A comparison of manual therapy and extracorporeal shockwave therapy in patients with carpal tunnel syndrome

Purpose: To investigate the effects on pain, symptom severity, and functionality of different physiotherapy methods applied to patients with carpal tunnel syndrome and to evaluate the advantages of these over each other.Methods: A total of 75 patients (69 females, 6 males) aged 25-60 years were separated into 3 groups. The patients in Group 1 were given a home exercise program (HP), including median nerve and tendon gliding exercises. Group 2 received the same HP plus manual therapy (MT), including soft tissue and joint mobilisation. Group 3 received the same HP plus extracorporeal shockwave therapy (ESWT). Pain severity was evaluated with a Visual Analog Scale. Symptom severity and levels of functionality were evaluated with the Boston Carpal Tunnel Syndrome Questionnaire and the Cochin Hand Function Questionnaire. All the patients were evaluated before and after treatment.Results: While there was a significant decrease in the resting and activity pain levels of each 3 groups after the treatment (p 0.05). However, the pain values of these two groups were significantly decreased compared to the EP group (p 0.05).Conclusion: In our study, the MT and ESWT applications we used in patients with CTS patients provided significant improvement compared to HP exercises only. We speculate that some differences that are not seen in the early period can be seen in long-term follow-up. Further studies should be performed to assess the long-term results

Structural insights on TRPV5 gating by endogenous modulators.

TRPV5 is a transient receptor potential channel involved in calcium reabsorption. Here we investigate the interaction of two endogenous modulators with TRPV5. Both phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) and calmodulin (CaM) have been shown to directly bind to TRPV5 and activate or inactivate the channel, respectively. Using cryo-electron microscopy (cryo-EM), we determined TRPV5 structures in the presence of dioctanoyl PI(4,5)P2 and CaM. The PI(4,5)P2 structure reveals a binding site between the N-linker, S4-S5 linker and S6 helix of TRPV5. These interactions with PI(4,5)P2 induce conformational rearrangements in the lower gate, opening the channel. The CaM structure reveals two TRPV5 C-terminal peptides anchoring a single CaM molecule and that calcium inhibition is mediated through a cation-π interaction between Lys116 on the C-lobe of calcium-activated CaM and Trp583 at the intracellular gate of TRPV5. Overall, this investigation provides insight into the endogenous modulation of TRPV5, which has the potential to guide drug discovery

Comparative effectiveness of diet alone and diet plus metformin treatment on omentin levels in type 2 diabetes patients with nonalcoholic fatty liver disease: a prospective randomized trial

Aim: The aim of this study was to compare the effectiveness of diet alone and diet plus metformin treatment on omentin levels in type 2 diabetes patients with nonalcoholic fatty liver disease. Methods: Consecutively 88 patients who had hepatic steatosis with type-2 DM were recruited for the study. For randomization, 28 patients who had exclusion criteria were excluded from the study. The remaining patients (n = 60) were randomized into two groups. Only diet therapy were given to Group 1(n = 30) and metformin 2 gram/day plus diet were given to group 2 (n = 30) during 3 months. During the follow-up period 5 patients in group 1 and 1 patient in group 2 did not come for follow-up. Therefore we evaluated 25 patients in group 1 and 29 patients in group 2. Omentin levels were analyzed at admission and at the end of the study.Results: There was a statistically significant difference in the values of body weight, body mass index, waist and hip circumference, body fat percentage (%), and omentin in group 1; and in the values of body weight, BMI, waist and hip circumference, body fat percentage (%), and omentin in group 2. Omentin levels were significantly decreased with the treatment in both groups (5.37 ± 1.31 ng/ml to 4.00 ± 1.46 ng/ml in group 1; 6.96 ± 2.10 ng/ml to 3.92 ± 0.89 ng/ml in group 2, p = 0.001 respectively). When compared the percentage of changes between two groups, it was found that the omentin value was more decreased in group 2 (p = 0.032).Conclusions: Although diet and diet plus metformin treatment decreased the omentin levels, diet plus metformin treatment would be more beneficial in type 2 diabetes patients with nonalcoholic fatty liver disease.<p

