Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.
Takayasu's arteritis (TA) is a rare idiopathic inflammatory condition that predominantly involves the aorta and its branches causing narrowing and aneurysms in vessels. In this case report, we present TA with a rare coexistence of aortic pseudocoarctation and anterior mitral leaflet perforation with moderate regurgitation.
BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetric peripheral synovial joint involvement. The most common mortality cause in rheumatoid arthritis (RA) is cardiovascular diseases. Recent guidelines recommend assessment of cardiovascular risk, however the management of cardiovascular risk is not clear.ObjectivesThe aims of the study were to find effect of cardiac rehabilitation on disease activity, functional status, fitness and cardiovascular risk score in patients with moderate disease activity.MethodsForty seven patients with RA who had filled ACR/EULAR 2010 classification criteria were enrolled to the study. The patients were randomized to cardiac rehabilitation (25 patients) and home based exercise program (22 patients) groups. The intervention in cardiac rehabilitation group included warming, bicycle ergometer, upper and lower extremity stregthening, cooling and stretching exercises. The patients had received cardiac rehabilitation three times a week for 10 weeks. Individualized home exercise program was given to cardiac rehabilitation group after 10th week. The patients in home exercise program were encouraged to do aerobic and strengthening exercises. The patients were evaluated at baseline, 10th and 24th week with exercise tolerance test, 6 minute walking test, DAS28 score, analysis of mSCORE risk profile, HAQ (Stanford Health Assessment Questionnaire), SF36 (Short Form-36) and Beck Depression Scale.ResultsThere were significant improvement in the VO2 max, MET level, DAS28, HAQ, SF36- pain, Beck Depression Scale parameters in cardiac rehabilitation group when compared to home exercise group. There was no effect on mSCORE risk profile.Table 1ParametersGroupsBaseline10th weeks24th weeksF timeP valueF groupP valueMET valueCardiac rehabilitation3.76±0.924.75±1.054.26±0.7912.57<0.00117.35<0.001Home exercise3.66±0.873.58±0.853.57±0.93VO2 maximumCardiac rehabilitation13.17±3.2616.6±3.6914.90±2.7512.26<0.00116.24<0.001Home exercise12.76±3.0812.52±3.0312.5±3.28Maximum energy consumptionCardiac rehabilitation5.13±1.286.42±1.205.81±1.3013.06<0.00116.60<0.001Home exercise5.10±1.315.03±1.364.96±1.32Maximum loadCardiac rehabilitation61.75±17.2881.65±18.2872.00±18.7912.56<0.00115.58<0.001Home exercise59.65±20.0058.60±20.1257.90±19.706 minute walking testCardiac rehabilitation499.20±61.99587.95±58.27581.05±67.3938.54<0.00134.46<0.001Home exercise468.95±71.77474.10±80.83467.85±73.91HAQ scoresCardiac rehabilitation1.32±0.680.78±0.430.86±0.482.7010.088.727<0.001Home exercise1.13±0.651.27±0.661.29±0.64Beck depression inventoryCardiac rehabilitation17.25±9.9411.50±7.0814.55±8.705.790.0053.850.025Home exercise15.20±9.1814.60±9.0514.55±7.81DAS 28 scoreCardiac rehabilitation4.02±0.473.14±0.543.51±0.5810.49<0.00117.30<0.001Home exercise4.04±0.604.14±0.594.20±0.56ConclusionsCardiac rehabilitation improved physical fitness, functional outcomes and decreased disease activity but did not affect mSCORE risk profile. mSCORE risk analysis was seemed to be useful to evaluate cardiovascular risk...
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