Engin Tastaban

Antioxidant status in patients with osteoporosis: A controlled study

OBJECTIVE We aimed to investigate serum antioxidant enzymes and nitric oxide (NO) levels in postmenopausal women with osteoporosis (OP) and in healthy controls; and to determine the relationship between these enzymes, NO and clinical parameters in this present study. METHODS Forty-five postmenopausal women fulfilling OP diagnostic criteria of World Health Organization (WHO) and 42 postmenopausal healthy women without OP were enrolled. Patients in the study population were selected among individuals that were not pre-diagnosed or pre-treated for OP. Patients with metabolic bone diseases, fracture history, which were smokers, alcohol users and taking antioxidant drug treatment, were excluded from the study. Dual Energy X-ray Absorptiometry (DXA) results, body mass indices and demographic data were recorded. Erythrocyte catalases (CAT), glutathione reductase (GR) enzyme activities and erythrocyte glutathione (GSH) levels, plasma malondialdehyde (MDA) levels were measured by spectrophotometer whereas plasma nitrite+nitrate (NOx) levels were measured by ELISA microplate-reader. RESULTS Patients had significantly lower GR (P<0.01) enzyme activity and higher levels of MDA (P<0.01) and NO (P<0.01) than non osteoporotic healthy controls. There was no significant difference between both groups in erythrocyte GSH levels and CAT activities. Total femoral BMD measurements significantly correlated with MDA levels (P=0.001). There was no significant relationship between other antioxidants and lumbar or femoral BMD. CONCLUSION Oxidative stress may play an important role in postmenopausal bone loss and therefore it might be considered when pathogenesis of postmenopausal OP has been investigated.

Serum antioxidants and nitric oxide levels in fibromyalgia: a controlled study.

We proposed to assess antioxidant status and nitric oxide in fibromyalgia (FM) patients in comparison to healthy controls. Additionally, the association between the serum antioxidant levels and clinical findings in FM patients was also investigated. Thirty-seven FM patients and 37 healthy controls were enrolled in this study. Severity of fatigue and pain were determined by Visual Analogue Scale. Functional capacity in daily living activities was evaluated by fibromyalgia impact questionnaire. Serum NO, catalase and glutathione were measured. Serum glutathione and catalase levels were significantly lower in FM patients than controls. However, no significant difference was seen in serum NO levels between the two groups. A significant correlation was evident between serum NO level and pain. Additionally, the correlation between glutathione level and morning stiffness was found to be significant. These findings support other studies, we assume that these two antioxidants might have impact on the pathogenesis of FM disease.

The relationship between serum trace element levels and clinical parameters in patients with fibromyalgia

We examined the association between serum trace elements and clinical findings such as number of sensitive tender points, severity of fatigue and functional status in patients with fibromyalgia (FM). Thirty-two patients diagnosed as having FM according to the ACR 1990 criteria and 32 normal healthy controls (NHC) were included in this study. The demographic data, disease duration, number of tender points and accompanying symptoms (fatigue, sleep disorders, headache, paresthesia, irritable bowel syndrome, sicca symptoms, Raynaud’s phenomena) of the patients were noted. Visual analog scale (10 cm) was implemented to estimate daily severity of pain and fatigue. Fibromyalgia impact questionnaire was used for functional assessment. Serum selenium (μg/dL) and serum zinc (μg/dL) levels were measured by atomic absorption spectrometer. Serum magnesium (mmol/L) level was measured by the original kits of Abbott Aeroset auto-analyzer. The mean age of patients in FM group and NHC were calculated as 42.9 (SD = 7.7) years and 41.3 (SD = 9.7) years, respectively. Serum levels of zinc (P = 0.001) and magnesium (P = 0.002) were significantly decreased by FM groups, whereas there was no considerable difference with selenium levels of both groups (P > 0.05). Association between serum zinc level and number of tender points (P = 0.008) and that between fatigue and magnesium level (P = 0.003) was found as meaningful. According to the results of this study, it was asserted that serum magnesium and zinc levels may play an important role in the pathophysiology of FM.

Angio‐oedema in a Patient Treated with Etanercept for Rheumatoid Arthritis

In the treatment of rheumatoid arthritis, specific drugs targeting disease-related proinflammatory cytokines such as tumour necrosis factor-alpha have been observed to show a positive impact on the clinical course of the disease. One of these drugs, etanercept, is a recombinant soluble fusion protein of tumour necrosis factor-alpha type 2 receptor. Although it has many well-established side effects, up to date there has not been any report of angio-oedema in the literature. Hence, we aimed to present clinical findings of a 59-year-old female patient who received etanercept for rheumatoid arthritis and developed angio-oedema during treatment, and to the discuss side effects of the drug within the context of current literature.

Effects of deep heating provided by therapeutic ultrasound on demyelinating nerves.

[Purpose] Physiotherapeutic heating agents are classified into two groups: superficial-heating agents and deep-heating agents. Therapeutic ultrasound is a deep-heating agent used to treat various musculosketal disorders. Numerous studies have attempted to determine the impact of ultrasound on healthy nerve conduction parameters. However, the instantaneous effects of deep heating via ultrasound on demyelinating nerves do not appear to have been described previously. The present study aimed to assess and compare the impact of ultrasound on demyelinating nerve and healthy nerve conduction parameters. [Subjects and Methods] Carpal tunnel syndrome was used as a focal demyelination model. Thirty-two hands of 25 participants with carpal tunnel syndrome were enrolled in the study. Ultrasound parameters were 3.3 MHz, 1.0 W/cm2, 8 minutes, and continuous wave. Electrodiagnostic studies were performed initially, at the midpoint (4th min), and immediately after (8th min) ultrasound application. [Results] Reduced motor conduction velocity was found in demyelinating nerves at the 4th and 8th minutes. Ulnar nerve onset latency was significantly prolonged in the 8th minute recording, compared to the initial value. There were no significant differences in relative velocity and latency changes between demyelinating and normal nerves. [Conclusion] Deep heating via ultrasound may inversely affect conduction velocity in demyelinating nerves.

Plantar pressure distribution in patients with ankylosing spondylitis

BACKGROUND Ankylosing spondylitis is one of the most common inflammatory rheumatic diseases and is associated with alterations in posture. The aim of this study was to investigate the pedobarographic changes among ankylosing spondylitis patients, in an attempt to understand whether the alterations in the posture affect the plantar pressure distribution. METHODS The study population consisted of 38 patients with ankylosing spondylitis and 33 healthy volunteers. The static and dynamic pedobarographic measurements were performed to determine the plantar pressure distribution. Moreover, the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire and Bath Ankylosing Spondylitis Metrology Index were used to assess the clinical state of the patients. RESULTS The static pedobarographic measurements did not reveal any intergroup difference. There were differences between the groups in the results of dynamic peak pressure measurements under the metatarsal areas and under the midfoot region. The percentage of the midfoot in the dynamic plantar contact area was higher in ankylosing spondylitis patients in comparison to the controls. No clinically significant correlation was found between the clinical scores and static pedobarographic measurements. The plantar pressures under the metatarsal heads, medial and lateral heel regions declined with increasing disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index scores. The lower peak pressures on the forefoot and rearfoot, were associated with the higher Bath Ankylosing Spondylitis Metrology Index scores of the patients. INTERPRETATION The alterations in the posture may have effects on the plantar pressures in patients with ankylosing spondylitis, especially during dynamic activities.