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Background: The aim of this study is to determine the usefulness of Orexin-A levels in differentiating between epileptic seizures and psychogenic non-epileptic seizures in patients presenting to the emergency service with epileptic seizure-type symptoms., Methods: A total of 80 individuals were included in this study, including 59 who presented to the emergency service within the first four hours of having been diagnosed with generalized tonic-clonic seizures (39 with epileptic seizures (ES) and 20 with pseudoseizures (PNES) and 21 controls. Orexin-A levels were measured in venous blood samples., Results: The mean Orexin-A levels were 5.16 ng/mL in the control group, 7.17 ng/mL in the PNES group, and 11.08 ng/mL in the ES group (Table 1). The mean Orexin-A level of the ES group was significantly different from both the control group and the PNES group (Table 1, p < 0.001); the difference between the control group and the PNES group was not significant (p > 0.05)., Conclusions: Results of this study suggest that blood Orexin-A may be an effective biomarker in the differential diagnosis of epileptic seizures/psychogenic non-epileptic seizures in patients presenting to the emergency service with an epileptic seizure-type clinical picture., Competing Interests: Declaration of Competing Interest There are no conflicts of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Aim: 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)., Method: The study included 55 patients with SpA and 38 patients with RA, together with 28 healthy subjects. In AS patients, we assessed disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional ability using the Bath Ankylosing Spondylitis Functional Index (BASFI), and mobility using the Bath Ankylosing Spondylitis Metrology Index (BASMI), radiologic progression using the Bath Ankylosing Spondylitis Radiology Index (BASRI). Serum fetuin-A and TGFβ1 were determined using enzyme-linked immunosorbent assay (ELISA) equipment., Results: Fetuin-A was significantly higher in the axial SpA and RA groups than in healthy subjects (P < 0.01). Serum TGFβ1 and fetuin-A levels were similar in the peripheral SpA group and in healthy subjects. A significant positive correlation was found between the fetuin-A and TGFβ1 levels in the axial SpA, peripheral SpA, and RA groups (r = 0.293, P = 0.009; r = 0.215, P = 0.04; r = 0.223, P = 0.05, respectively). Significant correlations were found between fetuin-A and the BASMI and BASRI values in the axial SpA patients (r = 0.444, P = 0.031; r = 0.486, P < 0.001, respectively)., Conclusion: We conclude that Fetuin-A may be one of the steps that can be active in disease progression in axial SpA patients., (© 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Aim: The aim of this study was to investigate the relationship between hematological markers and disease activity in patients with rheumatoid arthritis (RA)., Method: The study was designed and performed in the Department of Rheumatology of the Sakarya University Faculty of Medicine. In total, 102 patients with RA were retrospectively enrolled. We used the Disease Activity Score of 28 joints (DAS28) instrument to evaluate disease activity. Laboratory assessments included complete blood cell counts, measurement of erythrocyte sedimentation rate (ESR) and assessment of C-reactive protein (CRP) level. Exclusion criteria included active infection and/or the presence of any hematological, cardiovascular or metabolic disorder., Results: We found that the neutrophil lymphocyte ratio (NLR) and mean platelet volume (MPV) varied by disease activity status. NLR values correlated positively with the DAS28 scores of RA patients. Especially, higher NLR values (3.92 ± 0.31) were evident in the group exhibiting high-level disease activity, whereas the MPV values were lowest (7.11 ± 0.91 fL) in this group. Additionally, no significant difference was evident between DAS28 scores and platelet distribution width (PDW) values in patients with RA (r = -0.055, P = 0.124)., Conclusions: We found that the MPV value may serve as a marker of the absence of acute-phase disease, and the NLR level as a marker of the presence of such disease, in patients with RA. More detailed analysis of disease activity is required to further explain the associations of the markers described above with disease activity., (© 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)

Objectives: This study aims to investigate the relationship between neuroserpin (NSP) and claudin-5, as well as matrix metalloproteinase-9 (MMP-9), with respect to clinical activity of disease in patients with rheumatoid arthritis., Patients and Methods: The study included a total of 75 patients (18 males, 57 females; mean age 48.12±11.23 years; range 20 to 60 years) who were admitted to the rheumatology outpatient facility at the Medical Faculty Hospital, Sakarya University, in October 2014. Patients were divided into four groups based on their Disease Activity Score 28 (DAS28) scores as remission group (n=16, DAS28 <2.6), low disease activity group (n=16, DAS28 between 2.6-3.2), moderate disease activity group (n=28, DAS28 between 3.2-5.1), and high disease activity group (n=15, DAS28 >5.1). Ten healthy subjects (HS) served as controls., Results: Claudin-5, MMP-9, and NSP levels were significantly different in rheumatoid arthritis patients compared to HS (p=0.035, 0.026, and 0.014, respectively). Additionally, there were no differences between claudin-5 levels and disease activity among all RA groups. However, compared to HS, patient groups showed a significant difference (p=0.035) in terms of claudin-5 levels. Serum levels of MMP-9 were significantly different in moderate disease activity group compared to HS (p=0.013). Levels of NSP were significantly different in moderate disease activity and high disease activity groups compared to HS (p=0.008 and 0.031, respectively)., Conclusion: Our study demonstrated the differential associations of endothelial function/dysfunction biomarkers and disease activity in rheumatoid arthritis. How and why this impairment occurs is not fully understood and more data regarding NSP, MMP, and claudin expression in plasma are warranted., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Objective: Endothelial dysfunction is involved in inflammatory disorders, migration, angiogenesis, and tumor progression. There is a known relationship between migraine and inflammation; however, there are conflicting data as to whether there is a link between migraine and endothelial dysfunction. The current study aimed to determine the relationships between migraine and levels of serum Endocan (ESM-1), Claudin-5 (CLDN5), IL-1β, IL-6 and TNF-α levels, which are proven indicators of endothelial dysfunction and inflammation in patients with migraine., Patients and Methods: Thirty-one patients and 24 healthy subjects were included in this study. Participants underwent thorough physical and neurological evaluations, and levels of serum ESM-1, CLDN5, IL-1β, IL-6 and TNF-α were measured for each patient., Results: The levels of ESM-1, CLDN5, IL-1β, IL-6, and TNF-α were significantly higher in the migraine attack group than in the control group (p: 0.006, p: 0.002, p: 0.002, p: 0.003, p: 0.036, respectively). Additionally, there were significant differences in the ESM-1 levels of the visual analog scale (VAS) subgroup (p = 0.041), and there were moderate differences in the CLDN5 levels of the VAS subgroup (p = 0.064)., Conclusions: High serum levels of IL-1β, IL-6 and TNF-α in the migraine attack group indicate that inflammation plays a major role in migraine pathogenesis. In particular, the high ESM-1 and CLDN5 levels in patients with migraine suggest that inflammation should be investigated further, it may be a useful tool in the differential diagnosis of migraine.

Strongyloidiyasis is endemic in tropical and subtropical regions, and mostly soil transmitted nematode disease that is seen as sporadic cases in Turkey. As may be asymptomatic in healthy individuals, it may even cause death in immunosuppressive people. We report a case of Strongyloides stercoralis infection in a patient, 29 years old young male was admitted to our institution with diarrhea who has got vitamin B12 deficiency and eosinophilia. The case represents an extremely rare and in our knowledge, it is the first case in Sakarya.