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Öğe Assessment of Hand Functions in Patients with Chronic Hepatitis B(Aves, 2014) Oktayoglu, Pelin; Tekin, Recep; Caglayan, Mehmet; Bozkurt, Mehtap; Em, Serda; Yildiz, Mehmet; Ucmak, FeyzullahObjective: Motor dysfunction is an important clinical finding in patients with liver cirrhosis (LC), but there is no study assessing fine motor coordination in patients with chronic hepatitis B (CHB). We aimed to investigate hand functions and fingertip dexterity in patients with CHB. Materials and Methods: A total of 17 female and 15 male patients diagnosed with CHB without histopathological findings of cirrhosis were enrolled to the study; 21 female and 9 male healthy volunteers were included as a control group. Hand grip strength was assessed by Jamar hand dynamometer. Three kinds of pinch strength of fingers were assessed by Jamar pinchmeter. Functional status was evaluated by using the Stanford Health Assessment Questionnaire (HAQ). Duruoz Hand Index (DHI) was used to assess the hand functions. Fingertip dexterity was evaluated by Purdue pegboard test. Results: Bilateral hand grip strength and pinch strength were not statistically different from controls (p>0.05). There was also no significant difference between the categories of the Purdue pegboard test between the groups. HAQ scores of patients were higher than controls (p< 0.05). Conclusion: Hand functions are not influenced in patients with CHB. Disruptions in the functional status of patients with CHB may be due to fatigue and depression, which are usually seen in chronic liver diseases.Öğe Assessment of hand functions in patients with idiopathic cervical dystonia(Elsevier, 2020) Oktayoglu, Pelin; Acar, Abdullah; Gunduz, Ibrahim; Caglayan, Mehmet; Akbostanci, Muhittin CenkCervical dystonia (CD) is the most common form of focal dystonia characterized by involuntary contractions of the neck muscles, causing abnormal rotation of the head into specific directions. Studies report that idiopathic dystonia is a developmental disorder of the sensorimotor circuits, involving both the cortico-striatal and thalamo-cortical pathways. It is also suggested that enhanced cortical plasticity extends beyond the clinically affected region and may also be detected in the unaffected upper limbs of the patient with CD. In the present study, we aimed at exploring if patients with CD had hand motor dysfunctions. Forty patients with idiopathic CD and 40 healthy controls were included in this study. Dystonic symptoms were assessed by means of The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Stanford Health Assessment Questionnaire (HAQ) was used to assess functional status. Quality of life (QoL) was assessed by using the Medical Outcomes Study Short Form 36-Item Health Survey (SF 36). Grip strength was assessed by using hand dynamometers. Tip pinch, lateral pinch and chuck pinch of the hand were assessed by using a pinchmeter. Fingertip dexterity and hand coordination was assessed using Purdue Pegboard. Duruoz Hand Index (DHI) was used for the assessment of hand functions. There were no significant differences between the groups in grip and pinch strengths of hands and fingers. As to the fingertip dexterity, patients with CD had a mean Pin 1 and Pin 2 test score of 10.6 +/- 2.8 and 10.8 +/- 3.2 respectively and a mean assembling test score of 5.2 +/- 2.0. These results were significantly worse than those of the healthy controls. As to the SF 36 sub-scores, there were significant differences between the groups in all SF 36 sub-scores (p < .001). This study indicates that patients with CD suffer a deteriorated fine motor coordination of hands without dystonic involvement of upper extremities. Furthermore, lower SF 36 scores in patients with CD suggest poorer health-related quality of life.Öğe Assessment of Serum S100 Protein Levels in Patients with Fibromyalgia(Clinical & Exper Rheumatology, 2014) Cavas, Husamettin; Oktayoglu, Pelin; Verim, Sabahattin; Em, Serda; Caglayan, Mehmet; Bozkurt, Mehtap; Yildiz, Ismail[Abstract Not Available]Öğe Carvacrol prevents methotrexate-induced renal oxidative injury and renal damage in rats(Canadian Soc Clinical Investigation, 2014) Bozkurt, Mehtap; Em, Serda; Oktayoglu, Pelin; Turkcu, Gul; Yuksel, Hatice; Sariyildiz, Mustafa A.; Caglayan, MehmetPurpose: The purpose of this study was to investigate the effect of carvacrol (CAR) on methotrexate (MTX)-induced renal damage in rats. Methods: Twenty-four male rats were equally divided into three groups: group I, control treatment; group II, MTX-treated; and group III, MTX+CAR-treated. A single dose of CAR (73 mg/kg) was administered intraperitoneally to group III on the first day of the experiment and a single dose of MTX (20 mg/kg) was administered intraperitoneally to groups II and III on the second day of the experiment. Blood samples and kidney tissue were obtained from each animal on day 8 for the measurement of malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI). Light microscopy was used for histopathological examination of kidney specimens. Results: MDA, TOS and OSI levels were significantly greater in the group receiving MTX alone relative to the control animals, while the TAS level was significantly reduced in the MTX group compared with the control group. The administration of CAR was associated with signicantly decreased MDA, TOS, and OSI levels and increased TAS levels relative to the rats treated with MTX alone. Animals treated with CAR exhibited decreased tubular degeneration and architectural impairment relative to animals treated with MTX alone; however, the difference in histological scores did not meet the threshold of statistical significance. Conclusions: MTX treatment results in oxidative damage to the rat kidney; damage which is partially abrogated by the administration of CAR.Öğe Comparison of the Efficacy of Phonophoresis and Conventional Ultrasound Therapy in Patients with Primary Knee Osteoarthritis(Erciyes Univ Sch Medicine, 2014) Oktayoglu, Pelin; Gur, Ali; Yardimeden, Ibrahim; Caglayan, Mehmet; Cevik, Figen; Bozkurt, Mehtap; Em, SerdaObjective: To compare the efficacy of phonophoresis (PH) versus ultrasound (US) in patients with primary knee osteoarthritis (OA). Materials and Methods: Forty patients were divided into two groups as PH and US. Acoustic gel containing no pharmacological agent was applied in the US group, whereas a gel containing 1.16% diclofenac diethylamonium was applied in the PH group for 10 sessions. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and Visual Analogue Scale (VAS) were used for the assessment of pain. The WOMAC physical function subscale, Lequesne functional index and Stanford Health Assessment Questionnaire (HAQ) were used for the assessment of physical activities. Patients were assessed for a 3 month follow-up period. Results: In the PH group, painless walking duration improved at all follow-up times except for week 2 (p< 0.05). Painless walking distance and VAS scores also improved at all follow-up times (p< 0.05). In the US group, VAS scores during walking and flexion of the knee, WOMAC pain and physical function scores and total WOMAC scores improved significantly at all follow-up times (p< 0.05). Conclusion: Both therapeutic modalities were found effective. We suggest neither therapy is superior to the other but PH can improve painless walking duration more successfully than US.Öğe Elevated Serum Levels of Calprotectin (Mrp8/14) in Patients with Systemic Sclerosis(Clinical & Exper Rheumatology, 2014) Oktayoglu, Pelin; Mete, Nuriye; Kaya, Halide; Caglayan, Mehmet; Bozkurt, Mehtap; Nas, Kemal[Abstract Not Available]Öğe Elevated serum levels of calprotectin (MRP8/MRP14) in patients with Behcet's disease and its association with disease activity and quality of life(Taylor & Francis Ltd, 2015) Oktayoglu, Pelin; Mete, Nuriye; Caglayan, Mehmet; Bozkurt, Mehtap; Bozan, Turgut; Em, Serda; Nas, KemalBackground. Behcet's disease (BD) is an inflammatory disease with multisystem chronic vasculitis. The disease is characterized by attacks of oral and genital ulcerations, skin lesions, arthritis, uveitis and deep vein thrombosis. The main histopathological feature is known to be vascular inflammatory change. Calprotectin (MRP8/MRP14) has been identified as