Correlations with clinical and radiologic findings and prevalence of osteopenia/osteoporosis in the patients with bilateral temporomandibular joint osteoarthritis.

This study aimed to evaluate the prevalence of osteopenia/osteoporosis in patients with bilateral temporomandibular joint osteoarthritis (TMJ-OA) and its correlations with clinical and radiological findings. A total of 95 patients with bilateral TMJ-OA diagnosed by CBCT were included in the study. Clinical and radiological findings and bone mineral density (BMD) scores were recorded. Descriptive statistics and the Spearman rho correlation tests were performed. Osteopenia/osteoporosis was found in 44 of 95 patients (46.32 %) (30, osteopenia; 14 osteoporosis). Osteopenia/osteoporosis is significantly associated with postmenopausal status and age over 40 years, but it is not associated with clinical and radiological findings of TMJ-OA. Patients with bilateral TMJ-OA have a high prevalence of osteopenia/osteoporosis.

The effect of high-intensity intermittent and moderate-intensity continuous exercises on neurobiological markers and cognitive performance.

BACKGROUND: The effects of exercise on cognitive functions and general brain health have been increasingly studied. Such studies conducted among athletes are very important to understanding the effects of different exercise methods on biochemical parameters and cognitive performance. The present study aimed to compare the neuroprotective effects of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) based on biochemical parameters and cognitive performance in athletes. METHODS: A total of twenty-eight elite male boxing athletes aged > 18 years, with at least eight years of training experience, who successfully achieved national and international levels were included in this study. The elite athletes participating in the study were aged 24.43 ± 4.72 years, 14.45 ± 5.89 years of training experience, had a body weight of 74.64 ± 7.82 kg, and had a height of 177 ± 7.15 cm. Athletes who consumed any stimulants during the testing or supplementation phase, nutritional supplements, or steroids that may have affected hormone levels or sports performance in the last three months were excluded from this study. Venous blood samples were obtained, and cognitive performance tests (Stroop tests) were applied (i) immediately after high-intensity intermittent exercise (HIIE), (ii) one hour after HIIE, (iii) immediately after moderate-intensity continuous exercise (MICE), and (iv) one hour after MICE. Serum BDNF, S100B, and NSE levels were measured after each session. RESULTS: Serum BDNF levels were significantly (F = 2.142, P < 0.001, ηp 2 = 0.589) greater in the HIIE group (5.65 ± 1.79 ng/mL) than in the control group (1.24 ± 0.54 ng/mL) and MICE group (3.38 ± 1.29 ng/mL) for the samples obtained immediately after exercise. Serum S100B levels were significantly (F = 3.427, P < 0.001, ηp 2 = 0.427) greater in the HIIE group (71.92 ± 23.05 ng/L) than in the control group (47.39 ± 15.78 ng/L), however there was no significant difference between the HIIE and MICE groups (59.62 ± 28.90 ng/L) in the samples obtained immediately after exercise. Serum NSE levels were significantly (F = 1.475, P < 0.001, ηp 2 = 0.312) greater in the HIIE group (14.57 ± 2.52 ng/mL) than in the control group (9.51 ± 3.44 ng/ML mL), however there was no significant difference between the HIIE and MICE groups (59.62 ± 28.90 ng/L) in the samples obtained immediately after exercise. Compared with control groups, both HIIE and MICE improved cognitive performance demonstrated by the Stroop test results. Again, HIIE was superior to MICE in terms of Stroop task reaction time and error rate (incongruent task) scores. CONCLUSION: HIIE and MICE have favorable effects on improving cognitive performance and neuroprotection in an athlete population. HIIE is considered to be superior to MICE in improving neuroprotection and cognitive performance. Our study has remarkable results demonstrating the benefits of HIIT on neuroprotection and cognitive performance. HIIE is recommended instead of MICE, especially in sports where cognitive performance is more important.

A comparative analysis of prolotherapy efficacy in patients with knee osteoarthritis across varied dextrose concentrations.

OBJECTIVE: To compare the effectiveness of prolotherapy with dextrose concentrations of 5%, 10%, and 20% in patients diagnosed with knee osteoarthritis. METHODS: This study was planned as a prospective, randomized controlled interventional trial. Prolotherapy at 5% dextrose concentration in group 1, 10% in group 2, and 20% in group 3 was applied to the knee intra-articularly and periarticularly at 0, 3, and 6 weeks, and a home exercise program was given. Group 4 received a home exercise program. All groups received hotpack therapy at weeks 0, 3, and 6. Outcome measures included the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range of motion, timed up and go test, and Short Form-36. RESULTS: A total of 128 patients were divided into 4 groups. At the 6th and 12th weeks, VAS scores were significantly lower in groups 2 and 3 than in group 4 (p < 0.05). At the 12th week, the WOMAC pain score was significantly lower in group 3 than in group 4, and WOMAC physical function and WOMAC total scores were significantly lower in groups 1, 2, and 3 than in group 4 (p < 0.05). Week 6 active and passive knee flexion and week 12 passive knee flexion were significantly higher in group 3 than in group 4 (p < 0.05). CONCLUSIONS: Although no significant difference was observed among the dextrose prolotherapy groups, higher dextrose concentrations demonstrated a greater improvement compared to the control group. Therefore, the use of 20% dextrose is recommended due to its significant superiority. Long-term follow-up and placebo-controlled studies are needed. TRIAL REGISTRATION: ClinicalTrial.gov Identifier: NCT05537077, registration date: 09.03.2022, retrospectively registered. Key Points • The utilization of dextrose prolotherapy has gained popularity in the management of osteoarthritis, aiming to harness its regenerative and proliferative properties. However, the comparative efficacy of various concentrations of dextrose prolotherapy in treating knee osteoarthritis remains unexplored in the literature. This study aimed to address this gap by comparing different concentrations of dextrose prolotherapy in the treatment of knee osteoarthritis. The findings revealed no statistically significant difference among the various concentrations of dextrose prolotherapy for knee osteoarthritis treatment.

Musclin attenuates lipid deposition in hepatocytes through SIRT7/autophagy-mediated suppression of ER stress.

Musclin, an exercise-responsive myokine, has the ability to attenuate inflammation, oxidative stress, and apoptosis in cardiomyocytes under pathogenic conditions. While the potential benefits of musclin in the cardiovascular system have been well documented, its effects on hepatic endoplasmic reticulum (ER) stress and lipid metabolism are not fully understood. The present study showed that musclin treatment reduced lipid accumulation and lipogenic protein expression in primary hepatocytes exposed to palmitate. Palmitate treatment led to an increase in markers of ER stress, which was reversed by musclin treatment. Musclin treatment increased SIRT7 expression and markers of autophagy in a dose-dependent manner. Small interfering (si) RNA of SIRT7 or 3-methyladenine (3 MA) reduced the effects of musclin on lipogenic lipid deposition in hepatocytes under hyperlipidemic conditions. These findings suggest that musclin can suppress palmitate-induced ER stress by upregulating SIRT7 and autophagy signaling, thereby alleviating lipid accumulation in primary hepatocytes. The current study provides a potential therapeutic strategy for the treatment of liver diseases characterized by lipid accumulation and ER stress, such as nonalcoholic fatty liver disease (NAFLD).

Does Single or Combined Caffeine and Taurine Supplementation Improve Athletic and Cognitive Performance without Affecting Fatigue Level in Elite Boxers? A Double-Blind, Placebo-Controlled Study.

In previous studies, the effect of single or combined intake of caffeine (CAF) and taurine (TAU) on exercise performance was investigated. However, the potential synergistic effect on physical and cognitive performance after fatigue induced by anaerobic exercise is unknown. The effects of single and combination CAF and TAU supplementation on the Wingate test in elite male boxers and to evaluate balance, agility and cognitive performance after fatigue are being investigated for the first time in this study. Twenty elite male boxers 22.14 ± 1.42 years old were divided into four groups in this double-blind, randomized crossover study: CAF (6 mg/kg of caffeine), TAU (3 g single dose of taurine), CAF*TAU (co-ingestion of 3 g single dose of taurine and 6 mg/kg of caffeine) and PLA (300 mg maltodextrin). The findings are as follows: co-ingestion of CAF*TAU, improved peak (W/kg), average (W), minimum (W) power, time to reach (s), and RPE performances compared to the PLA group significantly (p < 0.05). Similarly, it was determined that a single dose of TAU, created a significant difference (p < 0.05) in peak power (W/kg), and average and minimum power (W) values compared to the CAF group. According to the balance and agility tests performed after the Wingate test, co-ingestion of CAF*TAU revealed a significant difference (p < 0.05) compared to the PLA group. In terms of cognitive performance, co-ingestion of CAF*TAU significantly improved the neutral reaction time (ms) compared to the TAU, CAF and PLA groups. As a result, elite male boxers performed better in terms of agility, balance and cognitive function when they consumed a combination of 6 mg/kg CAF and 3 g TAU. It has been determined that the combined use of these supplements is more effective than their single use.

