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Çimen Güneş E, Çolak S, Şenlik ZB, Tekgöz E, Altunay K, Özdemirkan T, Aytaç BC, Şimşek AÇ, Çınar M, Yılmaz S. Look after the COVID-19 pandemic: Mortality rates among patients with rheumatic diseases. Int J Rheum Dis 2024; 27:e15129. [PMID: 38514928 DOI: 10.1111/1756-185x.15129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/18/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
AIM Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may have a more severe course in patients with underlying disease or who have had immunosuppression. In this study, it was aimed to determine the frequency of coronavirus disease 2019 (COVID-19) and the mortality rates related to COVID-19 among patients with rheumatic disease. METHODS The patients who were followed up with rheumatic disease in the rheumatology outpatient clinic in a tertiary hospital were retrospectively assessed if they had COVID-19 infection or not between March 2020 and January 2022. RESULTS A total of 10 682 patients were evaluated. There were 2928 (27.4%) COVID-19-positive and 7754 (72.6%) COVID-19-negative patients. The mean age of COVID-19-positive patients was 46.2 ± 14.6 years, and 65.8% were female. Forty-two (1.4%) patients died due to COVID-19. Among COVID-19-negative patients, 192 patients died. The most common rheumatic disease among patients with COVID-19 was spondyloarthritis (SpA) (30.4%). Corticosteroids were the most common treatment agent in COVID-19-positive patients regardless of mortality. Thirty-one (73.8%) patients were receiving corticosteroids, and 35 (83.3%) patients were receiving immunosuppressive agents among patients with mortality. According to the logistic regression analysis, older age, male gender, and receiving corticosteroid, hydroxychloroquine, mycophenolate mofetil, tofacitinib, rituximab, and cyclophosphamide were found to be related to increased mortality. CONCLUSION COVID-19 is a serious infection and the current study emphasized that patients with rheumatic diseases had increased mortality rates, particularly in patients who were old, male, and on immunosuppressive treatments.
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Affiliation(s)
- Ezgi Çimen Güneş
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | - Baran C Aytaç
- Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Asiye Ç Şimşek
- Department of Public Health, Gulhane School of Medicine, University of Health Science, Ankara, Turkey
| | - Muhammet Çınar
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Sedat Yılmaz
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Tekgöz N, Tekgöz E, Çolak S, Sezer M, Çelikel E, Tekin Z, Çınar M, Yılmaz S, Acar B. Age-related differences in the clinical phenotypes of Behçet's disease: The experience of two referral centres. Mod Rheumatol 2023; 34:194-200. [PMID: 36688579 DOI: 10.1093/mr/road012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Behçet's disease (BD) is a multisystem disease and frequently occurs during the second-fourth decades of life, although disease onset may be seen at any age. This study aimed to analyze the influence of the age of onset on clinical manifestations of BD. MATERIALS AND METHODS This retrospective study analyzed two cohorts (paediatric and adult) to determine the association between the age of onset and clinical features in BD. Patients were classified into four groups to analyze the clinical characteristics according to the age of fulfilling the BD diagnostic criteria as follows: childhood onset (<12 years), adolescent onset (13-17 years), adult onset (18-39 years), and late onset (>40 years). RESULTS The study included 801 patients with BD. Male predominance, pathergy test positivity, aphthosis (oral or genital), and skin and ocular involvements were higher among adult patients than paediatric patients. The presence of positive family history for BD, neuro-BD, and epididymitis were observed significantly common in the paediatric group. CONCLUSION There may be differences in clinical manifestations with regard to the age of disease onset. Disease presentations may differ from adult patients, and clinicians should be aware of the high familial aggregation rate of BD, especially in countries where the disease is endemic.
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Affiliation(s)
- Nilüfer Tekgöz
- Ankara City Hospital, Department of Pediatric Rheumatology, University of Health Sciences, Ankara, Turkey
| | - Emre Tekgöz
- Gulhane Faculty of Medicine, Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Seda Çolak
- Gulhane Faculty of Medicine, Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Müge Sezer
- Ankara City Hospital, Department of Pediatric Rheumatology, University of Health Sciences, Ankara, Turkey
| | - Elif Çelikel
- Ankara City Hospital, Department of Pediatric Rheumatology, University of Health Sciences, Ankara, Turkey
| | - Zahide Tekin
- Ankara City Hospital, Department of Pediatric Rheumatology, University of Health Sciences, Ankara, Turkey
| | - Muhammet Çınar
- Gulhane Faculty of Medicine, Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Sedat Yılmaz
- Gulhane Faculty of Medicine, Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Banu Acar
- Ankara City Hospital, Department of Pediatric Rheumatology, University of Health Sciences, Ankara, Turkey
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Çimen Güneş E, Çolak S, Tekgöz E, Çınar M, Yılmaz S. Golimumab-induced posterior reversible encephalopathy syndrome (PRES): a case-based review. Clin Rheumatol 2023; 42:3407-3410. [PMID: 37715081 DOI: 10.1007/s10067-023-06771-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/27/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state which is characterized by seizures, headache, visual disturbances, paresis, and altered mental status. Golimumab is anti-tumor necrosis factor-α inhibitor (anti-TNF-α) that can be used in the treatment of rheumatologic diseases. Here, we present a patient who had developed PRES after golimumab treatment for ankylosing spondylitis (AS). A 45-year-old female patient was admitted to the emergency service with a newly onset severe headache, loss of vision in both eyes, and two generalized tonic-clonic seizures that lasted for 3 to 4 min. The patient had the diagnoses of AS for 12 years and hypertension for 3 years and receiving golimumab and carvedilol. The patient was diagnosed with PRES based on the current clinical and diffusion cranial magnetic resonance imaging (MRI) findings. On suspicion of being the trigger of this situation, golimumab was stopped. After starting anti-convulsant therapy and controlling blood pressure, the neurological findings recovered rapidly and no seizures were seen. Control MRI images, in the first month's visit, were normal. Although chemotherapeutic agents are well-known causes of PRES, there are few reported cases with anti-TNF-α agents in the literature. To our knowledge, this is the first case that developed PRES after golimumab. Demyelinating diseases are the most frightening neurologic complication of anti-TNF-α treatment; however, PRES should come to mind in patients presenting with neurological symptoms.
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Affiliation(s)
- Ezgi Çimen Güneş
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Muhammet Çınar
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Sedat Yılmaz
- Department of Internal Medicine, Division of Rheumatology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Kaya MN, Tekgöz E, Çolak S, Kılıç Ö, Çınar M, Yılmaz S. Drug-free remission is an achievable target with immunosuppressive treatment in idiopathic granulomatous mastitis. Ir J Med Sci 2023; 192:2815-2819. [PMID: 36928595 DOI: 10.1007/s11845-023-03338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease, in which there is no clear established treatment algorithm. Several physicians keep away from using immunosuppressive (IS) treatments in routine clinical practice. AIMS This study aimed to evaluate the rates of drug-free remission of the patients with IGM in a period of 3-year follow-up. METHODS This retrospective study conducted with 55 biopsy-proven IGM patients, who were followed up between February, 2011, and November, 2021, in rheumatology outpatient clinic of Gulhane Training and Research Hospital. The demographic and clinical characteristics of the patients were obtained from patients' files. The 3-year follow-up data were assessed for long-term outcome analyses. RESULTS There were 55 female patients with a mean age of 36.8 ± 6.3 years. Fifty-four (98.1%) patients were in drug-free remission at the end of 3 years. The median duration of drug-free remission in patients receiving methotrexate (MTX), only corticosteroid (CS), and azathioprine was 19.7, 32.9, and 14.7 months, respectively. The drug-free remission duration for the patient who received cyclosporine A as IS was 28.3 months. The median duration of IS treatment was 15.8 months, and the median duration of treatment with CS and other IS combination was 6.7 months. Recurrence was observed in 4 (80%) patients without IS therapy after surgery, of whom MTX was used in 3 (75%) patients and achieved remission. CONCLUSIONS IS agents provide high rate of prolonged drug-free remission and should be considered a part of routine medical care of the patients with IGM.
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Affiliation(s)
- Mehmet Nur Kaya
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.
| | - Emre Tekgöz
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Seda Çolak
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Özlem Kılıç
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Muhammet Çınar
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Sedat Yılmaz
- Rheumatology Department, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
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Çandereli ZÖ, Arslan T, Özdamar Ö, Yay M, Karaçayli Ü, Şişman-Kitapçi N, Adesanya A, Aksoy A, Belem JMFM, Taş MN, Cardin NB, Sacoor S, Gokani B, Armağan B, Sari A, Bozca BC, Tekgöz E, Desai P, Temiz Karadağ D, Badak SÖ, Tecer D, Bibi A, Yildirim A, Bes C, Şahin A, Erken E, Cefle A, Çinar M, Yilmaz S, Alpsoy E, Boyvat A, Şenel S, Yaşar Bilge Ş, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, Inanç N, Ergun T, Madanat W, de Souza AWS, Direskeneli H, Fortune F, Mumcu G. Does decision tree analysis predict oral ulcer activity-related factors in patients with Behçet's syndrome? Clin Exp Rheumatol 2023; 41:2078-2086. [PMID: 37902270 DOI: 10.55563/clinexprheumatol/5kr2b1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVES The study aimed to identify the interactions among treatment protocols and oral ulcer activity related factors in patients with Behçet's syndrome (BS) using the Classification and Regression Tree (CART) algorithm. METHODS In this cross-sectional study, 979 patients with BS were included from16 centres in Turkey, Jordan, Brazil and the United Kingdom. In the CART algorithm, activities of oral ulcer (active vs. inactive), genital ulcer (active vs. inactive), cutaneous involvement (active vs. inactive), musculoskeletal involvement (active vs. inactive), gender (male vs. female), disease severity (mucocutaneous and musculoskeletal involvement vs. major organ involvement), smoking habits (current smoker vs. non-smoker), tooth brushing habits (irregular vs. regular), were input variables. The treatment protocols regarding immunosuppressive (IS) or non-IS medications were the target variable used to split from parent nodes to purer child nodes in the study. RESULTS In mucocutaneous and musculoskeletal involvement (n=538), the ratio of IS use was higher in patients with irregular toothbrushing (ITB) habits (27.1%) than in patients with regular toothbrushing (RTB) habits (14.2%) in oral ulcer activity. In major organ involvement (n=441), male patients with ITB habits were more likely treated with IS medications compared to those with RTB habits (91.6% vs. 77.6%, respectively). CONCLUSIONS Male BS patients on IS who have major organ involvement and oral ulcer activity with mucocutaneous and musculoskeletal involvement have irregular toothbrushing habits. Improved oral hygiene practices should be considered to be an integral part for implementing patient empowerment strategies for BS.
