We have studied the prevalence of fibromyalgia syndrome (FMS) in patients with type 1 and type 2 diabetes mellitus (DM). Relationship with disease control of DM and the presence of FMS was also evaluated. We have studied 93 consecutive patients with DM (85 with type 2 DM and 8 patients with type 1 DM) followed in Diabetes Center. Single researcher took the history and did physical examination including manual tender point examination according to Manual Tender Point Survey instructions. For the diagnosis of FMS, 1990 American College of Rheumatology Classification Criteria for FMS was used. We measured patients' fasting blood sugar levels and HbA1c levels around the same time period. Patients were excluded from the study if they had any other serious disease, and if there was any history of drug use that interferes with the symptoms of FMS. Patients with rheumatoid arthritis (RA) were accepted as controls. FMS was found in 18% of patients with DM type 2 (no patients with FMS in type 1 DM group), in 34% of patients with RA. Female patients with DM type 2 had significantly higher FMS rates. Mean fasting blood sugar levels and mean HbA1c levels were not significantly different between type 2 DM patients with FMS and DM patients without FMS. In RA group, in RA patients without FMS, the use of steroids was significantly higher. We have found an increased prevalence rate of FMS in patients with DM type 2 and RA. There was no correlation between the prevalence rate of FMS and good DM disease control.
The Turkish experimental version of FSDC is a reliable and valid instrument in Turkish FMS patients. It is easily completed, simple to score providing valuable instrument to diagnose and follow FMS.
Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent attacks of fever, peritonitis, pleuritis, arthritis, or erysipelas-like skin lesion. FMF is the most common periodic febrile syndrome affecting more than 150,000 people worldwide. The majority of patients develop FMF before the age of 20. FMF may cause amyloidosis, which mainly affects the kidneys but may also be accumulated in other organs such as the heart, gastrointestinal tract, and reproductive organs. FMF being a systemic disorder with a risk for amyloidosis, affecting patients in their childbearing years, and with its lifelong colchicine therapy raises concern about its effect on the reproductive system. In this article, we review the impact of FMF and its treatment to the reproductive system of male and female patients, pregnancy, and lactation.
BackgroundThe fibromyalgia survey diagnostic criteria and severity scale (FSDC) is a self-reported version of 2010 preliminary diagnostic criteria for fibromyalgia syndrome (FMS). It measures pain [the Widespread Pain Index (WPI)/FSDC Section 3], the Symptom Severity (SS)/FSDC Section 1 and 2, and provides a score, polysymptomatic distress (PDS)/FSDC total score (1). The PDS is the sum of the (0–19) WPI and the 6-item (0–12) SS scale ranged between 0–31.ObjectivesIn our study, we evaluated the reliability and validity of the Turkish version of the FSDC.MethodsThe Turkish FSDC was obtained by forward and back translations of English FSDC. We have studied patients who were born in Turkey and the main language is Turkish, or had Turkish ancestors and were diagnosed FMS for the first time using ACR 1990 classification criteria (2). Manual Tender Point Survey was used for tender point examination (3). Patients who had serious internal and psychiatric disorders were excluded. Patients filled Turkish revised fibromyalgia impact questionnaire (rFIQ), Turkish nonvalidated FSDC, marked Visual Analog Scale (VAS) for pain and general status of disease. In 7 to 15 days, they have filled the FSDC for the second time.ResultsWe had 132 female patients with a mean age 42.78±8.58 years. Their mean tender point count was 16.17±2.04; the mean rFIQ total score was 70.34±19.18; the mean VAS for pain score was 8.03±1.76; the mean VAS for global disease severity score was 8±2.1. The Turkish version of FSDC assessment 1 mean total score (PSD score) was 22.61±4.64; the mean SS score was 9.26±2.07; the mean WPI score was 13.35±3.53. By the test to retest reliability analysis of Turkish FSDC, for the 25 single items, correlation coefficients ranged 0.383 to 0.818 (all p<0.01). There were significant correlations between FSDCs SS scores (r =0.748), WPI scores (r =0.775), and the total (PDS) scores (r =0.821) (all p<0.01). Cronbach alpha was 0.766 for FSDC assessment 1, and 0.77 for FSDC assessment 2. There were significant correlations between Turkish FSDC assessment 1 total (PDS) score and total rFIQ score (r=0.576); with VAS pain (r=0.443) and VAS disease severity (r=0.342) scores (all p<0.01).ConclusionsThe Turkish version of FSDC is a reliable and valid instrument in Turkish FMS patients. It is easily completed, simple to score providing valuable instrument to diagnose and follow FMS.ReferencesWolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, HauserW, Katz RS, et al. Fibromyalgia criteria and severity scalesfor clinical and epidemiological studies: a modification of theACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol 2011;38:1113–1122.Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL,Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT: The American College of Rheumatology 1990. Criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33(2):160–172.Sincl...
Objective This study aims to evaluate the photoreceptor outer segment (PROS) length in patients who use hydroxychloroquine (HCQ) prior to the development of retinopathy. Methods In this prospective, single-centre, comparative study, 44 patients using HCQ for ≥5 years, 30 patients using HCQ <5 years, and 45 age-and sex-matched healthy controls were enrolled. The participants underwent a detailed ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT) imaging, and 10-2 automated visual field testing. The PROS length was defined as the distance between the inner surface of the ellipsoid zone and the inner surface of the retina pigment epithelium. The measurements were performed subfoveally and at 500-1000-1500 µm temporally and nasally to the foveola. Results The mean PROS length of long-term users (≥5 years) was statistically greater than the controls at all measurement points (p < 0.001 at all points). Although the subfoveal PROS length was comparable between the long-term and short-term users (p = 0.148), the parafoveal PROS length measurements (nasal 1500 µm, nasal 1000 µm, nasal 500 µm, temporal 1000 µm, and temporal 1500 µm) of the long-term users were significantly greater than those of the short-term users (p < 0.001, p = 0.002, p = 0.027, p = 0.018, p = 0.001, respectively). No significant difference was found between the short-term users and the controls (p = 0.815, p = 0.395, p = 0.093, p = 0.079, p = 0.133, p = 0.686, p = 0.341, respectively). Conclusion The PROS length was greater in patients who used HCQ ≥5 years. Possible retinal pigment epithelium toxicity may have caused this finding.
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