İbrahim Tekeoğlu

Overlooked hematological markers of disease activity in rheumatoid arthritis.

The aim of this study was to investigate the relationship between hematological markers and disease activity in patients with rheumatoid arthritis (RA).

Levels of serum pentraxin 3, IL-6, fetuin A and insulin in patients with rheumatoid arthritis

OBJECTIVE The aim of this study was to investigate the relationship between disease severity and biochemical parameters such as pentraxin-3, fetuin-A, IL-6, insulin and HOMA-IR levels in patients with rheumatoid arthritis. METHODS This study included 60 patients with RA and 20 healthy controls. Serum pentraxin-3, fetuin-A, IL-6 and insulin concentrations were measured. Also, HOMA-IR values were calculated. Disease activity was assessed with Disease Activity Score (DAS28). To evaluate quality of life, the Health Assessment Questionnaire disability index was applied. RESULTS The serum values for ESR, CRP, pentraxin-3 and fetuin-A in patients with RA were found to be higher than control subjects (p values=0.001, 0.001, 0.000, 0.000, 0.01, 0.02, respectively). A positive correlation was evident between the DAS 28 score and IL6 levels (r=0.263, p=0.045). We found no correlation between the DAS28 score and HOMA-IR, the levels of pentraxin 3, fetuin A, insulin (p<0.05). Fetuin A levels were positively correlated with cumulative steroid dose (r=0.382, p=0.035). A statistically significant correlation was evident between presence of cardiovascular disease and HOMA-IR values in RA patients (r=0.437, p=0.032). CONCLUSION Elevated levels of pentraxin-3, fetuin-A, CRP, ESR might play a role in the pathogenesis of RA. Levels of fetuin-A, insulin HOMA-IR, pentraxin-3, CRP and ESR were not associated with clinical severity of the RA.

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis.

Abstract Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.

Comparison of fetuin-A and transforming growth factor beta 1 levels in patients with spondyloarthropathies and rheumatoid arthritis.

We investigated the serum transforming growth factor beta 1 (TGFβ1) and fetuin‐A levels, and determined the relationships between these biomarkers and disease activity, mobility and radiologic progression in patients with spondyloarthropathy (SpA) and rheumatoid arthritis (RA).

Nailfold videocapillaroscopy results in patients with rheumatoid arthritis

We aimed to analyse the nailfold capillaryscopy findings morphologically and examine their relationship with disease activity and demographic characteristics in patients with rheumatoid arthritis. In accordance with the 2010 ACR/EULAR classification criteria, 201 patients diagnosed with Romatoiad artrit (RA) and 50 healthy controls were included. We analysed capillaroscopic abnormalities such asmegacapillaries, haemorrhages, ramifications and avascular areas in patients affected with rheumatoid arthritis. The findings in our study are as follows: in 45.77% of the RA patients, there were nonspecific capillaryscopy findings. When compared to control group, the incidence of tortuosity, dilated capillary and bushy capillary was higher in RA patients (p values, respectively, 0.110, 0.330, 0.440 and 0.516). In RA patients with Raynaud’s phenomenon, the incidence of nonspecific capillaryscopy findings was higher. While there is a weak relationship between tortuosity and the duration of disease, no significant relation was detected between capillaryscopy findings and parameters such as RF, anti-CCP positivity and disease activity score (DAS28). When compared to controls, we have detected that RA patients have more nonspecific capillaryscopic findings. We could not find a relationship between nonspecific capillaryscopic findings and RA’a clinical findings and laboratory parameters. There is a need for a long-term wider-scale follow-up study to investigate whether there is a capillaryscopic pattern that can be correlated with RA’s clinical findings.