Serum BDNF and Selenium Levels in Elite Athletes Exposed to Blows.

Background and Objectives: The study aimed to investigate the combined acute and long-term effects of exposure to blows and exercise on serum BDNF (brain-derived neurotrophic factor) and selenium levels. Materials and Methods: Serum BDNF and selenium levels were determined in 40 male elite athletes before and after vigorous exercise (training match) with a probability of exposure to blows and in 10 sedentary men subjected to exercise (Astrand running protocol). Results: Serum BDNF levels were found 11.50 ± 3.50 ng/mL before exercise and 14.02 ± 3.15 ng/mL after exercise in the athlete group (p = 0.02), and 12.18 ± 4.55 ng/ mL and 11.74 ± 2.48 ng/ mL before and after exercise in the sedentary group, respectively (p = 0.873). Serum BDNF (pre-exercise, baseline) levels were slightly lower in the athlete group than those in the sedentary group (11.50 ± 3.50 and 12.18 ± 4.55 ng/mL, respectively, p = 0.796). Pre-exercise serum selenium levels in athletes were significantly higher compared to those of sedentary participants (130.53 ± 36.79 and 95.51 ± 20.57 µg/L, respectively, p = 0.011). There was no difference in selenium levels after exercise (124.01 ± 29.96 µg/L) compared to pre-exercise (130.53 ± 36.79 µg/L) in the athlete group (p = 0.386). Similarly, there was no difference in selenium levels after exercise (113.28 ± 25.51 µg/L) compared to pre-exercise (95.51 ± 20.57 µg/L) in the sedentary group (p = 0.251). Conclusions: BDNF results show that even if athletes are exposed to blows, they may be protected from the long-term effects of blows thanks to the protective effect of their non-sedentary lifestyle. Regular exercise may have a protective effect on maintaining serum selenium levels in athletes even exposed to blows chronically.

Impacts of different intensities of exercise on inflammation and hypoxia markers in low altitude.

BACKGROUND: This study aims to determine and compare the effects of exercise modalities with different intensities on the secretion of key inflammation and hypoxia markers in amateur athletes. METHODS: Twenty-three athletes with a mean age of 20.1 years, living at low altitude (1850 m) participated in this study. The participants' maximal oxygen consumption values (VO2 max) were determined with an incremental cycle exercise test as 54.15 ± 6.14 mL kg min-1. Athletes performed four protocols: at rest, 50% VO2 max, 75% VO2 max and 100% VO2 max (until exhaustion) with one-week intervals. 50% VO2 max, 75% VO2 max sessions were performed continuously for 30 min on a bicycle ergometer and 100% VO2 max session was performed by cycling until exhaustion. Blood samples were obtained at rest and immediately after each exercise session. Serum tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), interleukin-10 (IL-10), and hypoxia inducible factor-1 alpha (HIF-1α) levels were measured. RESULTS: There were significant differences in serum TNF-α levels in 75% VO2 max and 100% VO2 max sessions (489.03 ± 368.37 and 472.70 ± 365.21 ng/L, respectively) compared to rest conditions (331.65 ± 293.52 ng/L). Serum CRP levels of 50% VO2 max and 75% VO2 max sessions (1.19 ± 0.50; 1.07 ± 0.52 mg/L) were significantly higher than the rest condition (0.74 ± 0.35 mg/L). There were significant differences in serum IL-10 levels of rest condition and 50% VO2 max; 50% VO2 max, and 100% VO2 max sessions (328.09 ± 128.87; 446.36 ± 142.84; 347.44 ± 135.69; 324.88 ± 168.06 pg/mL). Serum HIF-1α levels were significantly higher in 75% VO2 max session compared to rest (1.26 ± 0.16; 1.08 ± 0.19 ng/mL) (P < 0.05 for all comparisons). CONCLUSIONS: Both inflammatory and anti-inflammatory pathway is induced on different exercise intensities. Exercise protocols performed until exhaustion may lead to activation of inflammatory pathways and hypoxia-induced damage.

