Serum levels of TNF-α and osteoprotegerin and bone mineral density in patients with Behçet’s Disease

Objectives: Osteoporosis is commonly developed due tonatural course of Behçet’s disease (BD) and therapeuticagents. It was aimed to investigate levels of osteoprotegerinand TNF-α (tumor necrosis factor), and bone mineral density(BMD) and correlation between them in BD.Materials and methods: The study included two groupsas the study and the control group. Serum levels of TNF-α,osteoprotegerin, osteocalcine, erythrocyte sedimentation rate(ESR), C-reactive protein (CRP), and urinary creatinine anddeoxypyridinoline along with BMD level were evaluated andcompared. Correlation between TNF-α and osteoprotegerinlevel was investigated.Results: The study enrolled 41 BD patients and 36 agedmatchedcontrol subjects. Mean age was 42.26±11.64 and41.66±70.99, in the study and control groups, respectively.There was no significant difference in body mass index(BMI) of subjects between groups (p>0.05). Level of TNF-α(p<0.001), deoxypyridinoline (p<0.001) and osteocalcine(p=0.041) was significantly higher in the study group comparedto the control group. Osteoprotegerin was lower inBD patients, but the difference was not significant (p>0.05).Urinary deoxypyridinoline/ urinary creatinine ratio in patientswith BD was significantly higher than those in control group(p=0.030). Patients had significantly lower BMD comparfedto the control group, except L2-L4 vertebral area (p<0.001,p<0.001, p=0.035, p<0.001, p=0.012, p<0.001, p<0.001 andp=0.111, respectively). No correlation was found betweenTNF-α and osteoprotegerin.Conclusions: The present study indicated that TNF-α andBMD was negatively correlated with each other and TNF-αhad an effect on osteoporotic process in patients with BD.Osteoprotegerin level was not decreased, and not correlatedwith TNF-α.Key words: Behçet’s disease, osteoprotegerin, TNF-α, osteocalcin

Intraobserver and interobserver agreements of leg circumference measurements by tape measure based on 3 reference points

The objective of this study was to evaluate the intraobserver and interobserver agreements in tape measurements of the ankle and calf circumference with due emphasis on the 3 main reference points, the patella, the tibial tuberosity, and the medial malleolus. The leg circumference at 2 locations was measured in 66 patients in the mornings of 2 consecutive days by 6 observers. Finally, a blinded couple measured leg circumferences at a line created on calves with a ballpoint pen of 68 outpatients to calculate interobserver agreement for lined regions. Leg circumference measurement was accepted as correct when the difference was less than 0.6 cm in 2 occasions. Intraobserver and interobserver agreements were calculated as the percentage of correct measurements. Chi-square test was used to compare intraobserver and interobserver agreements for each reference point. At the calf region, intraobserver and interobserver agreements based on the tibial tuberosity (88% and 81 %) were better than those of the patella (65% and 57%) and the medial malleolus (73% and 65%). On the other hand, at above the ankle region, the agreements (79% and 62%) were also better than those of the patella (60% and 43%) and nearly the same as those of the medial malleolus (86% and 65%). Finally, interobserver agreement of the measurements at the created line with ballpoint pen (96%) was better when compared to those of the tibial tuberosity (81%), the patella (57%), and medial malleolus (65%) (p = 0.005, p < 0.001, and p < 0.001, respectively). The results of this study suggest that the tibial tuberosity as a reference point for leg circumference measurement has better intraobserver and interobserver agreements than those of the patella and the medial malleoli

The evaluation of cochlear functions in Familial Mediterranean Fever

cure, erkan/0000-0001-7807-135X; yucel, abitter/0000-0002-6433-0362WOS: 000387700400008PubMed: 27130205Familial Mediterranean Fever (FMF) is a progressive disease characterized by chronic inflammation, which also has negative effects on cochlear functions and hearing levels. We investigated whether the cochlear functions and hearing levels of FMF patients were different than healthy controls and also evaluated the relationship of hearing levels with the age at diagnosis, duration without treatment, and inflammation and lipid parameters in this study. A total of 60 patients diagnosed with FMF and 48 age, gender and body mass index (BMI)-matched healthy controls were included in the study. the hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lipid parameters of the subjects were studied and they all underwent pure tone audiometry and Transient evoked otoacoustic emission tests after an otologic examination. the hearing levels of the FMF group were significantly higher than those of the control group. the TEOAE signal/noise (S/N) ratios were similar in both groups. A positive relationship was present between the audiometric test results and the age, BMI, low-density lipoprotein and triglyceride levels and a negative relationship with the high-density lipoprotein levels. A negative relationship was present between the TEOAE S/N ratios and the age of the patients, duration without treatment, lipid parameters, inflammation markers and the creatinine level. FMF patients are exposed to chronic inflammation and this can influence their hearing levels. the age at diagnosis, duration without treatment, chronic inflammation, unfavorable lipid parameters, and obesity can affect hearing tests negatively

Safe and successful use of oocyte in-vitro maturation in two infertile women with multiple sclerosis

There is evidence to support an impact of ovarian stimulation with gonadotrophin-releasing hormone analogues on the progression or recurrence of multiple sclerosis. In addition, there is no universally acknowledged approach toward ovarian stimulation in patients with multiple sclerosis. This report describes two patients at a large tertiary university hospital who underwent an in-vitro maturation protocol in order to avoid a risk of exacerbating their multiple sclerosis by ovarian stimulation. Both patients were referred to the infertility clinic because of the concern of exacerbation of multiple sclerosis during or after ovarian stimulation treatment. The patients underwent the in-vitro maturation protocol to avoid ovarian stimulating agents. Both patients gave birth to healthy babies at term. They did not suffer any relapses of multiple sclerosis during their treatment or during pregnancy. Exacerbation of disease related to ovarian stimulation encourages the search for a safer approach to these patients. To the authors' knowledge, these are the first babies described in the literature who were born after in-vitro maturation to mothers suffering from multiple sclerosis. In-vitro maturation can thus be recommended as an alternative in suitable women with multiple sclerosis

Apremilast for Behcet's Syndrome - A Phase 2, Placebo-Controlled Study

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