Materials and Methods:One hundred twenty individuals ≥65 years of age were included in the study. All subjects were evaluated using a questionnaire form, including items about demographic and clinical information (doctor diagnosed of chronic diseases, such as diabetes mellitus, hypertension, cardiovascular diseases, and hyperlipidemia). The intensity of pain was assessed by a visual analogue scale (VAS), quality of life was assessed by the Short Form-36 (SF-36), and the level of depressive symptoms was assessed by the Geriatric Depression Scale (GDS). Results:The mean age of the subjects was 71.53±4.69 years; 88.3% (n=106) were females and 11.7% (n=14) were males. Chronic diseases were present in 80.8% of the subjects (n=97) and hypertension was the most prevalent disease (49.7%). There was a significant negative correlation between quality of life and pain intensity and level of depression. When evaluated according to educational status, significant differences were found between the groups in some quality of life parameters (physical functioning, social functioning, mental health, and bodily pain) and the GDS (p<0.05). When evaluated according to the presence of chronic diseases, significant differences were also found between the groups in physical functioning, social functioning, vitality, and bodily pain subscales of quality of life measures and the GDS (p<0.05). Conclusion:The presence of a chronic disease and low educational status reduce the quality of life and increase the level of depression in the elderly. Quality of life is negatively affected with the level of depression and the pain intensity. Efforts to improve these conditions may contribute to improving the quality of life of elderly individuals.( Turk J Rheumatol 2010; 25: 165-73)

Background: The aim of this study was to investigate the effects of a postoperative respiratory physiotherapy program on pulmonary complications, length of hospital stay, and hospital cost after lobectomy for lung cancer. Methods: A total of 90 patients (75 males, 15 females; mean age 63.1±10.4 years; range, 30 to 82 years) who underwent elective lobectomy through thoracotomy due to lung cancer between June 2014 and December 2019 were retrospectively analyzed. The patients were divided into two groups as Group S who received standard postoperative care (n=50) and Group P who received postoperative respiratory physiotherapy in addition to standard care (n=40). Both groups were compared in terms of postoperative pulmonary complications, 30-day mortality, length of hospital stay, and hospital cost. Results: The preoperative and surgical characteristics of the groups were similar. Group P had a lower incidence of postoperative pulmonary complications (10% vs. 38%, respectively; p=0.002) than Group S. The median length of stay in the hospital was six (range, 4 to 12) days in Group P and seven (range, 4 to 40) days in Group S (p=0.001). The drug cost (639.70 vs. 1,211.46 Turkish Liras, respectively; p=0.001) and the total hospital cost (2,031.10 vs. 3,778.68 Turkish Liras, respectively; p=0.001) of the patients in Group P were significantly lower. The multivariate logistic regression analysis showed that respiratory physiotherapy had a protective effect on the development of postoperative pulmonary complications (odds ratio =0.063, 95% confidence interval: 0.010-0.401, p=0.003). Conclusion: An intensive physiotherapy program focusing on respiratory exercises is a cost-effective practice which reduces the risk of development of postoperative pulmonary complications in patients undergoing lobectomy for lung cancer.

The aim of this randomized trial was to evaluate the efficacy of subacromial corticosteroid injection and physical therapy (PT) in patients with subacromial impingement syndrome (SIS). Forty patients who diagnosed as SIS were included in this study and were randomly assigned to the PT and injection groups. Pain during rest, sleep and motion were evaluated by visual analog scale (VAS). Disability was determined by Costant- Murley score. Physical and social functions were evaluated with Short Form-36 (SF-36). Active range of motion (ROM) was measured by goniometer. Patients were evaluated at baseline, 3rd and 8th weeks of the therapy. PT continued for 3 weeks with ultrasound and interferential current combined to local heat and exercise. For patients in the injection group, a single steroid injection of 40 mg triamcinolone acetonide into the subacromial space was combined with exercise. After eight weeks, significant improvements at pain, SF-36 and Costant-Murley scores were observed in both groups (p<0.001). Improvement rates of pain during sleep and motion were significantly higher in PT group than the injection group after 8 weeks (p<0.01). Significant improvements were determined at ROM in both groups (p<0.001). No statistically significant differences were found between two groups in terms of Costant-Murley and ROM scores. Results of the PT group were significantly better in terms of physical and social function, and pain subscores of SF-36 (p<0.05). Our results suggest that both PT and corticosteroid injection have beneficial effects on shoulder mobility and pain relief in SIS. PT should be an alternative and effective treatment method to corticosteroid injection in SIS.

Objective: To evaluate the association between clinical symptoms and magnetic resonance imaging (MRI) findings in patients with osteoarthritis (OA) of the knee. Materials and Methods: Ten men and 24 women between 30 and 60 years of age, who fulfilled the American College of Rheumatology (ACR) criteria for knee OA, were included in the study. All patients underwent MRI of the more symptomatic knee and the MRI findings were evaluated by the same radiologist blinded to clinical findings, using a semi-quantitative whole-organ MRI scoring method (WORMS). The Western Ontario and Mc-Master University (WOMAC) osteoarthritis index was used to assess physical function, morning stiffness, and joint pain. Results: Linear regression analysis revealed that the total WORMS score and effusion severity were the most important predictors of the WOMAC pain score. The volume of the effusion was significantly correlated with the WOMAC pain and disability scores (r=0.601, p<0.001; and r=0.626 p<0.001, respectively). There was also a positive correlation between the WOMAC pain score and the WORMS bone marrow edema (BME) score (r=0.508, p<0.01). Patients with synovial effusions had significantly higher WOMAC pain and disability scores compared to patients without synovial effusions (p<0.01 and p<0.001, respectively). Similar results were also observed in patients with BME compared to those without edema. Conclusion: Our results demonstrated that the severity of synovial effusion on MRI was associated with increased pain and disability in knee OA. MRI allows the precise visualization of joint structures, such as cartilage, bone, synovium, ligaments, and menisci, so that the joint can be examined as a whole organ. (Turk J Rheumatol 2010; 25: 184-90 (Turk J Rheumatol 2010; 25: 184-90)