The Relationship Between Bone Formation and Functional Status in Symptomatic Lumbar Spinal Stenosis

WOS: 000346139300007Objective: the aim of the present study was to investigate the relationship between bone formation and functional status in patients with symptomatic lumbar spinal stenosis (LSS). Material and Methods: Sixty patients (range 45 to 65 years) diagnosed with symptomatic lumbar spinal stenosis and 30 age-and gender-matched healthy controls were included in this study. Bone mineral density (BMD) of the subjects included in the study was measured from the lumbar vertebra and proximal femur. Bone-specific alkaline phosphatase, osteocalcin, and 24-hour urinary calcium (Ca) and phosphorus (P) levels were tested to assess bone metabolism. the functional status of patients was evaluated with the modified Oswestry disability index (mODI) and Swiss spinal stenosis questionnaire (SSSQ). Results: the mean age of the patient and control groups was different but not significant. No statistically significant difference was found between the patient and the control groups in bone-specific alkaline phosphatase, osteocalcin, and 24-hour urinary Ca and P values. Mean BMD values measured from the lumbar vertebra and proximal femur were significantly lower in patients with LSS. in the patient group, the mean mODI score was 42.28 +/- 3.1. Mean SSSQ pain scale score was 3.34 +/- 0.2, whereas the mean functional status score was 2.35 +/- 0.2. There was no statistically significant relationship of mODI with bone-specific alkaline phosphatase and osteocalcin levels. the pain and functional status scales of the SSSQ had no significant correlation with bone-specific alkaline phosphatase and osteocalcin. Conclusion: in this study, we determined that LSS has a negative impact on the functional status of patients, does not influence bone metabolism, and decreases BMD

Evaluation of Peripapillary Retinal Nerve Fiber Layer Thickness in Patients With Vitamin B12 Deficiency Using Spectral Domain Optical Coherence Tomography

WOS: 000318646600009PubMed: 23317171Purpose: To compare peripapillary retinal nerve fiber layer (RNFL) thicknesses measured by Cirrus HD optical coherence tomography (OCT) of patients with vitamin B12 deficiency with healthy controls and to evaluate the correlation between the peripapillary RNFL thickness and plasma vitamin B12 levels. Materials and Methods: Forty-five patients (19 male and 26 female) with a diagnosis of vitamin B12 deficiency (patient group) and 45 age-and sex-matched healthy subjects (control group) were consecutively enrolled in this study. Average, temporal, nasal, inferior, and superior quadrant peripapillary RNFL thicknesses of each subject were obtained using the Cirrus HD OCT. Disc area (DA) and rim area (RA), central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were also measured. Results: Mean age of each group was 33.1 +/- 6.5 years (range: 21-45 years). Mean plasma vitamin B12 level was 114.8 +/- 34.0 pg/mL in the patient group and was 405.1 +/- 20.0 pg/mL in the control group (p < 0.001). the patient and control groups were similar regarding axial length, plasma folate levels, DA, RA, CST, CV, CAT, and RNFL thicknesses in superior, nasal, and inferior quadrants. However, average RNFL and RNFL in temporal quadrant were significantly thinner in the patient group than in the control group (p = 0.013 and p < 0.001, respectively). in addition, temporal (r = 0.356, p = 0.001) and average (r = 0.212, p = 0.045) peripapillary RNFL thicknesses were correlated with plasma vitamin B12 levels. Conclusion: We have shown that, as in other non-glaucomatous optic neuropathies, temporal quadrant RNFL thickness was thinner in patients with vitamin B12 deficiency and it was correlated with plasma vitamin B12 levels. Further studies are warranted to clarify the clinical relevance of these findings and the effects of vitamin B12 replacement therapy

Investigation of tear osmolarity in early rheumatoid arthritis: relation to disease activity

WOS: 000331148900021PubMed: 23931459Objective: To investigate the frequency of dry eye (DE) by measuring tear osmolarity (TO) with the recently introduced TearLab system (TearLab Corp, San Diego, Calif.) in patients with early rheumatoid arthritis (ERA) and the relationship between the severity of DE and ERA disease activity. Design: Prospective study Participants: Sixty-four eyes of 64 newly diagnosed and untreated patients with ERA were enrolled in this study. Methods: TO measurements, tear break-up time (TBUT), and Schirmer tests were performed. ERA disease activity was evaluated according to the disease activity score 28 (DAS28). the patients were divided into 3 groups according to DAS28 scores as follows: mild (DAS28 5.1). Results: DE was identified in 46 (71.8%) patients with ERA according to the TO values. There were significant differences among these groups concerning TO (p = 0.001) and TBUT (p = 0.005) scores, whereas there was no significant difference between these groups regarding Schirmer scores (p = 0.200). in addition, DAS28 values were positively correlated with TO values (r = 0.710, p < 0.001), negatively correlated with Schirmer scores, (r = -0.251, p = 0.045), and negatively correlated with TBUT scores (r = -0.335, p = 0.007) among all patients. Conclusions: Our study demonstrated a relationship between the ERA disease activity and severity of DE by using TO measurements with the TearLab system. Therefore, TO measurement could be added to other classical DE tests for diagnosing DE and for assessing the degree of disease activity of ERA

Ultrasonographic evaluation of the femoral cartilage thickness in patients with hypothyroidism

