An Evaluation of Sexual Functions and Marital Adjustment in Female Patients with Fibromyalgia Syndrome

Objective:The purpose of this study was to investigate sexual functions and marital adjustment which are neglected issue in married female patients diagnosed with Fibromyalgia syndrome (FMS) and to reveal the factors affecting these.Materials and Methods:Sexually active, 47 married females who diagnosed with FMS and 50 healthy volunteers in a similar age group were included in the study. Beck anxiety inventory, beck depression inventory, female sexual function index (FSFI) and dyadic adjustment scale (DAS) evaluations were also performed for both groups. In the patient group, the severity of pain was evaluated by the visual analogue scale and functional impairment due to the disease was assessed by the fibromyalgia impact questionnaire (FIQ).Results:No significant difference was determined between the two groups in terms of socio-demographic features. FSFI and DAS total scores were significantly lower in the patient group compared to the controls (p<0.001, p=0.028, respectively). Low DAS scores were determined in patients with low FSFI scores (p=0.003, r=+0.043). Neither FSFI nor DAS scores have exhibited correlation with duration of disease and FIQ scores. Depression was correlated with both FSFI and DAS (p<0.001, r=-0.569; p<0.001, r=-0.546, respectively).Conclusion:In this study, sexual functions and marital adjustment were adversely affected in patients with FMS. This effect was found closely related to depression. However, there was no relationship determined between duration of the disease, the severity of pain and the functional impact

Comparison of radiological changes in symphysis pubis and disease activity parameters in male patients with ankylosing spondylitis

Introduction: To determine the prevalence of involvement of symphysis pubis among male patients with ankylosing spondylitis (AS) and to analyze the relationship among this involvement, demographic data, clinical activity of the disease and radiological findings. Methods: Overall, 73 male patients diagnosed with AS who visited our clinic for follow-up were included in the study. In this retrospective study, clinical and radiological parameters were collected. In clinical evaluation, vertebral Visual Analog Scale (VAS) score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used. In AP pelvis radiography, symphysis pubis changes were rated as 0–4. Modified Stoke Ankylosing Spondylitis Spinal Score (M-SASSS) was calculated from the cervical and lumbar lateral radiography images. Results: Symphysis pubis involvement was radiologically observed in 45 patients (61.7%). The mean age (43.9 ± 12.6) of patients with symphysis pubis involvement was higher than the average (36.9 ± 9.0) of patients without involvement (p = 0.026). Average M-SASSS of patients with symphysis pubis involvement (15.9 ± 11.9) was higher than the average of patients without involvement (8.4 ± 7.4), and there was a significant positive correlation between symphysis pubis involvement and M-SASSS (p=0.002). BASDAI and BASMI averages of patients were not significant (p = 0.973 and p = 0.105, respectively). Conclusion: Symphysis pubis involvement is a common manifestation of AS and can be used to predict vertebral radiological involvement. Keywords: Ankylosing Spondylitis, Symphysis Pubis, Modified Stoke Ankylosing Spondylitis Spinal Scor

An Evaluation of Provoked Vulvodynia, Pelvic Floor Muscles and Sexual Functions in Female Patients with Fibromyalgia Syndrome

Objective: The aim of our study is to investigate the genital origin of pain, particularly provoked vulvodynia (PVD) in female patients with Fibromyalgia syndrome (FMS), to reveal the relationship between PVD and pelvic floor muscle functions and to evaluate patients’ sexual functions. Materials and Methods: Twenty four female patients who were diagnosed with FMS and who had not yet been treated, sexually active and 24 control cases were included to study. Severity of dyspareunia and dysmenorrhea was evaluated with a visual analogue scale, PVD was assessed using the cotton swab exam of vulva and sexual functions were evaluated with using the Female Sexual Function Index (FSFI). Additionally, pelvic floor muscles were graded using Brink scoring. Results: The severity means of menstrual term pain and dyspareunia severity were significantly higher in the patients than the control group (p=0.003, p=0.006). Significant differences were observed between the patient and control group in terms of vulvar pain in cotton swab exam and total Brink scores (both p<0.001). FSFI score was lower in the patient group than in the control group (p=0.001). A powerful correlation in the negative direction was determined between the result of cotton swab exam and Brink score (p<0.001, r=-0.575). Conclusion: The result of our study showed that dysmenorrhea, dyspareunia and PVD were significantly high in the FMS patients than in the control group. Pelvic floor muscle functions were affected in the FMS patients, and PVD was closely associated with the pelvic floor muscle functions

Psoriatic Arthritis in Psoriasis Patients: Evaluation of Clinical and Radiological Features

Objective: The purpose of this study was to perform radiological and clinical determination of the presence of psoriatic arthritis (PsA) in patients with psoriasis and to evaluate associations with clinical findings. Materials and Methods: The medical files of 72 patients with psoriasis presenting to our clinic between years 2009-2014 with a pre-diagnosis of PsA were reviewed retrospectively. Hand, foot and sacroiliac joint radiograms were evaluated by a radiologist who was blinded to the patient’s clinical status and who is experienced on musculoskeletal radiology. Patients with psoriasis were divided into two groups according to the presence of arthritis which was determined based on radiographic findings or on Classification Criteria for Psoriatic Arthritis (CASPAR) criteria. All patients’ demographic characteristics, length of disease, nail involvement, smoking-alcohol consumption were recorded. Results: The mean age of all patients was 47.24±14.61 years, and the mean duration of disease was 14.13±11.92 years. Smoking and alcohol consumptions were determined in 54.2% (n=39) and 23.6% (n=17) of the cases, respectively. Nail involvement was determined in 56.9% (n=41) of the cases. PsA was determined based on radiological findings in 58.3% (n=42) of the patients. The mean age and age at onset of disease were higher in PsA (+) patients than in radiologically non-PsA subjects. Based on clinical findings, PsA based on CASPAR criteria was determined in only 18.1% (n=13) of all patients. Conclusion: A higher level of PsA was determined using radiological evaluation in this study. The main cause of this condition is the existence of asymptomatic-subclinical patients. A detailed medical history should therefore be taken from patients, and good clinical evaluation is very important. Radiological and clinical evaluation should be performed together in the diagnosis

Mittleres thrombozytenvolumen und neutrophilen-lymphozyten-ratio in bezug zu entzündungsmarkern und anti-ccp bei rheumatoider arthritis

