Correlations between autonomic dysfunction and circadian changes and arrhythmia prevalence in women with fibromyalgia syndrome

WOS: 000265395700007PubMed: 19357052Objective: It is known that increased sympathetic activity and decreased parasympathetic activity are present in patients with fibromyalgia syndrome (FMS). This study aims to investigate the correlations of autonomic dysfunction and differences in autonomic circadian activity with arrhythmia prevalence in women with FMS. Methods: Fifty female patients with FMS and 30 healthy female controls were included in this cross-sectional, case-controlled study. A 12-lead electrocardiogram and 24-hour Holter monitoring were performed in all patients to evaluate arrhythmias and autonomic function tests. Heart rate variability (HRV) parameters were utilized to detect autonomic dysfunction in patients with FMS. HRV measurements were performed in total 24-hour, day time (06:00-22:59), night time (23:00-05:59) periods and during autonomic tests (stand - supine, inspiration-expiration and Valsalva tests) using 24-hour Holter monitoring recordings. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The correlation of data was tested by using Spearman correlation analysis. Results: The mean ages of the patient and control groups were 38 +/- 7.4 and 36 +/- 8.1 years, respectively. In HRV measurements, high frequency (HF) power, was significantly decreased in the patient group as compared with control group (167.4 msec(2) (107.0-312.0) vs.314.5 msec(2) (124.0-905.0), p=0.017). The low frequency/HF ratio (LF/HF) values for total 24 hours (2.22 +/- 0.18 vs. 1.22 +/- 0.12, p<0.001) and in the night time period (2.78 +/- 1.97 vs.1.15 +/- 0.77, p<0.001) were found to be significantly higher in the patient group than in control one. The ratio of LF/HFDay/LF/HFNight was markedly higher in the control group (2.67 (1.22-5.65) vs. 1.45 (0.83-2.05), p=0.004). The prevalence (p=0.028) and total number (127.1 +/- 21.4 vs. 187.3 +/- 62.3, p=0.019) of supraventricular extrasystoles in 24-hour period was higher in the patient group. Conclusion: The sympathetic activity was significantly increased and parasympathetic activity significantly decreased in FMS patients. Additionally, significant autonomic circadian activity changes were also detected in these patients. These autonomic changes might be linked to increased arrhythmia prevalence. (Anadolu Kardiyol Derg 2009, 9: 110-7

EVALUATION OF PANORAMIC RADIOGRAPHY MEASURES FOR IDENTIFYING REDUCED BONE MINERAL DENSITY IN ELDERLY

WOS: 000276780900005Introduction: The purpose of this study was to assess the validity of panoramic based indices (Mandibular cortical index, cortical width, panoramic mandibular index, and mandibular ratio) and to determine whether they correlate with bone mineral density in elderly. Materials and Method: The participants of this study were 120 patients; 53 males (45-83 years old, mean: 61.6 +/- 10.02) and 67 females (42-81 years old, mean: 60.58 +/- 9.15). Mandibular indices and number of teeth were measured and evaluated from panoramic radiographs. Bone mineral density (BMD) at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than -1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Results: There were statistically significant correlations between bone mineral density and sex, cortical width, mandibular ratio and mandibular cortical index (p0.05). Conclusion: Mandibular cortical index can be used for identifying subjects with low bone mass, allowing the dentists to have sufficient clinical and radiographic information to play a useful role in screening for individuals with osteoporosis

EVALUATION OF PANORAMIC RADIOGRAPHY MEASURES FOR IDENTIFYING REDUCED BONE MINERAL DENSITY IN ELDERLY (2)

WOS: 000208302700006Introduction: The purpose of this study was to assess the validity of panoramic based indices (Mandibular cortical index, cortical width, panoramic mandibular index, and mandibular ratio) and to determine whether they correlate with bone mineral density in elderly. Materials and Method: The participants of this study were 120 patients; 53 males (45-83 years old, mean: 61.6 +/- 10.02) and 67 females (42-81 years old, mean: 60.58 +/- 9.15). Mandibular indices and number of teeth were measured and evaluated from panoramic radiographs. Bone mineral density (BMD) at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than -1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Results: There were statistically significant correlations between bone mineral density and sex, cortical width, mandibular ratio and mandibular cortical index (p0.05). Conclusion: Mandibular cortical index can be used for identifying subjects with low bone mass, allowing the dentists to have sufficient clinical and radiographic information to play a useful role in screening for individuals with osteoporosis

Measurements of radiological disc heights and trunk flexibility in patients with mechanical low back pain

Lumbosakral omurganın rutin lateral grafilerinde saptanan intervertebral disk mesafesindeki daralmaların lumbal bölgedeki biyomekanik özellikleri değiştirdiği düşüncesinden yola çıkılarak planlanan çalışmada, mekanik bel ağrılı hastalar ve kontrol bireylerde, L4-L5 ve L5-S1 disk yükseklikleri, rutin lateral radyografilerde değişik metodlar kullanılarak ölçülmüş ve bu bulgularla bireylerin fron¬tal ve sagital plandaki bel hareketleri arasındaki ilişkiler araştırılmıştır. Yaşlan 28 ila 54 arasında değişen (ort:38,l±10.7) ve klinik inceleme sonucunda mekanik bel ağrısı tanısı alan 25 hasta ve aynı yaş grubunda 20 kontrol bireyde bel bölgesinin öne fleksiyon açıklığı modifiye Schober fleksiyon testi ile, sağ ve sol lateral fleksiyon açıklıkları ise modifiye Moll lateral fleksiyon testi ile ölçüldü. Radyografilerde disk mesafesi ölçümleri Hurxthal 2 metodu, Rl ve R2 metodu, Farfan metodu ve Dabbs metodu ile belirlendi. Bel ağrısı olan hastaların modifiye Schober ve modifiye Moll ölçümleri kontrol bireylere göre anlamlı düzeyde azalmış bulundu. Ağrılı grupta vücut kitle indeksi ortalamaları fazla bulunurken, iki grup arasında disk mesafelerinin tüm metodlarla ölçümleri açısından bir fark saptanmadı. Radyolojik ölçümlerde kullanılan tüm metodların birbirleri ile uyumlu oldukları gözlendi. L5-S1 disk mesafesi ölçüm sonuçları ile modifiye Schober fleksiyon ölçümleri arasında ve L4-L5 mesafesi ile modifiye Moll lateral fleksiyon değerleri arasında istatistiksel olarak anlamlı bir ilişkinin varlığı saptandı. Sonuç olarak, her nekadar radyolojik ve klinik bulgular arasında zayıf bir ilişkiden söz ediliyorsa da, idiopatik bel ağrısında disk mesafelerinin bel mobilitesi ile ilişkili olabileceği sonucuna varıldı.Although radiographic disc space narrowing is often poorly correlated with clinical findings in patients with low back pain, changes in disc heights are suspected to alter the biomechanics of the lumbar spine. The aim of this study was to describe and obtain different measurements of the L4-L5 and L5-S1 disc heights on the lateral radiographs of low back pain patients and control cases and to investigate the correlation between the radiographic findings and trunk flexibility measurements in the study group. 25 patients between 28 and 54 years of age (mean 38.1±J0.7), who were diagnosed to have mechanical low back pain and 20 control subjects of the same age group were included in the study. The trunk flexibility was measured by using the modified Schober flexion test for forward flexion, and modified Moll lateral flexion test for right and left lateral flexion. Disc space measurements were made on the radiographs by using the Hurxhall method 2, Rl and R2 methods Farfan method and Dabbs method. Statistically significant decrease in modified Schober and modified Moll measurements and significant increase in body mass index were found in the low back pain group. No statistical difference was determined between the disc height measurements of two groups. All of the measurements made by using different methods were correlated with each other. The L5-S1 disc space was found to be correlated with the modified Schober flexion measurements andL4-L5 disc space was found to be correlated with the modified Moll lateral flexion measurements in the study group. The results indicated a possible relation between disc heights and trunk flexibility in patients with mechanical low back pain

