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Sahin M, Karakose CC, Melikoglu MA. Potential biomarkers in Behçet's disease: monocyte, neutrophil, platelet, and C-reactive protein to albumin ratios. Reumatologia 2024; 62:308-313. [PMID: 39677880 PMCID: PMC11635622 DOI: 10.5114/reum/192391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/16/2024] [Indexed: 12/17/2024] Open
Abstract
Introduction The objective of this cross-sectional study was to evaluate the monocyte to albumin ratio (MAR), neutrophil to albumin ratio (NAR), platelet to albumin ratio (PAR), and C-reactive protein to albumin ratio (CAR) as potential biomarkers for disease activity in patients with Behçet's disease (BD). Material and methods Both BD cases and healthy controls were enrolled in this study. Demographic characteristics, disease duration, and current medications were recorded for all participants. The BD Current Activity Form (BDCAF) was utilized to assess the activity of BD. Additionally, erythrocyte sedimentation rate, CRP, and serum albumin levels were measured. The MAR, NAR, PAR, and CAR were compared between the two groups. Correlation analysis and receiver operating characteristic curves (ROC) were employed to establish cut-off points for these biomarkers. Results In the study, both BD cases and 45 controls were included, totaling 90 participants. Significant differences were observed in the mean ±SD values of ESR, MAR, PAR, CAR, and albumin between the BD cases and controls (p = 0.008, p = 0.009, p = 0.029, p = 0.034, p = 0.006, respectively). However, despite these differences, no significant correlation was detected between BDCAF and the parameters under investigation. The cut-off point was determined as 150.59 (sensitivity 46.67%, specificity 82.22%, p = 0.008, AUC = 0.655) for MAR; as 62,013.73 (sensitivity 60.00%, specificity 66.67%, p = 0.03, AUC = 0.629) for PAR; and as 1.16 (sensitivity 35.56%, specificity of 95.567%, p = 0.03, AUC = 0.629) for CAR. The results were not able to define any cut-off points for active-inactive BD. Conclusions Significantly higher levels of MAR, PAR, and CAR were observed in patients with BD than controls. Monocyte to albumin ratio, PAR, and CAR were notably elevated in patients with active BD. This finding suggests that these parameters possess discriminative ability and could potentially serve as biomarkers to aid in the clinical evaluation of BD.
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Akdogan MR, Melikoglu MA. A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index. North Clin Istanb 2024; 11:115-119. [PMID: 38757099 PMCID: PMC11095327 DOI: 10.14744/nci.2023.90132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/10/2023] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE Biomarkers using routine laboratory tests accurately presenting systemic lupus erythematosus (SLE) disease activity may have important practical values in clinical settings. The primary purpose of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII; neutrophil X platelet/lymphocyte) as potential biomarkers of disease activity in cases with SLE. METHODS In this case-control observational study, cases with SLE and demographically similar healthy controls were included. For clinical evaluation demographic features, disease duration and drugs were recorded. SLE clinical disease activity was assessed with SLEDAI scores. For laboratory assessments; erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and C3-C4 levels and anti-dsDNA positivity were recorded. Based on the simultaneous complete blood count (CBC) of the participants NLR, PLR and SII were calculated. The correlation between clinical and laboratory data was analyzed. RESULTS 68 cases with SLE (64 women, 8 men) and 69 controls (65 women, 4 men) were included in this investigation. The demographic features of the cases and controls were similar. ESR, CRP, NLR, PLR and SII scores were statistically higher in cases with SLE than controls (p<0.000). Statistically significant positive correlations between SLEDAI and NLR, PLR and SII scores were demonstrated (p=0.01, r=0.505; 0.414; 0.698, respectively). We determined a cut-off value of SII as 681,3 presenting 77% sensitivity and 76% specificity to discriminate no-mild disease activity and moderate-higher SLE disease activity status. The SII cut-off value was determined as 681,3 presenting 77% sensitivity and 76% specificity (p<0.000, and AUC=0.930). CONCLUSION CBC indices were shown to be higher in cases with SLE than healthy controls in our study. By presenting a strong correlation with disease activity and discriminating ability of disease status, SII might serve as a biomarker supporting clinical evaluation in SLE.
