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Öğe The 6-month drug survival rate in patients with rheumatoid arthritis treated with tofacitinib(2021) Karatas, Ahmet; Gur, Burak; Oz, Burak; Piskin Sagir, Rabia; Hohluoglu, Abdulvahap; Gozel, Nevzat; Koca, Suleyman SerdarAim: Rheumatoid arthritis (RA) is a progressive, inflammatory, autoimmune disease that particularly affects the joints. Tofacitinib is the first oral Janus kinase inhibitor approved for RA treatment. We aimed to analyze the 6-month drug survival rate and factors affecting the discontinuation of tofacitinib in RA patients. Materials and Methods: Age, gender, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) levels, whether to continue treatment tofacitinib, if treatment is not continued what treatment is applied, use of biological agent before tofacitinib treatment were retrospectively recorded from the patient data. Results: 30 RA patients included in the study (29 female, 1 male) with a mean age of 50.5 ± 11.3 years. At the 6th month of treatment of tofacitinib, the drug survival rates were 50%. There was no significant difference between CCP positive and negative patients as well as between RF positive and negative patients in terms of drug survival rates (p = 0.92 and p = 0.90, respectively). The drug survival rates were alike in tofacitinib monotherapy and combined therapy of tofacitinib with any conventional DMARD (p = 0.36). The tofacitinib survival rates were similar in biologically naïve patients and in patients who had received at least one previous biological DMARD (p = 0.70). Conclusion: Half of the RA patients receiving tofacitinib treatment continue their treatment at the 6th month. The drug survival rate was not associated with co-treatment with conventional DMARD, auto-antibody positivities, and previously used biological DMARD therapy. These findings support that tofacitinib shows similar efficacy when used as combined or monotherapy, in seronegative or seropositive patients, and in biologic resistant or naive patients.Öğe Association of Betatrophin, TNF-α and IL-6 with diabetic microvascular and macrovascular complications(2020) Gozel, Nevzat; Burkay Yakar, Elif Melek; Onalan, Erhan; Gursu, FeritAim: The most important goal in the treatment of Diabetes Mellitus is to protect patients from micro and macro complications. Inflammatory cytokines and betatrophin have been reported to play a role in diabetic micro and macro complications. This study aimed to investigate the effect of serum Betatrophin, TNF-α and IL-6 levels on diabetic micro and macro complications in patients with type 2 Diabetes Mellitus.Öğe Carotid artery stiffness in Behcet's disease(Aves, 2017) Yolbas, Servet; Gozel, Nevzat; Dagli, Mustafa Necati; Koca, Suleyman Serdar; Donder, EmirObjective: Increased carotid arterial stiffness (CAS) is a predictor of subclinical early atherosclerosis as well as carotid intima-media thickness (cIMT). We aimed to determine CAS and cIMT in Behcet's disease (BD). Material and Methods: BD (n= 49) and rheumatoid arthritis (RA) (n= 64) patients and healthy controls (HC) (n= 40) were included in the study. cIMT was measured. CAS indices, including arterial compliance (AC), arterial distensibility (AD), Young's elastic modulus (YEM), Peterson's elastic modulus (Ep), and beta stiffness index (beta SI) were measured based on the diameter-pressure relationship. Results: When compared to the HC group, the mean cIMT was significantly higher in the RA group (p= 0.033), but it was not higher in the BD group. The CAS indices, including AD, AC, Ep, and beta SI were not significantly different among the study groups. Moreover, the cIMT and CAS indices were not significantly different between active (n= 20) and inactive BD patients, and these indices were not correlated with the scores of disease activity. AD, AC and Ep were significantly lower in the BD patients with a positive pathergy reaction than in those with a negative reaction. Conclusion: These results suggest that BD does not directly lead to arterial stiffness or to an increase in cIMT.