Canan Erdogan

Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?

The role of free radicals in fibromyalgia is controversial. In this study, 85 female patients with primary fibromyalgia and 80 age-, height-, and weight-matched healthy women were evaluated for oxidant/antioxidant balance. Malondialdehyde is a toxic metabolite of lipid peroxidation used as a marker of free radical damage. Superoxide dismutase is an intracellular antioxidant enzyme and shows antioxidant capacity. Pain was assessed by visual analog scale. Tender points were assessed by palpation. Age, smoking, body mass index (BMI), and duration of disease were also recorded. Malondialdehyde levels were significantly higher and superoxide dismutase levels significantly lower in fibromyalgic patients than controls. Age, BMI, smoking, and duration of disease did not affect these parameters. We found no correlation between pain and number of tender points. In conclusion, oxidant/antioxidant balances were changed in fibromyalgia. Increased free radical levels may be responsible for the development of fibromyalgia. These findings may support the hypothesis of fibromyalgia as an oxidative disorder.

The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women

The aim of the study was to investigate the effect of osteoarthritis on hand function in postmenopausal women. One hundred patients with hand OA and 70 healthy volunteers as controls were evaluated. Grip and pinch strength measurements and Dreiser’s functional index were used for hand function. Pain was assessed by a visual analog scale, and tenderness was assessed by palpation and scored, depending on the severity of tenderness, as 0, 1 or 2. Heberden’s and Bouchard’s nodules and joint involvement were also recorded. The number of patients with only distal interphalangeal joint involvement was 50 (50%), those with distal interphalangeal joint plus proximal interphalangeal joint involvement was 49 (49%), and those with carpometacarpal joint involvement numbered 18 (18%). The incidence of Heberden’s and Bouchard’s nodules was 85% and 36%, respectively. Eighty-six (86%) patients were suffering from pain and 57 were found to have tenderness. Grip and pinch strength was significantly lower (p<0.05) and Dreiser’s functional index score was significantly higher (p<0.001) in the study group (particularly in grade 4 OA). Grip strength was lower in hand OA patients with distal interphalangeal joint plus proximal interphalangeal joint involvement than in those with only distal interphalangeal joint and carpometacarpal joint involvement. Pinch strength was also lower in patients with distal interphalangeal joint plus proximal interphalangeal joint plus carpometacarpal joint involvement. The patients with Heberden’s and Bouchard’s nodules had lower grip and pinch strength than controls. Also, pain and tenderness had significant (p<0.05) effects on hand function. Dreiser’s total score ranged from 0 to 10 in 80 (80%) patients and from 11 to 20 in 20 patients. In conclusion, hand osteoarthritis contributes to hand dysfunction, mainly related to the severity of osteoarthritis, pain, joint involvement and the presence of nodules.

Assessment of pain and disability in patients with chronic neck pain: reliability and construct validity of the Turkish version of the neck pain and disability scale.

Objectives: The objective of this study was to test whether a Turkish version of the Neck Pain and Disability Scale retains its reliability and validity of the original English version. Methods: Sixty-one patients with chronic neck pain were enrolled in the study. The Neck Pain and Disability Scale (NPDS), the Pain Disability Index (PDI) and The Hospital Anxiety and Depression Scale (HADS) were filled by all subjects. Reliability was determined by internal consistency. Internal consistency was measured by calculating Cronbachs alpha and item-total correlation. Validity was examined by correlating the NPDS scores to the Visual Analogue Scale (VAS), PDI and HADS scores. Results: Cronbachs alpha value for NPDS was found to be 0.86 and this was statistically significant (p < 0.0001). The item-total correlations of NPDS varied between 0.08 and 0.69. The cross-sectional construct validity coefficients were 0.51 for PDI, 0.45 for VAS, 0.35 and 0.33 for Hospital Anxiety and Depression Scales. Conclusion: Despite its major limitations, our results seem to support previous findings of the English and French versions of the Neck Pain and Disability Scale, indicating that this functional scale is valid and reliable.

