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Öğe 99mTc-dextran scintigraphy to detect disease activity in patients with rheumatoid arthritis(Lippincott Williams & Wilkins, 2004) Kaya, M; Tuna, H; Firat, MF; Tuna, F; Seren, G; Yigitbasi, ÖNAim To test the applicability of Tc-99m-dextran joint scintigraphy in the assessment of disease activity in patients with rheumatoid arthritis (RA), and to compare it with the clinical disease activity scores and laboratory parameters. Methods Twenty-seven patients with RA were investigated using Tc-99m-dextran joint scintigraphy. The images were evaluated semi-quantitatively and the regional uptakes of the radiopharmaceutical were calculated for the knee, wrist and ankle joints. The clinical and laboratory parameters were collected and fully analysed. An articular Ritchie index (a tender joint score), the number of swollen joints (Sw), the number of tender joints, the morning stiffness h, the total Ritchie articular index (R), the visual analogue scale (VAS) and the Disease Activity Score (DAS) were determined for all patients. Results Compared with controls, patients with RA had significantly higher regional Tc-99m-dextran uptake in the knee, wrist and ankle joints (P=0.001). The regional 99mTc-dextran uptake showed no correlation with the patient's age, gender, duration of disease, number of swollen joints (Sw), number of tender joints, morning stiffness (h), VAS, total Ritchie articular index and DAS, or any laboratory parameters. There was a significant correlation between the regional Tc-99m-dextran uptake for individual joints and the articular Ritchie index of the right and left wrist (r=0.42, P=0.03; r=0.45, P=0.02), right and left knee (r=0.66, P<0.0001; r=0.80, P<0.0001) and right and left ankle (r=0.47, P=0.014; r=0.76, P<0.0001), respectively. Conclusions This study demonstrates that 99mTc-dextran scintigraphy is a sensitive method to detect active joint inflammation and could be useful in the management of patients with RA. (C) 2004 Lippincott Williams Wilkins.Öğe Pressure-induced pain on the tibia: an indicator of low bone mineral density?(Springer Tokyo, 2004) Birtane, M; Tuna, H; Ekuklu, G; Demirbag, D; Tuna, F; Kokino, SPrevious literature investigating bone pain in osteoporosis has prominently focused on painful conditions following osteoporotic fractures. Is osteoporosis really a silent disease without bone pain and tenderness unless a fracture occurs? Our aim in this study was to answer the question by assessing the questionable tenderness on tibia bones of fracture-free patients with low bone density and to compare the findings with a normal population. One-hundred-thirty-three consecutive postmenopausal female patients with the mean age of 56 years admitted to our clinic for bone mass measurement were included in the study. Bone mineral density (BMD) values of lumbar spine (L2-L4) and right proximal femur (neck, trochanter, Ward's triangle) were measured by dual-energy X-ray absorptiometry (DXA). Patients with T scores lower than -1 formed the osteopenic-osteoporotic group of patients (low BMD group) whereas those with T scores higher than -1 constituted the normal BMD group according to the osteoporosis definition regarding T score for DXA. Mechanical pressure was applied by a hand algometer on the middle points of three equally divided sections on the anterior part of tibia, and the pressure levels starting the pain sensation (POPL) were recorded. Although the patients in the normal BMD group reported consistently high POPL at all regions of tibia for all BMD measurement sites, this difference reached to a statistical significance level only for the femur neck region. Only mean POPL for the whole tibia had independent association with only femur neck BMD by multiple linear regression analysis. These results are encouraging for assessing the significance of pressure-induced tibial pain as an indicator of low BMD in the future.Öğe 'Quality of life of primary caregivers of children with cerebral palsy(Cambridge Univ Press, 2004) Tuna, H; Ünalan, H; Tuna, F; Kokino, S[Abstract Not Available]
