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Objective: Serum YKL-40 plays roles in inflammatory and vascular processes. Our aim was to evaluate serum YKL-40 levels in patients with ankylosing spondylitis (AS) and to investigate their potential relationship with arterial stiffness based on carotid-femoral pulse wave velocity (CF-PWV). Methods: Forty-three patients with AS and 41 healthy controls with no history or current signs of cardiovascular disease were included in the study. All patients were administered nonsteroidal anti-inflammatory drugs (NSAIDs), and none were prescribed anti-tumor necrosis factor agents. Serum YKL-40 levels were measured. CF-PWV and intima-media thickness of the common carotid artery (IMT-C) were evaluated. Results: The mean age of AS patients was 34.6 ± 10.2 years and of controls was 36.3 ± 9.0 years. CF-PWV was significantly higher in AS patients than in controls (8.2±2.7 vs.7.0±1.6 m/s, respectively; P=0.015). However, the IMT-C was not significantly different between AS patients and controls (0.6±0.3 vs. 0.5±0.2 mm, P=0.501). YKL-40 levels were significantly higher in AS patients than in controls (78.9±37.9 vs. 58.4±21.2 ng/mL, P=0.003) and were strongly correlated with CF-PWV (r=0.773, P < 0.001) and IMT-C (r=0.548, P < 0.001). A multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels and IMT-C (adjusted R²= 0.707, P=0.013 and P=0.001, respectively). AS patients with a higher disease activity score had higher YKL-40 levels, IMT-C, and CF-PWV than did those with a lower disease activity score (P < 0.001, P=0.008, and P < 0.001, respectively) Conclusion: AS patients had higher serum YKL-40 levels, CF-PWV, and IMT-C than did healthy controls. Additionally, there was an association between increased CF-PWV and serum YKL-40 levels. Therefore, we conclude that CF-PWV and YKL-40 levels may be used for early diagnosis of atherosclerosis in AS patients.

Amaç: Lumbosakral transizyonel vertebra (LSTV) ve spina bifida okülta (SBO) lumbosacral omurgada sıklıkla görülür. Lomber disk herniasyonu (LDH) ve / veya bel ağrısı ile ilişkisinin varlığı mevcut literatürde tartışılmıştır ancak bir fikir birliği yoktur. Bu çalışmanın amacı, kronik bel ağrısı olan genç hastalarda LSTV ve SBO sıklığı ile LDH sıklığı arasındaki ilişkiyi değerlendirmektir.Çalışma tasarımı: Kesitsel.Gereç ve Yöntemler: 20 - 40 yaş arası bel ağrısı olan ve ağrısı 12 haftadan uzun süre devam eden toplam 1094 hasta çalışmaya alındı. Çalışmaya katılan tüm hastalar standart pelvis grafisi ve lomber vertebra manyetik rezonans görüntülemesi ile değerlendirildi. Ağrının şiddeti görsel analog skala ile ve bel ağrısının günlük yaşam aktivitelerine etkisi Oswestry dizabilite indeksi ile ölçülmüştür. Hastalar iki gruba ayrıldı: Grup 1, LDH'si olmayan hastalardan oluşuyordu ve Grup 2, LDH'li hastalardan oluşuyordu. Ek olarak, bu iki grup, üç alt gruba ayrılmıştır: Non-LSTV-SBO, LSTV ve SBO.Bulgular: Lomber disk herniasyon grubu grup 2'de LSTV sıklığının anlamlı olarak yüksek (p=0.004) olduğu görüldü. Buna ek olarak LDH'lı olan ve olmayan grupta da LSVT varlığının bel ağrısı (p

Objective: The aim of this study was to evaluate serum levels of interleukin (IL)-17, IL-6, and tumor necrosis factor alpha (TNF-α) in RA patients and to assess the correlation of these cytokines with clinical and laboratory parameters. Materials and Methods: 48 patients with RA and 35 healthy volunteers were enrolled in the study. Disease activity was determined by disease activity score (DAS28) in patients with RA. Patients with RA were categorized as mild (DAS28≤3.2), moderate (3.2 Results: The mean serum IL-17 and TNF-α levels did not differ between RA patients and controls (P>0.05). Serum IL-6 levels were significantly elevated in RA patients compared with controls (P Conclusions: This study showed that patients with RA had significantly increased cytokine level for IL-6, but not IL-17 and TNF-α and high level of serum IL-6 cytokine was associated with disease activity. However, further follow-up studies involving large samples are required to clarify precise role of these cytokines in disease development and progress.

Objective: The aim of the present study was to evaluate the relationship of hand grip strength (HGS) with bone mineral density (BMD) and vitamin D levels in postmenopausal women. Materials and Methods: One hundred thirty one postmenopausal women were included in this study. HGS was measured by Jamar hand dynamometer. BMD was measured by dual energy X-ray absorptiometry at lumbar spine and femoral neck sites. Serum 25-hydroxyvitamin D (25OHD) levels were measured. Results: The mean age of patients was 61.2±9.2 years. The mean HGS was 22.9 kg and 32 patients (24.4%) had low HGS. Thirty seven patients (28.2%) were osteoporotic and 62 (47.3%) were osteopenic. The mean 25OHD level was 17 ng/mL and 101 (77.1%) patients having vitamin D insufficiency. There was a significant difference in HGS values among groups with osteoporosis, osteopenia, and normal BMD (p=0.016). HGS values demonstrated a positive correlation with T-scores and BMD values at lumbar spine and femoral neck sites (p

Fibromyalgia, a potentially debilitating chronic pain syndrome, is a chronic disease. We aimed to compare the hand function of fibromyalgia (FM) patients and healthy individuals and to demonstrate the relationship between hand disability and FM. The study was consisted of 40 female patients with FM and 30 healthy controls. All participants were evaluated for pain threshold measurements, handgrip strength, and pinch strength. Functional states, hand disability, and hand skills and coordination were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) form, the Disability of Arm–Shoulder–Hand (DASH) questionnaire and the Purdue Pegboard Test, respectively. Handgrip strength values, DASH score, lateral pinch strength test, Pegboard placement time, and Pegboard collection time of the patient group were significantly lower than those of the control group (all p

[Purpose] The aim of this study was to investigate the effects of hypothyroidism on femoral cartilage thickness by using ultrasound, which has been found to be useful in the early diagnosis of knee osteoarthritis. [Subjects and Methods] Forty patients diagnosed with hypothyroidism and 30 age-, gender-, smoking status, physical activity-, and body mass index-matched healthy subjects were enrolled. The thickness of the femoral articular cartilage was measured using a 7- to 12-MHz linear probe. Three mid-point measurements were taken from each knee at the lateral condyle, intercondylar area, and medial condyle. [Results] Age, gender, body mass index, smoking status, and physical activity were similar between the groups, but patients with hypothyroidism had thinner femoral cartilage than the healthy controls at all measurement sites. Nonetheless, the differences were not statistically significant (except in the case of the left medial condyle). [Conclusion] Ultrasonographic measurement of femoral cartilage thickness may be useful in the early diagnosis of knee osteoarthritis in patients with hypothyroidism.

Amac: Saat cizme testi (SCT) kognitif fonksiyonlari degerlendirmede kullanilan kisa, pratik ve guvenli bir testtir. Biz SCT ile 25-hidroksivitamin D seviyesinin gunese maruziyet ve yurume suresi icin prediktif olup olmadigini ve SCT’nin dusuk egitim duzeyli (DE) yaslilarda guvenilir olup olmadigini arastirmayi amacladik. Materyal ve Metod: Ic hastaliklari klinigine basvuran 65 yas uzeri demansi olmayan 185 DE hasta bu calismaya dahil edildi. Hastalarin demografik verileri, gunes maruziyetleri, yurume sureleri, koroner kalp hastaligi (KKH) oykusu ve dusme sayisi kaydedildi. SCT, Manos skorlama sistemi kullanilarak olculdu. Bulgular: Calisma populasyonu yas ortalamasi 73 ± 6 yil olan 127 (%68.6) erkek ve yas ortalamasi 70 ± 5 yil olan 58 (%31.4) kadin hastayi iceriyordu. Manos skorlama sistemine gore, 90 (%48.6) kisinin CDT skoru 0, 70 (%37.9) kisinin CDT skoru 1-9 arasi ve 25 (%13.5) kisinin CDT skoru 10 idi. Hastalarin ortalama D vitamin duzeyi 18.4 ± 7.3 ng/mL idi. D vitamin seviyesi ve SCT skorlari gunes maruziyeti, yurume suresi ve dusme sayisi ve KKH icin tahmin edici degerdeydi. Sonuc: DE kisilerin SCT skorlari bilinc fonksiyonlarini gostermede guvenilir degildir. Bu calisma gosterdi ki DE bireylerde D vitamin seviyeleri gunes maruziyeti, yurume suresi, dusme sayisi ve KKH sikligini gostermede SCT skorundan daha gucludur.

Serdaroglu Beyazal, Munevver/0000-0001-5903-5708 WOS: 000348146300008 PubMed: 25642030 [Purpose] the aim of the present study was to investigate and compare the effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. [Subjects and Methods] Sixty outpatients (30 per group) with complex regional pain syndrome participated. They received 15 treatment 5 days per week for 3 weeks. the outcome measures were the visual analogue scale for pain, edema, range of motion of the wrist (flexion and extension), fingertip-to-distal palmar crease distance, hand grip strength, and pinch strength. All parameters were measured at baseline (week 0) and at the trial end (week 3). [Results] There were significant improvements in all parameters after therapy in both groups. the whirlpool bath group showed significantly better improvements in the visual analogue score, hand edema, hand grip strength, wrist range of motion (both flexion and extension), fingertip-to-distal palmar crease distance, and the three-point and fingertip pinch strengths than the neuromuscular electrical stimulation group; however, the lateral pinch strengths were similar. [Conclusion] Both whirlpool bath and neuromuscular electrical stimulation are effective in the treatment of complex regional pain syndrome, but the efficacy of the whirlpool bath treatment was better.

Objectives: This prospective clinical study aims to evaluate the effectiveness of long-term of anti-tumor necrosis factor-alpha (TNF-a) therapy on arterial stiffness in ankylosing spondylitis. Patients and methods: A total of 28 active ankylosing spondylitis patients (21 males, 7 females; mean age 33.5±9.5 years; range 20 to 52 years) were enrolled. Patients’ values for before the initiation of biological therapy and mid-term (24 weeks) evaluation were reported. For further evaluation, this initially reported patients were contacted two years after anti-TNF-α therapy, and their arterial stiffness was assessed by using pulse wave velocity. Results: After two years of anti-TNF-α therapy, despite the significant improvements in patients’ symptoms and clinical activity parameters including Bath Ankylosing Spondylitis Disease Activity Index score (4.9±0.9, 1.9±0.5 and 1.8±0.9, p=0.0001), erythrocyte sedimentation rate (35.5±23.1 mm/h, 13.8±9.2 mm/h and 25.0±17.9 mm/h, p=0.0001), and C-reactive protein (2.1±1.6 ng/dL, 0.4±0.3 ng/dL and 0.6±0.9 ng/dL p=0.0001), no significant difference was observed in arterial stiffness parameters (7.9±1.3 meter/second, 7.7±1.3 meter/second and 8.3±1.1 meter/second, p=0.620). Conclusion: In line with the previous 24-week evaluation, the results at two-year follow-up indicates that anti-TNF-α therapy does not improve arterial stiffness in patients with ankylosing spondylitis.

Objective: The aim of the present study was to investigate the relationship between bone formation and functional status in patients with symptomatic lumbar spinal stenosis (LSS). Material and Methods: Sixty patients (range 45 to 65 years) diagnosed with symptomatic lumbar spinal stenosis and 30 ageand gendermatched healthy controls were included in this study. Bone mineral density (BMD) of the subjects included in the study was measured from the lumbar vertebra and proximal femur. Bone-specific alkaline phosphatase, osteocalcin, and 24-hour urinary calcium (Ca) and phosphorus (P) levels were tested to assess bone metabolism. The functional status of patients was evaluated with the modified Oswestry disability index (mODI) and Swiss spinal stenosis questionnaire (SSSQ). Results: The mean age of the patient and control groups was different but not significant. No statistically significant difference was found between the patient and the control groups in bone-specific alkaline phosphatase, osteocalcin, and 24-hour urinary Ca and P values. Mean BMD values measured from the lumbar vertebra and proximal femur were significantly lower in patients with LSS. In the patient group, the mean mODI score was 42.28±3.1. Mean SSSQ pain scale score was 3.34±0.2, whereas the mean functional status score was 2.35±0.2. There was no statistically significant relationship of mODI with bone-specific alkaline phosphatase and osteocalcin levels. The pain and functional status scales of the SSSQ had no significant correlation with bone-specific alkaline phosphatase and osteocalcin. Conclusion: In this study, we determined that LSS has a negative impact on the functional status of patients, does not influence bone metabolism, and decreases BMD.

Objective: Lateral epicondylitis (LE) is a common painful problem of the elbow. This study was conducted to evaluate and compare the effectiveness of extracorporeal shock wave therapy (ESWT) and lowintensity laser therapy in LE treatment. Material and Methods: The study included 60 LE patients. Subjects were divided into two groups randomly. Group 1 received ESWT, while group 2 received laser therapy. Presence of lateral epicondyle tenderness, elbow pain, and hand grip strength (HGS) were evaluated at the beginning and at 4 and 12 weeks. Elbow pain was evaluated with the Short-Form McGill pain questionnaire (SF-MPQ). Results: The patients with tender lateral epicondyle were not significantly different between groups at each time point. Both groups had improvement on HGS evaluated at the 4th and 12th weeks, but in the ESWT group, the improvement was significantly higher. All SFMPQ parameters improved significantly after each therapy evaluated at the 4th and 12th weeks. However, mean visual analog scale, present pain intensity, affective pain subscale, and total pain scale scores were significantly lower in the ESWT group at the 4th and 12th weeks. Conclusion: Both ESWT and laser therapy are effective and safe treatment options for LE; however, ESWT seems to be more efficient in pain reduction and improvement of functions.

Objective: The aim of this study was to investigate the effect of bone mineral density and vitamin D level on the risk of falling and balance in postmenopausal women. Methods: The age ranged from 44 to 67 (57.25±7.27) years, 133 postmenopausal women were enrolled. Age, height, weight, socio-demographic information, history of falling and fracture in last year, risk factors for osteoporosis, and menopause duration were recorded. Serum 25OHD3 level and bone mineral density (BMD) of participants were measured. Postural balance function and the risk of falling were evaluated by time-up and go test (TUG), and Berg balance scale (BBS). Patients were divided into 4 groups; group 1: low vitamin D and osteoporosis, group 2: only low vitamin D, group 3: only osteoporotic, group 4: normal. Results: There was significant difference between the groups according to TUG (p, Amaç: Bu çalışmanın amacı postmenopozal kadınlarda kemik mineral yoğunluğu ve vitamin D düzeyinin birlikte ve ayrı ayrı denge ve düşme riski üzerine etkisini araştırmaktır. Yöntemler: Çalışmaya yaşları 44 ile 67 (57,25 ± 7,27) yıl arasında değişen 133 postmenopozal kadın alındı. Olguların yaş, boy uzunluğu, vücut ağırlığı, sosyodemografik bilgileri, son bir yıldaki düşme ve kırık öyküleri, osteoporoz risk faktörleri, menopoz süresi sorgulandı. Olguların serum 25OHD3 düzeyi ve kemik mineral yoğunluğu (KMY) ölçüldü. Hastaların postural denge fonksiyonu zamanlı ayağa kalk ve yürü testi (ZAYT) ile, düşme riski ise Berg denge skalası (BDS) ile değerlendirildi. Olgular 4 gruba ayrıldı; grup 1: vitamin D düzeyi düşük ve osteoporotik, grup 2: yalnızca vitamin D düzeyi düşük, grup 3: yalnızca osteoporotik, grup 4: normal. Bulgular: ZAYT\'e göre gruplar arasında anlamlı farklılık saptandı (p

Objective To investigate the frequency of dry eye (DE) by measuring tear osmolarity (TO) with the recently introduced TearLab system (TearLab Corp, San Diego, Calif.) in patients with early rheumatoid arthritis (ERA) and the relationship between the severity of DE and ERA disease activity. Design Prospective study Participants Sixty-four eyes of 64 newly diagnosed and untreated patients with ERA were enrolled in this study. Methods TO measurements, tear break-up time (TBUT), and Schirmer tests were performed. ERA disease activity was evaluated according to the disease activity score 28 (DAS28). The patients were divided into 3 groups according to DAS28 scores as follows: mild (DAS28 ≤ 3.2), moderate (3.2 5.1). Results DE was identified in 46 (71.8%) patients with ERA according to the TO values. There were significant differences among these groups concerning TO ( p = 0.001) and TBUT ( p = 0.005) scores, whereas there was no significant difference between these groups regarding Schirmer scores ( p = 0.200). In addition, DAS28 values were positively correlated with TO values ( r = 0.710, p r = –0.251, p = 0.045), and negatively correlated with TBUT scores ( r = –0.335, p = 0.007) among all patients. Conclusions Our study demonstrated a relationship between the ERA disease activity and severity of DE by using TO measurements with the TearLab system. Therefore, TO measurement could be added to other classical DE tests for diagnosing DE and for assessing the degree of disease activity of ERA.

Subclinical atherosclerosis has been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs of cardiovascular disease (CVD). The aim of this study was to investigate the relationship between serum YKL-40 level and arterial stiffness in patients with ERA. Forty two patients with ERA and 35 healthy controls with no history or current sign of CVD were included in the study. ERA patients with active disease, defined as DAS28 ≥3.2, and symptoms onset

PURPOSE: To evaluate dry eye in patients with fibromyalgia (FM). METHODS: Fifty-three FM patients and 53 age and sex well-matched controls were included in this study. Visual analog scale (VAS), number of tender points, FM impact questionnaire (FIQ), Beck depression scale (BDS), Ocular Surface Disease Index (OSDI), the tear break-up time (TBUT), Schirmer test, and tear osmolarity (TO) were assessed. RESULTS: The OSDI, TBUT, Schirmer test, and TO scores of the FM and control groups were significantly different (P < 0.05). The OSDI, TBUT, Schirmer test, and TO were higher in FM with high FIQ, and TBUT and TO were higher in FM with high BDS. In FM patients, Schirmer test was correlated with the VAS (r = -0.429, P = 0.001), BDS (r = -0.277, P = 0.044), and FIQ (r = -0.382, P = 0.005), and the TBUT was correlated with the VAS (r = -0.537, P < 0.001), BDS (r = -0.350, P = 0.010), and FIQ (r = -0.456, P = 0.001). In addition, TO was significantly correlated with the VAS (r = 0.681, P < 0.001), BDS (r = 0.661, P < 0.001), and FIQ (r = 0.842, P < 0.001). However, no significant correlation existed between the OSDI and the VAS, BDS, or FIQ. CONCLUSIONS: We have revealed an association between FM disease activity and dry eye severity. The consideration of this relation will be useful in the treatment of FM with deteriorated clinical status.

Purpose: To compare peripapillary retinal nerve fiber layer (RNFL) thicknesses measured by Cirrus HD optical coherence tomography (OCT) of patients with vitamin B12 deficiency with healthy controls and to evaluate the correlation between the peripapillary RNFL thickness and plasma vitamin B12 levels.Materials and Methods: Forty-five patients (19 male and 26 female) with a diagnosis of vitamin B12 deficiency (patient group) and 45 age- and sex- matched healthy subjects (control group) were consecutively enrolled in this study. Average, temporal, nasal, inferior, and superior quadrant peripapillary RNFL thicknesses of each subject were obtained using the Cirrus HD OCT. Disc area (DA) and rim area (RA), central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were also measured.Results: Mean age of each group was 33.1 ± 6.5 years (range: 21–45 years). Mean plasma vitamin B12 level was 114.8 ± 34.0 pg/mL in the patient group and was 405.1 ± 20.0 pg/mL in the control group (p < 0.00...

The aim of this study was to investigate the relationship between vitamin D and bone mineral density in newly diagnosed multiple sclerosis (MS) and to compare results with data from healthy controls. A total of 60 subjects, including 30 patients with MS, newly diagnosed and untreated (18 females, 12 males, at 18-40 years of age) and 30 healthy controls (20 female, 10 male) were enrolled in this study. Bone mineral density (BMD) of the lumbar spine and left femoral neck region were measured by dual-energy X-ray absorptiometry (DEXA). Serum levels of 25-hydroxyvitamin D (25OHD) were measured by chemiluminescence microparticle immunoassay (CMIA) on the Architect-i2000(®) (Abbott) system. 25OHD levels of MS patients were significantly lower than in controls. 25OHD levels were 27.2 ± 14.1 ng/ml in MS patients and 42.6 ± 8.8 ng/ml in controls (p = 0.001). Twenty-six (86.6 %) of our patients had a reduced BMD in lumbar spine or femoral neck region; of these 24 patients (80 %) had osteopenia and 2 patients (6.6 %) had osteoporosis. Interestingly, there was no significant correlation between 25OHD and BMD in lumbar spine and femoral neck region (r = 0.454, p = 0,074; r = 0.636, p = 0.082). Interestingly, a significant reduction of bone density in female MS patients was observed. In our study, 25OHD deficiency and lower BMD appeared in newly diagnosed multiple sclerosis. This is compatible with shared etiologic or pathogenic factors in MS and osteopenia/osteoporosis, and calls for an active approach to optimize bone health in early stages of MS.

ObjectiveTo evaluate the widespread pain of patients with fibromyalgia syndrome [FMS] with neuropathic pain and to investigate the correlation between widespread pain and the functional status of patients.MethodsThe study comprised 173 female patients with FMS [mean age, 39.35 ± 7.7 years; range: 20–50 years]. The demographic data, widespread pain index [WPI], symptom severity scale [SSS], and complaint durations of the patients were recorded. Current pain intensity was determined using a visual analog scale for pain [VASp], functional status using the Fibromyalgia Impact Questionnaire [FIQ], and pain characteristics using the McGill Pain Questionnaire [MPQ]. Neuropathic and nociceptive pains were differentiated using Leeds Assessment of Neuropathic Symptoms and Signs [LANSS].ResultsThe patients reported different types of neuropathic pain: knife-stabbing pain 20.8 percent, burning pain 19.7 percent, and stinging pain 16.8 percent. 52.6 percent of patients showed a LANSS score of ≥12, while 47.4 percent s...

Background: Recent recommendations have established clinical remission ideally or low disease activity (LDA) as therapeutic targets in all patients with rheumatoid arthritis (RA). Controlled studies of biologic agents have primarily assessed treatment effects in patients with severe RA; patients with moderate disease activity, whoconstitute a larger group, have received far less attention. In Period 1 of the PRESERVE trial, the proportion of subjects with moderately active RA achieving LDA or remission were evaluated after treatment with etanercept 50mg once weekly (QW) plus methotrexate for 36 weeks.Methods: Subjects with DAS28 >3.2 and ≤5.1 despite stable doses of oral methotrexate received open-label etanercept 50mg QW plus methotrexate (screening dose permitted to be titrated up to 25 mg/wk through week 28) for 36 weeks.Results: 834 subjects received treatment and were analyzed. Subjects were mostly female (83%), Caucasian (74%), RFþ (73%), and aCCPþ (78%), with a mean age of 48 years and disease duration of 7 years. Mean baseline DAS28 was 4.4; SDAI, 19.1; ESR, 22.2 mm/hr; and CRP, 12.3 mg/L. Efficacy results from Period 1 are shown in the table. The most commonly reported adverse events (AEs) were headache (6.1%), nasopharyngitis (5.4%), and upper respiratory tract infection (4.4%). Twenty-two subjects (2.6%) discontinued due to AEs.Conclusions: Substantial proportions of subjects with moderately active RA who received etanercept 50mg QW plus methotrexate for 36 weeks achieved LDA (85%-86%), DAS28 remission (67%), or SDAI remission (25%). Therefore, these ambitious goals can be achieved realistically in a high percentage of patients with moderate disease activity.

The objective of this study was to investigate any relationship between peripheral neuropathy and anti-TNF-α therapy used in ankylosing spondylitis (AS). Thirty-nine patients monitored in our clinic with a diagnosis of AS and without neuropathic symptoms were enrolled in the study. Patients were divided into two groups. The first consisted of 21 patients using biological agents for more than one year. The control group was made up of 18 patients of similar age and demographic characteristics receiving non-biological therapy. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were calculated, and sedimentation rate and C-reactive protein (CRP) levels measured. Motor and sensory nerve conduction analysis for the median, tibial, and sural nerves was performed. The nerve conduction results of the biological therapy group were then compared with those of the non-biological therapy group. Thirty-nine patients with a mean age of 37.05 ± 8.1 were enrolled. Patients were divided into two groups, depending on drugs used. The first group (using anti-TNF-α) consisted of 21 patients with a mean age of 42.2 ± 8.8, and the second (the non-biological group) of 18 patients with a mean age of 35.8 ± 7.5. There was no statistically significant difference between the groups in terms of age, sex, drug use, or duration of disease (p = 0.052, p = 0.55, p = 0.33, and p = 0.72, respectively). Sedimentation rate, CRP, and BASDAI scores were statistically significantly higher in the second group (p = 0.04, p = 0.03, and p = 0.009, respectively). No statistically significant difference was determined in any parameters at nerve conduction analysis between the two groups (p > 0.05). There was a positive correlation between sedimentation rate and median sensory conduction velocity (p = 0.02, r = 0.48) and tibial conduction velocity (p = 0.07, r = 0.43). A negative correlation was determined between duration of disease and median distal motor latency (p = 0.22, r = −0.37) and between length of drug use and median sensory conduction velocity (p = 0.02, r = −0.38). There was no significant correlation between other clinical and demographic data and nerve conduction parameters. No effect on nerve conduction of biological agents in AS patients without neurological symptoms was determined. Clinicians should be alert for signs and symptoms, suggesting neuropathy in patients given anti-TNF-α.

