Effects of acute aerobic exercise on brain-derived neurotrophic factor level in rheumatoid arthritis patients.

Objectives: The study aimed to investigate the variation of brain-derived neurotrophic factor (BDNF) levels following acute exercise in patients with rheumatoid arthritis (RA). Patients and methods: This cross-sectional study was conducted with 88 participants (25 males, 63 females; mean age: 45.1±8.3 years; range, 18 to 65 years) between July 2020 and May 2021. Of the participants, 44 were RA patients, and 44 were age-and sex-matched healthy controls. Aerobic exercise was utilized in all participants for a single session. Depression and anxiety levels were evaluated with the Beck Depression Inventory and Hospital Anxiety and Depression Scale. Blood samples were collected from all subjects before and immediately after the intervention. Results: Serum BDNF levels (both baseline and after exercise) were similar in the RA and control groups. Although serum BDNF levels significantly decreased in both groups after aerobic exercise (Wilcoxon rank p<0.05), ΔBDNF levels were significantly higher in the RA group than in the control group (p=0.047). Additionally, ΔBDNF levels were significantly correlated with the Hospital Anxiety and Depression Scale scores in the RA group (p<0.05) but not in the control group. Conclusion: A single bout of exercise may effectively decrease serum BDNF levels in patients with RA and healthy subjects. The long-term effect of exercise on BDNF levels should be investigated in prospective studies.

The effect of complex decongestive therapy on spatio-temporal parameters and balance in women with breast cancer-related upper extremity unilateral lymphedema.

BACKGROUND: The aim of this study was to investigate the effect of complex decongestive therapy on spatio-temporal parameters and balance in individuals with breast cancer-related upper extremity unilateral lymphedema. METHODS: The study was designed as a prospective, cross-sectional study. Thirty sessions of complex decongestive therapy were applied. Participants' pre-and post-treatment spatio-temporal parameters and balance parameters were evaluated with the Win Track platform. In addition, the Timed Up and Go test was used to evaluate the dynamic balance. Plethysmography, a water displacement method, was used to measure upper extremity volume. FINDINGS: Significant improvement was observed in limb volume asymmetry after complex decongestive therapy. While the stride length of the affected side was 409.93 mm before the treatment, it increased to 500.93 mm after the treatment, and a significant increase was observed (p = 001). Significant improvements were found in the other spatio-temporal parameters of the participants. Compared to the pre-treatment, a significant decrease was detected in the average cadence value, Timed Up and Go value, double stance time, and maximum plantar pressure point of the participants. Significant improvements were found in the participants' balance. INTERPRETATION: Complex decongestive therapy applied to individuals with unilateral upper extremity lymphedema provides significant improvement in both spatio-temporal and balance parameters. However, we recommend complex decongestive therapy as an effective and safe treatment to reduce the volume of lymphedema. Patients with unilateral lymphedema that may cause postural asymmetry should be informed about balance and gait disturbance and should be encouraged to receive lymphedema treatment as soon as possible.

Effects of acute aerobic exercise on cytokines, klotho, irisin, and vascular endothelial growth factor responses in rheumatoid arthritis patients.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes cartilage and bone damage as well as disability.  AIMS : The aim of this study was to examine the effects of acute aerobic exercise on cytokines such as serum interleukin-6 (IL-6), interleukin-1ß (IL-1ß), Tumor Necrosis Factor-α (TNF-α) and irisin, vascular endothelial growth factor(VEGF) and klotho in RA patients.  METHODS: Forty RA patient and 40 healthy volunteers of the same age participated in this study. All participants walked on the treadmill for 30 minutes at 60-80% of maximal heart rate. Blood samples were taken before and immediately after the exercise. Serum levels of IL-6, IL1ß, TNF-α and irisin, VEGF and klotho were measured by enzyme-linked immunosorbent analysis.  RESULTS: Baseline levels of inflammatory cytokines, irisin, VEGF and klotho were found to be higher in RA patients compared to the control group. In both groups, there was an increase in serum klotho levels after exercise compared to baseline (p<0.05), while a decrease in IL1ß, TNF-α levels were observed. While serum VEGF level decreased in RA group, it increased in the control group(p<0.05). Irisin levels decreased in both groups. IL-6 level did not change in the control group, while it increased in RA group. A single exercise session had an acute anti-inflammatory effect in RA patients. CONCLUSION: It can be concluded that acute aerobic exercise can be beneficial for patients with RA through cytokine, irisin, klotho and VEGF levels, and also it can be safely implemented to the RA rehabilitation program for additional anti-inflammatory effects. Trial registration ClinicalTrials.gov: NCT04439682.

Evaluation of major coronary artery Bifurcation angles with digital angiography: A detailed study of prevalence in the Upper Euphrates Basin.

Objectives: To investigate the diversity and average values of bifurcation angles in a large population to help develop new methods. Methods: One thousand five individuals (504 females, 501 male) who visited the Cardiology Polyclinic of Firat University Hospital with the complaint of chest pain between 2010 and 2015 were evaluated retrospectively. Bifurcation angle measurements between LMCA-CX, CX-LAD, LMCA-LAD, CX-OM1, CX-OM2, LAD-D1, LAD-D2, RCA-RMD, RCA-RVD and PDA-PL were evaluated in all cases. Results: Bifurcation angles between LMCA-LAD, LMCA-Cx and LAD-Cx branches with "> 90 wide angle bifurcations", and Cx-OM1, Cx-OM2, LAD-D1, LAD-D2, RCA-RMD and PDA-PL with "<70 Y type bifurcation angle" were found to be high in male and female individuals. The RCA-RVD in female individuals was "<70 Y-type bifurcation" in 14 (2.8%) people, "> 70-90 T-type bifurcation" in 209 (41.5%) people, and "> 90 wide angle bifurcation" in 281 (55.8%) people. Results for male subjects were compatible with this. The correlations of all angles were examined. Robust positive correlations (p≤0.001) were found for the angular measurements between the main branches and the side branches (Cx-OM1, Cx-OM2, LAD-D1, LAD-D2 and RCA-RMD, PDA-PL). Conclusion: With the help of developing technology, we believe that all this coronary angiography data will guide bifurcation stent techniques, which are essential alternatives to bypass.

Aerobic exercise increases irisin serum levels and improves depression and fatigue in patients with relapsing remitting multiple sclerosis: A randomized controlled trial.

BACKGROUND: Multiple sclerosis (MS) is a chronic progressive neurodegenerative disease of the central nervous system. Although there is increasing evidence that aerobic exercise has a positive effect on both cognitive and psychological functioning, there is limited evidence for Relapsing-Remitting MS (RRMS) patients. Moreover, it is unclear at what exercise modality and intensity the irisin, the cleaved and circulating form of the exercise-associated membrane protein Fibronectin Type III Domain Containing 5, is induced in patients with MS. This study aimed to investigate the effect of a regular aerobic exercise program on irisin serum level, depression, fatigue, and cognitive performance in patients with MS. METHODS: Thirty-two individuals with RRMS were randomized into 2 groups as control and study groups (mean EDSS score 1.69 and 1.97, respectively). While the Study Group received a combined exercise training consisting of three sessions of aerobic exercise and Frenkel Coordination Exercises per week for 6 weeks, the Control Group received only Frenkel Coordination Exercise training. Before and after the study, the cognitive performance of the participants were evaluated with the Paced Auditory Serial Addition Test with 3-second stimulus (PASAT-3), their maximum aerobic capacity with the Fitmate Pro® (VO2max), their fatigue status with the Fatigue Impact Scale (FIS), and their depression status with the Beck Depression Inventory (BDI). Irisin serum levels were analyzed with Enzyme-Linked ImmunoSorbent Assay (ELISA) test from the serum samples of individuals. RESULTS: Our results revealed that the irisin serum level significantly increased in the Study Group. Significant improvement in aerobic capacity, PASAT-3, FIS, and BDI values was observed in the Study Group compared to the Control Group. When the ΔIrisin, ΔVO2max, ΔFIS, and ΔBDI values between the groups were compared, a significant difference was found in favor of the study group. CONCLUSION: The aerobic exercise revealed significant changes in depression, fatigue and irisin serum levels in MS patients. We think that this study, in which a significant increase in irisin serum level, significant improvement in depression, cognitive performance and fatigue states were obtained in the Study Group, will be a pioneering study for the future studies aiming to investigate the effects of irisin serum level on these symptoms in detail.

