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    Cerebral Blood Flow Volume Using Color Duplex Sonography in Patients With Fibromyalgia Syndrome
    (Turkish League Against Rheumatism, 2018) Kaya, Arzu; Akgol, Gurkan; Gulkesen, Arif; Poyraz, Ahmet Kursad; Yildirim, Tulay; Atmaca, Murad
    Objectives: This study aims to evaluate cerebral blood flow using color duplex Doppler ultrasonography in patients with fibromyalgia syndrome (FMS). Patients and methods: The study included 30 female patients with FMS (mean age 42.3 years; range 22 to 59 years) and 30 female healthy controls (mean age 39.6 years; range 22 to 56 years). Color duplex Doppler ultrasonography imaging was performed with an EPIQ 5 unit equipped with a multi-frequency linear probe (3-12 MHz) in the supine position. Severity of pain, fatigue, and the patient's and physician's global assessments of disease were evaluated on a visual analog scale. The Symptom Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Evaluation Scale, and Fibromyalgia Impact Questionnaire were also implemented to assess disease severity. Results: Cerebral blood flow volume and bilateral internal carotid artery (ICA) and vertebral artery (VA) volumes were not significantly higher in FMS patients compared to controls. Bilateral ICA and VA diameters were similar between FMS patients and controls. Bilateral mean peak systolic velocities and end diastolic velocities in the common carotid arteries, ICAs and VAs were similar in both groups. A significant correlation between symptom severity parameter and the cerebral blood flow volume was noted in FMS patients. Conclusion: Cerebral blood flow volume, ICA flow, and VA flow do not appear to increase, and are correlated with only Symptom Severity Scale among other clinical parameters reflecting disease severity in patients with FMS.
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    Cerebral Blood Flow Volume Using Color Duplex Sonography in Patients With Fibromyalgia Syndrome
    (Turkısh league agaınst rheumatısm, talatpasa bulvarı dumlupınar cad 40 3 cebecı dortyol, ankara, 06100, turkey, 2018) Kaya, Arzu; Akgol, Gurkan; Gulkesen, Arif; Poyraz, Ahmet Kursad; Yildirim, Tulay; Atmaca, Murad
    Objectives: This study aims to evaluate cerebral blood flow using color duplex Doppler ultrasonography in patients with fibromyalgia syndrome (FMS). Patients and methods: The study included 30 female patients with FMS (mean age 42.3 years; range 22 to 59 years) and 30 female healthy controls (mean age 39.6 years; range 22 to 56 years). Color duplex Doppler ultrasonography imaging was performed with an EPIQ 5 unit equipped with a multi-frequency linear probe (3-12 MHz) in the supine position. Severity of pain, fatigue, and the patient's and physician's global assessments of disease were evaluated on a visual analog scale. The Symptom Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Evaluation Scale, and Fibromyalgia Impact Questionnaire were also implemented to assess disease severity. Results: Cerebral blood flow volume and bilateral internal carotid artery (ICA) and vertebral artery (VA) volumes were not significantly higher in FMS patients compared to controls. Bilateral ICA and VA diameters were similar between FMS patients and controls. Bilateral mean peak systolic velocities and end diastolic velocities in the common carotid arteries, ICAs and VAs were similar in both groups. A significant correlation between symptom severity parameter and the cerebral blood flow volume was noted in FMS patients. Conclusion: Cerebral blood flow volume, ICA flow, and VA flow do not appear to increase, and are correlated with only Symptom Severity Scale among other clinical parameters reflecting disease severity in patients with FMS.
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    A comparison of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients
    (Kare Publ, 2017) Acet, Gunseli; Kaya, Arzu; Akturk, Semra; Akgol, Gurkan
    OBJECTIVE: The present study is a comparison of the effectiveness of amitriptyline and pregabalin on the symptoms of fibromyalgia patients. METHODS: A total of 71 female patients aged >= 18 years were included in this study. The patients were divided into 2 groups. Pregabalin (n=36) or amitriptyline (n=35) treatment was initiated at daily oral dose of 450 mg and 25 mg, respectively for the indicated number of patients. The patients were evaluated at the start of treatment and at the end of 12 weeks. The Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety Depression Scale, Nottingham Health Profile, Mini Mental State Test, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were administered to all study participants. Pain at all tender points was measured using a pressure algometer. RESULTS: Significant improvement was observed in both groups after 12 weeks of treatment (p<0.05). Percent change in LANSS was greater in the pregabalin group compared with the amitriptyline group. Tender point pressure pain thresholds and total myalgic score improved significantly in both groups (p<0.05); however higher percentage change in these parameters was achieved in the amitriptyline group when compared with the pregabalin group (p<0.05). CONCLUSION: Both drugs improved pain, fatigue, sleep disorder, disability, psychological evaluation, and cognitive function; however, amitriptyline was more effective at reducing experimentally measured pain than neuropathic pain. According to these results, preference for pregabalin may be recommended in fibromyalgia patients whose primary complaint is neuropathic pain.
