Turkish version of the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire: A reliability and validity study.

Objectives: This study aimed to analyze the validity and reliability of the Turkish version of the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) in patients with fibromyalgia (FM) syndrome by translating and culturally adapting the CPFQ to Turkish. Patients and methods: One hundred seventeen patients (8 males, 109 females; mean age: 47.4±12.4 years; range, 18 to 77 years) diagnosed with FM according to the 2016 American College of Rheumatology FM diagnostic criteria between May 2021 and August 2021 were included in the reliability and validity study. The CPFQ was translated into Turkish, the intelligibility of the obtained Turkish version was evaluated by five patients and five healthcare professionals, and the final form of the questionnaire was prepared. Mini-mental state examination (MMSE), Fibromyalgia Impact Questionnaire (FIQ), and Hospital Anxiety and Depression Scale (HADS), which were proven to be reliable and valid in Turkish, were administered to the patients. For test-retest reliability, the Turkish version of the CPFQ was filled in two times with an interval of one week. Internal consistency was evaluated by calculating Cronbach's alpha. Validity was evaluated by looking at the correlations between the total score obtained from the Turkish version of CPFQ and the MMSE score, HADS depression and anxiety scores, and FIQ score. Results: In the evaluation of internal consistency, Cronbach's alpha was found to be high in all subgroups. In test-retest reliability, intraclass correlation coefficient was high in CPFQ subgroups. The CPFQ showed a significant positive correlation with HADS depression and a moderately positive correlation with HADS anxiety and FIQ. A significant but weak negative correlation was detected between CPFQ and MMSE. While there was no significant correlation between MMSE and FM disease activity and HADS anxiety, there was a significant but weak negative correlation between HADS depression. Conclusion: In this study, the Turkish version of CPFQ was shown to have high reliability and validity in FM patients. It was concluded that CPFQ could be applied to Turkish patients with FM.

Spinal Mobility Limitation Can Be the Main Reason of Kinesiophobia in Ankylosing Spondylitis.

Objective The aim of this study is to determine the presence of kinesiophobia in patients with ankylosing spondylitis (AS) and to examine the factors affecting kinesiophobia. Materials and methods Sixty patients with AS participated in the study. Kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK). Disease activity was assessed using the Bath AS Disease Activity Index (BASDAI) and AS Disease Activity Score with C-reactive protein (ASDAS-CRP), functional status using the Bath AS Functional Index (BASFI), spinal mobility using the Bath AS Metrology Index (BASMI), and quality of life using the AS Quality of Life Questionnaire (ASQoL). Those with a TSK score of >37 were classified as patients with high kinesiophobia, while those with a score of ≤37 as patients with low kinesiophobia. Results High kinesiophobia was detected in 29 (48.3%) patients. Age, disease duration, BASDAI, ASDAS-CRP, BASFI, ASQoL, and BASMI values were higher in these patients. The TSK scores correlated with age, duration of disease, ASDAS-CRP, BASFI, BASMI, and ASQoL (r = 0.697, r = 0.600, r = 0.410, r = 0.690, r = 0.889, and r = 0.576, respectively). As a result of the multivariate binary logistic regression analysis, BASMI was found to be the only statistically significant factor for high kinesiophobia (OR 5.338, 95% CI: 1.133-25.159, p = 0.034). Conclusion Kinesiophobia is seen at a high rate in patients with AS. In this study, the most important risk factor for kinesiophobia is found to be decreased spinal mobility. To prevent kinesiophobia - which prevents exercise, the cornerstone of AS treatment - patients should be encouraged to exercise and be active.

Temporomandibular joint involvement in elderly onset and young onset rheumatoid arthritis patients.

