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Introduction. Fibromyalgia syndrome (FS) comprises general body pain, sleep disturbances, and fatigue. Vitamin B12 (VB), vitamin D (VD), and iron deficiencies lead to similar complaints. First, this study aimed to evaluate the VB, VD, and ferritin levels of patients with FS. Second, it aimed to investigate whether there was a relationship between these parameters and FS severity.

Background: Subclinical atherosclerosis may be seen at an early age of ankylosing spondylitis (AS). Syndecan 1 (S1) expression is increased in response to proinflammatory cytokine and inflammation. High S1 may reduce carotid atherosclerosis progression. We aimed to investigate the relationship between S1 levels and subclinical atherosclerosis in patients with AS. Methods: Fifty-eight patients diagnosed with AS and 58 age-, sex-, and body mass index-matched controls were included in the study. S1 level and carotid intima-media thickness (cIMT) were evaluated using appropriate methods. Results: AS patients' cIMT (0.53 ± 0.1 vs 0.45 ± 0.1 mm, p = .008), S1 (6.0 [1.7-149.2] vs 5.5 [1.0-29.8] ng/ml, p = .020), CRP (C-reactive protein) (2.1 [0.1-19.7] vs 1.1 [0.3-9.6] mg/dl, p = .012), fibrinogen (330.2 ± 87.0 vs 278.0 ± 54.5 mg/dl, p < .001) values were significantly higher than the values of the control group. There was a negative correlation between cIMT and CRP (p = .034), age (p < .001), disease duration (p = .005), BASDAI (p = .048) and fibrinogen (p = .009) in AS patients. There was a negative correlation between cIMT and S1 (p = .029). In multivariate analysis, an independent relationship was found between cIMT and age (β = 0.611, p < .001) and syndecan (β = -0.196, p = .046). Conclusion: S1 level may rise in AS patients to suppress the inverse effects of proinflammatory cytokines and inflammation. A negative relationship between the cIMT values of AS patients and S1 level may reveal that S1 has a protective effect on the development of atherosclerosis in AS patients, independent of disease activity. [ABSTRACT FROM AUTHOR]

Byline: Erkan. Cure, Adem. Kucuk, Medine. Cure Although many potent drugs have been used for cytokine storm, mortality is high for patients with coronavirus disease-2019 (COVID-19), which is followed up [...]

Byline: Z. Kaya ?slamo?lu, Mehmet. Unal, Adem. Küçük Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis [...]

The incidence of cardiovascular disease is increased in patients with Behcet's disease (BD). Proprotein convertase subtilisin/kexin type 9 (PCSK9) causes the acceleration of atherosclerosis. We aimed to investigate whether there is a relationship between PCSK9 with carotid artery intima-media thickness (cIMT), a marker of subclinical atherosclerosis, and BD disease activity. Fifty-eight patients with BD and 58 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. The disease activity of the patients was estimated. Individuals' cIMT values were measured, and PCSK9 levels were studied. Patients with BD' cIMT (0.51 ± 0.1 vs 0.41 ± 0.1 mm, p <.001) and PCSK9 (623.2 ± 101.7 ± 10.1 vs 528.3 ± 242.7 ng/ml, p =.007), values were significantly higher than the control group. In stepwise regression analysis, there was an independent relationship between cIMT with PCSK9 (β = 0.179, p <.050). There was no independent relationship between disease activities with PCSK9. Based on the ROC curve analysis, the PCSK9 optimal cutoff value for cIMT was 595.1 ng/ml, sensitivity 66.7%, specificity 64.7% (AUC = 0.672; 95% CI: 0.530–0.815, p =.040). There is a strong independent association between subclinical atherosclerosis and PCSK9 in patients with BD. There may be no independent association between PCSK9 and disease activity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Increased reactive oxygen species may play an important role in Ankylosing spondylitis (AS) etiopathogenesis. The thiol group is a very potent antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with AS by evaluating thiol/disulfide homeostasis. METHODS: In this study, a total of 66 AS patients (27 male, 39 female) and 66 healthy controls (21 male, 45 female) were enrolled. Recently, a novel method for the thiol measurement was found. Thiol and disulfide values were measured by the novel methods. RESULTS: Native thiol (NT) (p<0.001) and native thiol/total thiol (NTT) (p<0.001) levels of AS patients were significantly lower compared to the values of the healthy group. However, disulfide (p<0.001), disulfide/native thiol (DNT) (p<0.001) and disulfide/total thiol (DTT) levels of AS patients were a strongly higher control group. A negative correlation was found between BASFI and NTT. Also, a negative correlation was found between BASDAI and NT, NTT levels. A positive correlation was found between BASFI and disulfide, DNT and DTT levels. A positive correlation was found between BASDAI and disulfide, DNT and DTT levels. CONCLUSION: The findings revealed that thiol-disulfide homeostasis deteriorated in patients with AS in favor of disulfide amounts. Thiol-disulfide homeostasis can play roles in the etiology and severity of AS. [ABSTRACT FROM AUTHOR]

Aim: Familial Mediterranean Fever (FMF) is an auto-inflammatory disease which is characterized by amyloid deposition in multiple organs. Pulse wave velocity (PWV) and augmentation index (AIx) are associated with cardiovascular diseases and important predictors of long term prognosis. We aimed to investigate effect of amyloidosis and amount of proteinuria on subclinical atherosclerosis determined by PWV and AIx in patients with FMF. Material and Methods: Aortic pulse wave velocity (PWV), augmentation index (AIx) were measured in 35 FMF patients (12 amyloidosis and 23 non-amyloidosis) and in 34 control subjects. Demographic, clinical and laboratory features and aortic stiffness parameters were compared between three groups (control, FMF with and without amyloidosis). Results: There was no difference between groups in terms of age, gender, and cardiovascular risk factors. AIx was higher in FMF patients with amyloidosis compared with FMF patients without amyloidosis and control group (respectively; p = 0.04, p = 0.006). AIx did not differ between FMF patients without amyloidosis and control group (p = 0.4). There was a positive correlation between AIx and amount of proteinuria in patients with FMF (r=0.51, p=0.002). Multivariable linear regression analysisdemonstrated that age, presence of amyloidosis and amount of proteinuria were independent factors affecting AIx. Conclusion: AIx is increased in FMF related amyloidosis. Presence of amyloidosis and amount of proteinuria in patients of FMF may be associated with increased cardiovascular risk. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases, among which atherosclerotic heart disease, are known to be one of the most important mortality and morbidity causes in patients with rheumatoid arthritis (RA). Ischemia modified albumin (IMA) is a potential marker that can be used to assess atherosclerosis‐related myocardial ischemia. Another frequently used marker for the assessment of atherosclerotic lesions is the carotid intima media thickness (CIMT). Aim: To evaluate the role that IMA has on atherosclerosis development and its clinical usability in patients with RA, by assessing the values of IMA and CIMT. Methods and materials: Our prospective study was conducted between June 2012 and March 2013 at the Rheumatology Department of Necmettin Erbakan Meram Medical School, Turkey. Fifty‐two RA patients, diagnosed according to the 1987 criteria of the American College of Rheumatology, and an age‐ and sex‐matched control group of 46 healthy subjects were included in this study. Results: No significant difference was detected between the groups with respect to age, sex and body mass index. In the patient group the IMA and CIMT values were found to be 0.37 ± 0.12 absorbance units (ABSU) and 0.80 ± 0.22 mm, respectively, while in the control group they were 0.31 ± 0.11 ABSU and 0.51 ± 0.18 mm, respectively. The IMA and CIMT values were significantly higher in the patient group (P = 0.022 and P < 0.0001, respectively). A positive correlation was found between IMA, CIMT and Disease Activity Score of 28 joints (P = 0.016 and P = 0.002, respectively). Conclusion: Since the values of IMA were higher in the patient group compared to controls and because of its correlation with CIMT, we suggest the use of IMA as an early marker of atherosclerosis in RA patients. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug‐related concern in patients treated with biological agents and to acquire additional information regarding the related causes. Materials and Methods: A total of 1134 patients who were using biological agents for at least 3 months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State‐Trait Anxiety Inventory (STAI). Results: The most common cause for drug‐related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P < 0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P < 0.001). Conclusion: Anxiety related to biological agents may significantly affect the patients’ anxiety levels. Awareness regarding the patients’ concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment. [ABSTRACT FROM AUTHOR]

