Pain types and risk factors in post-COVID-19.

Objectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.

Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study.

Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS.

Electrophysiological evaluation of carpal tunnel syndrome female patients after vitamin D replacement.

OBJECTIVE: The effects of vitamin D on the central and peripheral nervous system continue to be investigated today. In the present study, we aimed to evaluate pain and electrophysiologic response in patients with carpal tunnel syndrome (CTS) who have undergone replacement therapy due to vitamin D deficiency. METHODS: Fifty female patients diagnosed with mild and moderate CTS and accompanied by vitamin D deficiency were included in this study. Nerve conduction study (NCS) was performed before and after vitamin D replacement, and the patient's pain was evaluated with Visual Analogue Scale (VAS). RESULTS: When NCS were compared before and after treatment, there was a statistically significant improvement in the median distal sensory onset latency (DSOL) and sensory conduction velocity (CV) and motor distal latencies (DML) values (p=0.001; p<0.001; p=0.001, respectively). At the same time, there was a decrease in the VAS values in patients (p<0.001). When the two groups were compared there was an improvement in DSOL and sensory CV in both groups, but in DML only in moderate CTS group. CONCLUSION: In this study, it was shown that mild and moderate CTS patients had an improvement in pain and electrophysiological parameters after vitamin D replacement. Replacing vitamin D in early stages of CTS may be beneficial.

Is pentraxin 3 level an effective biomarker in disease activity in patients with rheumatoid arthritis?

INTRODUCTION: The aim of the current study was to identify whether serum pentraxin 3 (PTX3) level could be a marker of increased inflammation in rheumatoid arthritis (RA) patients. MATERIAL AND METHODS: The study included 41 patients diagnosed with RA according to the American College of Rheumatology (ACR) 1990 diagnostic criteria. We compared the serum PTX3 levels between RA patients and a healthy control group, the relationship between PTX3 level and disease activity was also examined. RESULTS: A statistically significant difference was determined between the RA patients and controls as regards PTX3, platelets, C-reactive protein, and mean platelet volume results (p = 0.042, p = 0.007, p = 0.017, p < 0.001, respectively). There was no statistically significant difference in terms of PTX3 level between anti-CCP-positive and -negative patients (p = 0.368). No statistically significant difference was determined in respect of PTX3 levels between RA patients with different disease activity scores (p = 0.346). CONCLUSIONS: No relationship was determined between PTX3 and disease activity in RA patients, nor with traditional clinical and biochemical measurements of disease activity. However, the PTX3 levels of the RA patients were found to be high in comparison with the control group. Because, from these results, the role of PTX3 in the pathogenesis of RA cannot be ignored, there is a need for further studies to determine the potential role of PTX3 in RA pathogenesis.

The effect of vitamin D on cognitive functions in young female patients: a prospective controlled study using the Montreal Cognitive Assessment.

AIM: Our aim was to determine whether there is a relationship between vitamin D [25(OH)D] and cognitive functioning in women with low 25(OH)D levels. METHODS: Ninety female patients, 25-45 years of age, who attended our outpatient clinic and had 25(OH)D levels < 30 ng/mL, were included. The Montreal Cognitive Assessment (MoCA) scale was used to determine cognitive functioning; the scale is divided into seven subgroups. Patients were divided into three subgroups according to their 25(OH)D levels. After a three-month period of 25(OH) D replacement, the patients underwent a re-evaluation using the MoCA scale. RESULTS: The total MoCA score before treatment was significantly different from the score after treatment (p < 0.05). Language and delayed recall functions were significantly different before and after treatment (p < 0.05). CONCLUSION: Vitamin D levels were related to cognitive functioning in our study group.

The effect of vitamin D on cognitive functions in young female patients: a prospective controlled study using the Montreal Cognitive Assessment / O efeito da vitamina D nas funções cognitivas em pacientes jovens do sexo feminino: um estudo prospectivo controlado usando a avaliação cognitiva de Montreal

ABSTRACT Aim: Our aim was to determine whether there is a relationship between vitamin D [25(OH)D] and cognitive functioning in women with low 25(OH)D levels. Methods: Ninety female patients, 25-45 years of age, who attended our outpatient clinic and had 25(OH)D levels < 30 ng/mL, were included. The Montreal Cognitive Assessment (MoCA) scale was used to determine cognitive functioning; the scale is divided into seven subgroups. Patients were divided into three subgroups according to their 25(OH)D levels. After a three-month period of 25(OH) D replacement, the patients underwent a re-evaluation using the MoCA scale. Results: The total MoCA score before treatment was significantly different from the score after treatment (p < 0.05). Language and delayed recall functions were significantly different before and after treatment (p < 0.05). Conclusion: Vitamin D levels were related to cognitive functioning in our study group.

RESUMO Objetivo: Nosso objetivo foi determinar se existe uma relação entre a vitamina D [25(OH)D] e o funcionamento cognitivo em mulheres com baixos níveis de 25(OH)D. Métodos: Noventa pacientes do sexo feminino (25-45 anos de idade) que se apresentaram ao nosso ambulatório e tinham níveis de 25(OH)D <30 ng/mL foram incluídas. A escala de avaliação cognitiva de Montreal (MoCA) foi usada para determinar o funcionamento cognitivo; a escala é dividida em sete subgrupos. As pacientes foram divididas em três subgrupos de acordo com seus níveis de 25(OH)D. Após um período de três meses de reposição de 25(OH)D, as pacientes foram submetidas a uma reavaliação de acordo com a escala MoCA. Resultados: O escore total da MoCA antes do tratamento foi significativamente diferente do escore após o tratamento (p <0,05). As funções de idioma e recordação atrasada foram mais significativamente diferentes entre antes e depois do tratamento (p <0,05). Conclusão: O nível de vitamina D foi relacionado ao funcionamento cognitivo em nosso grupo de estudo.

Paresthesia frequency in fibromyalgia and its effects on personality traits.

AIM: Paresthesia and personality disorders are common conditions among patients with fibromyalgia. However, no previous study has examined a possible relation of paresthesia with personality traits in fibromyalgia. This study investigates the frequency of paresthesia in fibromyalgia patients and its relation with personality traits. METHOD: Female patients with fibromyalgia (n = 101) were divided into two groups according to the presence (n = 49; mean age 40.63 ± 7.62 years; range 23-55 years) or absence (n = 52; mean age 40.50 ± 7.12 years; range 27-53 years) of paresthesia. Also, a healthy control group (n = 53; mean age 39.34 ± 5.26 years; range 23-55 years) was included. The groups were evaluated by the Temperament and Character Inventory. Accordingly, temperament includes four dimensions: harm avoidance, novelty seeking, persistence, reward dependence; and character consists of three dimensions: cooperativeness, self-transcendence, self-directedness. RESULTS: There were no significant differences among the three groups in the scores of novelty seeking, persistence, reward dependence and cooperativeness (for all P > 0.05). Both fibromyalgia groups had significantly higher scores in harm avoidance and had lower scores in self-directedness compared to the control group (P < 0.001). Also, fibromyalgia patients with paresthesia had significantly higher harm avoidance and self-directedness scores than those in patients without paresthesia (P < 0.001). In both fibromyalgia groups, self-transcendence scores were similar (P = 0.465) but significantly higher than in the control group (P < 0.001). CONCLUSION: This is the first study evaluating the association of paresthesia and personality traits in fibromyalgia. These results suggest that psychological distress associated with high harm avoidance and low self-directedness scores are more prominent in fibromyalgia patients, and especially of those who have paresthesia.

Polymorphisms in the Growth Differentiation Factor 5 (GDF 5) Gene in Knee Osteoarthritis.

OBJECTIVE: To identify the frequency of the rs143383 SNPin the GDF5 gene, which is located in the 5'-untranslated region of Turkish population with knee osteoarthritis (OA). STUDY DESIGN: Acase-control study. PLACE AND DURATION OF STUDY: Orthopedics and Traumatology Department, Bozok University Medical Faculty, Yozgat, Turkey, from 2012 to 2014. METHODOLOGY: Patients diagnosed with OA(n=94) and patients who did not have joint complaints (n=279) were enrolled in this study. Patients diagnosed with osteoarthritis according to the 1986 American College of Rheumatology osteoarthritis criteria and Kellgren and Lawrence scores were investigated, based on age, gender, and X-ray findings. Blood samples were taken for the identification of GDF5 (rs143383) SNPs by PCR/RFLP, according to a standard protocol. RESULTS: This study included 373 patients. The OAgroup (25.2%; n=94) was characterized by specific genotypes: TT (39.4%; n=37); heterozygotes (TC; 45.7%; n=43); and homozygotes (CC; 14.9%; n=14). The control group (74.8%; n=279) was comprised of TT(26.5%; n=74), TC (54.8%; n=153), and CC (18.6%; n=52) genotypes. An analysis of rs143383 SNP of the GDF5 gene polymorphism revealed that the rs143383 TTgenotype had a higher risk for OA(crude OR=1.798, 95% CI=1.010-2.941, p=0.021). CONCLUSION: This study demonstrated that there is a correlation of +104T/C polymorphism in the 5'-UTR of GDF5 with knee OAin a Turkish population.

