Quality of life and self-reported disability in patients with knee osteoarthritis.

OBJECTIVES: Osteoarthritis (OA) is the most common degenerative joint disorder and a major public health problem throughout the world. The aims of this study are to assess quality of life (QoL) in patients with knee OA using the generic instrument Short Form-36 (SF-36) and to determine its relationships with conventional clinical measures and self-reported disability. METHODS: Patients with knee OA (n = 112) with median age of 60 (45-76) years and 40 sex- and age-matched healthy controls were included in the study. Age, sex, body mass index (BMI), symptom duration, and Kellgren-Lawrence scores were recorded. QoL, disability, and pain were assessed using the SF-36, the Western Ontario and McMaster (WOMAC) index, the Lequesne index, and a visual analog scale (VAS) in patients. Also, QoL was assessed using the SF-36 in controls. RESULTS: Patients with knee OA had lower scores in all subgroups of SF-36 compared with controls. In patients, the SF-36 physical function (PF) and pain areas significantly correlated with effusion, VAS pain, and Lequesne and WOMAC subgroup scores (p < 0.05). The pain area of QoL did not show correlation with comorbidity with knee OA. We found that SF-36 and WOMAC pain scores were more severe in female patients. CONCLUSIONS: Patients with knee OA had significantly poorer QoL compared with healthy controls. SF-36 is related to the clinical status and functional ability of patients with OA and can be used as a sensitive health status measure for clinical evaluation. Also WOMAC can be used as a sensitive measure for disability of patients with knee OA.

Fatigue and correlation with disease-specific variables, spinal mobility measures, and health-related quality of life in ankylosing spondylitis.

OBJECTIVES: This study aimed to evaluate fatigue in Turkish patients with ankylosing spondylitis (AS) and its relationship with disease-specific variables, spinal mobility measures, and health-related quality of life (HR-QoL). METHODS: One hundred and ten patients diagnosed as AS according to the Modified New York Criteria and 40 healthy individuals were included in this study. The Multidimensional Assessment of Fatigue (MAF) was used in patient and control groups to assess fatigue. The first item of Bath AS Disease Activity Index (BASDAI) was also used to assess fatigue in the patient group. Evaluation included BASDAI, functional status [BAS Functional Index (BASFI)], and visual analog scale (VAS) of axial and joint pain. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. The generic instrument Short Form 36 (SF 36) was used to assess HR-QoL in the patient group. RESULTS: Patients with AS had higher total MAF scores and in all MAF subgroup scales than controls. All patient MAF scores were significantly correlated with morning stiffness, number of swollen joints, history of peripheral arthritis, BASDAI, BASFI, BASDAI-fatigue, VAS axial, VAS peripheral, and SF 36 subgroups (p < 0.05). No correlation was observed between all MAF scores and age, body mass index (BMI), disease duration, meteorological measures, and medications in patients. CONCLUSIONS: Patients with AS defined significantly more fatigue when compared with healthy persons. MAF was related to clinical and functional status and HR-QoL of patients with AS. We assume that MAF can be used as a sensitive fatigue measure in patients with AS.

Effects of Artcure Diffusional Patch application on pain and functional status in lumbar disc herniation patients: a prospective randomized controlled study.

BACKGROUND/AIM: The aim of this study was to assess the efficacy of the Artcure Diffusional Patch, which contains a mixture of 6 herbal oils (oleum thymi, oleum limonis, oleum nigra, oleum rosmarini, oleum chamomilla, oleum lauriexpressum) and has a hypoosmolar lipid structure, in the conservative treatment of lumbar disc herniation patients and to show the advantages and/or possibility of using this as an alternative method to surgery. MATERIALS AND METHODS: Of the 120 patients enrolled, 79 clinically diagnosed patients were included in the study. Clinical evaluations were performed on patients who had findings of protrusion or extrusion in their magnetic resonance results. The treatment group was treated with the Artcure Diffusional Patch while the control group received a placebo transdermal diffusional patch. The functional state of patients was measured using the Oswestry Disability Index and pain intensity was measured with a visual analog scale as primary outcomes. Secondary outcomes of the study were Lasegue's sign, the femoral stretching test, and paravertebral muscle spasm. RESULTS: The treatment group showed a dramatic recovery in the first month following the application in regards to Oswestry Disability Index scores and visual analog scale values. The patients treated with the Artcure Diffusional Patch showed a statistically significant difference in recovery as compared to the control group. CONCLUSION: These findings suggest that the Artcure Diffusional Patch may be an alternative for the conservative treatment of lumbar disc herniation with radiculopathy.

