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    Disease activation and laboratory parameters in Fibromyalgia Syndrome: Relationship with C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio, mean platelet volume
    (2021) Pamukcu, Melih; Aydoğan Baykara, Rabia; İzci Duran, Tuğba
    Fibromyalgia syndrome (FMS) is a chronic, widespread painful disease with unexplained etiopathogenesis and somatic-psychic findings. Unlike inflammatory rheumatic diseases, there are no specific laboratory parameters in FMS. In our study, we aimed to investigate the relationship between inflammatory markers and FMS activation scales. Eighty patients aged 18-65 years, diagnosed with FSM according to the American College of Rheumatology (ACR) 1990 criteria, were evaluated retrospectively. 61 healthy controls matched for sex, age, and body mass index (BMI) constituted the control group. In addition to the demographic data of the patients, the fibromyalgia impact questionnaire (FIQ) score, visual analog scale (VAS) fatigue score, VAS pain score, number of tender points, C- reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, and complete blood count values were evaluated and compared statistically. FIQ, VAS pain, and VAS fatigue score, number of tender points were significantly higher in the patient group (p<0.001). The mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), CRP values of the patient group were not statistically different from the control group. Patients' FIQ, VAS pain and VAS fatigue scores, number of tender points, and MPV, NLR, and CRP albumin ratio (CAR) parameters were not significant according to the correlation analysis. FIQ, VAS pain, VAS fatigue scores, and the number of tender points were statistically higher in the patient group, MPV, NLR, and CAR parameters were not different. Contrary to studies stating that FMS may be of inflammatory origin, no statistically significant difference was found in inflammatory disease activation parameters between patients with FMS and the control group in our study.
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    Which anti-TNF is most effective for my patient? Which one should I choose?
    (2021) Pamukcu, Melih; Aydoğan Baykara, Rabia
    Background/Aim: Multicenter controlled studies were conducted on the effect of anti-Tumor Necrosis Factor (TNF) agents in rheumatoid arthritis (RA) and varying effectiveness rates were reported. These agents have different advantages over each other. We aimed to compare the disease activation parameters in patients with RA at the beginning and the 52nd week of therapy in patients who were followed up in our center and started on anti-TNF (etanercept, adalimumab, and golimumab), and examine the effects of the drugs that are used by comparing them with each other. Methods: This retrospective cohort study included 187 patients with RA who were started on anti-TNF therapy because the disease activity could not be controlled by the concomitant use of at least three different conventional Disease-Modifying Anti-Rheumatic drugs, and whose adequate response to antiTNF were observed at the 12th-week follow-up. RA disease activity was measured using the 28-joint Disease Activity Score incorporating erythrocyte sedimentation rate (DAS-28 ESR) and the patients were evaluated by a Health Assessment Questionnaire (HAQ). For each drug group, disease activation and laboratory parameters were compared before treatment initiation and at 52 weeks of treatment. These values were then compared between the drug groups. Results: The mean age of 187 patients included in the study was 52.70 (10.17) years, 119 (63.6%) were female and 68 (36.4%) were male. Of the patients, 63 (33.7%) were using adalimumab, 62 (33.2%) were using etanercept and 62 (33.2%) were using golimumab. In all patients, there was a significant improvement in all parameters except mean corpuscular hemoglobin, gamma-glutamyl transferase, and creatinine. There were significant changes in hemoglobin, leukocyte and platelet count, erythrocyte sedimentation rate, C reactive protein, neutrophil count, serum albumin, DAS-28 ESR, and HAQ levels in all three groups (P<0.05). Conclusion: There were no differences in efficacy between adalimumab, etanercept and golimumab therapies, which were planned considering the comorbidities and drug preferences of the patients. In addition to controlled studies, real-life data to be reported by rheumatology centers will help us obtain more accurate information about the therapy results of anti-TNF agents.