Aktif ve inaktif romatoid artritli hastalarda adezyon molekülleri ve lenfosit subgruplarının incelenmesi

TEZ2419Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1996.Kaynakça (s. 59-68) var.68 s. ; 30 cm.

Sistemik lupus eritematozusta antinötrofil sitoplazmik antikorların sıklığı, hastalık aktivitesi ve klinik - laboratuvar parametrelerle ilişkisi

TEZ4638Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2003.Kaynakça (s. 46-49) var.v, 49 s. ; 30 cm.

Kronik hepatit C infeksiyonlarında yardımcı T hücre tip 1 ve tip 2 sitokinlerinin serum düzeyleri

Amaç: T hücre regülatuvar sitokinleri, vücudun hepatit C virüs infeksiyonlarına karsı geliştirdiği yanıtta önemli rol oynayabilirler. Yardımcı T hücre tip l sitokinleri, vücudun antiviral immün yanıtı için gerekli iken yardımcı T hücre tip 2 sitokinleri, bu etken mekanizmaların gelişimini inhibe edebilirler. Bu çalışmanın amacı, kronik HCV infeksiyonlarmda yardımcı T hücre tip l ve 2 sitokinlerinin düzeylerini belirlemektir. Yöntem: Yardımcı T hücre tip l sitokinlerinden Interferon (IFN)-gamma ve yardımcı T hücre tip 2 sitokinlerinden IL-4 ve IL-10 düzeylerine kronik hepatit C virüs infeksiyonu olan 30 hastada ve 25 sağlıklı kontrolde ELISA yöntemi ile bakıldı. Hasta ve kontrollerde, serum alanin transaminaz (ALT) düzeyleri de ölçüldü. Hasta grubunda, histolojik aktivite skoru değerlendirildi. Bulgular: Hepatic C virüs ile inpekte hasta grubunda serum IFN-gamma düzeyleri 59.03±46.24 pglmL, IL-4 düzeyleri 213.59+135.67 pg/mL, IL-10 düzeyleri 106.73±60.85 pglmL olarak bulunurken aynı sitokinlerin düzeyi sağlıklı kontrol grubunda sırası ile 61.84+54.87 pg l mL, 67.39±59.74 pglmL, 60.14±50.73 pglmL, olarak saptandı. Serum IL-4 ve IL-10 düzeyleri sağlıklı kontrol grubuna göre anlamlı olarak yüksek bulunurken, her iki grubun IFN-gamma düzeyleri arasında anlamlı fark saptanmadı. Sonuç: Bulgularımız, kronik hepatic C virüs infeksiyonunun patogenezinde yardımcı T hücre tip 2 sitokinlerinin yer aldığını düşündürtmektedir.Background/aims: T cell immunoregulatory cytokines may play a crucial role in the host response to hepatitis C virus infec-tion. While T-helper type 1 cytokines are required for host antiviral immune responses, T-helper type 2 cytokines can inhibit the development of these effector mechanisms. The aim of the present study was to determine T-helper type I and T-helper type 2 cytokine levels in chronic hepatitis C infection. Methods: Serum levels of T-helper type 1 cytokine, interferon-gamma (IFN-Y), and T-helper type 2 cytokines, IL-4 and IL-10 were measured in 30 patients with hepatitis C infection and 25 healthy controls using ELISA. Serum levels of alanine transaminase were also assessed in both patients and controls. Histologie activity score was evaluated in the chronic hepatic C infected patients. Results: Serum levels of IFN-j were 59.03+46.24 pg/mL, IL-4 were 213.59±135.67 pg/mL and IL-10 were 106.73±60.85 pg/mL in hepatitis C infected patients whereas in healthy controls they were found to be 61.84±54.87 pglmL, 67.39±59.74 pg/mL and 60.14±50.73 pglmL respectively. Serum levels of IL-4, IL-10 but not IFN-ywere found to be significantly increased in chronic HCV patients compared to those of control subjects. Conclusions: Our findings may suggest the involvement of Th2 cytokines in the pathogenesis of chronic hepatitis C virus liver disease

