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    Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency
    (Wiley, 2016) Yilmaz, Ramazan; Salli, Ali; Cingoz, Havva Turac; Kucuksen, Sami; Ugurlu, Hatice
    Aim: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency. Method: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3<25ng/mL) were included into the study. Replacement treatments of 50000IU/week oral vitamin D3 for 3months were given to the patients. Patients were assessed pre- and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction. Results: Fifty-eight patients with a mean age of 36.9 +/- 9.2years were included into the study. 25-OH D3 levels of patients elevated from 10.6 +/- 5.1ng/mL to 46.5 +/- 24.0ng/mL after replacement treatment (P<0.001). Marked decrease in VAS-pain, VAS-asthenia, severity of waking unrefreshed, TPC, and BDI and an evident increase in subgroups of SF-36 were established in patients after treatment (P<0.001). The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P=0.013); 85% of patients stated satisfaction with the treatment. Conclusions: Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.
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    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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    Relationship between prevalence and severity of restless legs syndrome and anemia in patients with systemic lupus erythematosus
    (Wiley, 2017) Kucuk, Adem; Uslu, Ali Ugur; Yilmaz, Ramazan; Salbas, Ender; Solak, Yalcin; Tunc, Recep
    Aim: Our aim was to evaluate the relationship between the prevalence and severity of restless legs syndrome (RLS) and the anemia in patients with systemic lupus erythematosus (SLE). Methods: This was a case-control study which was conducted at the rheumatology clinic of a university affiliated hospital, including 62 patients with SLE and 62 age-and sex-matched healthy controls. The patients were divided into two groups in terms of their hemoglobin levels. The criterion for anemia was hemoglobin level lower than 12 g/dL in females and 13 g/dL in males. Results: Nineteen patients (30.6%) in the patient group were diagnosed with RLS, and International RLS Study Group Rating Scale (IRLSSG-RS) score was 10.7 +/- 9.5 (median: 10.0 [range: 0.0-30.0]). Three subjects (4.8%) in the control group had RLS, and the IRLSSG-RS score was 0.7 +/- 3.3 (median: 0.0 [range: 0.0-18.0]). The prevalence of RLS and the IRLSSG-RS score were higher in the patient group than those in the control group (P < 0.001). Ten SLE patients (50%) with anemia had RLS, and their IRLSSG-RS score was 14.5 +/- 9.9 (median: 21.0 [range: 11.0-30.0]). Nine SLE patients (21.4%) without anemia had RLS and their IRLSSG-RS was 9.0 +/- 8.9 (median: 21.0 [range: 11.0-24.0]). Significant differences were present in the prevalence of RLS and the IRLSSG-RS score between SLE patients with and without anemia (P = 0.024, P = 0.044, respectively). Conclusion: The present study demonstrated that the prevalence of RLS was higher in patients with SLE than that of the normal population. Results of this study also suggested that anemia was associated with higher frequency of and more severe RLS in patients with lupus.
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    Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio
    (Wiley, 2015) Uslu, Ali Ugur; Kucuk, Adem; Sahin, Ali; Ugan, Yunus; Yilmaz, Ramazan; Gungor, Tayfun; Bagcaci, Sinan
    AimRheumatoid arthritis (RA) is an inflammatory autoimmune disease with unknown etiology and systemic involvement. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are two new inflammatory markers used in the assessment of systemic inflammation. The aim here is to study NLR and PLR in patients with RA to investigate their relation with Disease Activity Score of 28 joints (DAS-28). MethodsThe study included 104 patients with RA and a control group of 51 age- and gender-matched healthy subjects. We divided the patients into two groups according to the DAS-28 score. Group 1 included patients with a score of lower than 2.6 by the DAS-28 (patients in remission) and Group 2 included patients with a score of 2.6 and higher (patients with active disease). ResultsNLR was 2.120.83 in the patient group and 1.58 +/- 0.57 in the control group. PLR was 136.50 +/- 53.52 in the patient group and 114.84 +/- 29.41 in the control group. There was a statistically significant difference in NLR and PLR between the patient and control groups (P0.0001 and P=0.001, respectively). Patients in Group 1 had an NLR of 1.84 +/- 0.61 and a PLR of 119.25 +/- 41.77. Patients in Group 2 had an NLR of 2.29 +/- 0.90 and a PLR of 147.28 +/- 56.96. There was a statistically significant difference in NLR and PLR between the two groups (P=0.003 and P=0.005 respectively). A correlation was observed between NLR and PLR by DAS-28 (r=0.345, P0.0001 and r=0.352, P0.0001, respectively). ConclusionsThe present study showed us that NLR and PLR were two new inflammatory markers which could be used to assess disease activity in patients with RA.