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Doganci EB, Demirtas R, Melikoglu MA. Monckeberg's medial sclerosis in temporal artery mimicking giant cell arteritis. REUMATOLOGIA CLINICA 2023; 19:228-229. [PMID: 37061284 DOI: 10.1016/j.reumae.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/24/2022] [Indexed: 04/17/2023]
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Melikoglu M, Sahin M, Alkan Melikoglu M. Vitamin D in Behcet's Disease, a Brief Review of the Literature. Eurasian J Med 2022; 54:29-33. [PMID: 36655442 PMCID: PMC11163353 DOI: 10.5152/eurasianjmed.2022.22300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/23/2022] [Indexed: 01/19/2023] Open
Abstract
Behcet's disease is a chronic vasculitis of unknown etiopathogenesis. Serum vitamin D levels have been reported to be associated with a variety of inflammatory and autoimmune diseases one of which is Behcet's disease. The previous studies about vitamin D in Behcet's disease seem to be focused on 4 main categories; the studies evaluating serum vitamin D levels between patients with Behcet's disease and controls, the studies evaluating serum vitamin D in the susceptibility and pathogenesis of Behcet's disease, the studies evaluating serum vitamin D in clinical involvements and activity of Behcet's disease, and the studies evaluating the effect of serum vitamin D replacement in Behcet's disease. The aim of this manuscript was to evaluate the results of the studies on serum vitamin D in Behcet's disease and review the literature.
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Altıntas D, Melikoglu MA. The frequency of fibromyalgia in familial Mediterranean fever and its impact on the quality of life. Int J Rheum Dis 2022; 25:1123-1128. [PMID: 35851993 DOI: 10.1111/1756-185x.14389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Concomitant fibromyalgia syndrome (FMS) has been known to be more frequent in patients with several rheumatic diseases. In this study, our aim was to investigate the prevalence of FMS in patients with familial Mediterranean fever (FMF), to analyze the possible factors related to this frequency, and to evaluate the impact of FMS on the functionality and quality of life (QoL) of the patients with FMF. PATIENTS AND METHODS One hundred cases with FMF and 100 controls were included to this case-control study. FMS coincidence was investigated in all participants according to revised 2016 classification criteria. Demographic features, FMF disease duration, FMF gene mutations, drugs used, attack frequency per year, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum fibrinogen levels were recorded. FMF disease severity was assessed by International Severity Scoring System for Familial Mediterranean Fever (ISSF). For the assessments of QoL and functioning, FMF-QoL, Short form 36 (SF-36), and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used, and for the assessment of FMS impact, the fibromyalgia impact questionnaire (FIQ) were used. RESULTS We found an FMS frequency of 33% in patients with FMF in our study using the current FMS classification criteria. This result was significantly higher than in age- and gender-similar controls (6% FMS frequency; P < 0.05). The number of woman patients and FMF disease duration were significantly higher in patients with FMF + FMS than in patients with only FMF (P < 0.001). There was no significant difference in ISSF scores, ESR, CRP, and fibrinogen levels, management regimens, and FMF gene mutation distributions between FMF + FMS and FMF groups. FMF attack frequency was reported as significantly higher in FMF + FMS patients than in others (P < 0.000). In spite of similar FMF-QoL scores, there were significant differences in HAQ-DI and SF-36 scores between groups (P < 0.05). Higher impact of FMS presented negative correlation with functioning and general health, and positive correlation with QoL in FMF + FMS (P < 0.05). CONCLUSION Concomitant FMS was a common clinical problem in patients with FMF regardless of the severity and characteristics of FMF. The FMS impact may affect function and QoL in patients of FMF. Considerations of the FMS component in the management of FMF may contribute to the holistic approach to FMF.