İrritabl barsak sendromu olan hastalarda fibromyalji prevalansı

Amaç: İrritable barsak sendromu, afferent visseral hipersensitivite ile karakterize bir fonksiyonel barsak hastalığıdır. Fibromyaljisi olan hastalarda sık olarak gözlenir. Diğer yandan irritable barsak sendromu olan hastalarda fibromyalji varlığı iyi tanımlanmamıştır. Bu çalışmanın amacı, irritable barsak sendromu olan hastalarda, fibromyaljisi ve ilişkili semptomların prevalansını araştırmaktır. Yöntem: Tanısı Manning kriterlerine göre konulmuş irritable barsak sendromu olan 78 hasta ve kontrol olarak yaş ve cins olarak benzer 70 birey çalışmaya alındı. Fibromyalji tanısı, Amerikan Romatoloji Cemiyetinin fibromyalji için saptadığı kriterlere göre konuldu. Fibromyalji ile ilişkili semptomlar katılanlara soruldu ve subjektif yanıtları saptandı. Bulgular: Yetmiş sekiz irritable barsak sendromlu hastanın 18'inde (%23.1) ve 70 kontrol bireyin 4'ünde (%5.7) fibromyalji saptandı. Fibromyalji ile ilişkili semptomlar, irritable barsak sendromlu hastalarda ve kontrol grubunda şu oranlarda bulundu: uyku bozukluğu (%41'e karşı %12.9), halsizlik (%75.6'ya karşı %18.6), kolay yorulma (%79.5'e karşı %15.7), sabah sertliği (%38.5'e karşı %0), parestezi (%32.1'e karşı %5.7), baş ağrısı (%52.6'ya karşı %27.1) ve gözlerde ve ağızda kuruluk hissi (sikka semptomları) (%15.4'e karşı %0). Sonuç: Bulgularımız, fibromyalji ve ilişkili semptomlara, irritable barsak sendromlu hastalarda sıklıkla rastlandığını ortaya koymaktadır. Bu bozukluklarda, ortak patogenetik mekanizmaların rolü olabilir.Background/Aims: Irritable bowel syndrome is a functional bowel disorder which is characterized by afferent visceral hypersensitivity. It is frequently observed in patients with fibromyalgia but the presence of fibromyalgia in patients with irritable bowel syndrome has not been well defined. The aim of this study was to assess the prevalence of fibromyalgia and associated symptoms in patients with irritable bowel syndrome. Methods: Seventy-eight patients with irritable bowel syndrome diagnosed according to Manning's criteria and 70 age and gender matched controls were included in the study. Diagnosis of fibromyalgia was made using the criteria of the American College of Rheumatology for fibromyalgia. Patients were questioned about associated symptoms and subjective replies were recorded. Results: Eighteen of 78 irritable bowel syndrome patients (23.1%) and four of 70 controls (5.7%) had fibromyalgia. The presence of associated symptoms with fibromyalgia in patients and controls were as follows: sleep disturbance (41% vs 12.9%), fatigue (75.6% vs 18.6%), tiring easily (79.5% vs 15.7%), morning stiffness (38.5% vs 0%), paresthesia (32.1% vs 5.7%), headache (52.6% vs 27.1%) and sicca symptoms (feeling of dry eyes and mouth) (15.4% vs 0%). Conclusions: These results indicate that fibromyalgia and associated symptoms frequently coexist in irritable bowel syndrome. Common pathogenic mechanisms may have a role in both disorders

Pseudo-Kaposi's sarcoma in Behçet's disease

Thrombosis in BehÇet's disease (BD) is not uncommon and venous occlussions affecting the venae cavae and their tributaries may result in during the course of the disease. Pseudo-Kaposi's sarcoma is characterized with a nodule or plaque which may lead to a painful ulceration. The development of the Mali's syndrome, an entity of Pseudo-Kaposi's sarcoma, usually follows stasis dermatitis and occurs on the lower extremities. In this report, we present a Pseudo-Kaposi's sarcoma case a 25-year-old male during the fourth year of the diagnosis with BD. The association of Pseudo Kaposi's sarcoma and BehÇet's disease has never- to our knowledge- been reported before.Thrombosis in BehÇet's disease (BD) is not uncommon and venous occlussions affecting the venae cavae and their tributaries may result in during the course of the disease. Pseudo-Kaposi's sarcoma is characterized with a nodule or plaque which may lead to a painful ulceration. The development of the Mali's syndrome, an entity of Pseudo-Kaposi's sarcoma, usually follows stasis dermatitis and occurs on the lower extremities. In this report, we present a Pseudo-Kaposi's sarcoma case a 25-year-old male during the fourth year of the diagnosis with BD. The association of Pseudo Kaposi's sarcoma and BehÇet's disease has never- to our knowledge- been reported before

