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Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.

Purpose: To evaluate the effect of systemically used anti-tumor necrosis factor alpha (TNF-α) medication on the thickness of corneal epithelium and stroma in patients with ankylosing spondylitis (AS).Methods: A total of 125 eyes of 69 participants were included in this retrospective study of three groups: healthy participants (Group 1), AS patients receiving anti-TNF-α medication (Group 2), and AS patients receiving a nonsteroidal anti-inflammatory medication (Group 3).Results: According to anterior segment optical coherence tomography, the mean thickness of the corneal epithelium was significantly thicker in Group 2 than in Group 3 (51.6 ± 3.2 µm versus 50.4 ± 3 µm, p = 0.01), as was that of the stroma (475 ± 33 µm versus 443 ± 29 µm, p = 0.002).Conclusions: Anti-TNF-α medication and/or avoidance of nonsteroidal anti-inflammatory drugs could improve the thickness of both the corneal epithelium and stroma in AS patients. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the relationship between carotid intima-media thickness (CIMT) and clinical and metabolic variables in rheumatoid arthritis (RA) patients. Patients and methods: The study included 76 RA patients (18 males, 58 females; mean age 50.1±9.8 years; range 21 to 69 years) and 42 control subjects (11 males, 31 females; mean age 49.2±9.7; range 28 to 66 years). Erythrocyte sedimentation rate, C-reactive protein, and disease activity score were used to assess disease activation. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies, and metabolic syndrome components (fasting blood glucose, high density lipoprotein-cholesterol, triglyceride, blood pressure, and waist circumference) were measured. Results: Mean disease duration was 6.9±6.5 years. Patients with RA had higher CIMT than the controls (0.8±0.1 and 0.6±0.2, respectively; p<0.001). Statistically significant positive correlations were observed between CIMT and age, erythrocyte sedimentation rate, C-reactive protein, and systolic and diastolic blood pressure. The CIMT in RA patients having metabolic syndrome risk components ranging from one to four were 0.76±0.16, 0.82±0.14, 0.86±0.13, and 0.92±0.13, respectively. CIMT was positively correlated with the number of metabolic syndrome risk components. Conclusion: Our study has shown elevated CIMT in RA. Presence of metabolic syndrome components in RA patients increases tendency to atherosclerosis and constitutes a severe risk for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Heavy metals are commonly found in nature. Environmental and occupational exposure to heavy metals may lead to toxic effects in various organ systems. Acute and chronic exposures to heavy metals cause various clinical signs. The target tissue of many heavy metals is bone and chronic exposure leads to toxic effects in bone tissue. In this article, it was aimed to review commonly encountered heavy metal exposures' toxic effects on bone tissue. [ABSTRACT FROM AUTHOR]

Platelets contribute to the pathogenesis of atherosclerosis. Platelet activation has been linked with increased mean platelet volume (MPV) and platelet distribution width (PDW). We investigated the association between PDW, MPW, and the degree of carotid artery stenosis (CS). Patients (n = 229) were divided into 3 groups according to the North American Symptomatic Carotid Endarterectomy Trial criteria. Demographic and clinical features were collected retrospectively. Correlation analysis showed a positive association between PDW and the degree of CS. However, there was no significant correlation between CS and MPV. Moreover, we observed that PDW and low-density lipoprotein cholesterol were independent predictors of the degree of CS. This study showed that PDW, not MPV, is related to the degree of CS. Platelet distribution width could be a useful biomarker for CS. Whether targeting PDW will be of clinical benefit remains to be established. [ABSTRACT FROM PUBLISHER]

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: This study aims to investigate the association of serum fetuin-A levels with disease activation and clinical parameters in ankylosing spondylitis (AS) patients. Patients and methods: Forty-seven AS patients (30 males, 17 females; mean age 39.7±11.1 years; range 20 to 69 years) and 30 healthy controls (14 males, 16 females; mean age 42.0±11.5 years; range 19 to 63 years) were included in the study. Erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, and Bath Ankylosing Spondylitis Metrology Index were used in the assessment of AS. Serum fetuin-A levels were measured using ELISA. Results: Mean serum fetuin-A values in AS patients (984±203 ng/mL) were significantly lower compared to controls (1156±218 ng/mL) (p=0.001). While a statistically significant negative correlation was detected in AS patients between fetuin-A values and C-reactive protein (p=0.009, r=-0.377), no significant correlation was detected between erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index or Bath Ankylosing Spondylitis Radiology Index parameters and fetuin-A. Conclusion: Serum fetuin-A levels in AS patients were lower than the control group. However, further research is required to establish the role of serum fetuin-A levels as a surrogate marker of disease activity. [ABSTRACT FROM AUTHOR]