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Alkan Melikoglu M, Melikoglu M, Demirci E, Zafer Barin E. Discoid Lupus Erythematosus-Associated Cutaneous Squamous Cell Carcinoma in Systemic Lupus Erythematosus. Eurasian J Med 2022; 54:204-205. [PMID: 35703532 PMCID: PMC9634882 DOI: 10.5152/eurasianjmed.2022.21062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sahin A, Kilic K, Sakat MS, Melikoglu MA, Sarihan K. Early hearing loss detection in gout using extended high frequency audiometry. Clin Otolaryngol 2022; 47:577-582. [PMID: 35635502 DOI: 10.1111/coa.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 05/01/2022] [Accepted: 05/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The study aimed to analyse the hearing levels of patients with gout using extended high frequencies (EHFs) audiometry. Thus, we aimed to reveal the early detectability of potential hearing losses. DESIGN Comparative cross-sectional study. SETTINGS A single centre patient was diagnosed with gout disease. PARTICIPANTS Two groups consisted of 32 patients with gout and 32 healthy volunteers. MAIN OUTCOME MEASURES The primary outcome was hearing thresholds in pure tone (PT) audiometry and EHFs audiometry. Also, the association between audiometric results and haematological and biochemical parameters were evaluated. RESULTS There was no significant difference between groups in terms of mean hearing thresholds in PT audiometry. But, at all frequencies above 4000 Hz (4000-18 000 Hz), the hearing thresholds were significantly higher in patients with gout. Also, the hearing thresholds above 8000 Hz were positively correlated with serum uric acid levels. Hearing thresholds at higher frequencies were positively correlated with haemoglobin levels and negatively correlated with high-density lipoprotein levels. CONCLUSION To our knowledge, this is the first study in the literature demonstrating the high frequency of hearing loss in patients with gout using EHFs audiometry. We consider that using EHFs audiometry should have an important place in the early detection of potential hearing losses in gout patients.
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Melikoglu MA, Balkan E. Can we predict unresponsiveness to methotrexate in rheumatoid arthritis? A pharmacogenetic study. Inflammopharmacology 2022; 30:193-197. [PMID: 35043269 DOI: 10.1007/s10787-021-00921-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/27/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) and the therapeutic response to MTX has been observed to vary widely among these patients. The aim of this study was to investigate ABCB1 gene (the multidrug resistant 1 gene; MDR1 gene) polymorphism in patients with RA and to evaluate the relation between MTX unresponsiveness and this polymorphism. METHODS Forty-five patients with RA administered MTX were included in this pharmacogenetic cross-sectional study. The gender, age, body mass index (BMI), rheumatoid factor (RF) positivity, anti-cyclic citrullinated peptide (anti-CCP) positivity, doses of MTX and glucocorticoids were recorded. In addition, initial and third month disease activity (DAS28, Simplified and Clinical Disease Activity Index; SDAI and CDAI) scores were evaluated. We also examined frequencies of two single-nucleotide polymorphisms (SNPs), G2677T and C3435T, within the gene encoding ABCB1. RESULTS 22 patient's responsive and 20 patients unresponsive to MTX were enrolled. Initial demographic and disease related factors were similar between patients responsive or nonresponsive to MTX. In the third month evaluation, disease activity scores were significantly higher in patients unresponsive to MTX (p < 0.05). In addition, almost all patients unresponsive to MTX (19 of the 20 patients) presented heterozygosity in C3435T (p < 0.000). CONCLUSION We determined heterozygosity in C3435T SNP of ABCB1 gene (multidrug resistant 1 gene) in almost all patients with RA who were non-responders to MTX. This result may contribute to predict unresponsiveness to MTX in RA. Individualized treatment strategies based on the pharmacogenetic characteristics of MTX may lead to optimization of the treatment.
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Balcancı O, Melikoglu MA. The relatıonshıp between serum hydroxyvıtamın D levels and postural stabılıty ın young adults. J Bone Miner Metab 2022; 40:174. [PMID: 34549312 DOI: 10.1007/s00774-021-01265-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
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Ataman S, Sunar I, Bodur H, Melikoglu MA, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT. Demographic and Clinical Characteristics of Patients with Sustained and Switching Treatments Using Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs: A Multicenter, Observational Cross-Sectional Study for Rheumatoid Arthritis. Rheumatol Ther 2021; 9:223-241. [PMID: 34850376 PMCID: PMC8814119 DOI: 10.1007/s40744-021-00403-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results The study included a total of 565 patients. The mean age was 53.7 ± 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment.
