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21.
The hallmark of the inflammatory myopathies is muscle weakness. Although this feature can lead to significant disability and impairment of activities of daily living, its initial presentation may not be recognized early. Older individuals, in particular, may feel that the changes caused by myositis reflect the effects of aging rather than those of a disease process, and diagnosis, therefore, may be delayed. This factor has negative impact on the response to therapy. Inclusion body myositis, with its insidious onset in older people, and laboratory findings which may not be markedly abnormal, presents a diagnostic challenge. DM, with its characteristic symptomatic rash, is generally brought to medical attention more quickly. Another area of diagnostic concern occurs when associated organ involvement precedes myopathy. This has been observed, for example, with interstitial lung disease, and again represents a challenge to physicians. In this connection, the antisynthetase syndrome presenting with fevers, Raynaud's features, arthritis, or pulmonary involvement may not initially be recognized as a manifestation of inflammatory muscle disease. Each subgroup of IIM may present with a variety of extramuscular features that can complicate diagnosis and alter therapy and prognosis. This is particularly true for the pulmonary, GI, and cardiac manifestations and when cancer is associated with myositis. For these reasons, such features of IIM should be carefully evaluated, treated, and monitored over the course of the illness; in some cases these may play a greater role in determining the outcome of patients with IIM than the muscle involvement itself. It is hoped that in the future increased familiarity with the manifestations of the inflammatory myopathies, together with a better understanding of the underlying pathogenesis, will lead to more rapid diagnosis and more effective treatments. 相似文献
22.
Nesibe Korkmaz Seluk Nazik Raziye . Gümütakm Hanife Uzar Gülnur Kul Selma Tosun Aye Torun Hadiye Demirbakan Ayegül Seremet Keskin Asiye B. Kamaz Hüseyin A. Erdem Serhat Uysal Il D. Aliravci Emine Yeilyurt len Hüseyin Can Mustafa Deniz Ebru Demiray Gürbüz Uur Kostakolu Hilal Blükba 《International journal of clinical practice》2021,75(1)
23.
Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study 总被引:1,自引:0,他引:1
Sokka T Häkkinen A Kautiainen H Maillefert JF Toloza S Mørk Hansen T Calvo-Alen J Oding R Liveborn M Huisman M Alten R Pohl C Cutolo M Immonen K Woolf A Murphy E Sheehy C Quirke E Celik S Yazici Y Tlustochowicz W Kapolka D Skakic V Rojkovich B Müller R Stropuviene S Andersone D Drosos AA Lazovskis J Pincus T;QUEST-RA Group 《Arthritis and rheumatism》2008,59(1):42-50
OBJECTIVE: Regular physical activity is associated with decreased morbidity and mortality. Traditionally, patients with rheumatoid arthritis (RA) have been advised to limit physical exercise. We studied the prevalence of physical activity and associations with demographic and disease-related variables in patients with RA from 21 countries. METHODS: The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) is a cross-sectional study that includes a self-report questionnaire and clinical assessment of nonselected consecutive outpatients with RA who are receiving usual clinical care. Frequency of physical exercise (>or=30 minutes with at least some shortness of breath, sweating) is queried with 4 response options: >or=3 times weekly, 1-2 times weekly, 1-2 times monthly, and no exercise. RESULTS: Between January 2005 and April 2007, a total of 5,235 patients from 58 sites in 21 countries were enrolled in QUEST-RA: 79% were women, >90% were white, mean age was 57 years, and mean disease duration was 11.6 years. Only 13.8% of all patients reported physical exercise>or=3 times weekly. The majority of the patients were physically inactive with no regular weekly exercise: >80% in 7 countries, 60-80% in 12 countries, and 45% and 29% in 2 countries, respectively. Physical inactivity was associated with female sex, older age, lower education, obesity, comorbidity, low functional capacity, and higher levels of disease activity, pain, and fatigue. CONCLUSION: In many countries, a low proportion of patients with RA exercise. These data may alert rheumatologists to motivate their patients to increase physical activity levels. 相似文献
24.
Does patient education increase antimuscarinic treatment persistence in overactive bladder syndrome? 下载免费PDF全文
Tulin Yildiz RN PhD Cenk M Yazici MD Cagri Dogan MD Muzeyyen Cetintas RN Arzu Malak RN 《International Journal of Urological Nursing》2015,9(2):84-91
Overactive bladder syndrome (OAB) is a chronic condition that requires long‐term management. Patient education may have role in decreasing the unfavourable effects of long‐term treatment of OAB. The aim of the study was to evaluate the effect of detailed patient education on the patients' persistence with antimuscarinic treatment for OAB. A total of 140 patients with the diagnosis of OAB were included in this study. Patients were randomly divided into two groups. Patients in Group 1 were given information by the same urology doctor about the disease and treatment. Patients in Group 2 were given information by a urology nurse. Patients were recalled in the first, third and sixth months of treatment. The treatment persistency was evaluated in the whole study population and between the groups. The persistency rates of the whole group were 88·6% in the first month, 65·7% in the third month and 45·7% in the sixth month. At the end of the sixth month, 42·8% of males and 47·1% of females were taking antimuscarinics (p = 0·580). The persistence rate of Groups 1 and 2 were 82·8 and 94·3% at the first month. (p = 0·034). It decreased to 31·4% in the first and 60% in the second group at the sixth month (p = 0·001). The persistence rate of antimuscarinic treatment is low. Patient education is simple and effective way of increasing persistence. Clinicians must pay attention to inform their patients about the disease and possible side effects of treatment. An educated health provider may be very helpful in educating patients for OAB. 相似文献
25.
N. Imeryüz Prof. H. Yazici H. Koçak M. Erk A. Özder S. M. Karcier M. Özkan G. Öngen S. Yurdakul H. Özdogan 《Clinical rheumatology》1994,13(2):239-243
Summary Pericardial and lung involvement in rheumatoid arthritis (RA), suspected to be less severe in a developing nation (Turkey), have been evaluated. We have studied clinical, echocardiographic and pulmonary findings (radiological and functional) in 93 consecutive Turkish patients with definite/classical RA. Findings were compared with those of a group of patients with osteoarthritis or local rheumatological conditions (n=60) in a blind protocol. Fifty patients with systemic lupus (SLE) were studied as a high risk control group for pericardial involvement. While pericardial disease was detected in 5.5% (5/90) of RA patients, it was detected in 6.6% (4/60) of the control patients. SLE patients had a 26% (13/50) prevalence. Interstitial lung disease was found in 27.7% of RA patients but it was present in 6.6% (4/60) of the control patients. We observed that a group of patients with RA in Turkey had a low prevalence of pericardial disease. This is further evidence that RA has a mild course in developing countries. 相似文献
26.
Relations among handedness, eye dominance, and lateralisation in the formation of cataract were investigated in 35 male and 21 female patients with cataract. In right-handed patients, cataracts formed earlier in the right eyes than in the left eye; this was reversed in left-handed patients. For both right- and left-eye dominant patients, cataracts formed earlier in the dominant eye. 相似文献
27.
H. Yazici H. Fong B. Wilson E.E. Oren F.A. Amos H. Zhang J.S. Evans M.L. Snead M. Sarikaya C. Tamerler 《Acta biomaterialia》2013,9(2):5341-5352
Titanium (Ti) and its alloys are among the most successful implantable materials for dental and orthopedic applications. The combination of excellent mechanical and corrosion resistance properties makes them highly desirable as endosseous implants that can withstand a demanding biomechanical environment. Yet, the success of the implant depends on its osteointegration, which is modulated by the biological reactions occurring at the interface of the implant. A recent development for improving biological responses on the Ti-implant surface has been the realization that bifunctional peptides can impart material binding specificity not only because of their molecular recognition of the inorganic material surface, but also through their self-assembly and ease of biological conjugation properties. To assess peptide-based functionalization on bioactivity, the present authors generated a set of peptides for implant-grade Ti, using cell surface display methods. Out of 60 unique peptides selected by this method, two of the strongest titanium binding peptides, TiBP1 and TiBP2, were further characterized for molecular structure and adsorption properties. These two peptides demonstrated unique, but similar molecular conformations different from that of a weak binder peptide, TiBP60. Adsorption measurements on a Ti surface revealed that their disassociation constants were 15-fold less than TiBP60. Their flexible and modular use in biological surface functionalization were demonstrated by conjugating them with an integrin recognizing peptide motif, RGDS. The functionalization of the Ti surface by the selected peptides significantly enhanced the bioactivity of osteoblast and fibroblast cells on implant-grade materials. 相似文献
28.
