Ferda Büyük

Objectives: This study aims to determine the effect of accompanying lymphedema in patients with breast or genitourinary system cancer on the quality of life and anxiety levels of caregivers of these patients. Patients and methods: Sixty-three caregivers (37 males, 26 females; mean age: 47.5±14.4 years; range, 20 to 80 years) of patients with breast or genitourinary system cancer and lymphedema, 40 caregivers (21 males, 19 females; mean age: 43.9±15.6 years; range, 18 to 75 years) of patients with breast or genitourinary system cancer without lymphedema, and 52 healthy volunteers (15 males, 37 females; mean age: 37.0±10.8 years; range, 23 to 68 years) as the control group were included in the cross-sectional study between May 10, 2022 and August 10, 2022. Sociodemographic information of the caregivers and information about the cancer diagnosis of the patients were recorded. The anxiety level of the caregivers was assessed with the Beck Anxiety Inventory (BAI), hopelessness level with the Beck Hopelessness Scale (BHS), and quality of life with the Caregiver Quality of Life Index-Cancer (CQOL-C). Results: There was no statistically meaningful difference between the caregivers of patients with and without lymphedema and the control group regarding anxiety (p=0.818). The hopelessness level was higher in caregivers of patients with lymphedema compared to healthy controls (p=0.011). No statistically meaningful difference was found in CQOL-C burden, disruptiveness, positive adaptation, or financial concerns subscales in caregivers of patients with and without lymphedema (p=0.697, p=0.209, p=0.823, p=0.855, and p=0.257, respectively). Continuous caregiving was negatively associated with the total CQOL-C score in caregivers of patients with lymphedema (p=0.031). Complex decongestive therapy was negatively associated with high BAI and BHS scores (p=0.038 and p=0.034, respectively). Conclusion: Lymphedema has a negative impact on hopelessness, while complex decongestive therapy has positive effects on anxiety and depression. Continuous caregiving may be considered a risk factor for high total CQOL-C scores.

Purpose: The connection between thyroid disorders and the health of bone is an endocrinological dilemma for physicians. Several studies have been conducted to examine the correlation between levothyroxine use and the risk of fracture. Different results have been obtained in these studies. The objective of the present study is to evaluate the impact of prolonged thyroid hormone replacement therapy on bone health in postmenopausal women. Patients and Methods: We obtained demographic data, laboratory results, and anthropometric measurements of patients from the hospital database. After the exclusion of patients, 59 patients with post-procedural hypothyroidism (n = 59) and a control group (n = 45) were evaluated. The patient group consisted of individuals who had undergone thyroid surgery for a benign condition and had been on levothyroxine treatment for a minimum of 5 years. Densitometric measurements of bone mass in the hip and spine were performed by bone mineral densitometry. Results: Groups were similar in age, PTH, vitamin D, bone-specific ALP, and BMI (p>0.05). The control group had a significantly lower total T score-F than the hypothyroidism group (-0.77 +/- 1.3 to -0.29 +/- 1.02, p= 0.041). However, total T score-LV, total gr/cm2-LV, and total gr/cm2-F were similar in both groups. Conclusion: This study showed that long-term levothyroxine therapy, which aims to maintain TSH levels within the normal reference range, is associated with increased bone mineral density (BMD) in postmenopausal women compared with the control group. Thus, to maintain bone health and prevent osteoporosis, it is important that postmenopausal women on long-term levothyroxine replacement undergo medical follow-up to prevent TSH suppression.

Objective: The aim of this study was to research the frequency of Human Leukocyte Antigen (HLA)-B27 antigen positivity and relationship between HLA-B27 positivity and other autoantibodies and between HLA-B27 positivity and treatment in patients diagnosed with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and Method: The study is a retrospective study. Patients diagnosed with RA and AS as a result of the examinations performed at Physical Medicine and Rehabilitation outpatient clinic between January 2017 and September 2022 were retrospectively screened, and patients whose HLA-B27 antigen was tested were included in study. Results: A total of 569 patients, 199 with RA and 370 with AS were included in study. While HLA-B27 was positive in 11% of patients with RA, it was 37.5% in patients with AS and there was a significant difference between the groups. When we analyzed the correlation of autoantibodies with HLA-B27, we found that HLA-B27 was not correlated with RF, Anti-cyclic citrullinated peptides (Anti-CCP) or Anti-nuclear antibody (ANA). When we analyzed the relationship between HLA-B27 and the treatment method, there was no significant relationship between HLA-B27 and treatment method. Conclusion: While HLA-B27 was found to be 5% positive in the general population in the literature, we found 11% in 199 patients with RA. This study is important because it shows that HLA-B27 positivity is not very common in patients diagnosed with AS recently contrary to popular belief. More studies are needed to evaluate HLA-B27 frequency in RA and AS.

Aim. We aimed to examine the thiol-disulfide (SS) balance, a recognized marker of oxidative stress, in fibromyalgia syndrome (FMS). Methods. The study comprised 98 female participants (61 newly diagnosed patients and 37 patients under treatment) with FMS, along with 82 apparently healthy female volunteers. In both groups, assessments were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Short Form-36 (SF-36), Tender Point Count, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Native thiol (NT) and total thiol (TT) levels were measured, SS levels and SS/NT ratio were calculated. Results. FMS patients demonstrated significantly lower NT levels, higher SS levels, and an elevated SS/NT ratio compared to the control group (p< 0.05 for all groups). In FMS patients, a statistically significant correlation was found between SS level and the SS/NT ratio, as well as the number of tender points (r=-0.24, p=0.02; r=-0.21, p=0.04), SF-36 pain subscales (r=0.22, p=0.032; r=0.21, p=0.04), and BAI scores (r=-0.22, p=0.01; r=-0.23 p=0.03). In the subgroup analysis, all health assessment scales were observed to exhibit statistically significant differences between the under-treatment group and newly-diagnosed group when compared to the control group (p< 0.05 for all groups). The FIQ, VAS, FSS, and BAI scores were found to be significantly lower in the under-treatment group as compared to the newly-diagnosed group (p< 0.05 for all groups). In the newly-diagnosed group, NT was significantly lower and the SS/NT ratio was significantly higher than those in the control group (p< 0.05). In the under-treatment group, SS levels and SS/NT ratio were significantly higher as compared to the control group (p< 0.05). In the multivariate regression analysis, which incorporated age, health assessment scales, patient subgroups, tender points, and duration of symptoms to predict the SS/NT ratio, variabes such as being in the under-treatment group, tender points, and BAI score were identified as significant predictors (p< 0.05). Conclusions. The thiol-SS balance was observed to shift in the oxidative direction, and oxidative stress was higher in the FMS group. The absence of a significant difference between the under-treatment group and the newly-diagnosed group in terms of thiol-SS balance parameters suggests a shift to oxidative stress in patients, independent of the treatment status.

COVID-19 is an infectious disease caused by a newly discovered coronavirus (SARS-COV-2) that can cause a broad spectrum of symptoms, from asymptomatic to severe respiratory failure. Although the virus mainly affects the respiratory system, it is also known to affect many other systems. Myalgia, hyposmia, anosmia, and Guillain-Barre Syndrome are the most common manifestations due to the peripheral nervous system being affected by the virus. Bell's palsy is a unilateral and sudden facial nerve paralysis. Viral infections are most frequently blamed for etiopathogenesis. Bell palsy due to COVID-19 infection has been reported in the literature as a rare complication. In this case, we wanted to emphasize that Bell's palsy should be kept in mind among the neurological complications that may develop due to COVID-in in a patient who developed Bell's palsy after being diagnosed with COVID-19.