Nerve conduction study and gastrocnemius H reflex response in rheumatoid arthritis.

BACKGROUND AND PURPOSE: We aimed to evaluate nerve conduction studies and gastrocnemius H reflex responses in rheumatoid arthritis (RA) patients and compared to the healthy adult subjects. METHODS: Twenty-six RA patients and twenty-two healthy adult subjects were included in the study. The nerve conduction study (NCS) findings and bilateral gastrocnemius H reflex responses were evaluated in all the groups. Age, gender, subcutaneous nodules, joint deformities, laboratory parameters, duration of disease, anti-rheumatic drug and steroid usage were recorded. Activity of disease was assessed using a 28-joint disease activity score (DAS28).The functional status was measured using the health assessment questionnaire (HAQ), pain intensity measured using a visual analog scale (VAS). RESULTS: The rate of electroneuromyographic (ENMG) abnormalities was 73% in RA patients. The most common diagnosis was carpal tunnel syndrome (61.4%). There were no significant correlations between ENMG findings and clinical and laboratory features evaluated. Right H reflex latencies were statistically longer in RA patients (p=0.03). According to calculated cut-off levels, there were more subjects with longer H reflex latencies in RA patients. CONCLUSION: In this study, entrapment neuropathies were found common as independent identity from duration and severity of disease in RA patients. For H reflex latencies, cut-off values were longer in RA patients. It may provide information about the early neuropathic involvement of long peripheral nerves in RA patients. But this findings are needed to be supported by larger population study.

Relationship of Cognitive Functions with Daily Living Activities, Depression, Anxiety and Clinical Variables in Hospitalized Elderly Patients.

INTRODUCTION: Cognitive impairment in elderly patients, which may be a sign of dementia, depression, anxiety or medical diseases, has been determined as a risk factor for functional loss. In this study, we aimed to investigate the frequency of cognitive impairment and to investigate the relationship of cognitive status with sociodemographic variables, daily living activities, anxiety and depression in elderly inpatients. METHOD: The sample of this cross-sectional and descriptive study consists of 243 patients aged 65 years and older who were hospitalized in Bülent Ecevit University Hospital. A sociodemographic questionnaire,, the Mini-Mental State Examination (MMSE), Activities of Daily Living Scale, Lawton-Brody Instrumental Daily Activities Scale, Geriatric Depression Scale (GDS) and the Beck Anxiety Inventory were used for data collection. RESULTS: One hundred and six (43.6%) patients were female and 137 (56.4%) were male. The patients were divided into two groups according to the Mini-Mental State Examination (MMSE) 23/24 cut-off score. The cognitive decline was statistically significantly more frequent in patients who were older, female, less educated, low socioeconomic status, and living in rural areas. There were more problems in the basic and instrumental activities of daily living and nutrition in patients with cognitive decline. Anxiety and depression scores were higher in this group. In our study, although the frequency of cognitive decline and depression according to GDS were 56% and 48%, respectively; we found that only 10.5% of patients applied to the psychiatrist, and 9.3% of patients received psychiatric treatment. CONCLUSION: Cognitive decline may cause deterioration in the daily living activities, nutrition and capacity for independent functioning. Older age, female, low education, low socioeconomic status and living in rural area are important risk factors for cognitive impairment. Cognitive decline in older age may be associated with depression and anxiety. We assume that when cognitive decline, depression and other psychiatric problems are unidentified, it may contribute to deterioration of mental health in medically ill elderly.

Acquired retraction of the eye as the first sign of myositis.

The authors report a patient who was diagnosed with idiopathic orbital myositis based on the findings of diplopia, worse on right gaze, globe retraction on adduction and injection at the lateral muscle tendon insertion of the left eye. Although orbital myositis as a cause of acquired retraction of the eye is rare, they wish to emphasize the importance of globe retraction with injection over the recti as an important clue for the diagnosis of orbital myositis.

Aseptic leptomeningitis in systemic lupus erythematosus. A case report.

OBJECTIVE: Systemic lupus erythematosus (SLE) with leptomeningeal involvement is a rare condition. We report a case in a 17-year-old woman. CLINICAL PRESENTATION AND INTERVENTION: The patient was admitted to hospital with the complaints of vertigo, nausea, vomiting, headache, diplopia, ptosis on the left and weakness of the left leg. A diagnosis of SLE was established, with diffuse leptomeningeal involvement demonstrated by cranial magnetic resonance imaging. When treated with steroids, the clinical problems resolved almost completely. CONCLUSIONS: Although rare, leptomeningeal involvement can complicate SLE. Cranial magnetic imaging can demonstrate tissue involvement. The condition responds to steroid therapy.