Background: Various thrombocyte markers and white blood cell levels and their subtypes have recently been investigated in association with infl ammation. The purpose of this study was to determine the correlation of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with disease activation and clinical parameters in rheumatoid arthritis (RA) patients. Methods: 84 RA patients and 60 healthy controls were included. Platelet, MPV, white cell, neutrophil and lymphocyte levels in full blood counts were investigated, and NLR was calculated. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), disease activation score (DAS 28) and a health assessment questionnaire (HAQ) were used in the evaluation of RA. Results: In the present study a total of 144 patients was enrolled, 84 with RA and 60 healthy individuals. 75.2 % (n = 108) were women and 24.8 % (n = 36) were men. The patients with RA had lower MPV than control individuals (MPV; 8.52 ± 1.15 fL and 8.92 ± 0.87 fL, respectively) and CRP (r: - 0.234, p = 0.005). RA patients' mean NLR was signifi cantly higher than that of the control group (2.74 ± 1.74 and 1.80 ± 0.78, respectively; p < 0.001). Furthermore, anti-CCP positive patients had higher NLR than anti-CCP negative patients (NLR; 2.51 ± 1.92 and 1.95 ± 1.22, p = 0.019 respectively). NLR was positively correlated with ESR (r = 0.190, p = 0.023), CRP (r = 0.230, p = 0.035) and anti-CCP (r = 0.300, p = 0.005). Conclusion: In conclusion, MPV and NLR together with acute phase reactants can be a useful index for showing infl ammation in RA patients. © Georg Thieme Verlag KGStuttgart · New York Einleitung: Verschiedene thrombozytäre Marker und Grenzwerte von Leukozyten und ihren Subtypen sind in der jüngeren Vergangenheit bezüglich ihres Zusammenhangs mit Entzündung untersucht worden. Ziel dieser Untersuchung war die Korrelation des mittleren Thrombozytenvolumens (MPV) und der Neutrophilen/Lymphozyten Ratio (NLR) mit der Krankheitsaktivität und klinischen Parametern bei Patienten mit rheumatoider Arthritis (RA). Methoden: 84 RA Patienten und 60 gesunde Kontrollen wurden eingeschlossen. Aus dem Blutbild wurden Thrombozyten, MPV, Leukozyten-, Neutrophilen- und Lymphozytenwerte untersucht und die NLR errechnet. Die Erythrozytensedimentationsrate (ESR), C-reaktives Protein, Rheumafaktor (RF), anti-zyklisches citrullinieres Peptid (anti-CCP), der Krankheitsaktivität-Score DAS 28 und ein Gesundheitsbewertungsbogen (HAQ) wurden für die Bewertung der RA herangezogen. Ergebnis: In die vorliegende Studie wurden 144 Patienten eingeschlossen, 84 mit RA und 60 gesunde Kontrollen. 75,2 % (n = 108) waren Frauen und 24,8 % (n = 36) waren Männer. Patienten mit RA hatten ein niedrigeres MPV als die Kontrollen (MPV; 8,52 ± 1,15 fL bzw. 8,92 ± 0,87 fL) und CRP (r: − 0,234, p = 0,005). Die mittlere NLR von RA Patienten war signifi kant höher als die der Kontrollgruppe (2,74 ± 1,74 bzw. 1,80 ± 0,78; p < 0,001). Außerdem hatten anti-CCP positive Patienten höhere NLRs als antiCCP negative Patienten (NLR; 2,51 ± 1,92 bzw. 1,95 ± 1,22 p = 0,019). Die NLR korrelierte positiv mit der ESR (r = 0,190, p = 0,023), dem CRP (r = 0,230, p = 0,035) und dem anti-CCP (r = 0,300, p = 0,005). Schlussfolgerung: MPV und NLR können gemeinsam mit Akutphase-Proteinen ein hilfreicher Index für die Entzündungsaktivität bei RA Patienten sein.

Background: Cisplatin (Cis) is one of the most commonly used antineoplastic drugs. It is used as chemotherapy for many solid organ malignancies such as brain, neck, male and female urogenital, vesical and pulmonary cancers. Infliximab blocks tumor necrosis factor alpha (TNF-α). Several studies have reported that infliximab ameliorates cell damage by reducing cytokine levels. Aims: We aimed to investigate whether infliximab has a preventive effect against cisplatin-induced hepatotoxicity and whether it has a synergistic effect when combined with Cis. Study Design: Animal experimentation. Methods: Male Wistar albino rats were divided in three groups as follows: Cis group, infliximab + Cis (CIN) group and the control group. Each group comprised 10 animals. Animals in the Cis group received an intraperitoneal single-dose injection of Cis (7 mg/kg). In the CIN group, a single dose of infliximab (7 mg/kg) was administered 72 h prior to the Cis injection. After 72 h, a single dose of Cis (7 mg/kg) was administered. All rats were sacrificed five days after Cis injection. Results: TNF-α levels in the Cis group were significantly higher (345.5±40.0 pg/mg protein) than those of the control (278.7±62.1 pg/mg protein, p=0.003) and CIN groups (239.0±64.2 pg/mg protein, p=0.013). The Cis group was found to have high carbonic anhydrase (CA)-II and low carbamoyl phosphate synthetase-1 (CPS-1) levels. Aspartate transaminase (AST) and alanine transaminase (ALT) levels were lower in the CIN group as compared to the Cis group. Total histological damage was greater in the Cis group as compared to the control and CIN groups. Conclusion: Cis may lead to liver damage by increasing cytokine levels. It may increase oxidative stress-induced tissue damage by increasing carbonic anhydrase II (CA-II) enzyme levels and decreasing CPS-1 enzyme levels. Infliximab decreases Cis-induced hepatic damage by blocking TNF-α and it may also protect against liver damage by regulating CPS-1 and CA-II enzyme levels.