Bilateral plevra ve perikard sıvısı olan bir behçet hastalığı olgusu

Background and Observation.- BehÇet's syndrome is a primary vasculitis. In addition to mucocutaneous, ophthalmic and musculoskeletal symptoms, rarely pleural and pericardial fluid is reported in BehÇet's patients due to thrombosis of superior vena cava. Herein we report a patient with BehÇet's syndrome, who had superior vena cava syndrome that caused pericardial and pleural effision, and due to resistance to medical therapy, unilateral pleurodesis with bleomycin solution then was performed.Background and Observation.- BehÇet's syndrome is a primary vasculitis. In addition to mucocutaneous, ophthalmic and musculoskeletal symptoms, rarely pleural and pericardial fluid is reported in BehÇet's patients due to thrombosis of superior vena cava. Herein we report a patient with BehÇet's syndrome, who had superior vena cava syndrome that caused pericardial and pleural effision, and due to resistance to medical therapy, unilateral pleurodesis with bleomycin solution then was performed

Evaluation of serum TNF-alpha levels in heart failure

AMAÇ: Kalp yetersizliğinde (KY) tümör nekroz faktör-alfa (TNF-alfa) serum düzeyinin artmasının hastalığın prognostik belirleyicilerinden biri olduğu belirtilmektedir. Bu çalışmada, iskemik ve idiyopatik dilate kardiyomiyopatili hastalarda serum TNF-alfa düzeyinin saptanması ve bu düzeyin hastaların ejeksiyon fraksiyonu (EF) ile ilişkisinin olup olmadığının değerlendirilmesi amaçlandı. YÖNTEM: Çalışmaya KY olan 30 (16 erkek, 14 kadın; yaş ortalaması 49.0±14.58 yıl) hasta ile kontrol grubu olarak 20 (10 erkek, 10 kadın; yaş ortalaması 53.85±9.87yıl) sağlıklı birey alındı. SONUÇLAR: KY olan hastaların ortalama TNF-alfa düzeyleri 70.848±91.800 pikogram/mililitre (pg/ml), kontrol grubunun ise 19.915±5.567 pğ/ml olarak tesbit edildi (p<0.000). KY olan hastaların TNF-alfa düzeyleri ile EF arasında anlamlı korelasyon saptanmadı (p=0.093, r=-0.312). Hastalar, etyolojilerine göre iskemik ve dilate kardiyomiyopati olarak iki alt gruba ayrıldığında gruplar arasında TNF-alfa düzeyleri bakımından anlamlı fark bulunmadı (p=0.200). YORUM: Sonuç olarak, TNF-alfa düzeyinin KY olan hastalarda etyolojiden bağımsız olarak yükseldiği ve bunun KY patogenezinde rol oynayabileceği düşünüldü.PURPOSE: Increased serum level of tumor necrosis factor-alpha (TNF-alpha) in heart failure (HF) is suggested as a prognostic marker of the disease.-The detection of serum levels of TNF-alpha in ischemic and idiopathic dilated cardiomyopathy and the evaluation of relationbetween serum TNF-alpha levels and ejection fraction (EF) are aimed in this study. METHODS: Thirty patients (16 male, 14 female; mean age 49.0±14.58 years) with HF and 20 healthy controls (10 male, 10 female; mean age 53.85±9.87 years) were included in the study. RESULTS: Levels of serum TNF-alpha were found as 70.848+91.800 pg/ml in the patients with HF and 19.915±5.567 pg/ml in the healthy controls (<0.000). No correlation was observed between serum TNF-alpha levels and EF in the patients with HF (p=0.093, r=-0:312). When the patients with HF were grouped according to their etiology as ischemic and dilated cardiomyopathy, TNF-alpha levels did not show significant difference between the groups (p=0.200). CONCLUSION: Levels of TNF-alpha were found to be elevated in -the patients with HF independently from etiology and it was suggested that TNF-alpha might play a role in the pathogenesis of HF

