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Biomedical subjects

Funda Levendoglu

Publications and source records attributed to Funda Levendoglu.

6 recordsLinked to original sources

Radiological and functional assessment of pulmonary involvement in the rheumatoid arthritis patients.

The aim was to evaluate the findings of high resolution computed tomography (HRCT) and pulmonary function tests (PFT) in the rheumatoid arthritis (RA) patients with and without pulmonary symptoms and to determine their role in prediction of respiratory system involvement. Among 54 consecutive RA patients, 22 (41%) were symptomatic and 32 (59%) were asymptomatic after detailed respiratory examination. Abnormal findings in PFTs were present in 10 (45%) symptomatic and 15 (47%) asymptomatic patients. PFT results were similar in both groups. A total of 18 (82%) symptomatic and 16 (50%) asymptomatic patients had abnormalities in HRCT scans. About 16 (80%) of 20 patients with normal HRCT scans had no pulmonary symptoms at all and we noted a significant correlation (P < 0.05). HRCT was more useful mean than PFTs in evaluation of pulmonary involvement in the RA patients; however, no correlation was present between various respiratory symptoms and abnormal findings both in PFTs and HRCT scans.

Adult↗

Physical disability, psychological status, and health-related quality of life in older hemodialysis patients and age-matched controls.

We aimed at comparing the elderly adults and normal subjects with regard to their disability, psychological status, and quality of life (QOL). One hundred and twenty-five dialysis patients and 61 controls were recruited in the study. Depression and anxiety symptoms of the patients were evaluated with the Psychological Symptom Screening List (SCL 90-R). For evaluating the disability, the Rivermead mobility index (RMI) was utilized. For evaluating the QOL, we used the short form-36 (SF-36) scale. The Rivermead mobility index of the patients (9.6 +/- 3.4) was found. When compared with controls, dialysis patients had higher levels of disability (p = 0.0001). Depression and anxiety symptom scores of these patients were also significantly higher than that of the controls (p < 0.05). There was a correlation between the disability and depression symptom scores (r: 0.171, p = 0.037). Both physical and mental capacity scores of the dialysis patients were lower than those of the controls (p < 0.05 and p < 0.05) QOL scores for elderly hemodialysis patients were found to be lower. Their disability was higher, making them dependable on others during their daily lives. Specific exercise programs should be developed for these patients. Even the smallest effort in this regard will result in improvements in physical functioning while bringing them significant benefits.

Activities of Daily Living↗

Gabapentin is a first line drug for the treatment of neuropathic pain in spinal cord injury.

STUDY DESIGN: Prospective, randomized, double blind, placebo-controlled, crossover clinical trial. OBJECTIVES: To determine the efficacy of gabapentin in the treatment of neuropathic pain related to spinal cord injury. SUMMARY OF BACKGROUND DATA: Neuropathic pain is initiated or caused by a primary lesion or dysfunction in the nervous system. Neuropathic pain associated with spinal cord injury is quite refractory, and current treatments are not effective. Gabapentin, an anticonvulsant, has become the first choice in the treatment of neuropathic pain. The place of gabapentin in the treatment of spinal cord injury-related neuropathic pain was questioned in only a few recent reports; however, they are retrospectively designed, nonstandardized, and uncontrolled studies, or involve a very small series of patients using less than optimum doses. METHODS: A total of 18-week study period included a 4-week medication/placebo titration period. This was followed by a 4-week stable dosing period when the patients continued to receive maximum tolerated doses, a 2-week washout period, then a crossover of 4 weeks of medication/placebo titration, and another 4 weeks of stable dosing period. Twenty paraplegic patients (female/male: 7/13) with complete spinal cord injury at the thoracic and lumbar level, aged between 20 and 65 years, with neuropathic pain for more than 6 months were recruited for the study. RESULTS: All patients completed the study. Gabapentin reduced the intensity as well as the frequency of pain, relieved all neuropathic pain descriptors except the itchy, sensitive, dull, and cold types, and improved the quality of life (P < 0.05). CONCLUSIONS: Gabapentin can be added to the list of first-line medications for the treatment of chronic neuropathic pain in spinal cord injury patients. It is a promising new agent and offers advantages over currently available treatments.

Acetates↗

Increased bone resorption in the proximal femur in patients with hemiplegia.

OBJECTIVES: To investigate the relationship between the proximal femoral bone mineral density and bone resorption markers, determinants of calcium metabolism and vitamin D levels in elderly stroke patients. DESIGN: A total of 80 patients and 20 controls were enrolled in the study. Bone mineral density measurements were obtained at the proximal femur. In all subjects, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, deoxypyridinoline, and ionized calcium concentrations were measured. Barthel Index and Motricity Index Leg Score were recorded all patients. RESULTS: The serum concentrations of deoxypyridinoline, intact parathyroid hormone, and the mean serum ionized calcium levels were significantly higher in patients with stroke than that of the control subjects. The mean serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in patients were significantly lower than those of the control group (P < 0.05). The bone mineral density of proximal femurs of paretic limbs was decreased significantly compared with those of the control group (P < 0.05). There were significant correlations between the Z score of the hemiplegic side and the patients' Barthel Index, Motricity Index Leg Score, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, calcium, and deoxypyridinoline. CONCLUSIONS: This study provides clear evidence that decreased mobility, vitamin D status, and bone turnover variables in patients after stroke are important factors in the greater bone loss in the paretic leg.

Aged↗

Ventricular function abnormalities in active rheumatoid arthritis: a Doppler echocardiographic study.

OBJECTIVE: The aim of the present study was to evaluate cardiac involvement in patients with active rheumatoid arthritis (RA). METHODS: Forty patients with active RA participated. All were submitted to standard Doppler echocardiography and myocardial performance index (MPI) grading. RESULTS: There were left and right ventricular diastolic function abnormalities in RA patients. Left ventricular MPI was also significantly higher than in controls ( P<0.05). A relationship was found between left ventricular early diastolic (E)/atrial (A) flow velocities (E/A ratio), isovolumic relaxation time (IRT), and disease duration ( r=-0.47 and P=0.002, r=0.618 and P=0.000, respectively). CONCLUSION: Diastolic function was impaired in both ventricles in patients with active RA. There was a direct relationship between some of the parameters of left ventricular diastolic function and disease duration as well. These findings suggest a subclinical myocardial involvement in RA patients.

Arthritis, Rheumatoid↗

Spinal epidural abscess associated with IgG4 deficiency.

The objective is to present the possibility of an association between spinal epidural abscess and IgG deficiency. Spinal epidural abscess is a rare but potentially devastating condition. Review of the literature showed no reported acknowledgment about the relationship between spinal epidural abscess and IgG deficiency. This report discusses the case of a 16-year-old boy who developed progressive paraplegia within 24 hours. Clinical and neuroradiologic features are reported. Serum quantitative total IgG, IgA, and IgM concentrations were measured by nephelometry. Thoracic magnetic resonance imaging showed epidural abscess between T6 and T11 compressing the cord posteriorly. IgG subclasses (IgG ) were found abnormal. The possible importance of immunologic evaluation in the patients with spinal epidural abscess when no source of infection could be find is discussed.(4) (4) (4)

Adolescent↗