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Balcancı O, Melikoglu MA. The relationship between serum hydroxyvitamin D levels and fall risks in young adults. J Bone Miner Metab 2021; 39:1076-1081. [PMID: 34324081 DOI: 10.1007/s00774-021-01252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Serum hydroxyvitamin D [25(OH)D] has a role in several aspects of physical performance. Our aim was to determine the possible association between serum 25(OH)D deficiency on the fall risk in young adults by using an objective computerized technique. MATERIALS AND METHODS This cross-sectional study included 80 adults aged 18-40 years with 25(OH)D deficiency and 40 age-matched controls. The participants were devided into three groups according to serum 25(OH)D levels: Group 1; deficient, Group 2; insufficient and Group 3; sufficient (serum 25(OH)D level < 20, 20 to < 30 and 30-100 ng/mL, respectively). The age, gender, height and weight were recorded. To evaluate the fall risk, the Berg Balance test as a clinical assessment and a computerised posturography devise as an objective technique were used. Serum 25(OH)D levels were analyzed by ELISA. Pearson Chi-square, the Kruskal Wallis and Spearman correlation tests were used for statistical analysis. RESULTS 42 male and 78 female participants were evaluated. In posturographic evaluation, although fall risk score was the highest in group 1 and the lowest in group 3, these differences could not reach statistical significance. However, statistically significant higher fall risk was found in participants with 25(OH)D deficiency (25(OH)D< 30) than in controls (25(OH)D> 30) (p = 0.036). Also a statistically significant correlation was determined between serum 25(OH)D levels and the posturography fall risk scores (p = 0.016, r = - 0, 219). CONCLUSION By using an objective computerized technique, fall risk was found to be higher in young adults with 25(OH)D deficiency than in the controls. Vitamin D deficiency, even when clinically occult, seems to affect balance negatively.
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Melikoglu MA, Ataman S, Bodur H, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT, Sunar I. Clinical performance of rheumatoid arthritis impact of disease score: a real-life evidence from the multicenter nationwide registry BioStaR. Rheumatol Int 2021; 41:1971-1978. [PMID: 34559275 DOI: 10.1007/s00296-021-04992-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
The rheumatoid arthritis impact of disease (RAID) score was developed as a patient-derived composite response index for the evaluation of the disease impact on cases with rheumatoid arthritis (RA). The aim of this study was to evaluate the psychometric properties and performance of RAID score in the real-life settings. Cases with RA from our multi-center, nationwide registry called Biologic and targeted Synthetic antirheumatic drugs Registry RA (BioStaR RA) were included in this cross-sectional observational study. Demographic data, disease duration, pain, patient's global assessment (PGA) and physician's global assessment (PhyGA) were recorded. DAS28-ESR, DAS28-CRP, the simplified disease activity index (SDAI) and the clinical disease activity index (CDAI) were assessed as disease activity evaluations. The health assessment questionnaire-disability index (HAQ-DI) and RAID were completed by all the participants. The construct validity was tested by the analysis of correlations between RAID score and scores of PGA, disease activity indexes and HAQ-DI. We also evaluated the discriminatory ability of RAID to distinguish patients with different levels of disease activity and disability and the cut-off values were calculated by ROC analysis. 585 cases with RA were included in this investigation. The RAID score was significantly positively correlated with PGA, all disease activity indexes and HAQ-DI (p < 0.001). The discriminatory ability of RAID score in different disease activity and disability groups was also demonstrated (p < 0.001). To estimate DAS28-ESR (remission/low + moderate + high), RAID score cut-off points were 2.88 (sensitivity 73%, specificity 62%), 3.23 (sensitivity 75%, specificity 60%) and 3.79 (sensitivity 74%, specificity 58%), respectively. Our study indicated that RAID was a reliable tool in daily clinical practice by presenting its correlations with disease activity and disability assessments and by showing its discriminatory ability in these parameters in the real-life experiences.
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Gok K, Nas K, Tekeoglu I, Sunar I, Keskin Y, Kilic E, Sargin B, Acer Kasman S, Alkan H, Sahin N, Cengiz G, Cuzdan N, Albayrak Gezer İ, Keskin D, Mulkoglu C, Resorlu H, Bal A, Duruoz MT, Kucukakkas O, Yurdakul OV, Alkan Melikoglu M, Aydin Y, Ayhan FF, Bodur H, Calis M, Capkin E, Devrimsel G, Ecesoy H, Hizmetli S, Kamanli A, Kutluk O, Sen N, Sendur OF, Tolu S, Toprak M, Tuncer T. Impact of obesity on quality of life, psychological status, and disease activity in psoriatic arthritis: a multi‑center study. Rheumatol Int 2021; 42:659-668. [PMID: 34453579 DOI: 10.1007/s00296-021-04971-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 08/10/2021] [Indexed: 12/22/2022]
Abstract
This article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) ≥ of 30 kg/m2 were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients.