Öğe Effects of Vitamin D on adropine and apoptosis in kidney tissue(2019) Onalan, Erhan; Demircan, Selcuk; Aydin, Suleyman; Kuloglu, Tuncay; Yalcin, Mehmet Hanifi; Gozel, Nevzat; Donder, EmirAim: This study aims to investigate the effects of vitamin D on adropin and apoptosis in rat kidney tissue in the context of the experimental diabetes model created using streptozotocin (STZ).Material and Methods: 41 male Wistar-albino breed rats of 8-10 weeks were distributed into 5 groups, which consisted of 3 groups with 7 animals each and 2 groups with 10 animals each. No treatments were applied to the control group. The Buffer group was administered with single-dose 0.1 M sodium buffer intraperitoneally (ip). The Vitamin D group was orally administered 200 IU/day vitamin D. The Diabetes group was injected ip with single-dose 50 mg/kg STZ by dissolving the material in 0.1 M sodium buffer.Results: The biochemical and histological investigations revealed similar serum TOS and TAS levels, and TUNEL positivity and Adropin immunoreactivity for the Control, Buffer, and Vitamin D groups. While TOS levels and TUNEL positivity were significantly higher in the Diabetes group compared to the Control group, TAS levels and Adropin immunoreactivity were significantly lower. The TOS levels and TUNEL positivity were significantly reduced in the Diabetes+Vitamin D group compared to the diabetic group, and TAS levels, adropin immunoreactivity were significantly higher. Conclusion: In conclusion; it was determined that experimental diabetes increased TOS and apoptotic cells and decreased TAS and adropin levels in the kidney tissue in experimental diabetes, and that Vitamin D administered as treatment decreased TOS and apoptotic cells and increased TAS and Adropin levels. It was concluded that in order to uncover the role of diabetes in the pathophysiology of its effect on kidney tissue, future studies that consider various experimental diabetes times were necessary.Öğe Is urotensin 2 levels related to disease progression in acromegaly(2021) Kilinc, Faruk; Gozel, Nevzat; Evren, Bahri; Pekkolay, Zafer; Cakmak, Erkan; Ozdemir, Fethi AhmetThe study aimed to compare serum Urotensin-2 stages in the patients having active acromegaly with healthy individuals and to reveal and discuss the possible effects of UII on vascular changes in acromegaly patients. In this prospective, serum urotensin stages of 30 active acromegalic patients who are followed up in the experienced adult endocrinology center were compared with the serum urotensin stages of 30 healthy volunteers. Patients' IGF-1 along with GH were carefully measured by ECLIA method, and serum urotensin stages, by ELISA method. There was no variation between two groups comparing there age (p = 0.43). Patient group, mean GH was 6.60 ng / mL with mean IGF-1 stage of 355.2 ng / mL. The mean urotensin stage was 3.62±2.27 pmol / L in the acromegaly group, 4.82±2.87 pmol / L in the healthy control group. There was no significant positive correlation of urotensin with IGF-1 stages (r = 0.11, p>0.05). Similarly, the results did not display significant positive correlation urotensin stage with GH (r = 0.13, p>0.05). Serum urotensin-2 stage was lower in acromegaly patients compared to the healthy group (control) and this variation was not statistically significant.Öğe Neutrophil gelatinase-associated lipocalin reflects the severity of anemia without iron deficiency and secondary hyperparathyroidism in hemodialysis patients(Kare Publ, 2017) Yigit, Irem Pembegul; Ulu, Ramazan; Gozel, Nevzat; Taskapan, Hulya; Ilhan, Necip; Dogukan, AyhanOBJECTIVE: Secondary hyperparathyroidism (SHPT) and anemia are the primary and most common complications in patients receiving hemodialysis (HD). Neutrophil gelatinase-associated lipocalin (NGAL) is a new marker to assess iron deficiency and manage iron therapy for HD patients. The aim of this study was to determine any association between serum NGAL level and anemia without iron deficiency in patients with SHPT on chronic HD. METHODS: Total of 61 SHPT patients on chronic HD were enrolled in the study and divided into 3 groups: mild SHPT group (n=17), moderate SHPT group (n=21), and severe SHPT group (n=23). Hemogram, biochemical assays, and level of ferritin, high sensitivity C-reactive protein (hs-CRP), and NGAL were evaluated in all groups. RESULTS: Serum NGAL level was significantly higher and hemoglobin (Hb) level was significantly lower in severe SHPT patients compared with both mild and moderate SHPT patients. Furthermore, in severe SHPT group, serum NGAL level was significantly positively correlated with serum parathyroid hormone (r=0.79; p=0.00) and hs-CRP (r=0.52; p=0.01) level and negatively correlated with serum Hb (r=-0.56; p=0.00) level. CONCLUSION: SHPT was important factor affecting anemia in HD patients. Even when iron deficiency anemia is excluded in patients with SHPT, there was significant negative correlation between serum NGAL and Hb.Öğe Prevalence of vitamin D deficiency in patients with type 2 diabetes and its relationship with glycemic control(2019) Onalan, Erhan; Gozel, NevzatAim: The aim of our study is to investigate serum 25-hyrdoxy (OH) vitamin D levels in patients with type 2 diabetes, determine the prevalence of vitamin D deficiency, and reveal the potential relationship between vitamin D deficiency and glycemic control. Material and Methods: A total of 100 patients (50 females, 50 males) diagnosed with type 2 DM were included in the study. Data used in the study were retrospectively acquired from the records in the files of patients who had presented to the General Internal Medicine polyclinic and clinic at Firat University Hospital. Results: Mean vitamin D levels were determined as 11.8 ± 5,8 nmol/l in females and 13.5 ± 7.3 nmol/l in males. 57 patients (57%) in total demonstrated vitamin D deficiency. Vitamin D deficiency was detected in 31 (62%) female patients and 26 (52%) male patients. A significant negative correlation was determined between diabetic patients with and without vitamin D deficiency with regard to HbA1c, fasting blood glucose, post-prandial blood glucose (p<0.001). Diabetic patients with vitamin D deficiency and diabetic patients without vitamin D deficiency demonstrated no significant differences with regard to retinopathy, nephropathy, and neuropathy (p>0.05).A significant negative correlation was determined between diabetic patients with and without vitamin D deficiency with regard to BMI and patient weight (p<0.001). Conclusion: Our study concludes that vitamin D has a negative significant correlation with FBG, PPBG, HbA1C, and BMI. These results indicate that, as vitamin D levels decrease in patients with type 2 diabetes, insulin resistance increases, and consequently, glycemic control is disrupted. Although, along with our study, other studies too have reported an increased risk for Type 2 diabetes in the presence of vitamin D deficiency, evidence suggesting a causal relationship is limited as not an adequate number of high-quality randomized controlled studies exist.Öğe The rs3768777-G allele of ITGAV gene is associated with rheumatoid arthritis(Springer Heidelberg, 2014) Koca, Suleyman Serdar; Kara, Murat; Ozgen, Metin; Dagli, Mustafa Necati; Gozel, Nevzat; Yolbas, Servet; Gundogdu, BarisIntegrin alpha v beta 3 (vitronectin receptor) plays a prominent role in angiogenesis, a key pathogenic feature of rheumatoid arthritis (RA). Moreover, integrin alpha(V) (ITGAV) subunit gene has been associated with a susceptibility to RA. The aim of the present study was to detect the potential association between ITGAV gene polymorphisms and a susceptibility to RA in a Turkish cohort. DNA samples were harvested from 160 patients with RA and 144 healthy controls (HC). Three single-nucleotide polymorphisms of ITGAV gene (rs3738919, rs3768777, and rs10174098) were genotyped using real-time PCR. Serum vitronectin levels were analyzed in 30 RA patients, 28 Beh double dagger et's disease (BD) patients, and 30 HC subjects. There was no significant difference between the RA and HC groups in terms of the genotypic and allelic distributions of rs3738919 and rs10174098 polymorphisms. However, the prevalence of rs3768777-G allele was higher in the RA group than in the HC group (OR 2.3, 95 % CI 1.6-3.2, p < 0.0001). Moreover, there was a significant association between RA and the genotypic distribution of rs3768777 (GG + AG vs. AA: OR 2.1, 95 % CI 1.3-3.4; GG vs. AG + AA: OR 4.1, 95 % CI 2.1-7.8). Serum vitronectin levels were lower in the RA and BD groups than in the HC group (p (ANOVA) = 0.002). The rs3738919 and rs10174098 polymorphisms of the ITGAV gene seem not to be associated with susceptibility to RA in Turkish patients. However, rs3768777 increases the risk of RA in this group. These results suggest that the ITGAV gene may be a candidate gene for the etiopathogenesis of RA.
