Romatoid Artrit ve Ankilozan spondilitte vitamin D’nin hastalık aktivitesi ile ilişkisi

Amaç: Vitamin D eksikliğinin, romatoid artrit (RA) ve ankilozan spondilit (AS) gibi otoimmun hastalıklarda başlatıcı bir neden mi yoksa hastalık aktivitesiyle ilişkili mi olduğu hala merak edilen bir konudur. Çalışmamızın amacı, Th1 baskın hastalıklardan olan RA ve AS hastalarında serum vitamin D seviyeleri ile hastalık aktiviteleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmamız, retrospektif olarak 92 RA’li hasta, 100 AS’li hasta ve 62 sağlıklı kontrolün dosyalarından elde edilmiş bilgileri içermektedir. Çalışmaya alınanların yaşı, cinsiyeti, hastalık süreleri, kullandığı ilaçlar, vitamin D seviyeleri, kalsiyum, C-reaktif protein (CRP) ve eritrosit sedimentasyon hızı (ESH) değerleri kayıt edildi. Hastalık aktiviteleri RA’li hastalarda hastalık aktivite skoru-28 (DAS28) ile, AS’li hastalarda ise bath ankilozan spondilit hastalık aktivite indeksi (BASDAİ) ile değerlendirildi. Bulgular: Vitamin D seviyeleri tüm gruplarda düşüktü. AS hastalarında, vitamin D seviyeleri ile BASDAİ, ESH ve CRP arasında istatiksel olarak negatif korelasyon yoktu (sırasıyla, r=-0.059, p=0.560, r=-0.072, p=0.473, r=-0.112, p=0.268). RA’li hastalarda ise vitamin D düzeyi ile DAS28 arasında anlamlı negatif korelasyon yoktu (r=-0.090, p=0.392). Tartışma: Çalışmamızda, tüm gruplarda vitamin D seviyeleri düşük bulundu ve bu vitamin D eksikliğinin, RA ve AS’in etyolojisinden ziyade hastalık aktivitesi ile ilişkili olabileceğini akla getirmektedir.Aim: Vitamin D deficiency in autoimmune disorders such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS), whether an initiator cause or associated with disease activity is still wondered. The aim of our study is to investigate the association between serum vitamin D levels and disease activity in subjects with RA and AS which are known to be Th1 dominant diseases. Material and Method: The study included the data of 92 patients with RA, 100 patients with AS and 62 healthy controls, which were retrospectively obtained from the patient files. The age, gender, duration of the disease, medications, levels of vitamin D, calcium, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were recorded. Disease activities were evaluated by Disease Activity Score-28 (DAS28) in patients with RA and Bath Ankylosing Spondylitis Disease Index (BASDAI) in patients with AS. Results: Vitamin D levels were low in all groups. In AS patients, there was no statistical negative correlation among vitamin D levels and BASDAI, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (r=-0.059, p=0.560, r=-0.072, p=0.473, r=-0.112, p=0.268, respectively). In RA patients, there was also no significant negative correlation between vitamin D levels and DAS28 (r=-0.090, p=0.392). Discussion: In our study, low serum vitamin D levels were found in all groups, and it is suggested that vitamin D deficiency may be associated with the disease activity rather than the etiology of RA and AS

HER İKİ KALÇADA AYNI ANDA GELİŞEN İDYOPATİK BİLATERAL AVASKÜLER NEKROZ: OLGU SUNUMU

Avascular necrosis is the cellular death of bone caused by deterioration of blood flow from various reasons. Here, a case with bilateral avascular necrosis of both hips developing at the same time is presented. 50-year old male patient applied to our clinic with the complaint of pain in both hips for 2 months. His history was unremarkable. On physical examination, both hip movements were painful. MR imaging of both hips was reported as mild focal irregularity at the top of the femoral head. The patient was diagnosed with bilateral idiopathic avascular necrosis. As a result, usually hip avascular necrosis is seen unilaterally. However, sometimes as in our patient, both hips may be affected simultaneously without any revealed etiological facto

Predictors of difficult intubation in patients with ankylosing spondylitis : do disease activity and spinal mobility indices matter?

Objectives: This study aims to determine the predictors of difficult intubation and their possible correlations with disease activity and spinal mobility indices in patients with ankylosing spondylitis. Patients and methods: Forty-five ankylosing spondylitis patients were included in the study. Disease activity was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI). The predictors of difficult intubation were evaluated by using the modified Mallampati test, upper lip bite test, thyromental distance, sternomental distance, inter- incisor distance and neck extension. Results: There was no correlation between Bath Ankylosing Spondylitis Disease Activity Index and predictive test values (all p>0.05). There were significant correlations between BASMI with modified Mallampati test, sternomental distance, neck extension, and inter-incisor distance values (all p<0.05). The BASMI scores in patients with two or more predictors were significantly higher than BASMI scores in patients with none or one predictor (5.28±2.12 vs. 1.58±1.50; p<0.001). Among the patients with moderate to severe BASMI, the number of patients with two or more predictors was higher than in those patients with none or one predictor (p=0.001). Conclusion: Neck extension, inter-incisor distance, sternomental distance and modified Mallampati test are significant predictors for difficult intubation in patients with ankylosing spondylitis. These predictors were found to be correlated with spinal mobility index, but not with disease activity index. Clinicians should be aware of difficult intubation in ankylosing spondylitis patients with moderate to severe spinal mobility limitation.Objectives: This study aims to determine the predictors of difficult intubation and their possible correlations with disease activity and spinal mobility indices in patients with ankylosing spondylitis. Patients and methods: Forty-five ankylosing spondylitis patients were included in the study. Disease activity was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI). The predictors of difficult intubation were evaluated by using the modified Mallampati test, upper lip bite test, thyromental distance, sternomental distance, inter- incisor distance and neck extension. Results: There was no correlation between Bath Ankylosing Spondylitis Disease Activity Index and predictive test values (all p>0.05). There were significant correlations between BASMI with modified Mallampati test, sternomental distance, neck extension, and inter-incisor distance values (all p<0.05). The BASMI scores in patients with two or more predictors were significantly higher than BASMI scores in patients with none or one predictor (5.28±2.12 vs. 1.58±1.50; p<0.001). Among the patients with moderate to severe BASMI, the number of patients with two or more predictors was higher than in those patients with none or one predictor (p=0.001). Conclusion: Neck extension, inter-incisor distance, sternomental distance and modified Mallampati test are significant predictors for difficult intubation in patients with ankylosing spondylitis. These predictors were found to be correlated with spinal mobility index, but not with disease activity index. Clinicians should be aware of difficult intubation in ankylosing spondylitis patients with moderate to severe spinal mobility limitation

Thymoquinone attenuates trauma induced spinal cord damage in an animal model

BACKGROUND: Spinal cord injury (SCI) is one of the most devastating conditions leading to neurological impairment and disabilities. The aim of the study was to investigate the potential neuroprotective effect of thymoquinone (TQ) histopathologically in an experimental model of traumatic spinal cord injury (SCI). METHODS: Twenty-four male Wistar albino rats were randomly divided into 4 groups: control group; SCI group; SCI-induced and 10 mg/kg/day TQ administered group; SCI-induced and 30 mg/kg/day TQ administered group. TQ was given as intraperitoneal for three days prior to injury and four days following injury. Spinal cord segment between T8 and T10 were taken for histopathologic examination. Hemorrhage, spongiosis and liquefactive necrosis were analyzed semiquantatively for histopathological changes. RESULTS: Administration of TQ at a dose of 10 mg/kg did not cause any significant change on the histological features of neuronal degeneration as compared to the SCI group (p=0.269); however, 30 mg/kg TQ significantly decreased the histological features of spinal cord damage below that of the SCI group (p=0.011). CONCLUSION: Data from this study suggest that TQ supplementation attenuates trauma induced spinal cord damage. Thus, TQ needs to be taken into consideration, for it may have a neuroprotective effect in trauma induced spinal cord damageBACKGROUND: Spinal cord injury (SCI) is one of the most devastating conditions leading to neurological impairment and disabilities. The aim of the study was to investigate the potential neuroprotective effect of thymoquinone (TQ) histopathologically in an experimental model of traumatic spinal cord injury (SCI). METHODS: Twenty-four male Wistar albino rats were randomly divided into 4 groups: control group; SCI group; SCI-induced and 10 mg/kg/day TQ administered group; SCI-induced and 30 mg/kg/day TQ administered group. TQ was given as intraperitoneal for three days prior to injury and four days following injury. Spinal cord segment between T8 and T10 were taken for histopathologic examination. Hemorrhage, spongiosis and liquefactive necrosis were analyzed semiquantatively for histopathological changes. RESULTS: Administration of TQ at a dose of 10 mg/kg did not cause any significant change on the histological features of neuronal degeneration as compared to the SCI group (p=0.269); however, 30 mg/kg TQ significantly decreased the histological features of spinal cord damage below that of the SCI group (p=0.011). CONCLUSION: Data from this study suggest that TQ supplementation attenuates trauma induced spinal cord damage. Thus, TQ needs to be taken into consideration, for it may have a neuroprotective effect in trauma induced spinal cord damag

