Raftlin - a potential biomarker for axial spondyloarthritis and psoriatic arthritis: An observational study.

Our aim is to evaluate serum Raftlin levels as a biomarker for diagnosing and monitoring disease activity in patients with axial spondyloarthritis (axSpA) and Psoriatic arthritis (PsA). This trial included 40 axSpA patients, 40 PsA patients, and 40 healthy participants as the control group. Disease activity was assessed with Ankylosing Spondylitis Disease Activity Score for axSpA patients and The Disease Activity Index for Psoriatic Arthritis for PsA patients. The Spondyloarthritis Research Consortium of Canada index, health assessment questionnaire-disability index, and numeric rating scale were used to evaluate the enthesitis severity, disability, and pain status of all patients. Serum Raftlin levels were determined using the ELISA method. The 3 groups had no statistical differences regarding gender, age, weight, height, BMI, educational status, and exercise habits. The axSpA group had higher Raftlin levels than the PsA and control groups, and Raftlin levels were statistically significant in predicting the likelihood of axSpA. We found no statistically significant differences between the PsA and control groups. We found no statistically significant difference in Raftlin levels in HLA-B27 positive versus HLA-B27 negative patients in both axSpA and PsA groups. Our results also did not detect any correlation of Raftlin levels with Ankylosing Spondylitis Disease Activity Score, C-reactive protein, erythrocyte sedimentation rate, health assessment questionnaire-disability index, numeric rating scale, and Spondyloarthritis Research Consortium of Canada index in axSpA patients. Receiver operating characteristic analysis determined that Raftlin level ≥ 6.31 ng/mL discriminates axSpA from normal individuals with 92.5% sensitivity, 59% specificity, and an area under the curve of 0.738. Our results demonstrate that although serum Raftlin levels are elevated in axSpA patients, Raftlin cannot be used as an alone diagnostic marker for axSpA. Furthermore, it was not found to be related to the monitoring of disease activity, the level of pain, disability, or severity of enthesitis. This study is prospectively registered at www.clinicaltrials.gov (ID: NCT05771389).

Investigating the correlation between pulmonary function tests and ultrasonographic diaphragm measurements and the effects of respiratory exercises on these parameters in hemiplegic patients.

OBJECTIVE: To investigate the correlation of DUS and pulmonary function tests (PFTs), and investigate the effects of respiratory exercises on the above parameters. METHODS: For the treatment group (n=20), neurological rehabilitation and respiratory exercise program, and for the control group (n=21), only a neurological rehabilitation program was implemented for 30 sessions. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), end-inspiration diaphragm thickness (IDT), end-expiratory diaphragm thickness (EDT), and diaphragm thickening ratio (DTR) were measured pre- and post-treatment. RESULTS: IDTs and EDTs as well as DTRs of affected side (p < .001, .001, and .03, respectively) and intact side (p < .001, .001, and .02, respectively) were found to improve post-treatment than before treatment in the treatment group. Similarly, FVC, FEV1, and FEV1/FVC, were better post-treatment than before treatment in the treatment group. Moreover, the affected side IDT was positively correlated with FVC and FEV1 before treatment (r = .38, p = .03 and r = .35, p = .02) and post-treatment (r = .46, p = .02 and r = .39, p = .03). The affected side DTR was positively correlated with FVC and FEV1 before treatment (r = .44, p = .01 and r = .40, p = .02) and post-treatment (r = .32, p = .03 and r = .40, p = .04). CONCLUSION: DUS can be used for the evaluation of respiratory problems in stroke patients. Moreover, breathing exercises improve these parameters in stroke patients, and they can be followed up by DUS.

Cross-cultural adaptation and validation of the Turkish version of the Functional Index for Hand Osteoarthritis (FIHOA).

