Acute brucella melitensis M16 infection model in mice treated with tumor necrosis factor-alpha inhibitors

Introduction: There is limited data in the literature about brucellosis related to an intracellular pathogen and anti-tumor necrosis factor alpha (anti-TNFα) medication. The aim of this study was to evaluate acute Brucella infections in mice receiving anti-TNFα drug treatment. Methodology: Anti-TNFα drugs were injected in mice on the first and fifth days of the study, after which the mice were infected with B. melitensis M16 strain. Mice were sacrificed on the fourteenth day after infection. Bacterial loads in the liver and spleen were defined, and histopathological changes were evaluated. Results: Neither the liver nor the spleen showed an increased bacterial load in all anti-TNFα drug groups when compared to a non-treated, infected group. The most significant histopathological findings were neutrophil infiltrations in the red pulp of the spleen and apoptotic cells with hepatocellular pleomorphism in the liver. There was no significant difference among the groups in terms of previously reported histopathological findings, such as extramedullary hematopoiesis and granuloma formation. Conclusions: There were no differences in hepatic and splenic bacterial load and granuloma formation, which indicate worsening of the acute Brucella infection in mice; in other words, anti-TNFα treatment did not exacerbate the acute Brucella spp. infection in mice. © 2015 Kutlu et al

Factors affecting pain and fatigue in females with chronic widespread pain

Purpose: This study was conducted to investigate factors related to pain intensity and global fatigue in females with Chronic Widespread Pain (CWP). Material and methods: One hundred four patients with CWP were included. The mean age was 40.28±10.82 years. Both Pain intensity and global fatigue were assessed using a Visual Analogue Scale (VAS). The Hospital Anxiety and Depression Scale was used to describe anxiety and depression symptoms. Three different questionnaires (leisure time activity, and physical activity at home, at work) were used to determine physical activity levels. Dorsal regression was used to analyze the data. Results: The anxiety score was the most common factor affecting pain intensity (p=0.003). On the other hand, a moderate level of physical activity at home (p=0.027), physical activity level at work (p=0.008), and the anxiety score (p=0.027) were significant factors affecting global fatigue. Conclusion: Our results show that anxiety is the most important factor affecting both pain and global fatigue in women with CWP. These results also support the idea that the characteristics of pain, fatigue and anxiety should be evaluated separately

Wegener granulomatosis accompanying rheumatoid arthritis: A case report

Rheumatoid arthritis (RA) is a chronic, progressive, inflammatory disease that can lead to systemic involvement especially related to significant joint pain and disability. Tumour necrosis factor (TNF) has a pivotal role in its pathogenesis. TNF also has effects on the formation of granuloma and the defensive mechanisms against the intracellular injuries. While a case with RA has been evaluated before the TNF alpha antagonist treatment, the presence of respiratory symptoms and bilateral cavitary lung lesions led to further investigations and was diagnosed as accompanying Wegener granulomatosis. The effect of that coincidence on treatment decision was aimed at discussing a case report as being a rare condition

Comparison of emotional status and physical activity between women with chronic widespread pain and fibromyalgia

PubMed ID: 20582747Objectives! This study was conducted to compare the emotional status and physical activity level in women with chronic widespread pain (CWP) and fibromyalgia (FM). Methods: Thirty-three women with CWP above the waist, including the upper extremities, and 68 women with FM were evaluated. To determine physical and emotional status, the Fibromyalgia Impact Questionnaire (FIQ), the Experience of Physical Activity Instrument, the Leisure Time Physical Activity Instrument, the Physical Activity at Home and Work Instrument, and the Hospital Anxiety and Depression Scale (HADS) were used. Results: The CWP group had higher physical impairment scores than the FM group (p0.05). The results indicate that increased pain intensity and spread of pain have negative effects on both physical functioning and emotional status. Conclusion: The women with FM reported much more severe clinical symptoms than those with CWP. Therefore, in addition to physical functioning, the emotional status of women with chronic pain should also be evaluated

Impact of rheumatoid arthritis in Turkey: A questionnaire study

PubMedID: 24960289Objective: Unmet needs of rheumatoid arthritis (RA) patients regarding physician/patient communication, treatment preferences and quality of life issues were investigated in a Turkish survey study. Methods: The study was conducted with the contribution of 33 rheumatologists, and included 519 RA patients. The study population included patients who had been on biologic therapy for >6 months and were still receiving biologic therapy (BT group), and those who were biologic naive, but found eligible for biologic treatment (NBT group). Of the RA patients, 35.5% initially had a visit to an internal disease specialist, 25.5% to a physical therapy and rehabilitation specialist, and 12.2% to a rheumatology specialist for their RA complaints. The diagnosis of RA was made by a rheumatologist in 48.2% of patients. Results: The majority of RA patients (86.3%) visit their doctor within 15-week intervals. Most of the physician-patient communication focused on disease symptoms (99.0%) and impact of the disease on quality of life (61.8%). The proportion of RA patients who perceived their health status as good/very good/excellent was higher in the BT group than in the NBT group (74.3% vs. 51.5%, p<0.001). However, of those RA patients in the NBT group, only 24.8% have been recommended to start a biologic treatment by their doctors. With respect to dose frequency options, once-monthly injections were preferred (80%) to a bi-weekly injection schedule (8%). Conclusion: In conclusion, RA patients receiving biologic therapy reported higher rates of improved symptoms and better quality of life and seemed to be more satisfied with their treatment in our study. © Clinical and Experimental Rheumatology 2014