Sonographic evaluation of the nail plate and nail bed thickness in psoriasis patient with and without nail involvement

Amaç: Psoriazis toplumda %1-3 sıklıkta görülen deri, eklemler ve tırnakları, tutan eritemli skuamlı inflamatuar bir hastalıktır. Psoriazis hastalarında tırnak tutulumu sıklığı %15-% 69 arasında değişmektedir. Ankilozan spondilit ise psoriatik artrit gibi seronegatif spondilartritlerdendir. Ultrasonografi günümüzde yumuşak dokuları değerlendirmek için yaygın kullanılan non invaziv bir görüntüleme yöntemidir. Bu çalışmada tırnak tutulumu olan ve olmayan psoriazis hastalarında tırnak yatak ve tırnak plak kalınlıklarını ultrasonografik olarak ölçerek ankilozan spondilit hastaları ve kontrol grubu ile karşılaştırmayı hedefledik. Gereç ve Yöntem: Otuzyedi psoriazis, 39 ankilozan spondilit hastası ile 33 sağlıklı kontrol çalışmaya dahil edildi. Psoriazis hastaları ile ankilozan spondilit ve kontrol grubunun “tırnak plak kalınlığı” ve “tırnak yatak kalınlığı” hasta oturur pozisyonda ve sağ el masa üzerinde nötral pozisyonda iken gri skala ultrasonografi (LOGIQ5Pre, GE, 4-11- MHz lineer prob) ile aynı hekim tarafından sağ el ikinci parmak tırnağında(indeks tırnak) ölçüldü. Bulgular: Tırnak yatak kalınlıkları psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 1.60,1.58,1.51 mm olarak ölçüldü. Tırnak plak kalınlıkları ise psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 0.64,0.62,0.68 mm olarak ölçüldü. Psoriazis grubu ile ankilozan spondilit ve kontrol grupları arasında tırnak yatak ve tırnak plak kalınlıkları açısından istatistiksel olarak fark yoktu.(p=0.13,p=0.45)Tırnak yatak kalınlığı, sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksek ölçüldü. (p=0.030) Sonuç: Sonuç olarak çalışmamızda tırnak plak ve tırnak yatak kalınlıkları ultrasonografik olarak değerlendirildiğinde psoriazis grubu ile kontrol grubu ve ankilozan spondilit hastaları arasında fark bulunmadı. Ultrasonografik olarak ölçülen tırnak yatak kalınlıkları sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksekti.Objective: Psoriasis is an inflammatory and erythematousscaly disease which involve the skin, joint and nail. It’s prevalence is 1-3%. The incidence of nail involvement in psoriasis patient ranged between 15-69 %. Ultrasonography is a noninvasive imaging method widely using for assess the soft tissue image nowadays. In this study we aimed to assess the nail bed and nail plate thickness in psoriasis patient with and without nail involvement and compare with ankylosing spondylitis and control groups. Material and Methods: Thirty-seven patient with psoriasis, 39 patient with ankylosing spondylitis and 33 healthy control were included to the study. Nail bad and nail plate thicknesses was measured with grey scale USG(LOGIQ5Pre, GE, 4-11- MHz lineer prob) from the right hand’s second finger(index finger), when the patient seated with the hands in a neutral position over the table. Results: Nail bad thicknesses were measured as 1.60, 1.58, 1.51 mm respectively in psoriasis, ankylosing spondilytis and control groups. Nail plate thicknesses were 0.64,0.62 and 0.68 mm respectively in psoriasis, ankylosing spondylitis and control groups. Nail bad and nail plate thickness were not statistically different between psoriasis, ankylosing spondylitis and control groups.(p=0.13,p=0.45) Nail bad thicknesses were measured more in the psoriasis patient with righth and second finger nail involvement then without righth and second finger nail involvement. (p=0.030) Conclusion: Inconclusion when evaluated the nail plate thickness ultrasonographically there was no statistically significant difference between psoriasis, ankylosing spondylitis and control groups. Nail bed thickness was statistically higher in psoriasis patients with righth and second finger nail involvement compared to non

