Mittleres thrombozytenvolumen und neutrophilen-lymphozyten-ratio in bezug zu entzündungsmarkern und anti-ccp bei rheumatoider arthritis

Background: Various thrombocyte markers and white blood cell levels and their subtypes have recently been investigated in association with infl ammation. The purpose of this study was to determine the correlation of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with disease activation and clinical parameters in rheumatoid arthritis (RA) patients. Methods: 84 RA patients and 60 healthy controls were included. Platelet, MPV, white cell, neutrophil and lymphocyte levels in full blood counts were investigated, and NLR was calculated. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), disease activation score (DAS 28) and a health assessment questionnaire (HAQ) were used in the evaluation of RA. Results: In the present study a total of 144 patients was enrolled, 84 with RA and 60 healthy individuals. 75.2 % (n = 108) were women and 24.8 % (n = 36) were men. The patients with RA had lower MPV than control individuals (MPV; 8.52 ± 1.15 fL and 8.92 ± 0.87 fL, respectively) and CRP (r: − 0.234, p = 0.005). RA patients’ mean NLR was signifi cantly higher than that of the control group (2.74 ± 1.74 and 1.80 ± 0.78, respectively; p < 0.001). Furthermore, anti-CCP positive patients had higher NLR than anti-CCP negative patients (NLR; 2.51 ± 1.92 and 1.95 ± 1.22, p = 0.019 respectively). NLR was positively correlated with ESR (r = 0.190, p = 0.023), CRP (r = 0.230, p = 0.035) and anti-CCP (r = 0.300, p = 0.005). Conclusion: In conclusion, MPV and NLR together with acute phase reactants can be a useful index for showing infl ammation in RA patients.Einleitung: Verschiedene thrombozytäre Marker und Grenzwerte von Leukozyten und ihren Subtypen sind in der jüngeren Vergangenheit bezüglich ihres Zusammenhangs mit Entzündung untersucht worden. Ziel dieser Untersuchung war die Korrelation des mittleren Thrombozytenvolumens (MPV) und der Neutrophilen/Lymphozyten Ratio (NLR) mit der Krankheitsaktivität und klinischen Parametern bei Patienten mit rheumatoider Arthritis (RA). Methoden: 84 RA Patienten und 60 gesunde Kontrollen wurden eingeschlossen. Aus dem Blutbild wurden Thrombozyten, MPV, Leukozyten-, Neutrophilen- und Lymphozytenwerte untersucht und die NLR errechnet. Die Erythrozytensedimentationsrate (ESR), C-reaktives Protein, Rheumafaktor (RF), anti-zyklisches citrullinieres Peptid (anti-CCP), der Krankheitsaktivität-Score DAS 28 und ein Gesundheitsbewertungsbogen (HAQ) wurden für die Bewertung der RA herangezogen. Ergebnis: In die vorliegende Studie wurden 144 Patienten eingeschlossen, 84 mit RA und 60 gesunde Kontrollen. 75,2 % (n = 108) waren Frauen und 24,8 % (n = 36) waren Männer. Patienten mit RA hatten ein niedrigeres MPV als die Kontrollen (MPV; 8,52 ± 1,15 fL bzw. 8,92 ± 0,87 fL) und CRP (r: − 0,234, p = 0,005). Die mittlere NLR von RA Patienten war signifi kant höher als die der Kontrollgruppe (2,74 ± 1,74 bzw. 1,80 ± 0,78; p < 0,001). Außerdem hatten anti-CCP positive Patienten höhere NLRs als antiCCP negative Patienten (NLR; 2,51 ± 1,92 bzw. 1,95 ± 1,22 p = 0,019). Die NLR korrelierte positiv mit der ESR (r = 0,190, p = 0,023), dem CRP (r = 0,230, p = 0,035) und dem anti-CCP (r = 0,300, p = 0,005). Schlussfolgerung: MPV und NLR können gemeinsam mit Akutphase-Proteinen ein hilfreicher Index für die Entzündungsaktivität bei RA Patienten sein

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey

WOS: 000367258400020PubMed ID: 25736952BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p < 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p < 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles

Relationship between pulse wave velocity and serum YKL-40 level in patients with early rheumatoid arthritis

Karkucak, Murat/0000-0002-4348-8398WOS: 000325962100007PubMed: 23797781Subclinical atherosclerosis has been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs of cardiovascular disease (CVD). the aim of this study was to investigate the relationship between serum YKL-40 level and arterial stiffness in patients with ERA. Forty two patients with ERA and 35 healthy controls with no history or current sign of CVD were included in the study. ERA patients with active disease, defined as DAS28 a parts per thousand yen3.2, and symptoms onset < 12 months were recruited. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (CF-PWV), and the intima-media thickness carotid (IMT-C) was measured by carotid ultrasonography. Serum YKL-40 levels were measured by an enzyme-linked immunoassay method. the mean age was 43.1 +/- A 5.8 years in ERA patients and 41.0 +/- A 5.9 years in control group. the CF-PWV and IMT-C of the ERA patients were determined significantly higher than the control group (P = .001, P < .001, respectively). YKL-40 levels were significantly elevated in ERA patients than controls (P = .008). the serum levels of YKL-40 in the ERA patients showed a strong correlation with CF-PWV (r = .711, P < .001) and IMT-C (r = .733, P < .001). Multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels (adjusted RA(2)A = .493, P < .001). We have shown that patients with ERA had increased CF-PWV and serum YKL-40 levels. in addition, there was an association between CF-PWV values and serum YKL-40 levels in patients with ERA. As a result, we believe that serum YKL-40 level and CF-PWV might reflect early atherosclerosis in patients with ERA