Aim: Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. Urticaria is a disease with papules and plaques accompanied by pruritus and edema. In this study, the relationship between these two diseases, which have many common features, was evaluated. Material and Methods: Patients with urticaria and volunteers who did not have any dermatologic disease were included in the study. Participants were assessed for diagnosis of IBS according to Rome III diagnostic criteria. In addition, findings supporting IBS diagnosis, and fecal shape and consistency were evaluated. Results: Fifty urticaria patients (18 males - 36% and 32 females - 64%) and 70 volunteers (38 males - 54.3% and 32 females - 45.7%) were evaluated. The mean age of the urticaria group was 34.8 ± 15.0; the mean age of the control group was 25.8 ± 10.9. IBS was detected in 34 (68%) patients in the urticaria group; and in 22 (31.4%) controls (p <0.001). Diagnosis-supporting findings were more frequently detected in the group of urticaria (p values respectively: 0.037; < 0.001; 0.036; 0.050). It was observed that the higher the serum IgE level, the higher the incidence of IBS in chronic urticaria patients ( p: 0.02; eta: 0.206). Conclusion: IBS was observed more frequently in urticaria patients. Diagnosis-supporting findings for IBS were found more frequently in urticaria patients. Serum IgE values also seem to be associated with IBS. These results indicate an association between chronic urticaria and IBS. For this reason, the presence of IBS in patients with chronic urticaria diagnosis should be questioned. [ABSTRACT FROM AUTHOR]

Objective: Systemic lupus erythematosus (SLE) is characterized by chronic inflammation. Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in atherosclerosis and the cardiac risk in SLE patients. Materials and Methods: We included 56 female SLE patients who were selected according to the American College of Rheumatology (1997) diagnosis criteria. Furthermore, we selected age- and body mass index (BMI)-matched 56 female healthy individuals. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. We used carotid intima media thickness (cIMT) as an inflammatory marker because of its widespread use. The lipid and other biochemical parameters of patient and control groups were examined. Results: The PAI and cIMT values of SLE patients were 0.04±0.23 and 0.78±0.18 mm, respectively. Besides, for the control group, the PAI value was -0.09±0.20 and cIMT value was 0.50±0.15 mm (p=0.002, p<0.001; respectively). There was a strong correlation between cIMT and PAI (r=0.273, p=0.003). According to the multiple logistic regression analysis, we found that PAI value is an independent factor for cIMT in SLE patients (odds ratio: 2.6, 95 % confidence interval; 1.506-4.374; p=0.029). Conclusions: We determined that PAI can be used as an independent indicator for subclinical atherosclerosis in SLE patients. [ABSTRACT FROM AUTHOR]

Aim Our aim was to evaluate the relationship between the prevalence and severity of restless legs syndrome ( RLS) and the anemia in patients with systemic lupus erythematosus ( SLE). Methods This was a case-control study which was conducted at the rheumatology clinic of a university affiliated hospital, including 62 patients with SLE and 62 age- and sex-matched healthy controls. The patients were divided into two groups in terms of their hemoglobin levels. The criterion for anemia was hemoglobin level lower than 12 g/ dL in females and 13 g/ dL in males. Results Nineteen patients (30.6%) in the patient group were diagnosed with RLS, and International RLS Study Group Rating Scale ( IRLSSG- RS) score was 10.7 ± 9.5 (median:10.0 [range:0.0-30.0]). Three subjects (4.8%) in the control group had RLS, and the IRLSSG- RS score was 0.7 ± 3.3 (median:0.0 [range:0.0-18.0]). The prevalence of RLS and the IRLSSG- RS score were higher in the patient group than those in the control group ( P < 0.001). Ten SLE patients (50%) with anemia had RLS, and their IRLSSG- RS score was 14.5 ± 9.9 (median:21.0 [range:11.0-30.0]). Nine SLE patients (21.4%) without anemia had RLS and their IRLSSG- RS was 9.0 ± 8.9 (median:21.0 [range:11.0-24.0]). Significant differences were present in the prevalence of RLS and the IRLSSG- RS score between SLE patients with and without anemia ( P = 0.024, P = 0.044, respectively). Conclusion The present study demonstrated that the prevalence of RLS was higher in patients with SLE than that of the normal population. Results of this study also suggested that anemia was associated with higher frequency of and more severe RLS in patients with lupus. [ABSTRACT FROM AUTHOR]