OBJECTIVE: There are studies showing clinical and laboratory differences between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis. Temporomandibular joint involvement in rheumatoid arthritis is not rare. In this study, we aimed to examine the temporomandibular joint involvement and magnetic resonance imaging findings in elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients. METHODS: A total of 87 rheumatoid arthritis patients were investigated retrospectively. The onset ≥60 years was considered elderly-onset rheumatoid arthritis. Erosion, flattening, and resorption of the condyle, narrowing of the joint space, joint effusion, synovial hypertrophy, and synovitis were interpreted as temporomandibular joint involvement with magnetic resonance imaging. Patients' age, gender, rheumatoid factor, and anti-cyclic citrullinated peptide positivity, extra-articular findings, medical treatment, and disease activity score were noted. RESULTS: A total of 15 (17.2%) patients had elderly-onset rheumatoid arthritis. Temporomandibular joint involvement was detected in 67 (77%) patients; 9 (60%) of them were in the elderly-onset rheumatoid arthritis group (n=15) and 58 (80.6%) of them were in the young-onset rheumatoid arthritis group (n=72). Patients with temporomandibular joint involvement were significantly higher than those without temporomandibular joint involvement in both the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis groups (p<0.001). No significant difference was found between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis for the temporomandibular joint involvement (p=0.100). In the young-onset rheumatoid arthritis group, rheumatoid factor positivity and anti-cyclic citrullinated peptide positivity were more frequent in the patients with temporomandibular joint involvement (p=0.011, p=0.024). A comparison of the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients showed no significant difference in the magnetic resonance imaging findings except for the resorption of the condyle. CONCLUSION: According to our findings, elderly-onset rheumatoid arthritis is not much different from young-onset rheumatoid arthritis in terms of temporomandibular joint involvement, magnetic resonance imaging findings, and clinical and laboratory features.

The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial.

This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had started duloxetine treatment (30 mg/day). The patients in the study group received six sessions of posterior tibial nerve stimulation, twice weekly, 3-4 days apart, in addition to duloxetine; the controls received duloxetine only. The patients were evaluated three times (at baseline, 1st month, and 3rd month). Pain was evaluated using a numeric rating scale, the short-form McGill Pain Questionnaire, and quality of life with a 36-item short-form health survey (SF-36). Patient functional status and disease severity were evaluated using the fibromyalgia impact questionnaire (FIQ). A total of 64 patients met the inclusion criteria: 22 were ultimately included in the study group and 30 in the control group. Statistical improvements in pain and FIQ scores were observed after treatment in both groups. The SF-36 scores indicated improved vitality only in the 1st month in both groups, with no significant changes in the other quality-of-life subscales in either group. There was no statistical difference between the two groups in terms of changes in pain, FIQ, and SF-36 scores compared with baseline at the 1st month and 3rd month. The addition of PTNS to pharmacological treatment did not contribute to the reduction in pain or improvement in quality of life in fibromyalgia either in the 1st or 3rd month. NIH Clinical Trial Registration Number NCT05937711.

The validity and reliability of the Turkish version of the Community Integration Measure in patients with chronic stroke.

OBJECTIVE: To translate and cross-culturally adapt The Community Integration Measure into Turkish (CIM-T) and to assess its reliability and validity in patients with chronic stroke. PATIENTS AND METHODS: Fifty participants completed the CIM-T, Community Integration Questionnaire (CIQ) and the London Handicap Scale (LHS). All participants completed the CIM-T questionnaire twice in 7 days. The internal consistency of the CIM-T was assessed using Cronbach's alpha, while the Intraclass Correlation Coefficient (ICC) was used to evaluate test-retest reliability. The convergent validity of CIM-T was determined with CIQ and LHS by using Pearson's and Spearman's correlation coefficient analysis. RESULTS: The CIM-T demonstrated high internal consistency (Cronbach's α = 0.955) and test-retest reliability (ICC= 0.992). The CIM-T showed a good correlation with CIQ (R = 0.727, p < 0.001) and LHS (R = 0.694, p < 0.001). CONCLUSION: The Turkish version of CIM is a valid and reliable instrument for assessing chronic stroke patients. It is a preferable scale for the clinical evaluation of Turkish-speaking patients with chronic stroke.

The Community Integration Measure was successfully translated into Turkish and validated in a population with chronic stroke according to established guidelines.The Turkish version of the Community Integration Measure has very good internal consistency and test­retest reliability.The Turkish version of the Community Integration Measure is valid and reliable.

ULTRASONOGRAPHIC EVALUATION OF FEMORAL CARTILAGE THICKNESS IN PARTICIPANTS WITH ASYMPTOMATIC HYPERURICEMIA: A CASE-CONTROL STUDY.

