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Total antioxidant capacity and the severity of the pain in patients with fibromyalgia

Abstract The purpose of the study was to determine the oxidative and antioxidative status of plasma in patients with fibromyalgia. Total antioxidant capacity (TAC) of plasma was significantly lower in patients with fibromyalgia (n = 20) than in healthy controls (n = 20) [1.5 (SD 0.3) and 1.9 (SD 0.3) mmol Trolox equiv./l, P = 0.001]. In contrast, the total peroxide level of plasma was significantly higher in patients than in healthy controls [37.4 (SD 6.7) and 33.0 (SD 2.7) μmol H2O2/l; P = 0.01]. The oxidative stress index (OSI) level was significantly higher in patients with fibromyalgia than in healthy controls [2.5 (SD 1.0) and 1.8 (SD 0.4); P = 0.007]. A significant negative correlation between visual analogue scale (VAS) and TAC level was determined (r = −0.79, P < 0.001). The present results indicate that patients with fibromyalgia are exposed to oxidative stress and this increased oxidative stress may play a role in the etiopathogenesis of the disease. Supplementation of antioxidant vitamins such as vitamins C and E to the therapy may be indicated.

Relation of cortisol levels and bone mineral density among premenopausal women with major depression

We aimed to investigate the relationship between cortisol levels and bone mineral density (BMD) among premenopausal women with major depression. We compared BMD, plasma cortisol, osteocalcin and C‐telopeptide (CTx) levels of 36 premenopausal women with major depression with 41 healthy women who were matched for age and body mass index. Osteocalcin and CTx were used for the evaluation of bone turnover. The clinical diagnosis of major depression was made by using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) criteria. The 21‐item Hamilton Rating Scale for Depression was used for the assessment of depressive symptoms. In comparison with the controls, the mean BMD of the depressed women was significantly lower at the lumbar spine and at all sites of the proximal femur (p = 0.02, 0.01). Plasma cortisol levels were significantly higher in depressive patients than in controls (p = 0.001). Osteocalcin was lower and CTx was higher in the patient group than in controls (p = 0.04, p = 0.008). Lumbar and femur BMD scores were negatively correlated with cortisol levels in the patient group. Major depression had important effects on BMD and bone turnover markers. Depression should be considered among risk factors for osteoporosis in premenopausal women.

The Relationship Between Clinical Parameters and Depression Level in Patients with Myofascial Pain Syndrome

OBJECTIVE Several studies and reviews have documented the high degree of comorbidity between depression and chronic pain. It was reported that chronic muscle pain is frequently accompanied by symptoms of depression. The purpose of this study was then to investigate the prevalence of major depression in chronic pain patients (CPP) with myofascial pain syndrome (MPS) and to investigate the relationship between some clinical parameters and level of depression, utilizing a healthy control group without MPS. DESIGN/SETTING/PATIENTS The study group consisted of 77 MPS patients (65 female, 12 male) and 72 healthy volunteers (60 female, 12 male). The diagnosis of MPS was based on clinical characteristics, examination findings, and ruling out other diagnoses. Major depressive disorder was diagnosed by a psychiatrist utilizing DSM-IV criteria. Levels of depression were obtained from the Beck Depression Inventory (BDI). RESULTS There was no significant difference between MPS patients and controls with respect to age and gender (P > 0.05). The mean age of the patients was 31.1 years (SD 9.8) and the mean age of controls was 29.7 years (SD 7.1). Major depression was more frequently found in CPPs with MPS (P < 0.001). BDI scores were higher in the MPS group than in controls (P < 0.001). There was a significant correlation between the severity of pain and depression level in patients with MPS (r = 0.654, P < 0.001). CONCLUSION Major depression is found in MPS CPPs at a rate previously noted in the literature in mixed diagnoses CPPs. In addition, the severity of the depression may be related to perceived pain severity.

Paraoxonase and arylesterase activities in fibromyalgia

Abstract We aimed to evaluate the association of serum paraoxonase and arylesterase activities and oxidative/antioxidative status in patients with fibromyalgia. Forty-two patients with fibromyalgia and 53 healthy controls were included in the study. Serum paraoxonase and arylesterase activities were measured spectrophotometrically. Oxidative and antioxidative status were evaluated by measuring serum lipid hydroperoxide (LOOH) levels, total antioxidant status (TAS) and free sulfhydryl groups (–SH = total thiol). Lipid parameters were determined by routine laboratory methods. Serum paraoxonase and arylesterase activities, and TAS were lower in patients with fibromyalgia than in controls (P < 0.001, for all), and the –SH level was also lower in the patient group (P = 0.03). LOOH levels were higher in the patient group than in controls (P = 0.01). Our results suggest that patients with fibromyalgia were exposed to oxidative stress, and paraoxonase and arylesterase activities were decreased in these patients. Patients with fibromyalgia might be prone to development of atherosclerosis with reduced paraoxonase and arylesterase activities.

