The Effect of Uric Acid Levels on Bone Metabolism in Postmenopausal Women

Objective:The decrease in estrogen levels leads to oxidative stress by accumulating reactive oxygen species in the cell and suppressing the antioxidant defense system. Thus, the activity of osteoclasts and bone resorption are stimulated. It is stated that uric acid may contribute to the bone mineral density (BMD) due to antioxidant specialty. In our study; we investigated the relationship among serum uric acid levels, BMD and other bone metabolic markers in women with the postmenopausal period. Materials and Methods: BMD and laboratory data (glucose, urea, creatinine, calcium, phosphorus, alkaline phosphatase, uric acid, parathyroid hormone, and 25-hydroxyvitamin D3 levels) of 141 postmenopausal women aged between 50 and 69 were evaluated. The participants were divided into three groups according to the t-score. These were; the patients with t-score -1 were normal BMD group. Biochemical tests were measured by photometric method and hormone tests were measured by electrochemiluminescence method. Results:Uric acid levels were significantly higher in the osteopenia group than the normal BMD group (p=0.023). There was no statistically significant difference in uric acid levels between the osteoporosis-steopenia and the osteoporosis-normal BMD groups. No correlation was found between uric acid levels and BMD in all groups. While there was a negative correlation in uric acid levels between the postmenopausal osteopenia and the normal BMD groups (r=-0.423, p=0.016), there was no a significant difference between the osteoporosis and the normal BMD groups (p>0.05). Conclusion:As a result of our study, it is difficult to mention a clear relationship between uric acid and lumbar BMD in postmenopausal women. We believe that further studies are needed for solving the uric acid riddle and explaining the effect on bone metabolism. In addition, uric acid levels in patients with postmenopausal osteopenia should be examined in detail

Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study

Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients.Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3 +/- 12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS.Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385).Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS

Impact of Trigger Point Dry Needling on Neck Pain, Sleep, and Depression in Patients with Fibromyalgia

Introduction:The study aimed to assess the effectiveness of dry needling (DN) for neck pain in fibromyalgia caused by myofascial trigger points (MTrPs) in the trapezius muscle.Methods:Fibromiyalgia patients who were treated with DN were retrieved from the hospital database. The study included people with trapezius MTrPs-related neck pain who were between the ages of 18 and 65 and had a two-month follow-up. DN treatment was applied to MTrPs in the trapezius muscle once a week for 4 sessions. Demographic data for the patients were recorded from their files. Before treatment and four weeks after the program was finished, all patients underwent evaluations. In each evaluation we assessed pain, neck disability, sleep quality, anxiety and depression and fibromyalgia severity with visual analogue scale (VAS), Neck Disability Index (NDI), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression scale (HADS) and Fibromiyalgia Impact scale (FIQ), respectively.Results:In patients with FMS with neck discomfort, DN therapy administered to MTrPs in the trapezius muscle once per week for four sessions was beneficial in the short term. Additionally, with this treatment quality of sleep and life of the patients were improved; anxiety, depression levels, and pain severity were also significantly reduced. Statistically significant improvement was found in VAS, NDI, PSQI, HADS, and FIQ scores (for all parameters; p<0.001).Conclusion:For better management of patients with FMS patients, MTrPs should not be ignored. DN treatment should also be among the treatment options as an effective treatment

Arthritis in primary care

Arthritis is one of the most common conditions for visiting family physicians. Therefore, it is important to know how to diagnose and manage arthritis in primary care. Arthritis can be classified according to its duration, the number of joints involved, or whether it is inflammatory or non-inflammatory. Osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and gout arthritis are among the most common arthritic diseases presented in primary care. Better outcomes may be achieved with a multidisciplinary, holistic and integrative approach

Examination of Oxidative Stress Markers in Women with Postmenopausal Osteoporosis

Objective: Postmenopausal osteoporosis a disease with increased fracture tendency in the bones based upon reduced bone mineral density. Oxidative stress is an important risk factor for osteoporosis. In our study, it was aimed to investigate the levels of oxidative stress markers in women with postmenopausal osteoporosis