Evaluation of Dry Eye Syndrome in Patients With Familial Mediterranean Fever: A Cross-sectional Study

. It has been reported that some autoimmune diseases are associated with dry eye syndrome. There are limited studies that relates dry eye syndrome in patients with Familial Mediterranean fever (FMF). The aim of this study is to evaluate the relationship between dry eye syndrome in patients with FMF comparing with healthy controls. Methods. Prospective cross-sectional study was carried out in departments of physical medicine and rehabilitation and ophthalmology clinics in a tertiary public institution with a sample of 46 participants including 23 FMF patients and 23 healthy controls. Detailed eye examination was performed in all cases and indicators of xerophthalmia were assessed by Schirmer-I test, tear break-up time (TBUT) and ocular surface disease index (OSDI). In patient group; results of FMF gene analysis, acute phase reactants, concomitant diseases and number of FMF attacks were noted. Results. The average Schirmer-I test results for right-eye were recorded as 14.74±8.38 for the FMF group and 13.09±10.54 for the healthy group; the TBUT scores were 14.69±5.32 in FMF group and 15±6.45 in the healthy group; and OSDI scores were 9.04±2.75 and 10.86±1.77 in the FMF group and the healthy control, respectively.There were no statistically significant differences between FMF and control groups in terms of Schirmer-I, TBUT, and OSDI scores (all p＞0.05). No correlation was identified between acute phase reactants and the OSDI, TBUT and Schirmer-I tests for right-eye (all p＞0.05). Conclusion. This study identified no correlation between dry eye and FMF. Ocular pathology is rare and infrequently reported in FMF.

Femoral Neuropathy in a Patient with Rheumatoid Arthritis

Femoral mononeuropathy (FMN) as an extraarticular finding of rheumatoid arthritis (RA) is a phenomenon which has not been reported previously. We report a 53-year-old female patient with RA, presenting FMN findings during the course of the disease. On examination, right quadriceps and iliopsoas muscles showed grade 3 weakness on the Medical Research Council (MRC) scale. Sensory examination revealed sensory loss in the right medial leg and thigh. Patellar tendon reflex was absent in the right side. A diagnosis of a partial right femoral neuropathy was confirmed using nerve conduction study and electromyography. The probable mechanism of FMN was thought to be vasculitis.

The Role of Tendinitis in Fibromyalgia Syndrome

Fibromyalgia Syndrome (FS) is a common disease characterized by diffuse, widespread pain and multiple tender points. The syndrome has been subclassified as primary (PFS) and secondary (SFS) fibromyalgia. The aim of this study was to evaluate the role of common tendinitis (rotator cuff tendinitis, bicipital tendinitis, lateral epicondylitis, De-Quervain's tendinitis and pes anserinus tendinitis) in FS. Twenty female patients with PFS, 20 with SFS and 20 female controls, matched by age and body mass index, participated in the study. Existence of common tendinitis was evaluated with specific examination methods. Right and left rotator cuff tendinitis, pes anserinus tendinitis and left lateral epicondylitis were significantly more common in patients with PFS and SFS than in control subjects. As a result, considering the central hyperexcitability present in the fibromyalgia patients, concomitant pathologies such as tendinitis which lead to shoulder, arm, and leg pain must be evaluated. Follow up and therapy for the disease must be planned according to these factors which are not only probable symptoms of FS, but also leading causes for the occurence and continuity of the pain in this disease.

Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Subjects

The Martin - Gruber Anastomosis (MGA) is probably the most well known of the anastomotic anomalies that occur at various levels between the median and ulnar nerves. It is formed by motor axons from the median nerve or its branch anterior interosseous nerve that cross in the upper forearm to join the ulnar nerve. The purpose of this study was to establish the frequency of MGA in healthy subjects and to draw the attention of clinicians working in the neurophysiological laboratory to the presence of this anastomosis, and thus to avoid possible misinterpretations of data from needle electromyography (EMG) and nerve conduction studies. 100 volunteers (60 women and 40 men) were selected for the study. Surface recording electrodes were placed on the right hand thenar, hypothenar and on the first dorsal interosseous (FDI) muscles. The median and ulnar nerves were stimulated supramaximally at the wrist and at the elbow and compound muscle action potentials (CMAPs) were recorded and their amplitudes evaluated. MGA was found in 27 of the 100 subjects. The type of anastomosis most frequently seen was type II, which was observed in 21 subjects. Type I anastomosis was observed in three, type I + type II in two and type III anastomosis in one subject. It can thus be concluded that MGA is frequently encountered and it should be borne in mind that abnormal innervation models may influence the electrophysiological findings and thus give rise to faulty interpretations, especially in the case of median and ulnar nerve lesions.