Clinical and laboratory features of patients with musculoskeletal brucellosis

Amaç: Kırıkkale ve kırsalında kas-iskelet sistemi tutulumu olan brusellozisli hastalarda demografik, klinik ve laboratuvar özellikleri incelemek. Gereç ve Yöntemler: Çalışmaya kas-iskelet sistemi tutulumu olan brusellozis tanısı konulmuş 28 hasta dahil edildi. Hastaların demografik özellikleri, yakınmasının süresi, şekli, olası enfeksiyon kaynağı sorgulandı. Ayrıntılı sistemik ve kas-iskelet sistemi muayene bulguları not edildi. Rutin biyokimya, tam kan sayımı, eritrosit sedimentasyon hızı, C-reaktif protein, romatoid faktör, antinükleer antikor, kan kültürü ve standart tüp aglütinasyon testleri yapıldı. Hastaların tümünde sakroiliak, lumbosakral ve gerekli görülen durumlarda periferik eklem radyografileri değerlendirildi. Klinik ve radyografik olarak derin eklemlerin tutulumundan şüphede kalındığı durumlarda magnetik rezonans görüntüleme yönteminden faydalanıldı. Bulgular: Hastaların yaş ortalaması 39.4 ± 14.4 yıl, hastalık süreleri 10.1 ± 12.7 aydı ve %64.3’ü erkekti. En sık izlenen semptom artralji (%85.7), bulgu ise splenomegaliydi (%32.1). Kan kültürü %39.3 hastada pozitifti. Eklem tutulumu olarak periferik artrit %71 oranı ile ilk sıradaydı ve en sık tutulan periferik eklemler %35 ile kalça ve dizdi. Sakroiliit %32 hastada tespit edildi ve %89’u unilateraldi. Spondilit %14 hastada ve en sık lomber segmentte (%75) izlendi. Her bir kas-iskelet sistemi tutulumunun tipi tüm parametreler açısından diğerleri ile kıyaslandığında sakroiliit grubunda sadece sakroiliak testleri pozitifliği, spondiliti olan grupta yaş, perküsyonla vertebra hassasiyeti ve spinal hareketlerle ağrının varlığı, diğerlerinden anlamlı düzeyde farklıydı (p< 0.05). Sonuç: Bölgemizde brusellozis saptanan ve aynı zamanda kas-iskelet sistemi tutulumu olan olgularda en sık tutulum periferik eklemlerde izlenmektedir. Sakroiliak ekleme yönelik özel testler sakroiliit için yol gösterici olabilir. Özellikle spinal hareketleri ağrılı ve perküsyonla hassasiyet saptanan brusellozisli yaşlı hastalarda omurga tutulumu olabileceği akılda tutulmalıdır. Spinal ya da periferik eklem ağrısı olan ve yumuşak doku romatizmasına bağlı şikayeti bulunan hastalarda brusellozis ayırıcı tanıda yer almalıdır.Objective: To evaluate the demographic, clinical and laboratory features of patients with musculoskeletal brucellosis in urban and rural areas of Kırıkkale, Turkey. Material and Methods: Twenty-eight patients with the diagnosis of musculoskeletal brucellosis were included in the study. All patients were questioned for demographic characteristics, duration and characteristics of complaints and possible source of infection. The findings of detailed systemic and musculoskeletal examinations were noted. Routine blood chemistries, complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, antinuclear antibody, blood culture and standard tube agglutination tests were carried out. Radiographs of the sacroiliac joints and lumbosacral spine of all patients and, if required, radiographs of peripheral joints were evaluated. Magnetic resonance imaging was performed on those in whom deep joint involvement was suspected clinically and radiographically. Results: Patient mean age was 39.4&plusmn;14.4 yr, mean duration of disease was 10.1 &plusmn; 12.7 yr, and 64.3% of the patients were male. The most frequent symptom was arthralgia (85.7%), and the most prevalent sign was splenomegaly (32.1%). Blood cultures were positive in 39.3% of the patients. Peripheral arthritis had the highest incidence with a rate of 71% in joint manifestations, and the most frequent involvement sites were hip and knee with a ratio of 35%. Sacroiliitis was detected in 32% and was unilateral in 89% of the patients. Spondylitis was found in 14% of the patients, most frequently in lumbar segments (75%). Each musculoskeletal involvement site in terms of all parameters were compared with the others and only the sacroiliac test in the sacroiliitis group and age, vertebral tenderness with percussion and the presence of painful spinal movements in spondylitis group were significantly different from the others (p&lt; 0.05). Conclusion: Peripheral joints are the most common articular involvement sites in patients with musculoskeletal brucellosis in our region. Specific sacroiliac joints tests may serve as guides to sacroiliitis. Spinal involvement should be kept in mind in elderly patients with brucellosis, particularly when spinal movements are painful or tenderness is elicited with percussion over the spine. Brucellosis should be included in the differential diagnosis of patients with spinal or peripheral joint pain and in those presenting with complaints due to soft tissue rheumatism

Comparing clinical and computed tomography findings of cricoarytenoid joints changes in patients with rheumatoid arthritis