Effect of Early Orthopedic Rehabilitation on Development of Complex Regional Pain Syndrome Type 1.

OBJECTIVE: Complex regional pain syndrome (CRPS) is a syndrome usually occurs in one extremity and characterized by pain, tenderness with palpation, and symptoms of autonomic nervous system dysfunction. An essential factor in the etiology of CRPS is immobilization of the extremity as a result of a fracture. Delaying the start of physical medicine and rehabilitation program after removal of the plaster or splint may increase the rates of CRPS development in patients with fractures. This study aims to determine a direct relationship between delay time in rehabilitation and CRPS development. MATERIALS AND METHODS: Patients admitted to our physical therapy and rehabilitation outpatient clinic within the last 3 years (January 2016 to January 2018) for orthopedic rehabilitation following fractures were retrospectively analyzed. CRPS development status, the delay time for the rehabilitation program was determined in 38 CRPS patients of 91 patients with fractures. Probit regression was used to reveal the relationship between delay time for rehabilitation and CRPS development. RESULTS: CRPS development rates were decreased by years (48.71% in 2016, 43.47% in 2017, and 31.03% in 2018). When cases in 2016 were taken as a reference, it was seen that cases in 2017 and 2018 were exposed to CRPS approximately 0.03% and 16.00% lower than the reference year, 2016. A delay of one day exposes the patient to approximately 0.35% more CRPS. CONCLUSION: As the delay time for rehabilitation in our clinic decreased, the incidence of CRPS decreased. The awareness of physicians and patients about the importance of early rehabilitation should be improved.

Elevated serum interleukin-23 levels in ankylosing spondylitis patients and the relationship with disease activity.

This study was aimed to evaluate the relationship between serum interleukin-23 (IL-23) levels and ankylosing spondylitis (AS).Twenty male patients diagnosed with ankylosing spondylitis according to the 1984 modified New York criteria for AS and twenty male healthy controls were included in this study.The demographic characteristics, clinical and laboratory findings of the patients were recorded. Serum IL-23 levels, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured in both the AS and control groups. The Bath ankylosing spondylitis disease activity index (BASDAI), the Bath ankylosing spondylitis functional index (BASFI), and the Bath ankylosing spondylitis metrology index (BASMI) were evaluated as disease activity parameters. The AS patients were divided into two subgroups as active and inactive in respect of CRP, ESR levels and BASDAI scores. The mean serum IL-23 levels of the AS and control groups were 334.45±176.54 pg/ml and 166.49±177.50 pg/ml respectively, and there was a significant difference between the groups. Correlation analysis of serum IL-23 levels with clinical and laboratory parameters showed that there were positive correlations between serum IL-23 levels and the BASDAI, BASFI scores in total, active and inactive patients and the BASMI scores in total and inactive patients and negative correlations between serum IL-23 levels and ESR in inactive patients. It was shown that altered serum IL-23 levels were related to AS disease activity. Further studies in large patient series are necessary to investigate the role of IL-23 protein in etiopathogenesis of AS.

Circulating vascular endothelial growth factor concentrations in patients with postmenopausal osteoporosis.