Background: Various thrombocyte markers and white blood cell levels and their subtypes have recently been investigated in association with infl ammation. The purpose of this study was to determine the correlation of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with disease activation and clinical parameters in rheumatoid arthritis (RA) patients. Methods: 84 RA patients and 60 healthy controls were included. Platelet, MPV, white cell, neutrophil and lymphocyte levels in full blood counts were investigated, and NLR was calculated. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), disease activation score (DAS 28) and a health assessment questionnaire (HAQ) were used in the evaluation of RA. Results: In the present study a total of 144 patients was enrolled, 84 with RA and 60 healthy individuals. 75.2 % (n = 108) were women and 24.8 % (n = 36) were men. The patients with RA had lower MPV than control individuals (MPV; 8.52 ± 1.15 fL and 8.92 ± 0.87 fL, respectively) and CRP (r: − 0.234, p = 0.005). RA patients’ mean NLR was signifi cantly higher than that of the control group (2.74 ± 1.74 and 1.80 ± 0.78, respectively; p < 0.001). Furthermore, anti-CCP positive patients had higher NLR than anti-CCP negative patients (NLR; 2.51 ± 1.92 and 1.95 ± 1.22, p = 0.019 respectively). NLR was positively correlated with ESR (r = 0.190, p = 0.023), CRP (r = 0.230, p = 0.035) and anti-CCP (r = 0.300, p = 0.005). Conclusion: In conclusion, MPV and NLR together with acute phase reactants can be a useful index for showing infl ammation in RA patients.Einleitung: Verschiedene thrombozytäre Marker und Grenzwerte von Leukozyten und ihren Subtypen sind in der jüngeren Vergangenheit bezüglich ihres Zusammenhangs mit Entzündung untersucht worden. Ziel dieser Untersuchung war die Korrelation des mittleren Thrombozytenvolumens (MPV) und der Neutrophilen/Lymphozyten Ratio (NLR) mit der Krankheitsaktivität und klinischen Parametern bei Patienten mit rheumatoider Arthritis (RA). Methoden: 84 RA Patienten und 60 gesunde Kontrollen wurden eingeschlossen. Aus dem Blutbild wurden Thrombozyten, MPV, Leukozyten-, Neutrophilen- und Lymphozytenwerte untersucht und die NLR errechnet. Die Erythrozytensedimentationsrate (ESR), C-reaktives Protein, Rheumafaktor (RF), anti-zyklisches citrullinieres Peptid (anti-CCP), der Krankheitsaktivität-Score DAS 28 und ein Gesundheitsbewertungsbogen (HAQ) wurden für die Bewertung der RA herangezogen. Ergebnis: In die vorliegende Studie wurden 144 Patienten eingeschlossen, 84 mit RA und 60 gesunde Kontrollen. 75,2 % (n = 108) waren Frauen und 24,8 % (n = 36) waren Männer. Patienten mit RA hatten ein niedrigeres MPV als die Kontrollen (MPV; 8,52 ± 1,15 fL bzw. 8,92 ± 0,87 fL) und CRP (r: − 0,234, p = 0,005). Die mittlere NLR von RA Patienten war signifi kant höher als die der Kontrollgruppe (2,74 ± 1,74 bzw. 1,80 ± 0,78; p < 0,001). Außerdem hatten anti-CCP positive Patienten höhere NLRs als antiCCP negative Patienten (NLR; 2,51 ± 1,92 bzw. 1,95 ± 1,22 p = 0,019). Die NLR korrelierte positiv mit der ESR (r = 0,190, p = 0,023), dem CRP (r = 0,230, p = 0,035) und dem anti-CCP (r = 0,300, p = 0,005). Schlussfolgerung: MPV und NLR können gemeinsam mit Akutphase-Proteinen ein hilfreicher Index für die Entzündungsaktivität bei RA Patienten sein

Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae

Pregnancy-Associated Osteoporosis: Case Report - Case Report

Pregnancy associated osteoporosis is a rare complication manifested with back, low back pain after gestation, or in lactation period. The entity has been first described by Nordin and Roper in 1955. The etiology and pathogenesis has not been thoroughly understood. Preexisting osteoporosis which grows harder in gestation, or genetic tendency and idiosyncrasy have been suggested as etiologic factors. In this article the current literature was reviewed on the basis of a patient diagnosed and treated in our department. (Osteoporoz Dünyasından 2006; 12 (2): 39-42

Association between mean platelet volume and disease severity in patients with psoriasis and psoriatic arthritis

Introduction: Mean platelet volume (MPV) is an important marker that shows the activation and function of the platelets, which is effective in the inflammatory diseases. Aim : To show the relationship between MPV and the development of psoriatic arthritis (PA) in patients with psoriasis vulgaris (PV) and the correlation between MPV and psoriasis severity score (PASI). Material and methods : Our study included 116 patients with psoriatic arthritis (68 female, 48 male) and 41 patients in the psoriasis group (19 female, 22 male) and 90 subjects in the control group (55 female, 35 male). The demographic data of the patients, duration of disease, PASI, the nature of the disease were evaluated retrospectively. Results : Mean platelet volume levels of both the PV group (8.79 ±0.86 fl) and the PA group (9.18 ±1.26 fl) were significantly higher compared to the control group (8.42 ±0.74 fl). There was a weak statistically positive correlation between the PASI and the MPV according to the correlation analysis (r = 0.165; p = 0.046). Conclusions : Our results show that MPV may be helpful as an indicator of the clinical course of PV and PA. In this regard, that study should be supported by prospective studies to find strong correlations