Osteoprotegerin (OPG) is considered an important biomarker in cardiovascular (CV) disease. CV disease is the most common cause of mortality in patients with rheumatoid arthritis (RA), a consequence of accelerated atherosclerosis. The present study aimed to evaluate the relationship of serum OPG levels to arterial stiffness, carotid intima-media thickness (CIMT), and clinical and laboratory indices in RA patients. Included in the study were 68 RA patients with no history or signs of CV disease and 48 healthy subjects Disease activity was assessed by the 28-joint disease activity score (DAS28) in RA patients. Serum OPG level was measured using enzyme-linked immunosorbent assay (ELISA). Carotid femoral pulse wave velocity (PWV) was measured as an index of arterial stiffness and CIMT was evaluated by carotid ultrasonography. The mean serum OPG level was significantly higher in RA patients than controls (p

Patients with ankylosing spondylitis (AS) reportedly have a higher mortality and morbidity risk. Osteoprotegerin (OPG) was recently defined as an important cardiovascular (CV) marker in the general population. We aimed to assess the relationship of serum OPG levels with arterial stiffness, carotid intima media thickness (CIMT), and clinical and laboratory data in AS patients. We examined 60 AS patients without CV disease or risk factors and 50 healthy controls. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Serum OPG levels were measured with the enzyme-linked immunosorbent assay. Carotid-femoral pulse wave velocity (PWV) was used as an indicator of arterial stiffness, whereas CIMT (examined via carotid ultrasonography) was used to evaluate preclinical atherosclerosis. The mean serum OPG level, PWV, and CIMT were significantly higher in AS patients than in controls (106.7 ± 50.9 vs. 58.1 ± 12.7 pg/mL; 7.4 ± 1.8 vs. 6.2 ± 1.2 m/s; 0.72 ± 0.13 vs. 0.57 ± 0.07 mm, respectively; P < 0.001 for all). In AS patients, the serum OPG levels were not significantly correlated with PWV and CIMT but were significantly correlated with erthrocyte sedimentation rate, BASFI, and ASDAS. AS patients without CV disease or risk exhibited high OPG levels and increased PWV and CIMT values. Although OPG levels were not significantly correlated with PWV or CIMT, future long-term follow-up studies will help define the predictive value of OPG in these patients.

OBJECTIVE: The aim of this cross-sectional study was to determine the frequency of carpal tunnel syndrome (CTS) among women using tea leaf scissors and compare it with normal population. METHODS: Two hundred hands of 100 women using tea leaf scissors (tea leaf scissors group) and 112 hands of 56 healthy women (control group) were clinically and electrophysiologically evaluated for CTS. Women using tea leaf scissors were evaluated with visual analog scale (VAS) for pain and Boston Carpal Tunnel Syndrome Questionnaire for symptoms and functional status. RESULTS: Carpal tunnel syndrome was diagnosed bilaterally in 62 (62%) and unilaterally in 7 (7%) women using tea leaf scissors, whereas 2 (3.57%) bilateral and 6 (10.71%) unilateral cases of CTS was diagnosed in controls. The differences in demographic factors were not statistically significant. In women with CTS using tea leaf scissors, mean symptom severity, functional status, and VAS scores were 2.73±0.60, 2.42±0.71 and 5.19±1.84, respectively. There was statistically significant difference in the frequency of CTS between women using tea leaf scissors and the control group and the risk of having CTS among women using tea leaf scissors was approximately 12 times greater (p

