on fatigue, mobility, balance, depression, quality of life (QoL), muscle strength using The Multidimensional Assessment of Fatigue Scale (MAF), Timed Up and Go Test (TUG), Single leg stance test (SLS), Beck Depression Inventory (BDI), The Nottingham Health Profile(NHP), hand dynamometer, respectively at all visits. Results: After the 1 month, the vitamin D supplementation had significantly improved muscle strength, balance ability, mobility, QoL, depression, and fatigue symptoms. The levels of [25-(OH) D] significant decreased after 3 months. Conclusion: Supplemental vitamin D consistently demonstrated beneficial effects on muscle strength, mobility, balance control, depression, fatigue and QoL. The 300,000 bolus of vitamin D was well-tolerated and safe in adult population. We would recommend evaluating vitamin D status once in three months.

Effect of Illness Perception on the Quality of Life in Ankylosing Spondylitis

Ankara Medical Journal, 2018

The aim of the study was to assess the illness perception in patients with ankylosing spondilitis... more The aim of the study was to assess the illness perception in patients with ankylosing spondilitis (AS), to evaluate disease activity, functional ability, emotional status and to investigate their association with quality of life (QoL). Materials and Methods: Sixty-seven patients with AS were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used for the assessment of disease activity and of physical functions, respectively. The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire was used for disease-related quality of life and The Brief Illness Perception Questionnaire (B-IPQ) was used for the assessment of illness perception in AS patients. Beck Depression Inventory (BDI) was used for the assessment of psychological status. Results: Based on our results, significant association was found between QoL and illness perceptions. However, QoL was most associated with functional status and disease activity. Conclusion: Assessment of illness perception in routine clinical practice could contribute to a better understanding of problems in patients' behavior that may disturb adherence to treatment. Psychotherapeutic approaches in addition to conventional therapy might attempt to improve patient's QoL in AS.

Vitamin D Deficiency in Adults with Musculoskeletal Pain

Türk Osteoporoz Dergisi, 2015

Bu çalışmamızın amacı hastanemize kas iskelet sistemi ağrısı ile başvuran hastalarda D vitamini e... more Bu çalışmamızın amacı hastanemize kas iskelet sistemi ağrısı ile başvuran hastalarda D vitamini eksikliği olup olmadığını belirlemek ve yaş ile cinsiyete göre D vitamini düzeyleri arasındaki farkı tespit etmekti. Gereç ve Yöntem: Çalışmaya 28,702 hastadan D vitamini düzeyi çalışılmış olan toplam 857 (%3) hasta dahil edildi. Serum 25(OH) D düzeyi likit kromatografi kütle spektrometresi (LK-KS) ile ölçüldü. Hastalar 25(OH) D vitamini düzeyine göre üç gruba ayrıldı. Grup 1: >30 μg/L (yeterli), grup 2: 10-30 μg/L (ılımlı yetersiz) ve grup 3: <10 μg/L (şiddetli yetersiz) yer aldı. Bulgular: Hastaların yaş ortalaması 49,1±14,5 (18-87) yıl ve D vitamini düzeyi ortalaması 15,3±10,3 μg/L bulundu. D vitamini düzeyi hastaların %91'inde (780) normalin altındaydı. Hastaların %44,2'sinde (379) şiddetli yetersizlik tespit edildi ve 25(OH) D düzeyi <10 μg/L'nin altıdaydı. D vitamini düzeyleri kadınlarda erkeklerden daha düşüktü. Sekonder hiperparatiroidi %17 (146) hastada gözlendi. Sonuç: D vitamini eksikliği alınan tüm koruyucu önlemlere rağmen dünya çapında önemli bir sağlık problemidir, ülkemizde yaygın olarak görülür ve özellikle kadınları etkiler. Anahtar kelimeler: D vitamini eksikliği, paratiroid hormon, yaş, cinsiyet

Femoroacetabular Impingement Syndrome: Case Report

Türk Osteoporoz Dergisi, 2014

Femoroacetabular impingement syndrome is one of the main causes of hip pain which led to early os... more Femoroacetabular impingement syndrome is one of the main causes of hip pain which led to early osteoarthritis in young and active patients. This is characterized by a pathologic contact between femur and acetabulum. In addition to clinical tests, conventional radiography has an important role in diagnosing. Although it is effective to conservative treatment approaches, there are more publications on surgical interventions. In this article it is presented a 43 years old male patient diagnosed with femoroacetabular impingement. As a result of the physical examination of the patient admitted to our outpatient clinic due to increasing pain in the right hip for one year while walking and climbing stairs, it is found that the right hip movements are painfull. There are images in conventional radiography, thickness of femoral neck, hump malformation, subchondrial cystic resorbtion, supraacetabular sclerosis and avulsion.