Effect of verapamil on bronchial goblet cells of asthma: an experimental study on sensitized animals
Khakzad MR Mirsadraee M Mohammadpour A Ghafarzadegan K Hadi R Saghari M Meshkat M 《Pulmonary pharmacology & therapeutics》2012,25(2):163-168
IntroductionGoblet cell hyperplasia (GCH) and mucus hypersecretion in the airway is recognized as an important contributor to morbidity and mortality in asthma and COPD. Verapamil is a calcium channel blocker that binds to the alpha-subunit of L-type calcium channels and inhibits the mucin gene via the calmodulin and CaM kinase pathway. The objective of this study was to determine the in vivo effect of verapamil on GCH and eosinophilic inflammation in sensitized mice.MethodsMale BALB/c mice were sensitized to ovalbumin using the standard method. Two groups of animals were received verapamil via an intramuscular injection: 1-low dose (0.5 mg/kg/day for two weeks), 2-high dose (1.5 mg/kg/day for two weeks). Serum and bronchoalveolar lavage fluid (BALF) was collected and analyzed for inflammatory cells, interferon-γ and IL-4. The left lung was sent for histopathological evaluation, especially for periodic acid-Schiff (PAS), to identify goblet cells in the epithelium. The degree of inflammatory cell infiltration, including eosinophils, mucus plugging, and smooth muscle thickness of the airways were classified on a semi quantitative scale.ResultsInflammatory cell infiltration in peribronchial and perivascular areas was observed in all sensitized groups. Eosinophils percentage in the BALF significantly decreased in verapamil-treated mice compared with sensitized mice (from 19.8% in asthmatic to 5.4% for low dose and 4.4% for high dose). The ratio of airway goblet cells per epithelial cells were significantly lower in verapamil-treated mice versus sensitized mice (1.57 ± 1.30% for low dose; 1.50 ± 0.93% for high dose versus 12.93 ± 7.55%, P < 0.05, respectively). Mucus production of goblet cells decreased significantly in verapamil-treated mice versus sensitized mice (mean score was 1.45 ± 0.30 for low dose; 0.81 ± 1.00 for high dose versus 2.85 ± 0.86 in the sensitized control group, P < 0.05, respectively). The concentration of serum and BALF-IFN-γ in verapamil-treated mice markedly increased by the verapamil treatment when compared to sensitized mice (15.1 ± 0.43 versus 4.7 ± 0.96, P < 0.05 and 91.8 ± 47.7 versus 14.8 ± 4.6, P < 0.01, respectively).ConclusionVerapamil is a useful drug with therapeutic targeting on GCH and a potential way to limit mucous production and improve bronchial inflammation. 相似文献
29.
Selim Ayhan Serkan Ozturk Aytekin Alcelik Mehmet Fatih Ozlu Alim Erdem Tolga Memioglu Mesut Ozdemir Mehmet Yazici 《Journal of interventional cardiac electrophysiology》2012,35(3):247-252
Background
Prolonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography.Methods
Thirty patients with IFG (19 males and 11 females; age, 46.9?±?9.5?years) and 30 control subjects (18 males and 12 females; age, 46.7?±?8.2?years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area?Clength method. LA mechanical function parameters were calculated.Results
LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p?<?0.001 and p?<?0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p?<?0.001 and 15.0 [8.5] vs. 7.5 [2.0], p?<?0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r?=?0.76, p?<?0.001 and r?=?0.68, p?<?0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (???=?0.753, p?<?0.001).Conclusion
We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF. 相似文献30.
Cenk Murat Yazici Banu Sarifakioglu Aliye Guzelant Polat Turker Ozkan Ates 《International urology and nephrology》2013,45(3):659-667