The impact of coping strategies in behcet's disease: A case-control study.

BACKGROUND: Behcet's disease (BD) is a chronic, systemic inflammatory disease characterized with higher prevalence of psychiatric disorders, particularly major depression. This study aimed to determine the relationship between the psychological coping strategies with the disease and depression, anxiety, quality of life and disease activity in patients with BD. METHODS: Fifty Behcet's patients and 38 control subjects were compared by using Behcet's disease current activity form (BDCAF), quality of life instrument (QOL), structured clinical interview for DSM-IV axis I disorders (SCID-I), ways of coping questionnaire (WCQ), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). RESULTS: In terms of coping, self-controlling and positive reappraisal scores were lower in BD patients than controls while escape-avoidance was negatively correlated with age in patients. Confrontive coping, accepting responsibility, and escape-avoidance scores were positively correlated with BDI and BAI. Confrontive coping, accepting responsibility, and planful problem solving were positively correlated with QOL score. Multiple linear regression analysis indicated that confrontative coping was the major predictive factor for QOL and BDI scores. CONCLUSIONS: Excessive use of confrontive coping, accepting responsibility, and escape-avoidance strategies seems to increase depression and anxiety in Behcet's patients. Besides, among those strategies, confrontive coping is significantly associated with depression and quality of life in BD patients that should be considered in therapeutic approaches. Our results highlighted that Behcet's patients have different coping strategies than healthy controls that may impair the psychological adjustment process.

Evaluation of oxidative stress in patients with recalcitrant warts.

BACKGROUND: Warts are benign conditions of the skin and mucosa caused by human papilloma viruses (HPV) that affect many people worldwide. OBJECTIVE: The aim of this study was to evaluate OS by TOS/TAS, levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) an indicator of DNA damage, and also protein oxidation levels by determining the dynamic serum thiol/disulphide homeostasis in patients with warts. We also aimed to investigate whether there is a relationship between thiol/disulphide homeostasis, recalcitrance of warts and DNA damage. METHODS: Forty patients of age ≥18 years, having recalcitrant genital and/or non-genital warts that persisted for more than 2 years, 40 patients with warts that persisted for <2 years and 40 healthy controls were enrolled in the study. Blood TAS, TOS, OSI, 8-OHdG and dynamic thiol/disulphide homeostasis were evaluated. RESULTS: Significant differences were detected between the groups in the levels of 8-OHdG, TOS, OSI, total thiol, native thiol, reduced thiol, as well as native thiol/total thiol ratio, disulphide/total thiol ratio and disulphide/native thiol ratio. Compared with the controls, patients with recalcitrant warts had significantly higher levels of 8-OHdG, TOS and OSI levels. Total thiol and native thiol levels were significantly lower in patients with recalcitrant warts compared with patients with warts that persisted for <2 years. Disulphide levels were significantly higher in the latter group of patients compared with patients with recalcitrant warts and controls. Native thiol/total thiol ratio was significantly higher in both patient groups compared with controls whereas disulphide/total thiol and disulphide/native thiol ratios were significantly lower in both patient groups than in controls. CONCLUSION: Our findings suggest that impairment of thiol disulphide homeostasis in patients with recalcitrant warts may lead to increased OS and DNA damage. Thus, antioxidant administration with thiol containing proteins may help in the regression of warts and thereby prevent carcinogenesis.

Is there any relationship between serum and urine neopterin and serum interferon-gamma levels in the activity of Behcet's disease?

BACKGROUND: Behcet's disease (BD) is a chronic, inflammatory, multisystem vasculitic disorder. There is no reliable laboratory marker that indicates disease activity. Neopterin is an immunological marker of cellular immune activation, which is secreted by monocytes/macrophages as a result of interferon-gamma (IFN-gamma) secretion by activated T lymphocytes. OBJECTIVE: We aimed to investigate serum and urine neopterin levels in BD patients. METHODS: Forty-five patients who were diagnosed according to the criteria of the International Study Group for BD and 45 age- and sex-matched healthy controls were enrolled in the study. Disease activity was considered by clinical findings. Serum and urine neopterin levels and serum IFN-gamma levels were measured. RESULTS: The mean values of serum and urine neopterin levels were 12.68 +/- 4.87 nmol/L and 167.53 +/- 148.73 micromol/mol creatinine, respectively, in BD patients (P = 0.000 and P = 0.008, respectively), which were statistically significantly different from the control group. However, there was no significant statistical difference between serum and urine neopterin levels of the clinically active and inactive patients. It was also found that the mean value of serum IFN-gamma levels was higher in healthy controls than in BD patients (P = 0.000). CONCLUSIONS: We conclude that serum and urinary neopterin measurement can not be used as a reliable laboratory marker as the BD patients' serum and urinary neopterin levels do not increase in the active stage even though these levels increase when compared to healthy controls.