an important alarmin that is expressed by activated phagocytes, granulocytes, monocytes and vascular endothelial cells, recognized by toll-like receptors, and induces a thrombogenic and inflammatory response in human microvascular endothelial cells. Aim. We aimed to investigate the serum levels of calprotectin in patients with BD and its association with disease activity and quality of life. Materials and methods. Forty-eight patients (25 males and 23 females) and 47 healthy controls (29 males and 18 females) were included to study. BD Current Activity Form (BDCAF) was used to assess the disease activity of patients with BD. Quality of life was assessed by using the Nottingham Health Profile (NHP). Depression and anxiety symptoms were assessed by using the Hospital Anxiety and Depression Scale (HADS). Serum level of calprotectin was determined using an ELISA kit. Results. Serum levels of calprotectin was significantly higher in patients with BD compared to healthy controls (p = 0.001). Serum levels of calprotectin did not correlate with the sores of BDCAF, NHP and HADS. Conclusion. Calprotectin may play a significant role in the pathogenetic mechanisms of BD. Further insight into this area of research might provide opportunities to develop novel treatment strategies.Öğe Elevated Serum Levels of Calprotectin (Myeloid-Related Protein 8/14) in Patients With Ankylosing Spondylitis and Its Association With Disease Activity and Quality of Life(Lippincott Williams & Wilkins, 2014) Oktayoglu, Pelin; Bozkurt, Mehtap; Mete, Nuriye; Caglayan, Mehmet; Em, Serda; Nas, KemalBackground: Calprotectin is one of the major leukocyte S100 proteins showing both calcium binding and antimicrobial characteristics. The serum level of calprotectin is markedly elevated in patients with inflammatory bowel disease, rheumatoid arthritis, as well as systemic lupus erythematosus and has been suggested to play a prominent role in both progression and pathogenesis of these diseases. Aim: The purpose of this study was to investigate the serum level of calprotectin in patients with ankylosing spondylitis (AS) and its association with disease activity and other clinical characteristics of AS. Materials and Methods: Thirty-one patients who met the modified New York criteria for AS and 45 healthy controls were included in this study. Both Bath AS disease activity index and AS disease activity score were applied on the patients with AS for the assessment of disease activity; Bath AS functional index, for the assessment of functional activity; Bath AS radiology index, for the assessment of radiological damage; and the AS quality of life questionnaire for the assessment of disease-related life status. Spinal and hip measurements were performed using Bath AS metrology index. The serum level of calprotectin was determined using enzyme-linked immunosorbent assay kit. Results: Mean serum level of calprotectin was significantly higher in the patients with AS compared with healthy controls (P = 0.003). Serum levels of calprotectin did not correlate with Bath AS disease activity index, AS disease activity score, Bath AS functional index, Bath AS radiology index, Bath AS metrology index, modified Schober, chest expansion, AS quality of life questionnaire, erythrocyte sedimentation rate, and C-reactive protein values (P > 0.05). Conclusions: Our results suggest that calprotectin might play an important role in the pathogenetic mechanisms of AS; however, the calprotectin levels did not correlate with the measurements of disease activity, functional abilities, radiological damage, and the quality of life in these patients. Further insight into this area of research might provide opportunities to develop novel treatment strategies, which take into account the role of these peptides in the pathogenetic mechanisms of AS.