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Öğe Assessment of the Relationship Between Bone Mineral Density and Disease Activity in Ankylosing Spondylitis Patients with Osteopenia(Galenos Yayincilik, 2013) Guler, Hayal; Ustun, Nilgun; Bolac, Veli Enes; Yagiz, Abdullah Erman; Mansuroglu, Ayhan; Yengil, Erhan; Turhanoglu, Ayse DicleAim: Ankylosing Spondylitis (AS) is a chronic inflammatory disease. Spinal osteopenia is common in AS, probably due to immobility and local cytokine release. In this study, we evaluated the relationship between bone mineral density and disease activity in Ankylosing Spondylitis patients with osteopenia. Material and Methods: Sixty one AS patients (26F, 35M) were enrolled in this study. The disease duration, morning stiffness, Schober tests, Erythrocyte Sedimentation Rate (ESR) and C Reactive Protein (CRP) were analyzed and recorded. Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Bone mineral density (BMD) was measured by using GE/LUNAR DPX PRO equipment. Results: The mean age and disease duration of the patients were 38.67 +/- 10.81 and 7.87 +/- 7.09 year. There was osteopenia in 34 (% 55.7) patients. Spine and femur BMD values of this patients were 1.03 +/- 0.16 and 0.88 +/- 0.09. BMD measurements of 27 (% 44.3) patient were found normally. Spine and femur BMD values of this patients were 1.20 +/- 0.11 and 1.11 +/- 0.15. There was not statistically significant difference between osteopenia and normal group in ESR, CRP, and BASDAI values (p>0.05). There was not correlation between BMD values and ESR, CRP, and BASDAI values in osteopenia group (p>0.05). Conclusion: In our study, we did not find relationship between bone mineral density and disease activity in AS patients with osteopenia.Öğe DEMOGRAPHIC, CLINIC AND LABORATORY CHARACTERISTICS OF CASES PRESENTED TO EMERGENCY DEPARTMENT WITH SCORPION STING: 345 CASES OVER A 4-YEARS PERIOD(Carbone Editore, 2013) Duru, Mehmet; Karakus, Ali; Yengil, Erhan; Sahan, Mustafa; Zeren, Cem; Kekec, Zeynep; Yagiz, Abdullah ErmanIntroduction: In the scorpion stings, based on the involved system, clinical and laboratory changes may be seen in a wide spectrum from mild pain and flushing to death. The present study was aimed to assess patient demographics, clinical characteristics and outcomes. Methods:All patients presented to emergency department with scorpion sting between 2008 and 2011 were retrospectively evaluated by using electronic database. Results: Overall, 345 cases were included into the study, consisting of 160 male (46.4%) and 185 female (53.6%) with a mean age of 34.39 +/- 19.47 years. It was found that scorpion sting patients were most commonly stung at extremities (n=322; 93.3%). The most commonly observed complaint was pain (n=334; 96.8%).Localized flushing and edema were observed in 307 cases (89.0%). In the laboratory evaluation, it was found that mean values of complete blood counts, biochemistry assays and prothrombin time (PT). international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal range. Of the cases, 99.4%(n=343) were discharged, while two children (0.6%) died due to cardiac and respiratory complications. Conclusions: Since complete blood count and coagulation assays may be normal, these assays aren't routinely needed in all cases with scorpion sting. Anti-serum therapy should be considered at early course of the disease in children and elderly patients due to complications and mortality; it should be intravenously administered V indicated, but it should not be used in all patients.Öğe Demographic, clinic and laboratory characteristics of cases presented to emergency department with scorpion sting: 345 cases over a 4-years period(Acta Medica Mediterranea, 2013) Duru, Mehmet; Karakus, Ali; Yengil, Erhan; Sahan, Mustafa; Zeren, Cem; Kekec, Zeynep; Yagiz, Abdullah ErmanIntroduction: In the scorpion stings, based on the involved system, clinical and laboratory changes may be seen in a wide spectrum from mild pain and flushing to death. The present study was aimed to assess patient demographics, clinical characteristics and outcomes. Methods:All patients presented to emergency department with scorpion sting between 2008 and 2011 were retrospectively evaluated by using electronic database. Results: Overall, 345 cases were included into the study, consisting of 160 male (46.4%) and 185 female (53.6%) with a mean age of 34.39±19.47 years. It was found that scorpion sting patients were most commonly stung at extremities (n=322; 93.3%).The most commonly observed complaint was pain (n=334; 96.8%).Localized flushing and edema were observed in 307 cases (89.0%). In the laboratory evaluation, it was found that mean values of complete blood counts, biochemistry assays and prothrombin time (PT), international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal range. Of the cases, 99.4%(n=343) were discharged, while two children (0.6%) died due to cardiac and respiratory complications. Conclusions: Since complete blood count and coagulation assays may be normal, these assays aren't routinely needed in all cases with scorpion sting. Anti-serum therapy should be considered at early course of the disease in children and elderly patients due to complications and mortality; it should be intravenously administered if indicated, but it should not be used in all patients.Öğe Effect of GM-CSF levels on osteoporosis in postmenopausal period(Acta Medica Mediterranea, 2014) Yagiz, Abdullah Erman; Dokuyucu, Recep; Sumbul, Ahmet Taner; Yengil, Erhan; Ustun, Nilgul; Koca, Irfan; Gogebakan, BulentObjectives: Cytokines and hematopoietic growth factors may play a role in the pathogenesis of osteoporosis. The aim of this study was to assess the relationship between osteoporosis (OP) and granulocyte-macrophage colony stimulating factor (GM-CSF) in postmenopausal period. Materials and methods: Total number of 80 female patients between the ages of 45-75 and who had entered in menopause from at least one year and diagnosed with OP were enrolled in this study. As a control group, 80 healthy volunteer female patients who had entered in menopause from at least one year and had no diagnosis of OP were selected. The age, height, weight, body mass index, duration of menopause, exercise habits of the patients and controls were recorded and bone mineral density was measured for the diagnosis of OP. The serum GM-CSF concentrations of individuals were quantified using a specific enzyme immunoassay kit. Results: There was no significant relationship between the mean age, duration of menopause and body mass index of patients and controls (p>0.05). Serum GM-CSF levels of patients and control groups did not differ significantly (p> 0.05). Conclusion: The results of our study showed that there was no significant correlation between osteoporosis and serum GMCSF levels. Osteoporosis might be correlating with the levels of GM-CSF in bone microenvironment rather than serum levels.Öğe EFFECT OF GM-CSF LEVELS ON OSTEOPOROSIS IN POSTMENOPAUSAL PERIOD(Carbone Editore, 2014) Yagiz, Abdullah Erman; Dokuyucu, Recep; Sumbul, Ahmet Taner; Yengil, Erhan; Ustun, Nilgul; Koca, Irfan; Gogebakan, BulentObjectives: Cytokines and hematopoietic growth factors may play a role in the pathogenesis of osteoporosis. The aim of this study was to assess the relationship between osteoporosis (OP) and granulocyte-macrophage colony stimulating factor (GM-CSF) in postmenopausal period. Materials and methods: Total number of 80 female patients between the ages of 45-75 and who had entered in menopause from at least one year and diagnosed with OP were enrolled in this study. As a control group, 80 healthy volunteer female patients who had entered in menopause from at least one year and had no diagnosis of OP were selected. The age, height, weight, body mass index, duration of menopause, exercise habits of the patients and controls were recorded and bone mineral density was measured for the diagnosis of OP. The serum GM-CSF concentrations of individuals were quantified using a specific enzyme immunoassay kit. Results: There was no significant relationship between the mean age, duration of menopause and body mass index of patients and controls (p>0.05). Serum GM-CSF levels of patients and control groups did not differ significantly (p> 0.05). Conclusion: The results of our study showed that there was no significant correlation between osteoporosis and serum GMCSF levels. Osteoporosis might be correlating with the levels of GM-CSF in bone microenvironment rather than serum levels.