Quality of life ın psoriatic arthritis patients-association with disease activity and diagnostic delay time

Karkucak, Murat/0000-0002-4348-8398;WOS: 000346628200010Objective: the purpose of this study was to determine the socio-demographic and clinical characteristics of patients with psoriatic arthritis (PsA) and to examine their effects on quality of life. Material and Method: 37 patients with PsA and 30 healthy controls were included in the study. To determine disease activity, clinical [disease activity score (DAS-28), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)] and laboratoly [Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] parameters were used. To evaluate quality of life, the Nottingham health profile (NHP) and Short form-36 (SF-36) were used. Results: the mean age of the patients was 43.9 +/- 11.2 years. the diagnostic delay time had a median of I year (mnin-max=0-18). We examined NHP NHP scores showed that NHP pain, physical activity, tiredness and social isolation of PsA patients were higher than for control subjects. We evaluated SF-36. SF-36 scores indicated that physical function, physical role limitation, body pain, overall health, vitality and emotional role limitation were significantly decreased in PsA patients compared to control subjects. Correlation analysis was performed; Statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with disease activity parameters (DAS-28, BASDAI, ESR and CRP). Furthermore, statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with diagnostic delay time. Conclusion: We determined that quality of life was less in patients with PsA compared to control subjects. in addition, we have also found that disease activity and prolongation of diagnostic delay are associated with quality of life

Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae

Ankilozan Spondilitte Arteriyel Sertlik ve Anti-Tümör Nekroz Faktör-Alfa Tedavisi: İki yıllık uzun dönem takip sonuçları

Amaç: Bu prospektif klinik çalışma ankilozan spondilit'de damar sertliği üzerine anti-tümör nekroz faktör-alfa (TNF-?) tedavisinin uzun dönemde etkinliğini değerlendirmeyi amaçlamaktadır. Hastalar ve yöntemler: Toplam 28 aktif ankilozan spondilit hastası (21 erkek, 7 kadın; ort. yaş 33.5±9.5 yıl; dağılım 20-52 yıl) çalışmaya alındı. Hastaların biyolojik tedavi başlangıcından önceki değerleri ve orta dönem (24. hafta) değerlendirilmesi rapor edildi. İleri değerlendirme için başlangıç raporları bulunan hastalarla anti-TNF-? tedavisinden sonraki ikinci yılda iletişime geçildi ve arteriyel sertlikleri nabız dalga hızı ile değerlendirildi. Bulgular: Anti-tümör nekroz faktör-alfa tedavisinden iki yıl sonra, hastaların semptomlarında ve klinik aktivite parametrelerini değerlendiren Bath Ankilozan Spondilit Hastalık Aktivite İndeksi skoru (4.9±0.9, 1.9±0.5 ve 1.8±0.9, p=0.0001), eritrosit sedimentasyon hızı (35.5±23.1 mm/h, 13.8±9.2 mm/h ve 25.0±17.9 mm/h, p=0.0001) ve C-reaktif proteinde (2.1±1.6 ng/dl, 0.4±0.3 ng/dl ve 0.6±0.9 ng/dl p=0.0001) anlamlı düzelmeler olmasına rağmen, arteriyel sertlik parametrelerinde (7.9±1.3 metre/saniye, 7.7±1.3 metre/saniye ve 8.3±1.1 metre/saniye, p=0.620) anlamlı değişiklik gözlemlenmedi. Sonuç: Önceki 24 haftalık değerlendirmeyle uyumlu olarak, ikinci yıldaki takip sonuçları anti-TNF-? tedavisinin ankilozan spondilitli hastalarda arteriyel sertliği düzeltmediğini gösterdi.Objectives: This prospective clinical study aims to evaluate the effectiveness of long-term of anti-tumor necrosis factor-alpha (TNF-a) therapy on arterial stiffness in ankylosing spondylitis. Patients and methods: A total of 28 active ankylosing spondylitis patients (21 males, 7 females; mean age 33.5±9.5 years; range 20 to 52 years) were enrolled. Patients’ values for before the initiation of biological therapy and mid-term (24 weeks) evaluation were reported. For further evaluation, this initially reported patients were contacted two years after anti-TNF-&#945; therapy, and their arterial stiffness was assessed by using pulse wave velocity. Results: After two years of anti-TNF-&#945; therapy, despite the significant improvements in patients’ symptoms and clinical activity parameters including Bath Ankylosing Spondylitis Disease Activity Index score (4.9±0.9, 1.9±0.5 and 1.8±0.9, p=0.0001), erythrocyte sedimentation rate (35.5±23.1 mm/h, 13.8±9.2 mm/h and 25.0±17.9 mm/h, p=0.0001), and C-reactive protein (2.1±1.6 ng/dL, 0.4±0.3 ng/dL and 0.6±0.9 ng/dL p=0.0001), no significant difference was observed in arterial stiffness parameters (7.9±1.3 meter/second, 7.7±1.3 meter/second and 8.3±1.1 meter/second, p=0.620). Conclusion: In line with the previous 24-week evaluation, the results at two-year follow-up indicates that anti-TNF-&#945; therapy does not improve arterial stiffness in patients with ankylosing spondylitis

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey

WOS: 000367258400020PubMed ID: 25736952BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p < 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p < 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles

Efficacy and Safety of Trastuzumab Emtansine in Her2 Positive Metastatic Breast Cancer: Real-World Experience

Aim The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment. Method Retrospective analysis of T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey. Findings Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3-4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%). Discussion The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC