Frequency of fibromyalgia in a cohort of Turkish patients with lung cancer and its effect on pain, sleep quality, fatigue and quality of life.

This study aimed to examine the frequency of fibromyalgia (FM) in patients with lung cancer and evaluate its effect on patients' pain, sleep quality, fatigue, and quality of life parameters. The study was designed as a prospective cross-sectional and a total of 116 lung cancer patients were included. FM classification was made according to the 2016 ACR criteria. All patients were evaluated using a visual analog scale, fibromyalgia impact questionnaire, multidimensional assessment of fatigue, EuroQol 5D scale, Jenkins sleep scale, and Beck depression inventory. Patients were divided into FM-positive and negative groups according to the presence of FM. Demographic and clinical parameters were investigated between the groups. FM was detected in 14 (12.2%) patients. The mean age of the patients was 62.2 ±â€…8.4 years. There was a male predominance in 93 (80.2%) patients. No statistical difference was found between the groups in terms of body mass index, age, symptom duration, chemotherapy, and radiotherapy history. A statistically significant difference was found between FM positive and negative groups in FIQ, multidimensional assessment of fatigue, JSS, EQ-5D, visual analog scale, and Beck depression inventory scores. FM is seen more frequently in patients with lung cancer and has a negative effect on sleep, quality of life, fatigue, and mental functions. We think that physicians should not ignore the presence of FM when treating patients diagnosed with lung cancer.

YouTube as a source of information on systemic sclerosis.

AIM: YouTube is a popular online platform which patients and healthcare professionals often use to obtain information. However, the reliability and quality of videos on systemic sclerosis are not known. METHOD: We searched for the key words "systemic sclerosis" and "scleroderma" on YouTube. Features of videos such as the number of views and duration of videos were noted. The reliability and quality of videos were assessed with the modified DISCERN and Global Quality Scale (GQS), respectively. The videos were divided into three categories: useful, misleading and patient experiences. The videos were assessed according to these categories and their quality. RESULTS: A total of 200 videos listed by relevance were screened and 115 videos which met the inclusion criteria were analyzed further. Eighty-four (73%) of the 115 videos were useful, 20 (17.4%) were misleading, and 11 (9.6%) were patients' experiences. Useful videos had higher DISCERN and GQS scores compared to misleading videos and videos that contain patient experiences (P < 0.001). High-quality videos were mostly uploaded by academic institutions/professional organizations or physicians. CONCLUSIONS: The majority of YouTube videos have useful information on scleroderma and are important educational sources for both patients and physicians. However, patients in particular should be aware that videos might include advertisements and misleading information.

Fibromyalgia in patients with psoriatic arthritis: Relationship with enthesopathy, sleep, fatigue and quality of life.

OBJECTIVES: To evaluate the relationship of fibromyalgia with enthesopathy, sleep, fatigue and quality of life in patients with psoriatic arthritis. METHODS: The psoriatic arthritis patients according to CASPAR criteria were included in the study. The diagnosis of fibromyalgia was based on 2016 ACR criteria. Demographic and clinical parameters were noted. Disease activity and enthesopathy were evaluated with Disease Activity Score-28 (DAS-28) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), respectively. Functional assessment scales in this study were Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF). Fibromyalgia Impact Questionnaire (FIQ) was used to assess the functional status of fibromyalgia. The Mann-Whitney U test and Spearman correlation coefficient (ρ) were used. Hierarchical multiple regression analysis used to examine the differential contributions to FIQ score. P < .05 was accepted as significant. RESULTS: We enrolled 50 PsA patients (31 female, 19 male) with a mean age of 49.5 years (SD: 10.2) and mean disease duration 7.5 years (SD: 7.5). Thirty-two patients (64% of PsA patients) fulfilled ACR criteria for fibromyalgia. The mean scores of MASES, PSQI, MAF and PsAQoL were significantly higher in patients with fibromyalgia (P < .05). The correlations between FIQ and other functional parameters were as follows; MASES (ρ = 0.71, P < .0005), PSQI (ρ = 0.62, P < .0005), MAF (ρ = 0.60, P < .0005), PsAQoL (ρ = 0.61, P < .0005). A moderate correlation was existing between FIQ and DAS-28 (ρ = 0.42, P = .03). CONCLUSIONS: Coexistence of fibromyalgia in PsA patients is associated with the presence of enthesopathy, poor quality of life, sleep disturbance and fatigue.

The validity and reliability of the Turkish version of the Seattle Angina Questionnaire.

OBJECTIVE: The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. METHODS: The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. RESULTS: Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. CONCLUSION: The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.

Telephone versus self administration of outcome measures in low back pain patients.

OBJECTIVES: Comparison of self-rating method and telephone interview method on outcome measures' results. METHODS: This cross-sectional study included 100 patients aged 18-40 years who applied to Physical Medicine and Rehabilitation outpatient clinics with mechanical low back pain. Outcome measures [Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDI), Numeric Pain Rating Scale (NPRS), Istanbul Low Back Pain Disability Index (ILBPD] were administered, and the duration of administration was recorded by two different methods. The self-assessment method and scales were administered by patients in the outpatient clinic and the telephone interview method; scales were administered by the researcher via telephone-calls 24 hours after the out-patient visit. RESULTS: There were no significant differences observed in the results of outcome measures by the method of administration except the Istanbul Low-Back-Pain Disability Index (p=0.030). Outcome measures' results were highly correlated with one another when administered by different methods and orders of administration. Duration of administration was significantly shorter when outcome measures were administered by telephone interview (p<0.001). CONCLUSION: Different methods of administration usually do not have an impact on outcome measure results. However, in some scales like ILBPDI, it may emerge as a factor affecting outcome measures' results. Therefore, adherence to an initially preferred administration method throughout the follow-up period is important regarding the reliability of the results.

Neuropathic Pain: Unexplored and Significant Relationship With Psoriatic Arthritis and Functional Parameters.

OBJECTIVES: This study aims to examine the presence of neuropathic pain (NP) in psoriatic arthritis (PsA) and its relationship with functional parameters. PATIENTS AND METHODS: The study included 50 PsA patients (18 males, 32 females; mean age 50 years; range, 27 to 68 years) diagnosed according to The Classification Criteria for Psoriatic Arthritis. NP was assessed with PainDETECT questionnaire (PDQ). Associations of NP with quality of life (QoL), sleep and fatigue were analyzed by filling out the Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Assessment of Fatigue (MAF) scales, respectively. Group analysis was performed with independent-samples Mann-Whitney U test and Kruskal-Wallis test. Spearman's rank correlation coefficient (rho) was used for correlations between functional parameters. RESULTS: Mean disease duration of the PsA patients was 90.2±90.8 months]. The number of patients with ambiguous NP was eight (3 males, 5 females) while likely NP was detected in 12 patients (2 males, 10 females). The median scores of visual analog scale-pain, PSQI, PsAQoL and MAF were significantly higher in patients with NP (p<0.05). The correlations between PDQ and other functional parameters were found moderate-strong calculated as follows: PSQI (rho=0.44, p=0.003), MAF (rho=0.42, p=0.005), PsAQoL (rho=0.73, p<0.0001). CONCLUSION: The existence of NP in PsA is not rare and it has a significant relationship with impaired QoL and sleep disturbances. The assessment of NP in PsA patients is necessary to provide a holistic treatment strategy.

Cervical proprioceptive impairment in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) involving the cervical spine can lead to various neurologic defects and impairment of proprioception is just one of them. The aim of this study was the assessment of cervical proprioception and its relation with radiographic, clinical, and functional characteristics of patients with RA. One hundred and six rheumatoid arthritis patients who diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and age, gender, educational status matched one hundred and six healthy volunteers were enrolled in this study. Cervical joint position error test (CJPET) was applied to healthy volunteers and RA patients for cervical proprioception assessment. Fatigue, depression, balance, quality of life and balance scales were administered to all patients. Cervical radiography was used to assess cervical subluxations. Regression analysis was used for grading the factors which had relations with cervical proprioception. Mean age of patients and healthy volunteers was 51 ± 11.1 and 48.9 ± 9.2, respectively. Scores of CJPET were statistically significantly higher in RA group than healthy volunteers (p = 0.001). CJPET scores were negatively correlated with Berg balance scale findings in right rotation, left rotation, flexion and extension (rho = - 0.421,- 0.473,- 0.448,- 0.515). There was weak or not significant correlation between the scores of CJPET and fatigue, depression, and quality of life scales. Scores of CJPET in patients with atlantoaxial subluxations (AAS) were statistically significantly higher than those without AAS (p < 0.05). Regression analysis results showed that the AAS was related to impaired cervical proprioception on right and left rotations. There was no correlation between CJPET scores and functional parameters. Cervical proprioception impaired in RA patients. This impairment was related to the existence of AAS and balance problems.

