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Öğe 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, MuradObjectives: 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.Öğe 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, MuradObjectives: 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.Öğe A diffuse idiopathic skeletal hyperostosis case misdiagnosed as ankylosing spondylitis(2017) Alkan, Gokhan; Gulkesen, Arif; Gur, Canan; Akgol, Gurkan; Kaya, ArzuDiffuse 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.Öğe The evaluation of the efficacy of steroid iontophoresis in patients with rheumatoid arthritis(2018) Gulkesen, Arif; Ardicoglu, OzgeAim: Comparative evaluation of direct current and steroid iontophoresis treatments in patients with active wrist synovitis with rheumatoid arthritis. Material and Methods: Rheumatoid arthritis (RA) is a chronic, inflammatory disease that causes pain, swelling and limitation of motion, keeping wrist and hand joints symmetrical. In this study, we examined the efficacy of steroid iontophoresis with direct current to the wrists of active RA patients. 20 active patients with RA and wrist synovitis were included in the study. Steroid iontophoresis applied in one wrist of these patients, direct current to the other wrist (control). Patients’ number of painful joints (NPJ), number of swollen joints (SJN), hand grip strength (HG), lateral grip strength (LG), Hand Functional Evaluation (HFE), Health Assessment Questionnaire (HAQ), Disease Activity Score-28 (DAS-28) and power Doppler ultrasonography (PDUS) were compared. Results: Clinical and laboratory parameters were significantly improved according to pre-treatment (Pr-T) and post-treatment (Pst-T). We found significant improvement in Pr-T and Pst-T in the cases of HG, LG, HFE, SJN and NPJ in the wrist in treatment and control, but there was no significant difference between the control wrist and the treated wrist. There were no changes in Pr-T and Pst-T in grades, if any, resistive index (RI) and pulsatility index (PI) values of PDUS with pannus and current in hand wrist. Conclusions: Our results showed no difference between the steroid iontophoresis and direct current therapy in patients with RA who were active and have wrist synovitis in Pr-T and Pst-T.Öğe 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, ArzuAim 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.
