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Öğe Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis(Springer London Ltd, 2018) Cure, Erkan; Icli, Abdullah; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Baykara, Rabia Aydogan; Yavuz, FatmaAnkylosing spondylitis (AS) is associated with an increased risk of atherosclerotic cardiovascular disease (ACD). The atherogenic index of plasma (AIP), which is the logarithmic transformation of the plasma triglyceride (TG) level to the high-density lipoprotein level (HDL) ratio, has been suggested to be a novel marker in the identification of atherosclerosis risk. Therefore, this study aims to determine if the AIP can act as an accurate marker for the detection of subclinical atherosclerosis. Fifty-two male patients with AS and 52 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. For each patient, AIP and total cholesterol (TC)/HDL values were calculated and carotid artery intima-media thickness (cIMT) was measured. The mean (SD) cIMT and median (range) AIP values for AS patients were higher than that of the healthy control subjects (0.60 +/- 0.18 vs. 0.51 +/- 0.10, p = 0.003 and 0.23 [- 0.32 to 0.85] vs. 0.09 [- 0.53 to 0.49], p = 0.007, respectively). A positive correlation was found between the patients' cIMT and AIP values (r = 0.307, p = 0.002) and TC/HDL values (r = 0.241, p = 0.014). Regression analysis revealed an independent association between the subclinical atherosclerosis and AIP (beta [beta] = 0.309, p = 0.002). There were no independent correlations between subclinical atherosclerosis and TC (beta = 0.245, p = 0.065), TG (beta = 0.185, p = 0.515), HDL (beta = 0.198, p = 0.231), TC/HDL (beta = 0.032, p = 0.862), and low-density lipoprotein (LDL) (beta = 0.151, p = 0.246). A strong and independent correlation exists between AIP and cIMT values. Therefore, the AIP could serve as a better marker than the TC/HDL ratio for the detection of subclinical atherosclerosis in AS patients.Öğe Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis(Springer London Ltd, 2020) Kucuk, Adem; Cumhur Cure, Medine; Cure, Erkan[Abstract Not Availabe]Öğe Can emapalumab be life saving for refractory, recurrent, and progressive cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and Janus kinase inhibitors(Wolters Kluwer Medknow Publications, 2021) Cure, Erkan; Kucuk, Adem; Cure, Medine CumhurAlthough many potent drugs have been used for cytokine storm, mortality is high for patients with coronavirus disease-2019 (COVID-19), which is followed up in the intensive care unit. Interferons (IFNs) are the major cytokines of the antiviral defense system released from many cell types. However, IFN-gamma plays a key role in both primary and secondary cytokine storms. If the cytokine storm is not treated urgently, it will be fatal; therefore, it should be treated immediately. Anakinra, an interleukin-1 (IL-1) antagonist, tocilizumab, an IL-6 antagonist, and Janus kinase (JAK) inhibitors are successfully used in cytokine storm caused by COVID-19. However, sometimes, despite these treatments, the patient's clinical course does not improve. Emapalumab (Eb) is the human immunoglobulin G1 monoclonal antibody and is a potent and noncompetitive antagonist of IFN-gamma. Eb can be life saving for cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and JAK inhibitors.Öğe Central involvement of SARS-CoV-2 may aggravate ARDS and hypertension(Hindawi Ltd, 2020) Cure, Erkan; Cumhur Cure, Medine; Vatansev, Hulya[Abstract Not Availabe]Öğe Colchicine may not be effective in COVID-19 infection; it may even be harmful?(Springer London Ltd, 2020) Cumhur Cure, Medine; Kucuk, Adem; Cure, Erkan[Abstract Not Availabe]Öğe Comment on Smooth or Risky Revisit of an Old Malaria Drug for COVID-19?(Springer, 2020) Cure, Erkan; Cure, Medine Cumhur; Kucuk, Adem[Abstract Not Availabe]Öğe COVID-19 infection can cause chemotherapy resistance development in patients with breast cancer and tamoxifen may cause susceptibility to COVID-19 infection(Churchill Livingstone, 2020) Vatansev, Hulya; Kadiyoran, Cengiz; Cure, Medine Cumhur; Cure, ErkanBreast cancer is the most common cancer in women and is the second most common cause of death in women. Estrogen plays an important role in breast tumor etiopathogenesis. Tamoxifen and other anti-estrogen drugs are used in breast cancer patients who have a positive estrogen receptor (ER). While angiotensin II plays a key role in breast cancer etiology and causes tamoxifen resistance, angiotensin 1-7 has been reported to may reduce the spread and invasion of breast cancer. During the COVID-19 infection, the virus blocks ACE2, and angiotensin 1-7 production discontinued. Angiotensin III production may increase as angiotensin II destruction is reduced. Thus, aminopeptidase upregulation may occur. Increased aminopeptidase may develop resistance to chemotherapy in breast cancer patients receiving chemotherapy. Estrogen can have a protective effect against COVID-19. Estrogen increase causes ER-a upregulation in T lymphocytes. Thus, estrogen increases the release of interferon I and III from T lymphocytes. Increasing interferon I and III alleviates COVID-19 infection. Tamoxifen treatment causes down-regulation, mutation, or loss in estrogen receptors. In the long-term use of tamoxifen, its effects on estrogen receptors can be permanent. Thus, since estrogen receptors are damaged or downregulated, estrogen may not act by binding to these receptors. Tamoxifen is a P-glycoprotein inhibitor, independent of its effect on estrogen receptors. It suppresses T cell functions and interferon release. We think tamoxifen may increase the COVID-19 risk due to its antiestrogen and P-glycoprotein inhibitory effects.Öğe Cyclosporine therapy in cytokine storm due to coronavirus disease 2019 (COVID-19)(Springer Heidelberg, 2020) Cure, Erkan; Kucuk, Adem; Cumhur Cure, Medine[Abstract Not Availabe]Öğe Determination of hearing levels in gout patients and factors affecting hearing levels such as the dislipidemia, hemoglobin levels and hyperuricemia(W B Saunders Co-Elsevier Inc, 2020) Yucel, Abitter; Yucel, Hilal; Aydemir, Fuat; Cure, Erkan; Eryilmaz, Mehmet Akif; Cizmecioglu, Hilal Akay; Kucuk, Adem[Abstract Not Availabe]Öğe Effects of COVID-19 Pandemic on Psychological Condition and Disease Severity in Patients with Behcet's Disease(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2020) Kucuk, Adem; Vatansev, Hulya; Gica, Sakir; Demir, Salih; Cure, ErkanObjective: Behcet's disease (BD) is an episodic and chronic multisystemic disease. Many comorbid psychiatric disorders are frequently encountered in BD. In addition, it is reported that individuals with chronic diseases during the epidemic period are at risk for COVID-19 infection. Therefore, these situations may cause anxiety levels to increase and coping strategies to decrease overall psychological conditions in patients with BD. However, individuals with both psychiatric complaints and comorbid inflammatory and chronic diseases such as BD are more prone to this stressful situation than healthy individuals. In the current study, we aimed to determine whether patients with Behcet's Disease (BD) are psychologically more sensitive than healthy individuals and whether disease severity increase with the COVID-19 pandemic. Methods: One hundred and fifty-six patients with BD and 156 healthy volunteers were included in the study. All participants received Perceived COVID-19 Threat Form (PCTF), Suicide-Ideation Scale (SIS), Hospital Anxiety and Depression Scale (HADS), The Ability to Cope with Trauma (PACT), well-being index (PGWB) scales. Results: When the responses of the patient with BD and control groups to the psychiatric evaluation scales were examined; the mean scores of PCTF (p <0.001), SIS (p<0.001), HADS-depression (p<0.001) and HADS-anxiety (p<0.001) in patients with BD were significantly higher than the control group. Mean scores of PGWB (p<0.001) and PACT (p= 0.042) in the patient group were found to be lower. In the relationship analysis, BSAS scores were associated with PCTF scores (r=0.20, p=0.013), and PGWB scores were associated with PACT scores (r=0.53, p=0.001). Conclusion: COVID-19 pandemic affects the mental health of both male and female patients with BD significantly. In patients with BD, while disease severity was associated with the perceived COVID threat, psychological well-being was associated with existing psychiatric complaints and patients' ability to cope with trauma. The findings of our study support that patients with BD may need more psychological support than ever during the COVID-19 pandemic.