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Öğe Assessment of Temperament and Character of Rheumatoid Arthritis Patients(Georg Thieme Verlag Kg, 2015) Gokmen, F.; Altinbas, K.; Akbal, A.; Celik, M.; Resorlu, H.; Gokmen, E.; Savas, Y.Objective: It is widely known that perception of disease affects clinical course and treatment response in patients with rheumatoid arthritis (RA). In this study we aim to define temperament and character properties of RA patients and to discuss the relation between these specific temperament and character properties and clinic variables. Methods: Study involved 93 RA patients. Temperament and character properties of patients were evaluated using Temperament and Character Inventory. Associations of clinical variables and specific temperament characteristics were evaluated using correlation and association analyses. Approval was obtained from institutional ethical commitee. Results: 74 (79.6 %) of study subjects were females and 19 (20.4 %) were males. Mean age of the patients was 53.3 +/- 11.5 years. There wasn't any difference between sociodemographic and clinical variables and temperament scores of patients according to gender (p > 0.05). Comparison of temperament features and clinical variables showed that there was a weak correlation between harm avoidance and Anticitrullinated Peptide Antibodies (p = 0.04, r = 0.22) and between reward dependance and Disease Activity Score (DAS 28). Regression analysis showed an association between reward dependance and DAS-28. Conclusion: Our findings indicated that there is an association between harm avoidance and reward dependance temperament properties of RA patients and disease activation, and disease course is more severe in patients who have high scores in these temperament dimensions. Therefore, adding assessment of temperament and character properties will help clinicians while evaluating treatment compliance and motivation of patients at initial and later stages of disease.Öğe Epicardial adipose tissue thickness, flow-mediated dilatation of the brachial artery, and carotid intima-media thickness Associations in rheumatoid arthritis patients(Urban & Vogel, 2015) Temiz, A.; Gokmen, F.; Gazi, E.; Akbal, A.; Barutcu, A.; Bekler, A.; Altun, B.Aim. The purpose of this work was to evaluate epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), and flow-mediated dilatation (FMD) of the brachial artery in rheumatoid arthritis (RA) patients using ultrasonographic methods. Interrelationships between these three parameters in RA patients were also investigated. Methods. EAT thickness, CIMT, and FMD were measured by ultrasonography. We measured the disease activity score (DAS28), health assessment questionnaire (HAQ) score, and C-reactive protein (CRP) levels. Spearman or Pearson correlation analysis was used to evaluate the association between clinical findings, CIMT, FMD, and EAT. Results. A total of 90 RA patients [ 19 men, mean age 54 years (range 21-76 years)] and 59 age-and gender-matched control subjects [ 17 men, mean age 54 years (range 2680 years)] were included in the study. Patients with RA had a mean 4.34 DAS28 points (range 0-40 points) and the mean duration of the disease was 77.1 months (range 1-360 months). We found that RA patients had thicker EAT (7.7 +/- 1.7 mm vs 6.2 +/- 1.8 mm, p<0.001), increased CIMT [ 0.9 (0.5-1.2) mm vs 0.6 (0.4-0.9) mm, p<0.001], and decreased FMD values [ 5.7% (-23.5 to 20%) vs. 8.5% (-4.7 to 22.2%), p=0.028] when compared to control subjects. CRP levels were significantly higher in the RA group [ 0.81 (range 0.1-13.5) vs 0.22 (range 0.05-12), p<0.001]. EAT thickness was negatively correlated with FMD (r=-0.26, p<0.001) and positively correlated with CIMT values (r=0.52, p<0.001). CIMT also negatively correlated with FMD (r=-0.29, p<0.001). Conclusion. EAT can be simply measured by echocardiography and correlated with FMD and CIMT. It can be used as a first-line measurement for estimating burden of atherosclerosis in RA patients.Öğe Evaluation of the temperament and character properties of patients with ankylosing spondylitis(Springer Heidelberg, 2014) Gokmen, F.; Altinbas, K.; Akbal, A.; Celik, M.; Savas, Y.; Gokmen, E.; Resorlu, H.Purpose. The aim of this study was to evaluate temperament and character of ankylosing spondylitis (AS) patients and to examine the association between these specific temperament and character properties and clinical variables. Patients and methods. This study involved 73 AS patients. Temperament properties of patients were evaluated using Cloninger's Temperament and Character Inventory (TCI). Association between clinical variables and specific temperament features were evaluated using correlation and regression analyses. Results. Forty eight (65.8%) of the study participants were men and the mean age was 42+/-11.4 years. There was slight negative correlations between self directedness (S) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores (p=0.01, r=-0.30), and between the Visual Analog Scale (VAS) and reward dependence (RD) scores (p=0.03, r=-0.26). Regression analysis showed that correlations between BASDAI and S, and between VAS and RD scores were statistically significant. Conclusion. Our study showed that the dimensions temperament and character are related to disease activation, and disease course is more severe in patients who have low scores in these TCI dimensions. Therefore, we suggest that evaluating temperament and character properties of AS patients will help clinicians to predict treatment compliance and motivation of patients during disease course.Öğe H-FABP, cardiovascular risk factors, and functional status in asymptomatic spinal cord injury patients(Urban & Vogel, 2013) Akbal, A.; Kurtaran, A.; Selcuk, B.; Akyuz, M.This was a cross-sectional study in the setting of a rehabilitation hospital. The aim of the study was to determine the serum levels of heart-type fatty acid-binding protein (H-FABP) in patients with spinal cord injury (SCI). A further goal was to examine whether there is a relationship between H-FABP levels and Functional Ambulation Classification (FAC) scale, Functional Independence Measure (FIM) score, American Spinal Injury Association (ASIA) status, and metabolic syndrome (MetS). The study included 56 SCI patients and 37 age- and sex-matched healthy control subjects who had not been diagnosed with coronary artery disease in the past. Serum H-FABP levels were significantly higher in patients with SCI than in control subjects: paraplegia group, 18.5 +/- 11.4; tetraplegia group, 16.3 +/- 9.1; control group, 6.7 +/- 5.1 ng/ml (p < 0.001). There was no difference between the other cardiac enzymes (troponin I, AST, ALT, CK, CK-MB, and LDH) among the groups. The relationship between the serum H-FABP levels and FAC status was examined. There was a negative correlation between FAC status and H-FABP levels (p < 0.001, r = -aEuro parts per thousand 0.581). Patients with complete SCI were divided into two groups according to the level of the lesion: (lesion levels in C6-T6, n = 25; lesion levels in T7-L2, n = 11). In patients with complete motor injury, H-FABP levels were higher in subjects with injuries above T6 than in those with injuries below T6 (24.21 +/- 10.1 and 14.1 +/- 10.4, respectively; p = 0.011). Serum levels of H-FABP were higher in SCI patients with MetS (n = 10) than in those without MetS (n = 46; 25.8 +/- 11.6 ng/ml vs. 16.42 +/- 10.3 ng/ml, respectively; p = 0.014). Patients were then divided into two groups according to SCI duration: < 12 months (n = 27) and > 12 months (n = 29). H-FABP levels showed statistically significant differences between the two groups (14.8 +/- 11.7 ng/dl and 20.9 +/- 9.9 ng/dl, respectively; p = 0.036). H-FABP is related to MetS and FAC status in asymptomatic SCI patients.Öğe Mean Platelet Volume and Neutrophil Lymphocyte Ratio as Related to Inflammation Markers and Anti-CCP in Rheumatoid Arthritis(Georg Thieme Verlag Kg, 2016) Gokmen, F.; Akbal, A.; Resorlu, H.; Binnetoglu, E.; Cevizci, S.; Gokmen, E.; Kose, M. M.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.Öğe Mean platelet volume and platelet distribution width can be related to bone mineralization(Springer London Ltd, 2014) Akbal, A.; Gokmen, F.; Gencer, M.; Inceer, B. S.; Komurcu, E.Platelets functions are related to bone resorption and formation. The present study aimed at studying the association between platelet function and bone mineralization. We showed that mean platelet volume (MPV) and platelet distribution width (PDW) levels in osteoporosis patients increased. The study also showed that PDW and age independently associated with bone mineralization. MPV and PDW are widely used for assessing platelet function. Recently, authors argued that platelet function has an important role in bone mineralization. However, only one study has investigated the relationship between MPV and osteoporosis. We aimed to study the levels of MPV and PDW in postmenopausal osteoporosis. We investigated 320 bone mineral density (BMD) measurements between the years 2012 and 2013 retrospectively in our clinic. Eighty patients whom chronic diseases are absent and all laboratory findings are complete enrolled in this study. Patients were divided in three groups as an osteoporosis, osteopenia, and normal BMD group. MPV and PDW levels were investigated in these groups. We performed correlation test and linear regression analysis to determine whether there is a relationship between platelet function markers and BMD measurements. Eighty patients were divided as an osteoporosis, osteopenia, and normal BMD group. MPV levels and PDW levels in the osteoporosis group were lower than the normal BMD group. PDW was positively correlated with femur total T (FTT) score and lumbar 1-4T (L1-4T) scores. Linear regression analysis showed that age and PDW were independently related to FTT and LTT scores. Platelet functions are related to the bone mineralization. PDW and MPV have a significant role in the development of postmenopausal osteoporosis.Öğe Platelet indices can relate to bone mineralization: response to comments by Varol(Springer London Ltd, 2015) Akbal, A.; Resorlu, H.[Anstract Not Available]