INTRODUCTION: The role of vascular endothelial growth factor (VEGF) in osteoporosis has not yet been clearly established. Vascular endothelial growth factor is an important part of bone formation. In the literature, although the effects of VEGF on bone metabolism were investigated by different studies, there are very rare studies analysing the association between osteoporosis and VEGF. In the present study, our objective was to investigate serum VEGF concentrations in patients with postmenopausal osteoporosis (PMO) and the correlation of serum VEGF levels and bone mineral density (BMD). MATERIAL AND METHODS: This study was performed on 35 PMO patients, and 30 age-matched healthy controls. Serum VEGF concentrations were measured using a quantitative sandwich enzyme immunoassay technique according to the manufacturer's instructions. Bone mineral density values were determined by dual energy X-ray absorptiometry (DEXA). RESULTS: Serum VEGF concentrations were statistically significantly lower in PMO patients than in controls (150 ±65 pg/ml, 260 ±135 pg/ml respectively; p = 0.005). A positive correlation was found between serum VEGF concentrations and BMD values (r = 0.63, p = 0.001). CONCLUSIONS: Vascular endothelial growth factor concentrations were decreased in PMO patients and VEGF may play an important role in bone health.

Melatonin levels in premenopausal women with fibromyalgia syndrome.

The fibromyalgia syndrome (FMS) is a chronic, widespread pain disorder of unknown etiology. It has been suggest that familial component, environmental factors, endocrine and neurotransmitter alterations, and psychological factors may contribute to the development of FMS. The role of melatonin in FMS is unclear. Some studies describe a lower nocturnal peak and a decreased secretion of melatonin in women with FMS when compared with healthy matched controls. The aim of the present study was to determine the possible role of melatonin in FMS patients. We examined the characteristics and levels of melatonin in 25 consecutive premenopausal women with FMS. Serum blood samples were collected from 25 patients and 20 the age and gender matched healthy controls. Melatonin levels were measured by enzyme-linked immunosorbent assay. Then, the results were compared with those from healthy subjects. Serum melatonin levels of FMS patients were not statistically different from those of controls (P > 0.05). No association was observed between melatonin levels of patients with FMS and disease duration, sleep disturbances, fatigue, and pain scores. Our results demonstrate that melatonin levels were similar in patients with FMS and healthy controls. Further studies are needed to determine the possible role of melatonin.

Spastic paraparesis and sensorineural hearing loss in a patient with neurobrucellosis.

OBJECTIVE: Brucellosis is a zoonotic disease and still a major public health problem in many geographic areas including Mediterranean basin and Middle East. Brucellosis causes multisystemic involvement and although rare central nervous system involvement causes serious manifestations. Neurobrucellosis occurs less than 5% of patients and presents with meningitis,encephalitis, myelitis, myelopathy, stroke, paraplegia, radiculoneuritis, intracerebral abscess, epidural abscess, demyelination and cranial nerve involvement or any combination of these manifestations. Spastic paraparesis and the sensorineural involvement are rarely reported in the literature. METHODS: Herein we present a 28 years-old man with spastic paraparesis and sensorineural hearing loss due to neurobrucellosis. RESULTS: The patient was treated with antibiotics combination for 6 months and underwent rehabilitation program. CONCLUSIONS: Neurobrucellosis should be ruled out in patients with unexplained neurological symptoms and/or sensorineuralhearing loss particularly in those living in endemic areas.

Increased serum concentrations of homocysteine and lipoprotein (a) in familial Mediterranean fever.

Serum homocysteine, folic acid, lipoprotein (a) (Lp(a)), fibrinogen, and C-reactive protein (CRP) concentrations and erythrocyte sedimentation rates (ESR) were measured in 52 patients with familial Mediterranean fever (FMF) during attack-free periods and in 30 healthy control subjects. Serum homocysteine levels were significantly higher in the FMF patients (median 17.8 microg/dl; range 5.6-80.8) than in controls (median 11.7; range 5.6-42.2; p = 0.013). Serum homocysteine levels were elevated above the upper reference limit (15 microg/dl) in 56% of the FMF patients compared to 27% of the controls (p = 0.011). Serum Lp(a) levels were significantly higher in the FMF patients (median 39.3 mg/dl; range 6.6-124.5) than in controls (median 27.2; range 11.1-78.1; p = 0.035). Serum Lp(a) levels were elevated above the upper reference limit (30 mg/dl) in 71% of the FMF patients compared to 47% of the controls (p = 0.028). The ESR, fibrinogen, CRP, and folic acid levels were similar in both groups. In conclusion, serum homocysteine and Lp(a) concentrations are often increased in FMF patients during attack-free periods. The elevated homocysteine and Lp(a) levels, which are markers of sub-clinical inflammation, may be mediators of atherosclerotic disease in FMF patients.