Romatoid artrit etyolojisi bilinmeyen, simetrik erozif atini ve multisistem tutulumuyla giden otoimmün bir hastalıktır. Krikoaritenoid eklemler romatoid artritten etkilenen gerçek diartroidal eklemlerdir. Çalışmamızda, romatoid artritli olgularda bu eklemlerdeki değişikliklerin semptom, fizik muayene ve bilgisayarlı tomografi bulguları karşılaştırıldı. Romatoid artrit tanıtı 15 olguda, 30 krikoaritenoid eklemin üstüste binme tekniği ile elde edilen bilgisayarlı tomografi görüntüleri incelendi. Sonuçlar, semptom ve fizik muayene bulgularıyla karşılaştırıldı. Krikoaritenoid eklemde %66.7 olguda semptom, %13.3 olguda fizik muayene, %80 olguda bilgisayarlı tomografi pozitifti. Krikoaritenoid eklem incelemesinde, kıkırdaklarda volüm (%30), dansite artışı (%30), sublüksasyon (%20), eklemde belirginleşme (%16.7) ve eklem mesafesinde daralma (%6.7) saptandı. Bilgisayarlı tomografi romatoid artritli olgularda klinik bulgu vermeyen krikoaritenoid eklem değişikliklerini göstererek olguların olası risklere karşı korunmasını sağlar. Eklem değişikliklerinin gösterilmesi ve takibinde kullanılabilecek başarılı bir görüntüleme yöntemidir.Rheumatoid arthritis is an autoimmune disorder with unknown etiology characterized by symmetric, erosive synovitis and multisystem involvement. The cricoarytenoid joints are true diarthroidal joints that can be affected by rheumatoid disease. We investigated the involvement of these joints in patients with rheumatoid arthritis and compared the clinical findings with that of computed tomography findings. Thirty of cricoarytenoid joints were examined with overlapping technique of computed tomography in a total of 15 patients with rheumatoid arthritis. The results were compared with that of clinical findings. Syptom in 66.7% cases, physical examination in 13.3% cases and computed tomography in 80% cases were positive in cricoarytenoid joints. Increased volume (30%) and density of cartilages (30%), subluxation (20%), cricoarytenoid prominence (16.7%) and decreased joint space (6.7%) was diagnosed in cricoarytenoid joints. Computed tomography reveals cricoarytenoid joint changes which associated any clinical findings, and makes safe patients with rheumatoid arthritis. Computed tomography is a succesfull imaging method in revealing joint involvements and for follow up

Familial Mediterranean fever and ankylosing spondylitis in a patient with juvenile idiopathic arthritis: a case report and review of the literature

WOS: 000238158300011PubMed: 16307274The association of familial Mediterranean fever (FMF) with juvenile idiopathic arthritis (JIA) or ankylosing spondylitis (AS), most commonly with negative HLA-B27 antigen, was described in several previous reports, although the pathogenic mechanism of this association still remains unknown. Herein we report an uncommon association of FMF with HLA-B27 positive AS as an occasional coincidence in a patient who had been diagnosed as having JIA 23 years previously

Effects of ovariectomy and ascorbic acid supplement on oxidative stress parameters and bone mineral density in rats

Arslan, Mustafa/0000-0003-4882-5063;WOS: 000296700900002PubMed: 21980320Objectives: The aim of this study is to investigate the effects of ovariectomy on bone mineral density (BMD) and oxidative state in rats, and the alterations in these effects that vitamin C supplementation may produce. Materials and methods: Twenty female Wistar albino rats were randomly divided into three groups: control (C, n = 6); ovariectomy (O, n = 7); and ovariectomy + vitamin C supplement (OV, n = 7). Oxidative stress (OS) was assessed 100 days postovariectomy by measuring the activity of several enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase, as well as the concentrations of malondialdehyde (MDA), nitric oxide (NO), and total sulfhydryl groups in plasma and bone homogenates. Results: A significant decrease in BMD was observed in O group compared with C group (p = 0.015), and a significant increase was observed in OV compared with O group (p = 0.003). When groups were compared with respect to parameters of OS, MDA and NO levels in bone tissue were significantly higher in O than in C (p = 0.032, p = 0.022) and were significantly lower in OV than in O (p = 0.025, p = 0.018). SOD activity was significantly higher in O than in C (p = 0.032). In plasma, MDA activity was significantly higher in O than in C (p = 0.022) and NO level was significantly higher in O than in C and OV (p = 0.017, p = 0.018). Conclusions: Our results suggest that ovariectomy may produce osteoporosis and OS in females, and vitamin C supplementation may provide alterations regarding improvement in OS and BMD values. We assume that studies including more subjects are needed to make a decisive conclusion about OS-BMD relation

Predictive value of grip strength for bone mineral density in males: site specific or systemic?

WOS: 000243226400002PubMed: 16932964This study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD

Conservative treatment of femoral neuropathy following retroperitoneal hemorrhage: a case report and review of literature

Tosun, Ozgur/0000-0001-6755-2131;WOS: 000343097300021PubMed: 24686104Anticoagulant drugs are used to reduce the incidence thromboembolic events in patients at risk. However, minor and major bleeding complications may occur during anticoagulation therapy. Femoral neuropathy secondary to retroperitoneal hematoma is a well known complication of anticoagulant drugs. However, treatment of these patients is still controversial, both conservative and surgical treatments have been advocated. Herein, we report a male patient receiving warfarin for 7 years who developed femoral neuropathy due to retroperitoneal hematoma and was successfully treated with conservative methods. We suggest that conservative treatment and appropriate rehabilitation program should be given to the patients who do not demonstrate any signs of a continued bleeding and any progressive neurological deficits. Blood Coagul Fibrinolysis 25:769-772 2014 (C) Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins