Syndecan 1 may slow the progression of subclinical atherosclerosis in patients with ankylosing spondylitis.

BACKGROUND: Subclinical atherosclerosis may be seen at an early age of ankylosing spondylitis (AS). Syndecan 1 (S1) expression is increased in response to proinflammatory cytokine and inflammation. High S1 may reduce carotid atherosclerosis progression. We aimed to investigate the relationship between S1 levels and subclinical atherosclerosis in patients with AS. METHODS: Fifty-eight patients diagnosed with AS and 58 age-, sex-, and body mass index-matched controls were included in the study. S1 level and carotid intima-media thickness (cIMT) were evaluated using appropriate methods. RESULTS: AS patients' cIMT (0.53 ± 0.1 vs 0.45 ± 0.1 mm, p = .008), S1 (6.0 [1.7-149.2] vs 5.5 [1.0-29.8] ng/ml, p = .020), CRP (C-reactive protein) (2.1 [0.1-19.7] vs 1.1 [0.3-9.6] mg/dl, p = .012), fibrinogen (330.2 ± 87.0 vs 278.0 ± 54.5 mg/dl, p < .001) values were significantly higher than the values of the control group. There was a negative correlation between cIMT and CRP (p = .034), age (p < .001), disease duration (p = .005), BASDAI (p = .048) and fibrinogen (p = .009) in AS patients. There was a negative correlation between cIMT and S1 (p = .029). In multivariate analysis, an independent relationship was found between cIMT and age (ß = 0.611, p < .001) and syndecan (ß = -0.196, p = .046). CONCLUSION: S1 level may rise in AS patients to suppress the inverse effects of proinflammatory cytokines and inflammation. A negative relationship between the cIMT values of AS patients and S1 level may reveal that S1 has a protective effect on the development of atherosclerosis in AS patients, independent of disease activity.

A comparison of the effectiveness of splinting, exercise and electrotherapy in women patients with hallux valgus: A randomized clinical trial.

BACKGROUND: Hallux valgus (HV) is a very common foot deformity involving lateral deviation of the hallux and medial deviation of the first metatarsal head. OBJECTIVES: To investigate the effects of HV night splinting, exercise and electrotherapy on the HV angle, and foot-specific health-related quality of life. METHODS: Sixty women (120 feet) with bilateral HV deformity were randomly assigned to one of three groups - an HV night splint (SP) group, an exercise (EX) group, and a high-voltage galvanic stimulation (HVPGS) (EL) group. The patients in SP group used the HV night splints while resting or sleeping for at least 8 h a day and the patients in the EX group performed exercises 3-4 times a day with 10 repetitions for the duration of the one-month treatment period. Twenty-minute HVPGS was applied in total over three weekly sessions for four weeks in EL group. Angular degrees (hallux interphalangeal angle (HIPA), HV angle (HVA), and intermetatarsal angle (IMA)) were determined before (t0) and three months after treatment (t2). Foot-specific quality of life was assessed using the Manchester-Oxford Foot Questionnaire (MOFQ) at t0, after one month (t1), and at t2. RESULTS: All groups exhibited significant changes in the HIPA, HVA, and IMA angles and outcome measures (p ≤ 0.001). Decreases in the HIPA and IMA angles, and MOFQ-Pain subscale scores, were higher in the SP group than in the other two groups (p < 0.05). IMA angle at t2, MOFQ-Walking score at t1 and t2 and MOFQ-Pain subscale score at t1 were lower in the SP group (p < 0.05). CONCLUSION: The SP group exhibited more positive effects in the parameters measured than the other two groups. A combination of these conservative treatment approaches may be more beneficial to improve HV symptoms with longer follow-up periods. CLINICALTRIALS. GOV IDENTIFIER: NCT04393545.

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Background/aim: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity. Materials and methods: Age and sex-matched patients with AS (n = 80), RA (n = 80), and healthy controls (n = 80) were included in the study. All participants were evaluated with the "Perceived COVID-19 Threat Form (PCTF)", "Suicide-Ideation Scale (SIS)", "Hospital Anxiety and Depression Scale (HADS)", "The Ability to Cope with Trauma (PACT)", and "Psychological General Well-Being Index (PGWB)" scales. BASDAI was used in patients with AS, and DAS28 was used in patients with RA to assess disease severity. Results: Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p = 0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r = 0 .36 for PCTF, r = 0.53 for depressive scores, r = 0.54 for anxiety scores, r = 0.57 for suicidal ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r = ­.26 and r = .33, respectively). Conclusion: Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.

Reliability and validity of the Turkish Version of Arthritis Research UK Musculoskeletal Health Questionnaire.

OBJECTIVES: This study aims to investigate the validity and reliability of the Turkish version of the Musculoskeletal Health Questionnaire (MSK-HQ-T) for assessing the general health status in patients with axial spondyloarthritis (ax-SpA). MATERIALS AND METHODS: One hundred ax-SpA patients (42 males, 58 females; mean age 40.3±9.1 years; range, 18 to 65 years) who were able to speak and understand Turkish language were included in this study. All participants answered MSK-HQ-T, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Short-Form 36 (SF-36). MSK-HQ-T was repeated five-seven days later for test-retest and internal consistency reliability. RESULTS: The Cronbach's alpha value was 0.912, demonstrating high internal consistency. The test-retest score of MSK-HQ-T was 0.968, which was significant. The correlation of MSK-HQ-T with the subgroup scores of SF-36 was statistically significant (p<0.001). The correlation between MSK-HQ-T and the total scores of BASDAI and BASFI was statistically significant (r=-0.788, p<0.001; r=-0.743, p<0.001). CONCLUSION: The MSK-HQ-T is a reliable and valid questionnaire to assess general health status in Turkish patients with ax-SpA.

The profile of upper extremity muscular strength in female wheelchair basketball players: a pilot study.

BACKGROUND: The purpose of this study was to analyze and compare the profile of upper extremity muscle strength in female wheelchair basketball players with that of sex-matched non-disabled controls. METHODS: Nineteen female subjects were enrolled in this study. These were divided into two groups. Group 1 (N.=10) consisted of wheelchair basketball players and Group 2 (N.=9) of non-disabled individuals. Muscular strength in the shoulder was measured using an isokinetic dynamometer. Isometric and isotonic muscular endurance in the shoulder joint was evaluated in terms of the length of time subjects could hold a 5-kg dumbbell at 45° and the number of abduction repetitions to 45° with a 5-kg dumbbell in 30 seconds, respectively. Pinch strength and hand grip strength were measured using a Pinch gauge and hand dynamometer, respectively. RESULTS: Significant differences were observed between the groups in terms of all parameters of muscular strength in the shoulder joint, hand grip and pinch strength. Upper extremity muscular strength in female wheelchair basketball players was greater than in the non-disabled controls. CONCLUSIONS: We concluded that the difference in muscle strength between the groups mostly derived from using wheelchairs due to players' intense training and busy match schedules. Additionally, the profile of upper extremity muscle strength in female wheelchair basketball players in our study can be used as basic data for the introduction of exercise rehabilitation programs and as a guide for future research.