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Affiliation(s)
- Zehra Özge Çandereli
- Department of Health Management, Institute of Health Sciences, Marmara University, Istanbul, and Department of Health Management, Faculty of Economics and Administrative Sciences, Izmir Kâtip Celebi University, Izmir, Turkey
| | - Tuncay Arslan
- Department of Health Management, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Özge Özdamar
- Department of Statistics, Faculty of Science and Literature, Mimar Sinan Fine Arts Faculty, Istanbul, Turkey
| | - Meral Yay
- Department of Statistics, Faculty of Science and Literature, Mimar Sinan Fine Arts Faculty, Istanbul, Turkey
| | - Ümit Karaçayli
- Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Nur Şişman-Kitapçi
- Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Adebowale Adesanya
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | - Aysun Aksoy
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Joice M F M Belem
- Division of Rheumatology, Medical School, Universidade Federal de São Paulo, Brazil
| | - Mehmet Nedim Taş
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | | | - Sarah Sacoor
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | - Bindi Gokani
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | - Berkan Armağan
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Alper Sari
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Burçin Cansu Bozca
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey
| | - Pareen Desai
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | | | - Suade Özlem Badak
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Duygu Tecer
- Division of Rheumatology, Sanliurfa Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey
| | - Azimoon Bibi
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | - Alper Yildirim
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Cemal Bes
- Rheumatology Clinic, Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Ali Şahin
- Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey
| | - Eren Erken
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Medical School, Kocaeli University, Turkey
| | - Muhammet Çinar
- Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey
| | - Sedat Yilmaz
- Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey
| | - Erkan Alpsoy
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Ayşe Boyvat
- Department of Dermatology, Medical School, Ankara University, Ankara, Turkey
| | - Soner Şenel
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Gökhan Keser
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Nevsun Inanç
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology Department, Medical School, Marmara University, Istanbul, Turkey
| | - Wafa Madanat
- Medical Department, Jordan's Friends of Behçet's Disease Patients Society, Amman, Jordan
| | | | - Haner Direskeneli
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Farida Fortune
- Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK
| | - Gonca Mumcu
- Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
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Kaya MN, Yurumez S, Tekgöz E, Kılıç Ö, Çınar M, Yılmaz S. The Role of Rheumatologist in Smoking Cessation of Ankylosing Spondylitis Patients: A Single-Center Cross-Sectional Study. Cureus 2023; 15:e45461. [PMID: 37727839 PMCID: PMC10506527 DOI: 10.7759/cureus.45461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Smoking has a well-established detrimental effect on the prognosis and treatment success in patients with ankylosing spondylitis. It is important to encourage and convince patients to quit smoking. We aimed to evaluate the contribution of rheumatologists to smoking cessation in patients with ankylosing spondylitis. METHODS This single-center cross-sectional study was conducted in a tertiary research hospital between March 2022 and June 2022. The data related to demographics, smoking status, duration of smoking, average number of cigarettes smoked per day, reasons for quitting smoking, and methods of quitting smoking were obtained through face-to-face interviews. RESULTS This study was carried out on 308 patients. A total of 102 ankylosing spondylitis patients quit smoking. Of the patients who quit smoking, 39 (38.3%) patients quit smoking with a recommendation of a rheumatologist and 29 (28.4%) patients quit because of their concerns related to ankylosing spondylitis disease. The most commonly used methods for quitting smoking were herbal supplements in 40 (39.2%) patients and medication for smoking cessation in 40 (39.2%) patients. CONCLUSIONS It has been shown that about one-fifth of ankylosing spondylitis patients are not questioned by a rheumatologist about smoking. On the other hand, it was seen that the factor with the greatest effect on those who quit smoking was the rheumatologist. Therefore, rheumatologists should question all ankylosing spondylitis patients about smoking and encourage smokers to quit in order to achieve better outcomes in the long term.
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Affiliation(s)
- Mehmet Nur Kaya
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
| | - Seda Yurumez
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
| | - Emre Tekgöz
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
| | - Özlem Kılıç
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
| | - Muhammet Çınar
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
| | - Sedat Yılmaz
- Rheumatology, Gülhane Training and Research Hospital, Ankara, TUR
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Özgürtaş T, Yücel Ç, Sertoğlu E, Hayran Y, Çolak S, Tekgöz E, Omma A, Durukan AH. Evaluation of the relationship of lymphangiogenesis markers with disease pathogenesis in patients with Behçet's uveitis. Acta Clin Belg 2022; 77:387-395. [PMID: 33629934 DOI: 10.1080/17843286.2021.1890451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The present study aims to evaluate the relationship between Behçet's uveitis and lymphangiogenesis by determining levels of Vascular endothelial growth factor-C (VEGF-C, its receptors sVEGFR-2, sVEGFR-3 and lymphangiogenesis markers podoplanin (PDPN) and lymphatic vessel endothelial hyaluronan receptor 1(LYVE-1), and C-type lectin domain family 1 member B (CLEC2). MATERIALS AND METHODS 55 patients with BD uveitis and 31 healthy control subjects were enrolled in the study. RESULTS sVEGFR-2, sVEGFR-3, VEGF-C/sVEGFR-2 ratio, PDPN and LYVE-1 levels were higher in the patient group. A positive correlation was found between LYVE-1 and hsCRP levels. PDPN had a strong predictive value for progression with a cut-off value of 2 pg/mL, with 69% sensitivity and 68% specificity (p = 0.001). CONCLUSION LYVE-1 and PDPN can be good representatives of the ongoing inflammatory processes in BD uveitis and point out that the disease can be related to lymphangiogenesis.
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Affiliation(s)
- Taner Özgürtaş
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Çiğdem Yücel
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdim Sertoğlu
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yıldız Hayran
- Department of Dermatology, Ankara City Hospital, Ankara, Turkey
| | - Seda Çolak
- Department of Rheumatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Emre Tekgöz
- Department of Rheumatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Omma
- Department of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Ali Hakan Durukan
- Department of Ophthalmology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Kalyoncu U, Bilgin E, Erden A, Satış H, Tufan A, Tekgöz E, Ateş A, Coşkun BN, Yağız B, Küçükşahin O, Yazısız V, Kimyon G, Bes C, Başıbüyük CS, Alkan S, Cesur TY, Ertenli İ, Kiraz S. Efficacy and safety of tofacitinib in rheumatoid arthritis-associated interstitial lung disease: TReasure real-life data. Clin Exp Rheumatol 2021; 40:2071-2077. [DOI: 10.55563/clinexprheumatol/9h6dtb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Hasan Satış
- Division of Rheumatology, Department of Internal Medicine, Gazi University, Medical Faculty, Ankara, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Gazi University, Medical Faculty, Ankara, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine, Ankara, Turkey
| | - Aşkın Ateş
- Division of Rheumatology, Department of Internal Medicine, Ankara University, Medical Faculty, Ankara, Turkey
| | - Belkıs Nihan Coşkun
- Division of Rheumatology, Department of Internal Medicine, Uludag University, Medical Faculty, Bursa, Turkey
| | - Burcu Yağız
- Division of Rheumatology, Department of Internal Medicine, Uludag University, Medical Faculty, Bursa, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, Medical Faculty, Ankara, Turkey
| | - Veli Yazısız
- Division of Rheumatology, Department of Internal Medicine, Akdeniz University, Medical Faculty, Antalya, Turkey
| | - Gezmiş Kimyon
- Division of Rheumatology, Department of Internal Medicine, Mustafa Kemal University, Medical Faculty, Hatay, Turkey
| | - Cemal Bes
- University of Health Sciences Basaksehir Cam and Sakura State Hospital, Istanbul, Turkey
| | | | | | | | - İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey
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Yaşar Bilge NŞ, Kalyoncu U, Atagündüz P, Dalkılıç E, Pehlivan Y, Küçükşahin O, Bes C, Akar S, Cinar M, Emmungil H, Ersözlü D, Ateş A, Mercan R, Kimyon G, Koca SS, Gonullu E, Yazisiz V, Tekgöz E, Alpay-Kanitez N, Erden A, Kiraz S, Coskun BN, Yağız B, İlgen U, Karadağ Ö, Kilic L, Ertenli İ, Kasifoglu T. Uveitis-related Factors in Patients With Spondyloarthritis: TReasure Real-Life Results. Am J Ophthalmol 2021; 228:58-64. [PMID: 33826929 DOI: 10.1016/j.ajo.2021.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE Spondyloarthritis (SpA) is a group of diseases with overlapping skeletal and extra-articular features. Acute anterior uveitis (AAU) is the most common extra-articular manifestation of SpA. The relation between AAU and SpA is well defined in the current literature. Our study aims to analyze the frequency and factors associated with AAU in different forms of SpA in a large nationwide cohort of Turkish SpA patients. DESIGN Retrospective cohort study. METHODS The data were obtained from the TReasure database, which compiles data from records of the web-based Rheumatoid Arthritis (RA) and SpA patients treated with biological disease-modifying anti-rheumatismal drugs from different regions of Turkey. The clinical characteristics of SpA and uveitis are recorded. RESULTS Data of the 4,297 SpA patients were included in the study. Overall, 475 of 4,297 patients (11.0%) had experienced 1 or more episodes of uveitis. SpA patients with older age (P < .001), a smoking history (P = .004), delayed diagnosis (P = .001), longer disease duration (P < .001), arthritis (P < .001), positive HLA-B27 (P < .001), a family history of SpA (P < .001), and radiographic damage (presence of sacroiliitis, syndesmophytes, bamboo spine, hip involvement) (P < .001 for all) more commonly had uveitis. On the other hand, uveitis was less prevalent in patients with psoriasis and psoriatic arthritis (P < .001 for both). CONCLUSION Uveitis may be the key feature leading to SpA diagnosis. Patients with radiographic damage and long disease duration have an increased risk for uveitis in both male and female SpA patients. Patients with uveitis should be referred to a rheumatologist for a thorough evaluation of SpA.
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Çolak S, Tekgöz E, Mammadov M, Çınar M, Yılmaz S. Biological treatment in resistant adult-onset Still’s disease: A single-center, retrospective cohort study. Arch Rheumatol 2021; 37:11-18. [PMID: 35949865 PMCID: PMC9326374 DOI: 10.46497/archrheumatol.2022.8669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/26/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives
The aim of this study was to assess the demographic and clinical characteristics of patients with adult-onset Still’s disease (AOSD) under biological treatment. Patients and methods
This retrospective cohort study included a total of 19 AOSD patients (13 males, 6 females; median age: 37 years; range, 28 to 52 years) who received biological drugs due to refractory disease between January 2008 and January 2020. The data of the patients were obtained from the patient files. The response to the treatment was evaluated based on clinical and laboratory assessments at third and sixth follow-up visits. Results
Interleukin (IL)-1 inhibitor was prescribed for 13 (68.4%) patients and IL-6 inhibitor prescribed for six (31.6%) patients. Seventeen (89.5%) patients experienced clinical remission. Conclusion
Biological drugs seem to be effective for AOSD patients who are resistant to conventional therapies. Due to the administration methods and the high costs of these drugs, however, tapering the treatment should be considered, after remission is achieved.
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Affiliation(s)
- Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Maghrur Mammadov
- Department of Internal Medicine, Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Muhammet Çınar
- Department of Internal Medicine, Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Sedat Yılmaz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
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11
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Çolak S, Tekgöz E, Mammadov M, Çınar M, Yılmaz S. Biological treatment in resistant adult-onset Still’s disease: A single-center, retrospective cohort study. Arch Rheumatol 2021. [DOI: 10.46497/archrheumatol.2021.8669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives: The aim of this study was to assess the demographic and clinical characteristics of patients with adult-onset Still’s disease (AOSD) under biological treatment.
Patients and methods: This retrospective cohort study included a total of 19 AOSD patients (13 males, 6 females; median age: 37 years; range, 28 to 52 years) who received biological drugs due to refractory disease between January 2008 and January 2020. The data of the patients were obtained from the patient files. The response to the treatment was evaluated based on clinical and laboratory assessments at third and sixth follow-up visits.
Results: Interleukin (IL)-1 inhibitor was prescribed for 13 (68.4%) patients and IL-6 inhibitor prescribed for six (31.6%) patients. Seventeen (89.5%) patients experienced clinical remission.
Conclusion: Biological drugs seem to be effective for AOSD patients who are resistant to conventional therapies. Due to the administration methods and the high costs of these drugs, however, tapering the treatment should be considered, after remission is achieved.
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12
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Tekgöz E, Çolak S, Çınar Fİ, Yılmaz S, Çınar M. Non-adherence to colchicine treatment is a common misevaluation in familial Mediterranean fever. Turk J Med Sci 2021; 51:2357-2363. [PMID: 33957721 DOI: 10.3906/sag-2102-328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/06/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease that requires lifelong colchicine treatment. Colchicine is the mainstay of the treatment which decreases the frequency and the severity of recurrent FMF attacks, also, prevents the development of amyloidosis. This study aimed to investigate the rates of colchicine treatment adherence in patients with FMF and the factors related to treatment non-adherence. MATERIALS AND METHODS This observational study was conducted with 179 patients with FMF between November 2018 and April 2019 in a tertiary rheumatology outpatient clinic. The sociodemographic and clinical data were recorded. Compliance Questionnaire on Rheumatology (CQR) was used to assess the treatment adherence and the Beliefs About Medicines Questionnaire (BMQ-T) was used to assess a patient?s beliefs about colchicine. The factors associated with adherence to the treatment were evaluated. RESULTS The study included 113 male (63.1%) and 66 (36.9%) female patients with a mean age of 30 (25-44) years. The rate of the patients who declared regular colchicine usage was 66.5%. The frequency of non-adherent patients was 83.8% according to CQR. Treatment adherence was better in patients with comorbid diseases than those without (41.4% vs. 22%, respectively, p = 0.028). The frequency of married patients in the adherent group (72.4%) was higher than the non-adherent group (47.3%) (p = 0.013). The colchicine dose used in the adherent group was 1.5 (1.3-1.8) mg/day, whereas it was 1.5 (1.0-1.5) mg/day in the non-adherent group (p = 0.033). The adherence rate was rising with increasing scores of BMQ-T Specific Necessity. As the scores of BMQ-T General Overuse and General Harm increased, non-adherence to colchicine increased. CONCLUSION Evaluating adherence to colchicine treatment with objective methods is crucial to ensure sufficient treatment and prevent amyloidosis. Determining beliefs about colchicine may increase patients? adherence to treatment.
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Affiliation(s)
- Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Seda Çolak
- Division of Rheumatology, Department of Internal Medicine, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Fatma İlknur Çınar
- Department of Internal Medicine Nursing, Gülhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
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13
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Tekgöz E, Çolak S, Çinar M, Yilmaz S. Comment on ‘Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence’. Turk J Med Sci 2020; 50:2073-2074. [PMID: 32892544 PMCID: PMC7775682 DOI: 10.3906/sag-2006-80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/29/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Muhammet Çinar
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sedat Yilmaz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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14
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Çınar Fİ, Sinan Ö, Yılmaz S, Bağçivan G, Aydoğan I, Yalçın AG, Tekgöz E, Çınar M. Use of complementary and alternative medicine in patients with ankylosing spondylitis. Eur J Rheumatol 2020; 8:20-26. [PMID: 33196421 DOI: 10.5152/eurjrheum.2020.20111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Some studies have shown that the use of complementary and alternative medicine (CAM) is common in patients with chronic painful conditions, such as ankylosing spondylitis (AS). This study aimed to determine the prevalence and types of CAM usage in patients with AS and to evaluate the impact of treatment adherence and beliefs about medicines on CAM usage. METHODS This study has a descriptive design. A total of 140 patients with AS were included. The treatment adherence of the patients was evaluated using the Morisky Green Levine Medication Adherence Scale. The Beliefs about Medicines Questionnaire (BMQ-T) was used to assess patients' beliefs about medicines. RESULTS Previous or current CAM usage was stated by 40% of the patients. It has been found that CAM usage was significantly high (p<0.05) in patients who were married, older, and diagnosed at older ages. The difference between patients' beliefs about medicines and CAM usage was not statistically significant (p>0.05). The BMQ-T scores were significantly different in terms of the patients' treatment adherence (p<0.05). CONCLUSION This study showed that approximately half of the patients with AS were using 1 CAM method. Furthermore, medication adherence and patients' beliefs about medicines did not have any impact on CAM usage, but the patients' beliefs about medicines affected treatment adherence.
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Affiliation(s)
- Fatma İlknur Çınar
- Department of Internal Medicine Nursing, University of Health Sciences Turkey, Gülhane Faculty of Nursing, Ankara, Turkey
| | - Özlem Sinan
- Department of Nursing, Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
| | - Gülcan Bağçivan
- Department of School of Nursing, Koç University, İstanbul, Turkey
| | - Işıl Aydoğan
- Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ayşe Gül Yalçın
- Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
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15
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Mumcu G, Yay M, Karaçaylı Ü, Aksoy A, Taş MN, Armağan B, Sarı A, Bozca BC, Tekgöz E, Temiz Karadağ D, Badak SÖ, Tecer D, Yıldırım A, Bes C, Şahin A, Erken E, Cefle A, Çınar M, Yılmaz S, Alpsoy E, Boyvat A, Şenel S, Bilge ŞY, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H. Moderation analysis exploring associations between age and mucocutaneous activity in Behçet's syndrome: A multicenter study from Turkey. J Dermatol 2020; 47:1403-1410. [PMID: 32981075 DOI: 10.1111/1346-8138.15553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/19/2020] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to examine the effects of age on mucocutaneous activity by using moderation analysis in Behçet's syndrome (BS). In this cross-sectional study, 887 BS patients (female : male, 481:406; mean age, 38.4 ± 10.9 years) followed in 13 tertiary centers in Turkey were included. Mucocutaneous activity was evaluated by using the Mucocutaneous Index (MI) according to sex and disease course. Moderation analysis was performed to test the effect of age on mucocutaneous activity. A moderator variable is a third variable and affects the relationship between independent and outcome variables. Age was chosen as a potential moderator variable (interaction effect), MI score as the outcome variable and sex as an independent variable in the analysis. The moderation analysis tested the effects of age in three steps: whole BS patient group, patients without systemic involvement and those with systemic involvement. The moderation model was only significant in BS patients with systemic involvement (P = 0.0351), and a significant relationship was observed between female sex and MI score (P = 0.0156). In addition, the interaction plot showed that female patients had increased MI scores compared with male patients, especially in the 28-year-old age group (P = 0.0067). Moreover, major organ involvement was newly diagnosed in the majority of these young female BS patients. Our results suggest that the relationship between sex and mucocutaneous activity was moderated by age in the systemic involvement group. Also, increased mucocutaneous activity may be associated with new major organ involvement in young female BS patients with systemic involvement.
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Affiliation(s)
- Gonca Mumcu
- Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Meral Yay
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey
| | - Ümit Karaçaylı
- Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, Ankara, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Mehmet Nedim Taş
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Burçin Cansu Bozca
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Duygu Temiz Karadağ
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Suade Özlem Badak
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Duygu Tecer
- Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey
| | - Alper Yıldırım
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Cemal Bes
- Istanbul Bakırköy Dr. Sadi Konuk Education and Research Hospital, Rheumatology Clinic, Istanbul, Turkey
| | - Ali Şahin
- Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey
| | - Eren Erken
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Erkan Alpsoy
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Ayşe Boyvat
- Department of Dermatology, Medical School, Ankara University, Ankara, Turkey
| | - Soner Şenel
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Gökhan Keser
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology Department, Medical School, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
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Tekgöz E, Çolak S, Çinar M, Yilmaz S. Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence. Turk J Med Sci 2020; 50:1380-1386. [PMID: 32394683 PMCID: PMC7491308 DOI: 10.3906/sag-2003-93] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background/aim Idiopathic granulomatous mastitis is a rare, benign inflammatory disease of breast. There is no general agreement on the appropriate treatment choice. The aim of the study was to investigate the immunosuppressive administer for idiopathic granulomatous mastitis and risk factors related with disease recurrence. Materials and methods The data of 53 patients with idiopathic granulomatous mastitis were evaluated for this cross-sectional retrospective study. Demographic features and clinical characteristics and course of the patients were obtained from file records. Results The mean age of the patients was 37.2 ± 6.6 years. Fifty-one of 53 patients received immunosuppressive treatment with or without surgery. Forty-seven (88.6%) of the patients received only immunosuppressive treatment without surgery, while 4 (7.54%) patients received immunosuppressive treatment after surgery. Forty-one (77.3%) of 47 patients who had no surgical resection received methotrexate as immunosuppressive treatment. The other 6 (11.3%) patients received azathioprine or corticosteroid treatment. Complete or partial remission was observed in 50 (98%) of 51 patients who received immunosuppressive treatment, while only 1 (2%) patient did not reach remission. No factors were found related with recurrence of disease. Conclusion Methotrexate seems to be efficient in the treatment of idiopathic granulomatous mastitis and provides drug-free remission.
