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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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    Plasma leptin status and the relationship between different medical treatments used in ankylosing spondylitis
    (2013) Güler, Mustafa; Çapkin, Erhan; Karkucak, Murat; Aydin, Teoman; Türkyilmaz, Ayşegül Küçükali; Karaca, Adem; Gökmen, Ferhat
    Objective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study. The Bath AS Disease Activity Index (BASDAI) was used for disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-? (TNF-?) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized.
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    PLASMA LEPTIN STATUS AND THE RELATIONSHIP BETWEEN DIFFERENT MEDICAL TREATMENTS USED IN ANKYLOSING SPONDYLITIS
    (Nobel Ilac, 2013) Guler, Mustafa; Capkin, Erhan; Karkucak, Murat; Aydin, Teoman; Turkyilmaz, Aysegul Kucukali; Karaca, Adem; Gokmen, Ferhat
    Objective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study The Bath AS Disease Activity Index (BASDAI) was used for disease activity Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-alpha (TNF-alpha) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized.
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    Psöriatik artritli bir olguda bilateral üst ekstremite ödemi
    (2015) Gökmen, Ferhat; Akbal, Ayla; Savaş, Yılmaz; Zateri, Coşkun; Karaca, Adem; Tan, Yusuf Ziya
    Psöriatik artrit (PsA), seronegatif spondiloartropati grubunda yer alan,periferal artrit, entezit, spondilit ve psöriasis ile karakterize infamatuvarromatizmal bir hastalıktır. Lenfödem ekstremite distalinde daha fazlabir veya birden fazla bölgede görülebilen, tümörler, enfeksiyonlar,busitler, romatoid artrit, polimiyalji romatika gibi birçok infamatuvar venoninfamatuvar hastalığa sekonder olarak gelişebilen lenfatik akımdakiyavaşlama ile gelişen bir hastalıktır. Lenfödem PsAda nadir gelişen birkomplikasyondur. Sıklıkla asimetrik ve daha çok alt ekstremitede görülür.Bu yazıda PsA tanısı ile takip ettiğimiz ve her iki üst ekstremitede şişlikşikayeti ile başvuran ve yapılan incelemelerde bilateral üst ekstremite lenfödemi tanısı koyduğumuz olgu rapor edilmiştir.
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    QUALITY OF LIFE IN PSORIATIC ARTHRITIS PATIENTS-ASSOCIATION WITH DISEASE ACTIVITY AND DIAGNOSTIC DELAY TIME
    (Nobel Ilac, 2014) Gokmen, Ferhat; Karkucak, Murat; Capkin, Arzu; Karaca, Adem; Turkyilmaz, Aysegul Kucukali; Capkin, Erhan; Akbal, Ayla
    Objective: 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.
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    Quality of life in psoriatic arthritis patients-association with disease activity and diagnostic delay time
    (Nobelmedicus, 2014) Gökmen, Ferhat; Karkucak, Murat; Çapkın, Arzu; Karaca, Adem; Türkyılmaz, Ayşegül Küçükali; Çapkın, Erhan; Akbal, Ayla
    Objective: 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 laboratory [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 1 year (min-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. © 2014, Nobelmedicus. All rights reserved.
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    The association between radiographic features in patients with lumbar spine degenerative changes and body mass index; a preliminary stereological study
    (2013) Güler, Mustafa; Çapkin, Erhan; Barçak, Ömer Faruk; Karkucak, Murat; Aydin, Teoman; Türkyilmaz, Ayşegül Küçükali; Karaca, Adem
    Objective: To evaluate the association between radiographic features (osteophytes, disc space narrowing) in patients with lumbar spine degenerative changes and body mass index (BMI), with quantitative methods. Material and Method: One-hundred and three women with lumbar spine degenerative changes who had lower back pain were included in the study. Patients were divided into two groups according to their BMI. Pain and functional status of patients were evaluated using visual analog scale (VAS) and Roland Morris Questionnaire (RMQ), respectively. The size of osteophytes and disc space narrowing were calculated on lateral roentgenogram of the lumbar vertebrae by using computer based stereological methods. Results: No significant correlation was detected between the BMI and radiological findings. But, there was a positive correlation between the osteophyte surface area and RMQ, and VAS and RMQ (p<0.05). Conclusion: No significant correlation was detected between the BMI and radiographic findings in lumbar spine degenerative changes. To our knowledge, this is the first study quantitatively assessing the association between radiographic findings and BMI in lumbar spine degenerative changes.
