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    A Hybrid Schwannoma of Median Nerve
    (Coll Physicians & Surgeons Pakistan, 2014) Komurcu, Erkam; Kaymaz, Burak; Adam, Gurhan; Gokmen, Ferhat; Murath, Asli
    Schwannomas are the most common benign neoplasms of the peripheral nerves in the upper extremity originating from the schwann cells of nerve sheath. They account for 5% of all tumours in upper extremity. Schwannomas are usually solitary, encapsulated and homogeneous masses and present with slowly growing masses, sometimes associated with pain and paresthesia. Pre-operative evaluation is based on ultrasonography and magnetic resonance imaging, but final diagnosis requires histopathology. It is important to distinguish plexiform schwannoma from plexiform neurofibroma because of the possibility of malignant transformation in plexiform neurofibroma. Plexiform schwannoma may be confused with neurofibromatosis and this can lead to overtreatment. We present a very rare case of solitary mass which had a plexiform type multicentric extension: hybrid schwannoma of the median nerve of a 20-year-old young girl.
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    A Rare Association of Rheumatoid Arthritis with Crohn's Disease
    (Galenos Yayincilik, 2016) Resorlu, Hatice; Akbal, Erdem; Gokmen, Ferhat; Savas, Yilmaz
    [Anstract Not Available]
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    A rare cause of spinal dysraphism: lipomeningomyelocele
    (Elsevier Science Inc, 2016) Resorlu, Hatice; Gokmen, Ferhat; Resorlu, Mustafa; Akbal, Ayla; Bozkurt, Emre
    [Anstract Not Available]
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    Are inflammatory bowel disease patients aware of Achilles tendonitis?
    (Oxford Univ Press, 2014) Akbal, Ayla; Gokmen, Ferhat; Doner, Davut; Uysal, Fatma
    [Anstract Not Available]
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    Association between apparent diffusion coefficient and intervertebral disc degeneration in patients with ankylosing spondylitis
    (E-Century Publishing Corp, 2015) Resorlu, Mustafa; Gokmen, Ferhat; Resorlu, Hatice; Adam, Gurhan; Akbal, Ayla; Cevizci, Sibel; Sariyildirim, Abdullah
    Purpose: To assess the relation between ankylosing spondylitis (AS) and degenerative disc disease emerging in association with various intrinsic and extrinsic factors and to evaluate the correlation between degree of degeneration in intervertebral discs and apparent diffusion coefficient (ADC) values. Methods: Thirty-five patients with AS and a control group of 35 patients were included in the study. Three hundred fifty intervertebral discs were assessed in terms of degeneration by analyzing signal intensities and morphologies on T2 weighted series of a 1.5 Tesla magnetic resonance scanner. ADC values were determined in diffusion weighted images (DWI) using a b value of 500 s/mm(2). Patients in the AS and control groups were compared in terms of intervertebral disc degeneration, and association between degree of degeneration and ADC values was analyzed. Results: The mean of total degeneration degrees for five lumbar intervertebral discs was significantly higher in the patients with AS compared to the control group (16.77 +/- 4.67 vs 13.00 +/- 4.08, respectively; P=0.001). When intervertebral discs were analyzed separately, disc degeneration was again significantly higher in patients with AS compared to the control group, with the exception of L5-S1. Age, cholesterol level, triglyceride level, duration of disease and BASFI index were significantly associated with degree of degeneration in patients with AS. A negative correlation was determined between disc degeneration and ADC value. Conclusion: AS is a risk factor for degenerative disc disease due to its systemic effects, the fact it leads to posture impairment and its inflammatory effects on the vertebrae. A decrease in ADC values is observed as degeneration worsens in degenerative disc disease.
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    Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging
    (Soc Physical Therapy Science, 2015) Resorlu, Hatice; Resorlu, Mustafa; Gokmen, Ferhat; Akbal, Ayla; Adam, Gurhan; Komurcu, Erkam; Goksel, Ferdi
    [Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3 +/- 7.0 years, while it was 16.7 +/- 12.2 years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS.