Sonographic evaluation of the nail plate and nail bed thickness in psoriasis patient with and without nail involvement

Amaç: Psoriazis toplumda %1-3 sıklıkta görülen deri, eklemler ve tırnakları, tutan eritemli skuamlı inflamatuar bir hastalıktır. Psoriazis hastalarında tırnak tutulumu sıklığı %15-% 69 arasında değişmektedir. Ankilozan spondilit ise psoriatik artrit gibi seronegatif spondilartritlerdendir. Ultrasonografi günümüzde yumuşak dokuları değerlendirmek için yaygın kullanılan non invaziv bir görüntüleme yöntemidir. Bu çalışmada tırnak tutulumu olan ve olmayan psoriazis hastalarında tırnak yatak ve tırnak plak kalınlıklarını ultrasonografik olarak ölçerek ankilozan spondilit hastaları ve kontrol grubu ile karşılaştırmayı hedefledik. Gereç ve Yöntem: Otuzyedi psoriazis, 39 ankilozan spondilit hastası ile 33 sağlıklı kontrol çalışmaya dahil edildi. Psoriazis hastaları ile ankilozan spondilit ve kontrol grubunun “tırnak plak kalınlığı” ve “tırnak yatak kalınlığı” hasta oturur pozisyonda ve sağ el masa üzerinde nötral pozisyonda iken gri skala ultrasonografi (LOGIQ5Pre, GE, 4-11- MHz lineer prob) ile aynı hekim tarafından sağ el ikinci parmak tırnağında(indeks tırnak) ölçüldü. Bulgular: Tırnak yatak kalınlıkları psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 1.60,1.58,1.51 mm olarak ölçüldü. Tırnak plak kalınlıkları ise psoriazis, ankilozan spondilit ve kontrol grubunda sırasıyla 0.64,0.62,0.68 mm olarak ölçüldü. Psoriazis grubu ile ankilozan spondilit ve kontrol grupları arasında tırnak yatak ve tırnak plak kalınlıkları açısından istatistiksel olarak fark yoktu.(p=0.13,p=0.45)Tırnak yatak kalınlığı, sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksek ölçüldü. (p=0.030) Sonuç: Sonuç olarak çalışmamızda tırnak plak ve tırnak yatak kalınlıkları ultrasonografik olarak değerlendirildiğinde psoriazis grubu ile kontrol grubu ve ankilozan spondilit hastaları arasında fark bulunmadı. Ultrasonografik olarak ölçülen tırnak yatak kalınlıkları sağ el ikinci parmak tırnağı tutulumu olan hastalarda, olmayanlara göre istatistiksel olarak daha yüksekti.Objective: Psoriasis is an inflammatory and erythematousscaly disease which involve the skin, joint and nail. It’s prevalence is 1-3%. The incidence of nail involvement in psoriasis patient ranged between 15-69 %. Ultrasonography is a noninvasive imaging method widely using for assess the soft tissue image nowadays. In this study we aimed to assess the nail bed and nail plate thickness in psoriasis patient with and without nail involvement and compare with ankylosing spondylitis and control groups. Material and Methods: Thirty-seven patient with psoriasis, 39 patient with ankylosing spondylitis and 33 healthy control were included to the study. Nail bad and nail plate thicknesses was measured with grey scale USG(LOGIQ5Pre, GE, 4-11- MHz lineer prob) from the right hand’s second finger(index finger), when the patient seated with the hands in a neutral position over the table. Results: Nail bad thicknesses were measured as 1.60, 1.58, 1.51 mm respectively in psoriasis, ankylosing spondilytis and control groups. Nail plate thicknesses were 0.64,0.62 and 0.68 mm respectively in psoriasis, ankylosing spondylitis and control groups. Nail bad and nail plate thickness were not statistically different between psoriasis, ankylosing spondylitis and control groups.(p=0.13,p=0.45) Nail bad thicknesses were measured more in the psoriasis patient with righth and second finger nail involvement then without righth and second finger nail involvement. (p=0.030) Conclusion: Inconclusion when evaluated the nail plate thickness ultrasonographically there was no statistically significant difference between psoriasis, ankylosing spondylitis and control groups. Nail bed thickness was statistically higher in psoriasis patients with righth and second finger nail involvement compared to non