Ezgi Akyildiz Tezcan, M.D., Funda Levendoglu, M.D., Mehmet Sedat Durmaz, M.D., Hasan Kara, M.D., Elif Balevi Batur, M.D., Ilknur Albayrak Gezer, M.D., Muslu Kazım Korez, Ph.D.. J Rheum Dis 2023;30:36-44. https://doi.org/10.4078/jrd.22.0028

Objectives: This study aimed to evaluate the relationship between the median nerve cross-sectional area (CSA, mm²) and clinical findings, blood test results, and electrodiagnostic (EDX) measurements in patients with carpal tunnel syndrome (CTS). Methods: This cross-sectional study included 62 patients (111 hands). The median nerve CSA was assessed using ultrasound (US). The clinical assessment included symptom duration, symptom severity, the Boston Carpal Tunnel Questionnaire (BCTQ), and physical examination. Patient-level analyses used the CSA of the most symptomatic hand for clinical and laboratory variables (n = 62 patients). Hand-level EDX analyses accounted for within-patient clustering by reporting right and left hands separately. Associations were summarized with Spearman’s ρ and 95% confidence intervals (CIs); multiplicity was addressed using Benjamini–Hochberg false discovery rate (FDR). EDX units: latency ms, amplitude mV/µV, and velocity m/s. Results: CSA was not associated with global symptom burden (Visual Analog Scale; BCTQ). No laboratory marker remained significant after FDR across the full panel. By contrast, CSA correlated with EDX impairment at the hand level with low-to-moderate effect sizes; for example, distal motor latency was positively associated with CSA on the right (ρ = 0.557, 95% CI 0.334–0.733) and left (ρ = 0.318, 95% CI 0.022–0.578). CSA also correlated positively with CTS EDX severity (right: ρ = 0.449, 95% CI 0.223–0.646; left: ρ = 0.354, 95% CI 0.071–0.609). Conclusions: Ultrasonographic CSA was associated with electrophysiologic impairment and was not associated with overall symptom burden; laboratory signals did not survive FDR control. Accordingly, CSA may serve as a complementary morphologic adjunct to clinical assessment and EDX, with limited utility as a stand-alone severity metric.

Amaç: Rotator kaf (RK) yırtığı olan hastalarda santral sensitizasyon (SS) varlığı şimdiye kadar araştırılmamıştır. Bu çalışmada, semptomatik RK yırtığı olan hastalarda SS varlığının omuz ağrısı ve disabilite üzerine etkisini araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmaya, kronik RK yırtığı olan 52 semptomatik hasta ve hastalar ile yaş/cinsiyet olarak eşleştirilmiş 35 sağlıklı kontrol dâhil edildi. SS varlığı ve şiddeti Santral Sensitizasyon Ölçeği (SSÖ) ile değerlendirildi. Ağrı duyarlılığı için lokal (etkilenen omuz) ve uzak (tibialis anterior) bölgelerden basınç-ağrı eşikleri (BAE) kaydedildi. Hasta grubunda ağrı ve disabilite, Vizüel Analog Skala (ağrı) ve Omuz Ağrı ve Disabilite İndeksi (OADİ) ile değerlendirildi. Bulgular: Hasta grubunun kontrol grubuna göre SSÖ skorları anlamlı yüksek (p < 0,001) ve deltoidden ölçülen BAE değerleri anlamlı düşüktü (p = 0,040). SS (SSÖ skoru ≥ 40), hastaların 24 (%46,2)’ünde saptandı. SS’si olan hasta grubunda olmayanlara göre OADİ-ağrı skorları anlamlı yüksekti (p = 0,034). SSÖ skorları ile OADİ-ağrı skorları (r = 0,299) ve üst trapez (r = -0,302) ve deltoidden (r = -0,325) ölçülen BAE değerleri arasında orta derecede korelasyonlar saptandı (p < 0,05). Sonuç: Bu çalışma, RK yırtığı olan hastaların yaklaşık yarısında SS olduğunu gösterdi. Buna karşın, lokal bölgeden (deltoid) ölçülen BAE değerinin sağlıklı kontrol grubundan anlamlı düşük bulunması sadece periferik sensitizasyon ile ilişkilendirilebilir. Ayrıca, RK yırtığına bağlı gelişen SS hastalarda disabiliteden ziyade artan ağrı yükü ile ilişkili gözükmektedir.