Assessment of the validity and reliability of the Jenkins Sleep Scale in ankylosing spondylitis.

AIM: Ankylosing spondylitis (AS) affects sleep quality. Jenkins Sleep Scale (JSS) Evaluation Questionnaire is a simple and easy to understand scale. The aim of this study is to constitute validity and reliability of JSS-TR in AS patients. METHODS: Jenkins Sleep Scale was translated and culturally adapted by using guidelines. Clinical and demographic data of AS patients were noted. Correlations with other functional parameters such as Multidimensional Assessment of Fatigue (MAF) scale, Ankylosing Spondylitis Quality of Life (ASQoL), Pittsburgh Sleep Quality Index (PSQI) were used to assess convergent validity of JSS-TR (Turkish version). Discriminant validity was also assessed. Shapiro-Wilk test was used as a test of normality. Spearman's rank correlation coefficient (rho) was used to assess the relation. RESULTS: Sixty patients (24 female and 36 male) with mean age of 39.6 ± 10.8 years were recruited. The JSS-TR took an average of 1.5 minutes (±30 seconds) to complete. JSS-TR had the strongest correlation with PSQI scores (ρ = 0.75) and moderate-strong correlations with MAF, ASQoL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. There was insignificant correlation with non-clinical parameters. CONCLUSIONS: JSS-TR is a valid, simple and feasible sleep instrument that can be easily applied to AS patients both in research and clinical settings.

The Validity and Reliability of Turkish Version of the Jenkins Sleep Evaluation Scale in Rheumatoid Arthritis.

OBJECTIVES: This study aims to assess the validity and reliability of the Jenkins Sleep Evaluation Scale (JSS) when applied to a Turkish population with rheumatoid arthritis. PATIENTS AND METHODS: The Turkish version of JSS (JSS-TR) was obtained after translation from English into Turkish, according to standard guidelines. The study included 61 patients of rheumatoid arthritis (13 males, 48 females; mean age 50.5 years; range 19 to 72 years) as defined by the American College of Rheumatology 2010 criteria. The internal consistency (Cronbach's alpha) was assessed for reliability. Content and construct validity (convergent and divergent validities) were evaluated. The relationships between the JSS-TR and the Pittsburgh Sleep Quality Index, the Multidimensional Assessment of Fatigue scale, subgroups of the Nottingham Health Profile, and the Stanford Health Assessment Questionnaire were assessed for convergent validity. In addition, the relationships between the JSS-TR and age, disease duration, visual analog scale patient global score, and disease activity score 28 were assessed for divergent validity. RESULTS: The Cronbach's alpha of JSS-TR was 0.80. All questions and the answer choices for the scale were understood well and related to some dimension of sleep demonstrating good content validity. The JSS-TR had good correlations with functional parameters (which are convergent), and poor or insignificant correlations with non-functional parameters (which are divergent). This implies that the JSS-TR had good construct validity in the context of this study. Overall, the JSS-TR had the best correlation with the Pittsburgh Sleep Quality Index (Spearman's rank correlation coefficient=0.76). CONCLUSION: The JSS-TR is a valid and reliable instrument. It is a simple and effective tool which can be used to evaluate sleep disturbances in rheumatoid arthritis patients in both daily practice and clinical research.

Validation of the Toronto Psoriatic Arthritis Screen II (TOPAS II) questionnaire in a Turkish population.

