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Objective: Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) is a large family of proteoglycanase enzymes that show proteolytic activity. The expression levels of ADAMTS proteases in osteoarthritis and rheumatoid arthritis are upregulated. However, their expression levels in PsA patients have not been examined yet. The aim of this study was to determine the serum levels of ADAMTS4 and ADAMTS8 in PsA patients. Materials and Methods: This was a case-control study and enrolled 40 PsA patients and 40 individuals as controls. Serum levels of ADAMTS4 and ADAMTS8 were examined by the enzyme-linked immunosorbent assay (ELISA). The relationship between ADAMTS8 levels and demographic and clinical features of PsA patients were analyzed. Results: The results of this study showed that the ADAMTS8 level was significantly elevated in the serum of PsA patients (160.9+-49.79 pg/mL) compared to the control groups (

Abstract Background C-reactive protein (CRP) is often normal in patients with psoriatic disease. Herein, we aimed to define markers of systemic inflammation in patients with monomorphic and polymorphic psoriatic skin, entheseal, and joint disease. Methods Three-step approach: (i) selection of serum markers elevated in psoriatic arthritis compared healthy controls from a panel of 10 different markers reflecting the pathophysiology of psoriatic disease; (ii) testing of these selected markers as well as C-reactive protein (CRP) in a larger cohort of 210 individuals- 105 healthy controls and 105 patients with psoriatic disease with either monomorphic skin (S), entheseal (E) or joint (A) involvement or polymorphic disease with various combinations of skin, entheseal and joint disease (SE, SA, EA, SEA); (iii) testing whether tumor necrosis factor (TNF) and interleukin (IL)-17 inhibitor therapy normalizes these markers. Results CRP was not elevated or was rarely elevated in the subgroups (S 0%, E 0%, A 20%, SE 7%, SA 33%, EA 27%, SEA 33%) despite active psoriatic disease. In sharp contrast, beta-defensin 2 and lipocalin-2 levels were elevated in the majority of patients with monomorphic skin (93% and 73%) and entheseal (both 53%), but not joint disease (27% and 20%). Conversely, elevations of calprotectin and IL-8 were found in the majority of patients with monomorphic joint disease (both 73%). IL-22 was elevated in all three monomorphic disease manifestations (S 60%, E 46%; A 60%). Furthermore, the vast majority of patients with polymorphic psoriatic disease (SE, SA, EA, SEA) showed widespread marker elevation. IL-17- and TNF inhibitor treatment significantly lowered all 5 markers of inflammation in PsA patients. Conclusions Systemic inflammation is detectable in the majority of patients with psoriatic disease, even if CRP is normal. The respective marker pattern depends on the manifestation of psoriatic disease with respect to skin, entheseal, and joint involvement.

The aim of our study was to assess the levels of depression, anxiety, and fatigue in patients diagnosed with FMF (Familial Mediterranean Fever) and to examine their associations with drug compliance, attack, and being employed or not. Patients presenting to our rheumatology outpatient clinic Tel-Hashomer Classification Criteria were included in the study. Fifty-two diagnosed patients followed up in our rheumatology outpatient clinic (35 female, 17 male), and 30 healthy control subjects whose ages and genders match consisting of the accompanists and visitors of the patients (25 female, 5 male) were included. Risk for depression and anxiety was assessed with HADS (Hospital Anxiety and Depression Scale). Depression and anxiety were observed to be significantly more common in the patients with FMF compared to the healthy controls in this study. Also, the frequency of FMF attacks was found to be associated with depression, anxiety, and fatigue and that regular use of colchicine decreased fatigue. In the light of all these results, the mood should definitely be evaluated during the routine practice in case of a chronic disease such as FMF having a younger patient population compared to other rheumatic diseases, and, if needed, psychiatric support should be received. Also, it should be explained to the patients that the regular use of colchicine would be beneficial for both the disease and fatigue. There is a need for follow-up studies with large case series in order to support the results we obtained. [Med-Science 2018; 7(4.000): 773-6]

Background: Pentraxin (PTX) 3 is synthesized by leukocytes, dendritic cells, endothelial cells and monocytes in response to IL-1 and tumor necrosis factor (TNF)-α, and it might be informative regarding local inflammation. In additionally, pentraxin (PTX)-3, produced by endothelial cells in atherosclerotic plaques, acts as a modulator of inflammatory processes and is involved in the development of atherosclerotic lesions. Objective: This study aimed to identify the levels of proteins, such as PTX and fetuin-A, which are thought to play a role in the progression of atherosclerotic and cardiovascular disorders in patients with BD, and to investigate the relationship of these protein levels with BD activity, inflammatory cytokines, insulin resistance and dyslipidaemia. Patients and methods: This study included 58 patients (36 females, 22 males) with BD and 20 healthy controls. Serum PTX-3, fetuin-A, interleukin (IL)-17 and insulin concentrations were determined. Homeostasis model of insulin resistance (HOMA-IR) values were calculated, and disease activity was assessed using BD Current Activity Form (BDCAF) scores. Results: The levels pentraxin-3, fetuin-A, IL-17, insulin and HOMA-IR in patients with BD were found to be higher than control subjects (p 0.05). Conclusions: Similar to CRP, PTX-3 is an acute-phase reactant that is considered an inflammatory and atherosclerotic biomarker. This study showed that PTX-3 levels can increase, similar to IL-17, but no relationship was detected between disease activity and coronary risk factors such as serum lipids, glucose intolerance and obesity. This was a cross-sectional study; therefore, the patients should be followed in long-term studies to determine whether higher PTX levels in BD patients are associated with a higher incidence of cardiovascular disease.

Introduction: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. Aim: The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population. Materials and Methods: Patients were assigned into three groups as follows: patients with type II DM n: 100, patients with hypothyroidism n:48 and patients with acromegaly n:36. In addition, 50 healthy individuals were included in the study as control subjects. Patients were asked if they had any pain, symptoms of paraesthesia and numbness. Patients with peripheral neuropathy were excluded from the study. Boston Symptom Severity Scale and Functional Capacity Scale were used to assess symptom severity and functional capacity. CTS was investigated by performing electrophysiological study for both hands. Results: The incidence of CTS was significantly higher in all three groups compared to the control group (p>0.05). In addition, the incidence of CTS was significantly higher in the DM group compared to the hypothyroid and acromegaly groups (p

We describe a 31-years-old female patient with severe pain in both knees who had been diagnosed as Behcet’s disease (BD) for 12 years. She had had a history of complications due to BD including superior vena cava thrombosis, pulmonary thromboembolism, uveitis, and erythema nodosum and has reported the administration of corticosteroid therapy irregularly. After radiologic evaluation, she has been diagnosed with bone infarction of both left and right knee with the existance of lupus anticoagulants (LA) positivity. Severe joint pain without the evidence of arthritis must alert the clinician to the possibility of bone necrosis of the extremity, although those may rarely occur bilateral in BD.

BACKGROUND: Fibromyalgia syndrome (FMS) is a non-articular rheumatic disorder of unclear etiology, characterized by widespread body pain, fatigue and, psychological complaints OBJECTIVES: To investigate the serum levels of neuron-specific enolase (NSE) in patients with FMS and to evaluate the relationship between cognitive function, quality of life and psychological state. MATERIALS AND METHODS: Fifty-five female patients diagnosed with fibromyalgia according to the American College of Rheumatology (ACR) classification criteria, and 40 healthy female subjects were enrolled in the study. Life quality scale [(Fibromyalgia Impact Questionnaire (FIQ)], psychological state (Beck Depression Scale), and cognitive dysfunction (mini mental test, clock drawing test) scales were used for patients and control subjects. Serum NSE levels were studied using the ECLIA method. RESULTS: No significant differences were found in the serum NSE levels between the FMS patients and the control subjects (p> 0.05). Life quality and psychological state scores were found to be higher in FMS patients relative to the control group (p< 0.001). However, no significant differences were detected in cognitive function (p> 0.05). Significant correlations were not found between the serum NSE levels and quality of life, psychological state and cognitive functions (p> 0.05). CONCLUSION: No significant difference was determined between the groups in terms of NSE levels. Further studies, including larger series, should be carried out to clarify this relationship. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the demographic and epidemiological characteristics of traumatic spinal cord-injured patients.The hospital records of 539 patients (416 men, 123 women) with spinal cord injuries (SCIs) admitted to four hospitals that were major referral centers for trauma in the south-eastern region of Turkey from 1990 to 1999 were reviewed retrospectively. The patients with SCI were investigated for two periods; the first period covered patients admitted between 1990 and 1994 during which time an influx of people from rural to urban areas occurred and firearm injuries were common. In the second period (19951999) the influx of people declined and firearm injuries were reduced.The most common causes of injuries were road traffic accidents (200, 37.12%), followed by falls (172, 31.90%) and bullet wounds (115, 21.34%). In the first period, incomplete paraplegia was encountered more often than in the second period (P<0.001).In conclusion, in our series, while the leading cause of SCI for the two time periods was road traffic accidents, firearm injuries for the first period and falls for the second period were second-most frequent causes of SCI. In addition, the present study suggests that demographic and epidemiological factors may affect the characteristics of SCI in a region-based population even in a 10-year period of time. [ABSTRACT FROM AUTHOR]