[Purpose] The aim of this study was to investigate the effects of hypothyroidism on femoral cartilage thickness by using ultrasound, which has been found to be useful in the early diagnosis of knee osteoarthritis. [Subjects and Methods] Forty patients diagnosed with hypothyroidism and 30 age-, gender-, smoking status, physical activity-, and body mass index-matched healthy subjects were enrolled. The thickness of the femoral articular cartilage was measured using a 7- to 12-MHz linear probe. Three mid-point measurements were taken from each knee at the lateral condyle, intercondylar area, and medial condyle. [Results] Age, gender, body mass index, smoking status, and physical activity were similar between the groups, but patients with hypothyroidism had thinner femoral cartilage than the healthy controls at all measurement sites. Nonetheless, the differences were not statistically significant (except in the case of the left medial condyle). [Conclusion] Ultrasonographic measurement of femoral cartilage thickness may be useful in the early diagnosis of knee osteoarthritis in patients with hypothyroidism. © 2016 The Society of Physical Therapy Science. Published by IPEC Inc

Are Transitional Vertebra and Spina Bifida Occulta Related with Lumbar Disc Herniation and Clinical Parameters in Young Patients with Chronic Low Back Pain?

WOS: 000392738300005PubMed ID: 28149141Objective: Lumbosacral transitional vertebra (LSTV) and spina bifida occulta (SBO) are widespread within the lumbosacral spine. Their connection to lumbar disc herniation (LDH) and/or lower back pain has been debated in the current literature; however, there is no consensus. The purpose of this study is to evaluate the relationship between the frequency of LSTV and SBO with that of LDH among young patients with chronic lower back pain. Study Design: Cross-sectional. Materials and Methods: A total of 1094 patients with lower back pain, aged between 20 and 40 years, with lower back pain history persisting for longer than 12 weeks were studied. All the patients in the study were evaluated with standard pelvic radiographs and lumbar vertebra magnetic resonance imaging. The severity of pain was measured using the visual analog scale, and the effect of lower back pain on daily life activities was measured using the Oswestry disability index. The patients were separated into two groups: Group 1 consisted of patients without LDH, and Group 2 consisted of patients with LDH. Additionally, these two groups were separated into three subgroups: Non-LSTV-SBO, LSTV, and SBO. Results: It was determined that LSTV frequency was significantly higher (p=0.004) in the lumbar disc herniation group 2. In addition, the existence of LSTV increased the risk of lower back pain (p<0.001, p<0.001) and disability (p<0.001, p<0.001) in young patients with and without LDH or not. However, the presence of SBO did not increase lower back pain (p=0.251, p=0.200) and disability (p=0.134, p=0.161) in both groups. Conclusion: A relationship was detected between the frequency of LDH and LSTV in young patients with chronic lower back pain between the ages of 20 and 40 years. Also, the presence of LSTV was found to increase the risk of lower back pain and disability

PLASMA LEPTIN STATUS AND THE RELATIONSHIP BETWEEN DIFFERENT MEDICAL TREATMENTS USED IN ANKYLOSING SPONDYLITIS

Karkucak, Murat/0000-0002-4348-8398WOS: 000323802900022Objective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study the Bath AS Disease Activity Index (BASDAI) was used for disease activity Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-alpha (TNF-alpha) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized

The relationship between serum YKL-40 levels and arterial stiffness in patients with ankylosing spondylitis

WOS: 000405771400010PubMed: 27680106Objective: Serum YKL-40 plays roles in inflammatory and vascular processes. Our aim was to evaluate serum YKL-40 levels in patients with ankylosing spondylitis (AS) and to investigate their potential relationship with arterial stiffness based on carotid-femoral pulse wave velocity (CF-PWV). Methods: Forty-three patients with AS and 41 healthy controls with no history or current signs of cardiovascular disease were included in the study. All patients were administered nonsteroidal anti-inflammatory drugs (NSAIDs), and none were prescribed anti-tumor necrosis factor agents. Serum YKL-40 levels were measured. CF-PWV and intima-media thickness of the common carotid artery (IMT-C) were evaluated. Results: the mean age of AS patients was 34.6 +/- 10.2 years and of controls was36.3 +/- 9.0 years. CF-PWV was significantly higher in AS patients than in controls (8.2 +/- 2.7 vs. 7.0 +/- 1.6 m/s, respectively; P=0.015). However, the IMT-C was not significantly different between AS patients and controls (0.6 +/- 0.3 vs. 0.5 +/- 0.2 mm, P=0.501). YKL-40 levels were significantly higher in AS patients than in controls (78.9 +/- 37.9 vs. 58.4 +/- 21.2 ng/mL, P=0.003) and were strongly correlated with CF-PWV (r=0.773, P<0.001) and IMT-C (r=0.548, P<0.001). A multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels and IMT-C (adjusted R-2 = 0.707, P=0.013 and P=0.001, respectively). AS patients with a higher disease activity score had higher YKL-40 levels, IMT-C, and CF-PWV than did those with a lower disease activity score (P<0.001, P=0.008, and P<0.001, respectively) Conclusion: AS patients had higher serum YKL-40 levels, CF-PWV, and IMT-C than did healthy controls. Additionally, there was an association between increased CF-PWV and serum YKL-40 levels. Therefore, we conclude that CF-PWV and YKL-40 levels may be used for early diagnosis of atherosclerosis in AS patients