No effect of GA-AS (904 nm) laser irradiation on the intact skin of the injured rat sciatic nerve

AbstractWe evaluated the electrophysiological and histopathological effects of low-energy gallium arsenide (904 nm) laser irradiation on the intact skin injured rat sciatic nerve. Twenty-four male Wistar rats were divided into three groups (n=8 each). At the level of proximal third of the femur the sciatic nerve was crushed bilaterally with an aneursym clip (Aesculap FE 751, Tuttingen, Germany) for half a second. A gallium arsenide laser (wavelength 904 nm, pulse duration 220 ns, peak power per pulse 27 W, spot size 0.28 cm2, pulse repetition rate 16, 128 and 1000 Hz; total applied energy density 0.31, 2.48 and 19 J/cm2) was applied to the right sciatic nerve for 15 min daily at the same time on 7 consecutive days. The same procedure was performed on the left sciatic nerve of same animal, but without radiation emission, and this was accepted as control. Compound muscle action potentials were recorded from right and left sides in all three groups before surgery, just at the end of injury, at the 24th hour and on the 14th and 21st days of injury in all rats using a BIOPAC MP 100 Acquisition System Version 3.5.7 (Santa Barbara, USA). BIOPAC Acknowledge Analysis Software (ACK 100 W) was used to measure CMAP amplitude, area, proximal and distal latency, total duration and conduction velocity. Twenty-one days after injury, the rats were sacrificed. The sciatic nerves of the operated parts were harvested from the right and left sides. Histopathological evaluation was performed by light microscopy. Statistical evaluation was done using analysis of variance for two factors (right and left sides) repeated-measures (CMAP variables within groups) and the Tukey–Kramer Honestly Significant Difference test (CMAP variables between laser groups). The significance was set at p ≤ 0.05. No statistically significant difference (p ≥ 0.05) was found regarding the amplitude, area, duration and conduction velocity of CMAP for each applied dose (0.31, 2.48 and 19 J/cm2) on the irradiated (right) side and the control (left) side, or between irradiated groups. Twenty-one days after injury there were no qualitative differences in the morphological pattern of the regenerated nerve fibres in either irradiated (0.31, 2.48 and 19 J/cm2) or control nerves when evaluated by light microscopy. This study showed that low-energy GaAs irradiation did not have any effect on the injured rat sciatic nerve.

In vivo effects of meloxicam, celecoxib, and ibuprofen on free radical metabolism in human erythrocytes.

Abstract One of the major groups of chemical mediators involved in the inflammatory response is the prostaglandins, which are synthesized from arachidonic acid by the enzyme cyclooxygenase. The aim of this study is to compare the in vivo effects of celecoxib, meloxicam, and ibuprofen on the activities of catalase (CAT), glutathione peroxidase (GSHPx), superoxide dismutase (SOD) as well as malondialdehyde (MDA), and antioxidant potential levels (AOP) in human erythrocytes. Patients diagnosed as osteoarthritis were included in the study. Patients were treated with Celecoxib (200 mg/d) (n = 12), Meloxicam (15 mg/d) (n = 12), and Ibuprufen (1200 mg/d) (n = 9) for 21 days. SOD, CAT, GSHPx activities, MDA, and AOP levels were investigated in human erythrocyte haemolysates. SOD activity and AOP levels were significantly decreased in all NSAID groups when we compared the values before and after 21 days of celecoxib, meloxicam, ibuprofen treatment. There were no significant difference in CAT, GSHPx activities, and MDA levels before and after treatment in each group. Decreased SOD activities are thought to be related with the increased superoxide anion. Decreased AOP levels may indicate impairment in the total antioxidant defence system. These NSAIDs have similar effects on free radical metabolism on human erythrocytes; despite some difference in action mechanisms.

Study of Axial Bone Mineral Density in Postmenopausal Women with Diffuse Idiopathic Skeletal Hyperostosis Related to Type 2 Diabetes Mellitus

OBJECTIVE The association of bone mineral density (BMD) with diffuse idiopathic skeletal hyperostosis (DISH) related to diabetes mellitus was studied. METHODS We measured BMD and elevated known determinants of BMD (bone markers) in 35 patients with DISH-related type 2 diabetes mellitus, 47 type 2 female diabetics, and 52 female controls with no systemic disease and no drug administration. All subjects were matched for age and body mass index (BMI). All subjects were in the postmenopausal period. RESULTS Among subjects, BMD values were significantly higher in DISH patients than in diabetics and controls (p < 0.05). In addition, the duration of diabetes mellitus was longer in DISH patients and significantly correlated with total hip BMD in DISH patients (p < 0.05). CONCLUSIONS Patients with DISH have higher BMD, and increased BMD probably results from hyperostosis of the axial skeleton, which may cause decreased fracture risk.