Familial Mediterranean fever (FMF) is a disease characterized by chronic inflammation. Atherogenic index of plasma (AIP) is a logarithmic value of the triglyceride to high-density lipoprotein cholesterol ratio and it is a good marker for atherosclerotic heart disease and cardiac risk. In this study, we investigated subclinical atherosclerosis and cardiac risks in patients with FMF. Patients with FMF (78 men and 84 women) and healthy controls (74 men and 82 women) were included in this study. The AIP values of the patients were calculated and carotid intima–media thicknesses (cIMTs) were measured. The cIMT (P < .001) and AIP (P < .001) values of patients with FMF were higher than the values of the control group. There was a positive correlation between cIMT and AIP values (r = .304, P < .001). In regression analysis, we detected an independent relationship between cIMT and AIP (β = .248, P = .001). Atherogenic index of plasma may be highly correlated with the subclinical atherosclerosis. Particularly, male patients with FMF may have a high cardiac risk. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. A major cause of morbidity and mortality in SLE is accelerated atherosclerosis. Endothelial-specific molecule 1 (endocan) is a potential predictor of vascular events and is expressed in response to inflammatory cytokines in endothelial cells. We investigated the relationship between endocan and carotid intima–media thickness (cIMT) as a marker of early atherosclerosis. We included 44 women with SLE and 44 healthy women as controls. Disease severity of SLE was evaluated using the SLE Disease Activity Index. Endocan, C-reactive protein, erythrocyte sedimentation rate (ESR), and lipid panel were measured. The cIMT was 0.70 (range: 0.45-1.20) mm in patients with SLE and 0.40 (0.25-0.60) mm in controls (P < .001). Endocan value was 1.6 ± 0.9 ng/mL in controls and 2.2 ± 1.0 ng/mL in patients with SLE (P = .014). Endocan levels were positively correlated with cIMT (r = .469, P < .001), body mass index (r = .373, P = .013), and ESR (r = .393, P = .008). Endocan level may be associated with subclinical atherosclerosis in SLE. Consequently, endocan levels may be a promising clinical tool for patients with SLE as a guide for preventive strategy. [ABSTRACT FROM AUTHOR]

The constriction of vessels due to atherosclerotic lesions causes hypoxia/ischemia and oxidative changes resulting in transformation of free albumin to ischemia-modified albumin (IMA) in the circulation and increased carotid intima–media thickness (cIMT). We investigated the reliability of IMA increase in evaluating atherosclerosis in patients with familial Mediterranean fever (FMF) compared with cIMT. Patients with FMF (n = 58) diagnosed by the Tel-Hashomer criteria in attack-free period and 38 healthy people were included in the study. Patient demographics as well as the clinical and laboratory characteristics of the healthy controls and patients with FMF were noted. The IMA levels and cIMT in patients with FMF were 0.30 ± 0.09 absorbance units (ABSUs) and 1.12 ± 0.27 mm, respectively, and in the control group, IMA levels and cIMT were 0.25 ± 0.07 ABSU and 0.74 ± 0.26 mm, respectively. The IMA levels and cIMT were significantly higher in patients with FMF than in controls (P = .020 and P < .0001, respectively). The IMA values showed positive correlation with cIMT in patients with FMF(r = .302, P = .041). Our results reveal that IMA—an oxidative stress marker—may be an indicator of atherosclerosis in patients with FMF. This finding deserves further investigation. [ABSTRACT FROM AUTHOR]

Behçet's disease (BD) is a vasculitic and inflammatory disease causing endothelial dysfunction. Irisin is a metabolic hormone related to insulin resistance and endothelial functions. In this study, we investigated the relationship between irisin and carotid intima-media thickness (cIMT), which is a marker of atherosclerosis in patients with BD. 48 patients with BD and 50 healthy individuals were enrolled in the study. Disease severity was evaluated by BD current activity form. Irisin, glucose, insulin, C reactive protein, erythrocyte sedimentation rate and lipid panel were examined in all patients. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. A simple and inexpensive cIMT test was used as indicator of atherosclerosis. cIMT was 0.62 (0.45-1.05) mm in the patients, while it was 0.38 (0.25-0.65) mm in the control group (p < 0.001). Irisin value was found to be 197.3 (24.8-834.2) ng/mL in the control group, while it was 85.4 (4.7-471.1) ng/mL in the patient group (p = 0.007). There was a negative correlation between irisin level and cIMT (r = -0.511, p < 0.001) and HOMA-IR (r = -0.371, p = 0.009). Decreased irisin levels (OR 0.996, 95% CI 0.992 to 1.000, p = 0.041), male gender (OR 7.634, 95% CI 1.415 to 41.191, p = 0.018), and HOMA-IR (OR 2.596, 95% CI 1.451 to 4.643, p = 0.001) are independent risk factors for cIMT in patients with BD. We detected a very strong relationship between cIMT, which is an indicator of subclinical atherosclerosis, and decreased irisin levels in patients with BD. BD is characterized by chronic inflammation, and low serum irisin levels in BD may be related to atherosclerosis. [ABSTRACT FROM AUTHOR]

Objective Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. Method The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. Results The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p < 0.003) compared with patients without any personality disorder. Conclusions Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease. [ABSTRACT FROM AUTHOR]

Imperforate hymen is a rare congenital malformation to present with symptoms in the neonatal period. We present a case of a 5-day-old neonate with a marked interlabial swelling causing urinary retention. Imaging revealed hydrometrocolpos, hydrosalpinx, and bilateral hydronephrosis. Additionally, our patient had polydactyly of both feet and hands, and laryngocele that have not been previously described in literature. Hymenectomy is the mainstay of management to prevent the development of hematocolpos, pain, and possible retrograde menstruation. [ABSTRACT FROM AUTHOR]

Objective: This study presents the serum tumor necrosis factor-alpha (TNF-α) levels in rheumatoid arthritis (RA) patients with major depression and without any psychiatric disorder.Methods: The study sample included 61 patients with a diagnosis of RA. Major depression and other psychiatric disorders were screened with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Blood sample for the determination of serum TNF-α level was obtained before the psychiatric interview.Results: The prevalence rates of any depressive disorder and any anxiety disorder were 40.3% (n=25) and 22.6% (n=14), respectively. Fifteen (24.2%) patients had major depression alone, whereas 27 (43.5%) patients were not diagnosed with any psychiatric disorder. We could not determine any significant differences between the patients with major depression alone and patients without any psychiatric diagnosis with regard to the serum levels of TNF-α.Conclusions: The existence of major depression in RA patients does not seem to be associated with serum levels of TNF-α. [ABSTRACT FROM AUTHOR]