Promoter polymorphism (T-1486C) of TLR-9 gene is associated with knee osteoarthritis in a Turkish population.

In this study, we aimed to determine whether TLR-9 T-1486C SNP was associated with susceptibility to OA in the Turkish population. The study group comprised 272 patients with Grade 2-3-4 knee OA according to the Kellgren-Lawrence scoring system and the control group was formed of 296 individuals with Grade 0-1. The TLR-9 genotype were assessed by real-time polymerase chain reaction. An analysis of TLR-9 promoter -1486T/C polymorphism revealed that the -1486CC genotype appeared to have a higher risk for OA and -1486TT and -1486CT genotypes have a protective effect against the development of OA (crude OR = 0.473, 95% CI = 0.297-0.754, p = 0.002, adjusted OR = 0.531, 95% CI = 0.326-0.864, p = 0.011). This study indicate that there is a correlation of TLR-9 T-1486C gene polymorphism with advanced knee OA in a Turkish population. Changed in TLR expression due to different allelles may cause osteoarthrith development outcome cartilage degeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2484-2489, 2017.

Does fibromyalgia have an effect on hearing loss in women?

Background/aim: Fibromyalgia (FM) patients may have several neuroendocrine dysfunctions, resulting in a hypervigilant sensory output that may be responsible for sensorineural complaints. In this study, we evaluated the audiological findings of a cohort of female fibromyalgia patients. Materials and methods: Between 1 September 2012 and 1 June 2013, 35 female FM patients, followed by the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bozok University, were recruited for the study. The patients were referred to the Department of Otolaryngology for routine otolaryngological and audiological evaluations. Age range was between 30 and 65 years, with a mean age of 48.10 years. The control group consisted of 25 healthy female volunteers ranging from 32 to 65 years (mean age: 45.52). All subjects were audiologically tested, including tympanometric evaluation. Low- and high-frequency audiometry was carried out by a single experienced investigator under standard audiometric testing conditions.Results: At low frequencies, the mean air conduction threshold values between the two groups were not statistically significant. At high frequencies, the mean air conduction threshold values and tympanometric values between the FM and control groups were statistically significant (P < 0.05 for both). Conclusion: Our results point to a pathophysiologic link between FM and the development of audiological abnormalities in these patients.

Does vitamin D deficiency trigger carpal tunnel syndrome?

OBJECTIVE: Vitamin D deficiencies are associated with a variety of chronic diseases. The goal of the present study was to investigate the relationship between vitamin D levels and carpal tunnel syndrome (CTS). METHODS: This study included 90 patients with mild to moderate CTS and assessed their routine serum 25-hydroxyvitamin D levels. Additionally, the pain level of each subject was evaluated using the Visual Analogue Scale and the Douleur Neuropathique 4 Questionnaire (DN4). RESULTS: The severity levels of CTS were at a 75% mild level in the vitamin D deficiency group and a 47.1% mild level in the vitamin D normal group, with a significant difference between groups (p = 0.008). Correlation analyses revealed positive correlations between body mass index and DN4 scores (r = 0.499, p = 0.025) and between vitamin D levels and CTS severity (r = 0.364, p = 0.004) in the vitamin D deficiency group. CONCLUSIONS: The present findings demonstrated that CTS may be triggered by vitamin D deficiency, and that the severity of CTS was correlated with vitamin D levels in the deficiency group. Additionally, there was a correlation between weight gain and neuropathic pain intensity in CTS patients with vitamin D deficiency. The present findings indicate that vitamin D levels should be assessed in CTS patients.

Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle.

UNLABELLED: Carpal tunnel syndrome (CTS) is a condition involving nerve entrapment that often leads to chronic neuropathic pain. We aimed to evaluate sleep quality and related parameters in diabetic and non-diabetic CTS patients. METHOD: This study included a total of 366 patients with chronic CTS. These patients' sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and depression using the Beck Depression Inventory (BDI). The severity of neuropathic pain was evaluated using the Douleur Neuropathique-4 (DN4) questionnaire and a visual analogue scale (VAS). RESULTS: In the non-diabetic patient group, the total PSQI score was found to affect BDI and VAS, while in the diabetic patient group, the duration of symptoms affected VAS, BDI and fasting glucose levels. CONCLUSION: For diabetic patients, hyperglycemia depression and chronification of neuropathic pain may lead to deterioration of sleep quality. Therefore, consideration of these parameters in the treatment may break a vicious cycle.

Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle / Dor, depressão e distúrbios do sono em pacientes diabéticos e não diabéticos com síndrome do tumor do carpo: um ciclo vicioso

ABSTRACT Carpal tunnel syndrome (CTS) is a condition involving nerve entrapment that often leads to chronic neuropathic pain. We aimed to evaluate sleep quality and related parameters in diabetic and non-diabetic CTS patients. Method This study included a total of 366 patients with chronic CTS. These patients’ sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and depression using the Beck Depression Inventory (BDI). The severity of neuropathic pain was evaluated using the Douleur Neuropathique-4 (DN4) questionnaire and a visual analogue scale (VAS). Results In the non-diabetic patient group, the total PSQI score was found to affect BDI and VAS, while in the diabetic patient group, the duration of symptoms affected VAS, BDI and fasting glucose levels. Conclusion For diabetic patients, hyperglycemia depression and chronification of neuropathic pain may lead to deterioration of sleep quality. Therefore, consideration of these parameters in the treatment may break a vicious cycle.

RESUMO A síndrome do túnel do carpo (STC) é uma condição que envolve compressão do nervo frequentemente determinando dor neuropática crônica. Procuramos avaliar a qualidade do sono e parâmetros correlatos em pacientes diabéticos e não-diabéticos com STC. Método Este estudo incluiu 366 pacientes com STC crônica. A qualidade de sono destes pacientes foi avaliada pelo Pittsburgh Sleep Quality Index (PSQI) e a depressão foi avaliada usando Beck Depression Inventory (BDI). A gravidade da dor neuropática foi avaliada usando o questionário Douleur Neuropathique-4 (DN4) e a escala visual analógica (EVA). Resultados No grupo de pacientes não-diabéticos, o valor total do PSQI afetou BDI e VAS, enquanto no grupo de diabéticos a duração dos sintomas afetou VAS, BDI e níveis de glicemia de jejum. Conclusão Em pacientes diabéticos, depressão e cronificação da dor neuropática podem levar à deterioração da qualidade do sono. Assim, considerar todos estes parâmetros no tratamento pode quebrar este círculo vicioso.

Weight bearing the same day versus non-weight bearing for 4 weeks in Achilles tendon rupture.

INTRODUCTION: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men. Multiple studies discuss the correct treatment strategy based on surgical or nonsurgical intervention, including early mobilization. We aimed to compare the outcomes of bearing weight on the same day with non-weight bearing over a 4-week period of ATR patients. MATERIALS AND METHOD: Forty-seven ATR patients were conservatively treated and entered into our study. Group 1 consisted of 23 patients treated with partial weight bearing beginning the same day of conservative treatment; Group 2 consisted of 24 patients treated with non-weight bearing after a 4-week period. Patients were at least 18 years old and were followed for 12 months. Evaluation criteria were mechanism of injury, admission time to our clinic, complication rate, and time to return to work. Symptoms and physical activity levels of all patients were assessed on 6 and 12 months after treatment began, according to the Achilles Tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS: Rerupture rates were rate 17.4% (4 patients) in Group 1 and 12.5% (3 patients) in Group 2 (p = 0.81). Time to return to work was shorter in Group 1 compared with Group 2, but it was not statistically significant (p = 0.86). AOFAS, ATRS, and PAS scores at 6 and 12 months showed no significant differences between groups (p = 0.69, p = 0.59, p = 0.89, p = 0.77, p = 0.94, p = 0.66, respectively). CONCLUSION: This study showed that a well-conducted early-weight-bearing treatment has good clinical outcomes, with a complication rate no higher than non-weight-bearing treatment.

Exercise Profile and Diastolic Functions Measured via Tissue Doppler Imaging of Fibromyalgia Patients.