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Akgul O, Bodur H, Ataman S, Yurdakul FG, Capkin E, Gurer G, Sezer I, Duruoz MT, Melikoglu MA, Cay HF, Rezvani A, Yagci I, Gogus F, Kamanli A, Cevik R. Clinical performance of ASAS Health Index in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: real-world evidence from Multicenter Nationwide Registry. Rheumatol Int 2020; 40:1793-1801. [PMID: 32814986 DOI: 10.1007/s00296-020-04680-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/07/2020] [Indexed: 01/13/2023]
Abstract
The Assessment of SpondyloArthritis international Society Health Index (ASAS HI) is used as a new instrument in measuring the function, disability and health of patients with spondyloarthritis (SpA). However, the real-world evidence of ASAS HI is very limited. In the present study, our objective is to evaluate the psychometric properties and performance of ASAS HI in the real-world setting as well as comparing ASAS HI with the current instruments to assess the construct validity and determine the cut-off points in patients with both ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). A total of 991 patients with axSpA who fulfilled either the ASAS classification criteria for axial SpA (axSpA) or the Modified New York Criteria (mNY) for AS were recruited from the Biologic and targeted Synthetic antirheumatic drugs Registry (BioStaR) SpA. The construct validity of ASAS HI against the Bath Ankylosing Spondylitis Disease Activities Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (ASDAS-CRP) the Bath Ankylosing Spondylitis Functional index (BASFI) was performed. Using the receiver operating characteristic (ROC) curves analysis, the cut-off points were calculated. Of all the recruited patients, 851 (85.9%) were AS and 140 (14.1%) were nr-axSpA. The difference in the mean ASAS HI scores of the patients with AS and the ones with nr-axSpA were not statistically significant (6.12 ± 4.29 and 6.42 ± 4.86, respectively). The mean ASAS HI score was significantly higher in females and small city residents. The ASAS HI had a strong construct validity against ASDAS-CRP, BASDAI and BASFI. A cut-off point of ≤ 4 was determined to discriminate good and moderate, as well as ≥ 12 to discriminate moderate and poor health status. In conclusion, ASAS HI is a reliable instrument to evaluate health and functioning for both patients with AS and nr-axSpA in clinical practice.
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Melikoglu MA. Two birds with one stone: Anakinra for both gout and Familial Mediterranean fever attacks in a patient with renal transplant. Nefrologia 2020; 40:680. [PMID: 32127219 DOI: 10.1016/j.nefro.2019.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/14/2019] [Indexed: 10/24/2022] Open
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Sunar I, Ataman S, Nas K, Kilic E, Sargin B, Kasman SA, Alkan H, Sahin N, Cengiz G, Cuzdan N, Gezer IA, Keskin D, Mülkoğlu C, Resorlu H, Bal A, Duruöz MT, Küçükakkaş O, Yurdakul OV, Melikoglu MA, Aydın Y, Ayhan FF, Bodur H, Calis M, Capkın E, Devrimsel G, Gok K, Hizmetli S, Kamanlı A, Keskin Y, Kocabas H, Kutluk O, Şen N, Şendur OF, Tekeoğlu I, Tolu S, Toprak M, Tuncer T. Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study. Rheumatol Int 2019; 40:283-294. [PMID: 31773391 DOI: 10.1007/s00296-019-04480-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/19/2019] [Indexed: 12/30/2022]
Abstract
Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.
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Melikoglu MA. Joint manifestations can provide diagnostic clues in Morquio syndrome. Comment on: "Mucopolysaccharidoses seen in adults in rheumatology" by Mitrovic et al., Joint Bone Spine 2017;84:663-70. Joint Bone Spine 2018; 86:121-122. [PMID: 30025955 DOI: 10.1016/j.jbspin.2018.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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Abstract
OBJECTIVE We aimed to evaluate the quality of sleep (QoS) in patients with neuropathic pain (NP) and to investigate the association between possible QoS impairment and NP characteristics. MATERIALS AND METHODS Patients with NP and controls were examined. Age, sex, NP duration, NP cause (central, peripheral, or mixed), and pain intensity (with a Likert-type scale and visual analog scale) were recorded. NP was screened with Douleur Neuropathique 4 questions (DN4), and QoS was evaluated using the Pittsburg Sleep Quality Index (PSQI). Mann-Whitney U test and regression analysis were performed to evaluate the data. RESULTS Seventy patients with NP and 30 age- and sex-matched controls were included. The mean age of the patients and controls were 45.04±10.21 years and 39.00±19.23 years, respectively. Significantly higher scores of sleep latency (p=0.002), sleep duration (p=0.003), sleep efficiency (p=0.002), sleep disturbance (p<0.000), daytime dysfunction (p=0.04), and PSQI total were observed in patients with NP than in controls (p<0.000). In addition, 80% of patients with NP and 37 % of controls were classified as having poor QoS (p<0.000). Female sex, pain intensity, and NP duration were found to be factors related to having poor QoS in patients with NP (p=0.026, p=0.006, and p<0.000, respectively). CONCLUSION In our study, 80% of patients with NP had poor QoS regardless of the NP cause. Female sex, pain severity, and NP duration were found to be factors correlated with poor QoS. Treatment strategies that target not only NP itself but also better QoS may contribute to the overall success of management.