Öğe The effect of social support and severity of the disease on posttraumatic growth in ankylosing spondylitis(Acta Medica Mediterranea, 2014) Yagiz, Abdullah Erman; Kokacya, Mehmet Hanifi; Copoglu, Umit Sertan; Uruc, Vedat; Paksoy, Hacer; Yengil, Erhan; Ustun, NilgulAim: Posttraumatic growth (PTG) is described as the positive psychological changes after struggling with highly challenging life circumstances. This study aimed to evaluate PTG in patients with ankylosing spondylitis (AS) who were characterised with posture and joint motion disorders. The clinical and social factors that play a role in the development of PTG were also investigated. Materials and methods: Eighty AS patients aged 18 to 65 years were included in the study. Disease activity was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status by the Bath Ankylosing Spondylitis Functional Index (BASFI) and spinal mobility by the Bath Ankylosing Spondylitis Metrology Index (BASMI). For the evaluation of the positive psychological changes posttraumatic growth inventory (PTGI) was used, as multidimensional scale of perceived social support (MSPSS) and ways of coping inventory were respectively used to assess social support and coping strategies. Results: The population consists of 58 male and 22 female subjects. The mean total scores of PTG, total social support and coping inventory were 67.90 ± 18.96, 66.42 ± 14.52 and 96.97 ± 10.43, respectively. The total PTG scores were significantly higher in women than in men (p=0.016). BASDAI and BASFI were negatively correlated with PTG, whereas ways of coping and social support were positively correlated with PTG (p=0.001, r=0.352; p=0.044, r=0.226). Conclusion: Social support and ways of coping have a positive effect, whereas disease severity and poor functional index have a negative effection the development of PTG.Öğe THE EFFECT OF SOCIAL SUPPORT AND SEVERITY OF THE DISEASE ON POSTTRAUMATIC GROWTH IN ANKYLOSING SPONDYLITIS(Carbone Editore, 2014) Yagiz, Abdullah Erman; Kokacya, Mehmet Hanifi; Copoglu, Umit Sertan; Uruc, Vedat; Paksoy, Hacer; Yengil, Erhan; Ustun, NilgulAim: Posttraumatic growth (PTG) is described as the positive psychological changes after struggling with highly challenging life circumstances. This study aimed to evaluate PTG in patients with ankylosing spondylitis (AS) who were characterised with posture and joint motion disorders. The clinical and social factors that play a role in the development of PTG were also investigated. Materials and methods: Eighty AS patients aged 18 to 65 years were included in the study: Disease activity was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status by the Bath Ankylosing Spondylitis Functional Index (BASFI) and spinal mobility by the Bath Ankylosing Spondylitis Metrology Index (BASMI). For the evaluation of the positive psychological:changes posttraumatic growth inventory (PTGI),Was used as multidimensional scale of perceived octal support (MSPSS) and ways of coping inventory were respectively used to assess social support and coping strategies. Results: The population consists of 58 male and 22 female subjects. The Mean total scores of PTG, total social support and coping inventory were 67.90 +/- 18.96, 66.42 +/- 14 52 and 96.97 +/- 10.43, respectively. The total PTG scores were significantly higher in Women than in men (p=0.016). BASDAI and BASFI were negatively correlated with PTG, whereas ways of coping and social supF port were positively correlated with PTG (p=0.001, r=0352; p=0.44, r=0226). Conclusion: Social support and ways of coping have a positive effect, whereas disease severity and poor functional index have a negative effection the development of PTG:Öğe Efficacy of EMLA cream phonophoresis comparison with ultrasound therapy on myofascial pain syndrome of the trapezius: a single-blind, randomized clinical study(Springer Heidelberg, 2014) Ustun, Nilgun; Arslan, Fatma; Mansuroglu, Ayhan; Inanoglu, Deniz; Yagiz, Abdullah Erman; Guler, Hayal; Turhanoglu, Ayse DicleThe aim of this study is to investigate whether eutectic mixture of local anesthetics (EMLA) cream phonophoresis superior to conventional US over the trigger points (TPs) in terms of improvements of pain, range of motion and disability in myofascial pain syndrome (MPS). Fifty patients (42 female, 8 male) diagnosed with MPS were included in the study. Patients were randomly assigned into two treatment groups including phonophoresis (PH) group (n = 25) and ultrasound (US) group (n = 25). PH group received EMLA cream phonophoresis (2.5 % lidocaine, 2.5 % prilocaine); US group received conventional ultrasound therapy over the all active TPs on trapezius muscle for 10 min a day for 15 sessions. Outcome measures were performed before the treatment course and at the end of a 15-session course of treatment. Student T, Mann-Whitney U, chi-square and Wilcoxon tests were used for statistical analysis. At the end of the therapy, there was statistically significant decrease in both PH group and US group in terms of number of trigger point (NTP) (p = 0.001, p = 0.029), pain intensity on movement (p = 0.001 vs. 0.002) and right/left cervical lateral ROMs (p = 0.001/p = 0.001, p = 0.009/p = 0.020) relative to baseline. The NTP decrease in PH group was significantly higher than that in US group (1.84 +/- A 1.46 vs. 0.72 +/- A 1.45; p = 0.01). Pain intensity at rest (p = 0.001) and NPDI scores (p = 0.001) were statistically improvement in only PH group. EMLA cream phonophoresis is more effective than conventional ultrasound therapy in terms of pain and associated neck disability, and it seems the complementary treatment option for MPS.