Hypothyroidism and autoimmune thyroid disorders in rheumatoid arthritis: relationship with disease activity.

Background and aims: Thyroid function abnormalities and thyroid autoantibodies have previously been described in rheumatoid arthirits (RA) with limited data. In some studies, a relationship was found between thyroid autoantibodies and RA disease activity. However, there are not strong studies in the literature indicating the relationship between thyroid diseases and RA. The aim of this study was to determine the frequency of hypothyroidism and to investigate the relationship between thyroid hormone levels, autoantibodies and disease activity in patients with rheumatoid arthritis (RA). Methods : 1017 patients with the diagnosis of RA were recruited. This observational study was conducted between January 2014 and July 2015. Demographic variables were recorded. Anti-nuclear antibodies (ANA), anti-cyclic citrulli-nated peptide antibody (anti-CCP), Rheumatoid Factor (RF), C reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), anti-microsomal antibody (anti-TPO )and anti-thyroglobulin antibody (anti-TG) were determined. Visual analog score and Disease Activiy Score 28 (DAS-28) ESR and DAS-28 CRP were recorded. The relationship between thyroid hormone levels and thyroid antibodies and disease activity parameters were determined. Results: 98 (%9,7) patients had hypothyroidism and 61 (%6) patients had hyperthyroidism. 210 (20,7%) patients with RA was positive for TPOAb and 165(16,3%) for anti-TG. Positive correlation was detected between anti-TPO positivity and anti-CCP levels (p:0.005, r:0,274). In anti-TG antibody positive patients, there was a significant positive correlation of thyroid hormone levels with CRP and DAS 28-CRP (p:0.01, r:0,120; p:0.01, r:0,169). Conclusion: Thyroid autoantibodies were found to be positive in 16-21% of patients with RA. Though hypothyroidism is not very frequent in RA patients, autoimmune thyroid disease is quite common, which may be related to disease activity.

Carpal tunnel syndrome and nerve conduction studies in fibromyalgia patients.

INTRODUCTION: The aim of this study is to evaluate ENMG results of female patients with Fibromyalgia Syndrome (FMS) with a preliminary diagnosis of carpal tunnel syndrome (CTS) and to examine whether there are differences in ENMG results compared to control group. MATERIAL AND METHODS: Ethical approval was obtained for this study on 30.12.2022 with number E. Kurul-2022-20/32 and recorded retrospectively between January 2021 and January 2023. 201 female patients who were diagnosed with FMS in Physical Therapy and Rehabilitation polyclinic and who were requested to have ENMG testing with a preliminary diagnosis of CTS were included in study as patient group. 201 patients were included as control group. RESULTS: While the number of patients with right CTS was 39 (25.49%) in the FMS group, the number of patients with right CTS was 38 (24.20%) in control group. While the number of patients with left CTS was 34 (25%) in the FMS group, number of patients with left CTS in the control group was 36 (24.65%). When we analyzed a total of 592 ENMG results in our study, we found a high normal ENMG rate of 75%. CONCLUSION: We found that there was no difference between the FMS and the control group in terms of compatibility between the pre-diagnosis and electroneurophysiological diagnosis in the ENMG results requested with the pre-diagnosis of CTS in our study. The ENMG examination should be requested for right patient in right indication, by first evaluating the patient well.

Prolotherapy Versus Phonophoresis and Corticosteroid Injections for the Treatment of Plantar Fasciitis: A Randomized, Double-Blind Clinical Trial.

The aim of this study was to compare the effectiveness of prolotherapy with phonophoresis and steroid injection in patients with plantar fasciitis (PF). One hundred forty-six patients with PF were randomly divided into prolotherapy, phonophoresis, and injection groups. The treatment method to be applied to them was determined by drawing lots of equal numbers of papers with "Prolotherapy," "Corticosteroid," and "Phonophoress" written on it among those who accepted to be treated. Patients were evaluated using heel sensitivity index (HSI), visual analog scale (VAS), foot function index (FFI), and Short Form (SF)-36 at baseline, first and third months after the therapy. Plantar fascia thickness (PFT) was measured by ultrasonography (USG) at baseline, first and third months after the therapy. Statistically significant improvements were found in all parameters at 1 and 3 months after treatment in all groups (p < .05). There was no significant difference between VAS and FFI scores between the 3 groups (p > .05). Improvement in the HSI (p = .021) and SF-36 general health (GH) subscales at the third month after treatment in the prolotherapy group was significantly better at the first and third months compared to the other groups (p = .033 and p < .01). No complications were observed in any of the patients. Our study results suggest that prolotherapy, phonophoresis, and steroid injection are beneficial as safe treatment modalities in the early period of PF treatment. The improvement of HSI and SF-36 GH subscale lasts longer with prolotherapy, but ultrasonographic findings do not change in the third month of these treatment applications.