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    Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case
    (Aves, 2015) Gokmen, Ferhat; Akbal, Ayla; Savas, Yilmaz; Zateri, Coskun; Karaca, Adem; Tan, Yusuf Ziya
    Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy characterized by peripheral arthritis, enthesis, spondylitis, and psoriasis. Lymphedema arises from the slowing of lymphatic flow because of inflammatory or noninflammatory diseases such as tumors, infections, bursitis, rheumatoid arthritis, and polymyalgia rheumatica. It is commonly encountered in one or more regions of distal extremities. Lymphedema is a rare complication of PsA, and it is commonly seen asymmetrically and in lower extremities. We aimed to report a case, who followed-up with diagnosis with PsA and with complaints of upper extremity swelling and bilateral upper extremity lymphedema diagnosed as a result of the review.
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    C-reactive protein gene and Toll-like receptor 4 gene polymorphisms can relate to the development of psoriatic arthritis
    (Springer London Ltd, 2015) Akbal, Ayla; Oguz, Sevilay; Gokmen, Ferhat; Bilim, Serhat; Resorlu, Hatice; Sılan, Fatma; Uludağ, Ahmet
    We aimed to determine in psoriatic arthritis (PsA) patients the Toll-like receptor (TLR) 4 and C-reactive gene (CRP) polymorphisms and allele frequency and to investigate the relationship between clinical parameters and gene polymorphisms. We enrolled in this study 31 PsA and 41 healthy control subjects. PsA diagnosis was according to CASPAR criteria. Bath ankylosing spondylitis diseases activity index, Maastricht ankylosing spondylitis enthesitis score, and Bath ankylosing spondylitis functional index were measured. C, A, and T alleles of CRP and A and G alleles of TLR 4 were determined using the analysis of melting curves after real-time PCR. CRP A, C, and T allele frequency in controls was 26.8, 73.2, and 36.6 %, respectively. In the PsA patient group, A, C, and T allele frequency was 9.7, 87.1, and 12.9 %, respectively. Between control and PsA groups, there was a significant difference in A, C, and T allele frequency (P = 0.008, 0.038, and 0.001, respectively). The frequency of CRP gene polymorphisms (CA, AA, CT, TA, and TT alleles) in the control group was 56.1 % and in the PsA group was 22.6 %. There was a significant difference between the two groups (P = 0.004). The absence of a CRP gene polymorphism was a risk factor for PsA (odds ratio 4.3, 95 % CI; 1.5-12.4, P = 0.005). TLR gene haploid frequency was investigated, and all control subjects had the wild-type AA allele. PsA patient GA allele frequency was 6.5 %. There was no significant difference between the two groups (P = 0.182). GA mutant allele frequency was related to PsA (odds ratio 7.03, 95 % CI; 0.32-151.9, P = 0.214). We have shown that CRP gene polymorphisms are higher in control subjects than PsA patients, and TLR 4 gene polymorphisms were found to be related to PsA.
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    Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis?
    (Springer Wien, 2015) Kurt, Tolga; Temiz, Ahmet; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Sacar, Mustafa
    It takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.
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    Cubital tunnel syndrome secondary to gouty tophi: A case report
    (Pakistan Medical Assoc, 2017) Resorlu, Hatice; Zateri, Coskun; Akbal, Ayla; Gokmen, Ferhat; Adam, Gurhan; Bilim, Serhad; Bozkurt, Emre
    Gout is a chronic rheumatic disease resulting from accumulation of monosodium urate crystals in tissues. The most important risk factor for the disease is hyperuricaemia. Precipitation of uric acid in the joint in the form of monosodium urate crystals is the main factor responsible for triggering attacks of arthritis. Tophi occur as a result of urate crystals that precipitate into joints and surrounding tissues. Tophi can erode the bone where they are located and cause compression in soft tissue due to a mass effect. The following case report describes a case of cubital tunnel syndrome developed in association with tophaceous compression and resolved with surgical decompression in a patient with chronic gouty arthritis.