How does kinesiophobia affect short- and long-term gait parameters in individuals with total knee arthroplasty surgery?

Delays in weight transfer due to various fears after Total knee arthroplasty (TKA) surgery negatively affect recovery. Therefore, the presence of kinesiophobia is essential for the success of the treatment. This study was planned to investigate the effects of kinesiophobia on Spatio-temporal parameters in patients who underwent unilateral TKA surgery. This study was a prospective and cross-sectional study. Seventy patients with TKA were assessed preoperatively in the 1st week (Pre1W) and post- operatively in the 3rd month (Post3M) and 12th month (Post12M). Spatiotemporal parameters were assessed using the Win-Track platform (Medicapteurs Technology, France). The Tampa kinesiophobia scale and Lequesne index were evaluated in all individuals. A significant relationship was found between the Pre1W, Post3M, and Post12M periods and Lequesne Index scores (p<0.01), and this relationship was in favor of improvement. In the Post3M period, kinesiophobia increased compared to the Pre1W period, and kinesiophobia decreased effectively in the Post12M period (p<0.01). The effect of kine-siophobia was evident in the first postoperative period. In the correlation analyses between spatiotemporal para- meters and kinesiophobia, significant negative correlations were observed (p<0.01) in the early postoperative period (Post3M). Evaluating the effectiveness of kinesiophobia on Spatio-temporal parameters at different time intervals before and after TKA surgery may be necessary for the treatment process.

Spatiotemporal parameters of the operated and non-operated knees before and after unilateral total knee arthroplasty.

BACKGROUND: Knee osteoarthritis is a common condition in various orthopedic clinics and hospitals. The aim of this study was to investigate the effects of unilateral total knee arthroplasty (TKA) application on short and long-term spatiotemporal gait parameters, maximum plantar pressure (MPP), and functional status in patients with knee osteoarthritis. RESEARCH QUESTION: What is the change process in spatiotemporal parameters without any intervention before and after TKA surgery? METHODS: This study is a prospective and cross-sectional study. Participants were assessed preoperatively at the 1st week (Pre1W), postoperative 1st month (Post1M) and 6th month (Post6M). Spatiotemporal parameters and MMP were assessed using the Win Track platform (Medicapteurs Technology, France) and functional states were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Lequesne Index. RESULTS: Significant improvements were found in the WOMAC and Lequesne Index values in the Post1M and Post6M periods compared to the preoperative period. However, the improvement in WOMAC and Lequesne Index scores in the Post6M period was significant compared to the scores in the Post1M period (p < 0.01). Spatiotemporal parameters deteriorated in the Post1M period, while improvements were observed in the Post6M period. We observed that patients had worse gait parameters in the near postoperative period than before surgery. It was the period with the greatest improvements in long-term outcomes. SIGNIFICANCE: In the light of our study results, we think that early gait disturbances in patients who underwent direct TKA may be caused by physiological processes. Therefore, we believe that there is no need for any intervention for gait disorders that occur in the early postoperative period.

The Evaluation of Radiologic Angular Measurements in Patients with Foot Pain.