Relationship of hematologic markers with IL-17 and IL-1 beta in patients with rheumatoid arthritis

OBJECTIVES In this study, we aimed to investigate the relationship of NLR (Neutrophil lymphocyte ratio), MPV (mean platelet volume), PDW (distribution width) rates in rheumatoid arthritis (RA) patients with IL-17 and IL-1 beta which are within the cytokines playing an important role in etiopathogenesis and activity of the disease. PATIENTS AND METHODS Fifty-seven RA patients diagnosed according to RA classification criteria of ACR/EULAR 2010 and 37 controls were included into the study. WBC (white blood cell), NEU (neutrophil), PLT (platelet), LYM (lymphocyte) values in complete blood count received from routine blood examination of patients were recorded, and NLR, PLR (platelet lymphocyte ratio) rates were recorded. IL-17 and IL-1 beta were studies in serum samples. Disease activity of RA patients was evaluated with Disease Activity Score (DAS28). Age, gender, disease age, BMI (body mass index), medications used, co-morbid diseases, smoking of the patients were recorded. RESULTS Fifty-seven RA patients (46 (80.7%) females, 11 (19.3%) males), and 34 patients (24 (70.6% females and 10 (29.4) males) as a control group were involved. Demographic characteristics were similar between two groups, and statistically significant difference was not detected between patient and control groups in terms of gender, age, and BMI (p> 0.05). We found higher NLR, MPV, PDW, IL-17 values in RA patients compared to control group (p< 0.05). There was a positive correlation of NLR with DAS28, CRP. While erythrocyte sedimentation rate (ESR) had negative correlation with MPV and PDW, it had positive correlation with PLT. We found positive correlation of C-reactive protein (CRP) with NLR and PLT. We could not find correlation of IL-1 beta and IL-17 with hematologic markers. CONCLUSION In this study, we investigated the relationship of IL-17 and IL-1 beta which play an important role in pathogenesis of RA patients with the parameters analyzed in routine complete blood count, providing information about disease activity such as DAS 28, CRP, and ESR. We illuminated on an issue which has not discussed before by looking from a different angle. More extensive, follow-up studies are needed to emphasize the importance of these parameters and to reveal the relationship between cytokines during the follow-up of the disease activity.

Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study

We determined ankle pathologies in patients with different types of inflammatory rheumatic diseases using high‐resolution ultrasonographic (US) images, and compared the findings among the different patient groups.

FRI0396 Levels pentraxin 3 and c1q in systemic sclerosis: association with pulmonary arterial hypertension and clinical findings

Background Systemic sclerosis (SSc) is an autoimmune rheumatic disease with unknown etiology that characterized fibrosis and vascular endotelial damage with obliteration of the microvasculature caused from exaggerated syntesis of collagen and extracellular matrix deposition in skin and internal organs. Pentraxin 3 (PTX3) accepted as a vascular inflammatory marker which secreted in early stage of endothelial dysfunction. Objectives In this study, we aimed to investigate plasma PTX3 and serum complement C1q levels and their relations with cytokines and pulmonary arterial pressure in SSc. Methods Fifty nine patients diagnosed SSc and 28 subjects without inflammatory rheumatic disease recruited to the study. Plasma PTX3, and serum TNF-α, IL-1β, IL-4, IL-10, INF-γ, TGF-β and complement C1q measured in both groups. Clinical findings and pulmonary arterial pressure of the SSc patients assessed. Results Ages of fifty nine with SSc (54 female and 5 male) and 28 control subjects (23 female and 5 male) were 49,47±12.74 and 43,07±13,71 respectively. PTX3, IL-1β and IL-4 levels found decreased in SSc patients. There were no differentiations between limited and diffuse cutaneous SSc subgroups in terms of PTX3, cytikines and C1q levels. Plasma PTX3 and serum IL-1β concentrations found decreased only limited cutaneous SSc subgroup comparing controls. According to the immunosupressive drugs use; PTX3 levels found decreased in using group and TNF-α ve IL-1β levels found decreased in not using group comparing controls. Significant positive association found between PTX3 and C1q and all cytokines except TGF- β. Conclusions PTX3 suggested to be used in the pathogenesis and assessment of disease treatment efficacy of SSc, because of found decreased in SSc patients especially in limited cutaneous and immunosupressive drugs using subgroups. Associations between C1q, and PTX3 and pulmonary artey pressure highlighted possible roles of both parameters in development of pulmonary hypertension. It is possible to develop preventive treatment strategies with better understanding of these associations. Advanced studies should be carried out for clarifying this condition. Disclosure of Interest None declared

AB0751 The differences and similarities between patients and physician global assessment in patients with psoriatic arthritis

Background Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis, axial involvement, enthesitis, dactylitis and uveitis. The differences and similarities between patients global assessment (PtGA) and physicians global assessment (PhGA) were not assessed clearly in PsA. Objectives The aim of this study was to assess differences and similarities between patients and physicians perspective of global assessment in patients with PsA. Methods Patients with PsA over the age of 18-year-old who met the CASPAR classification criteria were underwent clinical and laboratory evaluation by using standardized protocol and case report form, from two universities outpatients clinics. PtGA and PhGA, VAS-pain, fatigue, BASDAI, BASFI, health-related QoL were recorded at baseline visit. Pearson correlation coefficient were calculated for PtGA and PhGA. Linear regression model were used to asses relationship between global assessments and clinical finding. Results A total 144 patients with PsA (male 51, female 93) were included. Symptom duration (7.8±7.5 vs 11.3±11.2), VAS-pain (4.4±2.6 vs 4.9±2.6), PtGA (4.7±2.5 vs 5.0±2.4) and PhGA (4.0±2.2 vs 4.4±2.2) were similar between male and female patients with PsA (p>0.05). VAS-fatigue was higher in female patients with PsA than male ones (5.9±2.7 vs 4.4±2.8, p=0.001). Disease activity measurements such as, tender and swollen joint count, DAS28, BASDAI and acute phase reactant were similar for both sex. Correlation coefficient of Physicians global assessment was higher than PtGA in various clinical findings. The highest correlation coefficient was observed in VAS-pain (r=0.784) and followed by SF36-bodily pain (r=-0.613), BASDAI (r=0.587), NHP-physical activity (r=0.584), VAS-fatigue (r=0.555), BASFI question 5 (r=0.551) for PhGA (p<0.0001). However the highest correlation coefficient was observed in VAS-pain (r=0.690) and followed by NHP-physical activity (r=0.536), BASFI question 10 (r=0.512), BASDAI (r=0.499), SF36 (r=-0.490) and BASFI total score (r=0.484) for PtGA (p<0.0001). Statistically significant positive linear relation was observed between global assessment and clinical parameters (VAS-pain, fatigue, BASDAI, BASFI, DAS28, NHP-physical activity) by using simple linear regression model. VAS-pain and BASDAI question 1 explained 83.3% of PtGA as a predictor in multiple linear regression model. However, VAS-pain and DAS28 explained 68.4% of PhGA as a predictor in multiple linear regression model (table 1).Table 1. Results of multiple linear regression of PtGA and PhGA R2 B SE t p Patients global assessment  Constant 0.833 0.597 0.311 1.920 0.060  VAS-pain 0.665 0.061 10.939 ?0.0001  BASDAI-1 How would you describe the overall level of fatigue/tiredness you have experienced in the past week? 0.205 0.063 3.243 0.002 Physicians global assessment  Constant 0.684 0.399 0.310 1.285 0.201  VAS-pain 0.587 0.050 11.846 ?0.0001  DAS 28 0.332 0.096 3.453 0.001 Conclusions Assessment of disease activity as well as clinical parameters is considered to be complex in PsA. Patients and physicians have different perspective of disease activity. Severity of pain and fatigue may be predictor of PtGA whereas; pain and objective disease activity measurement may be predictor of PhGA in patient with PsA. Disclosure of Interest None declared

Development of a wearable exercise device for rehabilitation of hemiplegic hand

Millions of people suffer a stroke each year. One of the problems after stroke is hemiplegic hand. In previous studies a lot of robotic based devices has been suggested for rehabilitation of hemiplegic hand. Actuators using for force transmitting in previous devices have some disadvantages. One of them is misalignment on the centre of rotation between joints used in devices and joints of the hand. In this study a novel device is suggested to perform the finger exercises. The device has a cable and spring driven mechanism with an electrical linear actuator. The device allows both passive and active exercises. It is aimed that the device is suitable for at home use, wearable, portable and low cost. It is expected from the new device that it will reduces the rehabilitation cost and therapy period. The device can be used for other rehabilitation treatments such as nerve injury, nerve compression, tendon injury, fracture and sport injury besides stroke rehabilitation.