The effect of low back pain on health care workers' functional and mental status

Bu çalışmanın amacı; sağlık çalışanlarında bel ağrısının fonksiyonel ve ruhsal durum üzerine etkisini incelemek ve bel ağrısı şikayetine sahip sağlık çalışanlarında bel ağrısı şiddeti ile ilişkili olabilecek faktörleri araştırmaktı. Çalışmaya 73 katılımcı dahil edildi. Katılımcıların sosyodemografik bilgileri araştırmacı tarafından daha önceden hazırlanan forma kaydedildi. Katılımcıların ağrı şiddeti Görsel Analog Skalası ile değerlendirildi ve ağrı lokalizasyonu için vücut diagramı kullanıldı. Katılımcıların fonksiyonel durumu Omurga Fonksiyonları İndeksi, özürlülük durumu Roland Morris Özürlülük Anketi, fiziksel aktivite düzeyi Fiziksel Aktivite Değerlendirme Anketi, ruhsal durumu Hastane Anksiyete ve Depresyon Anketi ile değerlendirildi. Sağlık çalışanları bel ağrısı olan (çalışma grubu; 31 kadın, 6 erkek; n=37) ve olmayan (kontrol grubu; 23 kadın, 13 erkek; n=36) olmak üzere iki grupta incelendi. Çalışma grubunu oluşturan bireylerin Görsel Analog Skalasına göre ortalama bel ağrısı şiddeti 5,18±1,35 cm olarak bulundu. Çalışma ve kontrol grubu sosyodemografik özellikleri açısından karşılaştırıldığında bel ağrılı sağlık çalışanlarının çalışma yıllarının kontrol grubuna göre daha uzun olduğu belirlendi (p0,05). Bel ağrısı olan sağlık çalışanlarında fiziksel aktivite düzeyi, fonksiyonel durum, ruhsal durum ve özür düzeyi bel ağrısı olmayan sağlık çalışanlarına göre istatistiksel olarak anlamlı düzeyde daha kötü bulundu (p<0,05). Çalışma grubu incelendiğinde bel ağrısı şiddeti ile toplam çalışma yılı, özür düzeyi, ruhsal durum, fonksiyonel düzey ve fiziksel aktivite düzeyi arasında ilişkili bulundu. Bu çalışmanın sonucu bel ağrısı olan sağlık çalışanlarında toplam çalışma yılının daha uzun olduğunu gösterdi. Aynı zamanda bel ağrısı olan sağlık çalışanlarında fonksiyonel ve ruhsal durumun olumsuz yönde etkilendiği belirlendi. Bel ağrısı şiddetinin sağlık çalşanlarında özür düzeyi, fonksiyonel durum, ruhsal durum ve fiziksel aktivite düzeyi ile ilişkili olduğu bulundu.The aim of this study was to investigate the effect of low back pain on the functional and mental status of health care workers and to investigate the factors that may be related to the severity of low back pain in health care workers with low back pain. 73 cases were included in the study. The sociodemographic information of the cases was recorded by the researcher in a form prepared previously. Pain severity of the cases was evaluated by Visual Analogue Scale and body diagram was used for pain localization. We used Spine Functions Index to evaluate functional status, Roland Morris Disability Questionnaire to evaluate disability level, Physical Activity Assessment Questionnaire to evaluate physical activity level, Hospital Anxiety and Depression Scale to evaluate mental status of the cases. Health care workers were examined in two groups as a study group with low back pain and a control group without low back pain. The average low back pain severity of the study group was found to be 5,18 ± 1,35 cm according to the VAS. When the two groups were compared in terms of sociodemographic characteristics, there was a significant difference only in terms of the “working years” parameter. It was determined that the working years of the cases with low back pain were longer than the others (p <0.05). The level of physical activity, functional status, mental state and disability level of cases with low back pain were found to be significantly worse than others (p <0,05). When the study group was examined, it was found that the severity of low back pain was correlated with the total working years, level of disability, mental status, functional status and physical activity level

Treatment Resistant Severe Digital Ischemia Associated with Antiphospholipid Syndrome in a Male Patient with Systemic Sclerosis

We report the case of a male patient with limited cutaneous systemic sclerosis (SSc) that was complicated with severe digital ischemia, resistant to medical treatment. Due to the lack of treatment response, further laboratory and imaging studies were conducted. Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. After successful anticoagulation no further recurrences of digital ischemia were seen. An underlying etiology in SSc patients with treatment resistant digital ischemic necrosis should be suspected for accompanying antiphospholipid syndrome (APS)

C-type lectin domain family 12, member a: a common denominator in Behcet's syndrome and acute gouty arthritis

C-type lectin domain family 12, member A (CLEC12A) is a C-type lectin-like pattern recognition receptor capable of recognizing monosodium urate crystals. Monosodium urate crystals, the causative agents of gout are also among the danger-associated molecular patterns reflecting cellular injury/cell death. In response to monosodium urate crystals, CLEC12A effectively inhibits granulocyte and monocyte/macrophage functions and hence acts as a negative regulator of inflammation. Behcet's syndrome and gout are autoinflammatory disorders sharing certain pathological (neutrophilic inflammation), clinical (exaggerated response to monosodium urate crystals) and therapeutic (colchicine) features. We propose the hypothesis that decreased expression of CLEC12A is a common denominator in the hyperinflammatory responses observed in Behcet's syndrome and gout. Major lines of evidence supporting this hypothesis are: (1) Downregulation/deficiency of CLEC12A is associated with hyperinflammatory responses. (2) CLEC12A polymorphisms with functional and clinical implications have been documented in other inflammatory diseases. (3) Colchicine, a fundamental therapeutic agent used both in Behcet's syndrome and gout is shown to oppose the downregulation of CLEC12A. (4) Behget's syndrome and gout are characterized by a hyperinflammatory response to monosodium urate crystals and other than gout, Behcet's syndrome is the only inflammatory condition exhibiting this exaggerated response. (5) Genomewide linkage and association studies of Behcet's syndrome collectively point to 12p12-13, the chromosomal region harboring CLEC12A. (6) Patients with severe forms of Behcet's syndrome underexpress CLEC12A with respect to patients with mild forms of the disease. If supported by well-designed, rigorous experiments, the forementioned hypothesis pertinent to CLEC12A will carry important implications for therapy, designing experimental models, and uncovering immunopathogenic mechanisms in Behcet's syndrome and gout. (C) 2015 Elsevier Ltd. All rights reserved

Association between single nucleotide polymorphisms in prospective genes and susceptibility to ankylosing spondylitis and inflammatory bowel disease in a single centre in Turkey

To establish the prevalence of the single nucleotide polymorphisms (SNPs) of endoplasmic reticulum aminopeptidase 1 (ERAP1), IL-23 receptor (IL-23R), signal transducer and activator of transcription 3 (STAT-3) and Janus kinase 2 (JAK-2) in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) in a Turkish population.Materials and Methods: A total of 562 subjects who presented at the Ankara University internal medicine departments of rheumatology and gastroenterology outpatient clinics were recruited in this study, including 365 patients with AS, 197 patients with IBD and 230 healthy controls. ERAP1, IL-23R, STAT-3 and JAK-2) were genotyped in competitive allele-specific polymerase chain reactions. Results: The ERAP1 (rs26653) polymorphism was found to increase the disease risk in patients with AS and IBD compared with the control group (p=0.02 and p=0.01, respectively). In addition, this polymorphism revealed a significant relationship with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI) in patients with AS (r=0.829, p&lt;0.001 and r=0.731, p&lt;0.001, respectively). Conclusion: The ERAP1 gene polymorphism might be a risk factor in the pathogenesis of AS and IBD. In contrast, IL-23R gene polymorphisms may serve a protective role in AS and IBDTo establish the prevalence of the single nucleotide polymorphisms (SNPs) of endoplasmic reticulum aminopeptidase 1 (ERAP1), IL-23 receptor (IL-23R), signal transducer and activator of transcription 3 (STAT-3) and Janus kinase 2 (JAK-2) in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) in a Turkish population.Materials and Methods: A total of 562 subjects who presented at the Ankara University internal medicine departments of rheumatology and gastroenterology outpatient clinics were recruited in this study, including 365 patients with AS, 197 patients with IBD and 230 healthy controls. ERAP1, IL-23R, STAT-3 and JAK-2) were genotyped in competitive allele-specific polymerase chain reactions. Results: The ERAP1 (rs26653) polymorphism was found to increase the disease risk in patients with AS and IBD compared with the control group (p=0.02 and p=0.01, respectively). In addition, this polymorphism revealed a significant relationship with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI) in patients with AS (r=0.829, p&lt;0.001 and r=0.731, p&lt;0.001, respectively). Conclusion: The ERAP1 gene polymorphism might be a risk factor in the pathogenesis of AS and IBD. In contrast, IL-23R gene polymorphisms may serve a protective role in AS and IB