OBJECTIVE: To evaluate the TOPAS II questionnaire validation in a Turkish population. METHODS: The Turkish translation of ToPAS II was sent to us by the developer authors of the original index. Subjects were recruited from dermatology, physical medicine and rehabilitation, and rheumatology outpatient clinics. All patients' demographic parameters and ToPAS II questionnaire results were recorded. After patients completed the questionnaire they were assessed by a rheumatologist according to a standard protocol which includes a complete history, detailed physical examination, laboratory tests and CASPAR criteria. Receiver operating characteristics (ROC) assessed to obtain sensitivity and specificity of Turkish version of ToPAS II questionnaire. RESULTS: One hundred and fifty subjects were recruited in the study. The mean age of subjects was 41.07 years (SD 12.59) and the 58% of subjects were female. There were 46 subjects from psoriasis group, 43 subjects from psoriatic arthritis (PsA) group, 41 subjects from physical medicine and rehabilitation group and 20 subjects from rheumatology (non-PsA) group. The area under the ROC curve was 0.99 which means as excellent predictor and optimum cut-off threshold to discriminate patients diagnosed with PsA was 8 according to this ROC curve analysis. The overall sensitivity and specificity based on cut-off threshold of 8, were 95.8 and 98%, respectively. CONCLUSION: The Turkish version of ToPAS II has high sensitivity and specificity. It is simple, not time consuming and useful tool to screen for PsA in both patients with and without psoriasis.

Fatigue in familial Mediterranean fever and its relations with other clinical parameters.

Fatigue is a common problem in patients with rheumatic disease. It may cause disability and poor quality of life. The aim of this study is to investigate fatigue in FMF patients as a disabling symptom and its associations with clinical and demographic variables. FMF patients were recruited into the study according to FMF Tel Hashomer criteria. Control group is composed of healthy individuals. Demographic and clinical features of the patients including PRAS scores were noted. Visual analogue score of pain (VAS-pain) and VAS-fatigue were used as clinical parameters. Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF), Nottingham Health Profile (NHP), Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS) and Hospital Anxiety and Depression Scale (HADS) were filled out by both control and study group. Sixty-one FMF patients and 61 age and gender (44 female, 17 male in each group)-matched controls were enrolled into the study. Mean age of FMF and control group were 35.5 ± 11.8 and 35.8 ± 11.7 years, respectively. The mean disease duration was 82.5 ± 81.7 months. Difference between mean of VAS-pain, VAS-fatigue, PSQI total score, MAF, all subsets of NHP, FSS, FIS, and HADS scores of FMF patients was significantly higher than of control group (p = 0.0001). This study has shown that fatigue in FMF is associated with a number of psychological, sleep, quality of life and disease-related factors. FMF group had increased pain, fatigue, sleep disturbance and decreased quality of life compared to control group. FMF patients with fatigue may benefit from pharmacological and psychological interventions which target these factors.

Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis.

OBJECTIVE: The aim of this study is to investigate the validity and reliability of the Turkish version of Jenkins Sleep Scale (JSS) in psoriatic arthritis (PsA). METHODS: Patients with PsA according to Classification Criteria for Psoriatic Arthritis (CASPAR) were included in the study. Data about age, sex, body mass index (BMI), disease duration (month) and joint symptom duration (month) were noted. Psoriatic Arthritis Quality of Life (PsAQoL) Scale was used to assess the quality of life, Multidimensional Assessment of Fatigue (MAF) Scale was used to evaluate fatigue, and Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The reliability of JSS scale was determined by internal consistency (Cronbach's alpha coefficient). Face validity and construct validity (convergent and divergent validities) were evaluated. The correlation of the JSS with the PSQI, MAF scale, and PsAQoL scale was assessed for convergent validity. The correlation of the JSS with age, body mass index (BMI), duration of joint symptoms and disease duration were assessed for divergent validity. RESULTS: The mean age of 56 patients was 42.71 ± 11.79. The Cronbach's alpha of the JSS was 0.862. The JSS had significant correlations with PSQI (rho = 0.653, P < 0.001), MAF (rho = 0.457, P < 0.001), PsAQoL (rho = 0.496, P < 0.001). There were no significant correlations between JSS and age (rho = - 0.052, P = 0.716), BMI (rho = - 0.085, P = 0.550), disease duration (rho = 0.161, P = 0.276) and duration of joint symptoms (rho = 0.107, P = 0.474). CONCLUSION: The Turkish version of JSS is a valid and reliable instrument in PsA.