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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 Conjunctival impression cytology and tear-film changes in cases with vitamin D deficiency(Springer, 2020) Dikci, Seyhan; Akatli, Ayse Nur; Yildirim, TulayPurpose To evaluate conjunctival surface cells and tear-film functions in cases with vitamin D deficiency. Methods Thirty-six patients with serum vitamin D deficiency and 27 control subjects with normal serum vitamin D levels were included in this prospective study. The tear break-up time (TBUT), Schirmer II test, and conjunctival impression cytology tests were performed to all participants. Results The mean serum vitamin D levels were 10.5 +/- 5.0 mu l in the study group and 33.9 +/- 11.7 mu l in the control group (p < 0.001). The median TBUT scores were 11 s and 17 s and the median Schirmer II values were 7.5 mm and 12 mm in the study and the control groups, respectively (p = 0.003, p = 0.049). According to the Nelson staging system, 69.4% of the patients in the study group had grade 2 or 3 impression cytology, whereas 18.5% of the participants in the control group had grade 2 or 3 impression cytology (p < 0.001). Conclusion Our study results showed that vitamin D deficiency may lead to dry eye causing conjunctival squamous metaplasia and loss of goblet cells on the ocular surface.Öğe The effect of negative automatic thoughts on hope in patients with schizophrenia(Wiley, 2021) Budak, Funda Kavak; Yildirim, Tulay; Ozdemir, AyselPurpose The purpose of this study is to determine the effect of negative automatic thoughts on hope in patients with schizophrenia. Design and Methods The sample size of the study was calculated to be 94 patients through the power analysis. The study was completed with 115 patients who met the inclusion criteria. descriptive characteristics form, automatic thoughts questionnaire-negative, and dispositional hope scale were used to collect the data. Findings In the study, it was found that there was a negative strong correlation between negative automatic thoughts and hope levels. In addition, the negative automatic thoughts of the patients had a statistical significance in accounting for hope (p < .05) and the negative automatic thoughts predicted the hope by 66%. Practice Implications In the study, it was found that the patients had high negative automatic thoughts and moderate level of hopes. As negative automatic thoughts increased, hope decreased.Öğe Endoplasmic reticulum aminopeptidase-1 polymorphism increases the risk of rheumatoid arthritis(Walter De Gruyter Gmbh, 2022) Akbulut, Ekrem; Yildirim, Tulay; Ozturk, OnurObjectives Endoplasmic reticulum aminopeptidase-1 (ERAP1) polymorphic changes cause autoimmunity. To understand the contribution of ERAP1 to the occurrence of rheumatoid arthritis (RA) disease, we investigated the relationship between ERAP1 and RA. Methods This study was conducted with 201 patients and 171 healthy controls. The rs26653, rs27044, rs27582, rs28096, and rs30187 polymorphic regions of ERAP1 were investigated. The comparison was done with Arlequin software and logistic regression. Haplotypes were analyzed with Phylogenetic Network software. ERAP1 was modeled using Promod3. Topological changes in ERAP1 were analyzed with TM-Score. Results The results showed that rs26653G>C (p=0.002, OR=2.001, 95%CI=1.276-3.137), rs27044C>G (p=0.037, OR=1.583, 95%CI=1.028-2.440), rs27582G>A (p<0.05, OR=0.348, 95%CI=0.194-0.622) and rs30187C>T (p=0.006, OR=1.849, 95%CI=1.191-2.870) polymorphisms are associated with RA disease risk. The relationship between rs28096 polymorphism and RA disease risk could not be determined (p=0.509). The risk haplotype for rheumatoid arthritis was determined as [CGAAT]. It was determined that polymorphisms of ERAP1 cause changes in the entry pocket of substrate and ligand. Conclusions We report a haplotype [CGAAT] that is associated with RA risk from Turkey that has not been described before. These data will make important contributions to elucidating the molecular mechanism of RA.Öğe Evaluation of the relationship between physical activity level and functional capacity, depression and quality of life in patients with knee osteoarthritis(2021) Yildirim, TulayAim: The aim of this study was to investigate the effects of physical activity level on functional capacity, depression and quality of life in patients with knee osteoarthritis (OA).Materials and Methods: Seventy nine patients who were diagnosed with knee OA according to ACR (American College of Rheumatology) criteria who applied to Inonu University, Turgut Özal Medical Center, Department of Physical Medicine and Rehabilitation, were included in the study. Radiological stage of knee osteoarthritis was evaluated according to the Kellgren Lawrence score. The patients were divided into two groups as Inadequate Activity Group (IAG) and Physically Active Group (PAG) according to their answers to the International Physical Activity Questionnaire (IPAQ-SF). Patients were evaluated using the ShortForm 36 (SF-36) questionnaire, the Beck Depression Inventory (BDI), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results: WOMAC physical function scores were lower on PAG. The average BDI score of PAG was significantly lower than IAG. The average SF-36 scores in PAG were found to be significantly higher when compared with the IAG (p 0.05).Conclusion: Increased physical activity in patients with knee osteoarthritis; It has positive effects on functional capacity, depression and quality of life.Öğe The influence of vitamin D deficiency on eradication rates of Helicobacter pylori(Wroclaw Medical Univ, 2017) Yildirim, Oguzhan; Yildirim, Tulay; Seckin, Yuksel; Osanmaz, Pelin; Bilgic, Yilmaz; Mete, RafetBackground. Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. Objectives. In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H. pylori. Material and methods. 220 patients diagnosed with H. pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H. pylori. Gastric biopsies obtained at endoscopy were examined for H. pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H. pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of < 10 ng/mL, while group 2 (sufficient) had a vitamin D level of >= 10 ng/mL. Results. Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 +/- 4.7 vs 19.03 +/- 8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). Conclusions. Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori, which may lead to a need for supplementation of vitamin D before eradication of H. pylori.Öğe Is 4-Hydroxynonenal a Predictive Parameter for the Development of Joint Erosion in Patients With Rheumatoid Arthritis?(Turkish League Against Rheumatism, 2016) Akgtol, Gurkan; Ulusoy, Hasan; Telo, Selda; Guslkesen, Arif; Yildirim, Tulay; Poyraz, Ahmet Kursad; Kaya, ArzuObjectives: This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA). Patients and methods: The study included 40 patients (8 males, 32 females; mean age 51.4 +/- 11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0 +/- 11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 <= 3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration <= 2 years) and established RA (disease duration >= 2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring. Results: Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001). Conclusion: These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.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.Öğe A Novel Physical Examination Test for Ischiofemoral Impingement: Validation With Magnetic Resonance Imaging Correlation(Lippincott Williams & Wilkins, 2021) Ozdemir, Zeynep Maras; Yildirim, Tulay; Karaca, Leyla; Kahraman, Aysegul Sagir; Aydingoz, UstunObjective The purpose of this study was to propose and validate a novel physical examination test for ischiofemoral impingement with magnetic resonance imaging (MRI) correlation. Methods We prospectively studied 24 women with buttock (deep gluteal) pain and 27 asymptomatic women. Each group underwent a 2-stage physical examination test that featured hip adduction-external rotation-extension and knee flexion. Visual analog scale pain scores were noted just before and during test stages on both sides. The MRI findings of the ischiofemoral impingement were evaluated quantitatively and qualitatively. Results Mean ages were 56.0 and 55.2 years (P = 0.797), and mean body mass indexes were 29.1 and 28.8 kg/m(2) (P = 0.817) in symptomatic and asymptomatic groups, respectively. Ischiofemoral spaces were significantly narrower (P < 0.001), ischial angles were wider (P < 0.001, right; P = 0.002, left), and soft tissue edema at the ischiofemoral space was more common (P < 0.001) in the symptomatic group, which also had higher pretest visual analog scale scores (P < 0.001) that increased significantly during both upright standing (P = 0.003, right; P < 0.001, left) and recumbent (P < 0.001 for both sides) stages of the physical examination test. Conclusions A novel physical examination test significantly increases symptoms of ischiofemoral impingement with positive MRI correlation.Öğe Relationship between mean platelet volume and vitamin D deficiency in fibromyalgia(Scientific Publishers India, 2016) Yildirim, Tulay; Solmaz, Dilek; Akgol, Gurkan; Ersoy, YukselObjective: 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.Öğe The relationship between vitamin D deficiencies and life quality of FMS patients(2017) Yildirim, Tulay; Ersoy, YükselAim: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal system disease characterized by widespread pain. Nonspecific skeletal pain can also be seen in patients with vitamin D deficiency. The association between low levels of vitamin D and nonspecific musculoskeletal pain, including FMS, is controversial. The aim of this study is to assess the relationship between vitamin D deficiencies and disease activity, life quality of FMS patients. Materials and Methods: Patients with Fibromyalgia (FMS) classified according to American College of Rheumatology (ACR) criteria. 25-OH vitamin D levels below 20 ng/ml were accepted as vitamin D deficiency. Study groups classified as first group; patient with isolated FMS (n:36), second group; isolated vitamin D deficiency (n:41) and third group was FMS in together with vitamin D deficiency (n:70). Pain level was measured by the visual analog scale (VAS). Functional and life quality assessments were determined by using Short Form Heath Survey 36 (SF-36) and Fibromyalgia Impact Index (FIQ). Results: In isolated FMS group, vitamin D level was found higher than other two groups (p>0.05). At the assessment of quality of life, VAS and FIQ scores in FMS group were significantly higher than ones found in vitamin D deficiency group (p<0.001). In terms of SF-36 subgroups, scores were much worse in vitamin D deficiency and FMS than isolated FMS group. However, some of subgroups reached statistically significance. Negative and moderate correlation was detected between vitamin D level and FIQ scores. Conclusion: Vitamin D level should be kept in mind as one of the factors negatively affecting quality of life in FMS. More extensive studies should be conducted to clarify this subject.Öğe Sarcopenia and clinical presentation(2017) Dogru Gunduz, Hacer; Yildirim, Tulay; Ersoy, YükselSarcopenia is characterized by the progressive generalized loss of muscle function, quality, strength and mass. Although it is known as a primary geriatric disease, it may also develop in younger individuals secondary to immobilization, malnutrion and cachexia. The exact etiology is unknown, but the most commonly suggested contributory factors are a decrease in protein synthesis, mitochondrial dysfunction, reactive oxygen products, chronic inflammation, nutritional deficiency, loss of perfusion, age-related neuromuscular alterations, decrease in sex hormone, growth hormone (GH), insulin-like growth factor (IGF-1) and vitamin D levels together with physical inactivity. There are severe negative effects on quality of life and the individual’s socio-economic status and thus, sarcopenia is a significant public health problem. Sarcopenia is strongly correlated with the increased fragility that develops in the elderly and is a significant risk factor and also an indicator of disability and mortality. The evaluation of muscle strength and physical performance is mandatory for the diagnosis of sarcopenia. Despite the lack of a definitive treatment method, the most commonly accepted approaches include physical activity, nutritional supplementation therapy, and hormonal and new pharmacological agents. In this review sarcopenia, which is a common but sometimes misdiagnosed condition in clinical practice, is discussed in the light of current knowledge.Öğe Serum level of vitamin D in obstructive sleep apnea patients with fibromyalgia syndrome(2021) Dumur, Seyma; Yildirim, Tulay; Alp, Recep; Kucur, Mine; Aydin, MuratAbstract: Objectives: The aim of this study was to investigate the serum concentration of vitamin D in patients with obstructivesleep apnea syndrome (OSAS) alone and with coexisting fibromyalgia syndrome (FMS) and to assess the relationshipto pain.Methods: A total of 60 patients diagnosed with OSAS and 40 healthy individuals whose age and sex were analogousto the patient group were included in this study. The OSAS patients were examined for FMS according to the AmericanCollege of Rheumatology criteria, and 27 cases were identified. Group 1 consisted of patients with OSAS alone (n=33)and Group 2 comprised patients with FMS+OSAS (n=27). Serum samples were analyzed using an ultra-performanceliquid chromatography analyzer (Thermo Dionex Ultimate 3000; Thermo Fisher Scientific, Inc., Waltham, MA, USA).Results: A comparison of the OSAS and FMS+OSAS groups with the healthy individuals revealed that the vitamin Dlevel was significantly lower in the patient groups (Group 1: p=0.001, Group 2: p=0.038). No statistically significant difference was found in the vitamin D level between the subgroups of OSAS and FMS+OSAS. A weak negative correlationwas determined between the number of the tender points (r=-0.428) and the vitamin D level in the subjects with FMS(p=0.013). In addition, the oxygen desaturation values of the FMS+OSAS and OSAS patient groups were significantlydifferent (p=0.001).Conclusion: Patients with OSAS and FMS+OSAS had a low vitamin D level, which should be considered when planningtreatment strategiesÖğe The use of baropodometry for the evaluation of plantar pressure distribution in ankylosing spondylitis(2017) Yildirim, Tulay; Ersoy, YükselAim: Ankylosing Spondylitis is among the most common inflammatory rheumatic diseases and associated with postural alterations. The aim was to investigate the baropodometric variations between patients with ankylosing spondylitis to detect whether postural alterations affect plantar pressure distribution. Materials and Methods: The study population consisted of 41 patients with ankylosing spondylitis and 32 volunteers with compatible age and gender. Moreover, Visual Analog Scale, and Bath Ankylosing Spondylitis Metrology Index were used to determine the clinical conditions of the patients. Plantar pressure distribution was determined by static baropodometric measurements. Results: There was no significant difference between two groups in terms of static baropodometric measurements (p>0.05). The lower peak pressures on the forefoot and rear foot are associated with higher BASMI, BASDAI, BASFI and ASQoL scores of the patients (p< 0.05). Conclusion: Postural alterations might have an impact on plantar pressure in patients with ankylosing spondylitis.
