Markers of autoimmune liver diseases in postmenopausal women with osteoporosis

INTRODUCTION: Osteoporosis is a common complication of chronic liver diseases. However, there is limited information about autoimmune liver diseases as a factor of secondary osteoporosis. Therefore, we aimed to investigate the autoantibodies of autoimmune liver diseases in patients with osteoporosis. METHODS: One hundred fifty female patients with postmenopausal osteoporosis were included. Bone mineral density was measured by dual energy X-ray absorptiometry. We analysized autoantibodies including antinuclear antibodies, liver membrane antibodies, anti-liver/kidney microsomal autoantibodies1, liver-specific protein, antismooth muscle antibodies, and anti-mitochondrial antibodies by indirect immunofluorescence. Serum was assayed for the levels of aminotransferases. RESULTS: The mean age of the patients was 63,13±8,6 years. The mean values of L1-L4 T-scores and femur total T-scores were -3,08±0,58 and -1,53±0,81, respectively. Among the 150 patients with osteoporosis, 14 (9.3%) were antinuclear antibodies, four (2.7%) were liver membrane antibodies, three (2.0%) were anti-liver/kidney microsomal autoantibodies1, and two (1.3%) were liver-specific protein positive. None of the patients had anti-mitochondrial antibodies or smooth muscle antibodies positivity. The mean values of levels of aminotransferases were within normal range. CONCLUSIONS: The presence of liver membrane antibodies, liver-specific protein, and anti-liver/kidney microsomal autoantibodies1 has permitted us to see that there may be some suspicious clues of autoimmune liver diseases in patients with osteoporosis as a secondary risk factor. On the other hand, there is a need for comprehensive studies with a larger sample size and studies designed to compare the results with a normal population to understand the clinical importance of our findings

Heart rate turbulence analysis in female patients with fibromyalgia

OBJECTIVE: Fibromyalgia is characterized by diffuse musculoskeletal pain and discomfort. There are several reports regarding autonomic nervous system dysfunction in patients with fibromyalgia. Heart rate turbulence is expressed as ventriculophasic sinus arrhythmia and has been considered to reflect cardiac autonomic activity. Heart rate turbulence has been shown to be an independent and powerful predictor of sudden cardiac death in various cardiac abnormalities. The aim of this study is to determine whether heart rate turbulence is changed in female patients with fibromyalgia compared with healthy controls. METHODS: Thirty-seven female patients (mean age, 40±11 years) with fibromyalgia, and 35 age- and sex-matched healthy female control subjects (mean age, 42±9 years) were included. Twenty-four hours of ambulatory electrocardiography recordings were collected for all subjects, and turbulence onset and turbulence slope values were automatically calculated. RESULTS: The baseline clinical characteristics of the two groups were similar. There were no significant differences in turbulence onset and turbulence slope measures between patients and control subjects (turbulence onset: −1.648±1.568% vs. −1.582±1.436%, p ϝ 0.853; turbulence slope: 12.933±5.693 ms/RR vs. 13.639±2.505 ms/RR, p ϝ 0.508). Although body mass index was negatively correlated with turbulence slope (r ϝ −0.258, p ϝ 0.046), no significant correlation was found between body mass index and turbulence onset (r ϝ 0.228, p ϝ 0.054). CONCLUSION: To the best of our knowledge, this is the first study to evaluate heart rate turbulence in patients with fibromyalgia. It appears that heart rate turbulence parameters reflecting cardiac autonomic activity are not changed in female patients with fibromyalgia

Investigation of the H reflexes, F waves and sympathetic skin response with electromyography (EMG) in patients with stroke and the determination of the relationship with functional capacity

The purpose of the study was to evaluate the relationship between sympathetic skin responses (SSR), electrodiagnostic reflex activities (F wave, H reflex), and functional capacity in post-stroke patients. The study comprised 40 hemiplegia patients (mean age 57.8 +/- 10.9 years) and 40 healthy volunteers (mean age 557 +/- 85 years). In electrophysiological studies, SSR, F wave and H reflex were evaluated and for the functional capacities of patients, FIM scores and Brunnstrom stages were calculated. There was no statistical significant difference between SSR latency and amplitude in the hemiplegic and non-hemiplegic extremities of patients (p > 0.05). SSR latency values of patients were higher than those of controls (p < 0.05). Amplitude values of paretic arms were significantly lower than the control group extremities (p < 0.05). There was a significant correlation between SSR amplitude values and FIM scores. A significant increase in H (max)/M (max) amplitude rate was detected in the affected side (p < 0.05) and F-wave mean latency values of the affected side were found to be significantly lower in the control group (p < 0.05)

Evaluation of the Efficacy of Spa Therapy on Pain and Quality of Life in Patients With Chronic Mechanical Neck Pain

Objectives: This study aims to evaluate the efficacy of spa therapy on pain and the quality of life in patients with chronic mechanical neck pain

Water-Based versus Land-Based Exercise Program for the Management of Shoulder Impingement Syndrome

Objective: In this study, we aimed to compare the clinical effect of land-based and water-based exercise programs in patients with subacromial impingement syndrome

Hearing and cochlear function of patients with ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss

The Effect of Water-Based Pulmonary Rehabilitation on Anxiety and Quality of Life in Chronic Pulmonary Obstructive Disease Patients

Objective: To investigate the effects of water-based pulmonary rehabilitation program on pulmonary functions, exercise capacity, anxiety and depression level and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). Material and Methods: Fifty moderate or severe COPD patients without respiratory failure were included. They were randomized either to water-based exercise (WE) group (n= 25) or to control group (n= 25). Spirometry and 6-minute walk test (6-MWT) were performed. QoL was assessed by the Chronic Respiratory Disease Questionnaire (CRDQ). Level of anxiety and depression was assessed using the Hospital Anxiety and Depression (HAD) Scale. WE group received 4-week water-based pulmonary rehabilitation program including shoulder girdle and upper extremity strengthening exercises for 35 minutes, three times a week (totally 12 sessions) in addition to medical therapy. Control group received only medical therapy. All the assessments were repeated one month after intervention in both groups. Results: The mean ages of the patients in WE and control groups were statistically not different (respectively 60.9 +/- 8.8, 64.1 +/- 8.9, p= 0.207). All the patients in both groups were males. No significant improvements in pulmonary functions and 6-MWT distance were observed at one month compared to baseline in both groups. We observed statistically significant decrease in anxiety scores and significant increases in dyspnoea, emotional function and patients' feeling of control over the disease scores of CRDQ at one month compared to baseline in WE group. In control group, no significant differences in anxiety and CRDQ scores were observed at one month compared to baseline. Conclusion: Pulmonary rehabilitation is known to be cost-effective in patients with COPD. Water-based exercises are effective in improving QoL and anxiety level in COPD patients, thus it can be supposed as an alternative to land based pulmonary rehabilitation programs

An Easily Overlooked Presentation of Malignant Psoas Abscess: Hip Pain

Psoas abscess is a rare infectious disease with nonspecific clinical presentation that frequently causes a diagnostic difficulty. Its insidious onset and occult characteristics can cause diagnostic delays. It is classified as primary or secondary. Staphylococcus aureus is the most commonly causative pathogen in primary psoas abscess. Secondary psoas abscess usually occurs as a result of underlying diseases. A high index of clinical suspicion, the past and recent history of the patient, and imaging studies can be helpful in diagnosing the disease. The delay of the treatment is related with high morbidity and mortality rates. In this paper, 54-year-old patient with severe hip pain having an abscess in the psoas muscle due to metastatic cervical carcinoma is presented