The aim was to evaluate the effect, if any, of asymptomatic hyperuricemia on distal femoral cartilage thickness through musculoskeletal ultrasonography. A total of 66 participants were evaluated in this prospective, controlled study, including 33 asymptomatic hyperuricemic patients who presented at our outpatient clinic between January and April 2020, and 33 normouricemic subjects matched for age, gender and body mass index. Participants with systemic diseases affecting uric acid level such as chronic renal failure, psoriasis, gout, etc., participants using drugs that can affect uric acid level, and those with knee complaints were excluded from the study. Cartilage thickness measurements were taken using musculoskeletal ultrasonography from the right medial condyle, right lateral condyle, right intercondylar area, left medial condyle, left lateral condyle and left intercondylar area. Distal femoral cartilage thickness was lower in all measurement areas in the asymptomatic hyperuricemia group than in the normouricemic group (p<0.05 all). No correlation was noted between uric acid levels and cartilage thickness in all measurement areas in either the asymptomatic hyperuricemic or normouricemic group (p>0.05 all). We think that distal femoral cartilages seem to be thinner in participants with asymptomatic hyperuricemia. Longitudinal studies are needed to determine whether asymptomatic hyperuricemia will lead to knee osteoarthritis in individuals, although we believe that people with asymptomatic hyperuricemia should be informed accordingly in order to prevent development of potential knee osteoarthritis.

Temporomandibular joint involvement in elderly onset and young onset rheumatoid arthritis patients

SUMMARY OBJECTIVE: There are studies showing clinical and laboratory differences between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis. Temporomandibular joint involvement in rheumatoid arthritis is not rare. In this study, we aimed to examine the temporomandibular joint involvement and magnetic resonance imaging findings in elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients. METHODS: A total of 87 rheumatoid arthritis patients were investigated retrospectively. The onset ≥60 years was considered elderly-onset rheumatoid arthritis. Erosion, flattening, and resorption of the condyle, narrowing of the joint space, joint effusion, synovial hypertrophy, and synovitis were interpreted as temporomandibular joint involvement with magnetic resonance imaging. Patients' age, gender, rheumatoid factor, and anti-cyclic citrullinated peptide positivity, extra-articular findings, medical treatment, and disease activity score were noted. RESULTS: A total of 15 (17.2%) patients had elderly-onset rheumatoid arthritis. Temporomandibular joint involvement was detected in 67 (77%) patients; 9 (60%) of them were in the elderly-onset rheumatoid arthritis group (n=15) and 58 (80.6%) of them were in the young-onset rheumatoid arthritis group (n=72). Patients with temporomandibular joint involvement were significantly higher than those without temporomandibular joint involvement in both the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis groups (p<0.001). No significant difference was found between elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis for the temporomandibular joint involvement (p=0.100). In the young-onset rheumatoid arthritis group, rheumatoid factor positivity and anti-cyclic citrullinated peptide positivity were more frequent in the patients with temporomandibular joint involvement (p=0.011, p=0.024). A comparison of the elderly-onset rheumatoid arthritis and young-onset rheumatoid arthritis patients showed no significant difference in the magnetic resonance imaging findings except for the resorption of the condyle. CONCLUSION: According to our findings, elderly-onset rheumatoid arthritis is not much different from young-onset rheumatoid arthritis in terms of temporomandibular joint involvement, magnetic resonance imaging findings, and clinical and laboratory features.

Evaluation of personality disorders using the structured clinical interview for DSM-5 personality disorders, quality of life, and disease activity in patients with systemic lupus erythematosus.

Objectives: This study aims to determine the frequency of personality disorders in patients with systemic lupus erythematosus (SLE) and healthy volunteers and to compare SLE patients with and without personality disorders in terms of quality of life (QoL) and other clinical and laboratory findings. Patients and methods: Between January 2021 and March 2021, a total of 64 patients (17 males, 47 females; mean age: 42.9±10.8 years; range, 21 to 62 years) who were diagnosed with SLE and 68 age- and sex-matched healthy volunteers (20 males, 48 females; mean age: 40.9±10.6 years; range, 21 to 65 years) without any known disease were included. The Nottingham Health Profile (NHP) was filled in to evaluate the QoL for all participants. For the diagnosis of personality disorder, the Structured Clinical Interview For DSM-5 Personality Disorders (SCID-5PD) form was used. Clinical and laboratory findings of patients with SLE were noted and disease activity index (SLEDAI) was calculated. Clinical and laboratory variables that may affect personality disorder were evaluated. Results: The prevalence of personality disorder in SLE patients was significantly higher than the control group (39.1% vs. 11.8%, respectively; p<0.001). In terms of the subgroups of personality disorders detected in SLE, only the prevalence of obsessive-compulsive personality disorder was significantly higher than the control group (26.6% vs. 10.3%, respectively; p=0.015). The frequency of personality disorder increased, as the education level decreased, the duration of SLE disease increased, and with antiphospholipid autoantibodies positivity in patients with SLE (p<0.05). The mean NHP total score was 126.1±55.1 in SLE patients with personality disorder and 62.9±43.8 in patients without personality disorder, indicating that the QoL of SLE patients with personality disorder was worse than those without personality disorder (p<0.001). Conclusion: The frequency of personality disorder in SLE seems to be higher than in the control group. Quality of life is adversely affected in SLE patients with personality disorders. Therefore, clinicians should be alert for personality disorders that may accompany SLE and fight with personality disorder with early diagnosis and optimal treatment.