Distal Interphalangial Joint Gouty Arthritis in a Patient with Nodal Osteoarthritis: A Case Report and Review of Literature

British Journal of Medicine and Medical Research, 2015

Case: Herein 73 year- old female patient with distal interphalangial (DIP) joint gouty arthritis ... more Case: Herein 73 year- old female patient with distal interphalangial (DIP) joint gouty arthritis accompanying nodal OA was presented. There was significant redness and swelling in the joint, joint was warm and tender on palpation and range of motion was very painful. Conclusion: The presentation of acute or subacute arthritis in interphalangial joints of a

Spinning-induced rhabdomyolysis: A case report and review of literature

European Journal of Rheumatology, 2015

Rhabdomyolysis is a condition of skeletal muscle breakdown in which muscle injury causes a releas... more Rhabdomyolysis is a condition of skeletal muscle breakdown in which muscle injury causes a release of myoglobin and the muscle enzymes creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and transaminases. Exertional rhabdomyolysis, which is precipitated by exercise or exertion, ranges from mild muscle injury with negligible symptoms or systemic effects to fulminant cases. Herein, we report a 26-year-old female patient who was admitted to our Physical Medicine and Rehabilitation outpatient clinics with severe bilateral thigh pain persisting for 5 days after participating in a spinning class and diagnosed with exertional rhabdomyolysis. Timely diagnosis and treatment prevented the potentially life-threatening consequences. We assume that it is essential to raise the awareness of this phenomenon not only by physicians but also by the community, since regular exercise and being physically active are increasingly encouraged in modern life.

Assessment of Fatigue in Undifferentiated Spondyloarthritis (USpA)

Open Journal of Rheumatology and Autoimmune Diseases, 2014

Objectives: This study aimed to evaluate the fatigue in patients with undifferentiated spondyloar... more Objectives: This study aimed to evaluate the fatigue in patients with undifferentiated spondyloarthritis [USpA], and its relationship with disease-specific variables, spinal mobility measures and healthy related quality of life [HRQOL]. Methods: Eighty patients with USpA and forty healthy subjects were included in this study. The multidimensional assessment of fatigue [MAF] and the generic instrument Short Form 36 [SF 36] were used in patient and control groups to assess fatigue and [HRQOL]. Fatigue was also assessed with the Bath ankylosing spondylitis disease activity index [BASDAI] fatigue item. The evaluation included the activity of the disease [BASDAI], functional status [Bath ankylosing spondylitis functional index], and visual analog scale [VAS] of axial and joint pain. Demographics and disease-related data were obtained. Results: Patients with USpA had higher scores in MAF total and in all MAF subgroup scales than controls. All SF-36 subgroups scores were also found to be significantly lower in patients. Severe fatigue experienced 60% in patients. MAF total scores were found to be significantly correlated with morning stiffness, BASDAI, Bath ankylosing spondylitis functional index (BASFI), BASDAI fatigue, VAS-axial, and SF-36 subgroups scores in patients [p < 0.05]. Conclusions: The patients with USpA defined significantly more fatigue and lower HRQOL when compared with healthy persons. MAF was found to be related with the clinical and functional status and health-related quality of life of patients with USpA.

Age, Sex, and Seasonal Variations in the Serum Vitamin D3 Levels in a Local Turkish Population

