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Atopic Dermatitis in Adults and Irritable Bowel Syndrome: A Cross-sectional Study
(Wolters Kluwer Medknow Publications, 2019) Islamoglu, Z. Gizem Kayo; Unal, Mehmet; Kucuk, Adem
Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis (AD) is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It was first described in 1933 but exists since antiquity. Aim and Objectives: To determine the relationship between AD and IBS. Materials and Methods: A total of 109 patients with AD and 100 healthy controls were included in the study. They were defined for diagnosis of IBS according to ROME-III diagnostic criteria. Supporting findings, Bristol stool scale, frequency of defecation and history of AD and IBS were also evaluated. AD severity was assessed using Severity Scoring of Atopic Dermatitis index. Results: A total of 62 patients (56.9%) in the AD group and 28 patients (28%) in the control group were diagnosed with IBS (P<0.001). Supportive findings excluding abnormal stool frequency and passage of mucus were more frequent in AD patients. There was no significant relationship between disease severity according to SCORAD index and variables in AD patients. Conclusions: This is a rather uncultivated area in the field of AD. We observed that IBS was more common in AD group. Also, supporting findings like abnormal stool form, abdominal distension, feeling of incomplete evacuation, and straining were found more frequently in AD patients. These results may indicate the association between AD and IBS. In our opinion, patients with atopic dermatitis should be questioned in terms of IBS.
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]
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 Cumhur
Although 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.
Co-existing proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis with immunoglobulin A nephropathy
(Korean Assoc Internal Medicine, 2016) Kucuk, Adem; Solak, Yalcin; Gaipov, Abduzhappar; Bagcaci, Sinan; Esen, Hasan; Turk, Suleyman; Tunc, Recep
[Abstract Not Availabe]
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]
Colchicine Toxicity in End-Stage Renal Disease Patients: A Case-Control Study
(Lippincott Williams & Wilkins, 2014) Solak, Yalcin; Atalay, Huseyin; Biyik, Zeynep; Alibasic, Hayrudin; Gaipov, Abduzhappar; Guney, Figen; Kucuk, Adem
Colchicine has been used in a number of disorders. Because colchicine is partially excreted from the kidney, there is a need for dose reduction in case of renal functional impairment. There are no data with regards to safe dosing schedule of colchicine in hemodialysis patients. We aimed to evaluate adverse effects of colchicine use in a hemodialysis cohort. We screened hemodialysis patients who were using colchicine for any reason. All patients were interviewed regarding possible toxicities of colchicine use and were examined with a special focus on neuromuscular system. Creatine kinase and myoglobin were used to detect any subclinical muscle injury or rhabdomyolysis, respectively. Twenty-two maintenance hemodialysis patients who were on colchicine for more than 6 months and 20 control hemodialysis patients not using colchicine were included in the study. Four of 22 patients were using 0.5 mg/day, 4 patients were using 1.5 mg/day, and 14 patients were using 1 mg/day colchicine. Mean duration for colchicine use was 8.9 +/- 8.2 years. There was no difference between the groups in terms of myoneuropathic signs and symptoms and blood counts except for white blood cell count, which was significantly higher in patients on colchicine. Serum creatine kinase (56.3 +/- 39.5 and 52.1 +/- 36.1 for colchicine and control groups, respectively, P = 0.72) and myoglobin (191.4 +/- 108.8 and 214.6+/-83.5 for colchicine and control groups, respectively, P = 0.44) levels were not different between the groups. We conclude that in a small number of haemodialysis patients who were apparently tolerating colchicine, detailed assessment revealed no evidence of sublinical toxicity when compared with controls.
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]
Corneal nerve loss and increased Langerhans cells are associated with disease severity in patients with rheumatoid arthritis
(Springernature, 2023) Bitirgen, Gulfidan; Kucuk, Adem; Ergun, Mustafa Cagri; Satirtav, Gunhal; Malik, Rayaz A.
Background/ObjectivesRheumatoid arthritis (RA) is a multisystem autoimmune disorder characterized by articular and extra-articular manifestations. Neuropathy is a poorly studied manifestation of RA. The aim of this study was to utilize the rapid non-invasive ophthalmic imaging technique of corneal confocal microscopy to identify whether there is evidence of small nerve fibre injury and immune cell activation in patients with RA.Subjects/MethodsFifty consecutive patients with RA and 35 healthy control participants were enrolled in this single-centre, cross-sectional study conducted at a university hospital. Disease activity was assessed with the 28-Joint Disease Activity Score and erythrocyte sedimentation rate (DAS28-ESR). Central corneal sensitivity was measured with a Cochet-Bonnet contact corneal esthesiometer. A laser scanning in vivo corneal confocal microscope was used to quantify corneal nerve fibre density (CNFD), nerve branch density (CNBD), nerve fibre length (CNFL), and Langerhans cell (LC) density.ResultsCorneal sensitivity (P = 0.01), CNFD (P = 0.02), CNBD (P < 0.001), and CNFL (P < 0.001) were lower, and mature (P = 0.001) and immature LC densities (P = 0.011) were higher in patients with RA compared to control subjects. CNFD (P = 0.016) and CNFL (P = 0.028) were significantly lower in patients with moderate to high (DAS28-ESR > 3.2) compared to mild (DAS28-ESR <= 3.2) disease activity. Furthermore, the DAS28-ESR score correlated with CNFD (r = -0.425; P = 0.002), CNBD (rho = -0.362; P = 0.010), CNFL (r = -0.464; P = 0.001), total LC density (rho = 0.362; P = 0.010) and immature LC density (rho = 0.343; P = 0.015).ConclusionsThis study demonstrates reduced corneal sensitivity, corneal nerve fibre loss and increased LCs which were associated with the severity of disease activity in patients with RA.