BACKGROUND: Our aim was to evaluate electrocardiographic and echocardiographic properties and exercise response of patients with fibromyalgia (FM). METHODS: The study included 60 women with primary FM and 30 healthy individuals. Resting electrocardiography, echocardiography and exercise treadmill test were used to compare these two groups. At apical four-chamber window, samples of transmitral diastolic inflow and tissue Doppler imaging of left ventricle lateral wall were obtained. Left ventricle ejection fraction was measured via modified Simpson's method. Exercise duration, maximal exercise capacity, maximal heart rate (HR) (bpm), maximal HR (%), rate-pressure product at maximal HR (bpm × mmHg), heart rate recovery 1 (bpm), heart rate recovery 2 (bpm) and chronotropic reserve (%) values were calculated. RESULTS: Resting HR and QTc values were similar in both groups. Echocardiographic measurements in both groups did not reveal statistically significant difference except left ventricle end-diastolic diameter and left atrial diameter. Parameters related to diastolic function of the left ventricle did not differ significantly in both groups. Also, there was not any significant difference between the groups for E/E' ratio and chronotropic reserve. Exercise treadmill test results were statistically similar for both groups. CONCLUSION: Patients with FM presented a normal HR response to exercise and those patients had normal diastolic function similar to their healthy controls.

Can mean platelet volume levels of trauma patients predict severity of trauma?

Abstract In this study, we aimed to evaluate the mean platelet voulme (MPV) levels of trauma patients who were admitted to our emergency department. Of the total 232 trauma patients, 40 females and 192 males over the age of 18 years were included in this study. Of them, 102 patients were mild trauma [Glasgow Coma Scale (GCS) 15-13)], 40 patients were moderate (GCS 12-9) and 90 patients were severe trauma (GCS 8-3) patients. We also calculated the Revised Trauma Score (RTS) of the patients. MPV levels were evaluated with GCS and RTS values. The control group was constituted of 100 healthy adults. Mean initial MPV value of GCS 15-13 patients was 8.25 fL, 8.25 fL in GCS 12-9 patients and 8.47 fL, in GCS 8-3 patients. Trauma severity was significantly related with initial MPV (iMPV) levels (p<0.05), initial Hb (iHb) levels (p<0.05), initial white blood count (iWBC) (p<0.05) and initial platelet (iPlt) levels (p<0.05). Severity of trauma was related with control MPV (kMPV) levels (p<0.05), control Hb (kHb) (p<0.05), control WBC (kWBC) (p<0.05), control Plt (kPlt) levels (p<0.05). MPV levels (p<0.05), Hb levels (p<0.05), WBC levels (p<0.05), Plt levels (p<0.05) were significantly different between trauma group and healthy group. IMPV and control kMPV levels were not related (p=0.149). But kHb - iHb levels (p<0.05), kWBC - iWBC levels (p<0.05), kPlt - iPlt levels (p<0.05), kGCS - iiGCS (p<0.05) were related to each other. We found a correlation between iMPV and iWBC levels (p<0.05, r=-0.342). Similarly, there was a correlation between severity of trauma and iMPV level (p<0.05, r=-0.224). We determined a significant correlation between iMPV and iPlt levels (p<0.05, r=-0.246). There was not a correlation between kMPV and kWBC (p>0.05, r=0.124). kMPV and kPlt levels (p<0.05, r=-0.174) were correlated. RTS was statistically related with GCS (p<0.05). Similarly, RTS was related with iMPV (p<0.05), iWBC(p<0.05) and iPlt (p<0.05) values, but there was not a relation with iHb (p>0.05). We found correlations between iMPV- trauma severity (p<0.05, r=-0.224), iMPV - RTS (p<0.05, r=0.134), iMPV - iWBC (p<0.05 r=-0.342), iMPV - iPlt (p<0.05, r=-0.246). Control RTS (seventh day of hospitalization) values were not related to kMPV (p>0.05), kHB (p>0.05), kWBC (p>0.05) and kPlt(p>0.05). There was a correlation between kRTS and kMPV (p<0.05, r=-0.169). Similarly, kMPV - kHb (p<0.05, r=-0.141), kMPV - kPlt (p<0.05, r=-0.174) were correlated. KMPV and kPlt were not correlated (p<0.05, r=0.124). Initial RTS and seventh day RTS values were significantly different (p<0.05). MPV may be helpful for emergency physicians for predicting the severity of trauma.

Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis.

Platelet count, C-reactive protein (CRP) and neutrophile countings are markers those reflect the inflammatory response. Mean platelet volume (MPV) is a simple indicator of platelet size and has been known to be a marker of platelet activity. Some platelet markers, including MPV, have been investigated to have relation with inflammation. MPV is inversely correlated with inflammation in inflammatory bowel diseases, rheumatoid arthritis, and ankylosing spondylitis, as shown in the previous studies. In this study, we aimed to investigate the levels of MPV in patients with synovitis of knee osteoarthritis. 147 patients diagnosed with synovitis associated to osteoarthritis, 191 patients with knee osteoarthritis, and 121 patients between the same age range who did not have joint complaints (control group), totally 459 participants were included to our study. MPV results of these groups were compared. We found a significant difference between the patient group with synovitis associated with osteoarthritis of knee and patients with knee osteoarthritis in MPV blood level (p < 0.0001), similarly a significant difference was found between the patient group with synovitis associated with osteoarthritis of knee and the control group (p < 0.0001). There was no significant difference between the knee osteoarthritis patient group and the control group (p = 0.78). We found a significant relation between MPV and ESR in the patient group with synovitis of osteoarthritis (p = 0.004). According to the Pearson correlation, it is found that there is a negative relationship between CRP and MPV variables in those of knee osteoarthritis patients. This correlation coefficient is statistically significant at the 10% level (p = 0.058). We could not find a relation between CRP and MPV in patients with the osteoarthritis group, but we found negative correlation (p = 0.65). Significant relationship was not found between ESR and MPV variables at the 10% level; the p value is 0.34. In the control group no correlation was found between CRP-MPV (p = 0.69) and ESR-MPV (p = 0.798). MPV levels may be beneficial in osteoarthritis with synovitis patients. MPV levels may be considered as a marker of inflammation but further comprehensive prospective trials are needed in osteoarthritis associated with synovitis patients.

Does bone mineral density have an effect on hearing loss in postmenopausal patients?

OBJECTIVES: An age-related decline in the bone mineral density (BMD) of the temporal bone, specifically in the segments that house the middle and inner ear, has been suggested as an additional risk factor for sensorineural hearing loss. We evaluated the effect of BMD on hearing loss in postmenopausal patients. METHODS: This study involved 120 postmenopausal women who were referred between May 1,2012, and September 1, 2012. The age range was 50 to 55 years (mean, 52.7 +/- 2.3 years). The subjects were divided into three groups according to the results of BMD measurements. Of these, 30 were control subjects with normal BMD values, 45 had osteopenia, and 45 had osteoporosis. Each subject was tested with low- and high-frequency audiometry by a single experienced investigator under standard audiometric testing conditions. For each set of tests, mean values of air and bone conduction at each frequency and tympanometric values were calculated for the osteopenia, osteoporosis, and control groups. RESULTS: All three groups were designed to have similar mean ages and roughly equal durations of menopause and body mass indexes. At low frequencies (0.25, 0.5, 1, and 2 kHz), the differences in the mean air conduction threshold values among the three groups were not statistically significant (p > 0.05). At high frequencies (4, 6, and 8 kHz), the difference in the mean air conduction threshold values between the osteopenia and control groups was not statistically significant (p > 0.05), but that in the osteoporosis group was statistically significantly higher than those in the osteopenia and control groups (p < 0.05). At low frequencies (0.5, 1, and 2 kHz), the differences in the mean bone conduction threshold values among the three groups were not statistically significant (p > 0.05). At 4 kHz, the difference in the mean bone conduction threshold values between the osteopenia and control groups was not statistically significant (p > 0.05), but that in the osteoporosis group was statistically significantly higher than those in the osteopenia and control groups (p < 0.05). There was no statistically significant difference among the three groups in tympanometric values (p > 0.05). CONCLUSIONS: We conclude that patients with low BMD values should routinely be counseled for an audiological assessment to detect any change in hearing thresholds.

A Retrospective Comparison of Conventional versus Transverse Mini-Incision Technique for Carpal Tunnel Release.

Background. In this retrospective study, we aimed to compare the results of two surgical techniques, conventional and transverse mini-incision. Materials and Methods. 95 patients were operated between 2011 and 2012 in Bitlis State Hospital. 50 patients were operated with conventional technique and 45 of them were operated with minimal transverse incision. Postoperative complications, incision site problems, and the time of starting to use their hands in daily activities were noted. Results. 95 patients were included in the study. The mean age was 48. 87 of them were female and 8 were male. There was no problem of incision site in both of the two surgical techniques. Only in one patient, anesthesia developed in minimal incision technique. The time of starting to use their hands in daily activities was 22,2 days and 17 days in conventional and minimal incision technique, respectively. Conclusion. Two surgical techniques did not show superiority to each other in terms of postoperative complications and incision site problems except the time of starting to use their hands in daily activities.