Öğe Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus(Sage Publications Ltd, 2014) Sefil, Fatih; Ulutas, Kemal Turker; Dokuyucu, Recep; Sumbul, Ahmet Taner; Yengil, Erhan; Yagiz, Abdullah Erman; Yula, ErkanObjective Leukocytosis is thought to be directly associated with the pathogenesis of atherosclerosis and metabolic syndrome. Increased white blood cell (WBC) count is related to cardiovascular disease in patients with type 2 diabetes mellitus; raised neutrophil lymphocyte ratio (NLR) is associated with metabolic syndrome. There is little information, however, concerning a correlation between glycosylated haemoglobin (HbA(1c)) and NLR. The aim of the present study was to investigate the relationship between NLR and blood glucose regulation. Methods This retrospective study was conducted in patients with type 2 diabetes mellitus, divided into two groups according to HbA(1c) levels: group 1, HbA(1c) levels7%; group 2, HbA(1c) levels>7%. Venous WBC, neutrophil and lymphocyte counts were determined. Results Of 71 patients included, fasting serum glucose, neutrophil and WBC counts were significantly higher in group 2 compared with group 1. NLR had a positive correlation with HbA(1c). Conclusion There may be a significant relationship between NLR and blood glucose regulation. The authors propose that increased NLR may be associated with elevated HbA(1c) in patients with type 2 diabetes mellitus.Öğe Low serum levels of vitamin D in metastatic cancer patients: a case-control study(Humana Press Inc, 2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Kavvasoglu, Gamze; Batmaci, Celal Yucel; Yengil, Erhan; Yagiz, Abdullah Erman; Gultepe, IhamiAccompanying comorbidities observed during the cancer treatment usually affect the course and outcome of the therapy. Hypovitaminosis D, which is one of these conditions, is a resolvable problem, if recognized. In this study, we investigated whether the serum 25(OH) D levels of the patients who were presented to our outpatient clinic were different from the serum levels of the healthy population living in the same area. Our study included 90 patients who were presented to the Medical Oncology outpatient clinic and 90 age, gender, body mass index and ethnic origin matched controls without a known disease, who were presented to the outpatient clinics of the Departments of Internal Diseases and Family Medicine for routine controls. Blood count tests, detailed biochemistry tests (including serum levels of Cr, Ca and P), measurement of serum 25(OH) D levels and C-reactive protein were performed in serum samples of all of the patients and controls. Mean serum levels of 25(OH) D were 13.5 ng/ml (SD 5.1) in all cancer patients, 13.1 ng/ml (SD 4.2) in the patients who were presented for adjuvant therapy, 13.8 ng/ml (SD 5.5) in the patients who were presented at metastatic stage and 18.4 ng/ml (SD 12.5) in the controls. Mean serum CRP levels were 5.4 mg/dl (SD 1.2) in the control group, 8.4 mg/dl (SD 4.3) in the adjuvant therapy group and 20.3 (SD 16.8) in the patients with metastatic disease. Generally, all cancer patients (p 0.003) and the patients with metastatic cancer (p 0.004) had lower serum 25(OH) D levels compared to controls, and there was an inverse correlation between serum 25(OH) D and CRP levels in patients with metastatic cancer (p 0.036). In metastatic cancer patients, hypovitaminosis D may be a comorbidity and it is recommended to consider during initial evaluation and follow-up. Because it might improve these patients quality of life and chemotherapy adherence.Öğe Spectral domain-optical coherence tomographic findings in patients with ankylosing spondylitis under anti-tumor necrosis factor-alpha therapy(Taylor & Francis Ltd, 2015) Ilhan, Nilufer; Ustun, Nilgul; Tuzcu, Esra Ayhan; Coskun, Mesut; Yagiz, Abdullah Erman; Ilhan, Ozgur; Parlakfikirer, NihanObjective: To evaluate the effect of tumor necrosis factor-alpha (TNF-alpha) blockade on the thickness of the peripapillary retinal nerve fiber layer (RNFL), the ganglion cell-inner plexiform layers (GCIPL), and the macula in ankylosing spondylitis (AS) patients under anti-TNF-alpha therapy. Materials and methods: Twenty-one patients with AS received etanercept, or adalimumab, or infliximab for at least 6 months. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were measured before and 6 months after the beginning of the treatment. Peripapillary RNFL, four regional fields (superior, inferior, nasal, and temporal), GCIPL, and macular thicknesses of the patients were analyzed by optical coherence tomography before the treatment, at 3 months and 6 months after the beginning of the treatment. Results: The mean BASDAI, ESR, and CRP values were 5.2 +/- 1.5, 31.6 +/- 21.7, and 15.7 +/- 13.9, respectively, at the beginning of the treatment and 2.3 +/- 1.7, 21.3 +/- 15.1, and 10.1 +/- 10.3, respectively, 6 months after the beginning of treatment. There were significant differences among the mean BASDAI, ESR, and CRP values at the beginning of treatment and 6 months later (p < 0.001, p = 0.007, and p = 0.009, respectively). There were no significant differences among peripapillary RNFL (p = 0.24), four regional fields (p = 0.98, p = 0.23, p = 0.09, p = 0.47), GCIPL (p = 0.25), or macular (p = 0.33) thicknesses of the patients during anti-TNF-alpha treatment. In addition, the mean intraocular pressure levels throughout the follow-up did not show significant variation on repeated-measures ANOVA (p = 0.77). Conclusions: TNF-alpha blockade does not seem to influence RNFL, GCIPL, or macular thickness of patients with AS in the short term.Öğe Ultrasound-Guided vs. Blind Steroid Injections in Carpal Tunnel Syndrome A Single-Blind Randomized Prospective Study(Lippincott Williams & Wilkins, 2013) Ustun, Nilgun; Tok, Fatih; Yagiz, Abdullah Erman; Kizil, Nurhan; Korkmaz, Inan; Karazincir, Sinem; Okuyucu, EsraObjective: The aim of this study was to compare the efficacy and the safety of ultrasound (US)-guided vs. blind steroid injections in patients with carpal tunnel syndrome (CTS). Design: This prospective randomized single-blind clinical trial included 46 patients with CTS (46 affected median nerves). The subjects were randomized-to either the US-guided or the blind injection group-before they received 40 mg of methylprednisolone. They were evaluated using the Boston Carpal Tunnel Questionnaire symptom/function at baseline and at 6 wks and 12 wks after injection, and the side effects were noted. Results: The symptom severity and functional status scores improved significantly in both groups at 6 wks after treatment, and these improvements persisted at 12 wks after treatment (all P < 0.05). The improvement in symptom severity scores in the US-guided group at 12 wks was higher than in the palpation-guided group (P < 0.05). Average time to symptom relief was shorter in the US-guided group (P < 0.05). There was no significant difference between the two groups in terms of side effects (P > 0.05). Conclusions: Although both US-guided and blind steroid injections were effective in reducing the symptoms of CTS and improving the function, an earlier onset/better improvement of symptom relief suggests that US-guided steroid injection may be more effective than are blind injections in CTS.Öğe Urotensin II (U-II), a novel cyclic peptide, possibly associated with the pathophysiology of osteoarthritis(Elsevier Science Inc, 2014) Gogebakan, Bulent; Uruc, Vedat; Ozden, Raif; Duman, Ibrahim Gokhan; Yagiz, Abdullah Erman; Okuyan, Hamza Malik; Aldemir, OzgurSynovial fibrosis is one of the main outcomes of osteoarthritis. Some authors have reported that urotensinII (U-II) may cause pathologic fibrosis in cardiovascular system, lung and liver. However there are no previous reports available in the literature about its relationship with the synovial fibrosis in osteoarthritis. The aim of this study was to compare the U-II levels in knee synovial fluids obtained from osteoarthritic and non-osteoarthritic patients. Two groups were created, the osteoarthritis group and non-osteoarthritic control group. The control group was consisted of patients who underwent arthroscopic surgery for other reasons than cartilage disorders. In the osteoarthritis group all patients had grade 4 primer degenerative osteoarthritis and were treated with total knee arthroplasty. Minimum 1 mL knee synovial fluids were obtained during operation. Levels of U-II were measured by using ELISA kit U-II levels were significantly higher in the osteoarthritic group than that in the control group. No correlation was found between U-II levels and age. In conclusion, the significantly high U-II levels in the knee synovial fluid of osteoarthritic patients supported our hypothesis that U-II may be associated with the synovial fibrosis in osteoarthritis.(c) 2014 Elsevier Inc. All rights reserved.