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome.

BACKGROUND: Fibromyalgia syndrome (FM) is a systemic disease of unknown etiology, which can cause widespread musculoskeletal pain. In patients with rheumatoid arthritis (RA), FM can cause an additional symptom burden, which can affect some variables on the RA disease activity score 28 (DAS28), a tool that evaluates 28 joints in RA patients. OBJECTIVE: Compare the results of four different versions of the DAS28 and the parameters used to determine disease activity scores in RA patients with and without FM, and determine whether there are treatment differences between RA patients with and without FM. DESIGN: Retrospective, cross-sectional. SETTING: Tertiary hospital. PATIENTS AND METHODS: We identified patients diagnosed with RA between 1 September 2016 and 1 February 2020 and identified patients with and without FM. MAIN OUTCOME MEASURES: Differences between variables in the DAS28 calculations (tender joint count [TJC], patient global assessment [PGA], and others), between patients with and without FM, and differences between patients with and without FM who were using or not using biological agents. SAMPLE SIZE: 381, including 322 females (84.5%). RESULTS: The frequency of FM in RA patients was 25.7% (89 females, 24.6%). In RA patients with FM, the TJC and PGA median values were significantly higher than in patients without FM (P<.05). The use of corticosteroids and biological therapy in patients with FM was more frequent than in patients without FM (P<.05). Compared to patients without FM, patients with FM switched treatment more often because of non-response to treatment (P=.01) Median values of the DAS28 scores (calculated by four different versions of the instrument) in RA patients with FM were higher than in patients without FM (P<.05). CONCLUSION: The presence of FM in RA patients may affect the subjective variables in different versions of DAS28 scores, causing the disease activity to score higher on the instrument, erroneously indicating worse disease than is actually present. LIMITATIONS: A single center, retrospective study. CONFLICTS OF INTEREST: None.

Comparison of ankylosing spondylitis patients with and without fibromyalgia syndrome according to the disease activation scores and response to treatment.

OBJECTIVES: The aim of this study was to investigate the association of fibromyalgia (FM) syndrome with ankylosing spondylitis (AS) and to compare the AS patients with and without FM according to the disease activity, clinical and laboratory findings, and response to treatment. PATIENTS AND METHODS: Between September 2016 and September 2020, a total of 511 patients (312 males, 119 females; mean age: 43.0±11.2 years; range, 18 to 77 years) who were diagnosed with AS were retrospectively analyzed. Age, sex, disease duration, disease onset age, and extra-articular findings were recorded. Medical treatments used by the patients for the treatment of AS and FM were noted. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), human leukocyte antigen-B27 (HLA-B27) status, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) with ESR (ASDAS-ESR) and ASDAS-CRP values were recorded. RESULTS: The frequency of FM in AS patients was 23.2%. Totally, 75.4% of the FM patients were female. The HLA-B27 positivity, extra-articular involvement frequency, disease duration, and acute phase reactants levels were similar between AS patients with and without FM (p=0.118, p=0.154, p=0.829, p=0.113, and p=0.763, respectively). The AS patients with FM had lower rates of achieving remission or low disease activity, compared to those without FM. The mean of all three disease activity scores between these two groups was also higher in the AS patients with FM (p<0.001). The rate of use of biological therapy was significantly higher in the AS patients with FM than those without FM (p=0.037). CONCLUSION: Since the treatment plan of AS is made based on the disease activity scores, unnecessary biological therapy may be initiated for patients or the biological therapies they use may be switched unnecessarily. Therefore, it should be kept in mind that FM may present with AS in patients who do not respond to treatment clinically, and this may be misinterpreted as treatment unresponsiveness.

Six month assessment of low dose rituximab in the treatment of rheumatoid arthritis during coronavirus disease 2019 (COVID-19) pandemic.

Aim of the work: To evaluate the 6-month treatment responses to low dose rituximab (LDR) compared to standard dose rituximab (SDR) in rheumatoid arthritis (RA) patients whose treatments were disrupted due to the pandemic with increased disease activity and to examine the effect of LDR treatment on serum immunoglobulin (Ig) levels. Patients and methods: Records were retrospectively analysed for 80 patients on SDR not admitted to the hospital due to fear of infection during pandemic, with increased disease activity and were resumed on LDR (500 mg intravenous RTX-infusion twice with 15 days intervals, and repeated for the second time in all patients after 6 months). Disease activity score (DAS-28) values were obtained. The Ig levels of the patients before and after rituximab treatment were calculated. Results: The mean age of patients was 55.1 ± 13.1 years. They were 46 (57.5%) female and 34 (42.5%) male (F:M 1.4:1) with median disease duration of 13 (0.5-50) years. After the second dose of LDR, there was a significant decrease in the disease activity DAS28 (6.5 ± 1.01 to 3.2 ± 1.2, p < 0.0001) and acute phase reactants with a tendency to decrease in Ig levels. After LDR, 6 (7.5%) patients developed COVID-19 infection that did not require hospitalization. There was no difference between the Ig levels of patients with and without COVID-19 infection. Conclusions: LDR is an effective treatment option in the treatment of RA. In our study, none of our patients developed severe COVID-19 infection requiring hospitalization, and LDR may be preferred during the COVID-19 pandemic period.

Association Between Familial Mediterranean Fever and Cachexia in Females.

OBJECTIVES: This study aims to investigate the association between familial Mediterranean fever (FMF) and cachexia in females. PATIENTS AND METHODS: The study included 32 female FMF patients (median age 27.50 years; range, 18 to 50 years) and 30 female healthy controls (median age 32 years; range, 18 to 50 years). Patients were classified according to Tel-Hashomer criteria. Circumference of arm, waist, and thigh was recorded. Short form 36 (SF-36) and Multidimensional Assessment of Fatigue (MAF) scale were applied. Composition of the body was measured with dual X-ray absorption. Muscle strength was measured with an isokinetic dynamometer, and strength of hand grip was measured from dominant hand with a hand dynamometer. C-reactive protein, erythrocyte sedimentation rate, fibrinogen and serum creatinine kinase (CK) levels were recorded. RESULTS: Body mass index was significantly higher in controls. Twelve patients and one control had cachexia. CK level was significantly higher in patients than controls. Mass of muscle without fat was significantly higher in patients than controls. Peak torque values of extension and flexion at the velocity of 60°/second [Newton meter (Nm)], and value of total work during extension at the velocity of 240°/second (Nm) in isokinetic measures were significantly higher in controls. MAF score was significantly higher in patients with cachexia than patients without cachexia where the subscale scores of SF-36, except the vitality score, were significantly lower in patients with cachexia. However, Tel-Hashomer score was significantly higher in patients with cachexia. CONCLUSION: This study pointed at a significant association between cachexia and FMF in females. Muscle endurance was not affected in FMF patients with cachexia; however, decreased muscle strength, impaired quality of life and increased fatigue were observed in these patients.

Can the efficacy of subacromial corticosteroid injection be improved using a single- session mobilization treatment in subacromial impingement syndrome? A randomized single-blind controlled trial

Background/aim: The objective in this study is to assess the short-term effects of a single-session mobilization in addition to subacromial corticosteroid (SACS) injection in impingement syndrome. Materials and methods: The study was designed as a prospective randomized controlled single-blind, parallel group clinical trial. Patients (totally 84) were divided randomly into two groups equally. Forty-two patients in Group 1 received mobilization and SACS injection, whereas 42 patients in Group 2 only received SACS injections. A single SACS injection was applied in all patients. Mobilization was administered as a single session right after SACS injection. Patients' evaluations were performed measuring active range of motion (AROM), visual analogue scale (VAS) during activity and rest, and Disabilities of Arm, Shoulder, and Hand Score (DASH) prior to treatment and in the first and fourth weeks following the treatment. Results: Both groups showed significant improvement in terms of AROM, VAS, and DASH scores in each evaluation step (P < 0.05). Visual analogue scale activity in the first week was significantly better in Group 1 (P = 0.028). Also, flexion and abduction degrees showed significantly better outcomes in Group 1 (P = 0.007, P = 0.036). Conclusion: Addition of single-session mobilization might provide rapid improvement in flexion and abduction as well as early pain relief following SACS injections.

