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The Investıgatıon Of The Relatıonshıp Of Ultrasonographıc Medıan Nerve Cross-Sectıonal Area Wıth Electrophysıologıcal Measurements And Dısease Actıvıty In Patıents Wıth Rheumatoıd Arthrıtıs
Get PDFBu çalışmada Romatoid Artrit hastalarında ultrasonografik median sinir kesit alanının elektrofizyolojik ölçümler ve hastalık aktivitesi ile ilişkisinin araştırılması amaçlandı.
Yöntem: Klinik ve elektrofizyolojik incelemelerle Karpal Tünel Sendromu (KTS) tanısı konan 30 romatoid artrit (RA) hastası, KTS olmayan 30 RA hastası ve 30 idiyopatik KTS kontrol grubu çalışmaya alındı. Hastaların yaş, cinsiyet, VKİ, hastalık süresi, kullandıkları ilaçlar, RF, anti CCP, ESH ve CRP değerleri kaydedildi. RA’lı hastalarda hastalık aktivitesi, DAS-28 ile değerlendirildi. Hastaların KTS semptom şiddeti ve fonksiyonel değerlendirilmesi için Boston KTS anketi, sağlıkla ilişkili yaşam kalitelerini ölçmek için Sağlık Değerlendirme Anketi (HAQ) kullanıldı. Ultrasonografik olarak tüm katılımcıların proksimal karpal tünel seviyesinde median sinir kesit alanı (MSKA) ölçümü yapıldı. Hastalar USG ile değerlendirildikten en geç 1 hafta sonra nörofizyolojik olarak değerlendirildi.
Bulgular: KTS+ RA olan grubun yaş ortalaması diğer iki gruba göre anlamlı derecede yüksek saptandı (p=0,023), diğer sosyodemografik veriler açısından gruplar arasında fark yoktu.
RA tanılı KTS+ ve KTS- grupların cinsiyet, kullandıkları RA ilaçları, RF ve anti-CCP pozitifliği ve DAS-28 skorları benzer iken, KTS+ RA’lı hastaların median sinir kesit alanı (12,95±2,35 vs 9,45±2,47 mm2, p<0,001) ve HAQ skorları (1,22±0,58 vs 0,80±0,62, p=0,006) istatistiksel olarak anlamlı düzeyde yüksek bulundu.
KTS olan gruplar birbiriyle ile karşılaştırıldığında, VKİ, KTS süresi, Boston semptom şiddet skoru, Boston fonksiyonel durum skoru ve HAQ skorları yönünden gruplar arasında fark yoktu. İdiyopatik KTS’li hastaların median sinir kesit alanı (15,13±3,32 mm2), KTS+RA’lı hastalardan (13,26±2,44 mm2) istatistiksel olarak anlamlı derecede yüksek saptandı (p=0,048). Duyusal elektrofizyolojik ölçümler açısından KTS grupları arasında fark yok iken KTS+ RA’lı hastaların median sinir motor iletim hızı (52,64±6,55 vs 58,97±6,64 m/sn, p<0,001) ve median sinir motor amplitüdü (4,51±1,05 vs 4,96±0,18 mV, p=0,021) idiyopatik KTS grubuna göre anlamlı derecede düşük idi.
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Sonuç: Çalışmamızın sonuçları, median sinir kesit alanının RA’lı hastalardaki KTS'de zayıf tanı potansiyeline sahip olduğunu ve hastalık aktivitesi ile korele olmadığını göstermektedir. Bu hastalarda USG’nin patofizyolojiyi aydınlatmak ve bölgenin anatomik yapısını değerlendirmek amacıyla kullanılması daha uygun görünmektedir.In this study, we aimed to investigate the relationship of median nerve cross-sectional area with electrophysiological measurements and disease activity in rheumatoid arthritis patients.
Material and Methods: Thirty rheumatoid arthritis (RA) patients diagnosed with carpal tunnel syndrome (CTS) by clinical and electrophysiological examinations, 30 RA patients without CTS and 30 idiopathic CTS control groups were included in the study. Age, gender, BMI, disease duration, medications, RF, anti CCP, ESR and CRP values of the patients were recorded. Disease activity in patients with RA was evaluated with DAS-28. The Boston CTS questionnaire was used for the symptom severity and functional evaluation of the patients. Health Assessment Questionnaire (HAQ) was used to measure the health-related quality of life. Ultrasonographic median nerve cross-sectional area (MSCA) was measured at the level of the proximal carpal tunnel of all participants. The patients were evaluated neurophysiologically no later than one week after they were evaluated with USG
Results: The mean age of the group with CTS+ RA was found to be significantly higher than the other two groups (p=0.023). There was no difference between the groups in terms of other sociodemographic data.
While the sex, RA drugs used, RF and anti-CCP positivity and DAS-28 scores of the CTS+ and CTS- groups with a diagnosis of RA were similar, the median nerve cross-sectional area (12.95±2.35 vs 9.45±2 .47 mm2, p<0.001) and HAQ scores (1.22±0.58 vs 0.80±0.62, p=0.006) of the patients with CTS+ RA were found to be statistically significantly higher.
When the groups with CTS were compared with each other, there was no difference between the groups in terms of BMI, duration of CTS, Boston symptom severity score, Boston functional status score and HAQ scores. Median nerve cross-sectional area (15.13±3.32 mm2) in patients with idiopathic CTS was found to be statistically significantly higher than in patients with CTS+RA (13.26±2.44 mm2) (p=0.048). While there was no difference between CTS groups in terms of sensory electrophysiological measurements, the median nerve motor
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conduction velocity (52.64±6.55 vs 58.97±6.64 m/sec, p<0.001) and median nerve motor amplitude of patients with CTS+ RA ( 4.51±1.05 vs 4.96±0.18 mV, p=0.021) were significantly lower than the idiopathic CTS group.
Conclusion: The results of our study show that the cross-sectional area of the median nerve has poor diagnostic potential in CTS in patients with RA and is not correlated with disease activity. In these patients, it seems more appropriate to use USG to elucidate the pathophysiology and to evaluate the anatomical structure of the region
Comparison of dyspnea, fatigue and quality of life in patients with systemic sclerosis with and without A pre-diagnosis of pulmonary arterial hypertension
No full textSistemik skleroz hastalarında pulmoner sistem tutulumu önemli morbidite ve mortalite sebebidir. İnterstisyel akciğer hastalığı ve pulmoner arteriyel hipertansiyon başta gelen tutulum şeklidir. Bu hastalarda nefes darlığı, halsizlik, yorgunluk yaygın semptomlardır. Bu çalışmadaki amacımız pulmoner arteriyel hipertansiyon ön tanısı olan ve olmayan sistemik skleroz hastalarında dispne, yorgunluk ve yaşam kalitesinin karşılaştırılmasıdır. GEREÇ VE YÖNTEM Çalışmaya Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon ve Dahiliye Anabilim Dalları Romatoloji Bilim Dalı, poliklinik ve servislerinde takipli 2013 ACR/EULAR klasifikasyon kriterlerine göre tanısı konmuş 49 sistemik sklerozlu hasta dahil edildi. Hastaların yaş, cinsiyet, vücut kitle indeksi, hastalık süresi gibi demografik bilgileri alındıktan sonra anamnez ve fizik muayene ile hastalığın tutulum tipi diffüz yada sınırlı olarak belirlendi. Hastane kayıtlarından yüksek çözünürlüklü bilgisayarlı tomografi raporlarına göre interstisyel akciğer hastalığı var veya yok şeklinde kaydedildi. Hastalar son bir yılda yapılmış olan ekokardiyografilerindeki pulmoner arter basıncına (PAB) göre iki gruba ayrıldı. Grup 1, PAB ≥25 mmHg olup pulmoner arteriyel hipertansiyon (PAH) ön tanısı olan grup; Grup 2 ise PAB <25mmHg olup PAH ön tanısı olmayan grup şeklindeydi. Her iki grup dispnenin değerlendirilmesi için Medical Research Council Scale (MRCS, Medikal Araştırma Kurulu Skalası), yorgunluğun değerlendirilmesi için Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F,Kronik Hastalık Tedavisi-Yorgunluğun Fonksiyonel Değerlendirmesi) ve yaşam kalitesinin değerlendirilmesi için de Short Form-36 (SF-36,Kısa Form-36) kullanılarak karşılaştırıldı. BULGULAR Karşılaştırılan gruplar arasında yaş, cinsiyet, vücut kitle indeksi, hastalık süresi, tutulum tipi ve akciğer tutulumu açısından istatistiksel olarak anlamlı fark yoktu. Hastalar dispne açısından karşılaştırıldığında ise iki grup arasında MRCS skorları benzer olup istatistiksel olarak anlamlı farklılık bulunmadı(p=0,424). Aynı zamanda dispne skorları ile yorgunluk ve SF-36 fiziksel komponent skalası (FKS) ve mental komponent skalası (MKS) skorları arasında istatistiksel olarak anlamlı korelasyon mevcuttu.(sırasıyla p=0,003, p<0,001, p=0,012) Gruplar arasında yorgunluk ve yaşam kalitesi açısından istatistiksel olarak anlamlı farklılık vardı;Grup 1'de yorgunluk değerleri daha yüksek, yaşam kalitesi değerleri daha düşüktü. Yorgunluk ve SF-36 FKS ve MKS skorları arasında istatistiksel olarak anlamlı korelasyon mevcuttu. (p<0.001) SONUÇLAR Yaptığımız çalışma sonucunda artan pulmoner arter basınçlarının yorgunluk düzeyinde artışa sebep olduğu ve yaşam kalitesini olumsuz yönde etkilediği görüldü. Hissedilen nefes darlığı derecesi ve pulmoner arter basınçları arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. Gözardı edilebilecek, genel bir semptom olan yorgunluğun sistemik skleroz hastalarında önemli bir komplikasyon olan pulmoner