Öğe Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis(Tubitak Scientific & Technological Research Council Turkey, 2021) Gica, Sakir; Akkubak, Yasemin; Aksoy, Zakire Kubra; Kucuk, Adem; Cure, ErkanBackground/aim: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity. Materials and methods: Age and sex-matched patients with AS (n = 80), RA (n = 80), and healthy controls (n = 80) were included in the study. All participants were evaluated with the Perceived COVID-19 Threat Form (PCTF), Suicide-Ideation Scale (SIS), Hospital Anxiety and Depression Scale (HADS), The Ability to Cope with Trauma (PACT), and Psychological General Well-Being Index (PGWB) scales. BASDAI was used in patients with AS, and DAS28 was used in patients with RA to assess disease severity. Results: Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p = 0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r = 0 .36 for PCTF, r = 0.53 for depressive scores, r = 0.54 for anxiety scores, r = 0.57 for suicidal ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r = -.26 and r = .33, respectively). Conclusion: Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.Öğe Endocan Levels and Subclinical Atherosclerosis in Patients With Systemic Lupus Erythematosus(Sage Publications Inc, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Mikhailidis, Dimitri P.; Ozturk, CengizSystemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. A major cause of morbidity and mortality in SLE is accelerated atherosclerosis. Endothelial-specific molecule 1 (endocan) is a potential predictor of vascular events and is expressed in response to inflammatory cytokines in endothelial cells. We investigated the relationship between endocan and carotid intima-media thickness (cIMT) as a marker of early atherosclerosis. We included 44 women with SLE and 44 healthy women as controls. Disease severity of SLE was evaluated using the SLE Disease Activity Index. Endocan, C-reactive protein, erythrocyte sedimentation rate (ESR), and lipid panel were measured. The cIMT was 0.70 (range: 0.45-1.20) mm in patients with SLE and 0.40 (0.25-0.60) mm in controls (P < .001). Endocan value was 1.6 +/- 0.9 ng/mL in controls and 2.2 +/- 1.0 ng/mL in patients with SLE (P = .014). Endocan levels were positively correlated with cIMT (r = .469, P < .001), body mass index (r = .373, P = .013), and ESR (r = .393, P = .008). Endocan level may be associated with subclinical atherosclerosis in SLE. Consequently, endocan levels may be a promising clinical tool for patients with SLE as a guide for preventive strategy.Öğe The evaluation of cochlear functions in Familial Mediterranean Fever(Springer, 2016) Eryilmaz, Mehmet Akif; Yucel, Abitter; Cure, Erkan; Sakiz, Davut; Koder, Ahmet; Kucuk, Adem; Tunc, RecepFamilial Mediterranean Fever (FMF) is a progressive disease characterized by chronic inflammation, which also has negative effects on cochlear functions and hearing levels. We investigated whether the cochlear functions and hearing levels of FMF patients were different than healthy controls and also evaluated the relationship of hearing levels with the age at diagnosis, duration without treatment, and inflammation and lipid parameters in this study. A total of 60 patients diagnosed with FMF and 48 age, gender and body mass index (BMI)-matched healthy controls were included in the study. The hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lipid parameters of the subjects were studied and they all underwent pure tone audiometry and Transient evoked otoacoustic emission tests after an otologic examination. The hearing levels of the FMF group were significantly higher than those of the control group. The TEOAE signal/noise (S/N) ratios were similar in both groups. A positive relationship was present between the audiometric test results and the age, BMI, low-density lipoprotein and triglyceride levels and a negative relationship with the high-density lipoprotein levels. A negative relationship was present between the TEOAE S/N ratios and the age of the patients, duration without treatment, lipid parameters, inflammation markers and the creatinine level. FMF patients are exposed to chronic inflammation and this can influence their hearing levels. The age at diagnosis, duration without treatment, chronic inflammation, unfavorable lipid parameters, and obesity can affect hearing tests negatively.Öğe Liver metastasis in colorectal cancer: evaluation of segmental distribution(Termedia Publishing House Ltd, 2019) Kadiyoran, Cengiz; Cizmecioglu, Hilal Akay; Cure, Erkan; Yildirim, Mehmet Aykut; Yilmaz, Pinar DiydemIntroduction: It is known that the liver is the main target for metastasis in colorectal cancer. However, we do not know enough from the literature to describe the segmental distribution of liver metastatic lesions of colorectal cancers. Aim: To investigate which liver segment is affected. Material and methods: A total of 326 patients (female/male, n = 115/221; age: 53 +/- 8/51 +/- 7 years) were included in our study, classified according to their pathological diagnosis. After liver metastases of the patients were determined, they were divided according to Couinaud classification. Results: While the total number of metastases detected in the right lobe was 691 (70.1%), the number of metastases detected in the left lobe was 294 (29.9%), and the difference was highly significant (p < 0.0001). Metastases in the right lobe anterior segment amounted to 279 (40.4%), and metastasis in right lobe posterior segment was 412 (59.6%), and the difference was significant. When the total number of metastatic lesions is evaluated by excluding segment I, the largest number of lesions were observed in segment VIII. The liver segments with the highest number of metastatic lesions were, respectively, VII, IV, VI, V, III, and II. In this case, the fewest metastatic lesions were observed in segment II. Conclusions: Liver metastases of colorectal cancer are more common in the right lobe than in the left lobe. The right lobe posterior segment (segment VI) is the main target of metastases.Öğe Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behcet's disease(Bmj Publishing Group, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Arslan, Sevket; Sakiz, DavutBehcet's disease (BD) is a vasculitic and inflammatory disease causing endothelial dysfunction. Irisin is a metabolic hormone related to insulin resistance and endothelial functions. In this study, we investigated the relationship between irisin and carotid intima-media thickness (cIMT), which is a marker of atherosclerosis in patients with BD. 48 patients with BD and 50 healthy individuals were enrolled in the study. Disease severity was evaluated by BD current activity form. Irisin, glucose, insulin, C reactive protein, erythrocyte sedimentation rate and lipid panel were examined in all patients. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. A simple and inexpensive cIMT test was used as indicator of atherosclerosis. cIMT was 0.62 (0.45-1.05) mm in the patients, while it was 0.38 (0.25-0.65) mm in the control group (p<0.001). Irisin value was found to be 197.3 (24.8-834.2) ng/mL in the control group, while it was 85.4 (4.7-471.1) ng/mL in the patient group (p=0.007). There was a negative correlation between irisin level and cIMT (r=-0.511, p<0.001) and HOMA-IR (r=-0.371, p=0.009). Decreased irisin levels (OR 0.996, 95% CI 0.992 to 1.000, p=0.041), male gender (OR 7.634, 95% CI 1.415 to 41.191, p=0.018), and HOMA-IR (OR 2.596, 95% CI 1.451 to 4.643, p=0.001) are independent risk factors for cIMT in patients with BD. We detected a very strong relationship between cIMT, which is an indicator of subclinical atherosclerosis, and decreased irisin levels in patients with BD. BD is characterized by chronic inflammation, and low serum irisin levels in BD may be related to atherosclerosis.Öğe NSAIDs may increase the risk of thrombosis and acute renal failure in patients with COVID-19 infection(Elsevier, 2020) Cure, Medine Cumhur; Kucuk, Adem; Cure, Erkan[Abstract Not Availabe]Öğe Plasma Atherogenic Index is an Independent Indicator of Subclinical Atherosclerosis in Systemic Lupus Erythematosus(Aves, 2017) Uslu, Ali Ugur; Kucuk, Adem; Icli, Abdullah; Cure, Erkan; Sakiz, Davut; Arslan, Sevket; Baykara, Rabia AydoganObjective: Systemic lupus erythematosus (SLE) is characterized by chronic inflammation. Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in atherosclerosis and the cardiac risk in SLE patients. Materials and Methods: We included 56 female SLE patients who were selected according to the American College of Rheumatology (1997) diagnosis criteria. Furthermore, we selected age-and body mass index (BMI)-matched 56 female healthy individuals. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. We used carotid intima media thickness (cIMT) as an inflammatory marker because of its widespread use. The lipid and other biochemical parameters of patient and control groups were examined. Results: The PAI and cIMT values of SLE patients were 0.04 +/- 0.23 and 0.78 +/- 0.18 mm, respectively. Besides, for the control group, the PAI value was -0.09 +/- 0.20 and cIMT value was 0.50 +/- 0.15 mm (p=0.002, p<0.001; respectively). There was a strong correlation between cIMT and PAI (r=0.273, p=0.003). According to the multiple logistic regression analysis, we found that PAI value is an independent factor for cIMT in SLE patients (odds ratio: 2.6, 95 % confidence interval; 1.506-4.374; p=0.029). Conclusions: We determined that PAI can be used as an independent indicator for subclinical atherosclerosis in SLE patients.Öğe The Relationship Between Atherogenic Index and Carotid Artery Atherosclerosis in Familial Mediterranean Fever: A Pilot Study(Sage Publications Inc, 2017) Icli, Abdullah; Cure, Erkan; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Ozucan, Miyase; Baykara, Rabia AydoganFamilial Mediterranean fever (FMF) is a disease characterized by chronic inflammation. Atherogenic index of plasma (AIP) is a logarithmic value of the triglyceride to high-density lipoprotein cholesterol ratio and it is a good marker for atherosclerotic heart disease and cardiac risk. In this study, we investigated subclinical atherosclerosis and cardiac risks in patients with FMF. Patients with FMF (78 men and 84 women) and healthy controls (74 men and 82 women) were included in this study. The AIP values of the patients were calculated and carotid intima-media thicknesses (cIMTs) were measured. The cIMT (P < .001) and AIP (P < .001) values of patients with FMF were higher than the values of the control group. There was a positive correlation between cIMT and AIP values (r = .304, P < .001). In regression analysis, we detected an independent relationship between cIMT and AIP ( = .248, P = .001). Atherogenic index of plasma may be highly correlated with the subclinical atherosclerosis. Particularly, male patients with FMF may have a high cardiac risk.Öğe The relationship of serum visfatin levels with clinical parameters, flow-mediated dilation, and carotid intima-media thickness in patients with ankylosing spondylitis(Tubitak Scientific & Technological Research Council Turkey, 2021) Aydogan Baykara, Rabia; Kucuk, Adem; Tuzcu, Ayca; Tuzcu, Goksel; Cure, Erkan; Uslu, Ali Ugur; Omma, AhmetBackground/aim: Atherosclerotic heart diseases can occur at an early age in patients with ankylosing spondylitis (AS). Flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT) values are reliable markers for early detection of subclinical atherosclerosis in patients with AS. We aimed to investigate the relationship between visfatin levels and indirect markers of subclinical atherosclerosis and endothelial dysfunction in patients with AS. Materials and methods: Forty-two patients diagnosed with AS and 42 age, sex, and body mass index (BMI)-matched controls were included in the study. Visfatin levels, FMD, and cIMT were measured using appropriate methods. Results: Visfatin levels of the patients were significantly higher than controls (p < 0.001). FMD values in patients with AS were significantly lower (p = 0.007) whereas cIMT were significantly higher than the controls (p = 0.003). There was a negative relationship between FMD with visfatin levels (p = 0.004), BASDAI (p = 0.010), and BASFI (p = 0.007). There was a positive relationship between cIMT with visfatin (p = 0.005), BASDAI (p < 0.001), and BASFI (p < 0.001). There was a positive relationship between visfatin with BASDAI (p < 0.001), and BASFI (p < 0.001). Conclusion: Visfatin levels are increased and associated with impaired FMD and increased cIMT in patients with AS. Increased visfatin levels may be associated with subclinical atherosclerosis in AS.