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Atamanalp SS, Akgun M, Kantarci M, Uyanik MH, Acemoglu H, Aksoy H, Melikoglu MA, Emet M, Gul M. The Codes of Publication Policy of the Eurasian Journal of Medicine: Parameters for a Stable and Sustainable Journal. Eurasian J Med 2016; 48:75. [PMID: 27551167 DOI: 10.5152/eurasianjmed.2016.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Atamanalp SS, Akgun M, Kantarci M, Uyanik H, Acemoglu H, Aksoy H, Alkan Melikoglu M, Emet M, Gul M. The Codes of Publication Policy of the Eurasian Journal of Medicine: Parameters for a Stable and Sustainable Journal. Eurasian J Med 2016. [DOI: 10.5152/eurasianjmed.2016.16092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Baygutal NK, Baygutalp F, Umay Altas E, Oztur N, Bakan E, Alkan Melikoglu M, Seferoglu B, Ugur M. Serum Interleukin-23 Levels and Relationship with Clinical Symptoms of Fibromyalgia Syndrome. Eurasian J Med 2016. [DOI: 10.5152/eurasianjmed.2016.15083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kocabas H, Sezer I, Melikoglu MA, Gurbuz U, Illeez O, Ozbudak IH, Butun B. Hyperostosis frontalis interna in a patient with giant cell arteritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-008-0021-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Senel K, Alkan Melikoglu M, Baykal T, Melikoglu M, Erdal A, Ugur M. Protracted febrile myalgia syndrome in familial Mediterranean fever. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0288-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Melikoğlu M, Melikoglu MA. What affects the quality of life in patients with Behcet's disease? ACTA REUMATOLOGICA PORTUGUESA 2014; 39:46-53. [PMID: 24811461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to evaluate the possible associations between quality of life (QoL) and sociodemographic features, disease characteristics and the Behcet's Disease (BD) disease activity of the patients with BD. PATIENTS AND METHODS One hundred and seven patients with BD were included in this study. Sociodemographic features including age, gender, education level of the patients and the disease characteristics including disease duration, disease onset age, the history BD clinical involvements were recorded. In patients with BD, the BD Current Activity Form was used for the evaluation of disease activity. The short form-36 (SF-36) QoL scale was used to evaluate the QoL in patients with BD. The Student t test, analysis of variance and Spearman's correlation matrix were used for the statistical analysis. RESULTS Men showed higher mean scores of role-physical and bodily pain domains of SF-36 than women did (p <0.000 and 0.001). Patients over 41 years of age had higher mean general health scores and university graduates patients had higher mean mental health scores than the other groups (p <0,01). Patients with a disease duration more than 5 years and patients have a younger disease onset age showed lower general health score than the others (p <0,01). Also patients with an anamnesis of uveitis, genital ulceration, erythema nodosum, thrombophlebitis, joint and gastrointestinal system involvement showed lower QoL than the patients without these complaints (p <0,05 and p <0,01). In the analysis of disease activity physical subscores of SF-36 were found to be correlated with fatigue, oral ulceration and joint involvement (p <0,01). Bodily pain showed a correlation with fatigue, headache and more highly with joint involvement (p <0,01 and p <0,001 respectively). General health was correlated with GIS and eye involvement and vitality was found to be correlated with fatigue, patient's and doctor's impression of disease activity (p <0,01). Mental and emotional scores were correlated with oral- genital ulceration, eye and joint involvements (p <0,01). CONCLUSION In addition to demografic features and clinical involvements, BD disease activity can affect QoL in patients with BD. These results highlight the importance of managing the symptoms and the disease activity effectively in order to improve QoL in BD.
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Melikoglu M, Melikoglu MA. An unusual cause of shoulder pain; herpes zoster induced brachial plexopathy, a case report and review of the literature. J Back Musculoskelet Rehabil 2013; 26:243-5. [PMID: 23887175 DOI: 10.3233/bmr-130377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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