Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits.

STUDY DESIGN: Occlusion of the infrarenal abdominal aorta with administration of pentoxifylline was applied to adult rabbits, followed by removal of aortic clamp and reperfusion. Tissue levels of cytokines, lipid peroxides, and antioxidant enzymes were assayed and compared within groups. OBJECTIVES: To examine the effect of pentoxifylline (PTX) on cytokine levels, lipid peroxidation, and antioxidant enzymes in a rabbit model of spinal cord ischemia-reperfusion injury induced by aortic occlusion. SETTING: Isparta, Turkey. METHODS: Rabbits were randomly allocated into four groups of sham laparotomy (SHAM), sham laparotomy with PTX administration (SHAM+PTX), aortic occlusion and reperfusion (AOR), aortic occlusion and reperfusion with PTX administration (AOR+PTX). An intravenous bolus of 50 mg/kg PTX was given just before aortic cross clamping. An atraumatic microvascular clamp was then placed on the abdominal aorta immediately distal to the left renal artery for 30 min. PTX was infused at a rate of 0.5 mg/kg/min during the aortic occlusion. Animals were subjected to 120 min of reperfusion after removal of the aortic clamp. All animals were sacrificed at the end of reperfusion. The lumbosacral segments of spinal cords were quickly harvested and stored at -78 degrees C for biochemical assays of IL-6, TNF-alpha, MDA, SOD, and CAT levels. Differences among groups were analyzed by one-way analysis of variance followed by a post hoc Tukey's honestly significant difference test. RESULTS: No differences in mean levels of IL-6, TNF-alpha, MDA, SOD, and CAT were noted between SHAM and SHAM+PTX groups (P>0.05). There was a significant increase in all biochemical parameters in the AOR group (P<0.05). Administration of PTX significantly attenuated the levels of all biochemical parameters in the AOR+PTX group (P<0.05). CONCLUSION: PTX pretreatment attenuated ischemia-reperfusion induced spinal cord injury in a rabbit model, in terms of biochemical parameters of ischemia and reperfusion.

QT dispersion and cardiac involvement in patients with rheumatoid arthritis.

OBJECTIVE: To investigate the dispersion of repolarization variables in patients with rheumatoid arthritis (RA). METHODS: Electrocardiography (ECG) and Doppler echocardiography were performed on 40 patients with RA, which were divided into two groups according to the duration of disease and in 48 healthy controls. RESULTS: All patients had significantly longer QT dispersion (QTd) and corrected QT dispersion (QTc-d) values (p<0.05). The mean values of diastolic function variables were significantly different in all patients compared to healthy controls (p<0.05). There were no statistically significant differences between patient groups in terms of diastolic function variables except IVRT. However, QTd and QTc-d were significantly longer in patients with disease duration over 5 years (p<0.05). CONCLUSION: We conclude that repolarization heterogeneity and diastolic dysfunction are commonly seen in RA, and QTd is significantly longer in those patients with a disease duration over 5 years compared to those with new onset RA.

Scintigraphic evaluation of synovial inflammation in rheumatoid arthritis with (99m)technetium-labelled human polyclonal immunoglobulin G.

The aim of this study was to investigate whether (99m)technetium-labelled polyclonal human immunoglobulin G (99mTc-IgG) scintigraphy reflects synovial inflammation in patients with rheumatoid arthritis (RA). We evaluated 29 patients with RA for this reason and found a highly significant correlation between total scintigraphic scores and total tenderness scores (r = 0.781, P < 0.001). A significant correlation was also found between 99mTc-IgG scintigraphic scores and tenderness in all joints other than the shoulders. The 99mTc-IgG scintigraphy had a sensitivity of 69% and specificity of 88% in cases with tenderness and 72% and 81%, respectively, in cases with swelling. Total scintigraphic scores were correlated with serum levels of C-reactive protein (r = 0.401, P < 0.05) but not with erythrocyte sedimentation rate (r = 0.149, P > 0.05). The correlation between disease activity scores and total scintigraphic scores was also found to be significant (r = 0.812, P < 0.001). We suggest that 99mTc-IgG scintigraphy is a reliable and objective method in detecting synovial activity and can be appropriate for observing disease prognosis in clinical trials with RA.

Low back pain and posture.