BACKGROUND: To perform reliability and validity study of the Functional Index for Hand Osteoarthritis (FIHOA) in the Turkish language. METHODS: FIHOA was translated into Turkish following the principles of cross-cultural adaptation. Our translation was firstly tested in 40 patients with hand osteoarthritis. Adapted FIHOA questionnaire was then administrated to 100 hand OA patients successively with Modified Health Assessment Questionnaire (mHAQ), Numerical Rating Scale (NRS), and Short Form-36 (SF-36). Patients filled out the FIHOA questionnaire one more time after five days for test-retest assessment. Patients were divided into two groups as symptomatic or asymptomatic, with a NRS score of 5 or above defining symptomatic OA. Internal consistency was assessed by Cronbach's alpha and intraclass correlation coefficient (ICC) of test-retest reliability. Spearman correlation analysis was used to determine the correlation and validity between data. External construct validity was assessed using the correlation between FIHOA, mHAQ, hand pain NRS, and negative correlation with SF-36 subgroups. RESULTS: According to the total score, Cronbach-alpha was found as 0.90, while ICC was determined as 0.98 for test-retest reliability. When the correlations between the FIHOA questionnaire, mHAQ, and NRS questionnaires were examined, significant correlations were determined, and negative correlations between FIHOA and SF-36 subgroups were observed. CONCLUSION: Turkish FIHOA is a reliable and valid method for assessing functionality in Turkish patients with hand osteoarthritis.

Evaluating the reliability and readability of online information on osteoporosis

ABSTRACT Objective: Internet usage for obtaining health-related information is widely popular among patients. However, there are still concerns about the reliability and comprehensibility of online information. The purpose of this study is to investigate the reliability and readability of osteoporosis-related websites. Materials and methods: On April 2, 2020, we searched the term "osteoporosis" on Google (https://www.google.com). We evaluated the first 200 uniform resource locators (URLs) in the query results regarding typology, the Journal of the American Medical Association (JAMA) scores, Health on the Net Foundation Code of conduct (HONcode) certification, Flesch-Kincaid Grade (FKG), and Simple Measure of Gobbledygook (SMOG) scores. The JAMA scoring system and HONcode stamp were used for assessing the reliability, whereas FKG and SMOG scores were used to assess the readability of online information. Results: Of the 151 analyzed websites, 57 (37.7%) were classified as highly reliable, and 19 (12.6%) were assigned with HONcode certification. The average FKG scores (8.81 ± 2.21) and SMOG scores (7.63 ± 1.81) were below the recommended grade, which is considered as easily readable. High reliable information was found to have higher readability scores, thereby representing the difficulty of readability. We observed a weak correlation between the increased reliability of information and decreased readability. Conclusion: Osteoporosis-related content on the internet generally has low reliability. High-reliable information is available online in scientific published materials, health portals, and news. Although the readability of the overall material is acceptable, the high-reliable websites still require high literacy and comprehension skills.

Evaluating the reliability and readability of online information on osteoporosis.

OBJECTIVE: Internet usage for obtaining health-related information is widely popular among patients. However, there are still concerns about the reliability and comprehensibility of online information. The purpose of this study is to investigate the reliability and readability of osteoporosis-related websites. METHODS: On April 2, 2020, we searched the term "osteoporosis" on Google (https://www.google.com). We evaluated the first 200 uniform resource locators (URLs) in the query results regarding typology, the Journal of the American Medical Association (JAMA) scores, Health on the Net Foundation Code of conduct (HONcode) certification, Flesch-Kincaid Grade (FKG), and Simple Measure of Gobbledygook (SMOG) scores. The JAMA scoring system and HONcode stamp were used for assessing the reliability, whereas FKG and SMOG scores were used to assess the readability of online information. RESULTS: Of the 151 analyzed websites, 57 (37.7%) were classified as highly reliable, and 19 (12.6%) were assigned with HONcode certification. The average FKG scores (8.81 ± 2.21) and SMOG scores (7.63 ± 1.81) were below the recommended grade, which is considered as easily readable. High reliable information was found to have higher readability scores, thereby representing the difficulty of readability. We observed a weak correlation between the increased reliability of information and decreased readability. CONCLUSION: Osteoporosis-related content on the internet generally has low reliability. High-reliable information is available online in scientific published materials, health portals, and news. Although the readability of the overall material is acceptable, the high-reliable websites still require high literacy and comprehension skills.

How does cross-education affects muscles of paretic upper extremity in subacute stroke survivors?

INTRODUCTION: This study aimed to evaluate the benefits of adding electromuscular stimulation (EMS) to the flexors of wrist muscles on the nonparetic limb in conventional stroke training to strengthen homologous agonist and antagonist muscles on the paretic side in patients with subacute stroke. METHODS: The EMS group patients (n = 15) received conventional therapy for 30 sessions for 6 weeks (60 min/session) with 30 min of electrical stimulation to their nonparetic forearm using wrist flexors, with 5 min of pre- and post-warm-up. The transcutaneous electrical nerve stimulation (TENS) group patients (n = 15) received the same conventional rehabilitation training with 30 min of conventional antalgic TENS at a barely sensible level to their nonparetic forearm. The Fugl-Meyer motor function assessment for upper extremity (FMA-UE), functional independence measure (FIM), Brunnstrom staging of recovery for hand, maximum and mean wrist flexion force (flexionmax and flexionmean), and wrist extension force (extensionmax and extensionmean) of paretic untrained limb were evaluated before and after the treatment. RESULTS: EMS and TENS group patients improved similarly in terms of FMA-UE, FIM, and Brunnstrom staging for hand recovery. However, flexionmax and flexionmean of the paretic limb increased more in the EMS group than in the TENS group. Extensionmax and extensionmean on the paretic side increased in the EMS group but did not differ in the TENS group. CONCLUSION: Cross-education via EMS may have a beneficial effect as an adjunct to conventional treatment methods. This study is retrospectively registered and is available at www.clinicaltrials.gov (ID: NCT04113369).

Neuropathic Pain Questionnaire and Neuropathic Pain Questionnaire-Short Form: Translation, Reliability, and Validation Study of the Turkish Version.

AIM: To perform reliability and validity studies of the Neuropathic Pain Questionnaire (NPQ) and NPQ-Short Form (SF) in the Turkish language. MATERIAL AND METHODS: The Turkish translation and cross-cultural validation were performed. Then, 101 patients (36 males, 65 females; mean age: 50.4 ± 14.49; range: 20-87) with chronic pain were asked to fill out a pack of questionnaires, including the NPQ, NPQ-SF, Douleur Neuropathique 4 (DN4), Leeds Assessment of Neuropathic Symptoms (LANSS), and Numeric Rating Scale (NRS). A subgroup of 41 patients (11 males, 30 females) completed the NPQ and NPQ-SF for the second time after 3 days by telephone. Internal consistency was tested by Cronbach's-α and test-retest reliability was assessed by calculating the intraclass correlation coefficients (ICC). Construct validity was assessed by comparing NPQ, NPQ-SF, and NRS. Concurrent validity was tested by comparing NPQ, NPQ-SF, DN4, and LANSS. RESULTS: Internal consistency by Cronbach's-I± was 0.84 and 0.67 for the NPQ and NPQ-SF, respectively, indicating adequate and low internal consistency, respectively. ICC was 0.96 (p < 0.001; 95% confidence interval [CI], 0.95-0.97) for NPQ and 0.97 (p < 0.001; 95% CI, 0.95-0.97) for NPQ-SF, indicating a high test-retest reliability for both questionnaires. CONCLUSION: The Turkish versions of NPQ and NPQ-SF were reliable and valid for patients with chronic pain. To our knowledge, this is the first Turkish adaptation and test of the reliability and validity of the NPQ and NPQ-SF (short-form). These questionnaires could potentially help clinicians who seek to assess neuropathic pain for clinical and investigational purposes.

Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire: a cross-cultural adaptation and validation to the Turkish language.

In chronic inflammatory rheumatic diseases (CIRD), it is important to understand patients' fears towards their disease in order to improve patient-physician dialog, to raise the quality of care offered, and to optimize treatment adherence. In this study, we aimed to translate the Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire into Turkish and evaluate its psychometric properties in patients with CIRD. One hundred fifteen patients filled the provided socio-demographic information form, FAIR-Tr questionnaire, Hospital Anxiety and Depression Scale (HADS), and Beck's Hopelessness Scale (BHS). For the analysis of short-term reliability, 50 patients re-filled the FAIR-Tr questionnaire 1 week later. Internal consistency was evaluated with Cronbach's α coefficient and test-retest reliability was evaluated with intraclass correlation coefficients (ICC). Construct validity analysis was investigated based on the correlation with HADS and BHS. All patients found FAIR-Tr easily understandable and acceptable. FAIR-Tr internal consistency (Cronbach's α = 0.93) and test-retest reliability (ICC = 0.91) were excellent. Psychometric validation was proved upon observing high correlation with HADS (Anxiety, r = 0.77; Depression, r = 0.70) and moderate correlation with BHS (r = 0.65). FAIR-Tr is a questionnaire that has excellent internal consistency and test-retest reliability. The successful correlation with HADS and BHS supported its psychometric validity in terms of evaluating the fear in CIRD cases. We think that FAIR-Tr is a specific scale that can help to evaluate the disease- and treatment-related fears of the Turkish patients with CIRD and may be useful in both routine practice and clinical studies.