Öğe Evaluation of the incidence of haemorrhoidal disease in patients with ankylosing spondylitis(Springer London Ltd, 2015) Caglayan, Mehmet; Turkoglu, Ahmet; Oktayoglu, Pelin; Yildiz, Mehmet; Dagli, Abdullah Zubeyir; Boyuk, Abdullah; Em, SerdaHaemorrhoidal disease (HD) is one of the most common diseases encountered by the clinicians of general surgery. Chronic constipation, pushing during defecation and increased abdominal pressure play an important role in development of haemorrhoidal disease. Patients with ankylosing spondylitis (AS) frequently use the Valsalva manoeuvre in their daily lives, which may increase the abdominal pressure, leading to formation of haemorrhoids. The purpose of this study was to evaluate the incidence of haemorrhoidal disease in patients with AS. A total of 221 individuals were included in this study in three groups as follows: 72 patients with ankylosing spondylitis (AS), 75 patients with chronic low back pain (LBP) and 74 healthy control subjects. Patients were examined both physically and anoscopically, and their histories were taken. The incidence of HD was 45.8 % in patients with AS, 16 % in patients with chronic LBP and 9.5 % in healthy control subjects. The incidence of HD was significantly higher in patients with AS compared to the other groups. Patients with AS have a high incidence of HD, which should be taken into consideration by clinicians during routine examination of these patients.Öğe A New Comorbidity in Female Patients With Ankylosing Spondylitis Pelvic Organ Prolapse(Lippincott Williams & Wilkins, 2019) Caglayan, Mehmet; Oktayoglu, Pelin; Agacayak, Elif; Dagli, Abdullah Zubeyir; Okcu, Mehmet; Nas, KemalAim The aim of this study was to investigate whether increased intra-abdominal pressure caused by pelvic inflammation and frequent use of the Valsalva maneuver increases the incidence of pelvic organ prolapse (POP) among female patients with ankylosing spondylitis (AS). Methods Thirty-nine patients diagnosed as having AS through the use of the modified New York criteria, 47 patients with chronic low-back pain (CLBP), and 38 healthy controls (HCs) were included in this study. All the patients and the HCs underwent thorough physical and gynecological examinations. Pelvic organ prolapse was graded blindly by a gynecologist. Presence or absence of cystocele (CS), rectocele (RC), and uterine prolapse (UP) was noted. Results The incidences of CS, RC, and UD were significantly higher among the AS patients compared with the HCs (p = 0.001, 0.026, and 0002, respectively). The incidences of CS (p = 0.042) and UD (p = 0.017) were significantly higher among the AS patients compared with the CLBP patients. Conclusions The incidence of POP is higher among patients with AS compared with normal population. These patients should be questioned about the symptoms of POP and recommended, if necessary, regular gynecological examinations, as well as specific exercises including those targeting AS.Öğe Psychological health of caregivers and association with functional status of stroke patients(Taylor & Francis Ltd, 2017) Em, Serda; Bozkurt, Mehtap; Caglayan, Mehmet; Cevik, Figen Ceylan; Kaya, Cemal; Oktayoglu, Pelin; Nas, KemalObjective: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients. Methods: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls. The functional state of patients was assessed by the Barthel Index (BI). Furthermore, emotional state of the caregivers was assessed by the Hospital Anxiety and Depression Scale (HADS) and their life quality was assessed by the SF36 Health Survey. Results: The mean anxiety (9.73 +/- 4.88) and depression rates (9.81 +/- 5.05) in the caregivers were significantly higher than those in controls (p<0.001, respectively). Significant impairments were observed in both their mental and physical health. Regression analysis also showed a significant negative correlation between the BI scores and the HADS scores. Conclusion: Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.Öğe A Rare Cause of Protrusio Acetabuli: Osteoporosis Associated with Collagen Type 1 Alpha 1 Gene Polymorphism(Galenos Yayincilik, 2014) Oktayoglu, Pelin; Aydinol, Belkis; Caglayan, Mehmet; Bozkurt, Mehtap; Nas, KemalProtrusio acetabuli (PA) is a rare cause of hip pain which manifests itself in the radiological investigation as intrapelvic protrusion of the acetabulum. It may be caused by a variety of etiopathogenetic factors. In this article, we aimed to present a-20-year-old young patient who presented to our outpatient clinic with complaints of bilateral hip pain, was diagnosed with PA in hip joints caused by primary osteoporosis and was shown to have polymorphism within the Collagen type 1 alpha 1 (COL1A1) Sp1-binding site by osteoporosis gene analysis.