Archives of Rheumatology, 2014

This study aims to assess the 25-hydroxyvitamin D [25-(OH)D] levels in patients who were seen at ... more This study aims to assess the 25-hydroxyvitamin D [25-(OH)D] levels in patients who were seen at a physical medicine and rehabilitation outpatient clinic while also taking into account the seasonal serum vitamin D (vit D) variation. Patients and methods: We retrospectively evaluated the medical records of the patients who attended a physical medicine and rehabilitation outpatient clinic, and the serum 25-(OH)D levels in 440 subjects of varying ages and sexes in both the summer (n=177) and winter (n=263). Serum 25-(OH)D, parathyroid hormone, alkaline phosphatase (ALP), calcium, and phosphorus levels were recorded. Results: A large percentage of the adult Turkish population has insufficient levels of vit D during the winter and summer. Serum 25-(OH)D levels were significantly lower in the winter compared with the summer season (mean vit D: 13.9 µ/l and 19.7 µ/l, respectively; p≤0.001). The prevalence of 25-(OH)D deficiency was 94% in the winter and 85% in the summer. With respect to age or sex, there were no differences in the 25-(OH)D levels. Conclusion: Our results indicate that although Turkey is a Mediterranean country, the Turkish people should check have their levels of 25-(OH)D periodically checked, and if necessary, appropriate supplements should be given to prevent a secondary chronic disease due to vit D deficiency.

Metastatic Oesophagus Carcinoma Presented with Neck and Arm Pain: A Case Report

Case Reports in Clinical Medicine, 2014

Oesophageal carcinoma is among malignancies with poor prognosis due to the late onset symptoms re... more Oesophageal carcinoma is among malignancies with poor prognosis due to the late onset symptoms related with large submucosal involvement, early lymphatic metastasis and its multicentric characteristics, majority of the patients decrease within the first year of diagnosis. However, bone metastasis is uncommon and reported to be 1% to 14% in autopsy series. Herein we report a case that was admitted to our outpatient clinics with severe neck and arm pain as presenting symptoms and diagnosed as metastatic oesophageal carcinoma afterwards.

Çağın Pandemisi: D Vitamini Eksikliği ve Yetersizliği

Türk Osteoporoz Dergisi, 2014

Vitamin D is not only a fat-soluble vitamin, but also a group of hormone and hormone precursor st... more Vitamin D is not only a fat-soluble vitamin, but also a group of hormone and hormone precursor sterols that can be synthesized endogenously in appropriate biological conditions. Its most profound effect is on calcium and phosphorus metabolism, and on bone mineralization. In recent years, it was reported that Vitamin D deficiency and insufficiency are related with many chronic diseases such as widespread cancers, cardiovascular diseases, metabolic syndromes, infectious diseases and autoimmune diseases. Vitamin D deficiency is also a defined risk factor for osteoporosis, falls and fractures. Vitamin D deficiency is now recognized as a global epidemic. 25(OH) Vitamin D levels under 20 ng/mL is accepted as Vitamin D deficiency, levels between 21-29 ng/mL as insufficiency, over 30 ng/mL as sufficient levels (preferred range is between 40-60 ng/mL), and over 150 ng/mL as Vitamin D intoxication. Vitamin D deficiency leads to ricketts clinics in children and osteomalacia clinics in adults. In this review, we aimed to define Vitamin D deficiency and insufficiency which is currently widespread in adults, and to provide a current approach to the treatment methods.

Quality of life and self-reported disability in patients with knee osteoarthritis

Modern Rheumatology, 2013

Objectives Osteoarthritis (OA) is the most common degenerative joint disorder and a major public ... more Objectives Osteoarthritis (OA) is the most common degenerative joint disorder and a major public health problem throughout the world. The aims of this study are to assess quality of life (QoL) in patients with knee OA using the generic instrument Short Form-36 (SF-36) and to determine its relationships with conventional clinical measures and self-reported disability. Methods Patients with knee OA (n = 112) with median age of 60 (45-76) years and 40 sex-and age-matched healthy controls were included in the study. Age, sex, body mass index (BMI), symptom duration, and Kellgren-Lawrence scores were recorded. QoL, disability, and pain were assessed using the SF-36, the Western Ontario and McMaster (WOMAC) index, the Lequesne index, and a visual analog scale (VAS) in patients. Also, QoL was assessed using the SF-36 in controls. Results Patients with knee OA had lower scores in all subgroups of SF-36 compared with controls. In patients, the SF-36 physical function (PF) and pain areas significantly correlated with effusion, VAS pain, and Lequesne and WOMAC subgroup scores (p \ 0.05). The pain area of QoL did not show correlation with comorbidity with knee OA. We found that SF-36 and WOMAC pain scores were more severe in female patients. Conclusions Patients with knee OA had significantly poorer QoL compared with healthy controls. SF-36 is related to the clinical status and functional ability of patients with OA and can be used as a sensitive health status measure for clinical evaluation. Also WOMAC can be used as a sensitive measure for disability of patients with knee OA.