Purpose: The aim of this study was to evaluate the nailfold capillaroscopy (NFC) findings of patients with rheumatic disease and healthy controls (HCs) who survived coronavirus disease 2019 (COVID-19). Materials and Methods: This study included patients with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and rheumatoid arthritis (RA) who recovered from COVID-19 and HCs. NFC was performed for all participants. NFC findings of the three groups [patients with COVID-19 (group 1), HCs with COVID-19 (group 2), and HCs without COVID-19 (group 3)] were compared. Results: A total of 142 individuals (group 1, n = 42; group 2, n = 50; group 3, n = 50) were included in the study. Hospitalization and oxygen therapy were more common in group 1 than in group 2. The median time from a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive real-time polymerase chain reaction (RT-PCR) test to NFC was 10.3 (6.3–24.4) weeks in group 1 and 17.1 (6.1–44.9) weeks in group 2. All NFC findings did not differ among the groups except for capillary ramifications, which were higher in group 1 than in groups 2 and 3. Underlying rheumatic disease was the only predictor that was significantly associated with capillary ramifications. Conclusion: The NFC findings of COVID-19 survivors with and without rheumatic disease were substantially similar to those of HCs who did not have COVID-19. Capillary ramifications may result from an underlying rheumatic disease in patients with axSpA, PsA, and RA.

Background: Hypertension is a major risk factor for cardiovascular disease, and aerobic exercise is recommended as complementary therapy for its management. This study aimed to evaluate the effects of a supervised aerobic exercise program on weight loss, functional capacity, quality of life (QoL), and depression in patients with essential hypertension. Methods: A nonrandomized controlled trial with patient preference allocation was conducted. The participants were assigned to either a supervised aerobic exercise group (n = 91) or a control group (n = 47). The exercise group underwent a six-week supervised aerobic training program (five sessions per week), while the control group maintained their usual lifestyle. Outcome measures, including resting blood pressure, weight, body mass index (BMI), lipid profile, functional capacity (6-minute walk test, 6 MWT), QoL (SF-36), and depression level (Beck Depression Inventory, BDI), were assessed at baseline and after six weeks. Results: The supervised aerobic exercise group showed significant improvements in the 6 MWT distance, SF-36 subscales (physical function, role physical, vitality, role emotional, and mental health), and reductions in resting systolic blood pressure, weight, BMI, and BDI scores compared to the control group (p < 0.05). Within-group comparisons further confirmed significant improvements in physical and mental health measures post-intervention (P < 0.01). Conclusions: A 6-week supervised aerobic exercise program significantly enhanced functional capacity, QoL, and mental health in patients with hypertension. These findings support supervised aerobic exercise as an effective complementary therapy for hypertension, promoting both physical and mental well-being with no reported adverse effects.

Aim: This study aimed to investigate the rate of carpal tunnel syndrome (CTS) and polyneuropathy in patients with new-diagnosed hypothyroidism and the relationship between median nerve conduction and the cross-sectional area of the median nerve by ultrasonography. Material and Methods: It was a prospective, cross-sectional and case-control study. This study included thirty-five new-diagnosed hypothyroidism cases and thirty-five healthy controls. Bilateral sensory and motor nerve potentials were noted in the lower and upper extremities. The cross-sectional area of the median nerve was examined at the entrance of the CT with the axial plan by ultrasonography. The relationship between the cross-sectional areas of the median nerve and nerve conduction parameters was investigated. Results: CTS was determined electrophysiologically in 8 (22.9%) patients. The control group had no CTS. There was no significant electrophysiological finding to support polyneuropathy in the patients. The cross-sectional areas of the median nerve were higher in the patient group but did not reach statistically significant (p>0.05). There was a positive correlation between the right and left cross-sectional area of median nerves and body mass index (BMI) (p<0.05). Conclusion: The rate of CTS is high in patients with newly diagnosed hypothyroidism. There is a positive correlation between cross-sectional nerve areas and BMI. There was no significant correlation between nerve conductions and median nerve ultrasonographic cross-sectional areas.