The cultural adaptation of Aberdeen Low Back Pain Scale in Turkish patients and the evaluation of response to physical therapy: A Turkish version study.

BACKGROUND: Unvalidated Turkish adaptations of existing low back pain disability scales are often used. OBJECTIVE: To evaluate the validity and the reliability of the Turkish version of Aberdeen Low Back Pain Scale (ALBP). METHODS: The cross-cultural adaptation was performed in accordance with recently published guidelines. The Turkish version was administered to 120 patients. Test-retest and internal consistency were evaluated for reliability. Construct validity and criterion validity were measured. Responsiveness of the questionnaire towards changes by the treatment were assessed. All questionnaires were administered at admission, 1 day later, at the end of treatment, and a month after the end of treatment. Patients were assessed with Ostwestry (OLBP), physical and mental component of SF-36 (PCSSF-36, MCSSF-36), Beck Depression Inventory (BDI), Schober test and visual analog scale for pain (VAS). RESULTS: Retest scores were significant and high (Internal Correlation Coefficent: 0.963). For internal consistency, Cronbach's alpha was 0.889. For construct validity, Spearman's Correlation Coefficent was 0.882. For criterion validity of ALBP, correlations were found significant and acceptable for OLBP, PCSSF-36, MCSSF-36, BDI, and VASactivity (p < 0.05). According to responsiveness; ALBP, OLBP, PCSSF-36, VAS and Schober test showed significant improvement after the treatment (p < 0.05). CONCLUSIONS: The Turkish version of the ALBP is reliable, valid and responsive.

Computer-assisted Joint Space Area Measurement: A New Technique in Patients With Knee Osteoarthritis.

OBJECTIVES: This study aims to assess the validity and reproducibility of computer-assisted joint space area measurement in knee roentgenograms of patients with knee osteoarthritis and compare it with a qualitative method in knee roentgenograms and quantitative and semi-quantitative methods in magnetic resonance imaging. PATIENTS AND METHODS: The study included 40 knees of 40 patients diagnosed as osteoarthritis (14 males, 26 females; mean age 57.4±5.9 years; range 47 to 67 years). Only the patients who wrote consents for publication of their radiologic data, and with knee roentgenograms and magnetic resonance images of the same knees were selected. Computer-assisted measurements were applied to joint spaces by two blinded physicians, for two times with an interval of one week. Data were evaluated for intraobserver and interobserver consistency. Also, data were compared with qualitative (Kellgren-Lawrence classification), quantitative (joint space width, cartilage thickness, meniscal thickness in magnetic resonance images) and semi-quantitative methods (whole-organ magnetic resonance imaging score). RESULTS: Intraobserver consistency was evaluated for each physician, which revealed no differences. Interobserver consistency was evaluated by comparing the measurements of two blinded physicians and no differences were found (p>0.05). There was no significant correlation between the grade of Kellgren-Lawrence classification and other variables; such as grade of meniscus, meniscal thickness, cartilage thickness and computer- assisted joint space area measurements (p>0.05). While there was a positive correlation between computer-assisted joint space area measurement and other quantitative measurements, there was a negative correlation between computer-assisted joint space area measurement and whole-organ magnetic resonance imaging scores. CONCLUSION: When compared with qualitative, quantitative, and semi-quantitative methods, computer-assisted joint space area measurement seems to be a useful, reproducible, and cost-effective quantitative method for evaluating knee osteoarthritis.

Gabapentinoids in penitentiaries: An abuse and addiction research.

OBJECTIVES: This study aims to examine the abuse and addiction of gabapentinoids in penal institutions. PATIENTS AND METHODS: Between September 2014 and November 2014, a total of 1,639 participants were administered an electronic questionnaire investigating the drug use and addiction. The questionnaire was requested to be asked and filled by the officers in charge for all voluntary convicts and prisoners in all penitentiaries throughout Turkey. RESULTS: The rate of answering the questions varied between 20.5% and 100%. It was found that 2% of the participants used pregabalin and gabapentin simultaneously, while 25.2% of them used multiple drugs. The usage rate of pregabalin and gabapentin was higher in some penitentiaries, compared to the normal population. There was a significant positive correlation between the use of gabapentinoids and multiple drugs and alcohol and drug addiction, various withdrawal symptoms, the number of going to the infirmary, and the number of referral to the hospital (p<0.05). CONCLUSION: Although gabapentinoids seem to be used in the treatment of addiction, and are proved effective treatment agents. With a definite diagnosis, appropriate follow-up, and timely completion of the treatment, it is necessary to strictly control their use due to the probability of abuse and addiction.

Cultural Adaptation of the Extended Aberdeen Spine Pain Scale: A Turkish Version Study.

AIM: To evaluate the validity and reliability of Turkish version of Extended Aberdeen Spine Pain Scale (EASP). MATERIAL AND METHODS: After cultural adaptation, the questionnaire was administered to 120 patients. Test-retest reliability, internal consistency, construct and criterion validity and responsiveness to treatment were measured. All questionnaires were administered at baseline, 1 day later and at the end of treatment. Patients were assessed with Physical and Mental Component scores of SF-36 (SF-36PCS, SF-36MCS), Beck Depression Inventory (BDI) and Visual Analog Scale for pain (VAS). RESULTS: Retest scores were significant (ICC: 0.878). For internal consistency, Cronbach"s alpha was 0.908, which means all parts of the questionnaire are highly homogenous. For construct validity, Spearman"s Correlation Coefficient was 0.907, which means that items of the questionnaire behaved as expected. For criterion validity of EASP, Spearman"s rho correlations with SF- 36PCS (-0.999), SF-36MCS (-0.367), BDI (0.350), VASactivity (0.429), VASrest (0.399) and VASsleep (0.308) were found significant (p=0.000). According to responsiveness, EASP, SF-36PCS, VASactivity, VASrest, VASsleep showed significant improvement after the treatment (p=0.000). CONCLUSION: The Turkish version of EASP seems reliable, valid, and responsive. Because of its usefulness for evaluating the whole spine as a functional unit, the EASP can be recommended for clinical trials.

Platelet-Rich Plasma Treatment With Physical Therapy in Chronic Partial Supraspinatus Tears.

BACKGROUND: Despite the insufficient evidence, due to potential contribution to the improvement, platelet-rich plasma (PRP) is emerging as a promising method. OBJECTIVES: The aim of this study was to assess the effectiveness of PRP injection in partial supraspinatus tears by comparing with physical therapy (PT). PATIENTS AND METHODS: Seventy patients with chronic partial supraspinatus tears in magnetic resonance imaging were randomized into two groups; PRP (n = 35) and PT (n = 35). Before the treatment, at the end of the treatment and at the 12th month after the end of the treatment, range of motion (ROM), visual analog scale (VAS) for pain, Disabilities of Arm, Shoulder and Hand questionnaire (DASH), Neer's, Hawkins' and drop arm tests and Beck Depression Inventory were investigated. RESULTS: Statistical analysis was made for 62 subjects (PRP group, n = 30; PT group, n = 32). There were no differences between the groups according to demographic data. At the 12th month after the end of the treatment, significant improvement in ROM was detected in both groups, pain was reduced significantly in both groups and improvement of the DASH score was observed in both groups. At all the evaluation steps, increases in ROM degrees were significantly higher in the PT group than the PRP group. For VAS in activity and in rest, after the treatment, improvement was higher in the PT group than the PRP group. However, improvement of the DASH score of the PRP group was significantly better than the PT group. CONCLUSIONS: When we compared with PT, PRP seemed to be a well-tolerated application which showed promising results in patients with chronic partial supraspinatus tears.

Sciatic nerve hypertrophy with Klippel-Trenaunay syndrome: a case report.

A 73-year-old female patient who had severe neuropathic pain due to sciatic nerve hypertrophy with the Klippel-Trenaunay Syndrome has been presented. Localized hypertrophic neuropathy is in one region and characterized by concentric proliferation of Schwann cells around the axon. It is very rare in the absence of generalized hypertrophic neuropathy. Very little is known about the etiology and the course of this neuropathy. Klippel-Trenaunay-Syndrome (KTS) is a rare syndrome characterized by hemangioma, abnormalities of the venous and lymphatic systems, and limb enlargement due to soft tissue and bone hypertrophy.