Objective: Primary Sjogren Syndrome (pSS) is a disorder characterized by dryness due to dysfunction of exocrine glands and additional non-exocrine manifestations from various organ systems. The most common non-exocrine manifestation is a fatigue defined as a general lack of energy not relieved by increased sleep. Excessive daytime sleepiness is defined as the propensity to fall asleep at a time when the individual would usually be awake and alert. One of the major causes for excessive day time sleepiness is periodic limb movement disorder association with restless legs syndrome (RLS). The aim of the present study was to evaluate sleep disturbances in patients with pSS. Method: Seventy-seven voluntary patients (70 female, 7 male) admitted to the rheumatology clinic were included in the study. The control group consisted of eighty healthy (70 female,10 male) individuals. The study sample was asked to complete a socio-demographic form (age, gender, marital status, income level and educational status), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the International RLS study group(IRLSSG) rating scale. The IRLSSG rating scale meets performance criteria for a brief, patient-completed instrument that can be used to assess RLS severity for purposes of clinical assessment, research, or therapeutic trials. Results: The mean scores of the mental health, general health, vitality, physical function, physical role function, and emotional role function parameters of the patients were statistically significantly lower than those of healthy volunteers. On the ESS scale, the average score was found to be 7.9±2.8 in the patient group and 4.5±2.1 in the control group. The average IRLSSG rating scale score was 13.4±7.6 in the patient group and 5.4±5.2 in the control group. The total PSQI score was 7.8±3.5 in the patient group and 4,11±1.64 in the control group. There was a statistically significant difference in terms of ESS, IRLSSG rating scale and sleep quality scores. Patients with urinary incontinence (n=26) had significantly higher PSQI and sf-36 scores than did patients without urinary incontinence (n=51). Conclusion: Prevalence of sleep disturbances appears to be increased in pSS and may be a useful therapeutic target to improve the quality of sleep in these patients. The effects of pSS treatment on sleep quality were not assessed due to the cross-sectional nature of the study. Further studies, where pSS patients should be followedup for an extended period of time and evaluated by polysomnography, are required. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate sexual dysfunction (SD), mood and anxiety disorders and the relationship between one another and their effects on quality of life in patients with fibromyalgia (FM). Methods: The study sample was composed of 96 female patients with FM and 94 female healthy control subjects. Mood and anxiety disorders were ascertained by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Clinical Version. Personality disorders were diagnosed with the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders SD was diagnosed with Diagnostic Statistical Manual of Mental Disorders, Fourth Edition. Results: Of the 96 patients, 46 (47.9%) had at least one sexual dysfunction. The most common sexual dysfunctions were lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had at least one mood or anxiety disorder and 13 (13.5%) has at least one personality disorder. Particularly, lack of sexual desire, orgasm disorder, arousal disorder, major depression, generalized anxiety disorder and histrionic personality disorder were more prevalent in the FM group compared to the control group. The presence of sexual dysfunction was associated with pain intensity. Conclusion: Sexual dysfunction, mood and anxiety disorders are more frequently seen in patients with FM. The impact of pain intensity was greater than psychiatric disorders on sexual dysfunction [ABSTRACT FROM AUTHOR]

Calcium pyrophosphate dihydrate deposition disease is a disease characterized by collecting of crystals in hyaline cartilage, fibrocartilage and soft tissues, related to many endocrine and metabolic conditions, and seen more commonly in old age. Hypopituitarism may occur in old age with fatigue, decrease in libido, weight loss and musculoskeletal symptoms as a major cause of the overall condition impairment. As one gets older, the signs of these two diseases may progress even without any significant disease. The natural process which comes with old age, and pseudogout and hypopituitarism can mask one to another clinically and the symptoms of three situation may be overlapping. This can lead to difficulty and delay in diagnosis. Our case was an elderly female patient diagnosed with hypopituitarism and pseudogout. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life," by W. E. Hoy and colleagues in the 2012 issue.

Objective: To compare the effects of N-acetylcysteine (NAC) and ethyl pyruvate (EP) on experimental testicular ischemia-reperfusion (I/R) injury. Design: Randomized, controlled, experimental study. Setting: University hospital. Animal(s): Twenty-four mature male Wistar rats. Intervention(s): Rats were divided into four groups: control group, torsion-detorsion (T/D) group, EP group, and NAC group. In the pretreatment of the NAC and EP groups, 20 mg/kg NAC and 50 mg/kg EP were given intraperitoneally (IP) 30 minutes before detorsion. Main Outcome Measure(s): Serum ischemia-modified albumin (IMA), tissue and serum malondialdehyde, and myeloperoxidase activity levels and histopathological damage scores were then compared. Result(s): Ethyl pyruvate and N-acetylcysteine exhibited a protective effect against I/R injury. Of the biochemical parameters evaluated as a result of testicular I/R, only IMA levels were significantly elevated. There was a strong and significant correlation between serum IMA levels and histopathological injury scores, and the increase in serum IMA level exhibited a strong parallel with the increase in histopathological injury. In the EP group, although the histopathological injury score was similar to that of the control group, serum IMA levels were significantly elevated. Conclusion(s): Both NAC and EP, the effects of which on I/R injury are evaluated in the present study, reduce such injury in testicular torsion-detorsion. Comparing their effects on IMA levels, NAC may be regarded as a relatively more effective treatment than EP. [Copyright &y& Elsevier]