Dynamic Thiol/Disulphide Homeostasis in Patients With Fibromyalgia.

OBJECTIVES: This study aims to investigate dynamic thiol/disulphide homeostasis in patients with fibromyalgia syndrome (FMS). PATIENTS AND METHODS: Fifty female patients with FMS (mean age 40.5±7.2 years; range 21 to 55 years) and 40 healthy female controls (mean age 39±9.4 years, range 22 to 55 years) were included in the study. Pain visual analog scale, tender points, Fibromyalgia Impact Questionnaire, and Beck Depression Inventory were evaluated. Age, body mass index (BMI), and symptom durations were also recorded. Native thiol, disulphide and total thiol levels were measured with a novel automated method. RESULTS: Serum disulphide levels were 14.7±3.4 µmol/L and 22.2±3.6 µmol/L in the FMS and control groups, respectively (p<0.001). Native thiol levels were 452.1±33.8 µmol/L and 433.5±37.6 µmol/L in the FMS and control groups, (p=0.015), while total thiol levels were 481.7±35.6 µmol/L and 477.5±38.9 µmol/L in the FMS and control groups, respectively (p=0.593). In the FMS group, disulphide/native thiol percent ratios and disulphide/ total thiol percent ratios were statistically significantly lower and native/total thiol percent ratios were statistically significantly higher than those of the control group. There were no correlations between serum thiol/disulphide profiles and pain scores & clinical variables in patients with FMS. CONCLUSION: Because of the decreased disulphide and increased native thiol levels, the thiol/disulphide balance has shifted to the reductive side. This metabolic disturbance may have a role in the pathogenesis of FMS.

Quality of life and correlation with musculoskeletal problems, hand disability and depression in patients with hemodialysis.

OBJECTIVES: The aims of this study were to assess the health-related quality of life (HRQOL) in patients with hemodialysis using the Kidney Disease Quality of Life (KDQOL™) and to determine its relationships with conventional clinical measures, musculoskeletal problems, hand disability and depression. MATERIALS AND METHODS: This study was conducted in our tertiary hospital's dialysis unit. Fifty patients under hemodialysis treatment were included in the study. HRQOL, disability, pain and depression were assessed using KDQOL-36, Duruoz hand index (DHI), visual analog scale (VAS) and Beck Depression Inventory (BDI). RESULTS: It was seen that all of the patients included had one or more musculoskeletal problems, the most common of which were muscle cramps, myalgias and arthralgias. Depression was the second most common accompanying disease. It was also seen that older patients had much poorer physical functioning scores, DHI scores and BDI scores than younger patients. DHI score was found to be significantly lower in men than in women. Educational level, presence of arthrosis, myalgia, bone pain, arthralgia, CTS, VAS-hand and VAS-upper extremities scales, DHI and BDI scores significantly affected both physical and mental areas of KDQOL-36, whereas age, shoulder periarthritis, mobilization scores and presence of hypertension only had effects on physical areas. CONCLUSION: Physical functioning depends mainly on the age, severity of comorbid conditions, depression, locomotor findings and hand disability of hemodialysis patients. The KDQOL-36 is related to the clinical status and functional ability of hemodialysis patients and it can be used as a sensitive health status measure for clinical evaluation.

Deep venous thrombosis in a patient presenting with severe left inguinal and hip pain: a case report.

Deep venous thrombosis (DVT) is a disease presenting with thrombosis and obstruction of its branches and interruption of blood flow of lower extremities. Pain, severe discomfort and swelling are the most frequent symptoms of DVT and the most life-threatening manifestation is pulmonary embolism. Herein an otherwise healthy, 27-year-old male patient presented with severe left inguinal and hip pain due to the DVT of proximal left lower extremity is presented. We assume that DVT should be kept in mind in patients presenting with musculoskeletal system pain, as it may cause life-threatening complications such as pulmonary thromboembolism.