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    Effect of Systemically Used Anti-Tumor Necrosis Factor- Medication on the Corneal Epithelium and Stroma of Patients with Ankylosing Spondylitis
    (Taylor & Francis Inc, 2017) Arikan, Sedat; Gokmen, Ferhat; Ersan, Ismail; Akbal, Ayla; Resorlu, Hatice; Gencer, Baran; Ali Tufan, Hasan
    Purpose: To evaluate the effect of systemically used anti-tumor necrosis factor alpha (TNF-alpha) medication on the thickness of corneal epithelium and stroma in patients with ankylosing spondylitis (AS). Methods: A total of 125 eyes of 69 participants were included in this retrospective study of three groups: healthy participants (Group 1), AS patients receiving anti-TNF-alpha medication (Group 2), and AS patients receiving a nonsteroidal anti-inflammatory medication (Group 3). Results: According to anterior segment optical coherence tomography, the mean thickness of the corneal epithelium was significantly thicker in Group 2 than in Group 3 (51.6 +/- 3.2 mu m versus 50.4 +/- 3 mu m, p = 0.01), as was that of the stroma (475 +/- 33 mu m versus 443 +/- 29 mu m, p = 0.002). Conclusions: Anti-TNF-alpha medication and/or avoidance of nonsteroidal anti-inflammatory drugs could improve the thickness of both the corneal epithelium and stroma in AS patients.
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    Effect of Using High-Speed Drill in Anterior Cervical Discectomy and Fusion
    (Turkish Neurosurgical Soc, 2016) Guven, Mustafa; Ceylan, Davut; Aras, Adem Bozkurt; Akbal, Ayla; Gokmen, Ferhat; Resorlu, Hatice; Alkan, Bahadir
    AIM: The objective of this study was to investigate the effect of using 2 different surgical techniques (curette or high-speed drill) in anterior cervical discectomy surgery on the healing of cases. MATERIAL and METHODS: Fifty-four operated cervical disc hernia cases were retrospectively examined in 2 groups. Discectomy and osteophytectomy were carried out in Group A by using a high-speed drill, while a curette was used for group B. Preoperative and postoperative computerized tomography and direct radiography were performed. Cervical disc height, cervical and segmental lordotic angles were calculated. The visual analogue scale and Odom's criteria were used in the assessment of pain and clinical healing. The fusion ratio of both groups was compared. The Mann-Whitney U test was used to compare data from the groups. RESULTS: Satisfactory results were obtained in the groups where high-speed drill and curette were used. Independently from the surgical technique, pain scores were significantly reduced in both groups after surgery. No radiologically significant differences were identified between the two groups within the postoperative period. CONCLUSION: Either high-speed drill or curette can be chosen for the osteophytectomy and discectomy stages of anterior cervical discectomy operations.
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    Epicardial adipose tissue thickness in patients with ankylosing spondylitis
    (Springer London Ltd, 2015) Resorlu, Hatice; Akbal, Ayla; Resorlu, Mustafa; Gokmen, Ferhat; Ates, Can; Uysal, Fatma; Adam, Gurhan
    The purpose of our study was to measure epicardial adipose tissue (EAT) thickness as a novel indicator of atherosclerosis and cardiovascular risk factor in ankylosing spondylitis (AS) patients and to show the relationship with clinical parameters and inflammatory markers. Forty AS patients (42.75 +/- 12.43 years) and 40 healthy individuals with no cardiovascular risk factor as the control group (43.02 +/- 14.78 years) were included in the study. Carotid intima-media thickness (CIMT) and EAT thickness were measured in AS patients and the control group. Total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, erythrocyte sedimentation rate, urea, and blood pressure were investigated in both groups. In addition, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to evaluate the association between clinical findings and CIMT and EAT in the patient group. CIMT and EAT thickness were higher in the AS patients compared to the control group. CIMT was 0.76 +/- 0.19 and 0.57 +/- 0.12 mm (p < 0.001) and EAT thickness was 4.35 +/- 1.56 and 3.03 +/- 0.94 mm (p < 0.001) in the AS and control groups, respectively. A correlation was determined between EAT thickness and CIMT. Triglyceride level, patient age, blood pressure, and duration of disease were correlated with both CIMT and EAT thickness. Increased CIMT and EAT thickness in AS patients compared to the control group shows a risk for subclinical atherosclerosis and cardiovascular disease.