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]
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]
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, Erkan
Objective: 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.
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, Erkan
Background/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.
Epicardial Adipose Tissue and Atherosclerosis In Patients With Familial Mediterranean Fever
(Wiley-Blackwell, 2013) Kucuk, Adem; Solak, Yalcin; Akilli, Hakan; Yildirim, Oguzhan; Guler, Ibrahim; Ucar, Ramazan; Aribas, Alpay
[Abstract Not Availabe]
Evaluation of coagulation with TEG in patients diagnosed COVID-19
(Tubitak Scientific & Technological Research Council Turkey, 2022) Vatansev, Hulya; Karaselek, Mehmet Ali; Yilmaz, Resul; Kuccukturk, Serkan; Topal, Ahmet; Yosunkaya, Sebnem; Kucuk, Adem
Background and aim: A high D-dimer level may indicate the risk of coagulopathy and mortality in COVID-19 patients. Thromboelastography (TEG) is a test that evaluates clot formation and fibrinolysis in real-time, unlike routine coagulation tests. The study aimed to investigate the coagulation process with TEG in patients diagnosed with COVID-19. Materials and Methods: The study was performed at our university hospital, chest diseases outpatient clinic as a cross-section study. A total of 51 patients with 23 high D-dimer levels group (HDG) and 28 low D-dimers group (LDG) were included in the study. TEG analysis was performed at the pretreatment evaluation in these two groups. Results: D-dimer and fibrinogen levels of the HDG were higher than those of the LDG (550 vs. 90 ng/mL, p < 0.001; 521 vs. 269 mg/ dL, p < 0.001, respectively). In TEG analysis, HDG's R and K values were lower than LDG, and HDG's Angle, MA, and CI values were higher than LDG (p = 0.037; p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). ROC curve analysis suggested that the optimum TEG parameters cut-off points for thrombosis risk were as below: for K was <_2.1 min, for R was <_6.1 min, for Angle was >62 degrees, MA was 60.4 mm. Conclusion: Our study showed that the risk of thrombosis might increase in COVID-19 patients who are not hospitalized in the intensive care unit. Thrombosis risk should be investigated with TEG analysis and laboratory tests in every patient diagnosed with COVID-19, and treatment should be started for risky patients.
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, Recep
Familial 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.
EVALUATION OF THE SLEEP QUALITY IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
(Carbone Editore, 2015) Kucuk, Adem; Albayrak, Ilknur; Bagcaci, Sinan; Karpuz, Savas; Kucuksen, Sami; Tunc, Recep
Background: Familial Mediterranean Fever (FMF) is a hereditary autoimmune disorder characterised by acute attacks of fever and serosal inflammation. This study aimed to investigate sleep quality in patients with familial Mediterranean fever (FMF). Methods The study involved 86 patients. The patients were enrolled in the study during an attack-free period. The sleep quality of all the patients. was evaluated by the Pittsburgh Sleep Quality Index (PSQ1). Results: The PSQ1 total score was 6.5 +/- 4 and the prevalence of poor sleepers was 50% (43/86) according the PSQ1 total score in this study. Women with a higher number of attacks per year and patients resistant to the colchicine treatment had a. poorer sleep quality (p<0.05)., Conclusions: This study underlines the need to assess and manage sleep problems in patients with FMF. Poor sleep quality cause other symptoms of the disease to aggravate. So, the physician must also assess the sleep quality when questioning the routine complaints Of the patients with FMF.