Pulmonary function tests, respiratory muscle strength, and endurance of patients with osteoporosis

Background It has been shown that patients with thoracic kyphosis due to osteoporosis have diminished pulmonary function. The aim of this study was to determine the pulmonary function, respiratory muscle strength, and endurance of patients with osteoporosis who did not have compression fractures. Methods The patient group consisted of 88 recently diagnosed postmenopausal osteoporotic women without spinal fractures. They were matched for age and body mass index with 54 healthy women, who formed the control group. Bone mineral density, pulmonary function test (PFT), maximum voluntary ventilation (MVV), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) measurements of both groups were performed. Results There were no significant differences between the two groups regarding PFT parameters and MIP and MEP. However, osteoporotic patients had significantly lower MVV values. Conclusion Women with postmenopausal osteoporosis without spinal compression fractures have normal PFT, MIP, and MEP values, but they have reduced respiratory muscle endurance.

Acute Electrophysiological Effect of Pulsed Gallium–Arsenide Low-Energy Laser Irradiation on Isolated Frog Sciatic Nerve

We evaluated the acute electrophysiological effects of low-energy pulsed laser irradiation on isolated frog sciatic nerve measured by extracellular recording technique. A pulsed gallium–arsenide (GaAs) laser (wavelength: 904 nm, pulse duration 220 ns, peak power per pulse: 27 W, spot size: 0.28 cm2, total applied energy density: 0.005–2.5 J/cm2) was used for the experiment. Sixty isolated nerves were divided into six groups (n=10), each of which received a different laser dose. In each group, action potentials were recorded before laser irradiation which served as the control data. The extracellular action potentials were recorded for each combination of 1, 3, 5, 7, 10, 13 and 15 minutes of irradiation time and 4, 8, 16, 32, 64 and 128 repetition frequency by using a BIOPAC MP 100 Acquisition System Version 3.5.7 (Santa Barbara, USA). Action potential amplitude, area, duration and conduction velocity were measured. Statistical evaluation was performed using repeated measures variance analysis by SPSS 9.0. There were no statistically significant differences for action potential amplitude, area and conduction velocity among the laser groups and control data (p>0.05). The study showed that low-energy GaAs irradiation at 4–128 Hz repetition frequencies administered for irradiation times of 1–15 min generates no effect on action potential amplitude, area, duration and conduction velocity in isolated frog sciatic nerve.

A case of ochronosis: upper extremity involvement

Abstract. We present an ochronotic patient with spondylosis and upper extremity involvement. We also evaluated radiologic findings of joints that were involved and MRI features of the lumbar spine.

Obesity Related Measurements and Joint Space Width in Patients with Knee Osteoarthritis

Background The aim of this study is to analyze the relationship between body mass index and obesity related measurements and tibiofemoral joint space which have been the principal method of radiographic evaluation in progression and therapeutic trials of knee osteoarthritis. Methods Fifty-five female patients with the diagnosis of osteoarthritis in knees according to the criteria of American College of Rheumatology in knees were included in the study. The mean age of patients was 57,42+/-8,60(SD) years with a range of 42-77. Medial and lateral compartment joint space widths were measured on antero-posterior knee radiography. Body mass index, triceps, biceps, subscapular and suprailiac skinfold thickness, waist and hip circumference were measured. Body composition was determined by dual energy X-ray absorpsiometry (DEXA) (Norland XR 46) and total lean mass (g), total fat mass (g), trunk lean mass, trunk fat mass, abdomen lean mass, abdomen fat mass measurements were recorded. Results Patients with body mass index>30 were accepted as obese patients. According to these criteria 33 of the 55 patients were obese. Tibial medial compartment and tibial lateral compartment measurements of obese patients were significantly lower than nonobese patients (p=0,000, p=0,003 respectively). Body mass index was correlated with total lean mass, total fat mass, trunk fat mass, abdominal fat mass, leg fat mass. Tibial medial compartment and tibial lateral compartment space measurements were negatively correlated with body mass index. Conclusion: Our results revealed significant difference in both medial and lateral joint spaces of obese and nonobese patients with knee osteoarthritis. Medial and lateral joint spaces of obese patients were narrower than nonobese osteoarthritis patients. The more body mass index had the patients the narrower joint space they had displayed. However body composition analysis and obesity related measurements did not show additional correlation with tibial compartment measurement.