Systematic review with meta-analysis: cytokines in fibromyalgia syndrome

<p>Abstract</p> <p>Background</p> <p>To perform a systematic review and meta-analysis on cytokine levels in patients with fibromyalgia syndrome (FMS).</p> <p>Methods</p> <p>Through December 2010 we systematically reviewed the databases PubMed, MEDLINE, and PsycINFO and screened the reference lists of 22 review articles for suitable original articles. Original articles investigating cytokines in patients with FMS were included. Data were extracted by two independent authors. Differences of the cytokine levels of FMS patients and controls were summarized by standardized mean differences (SMD) using a random effects model. Study quality was assessed applying methodological scores: modified Center of Evidence Based Medicine, Newcastle-Ottawa-Scale, and Würzburg Methodological Quality Score.</p> <p>Results</p> <p>Twenty-five articles were included investigating 1255 FMS patients and 800 healthy controls. Data of 13/25 studies entered meta-analysis. The overall methodological quality of studies was low. The results of the majority of studies were not comparable because methods, investigated material, and investigated target cytokines differed. Systematic review of the selected 25 articles revealed that FMS patients had higher serum levels of interleukin (IL)-1 receptor antagonist, IL-6, and IL-8, and higher plasma levels of IL-8. Meta-analysis of eligible studies showed that FMS patients had higher plasma IL-6 levels compared to controls (SMD = -0.34 [-0.64, -0.03] 95% CI; p = 0.03). The majority of investigated cytokines were not different between patients and controls.</p> <p>Conclusions</p> <p>The pathophysiological role of cytokines in FMS is still unclear. Studies of higher quality and with higher numbers of subjects are needed.</p

Selective Window Application of Gentamicin+ Dexamethasone in Meniere's Disease.

OBJECTIVE: The purpose of the study is to prevent hearing loss when using intratympanic (IT) gentamicin for intractable Meniere's disease. MATERIALS AND METHODS: It is a retrospective case review study. Twenty five patients who had definite Meniere's disease and had either selective window application or weekly IT gentamicin were included into the study. First group (selective) had dexamethasone on the round window and gentamicin on oval window during exploratory tympanotomy procedure. The second group had IT gentamicin at weekly intervals. The degree of caloric weakness (CW), average hearing level in low pitch (HLP) (250, 500, 1000, 2000 Hz) and high pitch (HHP) (4000, 6000, 8000 Hz) were compared before and after treatment. The need for further treatment was noted. RESULTS: In the first group, the average HLP was increased from 51.6±7dB to 52.2±5.6 dB. The average HHP was increased 41.96±20.2 dB to 47.2±18.3 dB after treatment. The CW changed from 37.6±23.9 % to 54.6±30.6 %. In the second group, the average HLP was increased from 56.3±10.5 dB to 61.65±18.3 dB. The average HHP was increased 59.05±17.4 dB to 69.4±21.98 dB after treatment. The CW changed from 45.8±22.3% to 71.53±29.63 %. Both methods had statisticaly significant increase in caloric weakness. But only IT gentamicin led a significant hearing loss in HHP. CONCLUSION: The use of dexamethasone and gentamycin via different windows in the middle ear is safe and effective method for Meniere's disease in the short term. Application of dexamethasone protects not only the hearing cells but vestibular cells also

An Unusual Complication of Otitis Media: Luc's Abscess.

Luc's abscess is an extremely rare complication of otitis media, caused by the spread of the middle ear infection to the subperiosteal area and its accumulation beneath the temporal muscle. Unlike other subperiosteal abscesses relating to otitis media, infection may not be associated with mastoid bone involvement. Therefore, it is defined as a benign complication of otitis media. However, its rare occurrence may lead to delayed diagnosis and treatment. Here we report a case of an 11-year-old boy diagnosed with Luc's abscess with mastoid involvement. We discuss its clinical presentation and treatment with a review of the literature

Correlation between Surgical Outcome and Stage of Acquired Middle Ear Cholesteatoma: Revalidation of the EAONO/JOS Staging System.

OBJECTIVES: This study aimed to evaluate the intraoperative findings, recurrence rate, and hearing outcome of cholesteatoma surgery and correlate them with the newly proposed EAONO/JOS Joint Consensus Statement. MATERIALS AND METHODS: The records of 407 patients diagnosed with chronic otitis media and cholesteatoma between 2009 and 2017 were reviewed. After the exclusion of records with unsatisfactory surgical notes and anamnesis, 353 patients were included in the study. The 290 patients who had undergone primary surgery and 63 who had undergone revision surgery were evaluated separately. RESULTS: Total 162 of 290 (56%) patients had retraction pocket cholesteatoma and 128 of 290 (44%) patients had non-retraction pocket cholesteatoma. Eighty (28%) patients had stage I, 114 (39%) had stage II, 91 (31%) had stage III, and 5 (2%) had stage VI disease. The recurrence rate was 6.9% (20/290). The average age of these patients at the time of the second operation was 23.31±10.3 years. Twelve patients had (60%) recurrent cholesteatoma, and eight (40%) had residual cholesteatoma. Hearing outcome and surgical technique were significantly associated with the disease stage; however, the recurrence rate showed no such association. CONCLUSION: We concluded that the EAONO/JOS staging system is beneficial for estimating the postoperative hearing results and planning the surgical technique. However, there was no significant relationship between the recurrence rate and the EAONO/JOS staging system. We believe that additional factors, such as infection, ossicles, and invasion, predict the recurrence. Widespread use of the EAONO/JOS staging system will enable better evaluation of surgical outcomes and prognosis

[Functional status, patient satisfaction and quality of life in patients with arthroscopic partial meniscectomy].

OBJECTIVES: This study aims to investigate the effects of clinical and demographic variables on functional status, patient satisfaction and quality of life following arthroscopic partial meniscectomy. PATIENTS AND METHODS: Between January 2001 and December 2010, 98 patients (44 males, 54 females; mean age 52.1±12.5 years; range 18 to 88 years) who underwent arthroscopic partial meniscectomy in our clinic and were eligible for the study. Demographic and clinical data of patients and surgical characteristics were recorded. Preoperative activity levels of patients were measured. Severity of activity pain and patient satisfaction following surgery were evaluated using Visual Analog Scale (VAS). Functional status was evaluated by Lysholm knee score and WOMAC (Osteoarthritis Index Western Ontario and McMaster Universities), while quality of life was evaluated by Short Form-36 (SF-36). RESULTS: Postoperative mean time from surgery was 62.5±26.1 (8-120) months, GAS score at rest was 1.7±2.6 (0-10), GAS activity score was 3.4±3.3 (0-10) and GAS patient satisfaction score was 7.0±3.0 (0-10). It was found that 68 of the patients (69.4%) were evaluated themselves as excellent or better than preoperative period with a mean Lysholm knee score of 73.8±17.4 (24-95). Significant influences of body mass index and preoperative symptom duration on evaluation parameters were not detected. Male gender, less than five years after surgery, less intraoperative joint degeneration and moderate to severe activity level before the onset of symptoms had a positive influence on the severity of pain, patient satisfaction and functional status. CONCLUSION: Our study provided critical data for optimal patient selection during the preoperative period to predict which patients may have better results in the mid-term follow-up after arthroscopic partial meniscectomy

Reliability and validity of the Turkish versions of Dark Triad Dirty Dozen (DTDD-T), Short Dark Triad (SD3-T), and Single Item Narcissism Scale (SINS-T)

The Dark Triad Dirty Dozen (i.e., DTDD), Short Dark Triad (i.e., SD3), and the Single Item Narcissism Scale (i.e., SINS) were adapted into Turkish and validated (N = 368). We examined internal consistency, factor structures, and convergent and discriminant validity of the scales using the Mach-IV, LSRP, NPI-16, Rosenberg's self-esteem scale, and Big Five scales. The Turkish versions of the scales had good psychometric properties and can be used in further research. (C) 2017 Elsevier Ltd. All rights reserved

Impact of body image on quality of life and mood in mastectomized patients and amputees in Turkey.

BACKGROUND: The aim was to investigate the impact of loss of the breast on body image, as well as the relationship of the body image with quality of life and severity of the depression, comparing mastectomized patients with those with an apparent limb loss (extremity amputation). METHODS: Demographic data, and the side of the tissue/limb loss for mastectomy and transtibial amputation patients were recorded. Postoperative shoulder range of motion limitations of the operated-side in mastectomized patients, and postoperative knee flexion contracture in patients with amputation were evaluated. All patients were asked to complete Body Image Scale, Beck Depression Inventory, and Short Form-36. RESULTS: All of the 40 patients in the mastectomized group were female. In the amputation group, 4 (10.8%) patients were female and 33 (89.2%) were male. Body-image scores in mastectomized and amputation groups were 98.7 ± 26.5, and 77.2 ± 19.7, respectively (p<0.05). Physical- function scores of quality-of-life were significantly lower in the amputation group. For both groups, a significant positive relationship was evident between body-image and depression (r=0.327 and r=0.574, respectively). There were also significant negative relationships between body-image and physical role limitations (r=-0.395) and mental health (r=-0.335) in the mastectomized group, and between body-image, and emotional role limitations in the amputation group (p<0.05). CONCLUSIONS: Although mastectomy does not result in loss of physical function, distortion of body image perception is worse than that caused by extremity amputation, and distortion of the body image affects the quality of life and mood negatively in mastectomized patients

Validation of the Turkish Version of the Facial Nerve Grading System 2.0

Objective: We aimed to adapt the Facial Nerve Grading System 2.0 (FNGS 2.0) to Turkish and to investigate the validity and the reliability of the Turkish version.Methods: The original FNGS 2.0 was translated into Turkish and validated by international standards. Six Turkish physicians, three specialists and three residents, independently rated the videos, two times each, of 40 adult facial palsy patients. Interrater and intra-rater reliability were assessed using the intraclass correlation coefficient (ICC) and Cronbach's alpha coefficient. As another indication of reliability, "generalizability" was also evaluated. For all analyses, a p value of <0.05 was considered statistically significant.Results: ICC and Cronbach's alpha coefficients for the inter-rater reliability of the total score of the FNGS 2.0 were 0.970 and 0.979 for the first assessment, 0.973 and 0.979 for the second assessment, respectively. The intra-rater reliability ICC results for the total score of the FNGS 2.0 were 0.95, 0.976, 0.982, 0.956, 0.96 and 0.931 for the six raters, respectively. The generalizability coefficient was found as G=0.894.Conclusion: In this study, we adapted the FNGS 2.0 to Turkish, and confirmed its reliability and validity as a facial palsy scale. The Turkish version of the FNGS 2.0 can be safely used to assess