Low levels of serum vitamin D3 are associated with fibromyalgia syndrome in pre-menopausal women: A pilot study.

OBJECTIVES: This study aims to investigate the prevalence of fibromyalgia syndrome (FMS) among patients with low and adequate vitamin D levels in premenopausal women. PATIENTS AND METHODS: Between October 2012 and April 2013, a total of 80 premenopausal patients (mean age 38.1±7.1 years; range, 18 to 50 years) with non-specific musculoskeletal symptoms were included in the study. The determination of 25-hydroxyvitamin D3 (25(OH)D3) deficiency was based on a reference value of 25 ng/mL. Patients with deficient serum 25(OH)D3 levels (<25 ng/mL, n=40) comprised the patient group, while those with adequate serum 25(OH)D3 levels (≥25 ng/mL, n=40) comprised the control group. Data including demographic characteristics, laboratory parameters (i.e., calcium, phosphorus, alkaline phosphatase [ALP], and parathyroid hormone [PTH]), and clinical findings (i.e., proximal muscle weakness [PMW] and periarticular sensitivity [PAS]) were recorded and compared between the groups. Pain severity was evaluated using the visual analog scale (VAS), psychological status was evaluated using the Beck Depression Inventory (BDI), and quality of life (QoL) was evaluated using the Short Form 36 (SF-36). The diagnosis of FMS was made based on the 2010 criteria of the American College of Rheumatology. RESULTS: Although there were no statistically significant differences in the demographic characteristics between the groups, ALP and PTH levels were higher in the patient group (p<0.05). The VAS, frequency of FMS, PMW, and PAS were also significantly higher in the patient group (p<0.05). Depression and the mental and physical component scores of the SF-36 did not significantly differ between the two groups (p<0.05). CONCLUSION: Our study results suggest that patients with low 25(OH)D3 levels may more frequently experience FMS and pain than healthy individuals.

Influence Disease Activity on Voice and Laryngeal Findings of Rheumatoid Arthritis Patients.

OBJECTIVES: To reveal and to compare the voice pathologies and the detectable laryngeal findings in different phases of rheumatoid arthritis (RA). STUDY DESIGN: Prospective clinical study. METHODS: Sixty-seven consecutive patients with RA, followed up at our Physical Therapy and Rehabilitation Clinic, were included in the study. Disease activity indices of patients were calculated with Disease Activity Score-28 Index. With Voice Handicap Index (VHI), patients answered 30 questions of functional, physical, and emotional aspects. Videolaryngostroboscopy was performed by the same physician for all patients with a 70° rigid telescope (Karl Storz, Tuttlingen, Germany), and then acoustic voice analysis (PRAAT program) was performed. Reflux Finding Score was used in evaluating the laryngopharyngeal reflux. RESULTS: Posterior comissure hypertrophy (25.3%) and hyperemia/edema in arytenoid mucosa (22.3%) were detected as the most frequent findings. Other common findings were thick endolaryngeal mucus, vocal cord varices. Twenty-two patients had reflux findings (32.8%). Fundamental frequency, shimmer, maximum phonation time and VHI value were not significantly different between active and remission phases of the disease (P > 0.05). In remission phase, the jitter value and the noise to harmonic ratio value were significantly higher (P < 0.05) than active phase of the disease (P < 0.05). Abnormal laryngeal findings are higher in active phase (28% in remission phase, 54% in active phase). The mean VHI score of patients in remission phase was lower than that in active phase. CONCLUSION: RA should be included in the differential diagnosis of patients with voice disorders. Nonspecific pathologies are more prevalent in the picture. There are more objective findings and subjective complaints of patients in active phase of the disease than in the remission phase.

Where are we in terms of poststroke functional outcomes and risk factors.

BACKGROUND: Stroke is acute vascular deterioration of cerebral functions and 2nd leading cause of death. As population gets older, as well as the increasing prevalence of stroke and disability from chronic disease, the demand for rehabilitation care will continue to rise. There is need for evidence based rehabilitation approaches and rehabilitation outcomes should be proved by objective questionnairres to qualify the process. OBJECTIVE: To present the functional outcomes of stroke rehabilitation process among functional impairment measure evaluation. Determine the contributing factors on functional gain. MATERIAL-METHODS: Retrospectively assessment of data of 142 posttroke patients performed. In addition to demographical and clinical properties, functional outcomes with functional impairment measurement (FIM) and motor evaluation by Brunnstrom Motricitiy Index were recorded. Risk factors for stroke were questionned also. RESULTS: The mean of ages was 64.30 ± 11.9 years, male/female ratios were 47.2%/ 52.8%. The functional gain was 20.4% in M-FIM, 14.7% in C-FIM. Better outcomes gained by the patients who stayed longer than 15 days (ANOVA, p: 0.000) and who had hemorrhagic etiology (MannWhitney U, p: 0.048), meanwhile there was no significant difference in gender and plegic side groups on both Motor-FIM and Cognitive-FIM gains (p > 0.05, MannWhitney U). Regression models exhibited highest impact on the M-FIM gain were the admission M-FIM scores and DM (adjusted Rsquare: 0.173, p: 0.000). Admission C-FIM scores had positive correlation with discharge C-FIM scores (r: 0.917, p: 0.000). Although older age was the negative determinant of C-FIM gain (r: -0.202, p: 0.016). We obtained the risk factor distribution 71.8% for HT, 29.6% for CAD, 25.6% for smoking, 16.2% for TIA and 33.1% for DM. All had negative impact on functional outcomes but DM had significantly (regression analysis p < 0.05). CONCLUSION: Improvement by rehabilitation programme determined by FIM scores. Data provided about the poststroke patients and present risk factors. Still there exists similar ratios of risk factors as studies before eventhough prevention recommendations.