Risk of cancer in Turkish patients after treatment with TNF antagonists

PubMedID: 18296720[No abstract available

Factors affecting pain and fatigue in females with chronic widespread pain

Purpose: This study was conducted to investigate factors related to pain intensity and global fatigue in females with Chronic Widespread Pain (CWP). Material and methods: One hundred four patients with CWP were included. The mean age was 40.28±10.82 years. Both Pain intensity and global fatigue were assessed using a Visual Analogue Scale (VAS). The Hospital Anxiety and Depression Scale was used to describe anxiety and depression symptoms. Three different questionnaires (leisure time activity, and physical activity at home, at work) were used to determine physical activity levels. Dorsal regression was used to analyze the data. Results: The anxiety score was the most common factor affecting pain intensity (p=0.003). On the other hand, a moderate level of physical activity at home (p=0.027), physical activity level at work (p=0.008), and the anxiety score (p=0.027) were significant factors affecting global fatigue. Conclusion: Our results show that anxiety is the most important factor affecting both pain and global fatigue in women with CWP. These results also support the idea that the characteristics of pain, fatigue and anxiety should be evaluated separately

Reliability and Validity of the Turkish Version of the ABILHAND Questionnaire in Rheumatoid Arthritis Individuals, Based on Rasch Analysis.

OBJECTIVES: This study aims to assess the reliability and validity of the Turkish version of the ABILHAND questionnaire in individuals with rheumatoid arthritis (RA) [ABILHAND-RA (TR)] using the Rasch analysis. MATERIALS AND METHODS: A total 90 individuals (15 males, 75 females; mean age 51.8±10.9 years; range, 20 to 65 years) diagnosed as RA according to the criteria of the American College of Rheumatology were included. The ABILHAND-RA (TR) was used to determine manual ability, while disease activity was evaluated by the use of Disease Activity Score 28 (DAS28). Jamar hand dynamometer and pinch-meter were used to examine grip and pinch strength of the participants. Nine Hole Peg Test (NHPT) and Duruoz Hand Index (DHI) measured hand disability level. Nottingham Health Profile (NHP) was used to assess quality of life. ABILHAND-RA (TR) results were analyzed using the Rasch analysis method. RESULTS: Item 20 was excluded from the 27-item ABILHAND-RA (TR) as 96% of the individuals rated this item as "easy". The new set of 18 items (7 subtests and 11 items) were found to sustain item invariance and fit to the Rasch model. Significant relationships were found between ABILHAND-RA (TR) and DAS28, bilateral grip strength, NHPT dominant side results, DHI, and NHP. CONCLUSION: Turkish version of the ABILHAND-RA was found to be clinically valid, reliable, and sensitive enough to be used in clinical evaluations, rehabilitation interventions, and for progression follow-up in individuals with RA

Central nervous system infections and diagnostic brain biopsy: Two case reports

Cerebral biopsy is an invasive technique with limited, specific indications in view of the potential risk of complications. Brain biopsy, aside from the direct sampling of a suspected neoplasm, is often diagnostic in cases of granulomatous angiitis, some forms of encephalitis, subacute spongioform encephalopathy, and a number of other rare diseases. Two cases who had a central nervous system infection and had undergone diagnostic brain biopsy in our clinic will be discussed by reviewing the literature. Copyright © 2005 by Türkiye Klinikleri

Development of reversible posterior leukoencephalopathy syndrome after cyclophosphamide treatment in a patient with lupus nephritis

Renal involvement in systemic lupus erythematosus is a frequent and serious complication that significantly increases morbidity and mortality. Despite all studies and usage of new drugs, treatment of lupus nephritis continues to be a problem. Diffuse proliferative lupus nephritis has a poor prognosis and aggressive treatment must be undertaken. Cyclophosphamide is commonly used in treatment despite its side effects. Reversible posterior leucoencephalopathy syndrome is a clinico-radiological syndrome manifested by blood pressure elevation, headache, visual disturbances, confusion, seizures and sometimes focal neurological signs that can develop due to usage of cytotoxic drugs. We present a case of lupus nephritis in which reversible posterior leucoencephalopathy syndrome developed after intravenous cyclophosphamide administration and recovered spontaneously by symptomatic treatment in this article