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Öğe Clinical and Ultrasonographic Findings in Patients with Early Rheumatoid Arthritis: An 18-Month Follow-Up Cohort Study(2018) Harman, Halil; Tekeoğlu, İbrahimObjectives: The aim of our study is to perform the clinical, functional and ultrasonographic (US) follow-up of the early and very early RA patient whoare naive among the disease modifying antirheumatic drugs (DMARDs) for 18 months and evaluate the relationship of these parameters with theradiological final state. Material and Methods: This prospective study included 48 early RA (15 very early RA) patients. Gray scale US (GSUS), Power Doppler US (PDUS)examinations, Disease Activity Score 28 (DAS 28), Health Assessment Questionnaire (HAQ), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein(CRP) were evaluated repeatedly at each visit (baseline, 1, 3, 6, 9, 12, 18 months). Hand, wrist, elbow, shoulder, knee joints and hand, wrist tendonstructures were evaluated via GSUS and PDUS.Results: During the follow-up period of the patients, the ESR and CRP levels started to decrease statistically significantly from the 1st month (p=0.006).Statistically significant improvement in HAQ, DAS 28 scores, total GSUS synovitis scores, total PDUS tenosynovitis scores, total GSUS tenosynovitisscores, total PDUS tenosynovitis scores started at 3th months (p=0.007, p=0.003, p=0.001, p=0.009, p=0.002, p=0.004 respectively). In follow-up of veryearly RA patients; laboratory, US findings were similar to early RA patients Inmultiple linear regression analysis, only the GSUS and PDUS scores at 0and 1, could have an effect on the radiographic progression scores (ß=0.417, p=0011, ß=0.549, p=0.028, ß=0.476, p=0015; ß=0.358, p=0.017, respectively).Conclusions: Radiographic damage progresses at the similar severity in early and very early RA patients. The most important factor affecting theradiographic damage progression is the severity of US synovitis at the baseline and in the 1st month, independently of the disease activityÖğe The levels of serum pentraxin 3, IL-6, fetuin A and insulin in patients with rheumatoid arthritis(Bmj Publishing Group, 2016) Tekeoğlu, İbrahim; Kamanlı, Ayhan; Sağ, Sinem; Harman, Halil; Altındiş, MustafaObjective: The aim of this study was to investigate the relationship between disease severity and bio- chemical parameters such as pentraxin-3, fetuin-A, IL-6, insulin and HOMA-IR levels in patients with rheumatoid arthritis. Methods: This study included 60 patients with RA and 20 healthy controls. Serum pentraxin-3, fetuin-A, IL-6 and insulin concentrations were measured. Also, HOMA-IR values were calculated. Disease activity was assessed with Disease Activity Score (DAS28). To evaluate quality of life, the Health Assessment Questionnaire disability index was applied. Results: The serum values for ESR, CRP, pentraxin-3 and fetuin-A in patients with RA were found to be higher than control subjects (p values = 0.001, 0.001, 0.000, 0.000, 0.01, 0.02, respectively). A positive cor- relation was evident between the DAS 28 score and IL6 levels (r = 0.263, p = 0.045). We found no corre- lation between the DAS28 score and HOMA-IR, the levels of pentraxin 3, fetuin A, insulin (p < 0.05). Fetuin A levels were positively correlated with cumulative steroid dose (r = 0.382, p = 0.035). A statistically significant correlation was evident between presence of cardiovascular disease and HOMA-IR values in RA patients (r = 0.437, p = 0.032). Conclusion: Elevated levels of pentraxin-3, fetuin-A, CRP, ESR might play a role in the pathogenesis of RA. Levels of fetuin-A, insulin HOMA-IR, pentraxin-3, CRP and ESR were not associated with clinical severity of the RA.Öğe Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis(Turkish League Against Rheumatism, 2017) Ayna, Ata Bora; Ermurat, Selime; Coskun, Belkis Nihan; Harman, Halil; Pehlivan, YavuzObjectives: This study aims to evaluate the role of neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) as activation and inflammatory markers in systemic lupus erythematosus (SLE) patients with nephritis. Patients and methods: A total of 108 SLE patients (8 males, 100 females; mean age 35.3 +/- 10.2 years; range 16 to 64 years) including 78 patients with renal involvement (8 males, 70 females; mean age 33.9 +/- 10.6 years; range 16 to 64 years) (SLEn+ group) and 30 patients without renal involvement (30 females; mean age 39.1 +/- 8.2 years; range 22 to 55 years) (SLEn-group) were included in this retrospective study. All patients' clinical characteristics and laboratory data which include erythrocyte sedimentation rate, C-reactive protein, white blood counts, neutrophil counts, lymphocyte counts, platelet counts, and MPV levels were obtained from medical records. The laboratory data at the highest proteinuria periods of the patients with renal involvement were recorded. Results: Mean MPV (SLEn+ = 9.1 +/- 2.2, SLEn-= 7.9 +/- 1.2, p= 0.001) and NLR (SLEn+ = 5.9 +/- 5.9, SLEn-= 2.6 +/- 2.5, p< 0.001) values were significantly higher in lupus nephritis group. Besides, a positive correlation between NLR and C-reactive protein was found in lupus nephritis group (r= 1.97, p= 0.045). Based on receiver operating characteristic curve with area under the curve of 0.76, cutoff NLR value of 1.93 had 83% sensitivity and 54% specificity [95% confidence interval, 0.66-0.85] in differentiating SLE patients with or without nephritis. Conclusion: Neutrophil to lymphocyte ratio and MPV may be discriminative for lupus nephritis. Also, NLR may be a predictor of lupus nephritis. Both MPV and NLR values may be affected by a great number of factors; therefore, further prospective studies are needed to evaluate the use of these parameters in SLE.Öğe The Relationship Between Serum Pentraxine 3 Levels and Hematological Markers in Patients With Rheumatoid Arthritis(2018) Sağ, Mustafa Serdar; Sağ, Sinem; Tekeoğlu, İbrahim; Kamanlı, Ayhan; Nas, Kemal; Harman, HalilObjectives: This study aims to investigate the association of pentraxin 3 (PTX3) with neutrophil/lymphocyte ratio (NLR) rather than the disease activity score 28 using C-reactive protein in rheumatoid arthritis (RA). Patients and methods: The study included 59 RA patients (11 males, 48 females; mean age 53.79±13.55 years; range 40 to 66 years) and 20 healthy controls (5 males, 15 females; mean age 50.41±6.11 years; range 43 to 56 years). Complete blood count tests were recorded and NLR and platelet/lymphocyte ratio were calculated. PTX3 and interleukin-6 levels were examined in serum samples. Disease activity of RA patients was assessed by disease activity score 28. Results: Demographic characteristics were similar between the two groups, with no statistically significant difference in terms of sex, age, and body mass index (p>0.05). NLR, PTX3 and interleukin-6 levels were higher in patients with RA than the control group (p<0.05). While erythrocyte sedimentation rate had a positive correlation with mean platelet volume, we found no correlation between NLR and other parameters of disease activity, PTX3, and interleukin-6. Conclusion: We found no correlation between PTX3 and disease activity score 28 or NLR, although PTX3 levels were higher in RA patients than the controls. As a result, we were unable to establish a relationship between PTX3 and disease activity, directly or indirectly. To our knowledge, our study was the first to investigate the relationship between PTX3 and NLR.Öğe The relationship of Pentraxin-3 levels in Behcet Disease with IL-17, disease activity and atherosclerotic risk factors(Bmj Publishing Group, 2016) Sağ, Sinem; Kamanlı, Ayhan; Tekeoğlu, İbrahim; Nas, Kemal; Sağ, Mustafa Serdar; Harman, Halil[No Abstract Available]Öğe The relationship of pentraxin-3 levels with IL-17, fetuin-A, insulin in patients with Behcet's disease(Elsevier Taiwan, 2017) Sağ, Sinem; Kamanlı, Ayhan; Altındiş, Mustafa; Sağ, Mustafa Serdar; Harman, HalilBackground: Pentraxin (PTX) 3 is synthesized by leukocytes, dendritic cells, endothelial cells and monocytes in response to IL-1 and tumor necrosis factor (TNF)-alpha, and it might be informative regarding local inflammation. In additionally, pentraxin (PTX)-3, produced by endothelial cells in atherosclerotic plaques, acts as amodulator of inflammatory processes and is involved in the development of atherosclerotic lesions. Objective: This study aimed to identify the levels of proteins, such as PTX and fetuin-A, which are thought to play a role in the progression of atherosclerotic and cardiovascular disorders in patients with BD, and to investigate the relationship of these protein levels with BD activity, inflammatory cytokines, insulin resistance and dyslipidaemia. Patients and methods: This study included 58 patients (36 females, 22 males) with BD and 20 healthy controls. Serum PTX-3, fetuin-A, interleukin (IL)-17 and insulin concentrations were determined. Homeostasis model of insulin resistance (HOMA-IR) values were calculated, and disease activity was assessed using BD Current Activity Form (BDCAF) scores. Results: The levels pentraxin-3, fetuin-A, IL-17, insulin and HOMA-IR in patients with BD were found to be higher than control subjects (p < 0.05). PTX-3 and fetuin-A levels showed no correlation with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or scores on the various BDCAF domains. IL-17 levels were significantly positively correlated with the BDCAF arthritis score. No significant relationships were identified between the lipid profile and PTX-3, IL-17 or fetuin-A levels. No correlations were found among PTX, IL-17, fetuin-A, and insulin and HOMA-IR levels (p > 0.05). Conclusions: Similar to CRP, PTX-3 is an acute-phase reactant that is considered an inflammatory and atherosclerotic biomarker. This study showed that PTX-3 levels can increase, similar to IL-17, but no relationship was detected between disease activity and coronary risk factors such as serum lipids, glucose intolerance and obesity. This was a cross-sectional study; therefore, the patients should be followed in long-term studies to determine whether higher PTX levels in BD patients are associated with a higher incidence of cardiovascular disease. Copyright (C) 2017, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC.