Selami Akkuş

Levels of lipid peroxidation and antioxidant vitamins in plasma and erythrocytes of patients with ankylosing spondylitis.

OBJECTIVES The aim of this study was to investigate plasma and erythrocytes antioxidant vitamins and lipid peroxidation (LP) levels in patients with ankylosing spondylitis (AS) and controls. METHODS The study was performed on the blood of 13 AS patients and 13 controls. Plasma and erythrocyte samples were obtained from blood of the patients and controls. RESULTS Erythrocyte sedimentation ratio, C-reactive protein level, Bath AS disease activity index and bath AS functional index were higher in patients with AS than in controls. Vitamins A, C, E and β-carotene concentrations in plasma, reduced glutathione (GSH) and glutathione peroxidase values in erythrocyte were lower in patients with AS than in controls. LP concentrations were higher in the plasma and erythrocyte of the patients than in controls. CONCLUSION These results provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant vitamins in ankylosing spondylitis.

Physiological parameters as a tool in the diagnosis of fibromyalgia syndrome in females: A preliminary study.

AIMS Although fibromyalgia (FM) syndrome is associated with many symptoms, there is as yet no specific finding or laboratory test diagnostic of this syndrome. The physical examination and laboratory tests may be helpful in figuring out this syndrome. MATERIALS AND METHODS The heart rate, respiration rate, body temperature (TEMP), height, body weight, hemoglobin level, erythrocyte sedimentation rate, white blood cell count, platelet count (PLT), rheumatoid factor and C-reactive protein levels and electrocardiograms (ECG) of FM patients were compared with those of control individuals. In addition, the predictive value of these tests was evaluated via receiver operating characteristic (ROC) analysis. KEY FINDINGS The results showed that the TEMP and the PLT were higher in the FM group compared with the control group. Also, ST heights in ECGs which corresponds to a period of ventricle systolic depolarization, showed evidence of a difference between the FM and the control groups. There was no difference observed in terms of the other parameters. According to the ROC analysis, PLT, TEMP and ST height have predictive capacities in FM. SIGNIFICANCE Changes in hormonal factors, peripheral blood circulation, autonomous system activity disorders, inflammatory incidents, etc., may explain the increased TEMP in the FM patients. The high PLT level may signify a thromboproliferation or a possible compensation caused by a PLT functional disorder. ST depression in FM patients may interrelate with coronary pathology. Elucidating the pathophysiology underlying the increases in TEMP and PLT and the decreases in ST height may help to explain the etiology of FM.

Ultrasonographic evaluation of the median and sciatic nerves in hemiplegic patients after stroke.

ObjectiveThe aim of this study was to evaluate morphologically and electrophysiologically the peripheral nerves of hemiplegic patients. DesignThirty-three (18 women and 15 men) stroke patients were recruited. The mean (SD) age was 55.6 (11.3) yrs, and the mean (SD) disease duration was 14.2 (16.0) mos. Motor nerve conduction study of the median, ulnar, fibular, and tibial nerves as well as sensory nerve conduction study of the median, ulnar, and sural nerves were performed. Diameters and cross-sectional area (CSA) measurements of the median (wrist/midarm levels) and sciatic nerves (midthigh level) were acquired using a 7- to 12-MHz linear probe. The values of the nonparetic limbs were taken as controls. ResultsProlonged distal latency and slowed motor conduction velocity of the tibial nerve as well as reduced amplitudes of the median and ulnar nerves were observed on the paretic sides when compared with those of the nonparetic sides (all P < 0.05). The median and sciatic nerve cross-sectional area values were found to be smaller on the paretic sides when compared with the nonparetic sides (all P < 0.05). The median and ulnar nerve compound muscle action potential amplitudes (paretic side) were positively correlated with arm/hand Brunnstrom Motor Recovery Stage, disease duration, motor Functional Independence Measure score, and Functional Ambulation Category. ConclusionsThe peripheral nerves of stroke patients seem to be affected—morphologically and electrophysiologically—on the paretic side.

Isokinetic muscle performance of the hip and ankle muscles in women with fibromyalgia.

To compare isokinetic muscle performances of a proximal (hip) and a distal (ankle) muscle of fibromyalgia syndrome (FMS) patients with those of age‐ and body mass index (BMI)‐matched healthy subjects.

The prevalence and risk factors for osteoporosis among 18- to 49-year-old Turkish women

ABSTRACT The aim of this study was to determine the prevalence of osteoporosis and associated risk factors in Turkish women aged 18–49 years. A population-based, cross-sectional study was conducted between January and April 2014. The sample (n = 1,792) was comprised of women aged 18–49 years, who resided in Cubuk, Ankara, Turkey, and were selected by simple random sampling. The data were collected in face-to-face interviews using an Individual Information Form and an Osteoporosis Risk Estimation Scale. Bone mineral density was assessed using standard dual-energy X-ray absorptiometry. Multiple logistic regression and chi-square analyses were used for analyses. Most participants (80.1%) were at low risk of developing osteoporosis, while 6.9% were at medium to high risk of developing the disease. From bone mineral density levels, 33.3% were osteopenic; 4.0% were osteoporotic; 33.3% were osteopenic at the femoral neck; and 6.7% were osteoporotic at the lumbar vertebra L1−L4. Further, results of multiple logistic regression analyses showed that osteoporosis risk was significantly associated with smoking, having light skin, multiparity, and having a family history of osteoporosis (p < .05). These results indicated that public health screening strategies for protecting women’s bone health at earlier ages than previously thought might be beneficial.

An Unusual Cause of Myelopathy: Ochronotic Spondyloarthropathy with Positive HLA B27.

Ochronosis is a late developing complication of alkaptonuria, a black brownish pigment in the fibrous and cartilaginous tissues. Although most previous studies reported alkaptonuria and back pain due to ochronosis, thoracic myelopathy is an extremely rare complication. In this report, a paraparetic patient who has ochronotic spondiloarthropathy with the presence of HLA B27 antigen is described. He had low back and leg pain and morning stiffness for 5 yrs. Last year, these were followed by tingling, numbness, and weakness the in lower extremities and he was operated on with preliminary diagnosis of prolapsed disc herniation and cord compression. Surgery is suggested for disc herniations related to ochronotic spondyloarthropathy if it is necessary or neurologic symptoms are present. However, his pain and weakness have partially recovered after the operation. After medical and physical treatment, he showed clinically significant improvements. This case report demonstrates that the management of ochronosis needs a multidisciplinary approach with physiologic, neurologic, and psychologic effects and proper treatment may significantly improve functional outcomes in these patients.

Association between Bone Mineral Density and Clinical Parameters in Traumatic Brain Injury Patients

Yaz›flma Adresi/Address for Correspondence: Dr. Selçuk Sayılır, Sıtkı Koçman Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Muğla, Türkiye Tel.: +90 252 211 50 25 E-posta: selcukssay@gmail.com Geliş Tarihi/Received: 19.06.2015 Kabul Tarihi/Accepted: 01.09.2015 Objective: Determine the association between the bone mineral density and traumatic brain injury (TBI). Materials and Methods: Twenty-two patients with TBI included to the study. Dual energy X-ray absorptiometry measurements which determines the femur neck and L1-4 vertebrate T scores in patients was performed via Lunar Prodigy DPX system. Clinical parameters such as types of involvements (plegia), upper-lower extremity spasticity values, presence of heterotypic ossification, ambulation levels were determined and their relations with femur neck and L1-4 vertebrate T scores were examined with Mann-Whitney U Test. Results: In the comparison of sub groups of type of plegia (tetraplegic/hemi-paraplegic), lower extremity spasticity values [Ascworth score 0/1-2-3-4), presence of heterotopic ossification no statistically significant (p>0.05) difference was found in the femur neck and L1-4 vertebrate T scores. On the other hand, in the subgroups determined according to ambulatory levels of the patients (confined to bed-wheelchair/ ambulated (orthesis-hand support-independent)] significant difference was observed in the femur neck T scores (p=0.044). Femur neck T scores were significantly high in ambulated patients (p=0.044). Conclusion: In TBI cases ambulation level is a factor which significantly affect bone mineral density. It is necessary to ambulate patients with potential as soon as possible and to plan alternative approaches in patient could not be ambulated.

Hand Function in Metabolic Disorders: Hemodialysis, Diabetes Mellitus, and Gout

Metabolic disease including chronic renal failure, gout, and diabetes mellitus impair hand function via occurring musculoskeletal abnormalities and hemodynamic, vascular, or neurological dysfunctions. Carpal tunnel syndrome (CTS), destructive arthropathy, bone cyst, bone erosions, and tendon abnormalities are seen in patients receiving hemodialysis. Diabetes mellitus is associated with an increased incidence of functional disability. The complications of diabetes mellitus seen in the hand are diabetic stiff hand syndrome, Dupuytren’s disease, CTS, trigger finger, Complex Regional Pain Syndrome type-1, and neuropathy. Hand involvements of the patients with gout are monosodium urate crystal deposition in tendon, joints, and nerve. Tophi lead to destructive arthropathy and present on the fingers and the volar surface of the hands. Muscle strength test, range of motion evaluation, hand dexterity, and daily activity tests could be assessed in those patients. In this chapter, the musculoskeletal and the other involvements of the hand were mentioned. Additionally, the tests evaluating hand functions and index which were used for evaluating hand disability were reviewed.