Evaluation of sleeping energy expenditure using the SenseWear Armband in patients with overt and subclinical hypothyroidism

Purpose: The aim of the present study was to evaluate the average sleeping energy expenditure (EE) levels using the SenseWear Armband (SWA) in patients with overt and subclinical hypothyroidism. Methods: Sixty patients with hypothyroidism and 30 healthy individuals were recruited for the study. Hypothyroid patients were divided into two groups: group 1 (n = 30) consisted of patients with overt hypothyroidism and group 2 (n = 30) consisted of patients with subclinical hypothyroidism. Lastly, group 3 (n = 30) consisted of healthy subjects. The average EE and metabolic equivalent of task (MET) values during sleep of all the hypothyroid participants were analyzed at baseline and at the end of the study. Data were also obtained from the healthy subjects at baseline. Results: The average sleeping EE and METs values were not significantly different at baseline. Similarly, these values did not change significantly after achieving a euthyroid state via thyroid hormone replacement (both p > 0.05). Conclusions: Contrary to what has been previously reported , the average sleeping EE and METs values in all hypothyroid patients and healthy individuals were similar at baseline and did not change in the patients with overt and subclinical hypothyroidism after achievement of a euthyroid state

Structural insights on TRPV5 gating by endogenous modulators.

TRPV5 is a transient receptor potential channel involved in calcium reabsorption. Here we investigate the interaction of two endogenous modulators with TRPV5. Both phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) and calmodulin (CaM) have been shown to directly bind to TRPV5 and activate or inactivate the channel, respectively. Using cryo-electron microscopy (cryo-EM), we determined TRPV5 structures in the presence of dioctanoyl PI(4,5)P2 and CaM. The PI(4,5)P2 structure reveals a binding site between the N-linker, S4-S5 linker and S6 helix of TRPV5. These interactions with PI(4,5)P2 induce conformational rearrangements in the lower gate, opening the channel. The CaM structure reveals two TRPV5 C-terminal peptides anchoring a single CaM molecule and that calcium inhibition is mediated through a cation-π interaction between Lys116 on the C-lobe of calcium-activated CaM and Trp583 at the intracellular gate of TRPV5. Overall, this investigation provides insight into the endogenous modulation of TRPV5, which has the potential to guide drug discovery

A score for predicting colchicine resistance at the time of diagnosis in familial Mediterranean fever: data from the TURPAID registry.

Objectives Colchicine forms the mainstay of treatment in FMF. Approximately 5-10% of FMF patients are colchicine resistant and require anti-IL-1 drugs. We aimed to compare the characteristics of colchicine-resistant and colchicine-responsive patients and to develop a score for predicting colchicine resistance at the time of FMF diagnosis. Methods FMF patients (0-18 years) enrolled in the Turkish Paediatric Autoinflammatory Diseases (TURPAID) registry were included. The predictive score for colchicine resistance was developed by using univariate/multivariate regression and receiver operating characteristics analyses. Results A total of 3445 FMF patients [256 (7.4%) colchicine-resistant and 3189 colchicine-responsive) were included (female:male ratio 1.02; median age at diagnosis 67.4 months). Colchicine-resistant patients had longer, more frequent attacks and were younger at symptom onset and diagnosis (P < 0.05). Fever, erysipelas-like erythema, arthralgia, arthritis, myalgia, abdominal pain, diarrhoea, chest pain, comorbidities, parental consanguinity and homozygosity/compound heterozygosity for exon 10 MEFV mutations were significantly more prevalent among colchicine-resistant than colchicine-responsive patients (P < 0.05). Multivariate logistic regression analysis in the training cohort (n = 2684) showed that age at symptom onset, attack frequency, arthritis, chest pain and having two exon 10 mutations were the strongest predictors of colchicine resistance. The score including these items had a sensitivity of 81.3% and a specificity of 49.1%. In the validation cohort (n = 671), its sensitivity was 93.5% and specificity was 53.8%. Conclusion We developed a clinician-friendly and practical predictive score that could help us identify FMF patients with a greater risk of colchicine resistance and tailor disease management individually at the time of diagnosis