The association between varicocele and ankylosing spondylitis via color duplex sonography.

OBJECTIVE: To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS). METHODS: Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS. RESULTS: Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p < 0.001 and p = 0.003, respectively). The incidence of varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively). CONCLUSIONS: The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS.

Elevated serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis and its association with disease activity and quality of life.

This study was carried out to determine the serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis (AS) and to evaluate its correlation with disease activity and quality of life. According to our knowledge, it is the first trial evaluating HMGB1 levels in AS. Serum samples of 30 patients (18 males and 12 females) with AS and 29 healthy controls (HC) (15 females and 14 males) were collected. HMGB1 levels were measured by enzyme-linked immunosorbent assay, activity of disease was assessed according to the Bath AS Disease Activity Index (BASDAI), and functional status of patients was evaluated with Bath AS Functional Index (BASFI). Modified Schober, chest expansion values and AS Quality of Life Questionnaire (ASQoL) scores were noted. The serum levels of HMGB1 were obtained significantly increased in AS patients compared to HC (p < 0.05). There was no significant correlation between HMGB1 levels and ESR (p > 0.05), and CRP (p > 0.05) values. BASDAI, BASFI and ASQoL scores were also not correlated with serum levels of HMGB1 (p > 0.05). Our results suggest that HMGB1 might play an important role in the pathogenesis of AS; however, it seems not to be a good candidate for reflecting disease activity, functional abilities and the quality of life in patients with AS; on the other hand, the increased levels of HMGB1 in patients may open a new dimension for targeting this cytokine as a new therapy option in AS.

Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis.

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients with AS. This impairment in the sexual function is especially correlated with the BASFI and BASMI among the clinical and laboratory parameters.

Serum levels of high mobility group box 1 protein and its association with quality of life and psychological and functional status in patients with fibromyalgia.

AIM: High mobility group box 1 protein (HMGB1) is a proinflammatory cytokine. Previous studies have suggested that HMGB1 can play an important role in the pathogenesis of many rheumatic diseases. The purpose of this study was to investigate the serum levels of HMGB1 in patients with fibromyalgia (FM) and its association with quality of life and psychological and functional status in these patients. METHODS: Twenty-nine patients who met the 1990 American College of Rheumatology (ACR) criteria for the classification of FM and 29 healthy controls (HC) were included in the present study. Serum samples were collected from both the patients and the HC, and HMGB1 levels were measured by enzyme-linked immunosorbent assay (ELISA). The Fibromyalgia Impact Questionnaire (FIQ) was used to assess the disease severity and functional status in patients with FM. Furthermore, the Nottingham Health Profile was used to assess quality of life in all subjects, as well as the Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety. RESULTS: The serum levels of HMGB1 protein were positively correlated with the FIQ scores in patients with FM (P = 0.002). Mean serum levels of HMGB1 were higher in patients with FM than in HC but this difference was not statistically significant. CONCLUSION: HMGB1 protein might be a good laboratory-sourced candidate for the assessment of functional status and disease severity in patients with FM.

Bilateral Knee Pain Associated with Bone Infarction in a Patient with Behcet's Disease.

We describe a 31-years-old female patient with severe pain in both knees who had been diagnosed as Behcet's disease (BD) for 12 years. She had had a history of complications due to BD including superior vena cava thrombosis, pulmonary thromboembolism, uveitis, and erythema nodosum and has reported the administration of corticosteroid therapy irregularly. After radiologic evaluation, she has been diagnosed with bone infarction of both left and right knee with the existance of lupus anticoagulants (LA) positivity. Severe joint pain without the evidence of arthritis must alert the clinician to the possibility of bone necrosis of the extremity, although those may rarely occur bilateral in BD.

Diagnostic value of F-wave inversion in patients with early carpal tunnel syndrome.

Routine electrophysiological studies usually give normal results in patients with early stage carpal tunnel syndrome (CTS). Diagnostic significance of the F-wave inversion (the median of F-wave minimal latencies (FWML) exceeds a normal ipsilateral ulnar FWML by 1ms) has not been previously reported in early stage CTS. In this study, our primary aim was to investigate the diagnostic value of F-wave inversion in early stage CTS. Additionally, we aimed to demonstrate any possible relationship between F-wave inversion and symptom scores of the Boston questionnaire and functional capacity in early stage CTS. The study included 60 early stage CTS patients who presented with a median sensory nerve conduction velocity of ≥50m/s. The symptom severity and functional status of the patients were assessed by using the Boston questionnaire. The control group consisted of 45 healthy volunteers. We compared early stage CTS patients and healthy control subjects in terms of the results obtained from median-ulnar FWML. Existence of F-wave inversion was found in 32 (53.3%) of the early stage CTS patients and in 3 (8.7%) of the healthy controls (p=0.001). It was also found to be positively correlated with the Boston questionnaire scores (p=0.001, r=0.41) and functional capacity scores (p=0.001, r=0.41). The sensitivity and specificity of F-wave inversion for the diagnosis of early stage CTS were calculated as 53.3% and 93.3%, respectively. The addition of F-wave inversion measurement to the set of the routine nerve conduction studies can increase the reliability of the electrophysiological studies in patients with early stage CTS.

The relationship of metabolic syndrome with disease activity and the functional status in patients with rheumatoid arthritis.

BACKGROUND: The aim of this study is to investigate the frequency of metabolic syndrome (MS) in patients with rheumatoid arthritis (RA) and to determine the relationship between the clinical and laboratory parameters of RA and the components of the metabolic syndrome (MS). METHODS: Fifty-four patients with RA and 52 healthy individuals were enrolled in this study. The diagnosis of rheumatoid arthritis was based on the American College of Rheumatology criteria and the diagnosis of the metabolic syndrome was made according to the criteria set out in the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). The functional status and disease activity were also recorded in patients with RA. RESULTS: MS was diagnosed in 42.6% of the patients with RA and in 9.6% of the healthy controls. The systolic and diastolic blood pressure values were observed to be significantly higher in the patients with RA in comparison to the controls. Also, the frequency of MS was higher in the inferior functional group in relation to the higher functional group. A positive correlation was observed between the DAS28 scores and hypertension in patients with RA. CONCLUSIONS: In this study, MS was more frequently detected in the patients with RA compared to the control group. Also, an inferior functional status in RA was also found to be associated with the presence of MS. Thus, the presence of MS in patients with RA may be associated with a higher cardiovascular risk.