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    THE ASSOCIATION BETWEEN RADIOGRAPHIC FEATURES IN PATIENTS WITH LUMBAR SPINE DEGENERATIVE CHANGES AND BODY MASS INDEX; A PRELIMINARY STEREOLOGICAL STUDY
    (Nobel Ilac, 2013) Guler, Mustafa; Capkin, Erhan; Barcak, Omer Faruk; Karkucak, Murat; Aydin, Teoman; Turkyilmaz, Aysegul Kucukali; Karaca, Adem
    Objective: To evaluate the association between radiographic features (osteophytes, disc space narrowing) in patients with lumbar spine degenerative changes and body mass index (BMI), with quantitative methods. Material and Method: One-hundred and three women with lumbar spine degenerative changes who had lower back pain were included in the study. Patients were divided into two groups according to their BMI. Pain and functional status of patients were evaluated using visual analog scale (VAS) and Roland Morris Questionnaire (RMQ), respectively. The size of osteophytes and disc space narrowing were calculated on lateral roentgenogram of the lumbar vertebrae by using computer based stereological methods. Results: No significant correlation was detected between the BMI and radiological findings. But, there was a positive correlation between the osteophyte surface area and RMQ, and VAS and RMQ (p<0.05). Conclusion: No significant correlation was detected between the BMI and radiographic findings in lumbar spine degenerative changes. To our knowledge, this is the first study quantitatively assessing the association between radiographic findings and BMI in lumbar spine degenerative changes.
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    Treatment of ankylosing spondylitis with TNF inhibitors does not have adverse effect on results of liver function tests: a longitudinal study
    (Wiley, 2015) Capkin, Erhan; Karkucak, Murat; Cosar, Arif M.; Ak, Emel; Karaca, Adem; Gokmen, Ferhat; Budak, Bayram S.
    AimTo retrospectively investigate and compare the effects of tumor necrosis factor alpha inhibitors (TNFi) on hepatic enzymes in ankylosing spondylitis (AS) patients. MethodsA retrospective analysis of the records of 94 AS (66 male, 28 female) patients using TNFi was performed. Patients' clinical data, Bath Ankylosing Spondylitis Disease Activity (BASDAI) scores, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were all examined. Liver function test (LFTs) results of patients before the treatment and 3, 6 and 12months after treatment with TNFi were investigated. Aspartate transaminase (AST) and alanine transaminase (ALT) levels were investigated as indicators of LFTs. ResultsThe TNFi drugs used were infliximab (n=28), adalimumab (n=32) and etanercept (n=34). Pre-treatment values of ESR, CRP and BASDAI scores were 28.320.1mm/h, 1.5 +/- 1.2ng/dL and 5.2 +/- 0.8, respectively. Following TNFi use there was a statistically significant decrease in disease activity score (P=0.001). There was a significant increase in LFT at the third month evaluation compared to the initial values, while the average value was within normal range (baseline AST 19.6 +/- 10.8U/L, ALT 19.1 +/- 6.4U/L, third month AST 31.3 +/- 21.6U/L, ALT 28.1 +/- 18.1U/L, P=0.001). Drug group comparison analysis revealed a significant difference in the adalimumab group value at the end of the first year, but no other significant difference in the data for the other months (P>0.05). No significant correlation was determined between initial disease activity scores and LFT. ConclusionTNFi use-associated rises in hepatic enzymes were determined compared to pre-treatment but the mean values remained within normal limits. Considering the cases in the literature, in daily practice patients must be carefully monitored for liver function before treatment and at follow-up.