Evaluation of thiol-disulfide homeostasis in active ankylosing spondylitis patients.

INTRODUCTION AND OBJECTIVES: The etiopathogenesis of ankylosing spondylitis (AS), which is a chronic, progressive, inflammatory, systemic disease, has not been fully elucidated yet. Thiol-disulfide homeostasis, a component of antioxidant defense, is thought to play a role in the etiology of inflammatory diseases. We aimed to evaluate the existence of oxidative stress in active AS patients with thiol-disulfide homeostasis. MATERIALS AND METHODS: Patients who were found to have high (n: 27) and very-high (n: 18) activity levels with ASDAS-ESR and 40 healthy controls participated in the study. Serum native-thiol (NT), total-thiol (TT), and disulfide levels were analyzed by an automated colorimetric method. RESULTS: While TT and NT levels were significantly decreased in patients compared to the control group, the disulfide levels were increased. There was a significant negative correlation between ESR, and NT, TT in both groups and also between hsCRP and NT, TT in very-high active AS patients.TT and NT levels were significantly higher in the nonsteroidal anti-inflammatory drug (NSAID) users compared to those using biological agents. CONCLUSIONS: The deterioration of thiol-disulfide homeostasis in favor of disulfide; correlations between ESR, CRP, and NT, TT support the use of thiol-disulfide variables in determining the disease activity level.

Evaluation of Thiol-disulfide Homeostasis in Active Ankylosing Spondylitis Patients.

INTRODUCTION AND OBJECTIVES: The etiopathogenesis of ankylosing spondylitis (AS), which is a chronic, progressive, inflammatory, systemic disease, has not been fully elucidated yet. Thiol-disulfide homeostasis, a component of antioxidant defense, is thought to play a role in the etiology of inflammatory diseases. We aimed to evaluate the existence of oxidative stress in active AS patients with thiol-disulfide homeostasis. MATERIALS AND METHODS: Patients who were found to have high (n: 27) and very-high (n: 18) activity levels with ASDAS-ESR and 40 healthy controls participated in the study. Serum native-thiol (NT), total-thiol (TT), and disulfide levels were analyzed by an automated colorimetric method. RESULTS: While TT and NT levels were significantly decreased in patients compared to the control group, the disulfide levels were increased. There was a significant negative correlation between ESR, and NT, TT in both groups and also between hsCRP and NT, TT in very-high active AS patients.TT and NT levels were significantly higher in the nonsteroidal anti-inflammatory drug (NSAID) users compared to those using biological agents. CONCLUSIONS: The deterioration of thiol-disulfide homeostasis in favor of disulfide; correlations between ESR, CRP, and NT, TT support the use of thiol-disulfide variables in determining the disease activity level.

The Impact of Fibromyalgia on Disability, Anxiety, Depression, Sleep Disturbance, and Quality of Life in Patients with Migraine.

INTRODUCTION: The aim of the present study was to assess the impact of fibromyalgia (FM) comorbidity on disability, anxiety, depression, sleep disturbance, and quality of life in patients with migraine. METHODS: Eighty-six consecutive migraine patients (age, 35.4±10.3 years; 69 women and 17 men) were enrolled in the study. The headache characteristics of the patients were recorded. FM was diagnosed based on the 1990 American College of Rheumatology classification criteria for the diagnosis of FM. All patients were asked to complete selfreport questionnaires, including the Fibromyalgia Impact Questionnaire (FIQ), Headache Impact Test (HIT-6), Migraine Disability Assessment Questionnaire (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the 36- Item Short Form Survey (SF-36) to assess their pain-related disability, migraine-related disability, depression, anxiety, sleep disturbance, and quality of life. RESULTS: Of the migraine patients, 28 (32.6%) met the criteria for FM. Migraine patients with FM showed significantly increased migraine frequency and BDI, BAI, and PSQI scores and decreased quality of life scores for all eight domains of the SF-36 compared to patients with migraine alone, whereas the mean HIT-6 and MIDAS values did not differ between the groups. FIQ score showed statistically significant positive correlations with BDI, BAI, PSQI, and MIDAS scores and with headache frequency (p<0.001, r=0.657; p<0.001, r=0.730; p<0.001, r=0.754; p=0.005, r=0.300; p=0.008, r=0.286, respectively); FIQ score showed negative correlations with scores for all domains of the SF-36. In multivariate linear regression analysis, BDI, BAI, and PSQI scores independently predicted FIQ score. CONCLUSION: Our study results demonstrate the significant impact of FM comorbidity on anxiety, depression, sleep disturbance, and quality of life in this population. FM evaluation and treatment should be considered in the routine care of patients with migraine to globally improve the patient's quality of life.

The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women.

Vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. We found that 25-hydroxyvitamin D levels and bone mineral density were lower in patients with prior cholecystectomy. PURPOSE: The influence of bile salts on vitamin D absorption is well-known, and increased incidence of vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. Herein, we aimed to investigate the effects of cholecystectomy on vitamin D levels and osteoporosis in postmenopausal women. METHODS: The study group comprised 50 postmenopausal women who had previously undergone cholecystectomy; the control group comprised 50 age-matched postmenopausal women. Serum vitamin D, calcium, and phosphorus levels were determined. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry. RESULTS: The study group had significantly higher parathyroid hormone levels (94.4 ± 45.1 vs. 69.2 ± 37.5, p < 0.001) but significantly lower 25-hydroxyvitamin D levels (16.3 ± 7.6 vs. 19.8 ± 8.7, p = 0.03). Compared with the control group, the BMDs of both the lumbar spine (- 1.5 ± 1.0 vs. - 0.9 ± 1.0, p = 0.004) and femur (- 0.5 ± 0.8 vs. 0.19 ± 1.1, p = 0.001) were significantly lower in the study group. Body mass index [B = 0.81 (CI 0.67-0.98), p = 0.03] and prior cholecystectomy [B = 7.9 (CI 1.0-71.7), p = 0.04] were independent predictors of osteoporosis. CONCLUSION: In postmenopausal women, prior cholecystectomy is associated with lower serum 25-hydroxyvitamin D levels and BMD.

Ultrasonographic evaluation of the femoral cartilage thickness in patients with hypothyroidism.

[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.

The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome.

[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.

Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis.

[Purpose] This study aimed to determine and compare the effectiveness of extracorporeal shock wave therapy and local corticosteroid injection in patients with lateral epicondylitis. [Subjects and Methods] Sixty-four patients with lateral epicondylitis were randomly divided into extracorporeal shock wave therapy and steroid injection groups. Patients were evaluated using hand grip strength, visual analog scale, and short-form McGill pain questionnaire at baseline and at 4 and 12 weeks post-treatment. [Results] Both groups showed statistically significant increase in hand grip strength and decreases on the visual analog scale and short form McGill pain questionnaire overtime. There was no statistically significant difference in the percentage of improvement in hand grip strength and on the short-form McGill pain questionnaire between groups at 4 weeks post-treatment, whereas the extracorporeal shock wave therapy group showed better results on the visual analog scale. The percentages of improvements in all 3 parameters were higher in the extracorporeal shock wave therapy group than in the injection group at 12 weeks post-treatment. [Conclusion] Both the extracorporeal shock wave therapy and steroid injection were safe and effective in the treatment of lateral epicondylitis. However, extracorporeal shock wave therapy demonstrated better outcomes than steroid injection at the long-term follow-up.