Öğe The Relationship between Disease Activity and Visceral Fat in Patients with Rheumatoid Arthritis(Clinical & Exper Rheumatology, 2014) Aydin, Fatma; Caglayan, Mehmet; Bozkurt, Mehtap; Oktayoglu, Pelin; Em, Serda; Yildiz, Ismail; Nas, Kemal[Abstract Not Available]Öğe SERUM CATHELICIDIN (LL 37) LEVELS IN PATIENTS WITH BEHCET'S DISEASE AND ITS ASSOCIATION WITH DISEASE ACTIVITY(Bmj Publishing Group, 2019) Cakir, Melike Zelal; Oktayoglu, Pelin; Mete, Nuriye; Caglayan, Mehmet[Abstract Not Available]Öğe Serum Coenzyme Q10 Levels and Oxidative Status in Patients with Fibromyalgia Syndrome(Taylor & Francis Ltd, 2014) Bozkurt, Mehtap; Oktayoglu, Pelin; Em, Serda; Caglayan, Mehmet; Yuksel, Hatice; Ucar, Demet; Batmaz, IbrahimObjectives: The aim of this study was to determine the relationship between serum coenzyme Q10 [CoQ10] levels and symptoms of fatigue associated with fibromyalgia syndrome [FMS]. Methods: Patients diagnosed with primary FMS and domographically matching healthy normal controls [HNCs] were sought to participate in the study. The total antioxidant status, total oxidative status, and CoQ10 levels were measured in blood samples from the patients and the controls. Results: A total of 40 patients with FMS and 30 HNCs were recruited. There were no statistically significant differences between the two groups in regard to C-reactive protein, mean erythrocyte sedimentation rate, mean age, and mean body mass index [p>0.05]. The mean time from symptom onset to diagnosis for the FMS patients was 2.88 years, and the average number of tender points was 14. The serum CoQ10 levels were significantly lower in the FMS patients compared with the HNC group [p=0.000]. The serum total oxidative status and oxidative stress index levels were higher, and the serum total antioxidant status levels were lower in the FMS patients compared with those of the HNC group [p<0.05]. The visual analog scale [VAS] pain scores and the VAS fatigue scores were significantly higher in the FMS group than in the HNC group [p=0.000]. The serum CoQ10 levels were negatively correlated with the mean Modified Fatigue Impact Scale scores [p=0.02, r=0.301, VAS pain scores [p=0.00, r=0.38], and VAS fatigue scores [p=0.03, r=0.28]. Conclusions: The CoQ10 deficiency may contribute to the etiopathogenesis of FMS fatigue.Öğe SERUM OXYTOCIN LEVELS IN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NONRADIOGRAPHIC AXIAL SPONDYLARTHRITIS(Bmj Publishing Group, 2019) Yukselmis, Ozkan; Caglayan, Mehmet; Oktayoglu, Pelin; Mete, Nuriye[Abstract Not Available]Öğe Serum Progranulin Levels and Disease Activity in Patients with Axial Spondyloarthritis(Georg Thieme Verlag Kg, 2023) Mercan, Irem; Oktayoglu, Pelin; Mete, Nuriye; Caglayan, MehmetBackground Axial spondyloarthritides (ax-SpA) are a group of chronic systemic diseases of unknown aetiology, affecting mostly young men, with common features such as inflammatory low back pain, axial skeletal involvement, sacroiliitis, and association with HLA-B27. Inflammatory cytokines, mainly TNF-alpha, play a role in its aetiopathogenesis. Progranulin (PGRN) is thought to be an anti-inflammatory molecule that acts through the TNF-alpha pathway. In our study, we aimed to investigate the relationship between serum PGRN levels and disease activity in patients with AS. Material and Methods Forty-five patients between the ages of 18 and 65 who were classified as having ax-SpA according to ASAS classification criteria were included in our study. Forty-five individuals between the ages of 18 and 65 who did not have pregnancy or lactation status, no acute or chronic infection and no malignancy or rheumatic disease were included as the healthy control group. In addition, BASDAI, BASFI, BASMI, ASDAS-CRP, ESR and CRP levels were recorded in the patient group to determine the laboratory and clinical findings of patients with ax-SpA. Results