Objective Bilirubin is a bile pigment with potent anti-oxidant properties; in previous studies it has been reported to be negatively associated with coronary artery disease (CAD). Although elevated serum bilirubin concentrations may protect against endothelial dysfunction, it is not clear whether higher serum bilirubin levels (SBLs) in physiological ranges may work in favor of good collateral development in patients with chronic total coronary occlusion (CTO). Methods The study population consisted of patients who underwent coronary angiography with a suspicion of CAD. Patients who had CTO in at least one major coronary artery were included. Coronary angiograms of 179 eligible patients from our database were reanalyzed and 110 of them had good collateral development and 69 had poor collateral development according to the Cohen-Rentrop method. Results Patients with good collateral development had a lower fasting plasma glucose level (FPG) (p= 0.024) and higher SBLs in comparison to patients with poor collateral development (p<0.001). The number of CTO vessels (p=0.013) and left ventricular ejection fraction (EF%) were higher in good collateral group than poor collateral group (p=0.017). In multivariate analysis, FPG negatively (odds ratio [OR]: 0.981, p= 0.003) and SBL (OR for per 0.1-mg/dL increase: 1.832, p<0.001) and the number of CTO vessels (OR: 5.642, p=0.007) were positively related to coronary collateral development. Conclusion This study suggests that higher bilirubin levels within relatively normal ranges were related with favorable coronary collateral growth in patients with CTO. SBL may be responsible for the difference in coronary collateral vessel development among different patients with coronary artery disease. The antiinflammatory and anti-oxidant properties of bilirubin may mediate this effect.

In this study, the physical characteristics and metal contents of particulate matter (PM) have been determined. In this scope, PM sampling has been done at 5 stations (Avcılar, Beşiktaş, Kilyos, Rasathane, Göztepe) for 2 years. PM filter samples were collected for 8 different size(<0.43 µm, 1-0.43 µm, 1-1.7 µm, 1.7-2.6 µm, 2.6-3.5 µm, 3.5-5 µm, 5.2-6.5 µm, 6.5-8 µm and >8 µm) using the cascade impactor. PM filters were decomposed and analyzed for 8 metals (Cr, Mn, Fe, Cu, Pb, Ni, Cd and V). According to the results, trace element concentrations at all the stations were at least 2 times higher than at the Kilyos station which was selected as the urban background station. Pb, Cd and V elements are mainly present in fine fraction of PM, while Cu, Mn and Fe mass is found in coarse fraction of PM. Mass Median Aerodynamic Diameter (MMAD) values for crustal element (Fe, Cr, Cu and Mn) were found to be in the coarse size fraction and anthropogenic element (Pb, Cd and V) were found to be in the fine particles. The major PM source was observed industrial facilities at the Avcılar; traffic and domestic heating at the Beşiktaş, Göztepe and Rasathane.

BackgroundFamilial Mediterranean fever (FMF) is a disease having inflammatory attacks.1 Systemic inflammation has an important role in the etiology of endothelial dysfunction. Fibroblast Growth Factor 23 (FGF-23) is expressed by osteoblasts and needs serum soluble klotho. FGF-23 provides phosphate regulation. Increased FGF-23 is associated endothelial dysfunction.2 An invasive way of measuring endothelial dysfunction is Flow-Mediated dilatation (FMD).3 ObjectivesTo investigate the possible relationship between FGF23, serum soluble klotho levels and FMD in patients with FMF and healthy subjects.MethodsBetween March 2017 - September 2017, sixty -FMF patients that following-up at Cumhuriyet University Medical Faculty Rheumatology-Internal Medicine Department and thirty healthy volunteers were included into the study. Blood samples were taken from all participants and serum soluble klotho, FGF23 values were measured. Clinical findings of all patients were recorded. Blood tests were examined by Elisa method in Cumhuriyet University Department of Biochemistry. FMD assessed by Doppler ultrasound in all participants.ResultsMean serum FGF 23 level was measured as 221.01 pg/ml pg in FMF group and 99.4 pg/ml in healthy control (HC) group. There was statistically significant difference between two groups (p<0.05). The mean serum levels of serum soluble Klotho was measured as 3.0 pg/ml FMF group and 8.25 pg/ml in the HC group. There was statistically significant difference between the two groups (p<0.05) (figure 1). The mean percentage of FMD was measured as 10.1 in FMF group and 13.6 in the HC group. There was statistically significant difference between the two groups (p<0.05).Abstract THU0608 – Figure 1Serum Levels of FGF-23 and Serum Soluble klotho in FMF patients and control groupConclusionsWe found that high FGF 23 levels in FMF patients caused a significant decrease in FMD. In addition, FGF23 may be a parameter for the early diagnosis and prognosis of possible cardiovascular events showing significant change in FMD which demonstrates endothelial dysfunction indirectly.References[1] Sahin A, Karakus S, Durmaz Y, et al. Evaluation of Ovarian Reserve with Anti-Müllerian Hormone in Familial Mediterranean Fever. Int J Rheumatol2015;2015:380354. doi:10.1155/2015/380354. Epub 2015 May 12[2] Silswal N, Touchberry CD, Daniel DR, et al. FGF23 directly impairs endothelium-dependent vasorelaxation by increasing superoxide levels and reducing nitric oxide bioavailability. Am J Physiol Endocrinol Metab2014Sep 1;307(5).[3] Ghiadoni L, Salvetti M, Muiesan ML, Taddei S. Evaluation of endothelial function by flow mediated dilation: methodological issues and clinical importance. High Blood Press Cardiovasc Prev2015Mar;22(1):17–22.Acknowledgements: We would like to thank to ”Cumhuriyet University Scientifical Projects Unit (CUBAP)” for funding this project.Disclosure of InterestNone declared

BackgroundIn the treatment of chronic neck pain (CNP), education, medical treatment, exercise and physical therapy (PT) modalities are in place. However, there are not enough studies on the efficacy of PT modalities in CNPObjectivesTo evaluate the effectiveness of the addiction of PT modalities to exercise and medical treatment in relieving pain and improving the funcitonal status of patient with CNPMethods80 patients with CNP were included in a randomised, controlled trial. Patients were assigned in two groups randomly. Treatment group (TG) recieved convantional PT (hot pack (HP), ultrasound (US), Transcutaneous Electrical Nerve Stimulation (TENS)) treatment in addition.PT was applied ten sessions.HP treatment was applied in 20 min.US treatment was applied with 1,5watt/cm² dose and continuous type in 10 min.TENS treatment was applied with conventional type in 30 min. All patients were informed about correct posture and daily life activities. Both groups received home-based exercises program and analgesic medical treatment if it is necessary. Patients were evaluated before and after therapy and 3th month later by Visual Analogue Scale (VAS), cervical range of motion (ROM), Beck Depression Scale (BDS) and short form-36 (SF-36)ResultsIn both groups there is significant improvement in VAS, cervical ROM, SF 36 and BDS after treatment (p<0.01). In TG significant improvement was seen on 3th month follow up. But the significant improvement was not seen on 3th month in control group (CG).There is no significant difference between groups for VAS, SF-36 parameters and BDS before and after treatment (p>0.05). There was a significant improvement in VAS, SF-36 parameters and BDS in the TG compared with the CG at the end of therapy and 3 months post-treatment (p < 0.01)ConclusionsMedical treatment and exercise with HP, US and TENS therapy was effective on both pain and disability during the treatment. This improvement keep on 3th month follow up. Also same improvement was seen on mood and life qualty. Exercise has better effects on after treatment, but these goods effects decrease on 3th month follow up. So we think physical medicine modalities should be used in CNP with disabilityReferences[1] Binder A.The diagnosis and treatment of nonspecific neck pain and whiplash.Eura Medicophys2007;43:79–89.[2] Leaver AM, Refshauge KM, Maher CG, et al. Conservative interventions provide short-term relief for non-specific neck pain. J Physiother2010;56:73–84.[3] Wang WTJ, Olson SL, Campbell AH, et al.Effectiveness of Physical Therapy for Patients with Neck Pain. A Individualized Approach Using a Clinical Decision-Making Algorithm. Am J Phys Med Rehabil2003;82:203–218.Disclosure of InterestNone declared