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    A comparison of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients
    (Kare publ, kare yayıncılık, sogutlucesme cad, no 76-103, ıstanbul, 34000, turkey, 2017) Acet, Gunseli; Kaya, Arzu; Akturk, Semra; Akgol, Gurkan
    OBJECTIVE: The present study is a comparison of the effectiveness of amitriptyline and pregabalin on the symptoms of fibromyalgia patients. METHODS: A total of 71 female patients aged >= 18 years were included in this study. The patients were divided into 2 groups. Pregabalin (n=36) or amitriptyline (n=35) treatment was initiated at daily oral dose of 450 mg and 25 mg, respectively for the indicated number of patients. The patients were evaluated at the start of treatment and at the end of 12 weeks. The Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety Depression Scale, Nottingham Health Profile, Mini Mental State Test, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were administered to all study participants. Pain at all tender points was measured using a pressure algometer. RESULTS: Significant improvement was observed in both groups after 12 weeks of treatment (p<0.05). Percent change in LANSS was greater in the pregabalin group compared with the amitriptyline group. Tender point pressure pain thresholds and total myalgic score improved significantly in both groups (p<0.05); however higher percentage change in these parameters was achieved in the amitriptyline group when compared with the pregabalin group (p<0.05). CONCLUSION: Both drugs improved pain, fatigue, sleep disorder, disability, psychological evaluation, and cognitive function; however, amitriptyline was more effective at reducing experimentally measured pain than neuropathic pain. According to these results, preference for pregabalin may be recommended in fibromyalgia patients whose primary complaint is neuropathic pain.
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    A diffuse idiopathic skeletal hyperostosis case misdiagnosed as ankylosing spondylitis
    (2017) Alkan, Gokhan; Gulkesen, Arif; Gur, Canan; Akgol, Gurkan; Kaya, Arzu
    Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatologic disease with unknown etiology characterized with ossifications of columna vertebralis. Signs and symptoms include stiffness, pain and movement limitation of spine. The radiographic diagnostic criteria in the spine include osseous bridging along the anterolateral aspect of at least four vertebral bodies, relative sparing of intervertebral disc heights with minimal or absent disc degeneration, and absence of apophyseal joint ankylosis and sacroiliac sclerosis. The diagnosis of DISH can be confused with ankylosing spondylitis (AS) because of some common clinical and radiological characteristics. In this paper a diffuse idiopathic skeletal hyperostosis case misdiagnosed as ankylosing spondylitis is reported.
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    Lipocalin 2 as a clinical significance in rheumatoid arthritis
    (Termedia Publishing House Ltd, 2017) Gulkesen, Arif; Akgol, Gurkan; Poyraz, Ahmet K.; Aydin, Suleyman; Denk, Affan; Yildirim, Tulay; Kaya, Arzu
    Aim of the study: In this study, serum lipokalin 2 (LCN-2) levels and its clinical and radiological significance in patients with rheumatoid arthritis was evaluated. Material and methods: The study enrolled 37 patients with RA and 34 healthy controls. Serum LCN-2 level was measured using ELISA method. Patients with DAS 28 scores <= 3.2, and > 3.2 were allocated into lower and high/moderate disease activity groups, respectively. Additionally patients were divided into 2 groups as early RA (disease duration <= 2 years) and established RA (duration of the disease >= 2 years). Functional disability was evaluated using Health Assessment Questionnaire (HAQ). Radiographs were scored using the modified Larsen score. Results: Serum LCN-2 (p = 0.029) levels were significantly higher in patients with RA than in the controls. Serum LCN-2 level did not correlate with laboratory and clinical parameters of disease activity like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAS 28, Health Assessment Questionnaire Score (HAQ) and Nottingham Health Profile (NHP). Similarly, any correlation could not be found between structural joint damage and serum LCN2 levels. Conclusions: These results indicate that serum LCN-2 levels may be used as an indicator for structural damage like erosions in the early stage of the disease but do not able to be used to monitor disease activity.
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    Relationship between mean platelet volume and vitamin D deficiency in fibromyalgia
    (Scientific Publishers India, 2016) Yildirim, Tulay; Solmaz, Dilek; Akgol, Gurkan; Ersoy, Yuksel
    Objective: To investigate whether vitamin D deficiency is associated with high mean platelet volume (MPV) in fibromyalgia (FMS) compared to healthy controls. Methods: Ninety-nine patients with fibromyalgia and ninety-nine age-and sex-matched healthy female control subjects were included. Tenderness was evaluated by applying pressure (4 kg/cm(2)) over 18 specific body points, and the number of tender points was recorded. FMS patients completed visual analog scales (VAS) to evaluate their level of pain and were evaluated with the FMS Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI). In all cases, platelet count and MPV were measure as part of each full blood count. Serum 25(OH) D3 levels were analyzed with Enzyme-Linked ImmunoSorbent Assay (ELISA). Patients were divided into three groups as follows: Group 1, vitamin D level of <10 ng/ml (n=33); Group 2, vitamin D level of 10-20 ng/ml (n=3); and Group 3, vitamin D level of > 20 ng/ml (n=33). Results: MPV values were significantly higher in the vitamin group 1 compared to the control group. There was no significant difference between the vitamin group 3 and the controls. A negative correlation was determined between MPV and vitamin D status or 25 (OH) D level. Conclusion: Vitamin D deficiency may contribute to an increase in MPV levels, which is a risk factor in cardiovascular disease (CVD) in FMS.