C-Reactive protein-to-Albumin ratio: A novel inflammatory marker and disease activity sign in early rheumatoid arthritis

Objective A novel inflammation-based score, C-reactive protein (CRP)-to-albumin ratio (CAR), has been shown to have an association with the inflammatory status in several diseases. We aimed to analyse the association between CAR and disease activity in patients with early rheumatoid arthritis (RA) and to determine the cut-off value of CAR in early and established RA. Methods A total of 177 patients with RA and 111 age and gender-matched healthy controls were included in this study. Cases with a disease duration of less than 1 year were classified as early RA. Serum albumin, CRP, erythrocyte sedimentation rate (ESR), Disease Activity Score-28 (DAS-28-ESR), Clinical Disease Activity Index (CDAI) and Health Assessment Questionnaire (HAQ) scores were recorded. Results CAR was 2.44 (0.21–30.83) in the RA group and 0.45 (0.21–10.47) in the control group (p<0.001). Eighty-seven (49.15%) of the RA cases were classified as early RA. The analyses indicated that the ESR, CRP and CAR values were higher in patients with early RA than in those with established RA and controls. CAR was correlated with albumin, CRP, ESH, DAS-28 and HAQ scores in both early RA and established RA groups. The receiver operating characteristic curves revealed a CAR cut-off value of 2.67 (80% sensitivity and 85% specificity) and 1.63 (77% sensitivity and 72% specificity) for the prediction of early and established RA, respectively. Conclusion CAR, a formulated ratio, has been described as a predictor for disease activity in patients with early RA as well as in those with established RA. However, CAR has higher sensitivity and specificity for early RA than for established RA

Aromataz inhibitör terapisinin neden olduğu artraljinin değerlendirilmesi

Amaç: Meme kanseri hormon tedavisinde, aromataz inhibitörleri (AI) ve (Tamoksifen) Tmx sık olarak kullanılmaktadır. Bu çalışmada, meme kanserli kadınlarda görülen artralji yakınmalarının hormon tedavisinde kullanılan ajanlarla ilişkisi araştırılmıştır. Yöntem: Meme kanseri olan ve AI grubu ilaç alan 32 hasta ve Tmx alan 32 hasta çalışmaya dahil edildi. Hastaların eklem ağrılarının şiddetini belirlemek için Görsel Analog Skalası (VAS) kullanıldı. Yine tüm hastalara „mevcut eklem ağrılarınızın kaynağı hakkındaki nedenlerle ilgili düşünceniz nedir?? sorusuna cevap arayan beş seçenekli Likert ölçeği uygulandı. Laboratuar parametresi olarak, hastaların CBC, BUN, kreatinin, ALT, AST, alkalen fosfataz, kalsiyum, CRP, ESR, ANA, Anti-DNA, RF, östradiol seviyelerine bakıldı. Bulgular: AI kullanan hasta grubun yaş ortalaması 52,7±8,2 yıl, Tmx kullanan grubun yaş ortalaması 47,4±6,5 yıl idi (p0,05). Sonuç: Çalışmamızda AI alan hastalarda Tmx alan hastalara göre daha sık ve daha şiddetli artralji olduğu saptanmıştır. AI kullanan hastalardaki artralji nedenlerinden biri de, düşük östradiol düzeyi olabilir.Purpose: In breast cancer treatment, aromatase inhibitors (AI) and tamoxifen (Tmx) are frequently used. In this study, the relationship between the hormonal therapy and arthralgia in women with breast cancer was studied. Methods: Sixty-four patients of whom 32 taking AI and 32 taking Tmx were included in the study. VAS was used to determine the intensity of pain. Also five options Likert scale was applied to all patients to answer the question “what are your thoughts about the sources of your current pain?”. As laboratory parameters, CBC, BUN creatinine, ALT, AST, alkaline phosphatase, calcium, CRP, ESR, ANA, RF, and estradiol levels of the patients were analyzed. Results: The mean age of the AI group was 52.7 ± 8.2 years old and in the Tmx group, it was 47.4 ± 6.5 years old (0.05, for each). Conclusion: In our study, more frequent and severe arthralgia has been observed in patients under AI treatment when compared to tamoxifen. One of the causes that leads to arthralgia in patients using AI may be low levels of estradiol