Validation and reliability of the Turkish version of the fear avoidance beliefs questionnaire in patients with low back pain.

AIM: The aim of this study was to translate the questionnaire into Turkish and to investigate the test-retest reliability, construct validity and its sensitivity to change following physical therapy. METHODS: The questionnaire was translated into Turkish using the forward and backward translation technique. Test-retest reliability was assessed with the correlation coefficients. Scale analysis for internal validity, the Cronbach's alpha score was calculated. Construct validity was tested with principal components analysis and was also tested with divergent validity. Following three weeks of treatment, sensitivity to change and responsiveness of the questionnaire was assessed. RESULTS: The questionnaire was applied on 55 patients and high correlations were found on the repeated items 48 hours later. In the scale analysis, the Cronbach's alpha score was found as 0.911 for the total questionnaire. Two factors were found compatible with the original questionnaire with principal components analysis. These two factors explain 61.647% of the total variance in the questionnaire performed on 150 patients. In divergent validity, the fear avoidance beliefs were found in low correlation with the clinical variables. Sensitivity to change and responsiveness of the FABQ was found to be low. CONCLUSIONS: FABQ has sufficient psychometric features for its applicability in the Turkish population with subacute and chronic low back pain.

A computerized diagnostic system for the interpretation of umbilical artery blood flow velocity waveforms.

OBJECTIVE: Development of an artificial intelligent diagnostic system for the interpretation of umbilical artery blood flow velocity waveform measurements. STUDY DESIGN: Study design comprised several stages including data acquisition, image processing and analysis, training of artificial neural network and testing the predictive value of the system. The clinical material was handled in two groups. The training group consisted of 952 umbilical artery blood flow velocity waveform images of 174 normal pregnancies with normal outcome, while the testing group was composed of 138 images derived from 20 normal pregnancies with normal outcome and 68 images of 16 high risk pregnancies with poor outcome. All subjects were evaluated by Doppler ultrasonography and umbilical artery blood flow velocity waveform images were transferred to the computer environment by means of a special data acquisition system. Automated image processing and analysis were performed to derive indices such as A/B ratio, resistance index, pulse related index, area ratio of wave and angle of coincident slopes. We have used a supervised artificial neural network (back propagation learning algorithm) to develop an intelligent diagnostic system which is called the BOLU system. RESULTS: This version of the system was trained with the umbilical artery blood flow velocity waveform images of normal pregnancies. Thus, the BOLU system decides whether the tested image is normal for a given gestational week or not. The specificity and sensitivity of this system were estimated to be 98.6% and 51.5% respectively. CONCLUSION: We have developed an artificial intelligent diagnostic system for the interpretation of umbilical artery blood flow velocity waveform measurements. Waveform indices were obtained automatically by image processing and analysis. The predictive value of the system was found to be satisfactory.

The effects of sulfur dioxide inhalation and antioxidant vitamins on red blood cell lipoperoxidation.

An attempt was made to determine whether sulfur dioxide (SO2,) inhalation at 10 ppm, 1 hr daily, for 30 days induces oxidant stress and whether vitamin E (40 mg/kg) together with vitamin C (200 mg/kg), administered intraperitoneally once in every 3 days, can reduce the damage in red blood cell membranes of guinea pigs. Malonyldialdehyde (MDA) levels, osmotic fragility ratios, and methemoglobin and sulfhemoglobin values were significantly higher in the SO2-treated group compared with the control group (P < 0.05), and marked decreases in MDA levels and osmotic fragility ratios were determined in the group treated with SO2 + antioxidant vitamins (P < 0.05).

Effects of ACE inhibition on left ventricular dimensions and haemodynamics in systemic hypertension: a radionuclide and echocardiographic study.

The aim of this study was to assess the effects of Angiotensin Converting Enzyme (ACE) inhibition on cardiac systolic and diastolic parameters and left ventricular muscle mass in hypertensive patients. For this purpose 30 patients (22 female and eight male) with mild to moderate essential hypertension, aged 47 +/- 2 years, were treated with enalapril maleate (MK 421, an ACE inhibitor) for six weeks. They underwent M-mode and Doppler echocardiography and radionuclide ventriculography at the beginning and after six weeks of enalapril treatment. In this study all patients treated with the ACE inhibitor enalapril responded with a significant decrease in mean arterial pressure (p < 0.001). A significant reduction in left ventricle and mass index were shown after six weeks of treatment with enalapril (p < 0.01). Total peripheral resistance and end-systolic stress decreased in the same time course (p < 0.001). Ejection fraction increased in both examinations after six weeks of therapy with enalapril, but this increase was not statistically significant. In radionuclide examinations, time to peak filling rate decreased significantly after six weeks of enalapril therapy (p < 0.02). Despite these improvements in cardiac systolic and diastolic parameters, cardiac output and stroke volume decreased slightly after enalapril treatment. We concluded that enalapril improves diastolic and systolic parameters in LV function but causes slight decreases in cardiac output and stroke volume in addition to lowering blood pressure.

Homozygosity for dominant form of hereditary spherocytosis.

A 6-month-old male infant with hereditary spherocytosis (HS) who was the first child of a cousin marriage is presented. The patient had splenomegaly and severe anaemia. Examination of the peripheral blood smear revealed spherocytes and the osmotic fragility of red blood cells was greatly increased. Physical examination of the parents revealed that both parents had mild anaemia, jaundice and splenomegaly. Their peripheral blood smears showed spherocytes and a few acanthocytes. Osmotic fragility of red blood cells of both parents were increased. Red cell membrane electrophoresis indicated a deficiency of ankyrin in the propositus; mild deficiency was also detected in both parents. Electrophoretic patterns of red cell membrane proteins suggested that the child was homozygous for the dominant form of HS associated with ankyrin deficiency, while both parents had the simple dominant form of the disease. Red blood cell transfusions were given to the patient starting at the age of 1 month until splenectomy was performed at the age of 1 year that resulted in complete haematological response. This observation indicates that homozygosity for dominant type of HS associated with ankyrin deficiency is life compatible and splenectomy may cure the anaemia.