arteriyel hipertansiyon için uyarıcı olabilecegini düşünmekteyiz. Ayrıca hastaların yaşam kalitesini de oldukça düşürmektedir. Bu sebeple hastaların yorgunluk şikayetinin dikkate alınması ve bu açıdan gözlemlenmelerini önermekteyiz. Anahtar kelimeler: Sistemik skleroz, Pulmoner arteriyel hipertansiyon, Yorgunluk, Yaşam kalitesiObjectives Pulmonary system involvement is an important cause of morbidity and mortality in patients with systemic sclerosis. Interstitial lung disease and pulmonary arterial hypertension are the leading forms of involvement. Shortness of breath, weakness and fatigue are common symptoms in these patients. In this study, it was aimed to compare dyspnea, fatigue and quality of life in patients with systemic sclerosis with and without a pre-diagnosis of pulmonary arterial hypertension. Material and Methods Forty-nine patients with systemic sclerosis, diagnosed according to the 2013 ACR / EULARclassification criteria, who were followed up in the Necmettin Erbakan University, Meram Faculty of Medicine department of Physical Medicine and Rehabilitation and Internal Medicine Rheumatologydivision outpatient clinics and services were included in the study. Demographic information of the patients such as age, gender, body mass index, and duration of disease was obtained. Then, with the history and physical examination, the type of involvement of the disease was determined as diffuse or limited. According to high resolution computed tomography reports from hospital records, interstitial lung involvement was recorded as present or absent. The patients were divided into two groups according to their pulmonary artery pressure (PAP) in their echocardiography performed in the last year.Group 1, the group with PAP ≥25 mmHg and pre-diagnosis of pulmonary arterial hypertension (PAH); Group 2 was the group with PAP <25mmHg without a pre-diagnosis of PAH.Both groups were compared using the Medical Research Council Scale for the assessment of dyspnea, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) for the assessment of fatigue, and the Short Form-36 (SF-36) for the assessment of quality of life. Results There was no statistically significant difference between the compared groups in terms of age, gender, BMI, disease duration, involvement type and lung involvement. When the patients were compared in terms of dyspnea, the MRCS scores were similar between the two groups, and no statistically significant difference was found. (p = 0.424) There was also a statistically significant correlation between dyspnea scores and fatigue and SF-36 physical component scale (PCS) and mental component scale (MCS) scores. (p = 0.003, p <0.001, p = 0.012) There was a statistically significant difference between the groups in terms of fatigue and quality of life, and the Group 1 had higher fatigue values and lower quality of life values. There was a statistically significant correlation between fatigue and SF-36 PCS and MCS scores. (p <0.001) Conclusion As a result of our study, it was seen that increased pulmonary artery pressures caused an increase in fatigue and negatively affected the quality of life. There was no statistically significant relationship between the degree of dyspnea and pulmonary artery pressures. We think that fatigue, which is a general symptom that can be ignored, may be a warning for pulmonary arterial hypertension, which is an important complication in patients with systemic sclerosis. It also significantly reduces the quality of life of patients. For this reason, we recommend that patients' complaints of fatigue should be taken into consideration and observed in this respect. Keywords: Systemic sclerosis, Pulmonary arterial hypertension, Fatigue, Quality of lif
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Is procalcitonin elevation always an indicator of bacterial infection?
No full textAdult-onset Still’s disease is a systemic inflammatory disorder with fever, arthritis, and rash.[1] Although the etiology is not known, some viral (rubella, echovirus, Epstein-Barr, cytomegalovirus) and bacterial (Yersinia enterocolitica, Mycoplasma pneumoniae) factors have been accused.[2] It is difficult to diagnose and can be diagnosed by excluding other causes, such as malignancy, collagen tissue disease, and infection. It is very difficult to distinguish from bacterial infections, especially since it is accompanied by fever and rashes, elevated C-reactive protein (CRP), erythrocyte sedimentation rate, and leukocytosis
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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