Mean serum progranulin levels were higher in axial SpA patients compared with the control group (5156.72 +/- 1274.34 vs. 4836.50 +/- 1422.10), but this result was not statistically significant (p = 0.275). Serum progranulin levels were negatively correlated with ESR (p = 0.031) but ASDAS-CRP (p = 0.407) and BASDAI (p = 0.297) values were not correlated with the progranulin levels. Conclusion Although we found a negative correlation between progranulin and ESR, we did not find any association between progranulin and disease activity in patients with axSpA. There is a need for new and larger studies to be conducted with a higher number of participants in this patient group and to measure serum PGRN levels as well as antibodies against PGRN.Öğe Serum prolidase Activity in Ankylosing spondylitis and Rheumatoid Arthritis(Sage Publications Ltd, 2013) Ucar, Demet; Em, Serda; Bozkurt, Mehtap; Oktayoglu, Pelin; Yuksel, Hatice Kurt; Caglayan, Mehmet; Gezer, OrhanThe aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups (P, 0.001/P = 0.002). No statistically significant difference was found between the RA and the control groups (P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.Öğe Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia(Taylor & Francis Ltd, 2014) Bozkurt, Mehtap; Caglayan, Mehmet; Oktayoglu, Pelin; Em, Serda; Batmaz, Ibrahim; Sariyildiz, Mustafa Akif; Nas, KemalObjective: This study was performed to investigate serum prolidase enzyme activity and oxidative stress in patients diagnosed with fibromyalgia (FM). Methods: The study population consisted of 40 patients with a previous diagnosis of FM and 30 healthy subjects. We measured serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) levels. Results: On average, FM patients were diagnosed within 3.2 years of symptom onset, and patients had a mean of 14 tender points. There were no significant differences between patients and controls in age, body mass index, serum TAS, or PON-1 levels. However, patients with FM demonstrated higher serum prolidase activity, TOS, and OSI than the control group. Serum prolidase activity was positively correlated with serum TOS, OSI, and visual analog scale pain and fatigue scores. No correlation was found between serum prolidase activity and FM duration or the average number of tender points. Discussion: Our results demonstrate a previously unreported association between serum prolidase enzyme activity and FM. Increased prolidase activity may contribute to the pathogenesis of FM, and measuring serum prolidase enzyme activity may be a useful FM biomarker.Öğe SERUM PROLIDASE ENZYME ACTIVITY AND OXIDATIVE STATUS IN PATIENTS WITH SCLERODERMA(Carbone Editore, 2014) Bozkurt, Mehtap; Dag, Evin; Oktayoglu, Pelin; Em, Serda; Yuksel, Hatice; Caglayan, Mehmet; Sariyildiz, Mustafa AkifObjective: To assess serum prolidase enzyme activity and oxidative stress in patients with scleroderma (also known as systemic sclerosis, or SSc) and determine its relationship with serum oxidative status. Methods: The study population consisted of SSc patients (n = 21) and healthy participants (n =29). Serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (051), and paraoxonase-1 (PON-1) levels were compared betweeen the two groups. Results: The mean duration of SSc involvement was 5 years; and the mean modified Rodnan skin score was 16. No statistically significant differences existed between the SSc groups and the control participants in terms of age, gender, TAS, PON-I, and haematocrit levels. Serum prolidase activity, 051, and TOS levels were statistically significantly higher in SSc patients in comparison with controls participants. Also serum prolidase activity was statistically higher in Raynaud's phenomenon positive patients than Raynaud's phenomenon negative patients. But no correlation emerged between the serum prolidase activity and modified Rodnan Skin Score (P=0.235, r=0.304). Conclusion: High prolidase activity may indicate critical biological activities relevant to pathological events in SSc, and this activity may be a biological indicator of disease. Further studies are needed to verify these findings.