Objective: Arsenic (As) exposure may cause several medical problems. There were a few studies investigated whether it has affected bone tissue in women. However, there was no study in men. The aim of this study was to evaluate associations between bone mineral density (BMD) and As exposure in men subjects. Material and methods: We enrolled in this study 254 subjects who due to chronic As exposure suspected and 82 subjects as a control group. Hair As levels were detected by a hair analysis (Varian AA240Z Zeeman Atomic Absorption Spectrometer, USA). BMD measurements were obtained using dual-energy X-ray absorptiometry instrumentation. We investigated associations between the hair As levels and BMD measurements. Results: The frequency of osteoporosis and osteopenia was found to be 0.8% and 54.5%, respectively, in the As exposure group. The frequency of osteoporosis was found to be 1% and osteopenia was 32.4% in control subjects. There was significant difference between two groups ( p < 0.001). Hair As level has a median 1.01 (min: 0.06 and max: 25.71). There were no significant correlation between hair As levels and BMD measurements. Conclusion: According to our observations, As exposure was associated with bone metabolism. Possible cause of osteopenia may be exposure to As. Further investigations are needed to estimate the relationship between As and bone metabolism. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to article "Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with kneeosteoarthritis" by Balbaloglu O.

Introduction: Mean platelet volume (MPV) is an important marker that shows the activation and function of the platelets, which is effective in the inflammatory diseases., Aim: To show the relationship between MPV and the development of psoriatic arthritis (PA) in patients with psoriasis vulgaris (PV) and the correlation between MPV and psoriasis severity score (PASI)., Material and Methods: Our study included 116 patients with psoriatic arthritis (68 female, 48 male) and 41 patients in the psoriasis group (19 female, 22 male) and 90 subjects in the control group (55 female, 35 male). The demographic data of the patients, duration of disease, PASI, the nature of the disease were evaluated retrospectively., Results: Mean platelet volume levels of both the PV group (8.79 ±0.86 fl) and the PA group (9.18 ±1.26 fl) were significantly higher compared to the control group (8.42 ±0.74 fl). There was a weak statistically positive correlation between the PASI and the MPV according to the correlation analysis ( r = 0.165; p = 0.046)., Conclusions: Our results show that MPV may be helpful as an indicator of the clinical course of PV and PA. In this regard, that study should be supported by prospective studies to find strong correlations., Competing Interests: The authors declare no conflict of interest.

Gout is a chronic rheumatic disease resulting from accumulation of monosodium urate crystals in tissues. The most important risk factor for the disease is hyperuricaemia. Precipitation of uric acid in the joint in the form of monosodium urate crystals is the main factor responsible for triggering attacks of arthritis. Tophi occur as a result of urate crystals that precipitate into joints and surrounding tissues. Tophi can erode the bone where they are located and cause compression in soft tissue due to a mass effect. The following case report describes a case of cubital tunnel syndrome developed in association with tophaceous compression and resolved with surgical decompression in a patient with chronic gouty arthritis.

Aim: The objective of this study was to investigate the effect of using 2 different surgical techniques (curette or high-speed drill) in anterior cervical discectomy surgery on the healing of cases., Material and Methods: Fifty-four operated cervical disc hernia cases were retrospectively examined in 2 groups. Discectomy and osteophytectomy were carried out in Group A by using a high-speed drill, while a curette was used for group B. Preoperative and postoperative computerized tomography and direct radiography were performed. Cervical disc height, cervical and segmental lordotic angles were calculated. The visual analogue scale and Odom's criteria were used in the assessment of pain and clinical healing. The fusion ratio of both groups was compared. The Mann-Whitney U test was used to compare data from the groups., Results: Satisfactory results were obtained in the groups where high-speed drill and curette were used. Independently from the surgical technique, pain scores were significantly reduced in both groups after surgery. No radiologically significant differences were identified between the two groups within the postoperative period., Conclusion: Either high-speed drill or curette can be chosen for the osteophytectomy and discectomy stages of anterior cervical discectomy operations.

Purpose: To assess the relation between ankylosing spondylitis (AS) and degenerative disc disease emerging in association with various intrinsic and extrinsic factors and to evaluate the correlation between degree of degeneration in intervertebral discs and apparent diffusion coefficient (ADC) values., Methods: Thirty-five patients with AS and a control group of 35 patients were included in the study. Three hundred fifty intervertebral discs were assessed in terms of degeneration by analyzing signal intensities and morphologies on T2 weighted series of a 1.5 Tesla magnetic resonance scanner. ADC values were determined in diffusion weighted images (DWI) using a "b value of 500 s/mm(2)". Patients in the AS and control groups were compared in terms of intervertebral disc degeneration, and association between degree of degeneration and ADC values was analyzed., Results: The mean of total degeneration degrees for five lumbar intervertebral discs was significantly higher in the patients with AS compared to the control group (16.77±4.67 vs 13.00±4.08, respectively; P=0.001). When intervertebral discs were analyzed separately, disc degeneration was again significantly higher in patients with AS compared to the control group, with the exception of L5-S1. Age, cholesterol level, triglyceride level, duration of disease and BASFI index were significantly associated with degree of degeneration in patients with AS. A negative correlation was determined between disc degeneration and ADC value., Conclusion: AS is a risk factor for degenerative disc disease due to its systemic effects, the fact it leads to posture impairment and its inflammatory effects on the vertebrae. A decrease in ADC values is observed as degeneration worsens in degenerative disc disease.