We aimed to evaluate the sociodemographic and clinical characteristics as well as the quality of life of patients with fibromyalgia (FM).A total of 37 female patients diagnosed with FM and 31 healthy females were included into the study. Individuals were asked about their demographic characteristics. The number of sensitive points (NSP), skin fold sensitivity, cutaneous hyperemia and reticular skin changes of patients and healthy controls were evaluated during physical examination. Individuals were evaluated for pain severity using the Visual Analogue Scale (VAS), for psychological states using the Beck Depression Scale (BDS), for quality of life using the Short Form-36 (SF-36) and for functional status using the Fibromyalgia Impact Questionnaire (FIQ).The mean age of FM patients was 39.2±6.5 years versus 39.1±6.2 years in the controls. The most frequently encountered FM symptoms were fatigue (94.6%), sleep disturbances (86.5%) and anxiety (86.5%). Differences between FM patients and controls were statistically significant for NSP (p=0.001), VAS (p=0.001), FIQ (p=0.001), BDS (p=0.001) and SF-36 (p=0.003), and FIQ subgroups were also different between the two groups (p0.001). In the SF-36 survey, FM patients were different from the control in the physical function (p=0.001), pain (p=0.005), general health (p=0.017), physical fitness (p=0.003), and mental health (p=0.008) portions of the survey.Fibromyalgia has distinct clinical features that lead to low functional capacity and quality of life. Thus, patients' sociodemographic characteristics and the evaluation of their quality of life may be important in the diagnosis and monitoring of treatment progress.Fibromiyalji (FM) hastalarının sosyodemografik, klinik özellikleri ve yaşam kalitesini değerlendirmeyi amaçladık.Fibromiyalji tanısı almış 37 kadın hasta ve 31 sağlıklı kadın çalışmaya alındı. Bireylerin demografik özellikleri sorgulandı. Hastaların ve kontrol grubunun fizik muayenesinde hassas nokta sayısı (HN), deri kıvrım hassasiyeti, kutanöz hiperemi ve retiküler cilt değişikliği değerlendirildi. Bireylerin ağrı şiddeti Görsel Ağrı Skalası (GAS), psikolojik durumları Beck Depresyon Ölçeği (BDÖ), yaşam kalitesi Kısa Form-36 anketi (KF-36), fonksiyonel durumları Fibromiyalji Etki Sorgulama Formu (FES) ile değerlendirildi.Fibromiyaljili hastaların yaş ortalaması 39.2±6.5, kontrol grubunun 39.1±6.2 idi. FM’li hastalarda en sık yorgunluk (%94.6), uyku bozukluğu (%86.5), anksiyete (%86.5) semptomları tespit edildi. FM hastaları ile kontrol grubu arasında HN (p=0.001), GAS (p=0.001), FES (p=0.001), BDÖ (p=0.001) ve KF-36 (p=0.003) açısından anlamlı farklılık saptandı. İki grup arasında FES alt grupları açısından anlamlı farklılık mevcut idi (p0.001). KF-36 alt gruplarının karşılaştırmasında gruplar arasında fiziksel fonksiyon (p=0.001), ağrı (p=0.005), genel sağlık (p=0.017), zindelik (p=0.003), mental sağlık (p=0.008) açısından anlamlı farklılık tespit edildi.Fibromiyalji farklı klinik özelliklere sahiptir. FM’li hastalarda fonksiyonel kapasite ve yaşam kalitesi düşük tespit edilmiştir. Bu yüzden hastaların sosyodemografik özellikleri ve yaşam kalitesinin değerlendirilmesi hastalığın tanı, tedavi ve takibinde önemli olabilir.

The aim of this study was to determine the frequency and features of low back pain (LBP) among stroke caregivers.Participants included 64 caregivers of stroke survivors in our inpatient clinic. Age, gender, body weight, FIMTM, and Brunnstrom Scale of patients and low back pain history, Short Form-36 (SF-36), Beck Depression Measure (BDM), and Oswestry Disability Scale (ODS) of caregivers were reported. Descriptive statistics, Spearman correlation, and Mann-Whitney U test were used.Fifty-three (82.8 %) of caregivers had LBP. Stroke survivors of caregivers with LBP (group 1) had significantly lower FIMTM scores when compared with stroke survivors of caregivers without LBP (group 2) (P.05). All SF-36 subscores and total score of group 1 except mental health were significantly lower than SF-36 scores of group 2.The lifetime, 12-month period, and point prevalence of LBP were 44.1%, 34.0%, and 19.7%, respectively, in our country. Caregivers had a higher frequency of LBP in this study. However it was a study with a small number of participants. There are many studies about stroke caregivers' depression and life quality. LBP should also be investigated.

Adult-onset Still's disease (AOSD) is an uncommon idiopathic disorder with various clinical manifestations. The absence of specific serological and pathological findings often makes the disease difficult to diagnose. The presence of skin lesions is important to the correct diagnosis of the disease. Various atypical skin lesions have been reported in association with Adult-onset Still's disease. We present a 52-year-old male who had atypical cutaneous manifestations of Adult-onset Still's disease. The rash manifested as persistent, pruritic, dark reddish, confluent, erythematous maculopapules and plaques on his chest, abdomen, upper back and proximal extremities. He suffered high, spiking fevers and had marked elevations of ferritin, C-reactive protein, and the erythrocyte sedimentation rate, which are characteristic of Adult-onset Still's disease. The fever and systemic symptoms improved after the administration of intravenous pulse methylprednisolone therapy. The skin lesions improved after prednisolone and methotrexate combination therapy. Therefore, to make the correct diagnosis, it is important to understand that patients with Adult-onset Still's disease may present with various types of skin lesions.

To determine plasma homocysteine levels in ankylosing spondylitis (AS) and their correlation with disease activity measurements. To examine the effects of different treatment modalities on homocysteine levels. One hundred eight patients diagnosed with AS according to New York criteria and 65 healthy individuals matched in terms of age and gender were enrolled in the study. Patients were given detailed physical examinations. The Bath AS Disease Activity Index (BASDAI) was used for disease activity, the Bath AS Metrology Index (BASMI) for spinal mobility, the Bath AS Functional Index (BASFI) to determine functional status and the Bath AS Radiological Index (BASRI) for radiological analysis. Sedimentation rate (ESR) and C reactive protein (CRP) levels, acute phase reactants, were measured. Plasma homocysteine levels, serum interleukin (IL) -6 and serum tumor necrosis factor- α (TNF- α) levels were investigated using the enzyme-linked immunosorbent assay (ELISA) method. Plasma homocysteine levels in AS patients were statistically significantly lower compared with those in the healthy control group (P = 0.0001). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity (BASDAI ≤4 and >4). No statistically significant correlation was determined between homocysteine level and disease activity parameters, radiological score and functional indices. A significant negative correlation was, however, established between age and homocysteine level in the AS group (P