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    Evaluation of paravertebral muscle atrophy and fatty degeneration in ankylosing spondylitis
    (Taylor & Francis Ltd, 2017) Resorlu, Hatice; Savas, Yilmaz; Aylanc, Nilufer; Gokmen, Ferhat
    Aim: The purpose of this study was to assess morphological changes in the paravertebral muscles in patients with ankylosing spondylitis. Materials and methods: Fifty-one patients diagnosed with ankylosing spondylitis and a 50 member control group were included in the study. The surface area of the multifidus and erector spinae muscles was measured at four levels between L1 and L5, and fatty degeneration in these muscles was scored. Lumbosacral and lumbar lordotic angles were determined for the patient and control groups. Results: Loss of muscle cross-sectional area compatible with atrophy was present at all four levels in the paraspinal muscles in patients with ankylosing spondylitis. A negative correlation was observed between paravertebral muscle area and duration of disease at three levels, but not at L1-2. Although muscle area decreased with the duration of disease at the L1-2 level, this was not statistically significant (r=-0.195, p=0.171). Comparison of intramuscular fatty degeneration between the groups revealed increased intramuscular fat at all levels in patients with ankylosing spondylitis, with the exception of L3-4, and a positive correlation between fatty degeneration and duration of disease was determined at all levels. Conclusion: Chronic inflammation, cytokine-mediated fibrosis, immobilization, and postural changes in ankylosing spondylitis contribute to fatty degeneration and atrophy in the paravertebral muscles.
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    Evaluation of possible factors affecting contrast sensitivity function in patients with primary Sjogren's syndrome
    (Consel Brasil Oftalmologia, 2015) Arikan, Sedat; Gokmen, Ferhat; Comez, Arzu Taskiran; Gencer, Baran; Kara, Selcuk; Akbal, Ayla
    Purpose: The contrast sensitivity (CS) function in patients with primary Sjogren's syndrome (pSS) may be impaired either frequently as a result of dry eye diseases or rarely as a result of optic neuropathy. In this study, we aimed to evaluate the CS function in pSS patients as well as to assess corneal aberrations and thickness of the peripapillary retinal nerve fiber layer (pRNFL). Methods: Fourteen eyes of 14 pSS patients (pSS group) and 14 eyes of 14 healthy participants (control group) were subjected to assessment of CS at the spatial frequencies of 1.5, 3.0, 6.0, 12, and 18 cycles/degree (cpd) using a functional visual acuity contrast test (FACT); measurement of corneal high-order aberrations (HOAs) in terms of coma-like, spherical-like, and total HOAs using Scheimpflug corneal topography; and measurement of the thickness of both the macular ganglion cell-inner plexiform layer (mGCIPL) and pRNFL in all quadrants using optical coherence tomography. None of the participants were under treatment with artificial tears. Results: The results of the CS test did not differ between the 2 groups at all spatial frequencies (p>0.05). In addition, there were no statistically significant differences between the 2 groups in terms of corneal HOAs (p>0.05) and thickness of mGCIPL (p>0.05). However, among all quadrants, only the inferior quadrant of pRNFL in pSS patients was statistically significantly thinner than that in the healthy participants (p=0.04). Conclusions: The CS function in pSS patients can be maintained with normal thickness of both pRNFL and mGCIPL and with lack of increased corneal HOAs, which may be present even in the absence of artificial tear usage.
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    Evaluation of serum endothelial cell-specific molecule-1 levels and carotid intima-media thickness in patients with ankylosing spondylitis
    (Walter De Gruyter Gmbh, 2016) Turkon, Hakan; Gokmen, Ferhat; Uysal, Sema; Akbal, Ayla; Inceer, Besir Sahin; Resorlu, Mustafa; Gokmen, Esra
    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated. Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3 +/- 185.2 vs. 373.9 +/- 206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77 +/- 0.16 vs. 0.53 +/- 0.09 mm, respectively; p<0.001). While a statistically significant positive correlation was detected in all subjects between CIMT levels and ESR, CRP (r=0.378, p=0.002, r=0.547, p<0.001, respectively), no significant correlation was detected between serum ESM-1 levels and ESR, CRP, BASDAI, BASFI and CIMT. Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.
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    HOW IMPORTANT IS EARLY DIAGNOSIS OF SUBCLINICAL ATHEROSCLEROSIS IN PRIMARY SJOGREN'S SYNDROME PATIENTS?
    (Carbone Editore, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, Ahmet
    Introduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4 +/- 25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group II (II%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.
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    How important is early diagnosis of subclinical atherosclerosis in primary Sjogren's syndrome patients?
    (Acta Medica Mediterranea, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, Ahmet
    Introduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4±25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group 11 (11%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.
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    Increased Levels of Serum Ischemia Modified Albumin in Patients with Ankylosing Spondylitis
    (Clin Lab Publ, 2016) Turkon, Hakan; Gokmen, Ferhat; Cakir, Dilek Ulker; Sehitoglu, Muserref Hilal; Resorlu, Hatice; Doner, Davut; Essizoglu, Ertan
    Background: The aim of the study was to investigate oxidant/antioxidant status by determining serum ischemia-modified albumin (IMA) levels with oxidative/antioxidant parameters in patients with ankylosing spondylitis (AS) compared to the controls. Methods: The serum concentrations of IMA, IMA/albumin ratio (IMAR), malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI), superoxide dismutase (SOD), glutathione peroxidase (GPx), and total antioxidant capacity (TAC) were measured in 40 AS patients and 35 healthy controls. Results: Mean serum IMA, IMAR, MDA, TOS, and OSI levels were increased in patients with AS when compared to the control group (p < 0.05 for all). Serum levels of SOD and GPx were significantly lower in the patient group than in the healthy subjects (p < 0.001 for both). Serum TAC levels were decreased in patients with AS compared to the controls but the statistical difference was not significant. Serum IMA levels were found to be positively correlated with BASDAI, BASFI, BASMI, and ASDAS-CRP (r = 0.356, r = 0.370, r = 0.412, r = 0.353, respectively, and p < 0.05 for all). IMAR values showed significant correlations with BASFI, BASMI, and ASDAS-CRP (r = 0.351, p = 0.026; r = 0.400, p = 0.010; and r = 0.379, p = 0.016, respectively). Conclusions: Depletion in antioxidant systems and overproduction of free radicals leading to formation of the oxidative stress may play a role in the development of AS. Increased levels of IMA might provide important contributions to the underlying oxidative stress in AS.
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    Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis
    (Wiley, 2015) Gokmen, Ferhat; Akbal, Ayla; Resorlu, Hatice; Gokmen, Esra; Guven, Mustafa; Aras, Adem Bozkurt; Erbag, Gokhan
    BackgroundIn recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). Materials and methodsWe enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. ResultsIn the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 12.9 and 46.5 +/- 11.2 years, respectively. Mean disease duration of AS patients was 6.9 +/- 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 +/- 1.23 and 1.73 +/- 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 +/- 0.62 and 2.41 +/- 1.33, respectively, P = 0.02). ConclusionNLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF- therapy.