IRRITABLE BOWEL SYNDROME PREVALENCE IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
(Carbone Editore, 2015) Kucuk, Adem; Biyik, Murat; Solak, Yalcin; Ucar, Ramazan; Polat, Ilker; Pektas, Fatih; Gungor, Gokhan
Introduction: Patients with Familial Mediterranean Fever (FMF) and Irritable bowel syndrome (IBS) share some clinical features including abdominal pain, constipation and diarrhea. Furthermore, some patients with FMF do not have typical abdominal pain and fever attacks rather they have nonspecific symptoms. This makes the diagnosis of FMF harder and lead to a delay in starting the colchicine treatment. Both diseases lack specific diagnostic tests. We aimed to determine the prevalence of IBS in patients with established diagnosis of FMF. Materials and methods: FMF patients who had been diagnosed according to Tel-Hashomer criteria in Rheumatology clinic of a university hospital were included in the study between January 2011 and December 2011. 10 point IBS questionnaire according to Rome III criteria was used to determine the presence of IBS. Patients with recent FMF attack and abdominal pain from other reasons were excluded. Results: One-hundred and thirteen patients (67 females and 46 males) with an established diagnosis of FMF were included in the study. The mean duration of FMF was 6.4 +/- 6.7 years. IBS prevalence based on Roma III criteria was 40.7% (n=46). IBS prevalence was 30.4% (n=14) in male patients and 47.8 % (n=32) in female patients (p=0.06). In female patients IBS subtypes were as follows; IBS mixed type (IBS-M) 37% (n=12), IBS diarrhea predominant (IBS-D) 22% (n=7), IBS unsubtyped (MS-U) 22% (n=7), and IBS constipation predominant (IBS-C) 19% (n=6), whereas in male patients, IBS-M 57% (n=8), IBS-C 29% (n=4), IBS-D 7% (n=1) and IBS-U 7% (n=1). The most common subtype of IBS was IBS-M in both sexes. Conclusion: IBS is frequent in FMF patients when Rome HI criteria are used for diagnosis. The question to be answered is whether increased frequency or merely the failure of Rome III criteria to differentiate IBS in such patient groups with abdominal discomfort.
Is major depression associated with serum levels of tumor necrosis factor-alpha in patients with rheumatoid arthritis?
(Pergamon-Elsevier Science Ltd, 2015) Uguz, Faruk; Kucuk, Adem; Aydogan, Semra; Arslan, Sevket; Kurt, Hatice Guncu; Toker, Aysun; Sahin, Muhammed
Objective: This study presents the serum tumor necrosis factor-alpha (TNF-alpha) levels in rheumatoid arthritis (RA) patients with major depression and without any psychiatric disorder. Methods: The study sample included 61 patients with a diagnosis of RA. Major depression and other psychiatric disorders were screened with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Blood sample for the determination of serum TNF-alpha level was obtained before the psychiatric interview. Results: The prevalence rates of any depressive disorder and any anxiety disorder were 40.3% (n = 25) and 22.6% (n = 14), respectively. Fifteen (24.2%) patients had major depression alone, whereas 27 (43.5%) patients were not diagnosed with any psychiatric disorder. We could not determine any significant differences between the patients with major depression alone and patients without any psychiatric diagnosis with regard to the serum levels of TNF-alpha. Conclusions: The existence of major depression in RA patients does not seem to be associated with serum levels of TNF-ce. (C) 2015 Elsevier Inc. All rights reserved.
Ischemia Modified Albumin Levels in Rheumatoid Arthritis
(Wiley, 2015) Uslu, Ali Ugur; Kucuk, Adem; Balta, Sevket; Arslan, Sevket; Tekin, Levent; Kucuksen, Sami; Toker, Aysun
[Abstract Not Availabe]
Ischemia-Modified Albumin and Atherosclerosis in Patients With Familial Mediterranean Fever
(Sage Publications Inc, 2016) Kucuk, Adem; Uslu, Ali Ugur; Arslan, Sevket; Balta, Sevket; Ozturk, Cengiz; Uysal, Saliha; Yilmaz, Ramazan
The constriction of vessels due to atherosclerotic lesions causes hypoxia/ischemia and oxidative changes resulting in transformation of free albumin to ischemia-modified albumin (IMA) in the circulation and increased carotid intima-media thickness (cIMT). We investigated the reliability of IMA increase in evaluating atherosclerosis in patients with familial Mediterranean fever (FMF) compared with cIMT. Patients with FMF (n = 58) diagnosed by the Tel-Hashomer criteria in attack-free period and 38 healthy people were included in the study. Patient demographics as well as the clinical and laboratory characteristics of the healthy controls and patients with FMF were noted. The IMA levels and cIMT in patients with FMF were 0.30 +/- 0.09 absorbance units (ABSUs) and 1.12 +/- 0.27 mm, respectively, and in the control group, IMA levels and cIMT were 0.25 +/- 0.07 ABSU and 0.74 +/- 0.26 mm, respectively. The IMA levels and cIMT were significantly higher in patients with FMF than in controls (P = .020 and P < .0001, respectively). The IMA values showed positive correlation with cIMT in patients with FMF(r = .302, P = .041). Our results reveal that IMAan oxidative stress markermay be an indicator of atherosclerosis in patients with FMF. This finding deserves further investigation.

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