BACKGROUND: The aim of this study was to investigate the relationship between foot deformities by comparing foot radiographs of patients with complaints of foot pain with those of healthy individuals. METHODS: The study included 30 patients with pes cavus, 30 patients with pes planus, 30 patients with calcaneal spur, and 30 controls aged 30 to 60 years. All participants underwent measurement of right and left foot length; metatarsophalangeal width; and calcaneal pitch (CA), talohorizontal (TA), talometatarsal (TM), and lateral talocalcaneal (LTC) angles from lateral radiographs. RESULTS: There were no statistically significant differences between all participants regarding sex, age, weight, and body mass index (P > .05). Among patients with clinically diagnosed pes cavus, the diagnostic rate of CA was 100% in both feet, and 83.3% in the right foot and 96.7% in the left foot according to the TM angle. The diagnostic rates of angular measurements in patients with pes planus were as follows: 20% in the right foot and 30% in the left foot depending on the CA angle, 100% in both feet depending on the TM angle, and 66.7% in the right foot and 46.7% in the left foot depending on the LTC angle. A very strong positive correlation was found between the CA and LTC angles in patients with calcaneal spur and pes planus (P < .001); also, statistically significant positive correlation was found between the CA and TA angles (P < .05). The angular measurements in patients with calcaneal spur were found to be consistent with pes planus with a high rate. CONCLUSIONS: Angular changes caused by deterioration of foot biomechanics lead to various deformities. Pes planus ranks first among these. Therefore, we believe that radiographic angular measurements in patients presenting with foot pain in addition to clinical evaluation would be useful in considering associated deformities and planning treatments.

The effect of additional neuromuscular electrical stimulation applied to erector spinae muscles on functional capacity, balance and mobility in post-stroke patients.

OBJECTIVE: The aim of this study was to investigate the effects of neuromuscular electric stimulation applied to the erector spinae on balance, motor function and functional capacity in patients with stroke in a randomized controlled trial. METHODS: Sixty patients with stroke were recruited and randomly distributed into two groups: control group and neuromuscular electric stimulation group. All participants underwent conventional physical therapy five times a week for six weeks. The neuromuscular electric stimulation group received additional electrical stimulation. Outcome measures were evaluated with Brunnel Balance Assessment, Stroke Rehabilitation Movement Assessment, Functional Ambulation Classification, Adapted Patient Evaluation and Conference System, Postural Assesment Scale for Stroke patients, Short Form-36, and Minimental State Examination scales. RESULTS: Significant differences were observed in all scores at the end of the study in both groups. Postural Assesment Scale for Stroke patients and Stroke Rehabilitation Movement Assessment scores were higher in the neuromuscular electric stimulation group compared to the control group (p < 0.05). All the other scores were not statistically significant. CONCLUSION: It is recommended to evaluate and treat trunk muscle, which is usually neglected in treatment, and to consider the combination of conventional treatment and neuromuscular electric stimulation when designing an ideal rehabilitation program.

Resveratrol inhibits Src tyrosine kinase, STAT3, and Wnt signaling pathway in collagen induced arthritis model.

Resveratrol, a phytochemical, acts several cellular signaling pathways and has anti-inflammatory potentials. The purpose of this study is to research the therapeutic effect of resveratrol in collagen-induced arthritis (CIA) model in rats and whether resveratrol affects the activities of signaling pathways those are potent pathogenic actors of rheumatoid arthritis. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant in Wistar albino rats. One day after the onset of arthritis (day 14), resveratrol (20 mg/kg/day) was given via oral gavage, until day 29. The paws of the rats were obtained for further analysis. Tissue Wnt5a, mitogen-activated protein kinase (MAPK), Src tyrosine kinase and signal transducer, and activator of transcription-3 (STAT3) mRNA expressions were determined by real-time polymerase chain reaction. Resveratrol ameliorated the clinical and histopathological (perisynovial inflammation and cartilage-bone destruction) findings of inflammatory arthritis. The tissue mRNA expressions of Wnt5a, MAPK3, Src kinase, and STAT3 were increased in the sham group compared to the control group. Resveratrol supplement decreased their expressions. The present study shows that Src kinase, STAT3, and Wnt signaling pathway are active in the CIA model. Resveratrol inhibits these signaling pathways and ameliorates inflammatory arthritis. © 2018 BioFactors, 45(1):69-74, 2019.

Systemic melatonin application increases bone formation in mandibular distraction osteogenesis.

This study aimed to investigate the effects of different doses of systemic melatonin application on new bone formation during mandibular distraction osteogenesis (DO) in rats. Mandibular DO was performed on 30 adult female Sprague-Dawley rats, which were randomly divided into three groups: control group (CNT), melatonin dose 1 (MLT-D1), and melatonin dose 2 (MLT-D2). A five-day latent waiting period and a ten-day distraction phase followed the surgery. After the surgery, rats from the MLT-D1 and MLT-D2 groups received 25 and 50 mg/kg melatonin, respectively, at 7, 14, 21, 28, and 35 days. The animals were euthanised 28 days after distraction, i.e. at 43 days after surgery. Histological and histomorphometric analyses revealed that the distracted bone area was completely filled with new bone formation in all three groups. The MLT-D2 group exhibited the most new bone formation, followed by MLT-D1 and CNT. The melatonin groups had more osteoclasts than the CNT (p < 0.05). The number of osteoblasts was higher in the melatonin groups than in the CNT group, and the MLT-D2 had more osteoclasts than the MLT-D1 group (p < 0.05). Finally, the osteopontin (OPN) and vascular endothelial growth factor (VEGF) levels were higher in the melatonin groups than in the CNT group, and the MLT-D2 had higher OPN and VEGF levels than the MLT-D1 (p < 0.05). This study suggests that systemic melatonin application could increase new bone formation in DO.

Systemic melatonin application increases bone formation in mandibular distraction osteogenesis

Abstract This study aimed to investigate the effects of different doses of systemic melatonin application on new bone formation during mandibular distraction osteogenesis (DO) in rats. Mandibular DO was performed on 30 adult female Sprague-Dawley rats, which were randomly divided into three groups: control group (CNT), melatonin dose 1 (MLT-D1), and melatonin dose 2 (MLT-D2). A five-day latent waiting period and a ten-day distraction phase followed the surgery. After the surgery, rats from the MLT-D1 and MLT-D2 groups received 25 and 50 mg/kg melatonin, respectively, at 7, 14, 21, 28, and 35 days. The animals were euthanised 28 days after distraction, i.e. at 43 days after surgery. Histological and histomorphometric analyses revealed that the distracted bone area was completely filled with new bone formation in all three groups. The MLT-D2 group exhibited the most new bone formation, followed by MLT-D1 and CNT. The melatonin groups had more osteoclasts than the CNT (p < 0.05). The number of osteoblasts was higher in the melatonin groups than in the CNT group, and the MLT-D2 had more osteoclasts than the MLT-D1 group (p < 0.05). Finally, the osteopontin (OPN) and vascular endothelial growth factor (VEGF) levels were higher in the melatonin groups than in the CNT group, and the MLT-D2 had higher OPN and VEGF levels than the MLT-D1 (p < 0.05). This study suggests that systemic melatonin application could increase new bone formation in DO.

[The relationship between the duration of drug use and the bipolar disorder patients' sociodemographic and clinical characteristics]. / Bipolar bozukluk hastalarinin ilaç kullanim sürelerinin sosyodemografik ve hastalik özellikleri ile iliskisi.

OBJECTIVE: The purpose of this study was to determine the duration of psychotropic drug use in the long-term follow-up of bipolar disorder (BD) patients. In addition, this study aimed to investigate their role in the daily clinical practice in association with patient sociodemographic and clinical characteristics. The overarching goal for this study was to produce results that enlighten the development of new treatment strategies. METHOD: Follow-up data acquired from the Psychiatry Department of Uludag University Faculty of Medicine was used to retrospectively evaluate 151 patients diagnosed with BD. Socio-demographic data of the patients and information regarding the disease and the drugs used were analyzed. RESULTS: Of the patients studied, 57.0% were female with a mean age of 41.5±12.8. The mean duration of follow-up was 1985.3±1933 [median 1291 (15-9135)] days; euthymic period accounted for 86.0% of this duration. Interestingly, incompliance with the treatment triggered the switch to mania and ineffective treatment triggered the switch to depression. Medication distribution was as follows: 95.4% of the patients received antipsychotic and mood stabilizer treatments, 3.3% received only mood stabilizer treatment, and 1.30% received only antipsychotic treatment. The major findings of this study was that many sociodemographic as well as clinical manifestations including, early onset (aged ≤18 years), unmarried, first episode of mania, those with disease not showing seasonal features, psychotic symptoms, history of hospitalization, and higher number of manic or hypomanic episodes resulted in increased patient prescribed antipsychotic drugs CONCLUSION: Our data suggests that antipsychotic drugs are being used more frequently and for longer durations in the treatment of BD.