Efficacy of transdermal fentanyl in patients with mechanic neck or back pain

Study population included 50 subjects who were consecutively recruited from Gaziantep University Department of Physical Medicine and Rehabilitation among patients referred for screening of mechanic low back or neck pain. They were diagnosed as cervical or lumbar disc herniation according to their clinical and radiological findings. The demographical features, medications, duration of each medications, concomitant diseases, routine test results were recorded. The severity of pain, health related quality of life was evaluated by Visual Analogue Scale (VAS), Short Form 36 (SF 36) in respectively. Transdermal fentanyl was applied as 12 μg/h patch after the first evaluation. Mean age of patients with low back pain and neck pain was measured as 43.6±10.5 and 48.7±10.6 years, respectively. There were no significant differences between two patients group in respect to age, gender, erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) levels (p>0.05). There were significant healing in mean scores of role emotional, physical functioning, role physical, bodily pain subscales of SF 36 after treatment in cervical disc herniation group (p

Efficacy of Pulmonary Rehabilitation Program with Cycle Ergometer in Obstructive Sleep Apnea Syndrome

Background and objectives: Obstructive Sleep Apnea Syndrome (OSAS) is characterized by recurrent upper airway obstruction during sleep. The aim of this study was to investigate impact of respiratory rehabilitation program with cycle ergometer on exercise capacity, respiratory parameters, sleep and quality of life in OSAS. Patients and methods: Study population was consisted of mild and moderate OSAS patients aged 18-65. Controlled breathing techniques and respiratory muscle exercises were asked to practice 2 times a day for 10-20 minutes. Upperlimb muscles of the shoulder girdle and cycle ergometer exercise device consisting of aerobic exercise and resistance programs we implement, was performed 3 times a week for 50-60 minutes. Anthropometric measurements, respiratory function tests; exercise capacity, 6 Minute Walk Test; level of day time sleepiness the Ep worth Sleepiness Scale; sleep and quality of life, Functional Outcome of Sleep Questionnaire and the Short Form-36 Questionnaire; anxiety levels were assessed using the State-Trait Anxiety Inventory. Results: 40 patients were included in the study. After treatment, neck circumference, level of daytime sleepiness, resting and post-exercise heart rate and blood pressure response, dyspnea and leg fatigue decreased; and improved exercise capacity, MIP, quality of life and sleep were observed. Conclusion: PR may be an effective treatment option in patients with OSAS. To our knowledge this is the first report that demonstrating the effectiveness of cycling exercises on functional status, exercise capacity, life and sleep quality in patients with OSAS.

Multifocal skeletal tuberculosis presenting as paraplegia: A case report

BACKGROUND Tuberculosis of the musculoskeletal system is not a common clinical condition; however, multifocal bone involvement is even rarer and difficult to recognize. CASE In this paper, we presented a patient who developed paraplegia 15 days before his hospital admission. He was operated by neurosurgeons due to spinal mass, but postoperative examination revealed vertebral and multifocal skeletal tuberculosis. It is difficult to diagnose this condition by conventional imaging methods. The importance of positron emission tomography (PET) in the diagnosis of skeletal tuberculosis was emphasized. RESULT The importance of rehabilitation program in restoring functionality was overviewed in the light of current literature. Vertebral and osteoarticular tuberculosis should be considered in patients with vertebral and thoracic mass presenting with neurological deficits.

Osteoporosis significantly reduces quality of life

The study was planned to investigate the quality of life in women with postmenopausal osteoporosis. Sixtyfour patients with postmenopausal osteoporosis and 80 postmenopausal healthy women were included in the study. Quality of life was evaluated by QUALEFFO-41 and bone mineral density was measured using dual-X-ray absorptiometry. There were no significant differences between two groups with respect to age, and body mass index (P>0.05). QUALEFFO pain, QUALEFFO physical function household chores, QUALEFFO physical function mobility, QUALEFFO general health scores were significantly higher in patients, than in controls (P<0.001, for all). There were no significant differences QUALEFFO social activity and QUALEFFO mental function scores between patients and controls (P>0.05). We have shown that the quality of life was lower in osteoporotic patients than in controls. We thought that the life quality should be assessed in osteoporotic patients even before fracture occurrence.

The effect of antipsychotics on bone mineral density in bipolar disorder: a case-controlled pilot study

The purpose of this study was to evaluate the effect of antipsychotics on bone mineral density in bipolar disorder. A total of 44 premenopausal female patients receiving antipsychotic medication for at least 1 year and 43 healthy premenopausal female volunteers were included in the present study. Clinical evaluation was performed via Hamilton Depression Scale and Clinical Global Impression Scale, bone metabolism via serum levels of calcium, phosphorus, parathormone, alkaline phosphatase (ALP), vitamin D and prolactin, while bone mineral density via dual energy X-ray absorptiometry. Bone mineral density scores were determined to be significantly lower, while prolactin, parathormone and ALP levels were significantly higher in the patient group. Comparison of patient group in itself based on patients under atypical antipsychotic vs. atypical antipsychotic + mood stabilizer treatment revealed no significant difference between groups in terms of clinical and biochemical parameters. In conclusion, contrary to what many studies suggest, our findings revealed that atypical antipsychotics offered no advantages over other medications in the development of secondary osteoporosis in patients with bipolar disorder. There was no significant difference between patients receiving atypical antipsychotics and other mood stabilizers in terms of osteoporosis incidence.