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Affiliation(s)
- Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Muhammet Çinar
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - Sedat Yilmaz
- Department of Internal Medicine, Division of Rheumatology, Gülhane Faculty of Medicine, University of Health Sciences Turkey, Ankara, Turkey
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Mumcu G, Yay M, Aksoy A, Taş MN, Armağan B, Sarı A, Bozca BC, Tekgöz E, Karadağ DT, Badak SÖ, Tecer D, Bes C, Şahin A, Erken E, Cefle A, Çınar M, Yılmaz S, Karaçaylı Ü, Alpsoy E, Şenel S, Yaşar Bilge Ş, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H. Predictive factors for work-day loss in Behçet's syndrome: A multi-center study. Int J Rheum Dis 2019; 23:240-246. [PMID: 31858715 DOI: 10.1111/1756-185x.13771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this multi-center study was to assess predictive factors for work-day loss as an indirect cost element in Behçet's syndrome (BS). METHODS In this cross-sectional, multi-center study, 834 BS patients (F/M: 441/393, age mean: 38.4 ± 10.9 years) were included. Data were collected by a questionnaire regarding treatment protocols, disease duration, smoking pattern, frequency of medical visits during the previous year and self-reported work-day loss during the previous year. RESULTS Work-day loss was observed in 16.2% of patients (M/F: 103/32). The percentages of being a smoker (81.8%), using immunosuppressive (IS) medications (82%), and having disease duration <5 years (74%) were higher in male patients with work-day loss (P < .05). The majority of males (90.9%) had more than four clinic visits during the previous year. Moreover, the mean work-day loss (30.8 ± 57.7 days) was higher in patients with vascular involvement (56.1 ± 85.9) than those without (26.4 ± 50.6 days) (P = .046). In addition, increased frequency of ocular involvement (25.9%) was also observed in patients with work-day loss compared to others (8.6%) (P = .059). CONCLUSION Work-day loss was associated with both vascular and ocular involvement. Close associations were observed among male gender, early period of the disease, frequent medical visits, being a smoker and treatment with IS medications in patients with work-day loss.
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Affiliation(s)
- Gonca Mumcu
- Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Meral Yay
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Mehmet Nedim Taş
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Burçin Cansu Bozca
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Emre Tekgöz
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Duygu Temiz Karadağ
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Suade Özlem Badak
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Duygu Tecer
- Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey
| | - Cemal Bes
- Rheumatology Clinic, Istanbul Bakırköy Dr.Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Ali Şahin
- Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey
| | - Eren Erken
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Muhammet Çınar
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Sedat Yılmaz
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Ümit Karaçaylı
- Gulhane Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Erkan Alpsoy
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Soner Şenel
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Gökhan Keser
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology Department, Medical School, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
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Mumcu G, Karacayli Ü, Yay M, Aksoy A, Taş MN, Armağan B, Sari A, Bozca BC, Tekgöz E, Karadağ DT, Badak SÖ, Tecer D, Bes C, Şahin A, Erken E, Cefle A, Çinar M, Yilmaz S, Alpsoy E, Şenel S, Bilge ŞY, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, Inanç N, Ergun T, Direskeneli H. Oral ulcer activity assessment with the composite index according to different treatment modalities in Behçet's syndrome: a multicentre study. Clin Exp Rheumatol 2019; 37 Suppl 121:98-104. [PMID: 31856935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/18/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The aim of this multicentre study was to understand patients' needs and to evaluate the oral ulcer activity with the Composite Index (CI), according to different treatment modalities in Behçet's syndrome (BS). METHODS BS patients (n=834) from 12 centres participated in this cross-sectional study. Oral ulcer activity (active vs. inactive) and the CI (0: inactive vs. 1-10 points: active) were evaluated during the previous month. The effects of treatment protocols [non-immunosuppressive: non-IS vs. immunosuppressive: (ISs)], severity (mild vs. severe), disease duration (<5 years vs. ≥5 years) and smoking pattern (non-smoker vs. current smoker) were analysed for oral ulcer activity. RESULTS Oral ulcer activity was observed in 65.1% of the group (n=543). In both genders, the activity was higher in mild disease course with non-IS treatment group compared to severe course with ISs (p<0.05). As a resistant group, patients with mild disease course whose mucocutaneous symptoms were unresponsive to non-IS medications were treated with ISs in a limited period and achieved the highest CI scores in females. Oral ulcer activity and poor CI score were associated with disease duration less than 5 years compared to others in male patients (p<0.05). CONCLUSIONS Oral ulcer activity pattern is affected by both the combination of disease course, treatment protocols and disease duration. CI scores reflected the oral clinical activity and CI might be a candidate scale to evaluate the efficacy of treatments during the follow-up of oral ulcer activity in BS.
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Affiliation(s)
- Gonca Mumcu
- Marmara University, Faculty of Health Sciences, Istanbul, Turkey
| | - Ümit Karacayli
- Gulhane Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, University of Health Sciences, Ankara, Turkey.
| | - Meral Yay
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey
| | - Aysun Aksoy
- Marmara University, Medical School, Division of Rheumatology, Istanbul, Turkey
| | - Mehmet Nedim Taş
- Ege University, Medical School, Division of Rheumatology, Izmir, Turkey
| | - Berkan Armağan
- Hacettepe University, Medical School, Division of Rheumatology, Ankara, Turkey
| | - Alper Sari
- Hacettepe University, Medical School, Division of Rheumatology, Ankara, Turkey
| | - Burçin Cansu Bozca
- Akdeniz University, Medical School, Dermatology Department, Antalya, Turkey
| | - Emre Tekgöz
- Gulhane Medical Faculty, Gulhane Education and Research Hospital, Division of Rheumatology, Gulhane, Turkey
| | - Duygu Temiz Karadağ
- Kocaeli University, Medical School, Division of Rheumatology, Kocaeli, Turkey
| | - Suade Özlem Badak
- Cukurova University, Medical School, Division of Rheumatology, Adana, Turkey
| | - Duygu Tecer
- Şanlıurfa Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey
| | - Cemal Bes
- Istanbul Bakırköy Dr.Sadi Konuk Education and Research Hospital, Rheumatology Clinic, Istanbul, Turkey
| | - Ali Şahin
- Cumhuriyet University, Medical School, Division of Rheumatology, Sivas, Turkey
| | - Eren Erken
- Cukurova University, Medical School, Division of Rheumatology, Adana, Turkey
| | - Ayse Cefle
- Kocaeli University, Medical School, Division of Rheumatology, Kocaeli, Turkey
| | - Muhammet Çinar
- Gulhane Medical Faculty, Gulhane Education and Research Hospital, Division of Rheumatology, Gulhane, Turkey
| | - Sedat Yilmaz
- Gulhane Medical Faculty, Gulhane Education and Research Hospital, Division of Rheumatology, Gulhane, Turkey
| | - Erkan Alpsoy
- Hacettepe University, Medical School, Division of Rheumatology, Ankara, Turkey
| | - Soner Şenel
- Erciyes University, Medical School, Division of Rheumatology, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Eskisehir, Osmangazi University, Medical School, Division of Rheumatology, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Eskisehir, Osmangazi University, Medical School, Division of Rheumatology, Eskisehir, Turkey
| | - Ömer Karadağ
- Hacettepe University, Medical School, Division of Rheumatology, Ankara, Turkey
| | - Kenan Aksu
- Ege University, Medical School, Division of Rheumatology, Izmir, Turkey
| | - Gökhan Keser
- Ege University, Medical School, Division of Rheumatology, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Marmara University, Medical School, Division of Rheumatology, Istanbul, Turkey
| | - Nevsun Inanç
- Marmara University, Medical School, Division of Rheumatology, Istanbul, Turkey
| | - Tülin Ergun
- Marmara University, Medical School, Dermatology Department, Istanbul, Turkey
| | - Haner Direskeneli
- Marmara University, Medical School, Division of Rheumatology, Istanbul, Turkey
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Çınar M, Tekgöz E, Çınar Fİ, Yılmaz S. Reliability and Validity of the Turkish Translation of the Beliefs about Medicines Questionnaire (BMQ-T) in Patients with Behçet's Disease. Turk Thorac J 2018; 19:231. [PMID: 30455995 DOI: 10.5152/turkthoracj.2018.180108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/26/2018] [Indexed: 11/22/2022]
Affiliation(s)
- Muhammet Çınar
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Gülhane School of Medicine, Ankara, Turkey
| | - Emre Tekgöz
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Gülhane School of Medicine, Ankara, Turkey
| | - Fatma İlknur Çınar
- Department of Internal Medicine Nursing, University of Health Sciences, Gülhane School of Nursing, Ankara, Turkey
| | - Sedat Yılmaz
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Gülhane School of Medicine, Ankara, Turkey
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Yılmaz S, Tekgöz E, Çınar M. Recurrence of proteinuria after cessation of tocilizumab in patients with AA amyloidosis secondary to FMF. Eur J Rheumatol 2018; 5:278-280. [PMID: 30071938 PMCID: PMC6267750 DOI: 10.5152/eurjrheum.2018.17183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/10/2018] [Indexed: 11/25/2022] Open
Abstract
There is no established treatment protocol for amyloid-A (AA) amyloidosis secondary to Familial Mediterranean Fever (FMF). Recently, we reported the efficacy of tocilizumab in 11 amyloidosis cases associated with FMF. In 2 patients of 11, we discontinued the tocilizumab administeration owing to the normalization of amyloidosis-related symptoms, but proteinuria re-occurred eventually. Fortunately, the patients responded to tocilizumab re-treatment. This led us to conclude that physicians should not stop the treatment, even in patients with normalized proteinuria levels.
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Affiliation(s)
- Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
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Tekgöz E, Akıncıoğlu E, Çınar M, Yılmaz S. A case of exogenous ochronosis associated with hydroxychloroquine. Eur J Rheumatol 2018; 5:206-208. [PMID: 30071940 DOI: 10.5152/eurjrheum.2018.17190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/26/2018] [Indexed: 11/22/2022] Open
Abstract
Exogenous ochronosis is characterized by hyperpigmented skin lesions that arise in association with local suppression of homogentisic acid oxidase enzyme. Although it generally develops in association with topical application of chemical agents, it can occasionally develop in association with antimalarial drugs. Here we present the case of a patient with rheumatoid arthritis who developed hyperpigmentation on the face and neck regions during hydroxychloroquine treatment. Hydroxychloroquine is being widely used in rheumatology practice, and cutaneous hyperpigmentation may develop as an adverse effect. In the present case, we emphasize the potential underlying mechanisms through which it may cause cutaneous hyperpigmentation and determine the clinical and histopathological findings of exogenous ochronosis.
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Affiliation(s)
- Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
| | - Egemen Akıncıoğlu
- Department of Pathology, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University Gülhane School of Medicine, Ankara, Turkey
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