The objectives of this study were to assess the relationship between physical impairment and disability during stroke rehabilitation and to determine the effect of cognitive functions on physical impairment during rehabilitation. Prospectively collected data from stroke patients admitted for rehabilitation were compared at admission and at discharge by the Chedoke–McMaster Stroke Assessment (the Chedoke Assessment) impairment inventory and subscores of the Functional Independence Measure (FIM). The Chedoke Assessment was used to measure physical impairment in the lower extremities and the FIM was used to measure physical disability; motor and cognitive subscales of the FIM instrument were also evaluated. Although stroke-related impairment and motor FIM were significantly correlated with each other, cognitive measures on the FIM at discharge were not correlated with motor impairment, although cognitive disability was slightly improved. It is possible that dependency in physical activities of daily living and walking after stroke are mostly affected by degree of motor impairment. [ABSTRACT FROM AUTHOR]

As data on the relationship between parity and bone mineral density often seem to be controversial, ultimately, a comprehensive research study was thought to be necessary. This study focused on examining the influence of the number of pregnancies on bone mineral density and investigating the relationship between pregnancy and bone mineral density at four sites in postmenopausal women of different age groups. A total of 509 postmenopausal women, varying from 45 to 86 years of age (mean age of 60.85 ± 7.53 years) were considered for the study. A standardized interview was employed to obtain information on demographics, lifestyle, and, reproductive and menstrual histories. Patients were separated into four groups according to the number of pregnancies, i.e., nulliparae (52 patients), one to two parity (66 patients), three to five parity (178 patients), and more than five parity (213 patients). The patients were further classified into two age groups, 40–59 years (233 patients) and 60–80 years (276 patients), respectively. The number of pregnancies was found to range from 0 to 17 (with an overall mean of 5.42 ± 3.68), with 4.29 ± 2.74 (range, 0–16) accounting for live births, while 1.02 ± 1.53 (range, 0–14) were abortions. There were no significant differences among the groups with respect to parameters such as, age, body mass index (BMI), age at menarche, age at menopause, and years since menopause (P > 0.05) in all of the 509 women and in the 40- to 59- and 60- to 80-year groups. When all the patients were considered, the bone mineral density (BMD) values of the spine and the trochanter for the more-than-five-parity group, were found to be significantly lower than those of the other groups (P < 0.05), while the BMD values of the spine and the femur (neck, trochanter) appeared to decrease with increasing parity. In the 40- to 59-year group, the BMD of the spine in both the nulliparae and one-to-two-parity groups was significantly higher than that of the more-than-five-parity group (P < 0.05). No significant differences were found among the groups with respect to the BMD values at any femur sites. The nulliparae patients in the 60- to 80-year group exhibited significantly higher trochanter and Ward''s BMD values than those of the more-than-five-parity group (P < 0.05), whereas in the one-to-two-parity group, spine BMD values appeared to be significantly higher than those of the more-than-five-parity group (p < 0.05). Significant correlations were found between the number of pregnancies and BMD values for the spine (r = -0.23; P < 0.01), trochanter (r = -0.16; P < 0.01), and Ward''s triangle (r = -0.14; P < 0.05), with no significant correlation for femur neck BMD (r = -0.08; P > 0.05) values. In conclusion, the present study suggests that the number of pregnancies has an effect on the BMD values and that this situation shows a variation in different age groups. In addition, our study indicates that there is a significant correlation between the number of pregnancies and the spine, trochanter, and Ward''s triangle BMD, but there is no correlation for the femur neck BMD. [ABSTRACT FROM AUTHOR]