A New Comorbidity in Female Patients With Ankylosing Spondylitis Pelvic Organ Prolapse

Aim The aim of this study was to investigate whether increased intra-abdominal pressure caused by pelvic inflammation and frequent use of the Valsalva maneuver increases the incidence of pelvic organ prolapse (POP) among female patients with ankylosing spondylitis (AS). Methods Thirty-nine patients diagnosed as having AS through the use of the modified New York criteria, 47 patients with chronic low-back pain (CLBP), and 38 healthy controls (HCs) were included in this study. All the patients and the HCs underwent thorough physical and gynecological examinations. Pelvic organ prolapse was graded blindly by a gynecologist. Presence or absence of cystocele (CS), rectocele (RC), and uterine prolapse (UP) was noted. Results The incidences of CS, RC, and UD were significantly higher among the AS patients compared with the HCs (p = 0.001, 0.026, and 0002, respectively). The incidences of CS (p = 0.042) and UD (p = 0.017) were significantly higher among the AS patients compared with the CLBP patients. Conclusions The incidence of POP is higher among patients with AS compared with normal population. These patients should be questioned about the symptoms of POP and recommended, if necessary, regular gynecological examinations, as well as specific exercises including those targeting AS

A useful marker in the assessment of remission and activation of disease in patients with rheumatoid arthritis: Serum human neutrophil peptides 1-3

WOS: 000460934000017PubMed ID: 29991120AIM: Rheumatoid arthritis (RA) is a chronic disease of unknown etiology. Various cellular and molecular immunological factors are involved in the pathophysiology of RA. Recent studies suggest that neutrophils and alpha-defensins released from the neutrophils assume significant roles in the pathogenesis of RA. The aim of this study was to investigate the potential association between serum alpha-defensin levels and disease activity, functional status, radiological damage and several laboratory parameters in patients with RA. MATERIALS AND METHODS: A total of 42 patients with established RA who presented to the outpatient clinics of rheumatology of Dicle University Hospital and 38 healthy control subjects were included in this study. Disease activity was assessed by using the Disease Activity Scale 28 (DAS28). Quality of life was assessed by using the Rheumatoid Arthritis Quality of Life (RAQoL) Questionnaire and the Nottingham Health Profile (NHP). Functional status was assessed by using the Stanford Health Assessment Questionnaire (HAQ). Laboratory examinations included the following tests: CBC, ESH, CRP, and HNP 1-3. RESULTS: Patients with an active disease exhibited higher HNP 1-3 levels compared to patients in remission. At a cut off value of 708 pg/ml, sensitivity and specificity of the tests for HNP 1-3 were 72% and 70.6%, respectively. CONCLUSION: In the present study, patients with an active disease had significantly higher serum HNP 1-3 levels compared to patients in remission. In this respect, serum HNP 1-3 can be a useful marker in the assessment of disease activity and remission in patients with RA

Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis

The aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA

Gender specific differences in patients with psoriatic arthritis

Objectives: To assess gender related differences in a cohort of patients with psoriatic arthritis (PsA).Methods: Consecutively recruited patients were included and underwent clinical, radiological and laboratory evaluation by using standardized protocol and case report forms.Results: Women (n=115) with PsA had higher symptom duration and body mass index (BMI), tender and swollen joint counts, disease activity score-28 joints (DAS28), Erythrocyte sedimentation rate (ESR) and poorer physical activity and fatigue than men (n=72) with PsA. Psoriasis area and severity index (PASI) were higher in male patients. However quality of life (SF36 physical and mental component scores), articular pattern, extra-articular features (including uveitis, iritis) and family history for psoriasis, spondyloarthritis (SpA) (PsA and ankylosing spondylitis [AS]) were quite similar between men and women.Conclusions: Some of the clinical and laboratory variables tend to be different between men and women with PsA. The extent of quality of life and articular pattern seem to be similar in both genders. Men with PsA are more likely to have higher PASI scores and longer duration to develop arthritis after the onset of psoriasis, while women are more likely to have higher disease activity and report more fatigue and physical activity limitations

Effects of Speech Output on Maintenance of Requesting and Frequency of Vocalizations in Three Children with Developmental Disabilities

Item does not contain fulltextWe evaluated the role of digitized speech output on the maintenance of requesting and frequency of vocalizations in three children with developmental disabilities. The children were taught to request access to preferred objects using an augmentative communication speech-generating device (SGD). Following acquisition, rates of requesting and vocalizations were compared across two conditions (speech output on versus speech output off) that were alternated on a session-by-session basis. There were no major or consistent differences across the two conditions for the three children, suggesting that access to preferred objects was the critical variable maintaining use of the SGDs. The results also suggest that feedback in the form of digitized speech from the SGD did not inhibit vocalizations. One child began to speak single words during the latter part of the study, suggesting that in some cases AAC intervention involving SGDs may facilitate speech