This study was designed to analyse postural aberrations of the back and lower back region in patients with acute and chronic low back pain and to investigate the accordance of clinical and radiological assessments. Fifty patients with acute and 50 with chronic low back pain and 50 controls were studied and a detailed spinal physical examination was performed. In addition, the angles of thoracic kyphosis, lumbar lordosis and sacral inclination were assessed radiologically. Differences among the three groups, correlations of radiological parameters with each other and with clinical parameters such as age, gender and body mass index, and the accordance of clinical and radiological postural assessments were investigated. It was concluded that there were no statistically significant differences among the groups for angles of thoracic kyphosis, lumbar lordosis and sacral inclination; however, we found significant correlations among all radiological parameters, especially between lumbar lordosis and sacral inclination. Both lumbar lordosis and sacral inclination were increased with body mass index, and lumbar lordosis and thoracic kyphosis were increased with age. Clinical assessments of thoracic kyphosis and lumbar lordosis were not in accordance with radiological assessments.

Effect of muscle relaxation splint therapy on the electromyographic activities of masseter and anterior temporalis muscles.

The purpose of this study was to compare the effectiveness of splint therapy on the electromyographic activity of masticatory muscles (anterior temporalis and masseter) before and after the application of a muscle relaxation splint. Electromyography recordings from the masseter and anterior temporalis muscles were analyzed quantitatively during maximal biting in the intercuspal position both before and after treatment without a splint. Fourteen patients whose chief complaint was masticatory muscle pain were selected for the study. After the initial evaluations muscle relaxation splints were applied, and the patients were instructed to use the splints for 6 weeks. Surface electromyographic recordings were taken from each patient before the beginning of clinical therapy and after 6 weeks of wearing the splints. The data obtained were analyzed through paired sample t tests and Wilcoxon's signed rank tests. The results of the study were as follows: (1) the electromyographic activity of the two muscles during maximal biting was not markedly changed after the muscle relaxation splint was used; and (2) the changes observed in electromyographic activity of the involved and noninvolved sides were insignificant as well.

Effect of anterior repositioning splints on the electromyographic activities of masseter and anterior temporalis muscles.

The effect of anterior repositioning (AR) splint therapy on masticatory muscle activity was investigated in seventeen patients with internal derangement; disk displacement with reduction in particular. Integrated electromyography (EMG) recordings from the masseter and anterior temporalis muscles were analyzed quantitatively during maximal biting in intercuspal position before and after eight week treatment period, EMG recordings were taken for each subject prior to the beginning of clinical therapy and final EMG recordings were made without AR splint to provide a standard for comparison. The results of the investigation revealed the following: 1. AR splint therapy did not cause any significant modification of the EMG activity in the recorded muscles during maximal biting in intercuspal position; 2. Before and after treatment the EMG activity from the masseter muscle was less than from the temporal muscle; 3. AR splint therapy resulted in reduction of the pain (88.2%) and jaw joint sounds (64.7%) and mean vertical opening which was 42.17 mm before treatment increased to 45.06 mm.

Bowel dysfunction and irritable bowel syndrome in fibromyalgia patients.

Fibromyalgia and irritable bowel syndrome are both common conditions which account for most of the referrals to physical medicine and rehabilitation-rheumatology and gastroenterology clinics, and they frequently coexist. In this study, we utilized a previously validated questionnaire to assess the prevalence of symptoms of bowel dysfunction and irritable bowel syndrome, and to survey the range of bowel pattern in 75 patients with fibromyalgia as compared to 50 normal controls. Symptoms associated with irritable bowel syndrome (p < 0.05) were reported in 41.8% of the fibromyalgia patients and 16% of the normal controls. In conclusion, we found that patients with fibromyalgia have a high prevalence of gastrointestinal complaints confirming the results indicating that fibromyalgia and irritable bowel syndrome frequently coexist. This may suggest a common pathogenic mechanism for both conditions.

Osteoporosis in rheumatoid arthritis: effect of disease activity.

In addition to juxtaarticular osteoporosis, which appears to reflect predominantly local disease mechanisms, more generalized bone loss can occur in rheumatoid arthritis (RA). The aim of this study was to compare bone mineral density (BMD) of the lumbar spine and proximal femur in RA patients versus controls and evaluate the influence of disease related determinants. Twenty-seven patients with RA and twenty healthy subjects were included in this study. BMD was significantly reduced in RA patients compared with the control group. BMD was correlated with duration of disease, health assessment questionnaire scores, hand grip strength and erythrocyte sedimentation rate. These results support the hypothesis that BMD may be affected by RA related determinants.