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Ekici M, İleri S, Ünaldı E, Bayram GSK, Kılıç L, Akdoğan A. Are Behçet's disease patients with Budd-Chiari at increased risk for the development of pulmonary hypertension? Rheumatology (Oxford) 2024:keae067. [PMID: 38305459 DOI: 10.1093/rheumatology/keae067] [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: 11/25/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Mustafa Ekici
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Serez İleri
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Erdinç Ünaldı
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Gözde Sevgi Kart Bayram
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Ali Akdoğan
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
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Sözeri B, Şahin N, Açarı C, Avar Aydın PO, Baba O, Bağlan E, Bakkaloğlu S, Bakırcı S, Bilginer Y, Bozkaya BY, Çağlayan Ş, Çakan M, Çakmak F, Coşkuner T, Demir F, Demirkan FG, Doğantan Ş, Adıgüzel Dündar H, Ersözlü ED, Gücenmez S, Gürler O, İşgüder R, Küçük A, Kalyoncu M, Kılıç L, Kılıç SŞ, Kısaoğlu H, Paç Kısaarslan A, Kızıldağ Z, Kurtuluş D, Özdel S, Öztürk K, Şenol P, Tanatar A, Taşkın SN, Tuncer Kuru F, Türkuçar S, Ulu K, Ünsal E, Yazıcı A, Gezgin Yıldırım D, Yüksel S, Kasapçopur Ö, Özen S, Aktay Ayaz N, Sönmez HE. Towards a standardized program of transitional care for adolescents with juvenile idiopathic arthritis for Turkey: a national survey study. Pediatr Rheumatol Online J 2024; 22:7. [PMID: 38167070 PMCID: PMC10762787 DOI: 10.1186/s12969-023-00943-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is a prevalent childhood chronic arthritis, often persisting into adulthood. Effective transitional care becomes crucial as these patients transition from pediatric to adult healthcare systems. Despite the concept of transitional care being recognized, its real-world implementation remains inadequately explored. This study aims to evaluate the thoughts and practices of healthcare providers regarding transitional care for JIA patients. METHODS A cross-sectional survey was conducted among pediatric and adult rheumatologists in Turkey. Based on the American Academy of Pediatrics' six core elements of transitional care, the survey included 86 questions. The respondents' demographic data, attitudes towards transitional care, and practical implementation were assessed. RESULTS The survey included 48 rheumatologists, with 43.7% having a transition clinic. The main barriers to establishing transition programs were the absence of adult rheumatologists, lack of time, and financial constraints. Only 23.8% had a multidisciplinary team for transition care. Participants agreed on the importance of coordination and cooperation between pediatric and adult healthcare services. The timing of the transition process varied, with no consensus on when to initiate or complete it. Participants advocated for validated questionnaires adapted to local conditions to assess transition readiness. CONCLUSIONS The study sheds light on the challenges and perspectives surrounding transitional care for JIA patients in Turkey. Despite recognized needs and intentions, practical implementation remains limited due to various barriers. Cultural factors and resource constraints affect the transition process. While acknowledging the existing shortcomings, the research serves as a ground for further efforts to improve transitional care and ensure better outcomes for JIA patients transitioning into adulthood.
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Affiliation(s)
- Betül Sözeri
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Nihal Şahin
- Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ceyhun Açarı
- Department of Pediatric Rheumatology, Faculty of Medicine, Inönü University, Malatya, Turkey
| | | | - Ozge Baba
- Department of Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Etlik State Hospital, Ankara, Turkey
| | - Sevcan Bakkaloğlu
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sibel Bakırcı
- Department of Rheumatology, Antalya State Hospital, Antalya, Turkey
| | - Yelda Bilginer
- Department of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Yücel Bozkaya
- Department of Pediatric Rheumatology, Samsun Research and Training Hospital, Samsun, Turkey
| | - Şengül Çağlayan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, Zeynep Kamil Research and Training Hospital, Istanbul, Turkey
| | - Figen Çakmak
- Department of Pediatric Rheumatology, Başakşehir Çam and Sakura State Hospital, Istanbul, Turkey
| | - Taner Coşkuner
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Acıbadem Hospital, Istanbul, Turkey
| | - Fatma Gül Demirkan
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Şeyda Doğantan
- Department of Pediatric Rheumatology, Mersin City Hospital, Mersin, Turkey
| | - Hatice Adıgüzel Dündar
- Department of Pediatric Rheumatology, Behçet Uz Research and Training Hospital, Izmir, Turkey
| | - Emine Duygu Ersözlü
- Department of Rheumatology, Adana City Research and Training Hospital, Adana, Turkey
| | - Sercan Gücenmez
- Department of Rheumatology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Oğuz Gürler
- Department of Rheumatology, Medikal Park Hospital, Samsun, Turkey
| | - Rana İşgüder
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Adem Küçük
- Department of Rheumatology, Faculty of Medicine, Konya Selçuk University, Konya, Turkey
| | - Mukaddes Kalyoncu
- Department of Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sara Şebnem Kılıç
- Department of Pediatric Rheumatology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Hakan Kısaoğlu
- Department of Pediatric Rheumatology, Kayseri City Hospital, Kayseri, Turkey
| | - Ayşenur Paç Kısaarslan
- Department of Pediatric Rheumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Zehra Kızıldağ
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Duygu Kurtuluş
- Department of Physical Therapy and Rehabilitation, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Semanur Özdel
- Department of Pediatric Rheumatology, Etlik State Hospital, Ankara, Turkey
| | - Kübra Öztürk
- Department of Pediatric Rheumatology, Göztepe Research and Training Hospital, Istanbul, Turkey
| | - Pelin Şenol
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşe Tanatar
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sema Nur Taşkın
- Department of Pediatric Rheumatology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Fatma Tuncer Kuru
- Department of Rheumatology, Osmaniye State Hospital, Osmaniye, Turkey
| | - Serkan Türkuçar
- Department of Pediatric Rheumatology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Kadir Ulu
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Erbil Ünsal
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayten Yazıcı
- Department of Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Deniz Gezgin Yıldırım
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Selçuk Yüksel
- Department of Pediatric Rheumatology, Faculty of Medicine, Onsekiz Mart University, Çanakkele, Turkey
| | - Özgür Kasapçopur
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School, Istanbul, Turkey
| | - Seza Özen
- Department of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
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Sandal Uzun G, Taghiyeva A, Çakır İY, Moral K, Yardımcı GK, Bölek EÇ, Farisoğulları B, Duran E, Ayan G, Özsoy Z, Ekici M, Unaldı E, Germe ŞA, Fırlatan B, Kart-Bayram GS, Bilgin E, Kılıç L, Karadağ Ö, Akdoğan A, Bilgen ŞA, Kiraz S, Ertenli AI, Kalyoncu U. Factors that predict development of chronic kidney disease in patients with rheumatoid arthritis receiving biologic DMARDs and mortality rates. Int J Rheum Dis 2024; 27:e14967. [PMID: 38057290 DOI: 10.1111/1756-185x.14967] [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: 07/22/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES We aimed to determine the choice of biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/ts-DMARDs), factors associated with the development of chronic kidney disease (CKD), and mortality in RA patients with CKD receiving b/ts-DMARDs. METHODS Two thousand one hundred forty-one RA (79.4% female) patients were included in the analysis from the HUR-BIO prospective registry. Patients were divided into the CKD group and the non-CKD group. Age and gender-matched patients were selected from the non-CKD group, and then three main groups were determined. CKD was staged according to the glomerular filtration rate criteria. The clinical characteristics of the patients, disease activities, treatment choices, drug retention rate, and mortality rates were compared between the groups. RESULTS CKD was detected in 90/2141 (4.2%) RA patients on b/ts-DMARDs. Forty patients (2.3%) developed CKD during follow-up after the initiation of b/ts-DMARDs. In the CKD group, anti-TNF agents were chosen as the first-line b/ts-DMARDs therapy in 64.4% of patients, with etanercept leading in 31 (34.4%) patients. In multivariate analysis, age at the start of treatment, DAS-28-ESR at last visit, amyloidosis, hypertension, and history of smoking were the factors associated with the development of CKD in RA patients receiving b/ts-DMARDs. The mortality rate in RA-CKD patients until the onset of the pandemic was 15.41 per 1000 patient years, whereas it was 85.9 per 1000 patient years after the pandemic. CONCLUSION Comorbidities and control of disease activity are critical in the development of CKD in RA patients receiving b/ts-DMARDs. While there was no significant difference in mortality rate between CKD and non-CKD patients, the overall mortality rate increased after the COVID-19 pandemic duration in both groups.
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Affiliation(s)
- Güllü Sandal Uzun
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Arzu Taghiyeva
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İbrahim Y Çakır
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kenan Moral
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ertuğrul Ç Bölek
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bayram Farisoğulları
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emine Duran
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gizem Ayan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Zehra Özsoy
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Ekici
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdinç Unaldı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Şerife A Germe
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Büşra Fırlatan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gözde S Kart-Bayram
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Şule A Bilgen
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Ihsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Okyar Baş A, Yardımcı GK, Güner Oytun M, Ceylan S, Kahyaoğlu Z, Öztürk Y, Çöteli S, Halil MG, Cankurtaran M, Kılıç L, Doğu Yavuz BB. Cognitive Status is Better in Older Adults under Colchicine Treatment: A Case-Control Study. Exp Aging Res 2024; 50:17-27. [PMID: 36373385 DOI: 10.1080/0361073x.2022.2145164] [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: 06/30/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE We aimed to investigate the effects of colchicine, an important anti-inflammatory agent, on cognitive functions in a geriatric population diagnosed with gout or osteoarthritis by comparing it to non-colchicine users. METHODS 138 geriatric patients (67 colchicine users and 71 non-users) were enrolled. Within comprehensive geriatric assessment (CGA), cognitive status assessment via Mini-Mental State Examination test (MMSE), Quick Mild Cognitive Impairment Screening test (Qmci), clock drowning test (CDT), and digit span tests were performed. RESULTS Median age was 68 (65-72), and there were 82 female (59.4%) patients. The scores of CDT, Backward Digit Span Test, MMSE-Total, MMSE-Attention, MMSE-Motor Function, Qmci-Total Score, Qmci-Clock drawing, and Qmci-Logical Memory were significantly higher in the colchicine user group (p < .005), showing better cognitive function. Adjusted model analysis showed that colchicine usage is independently correlated with higher Qmci-Total Score and Qmci-Logical Memory Score (For Qmci total score β = 7.87 95%CI = 5.48-10.27, p = <0.0001, and for Qmci Logical memory score β = 3.52, 95%CI = 2.12-4.91, p = <0.0001). CONCLUSION To the best of our knowledge, this is the first study revealing that colchicine usage is associated with better cognitive performance in older adults. Further investigations with a prospective, larger-sampled and randomized design are needed to show the causal relationship between colchicine and cognition.
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Affiliation(s)
- Arzu Okyar Baş
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Merve Güner Oytun
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serdar Ceylan
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Kahyaoğlu
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Öztürk
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Süheyla Çöteli
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Gülhan Halil
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Balam Doğu Yavuz
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Kiracı M, Bilgin E, Duran E, Farisoğulları B, Bölek EC, Yardımcı GK, Ozsoy Z, Ayan G, Uzun GS, Akbaba TH, Balci-Peynircioglu B, Karadag O, Akdogan A, Bilgen SA, Kiraz S, Ertenli AI, Kalyoncu U, Kılıç L. Comparison of demographic, clinic and radiological features of patients with axial spondyloarthritis accompanying familial Mediterranean fever to patients with each condition alone. Scand J Rheumatol 2023; 52:530-538. [PMID: 36503416 DOI: 10.1080/03009742.2022.2143621] [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: 05/17/2022] [Accepted: 11/01/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare the demographic, clinical, and radiological features of patients with axial spondyloarthritis (axSpA) accompanying familial Mediterranean fever (FMF) to patients with each condition alone. METHOD Hacettepe University Hospital database was screened regarding ICD-10 codes for FMF (E85.0) and axSpA (M45). The diagnosis of FMF was confirmed by Tel-Hashomer criteria, and axSpA by the presence of sacroiliitis according to the modified New York criteria or active sacroiliitis on magnetic resonance imaging. As control groups, 136 gender-matched, consequent FMF patients without axSpA and 102 consequent axSpA patients without FMF previously treated with any biological agents were included in the analysis. RESULTS In patients with FMF + axSpA compared to the axSpA group, age at axSpA symptom onset and age at diagnosis were lower [median with interquartile range (IQR): 21 (17-30) vs 27 (21-37), p < 0.001; 23 (21-38) vs 32 (24-43) years, p = 0.001], moderate to severe hip disease and total hip replacement were more prevalent (23.4% vs 4.7%, p < 0.001; 11.2% vs 2.8%, p = 0.016). In patients with FMF + axSpA compared to the FMF group, age at FMF symptom onset and age at diagnosis were higher [13 (6-30) vs 11 (5-18), p = 0.057; 23 (13-33) vs 18 (10-31) years, p = 0.033] and amyloidosis was more prevalent (6.6% vs 2.2%, p = 0.076). Although the M694V variant (in one or two alleles) was more prevalent in the FMF + axSpA group, the difference was not statistically significant. CONCLUSION In patients with FMF + axSpA, the age of onset of axSpA was significantly earlier, moderate to severe hip involvement and amyloidosis were more common than in patients with each condition alone.
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Affiliation(s)
- M Kiracı
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - E Bilgin
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - E Duran
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - B Farisoğulları
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - E C Bölek
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - G K Yardımcı
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Z Ozsoy
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - G Ayan
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - G S Uzun
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - T H Akbaba
- Department of Medical Biology, Hacettepe University, Ankara, Turkey
| | | | - O Karadag
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - A Akdogan
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - S A Bilgen
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - S Kiraz
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - A I Ertenli
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - U Kalyoncu
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - L Kılıç
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
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Taghiyeva A, Kılıç L, Cagan M, Cagri Bolek E, Yardımcı GK, Ozyuncu O, Bilgen ŞA, Karadag O. Fertility, early menopause and pregnancy outcomes of patients with Takayasu's arteritis. Eur J Obstet Gynecol Reprod Biol 2023; 283:1-5. [PMID: 36746073 DOI: 10.1016/j.ejogrb.2023.01.021] [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: 05/11/2022] [Revised: 12/03/2022] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The reproductive health of patients with Takayasu's arteritis (TA) is an important issue. Systemic inflammation and treatments used in TA may affect female reproductive organs, leading to infertility, maternal and fetal morbidity, and early menopause. This study aimed to evaluate fertility, early menopause and pregnancy outcomes of patients before and after TA diagnosis. In addition, pregnancy morbidities following TA diagnosis were analysed for each cluster. STUDY DESIGN Two hundred and two patients with TA (184 females) who met the 1990 American College of Rheumatology criteria were registered in the prospective database of Hacettepe University Vasculitis Research Centre by the end of February 2020. Demographic and clinical features, comorbidities, distribution of vascular involvement, obstetric histories and outcomes were evaluated retrospectively. Patients with TA were classified according to novel proposed disease clusters. Early menopause was defined as menopause before 45 years of age. RESULTS One hundred and twenty-one female patients with TA, for whom gynaecological records and marriage status could be obtained, were included in the study. Ninety-seven patients were married, of whom 12 (12.5 %) patients were infertile. In total, there were 238 pregnancies in 83 female patients with TA: 203 before TA diagnosis, 35 after TA diagnosis, and two patients were diagnosed during pregnancy. Compared with the pre-diagnosis group, maternal complications were significantly more common in the post-diagnosis group [23 (11.3 %) vs 9 (25.7 %); p = 0.048]. The most common maternal complication was gestational hypertension (12.1 %). Fetal complications were common in both groups (21.5 % pre-diagnosis vs 34.2 % post-diagnosis; p = 0.18), and included prematurity, intrauterine growth retardation and low birth weight. According to novel disease subsets, post-diagnosis patients were classified as C1 (n = 3, 15.7 %), C2 (n = 9, 47.3 %) or C3 (n = 6, 31.5 %). One patient could not be classified. There was no difference in obstetric outcomes between these subgroups. Early menopause was observed in 20 (16.5 %) of 121 patients, but some patients had not yet reached 45 years of age. CONCLUSION Infertility was higher in patients with TA in comparison with the general population in Turkey (12.5% vs 8.6%), and the early menopause rate was lower in patients with TA (16.7% vs 36.1%). Pregnancies following a diagnosis of TA had more maternal complications than pre-diagnosis pregnancies. Fetal complications were more common both pre- and post-diagnosis. Chronic inflammation before TA diagnosis may lead to increased infertility and fetal complications.
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Affiliation(s)
- Arzu Taghiyeva
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Levent Kılıç
- Hacettepe University Vasculitis Research Centre, Ankara, Turkey
| | - Murat Cagan
- Division of Perinatology, Department of Obstetrics and Gynaecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | - Ozgur Ozyuncu
- Division of Perinatology, Department of Obstetrics and Gynaecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Omer Karadag
- Hacettepe University Vasculitis Research Centre, Ankara, Turkey
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Armağan B, Okşul M, Şener YZ, Sarı A, Erden A, Yardımcı GK, Hayran KM, Kılıç L, Karadağ Ö, Kaya EB, Tokgözoğlu SL, Ertenli Aİ, Akdoğan A. Pulmonary hypertension in Behçet's disease: echocardiographic screening and multidisciplinary approach. Turk J Med Sci 2023; 53:563-571. [PMID: 37476876 PMCID: PMC10388096 DOI: 10.55730/1300-0144.5617] [Citation(s) in RCA: 1] [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: 06/29/2022] [Accepted: 02/01/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Little is known about the prevalence and causes of pulmonary hypertension (PH) in Behçet's disease (BD). This study was conducted to determine the prevalence and causes of PH in BD. METHODS In this descriptive study, we screened 154 patients with BD for PH using transthoracic echocardiography between February 2017 and October 2017. An estimated systolic pulmonary arterial pressure (sPAP ≥ 40 mmHg) was used as the cutoff value to define PH. Patients with BD were categorized into 5 groups according to organ involvement including mucocutaneous/ articular, ocular, vascular, gastrointestinal, and neurologic involvement. Additional laboratory and imaging results were obtained from hospital file records to determine the causes of PH. RESULTS PH was detected in 17 (11%) patients. Nine (52.9%) of these patients had group II PH (due to left heart disease), 4 (23.5%) had IV PH (due to pulmonary arterial involvement), and 1 had III PH (due to chronic obstructive lung disease). The frequency of PH was higher in BD patients with vascular involvement than those without (52.9% vs 28.5%; p = 0.04). Among 10 patients with pulmonary artery involvement (PAI) 4 (40%) had PH. Although the vascular BD group had the highest rate of PH, we observed no statistically significant difference in the frequency of PH between the predefined BD subgroups. DISCUSSION : PH is not rare in patients with BD. The majority of BD patients with PH are in group II or IV PH. Patients with vascularinvolvement carry a higher risk for the development of PH. Monitoring BD patients with PAI should be considered for the development of group IV PH.
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Affiliation(s)
- Berkan Armağan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Metin Okşul
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yusuf Ziya Şener
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kadir Mutlu Hayran
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ergün Barış Kaya
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ali İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Şentürk EF, Erden A, Sarı A, Armağan B, Kılıç L, Kalyoncu U, Karadağ Ö, Bilgen ŞŞA, Kiraz S, Ertenli Aİ, Akdoğan A. The impact of antiphospholipid antibodies in Takayasu arteritis. Turk J Med Sci 2023; 53:199-205. [PMID: 36945962 PMCID: PMC10388031 DOI: 10.55730/1300-0144.5573] [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] [Received: 06/27/2022] [Accepted: 11/01/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The significance of antiphospholipid antibodies (aPL) is controversial in Takayasu arteritis (TA). This study was conducted to explore the frequency of aPL and their association with disease-related complications in TA. METHODS : This cross-sectional study was conducted to investigate the presence of anti-cardiolipin (aCL), anti-beta 2 glycoprotein- 1(aβ2G1) antibodies, and lupus anticoagulant (LA) in TA patients. TA patients admitted to the Department of Rheumatology of Hacettepe University Faculty of Medicine between December 2015 and September 2016 who fulfilled the American College of Rheumatology (ACR) classification criteria for TA were consecutively enrolled in the study. Patients were grouped according to aPL positivity and compared in terms of disease manifestations, type of vascular involvement at diagnosis, and vascular complications/interventions attributable to TA. RESULTS Fifty-three TA (49 female) patients were enrolled in the study. We detected 9 (16.9%) patients with IgM and/or IgG aβ2G1 and/or LA positivity. There were no patients with positive aCL. All aβ2G1 titers were low. There were no differences in terms of symptoms, signs, type of vascular involvement, the number of patients with disease-related complications or vascular interventions/surgery between aPL (+) and aPL(-) groups (p > 0.05 for all). The number of patients with thrombotic lesions was similar between the groups (p > 0.05). There were no patients with a history of venous thrombosis or on anticoagulant treatment in the aPL(+) group. Only 1 patient with IgM aβ2G1 (+) had a history of pregnancy loss. DISCUSSION Our results indicate that aPL positivity is not rare in TA. On the other hand, all aPL titers were low and no differences were found in the frequency of disease-related complications between aPL(+) and aPL(-) patient groups. Only TA patients with atypical manifestations with high suspicion of aPL-related complications should be considered to be investigated for aPL.
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Affiliation(s)
- Esra Fırat Şentürk
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | | | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ali İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
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Armağan B, Kılıç L, Farisoğulları B, Yardımcı GK, Bilgin E, Bölek EÇ, Karadağ Ö, Bilgen ŞA, Kiraz S, Ertenli İ, Kalyoncu U. Drug retention rate and predictive factors of drug survival for secukinumab in radiographic axial spondyloarthritis. Rheumatol Int 2023; 43:147-156. [PMID: 36129541 DOI: 10.1007/s00296-022-05213-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/12/2022] [Indexed: 02/02/2023]
Abstract
The drug retention rate has been an important indicator for evaluating the treatment tolerance. Unfortunately, our knowledge of the secukinumab retention rate in radiographic axial spondyloarthritis (r-AxSpA) is limited. The objective of this study was to assess the retention rate of secukinumab and evaluate predictive factors of drug survival based on data from a real-life cohort. We retrospectively assessed 147 r-AxSpA patients between May 2018 and January 2020 from the HUR-BIO database. Secukinumab retention rates were analyzed using the Kaplan-Meier method and Cox proportional hazard model was used for predictors factors. The global retention rate of secukinumab was 55% at 12 months. r-AxSpA patients with obesity had a lower frequency of secukinumab discontinuation (29% vs. 50%, p = 0.013) in comparison r-AxSpA patients without obesity. In multivariate analysis, multiple TNFi usage had a higher risk of secukinumab discontinuation [HR 1.99 (1.09-3.62), p = 0.024]; on the other hand, obesity had a lower risk [HR 0.45 (0.27-0.90), p = 0.008]. Except for not using multiple TNFi, this real-life analysis showed for the first time that obesity is not an adverse risk factor for secukinumab drug retention in r-AxSpA. Secukinumab, which is an interleukin-17A inhibitor, could act via a different pathway than tumor necrosis factor inhibitors (TNFi). The identification of predictive factors such as obesity that may affect the individual drug selection may provide more appropriate biologic treatment strategies for r-AxSpA.
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Affiliation(s)
- Berkan Armağan
- Ankara City Hospital, Rheumatology Clinic, Ankara, 06100, Turkey.
| | - Levent Kılıç
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Bayram Farisoğulları
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Emre Bilgin
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Ertuğrul Çağrı Bölek
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Şule Apraş Bilgen
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Sedat Kiraz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - İhsan Ertenli
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
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Alpay Kanıtez N, Kiraz S, Dalkılıç E, Kimyon G, Mercan R, Karadağ Ö, Bes C, Kılıç L, Akar S, Ateş A, Emmungil H, Ertenli İ, Pehlivan Y, Coşkun BN, Yağız B, Ersözlü D, Gönüllü E, Çınar M, Kaşifoğlu T, Koca SS, Karasu U, Küçükşahin O, Kalyoncu U, Kalyoncu U. The First Effect of COVID-19 Pandemic on Starting Biological Disease Modifying Anti-Rheumatic Drugs: Outcomes from the TReasure Real-Life Database. Eur J Rheumatol 2022; 9:206-211. [PMID: 36650959 PMCID: PMC10089133 DOI: 10.5152/eurjrheum.2022.21153] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The coronavirus disease 2019 pandemic has been resulting in increased hospital occupancy rates. Rheumatic patients cannot still reach to hospitals, or they hesitate about going to a hospital even they are able to reach. We aimed to show the effect of the first wave of coronavirus disease 2019 pandemic on the treatment of biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis or spondyloarthritis. METHODS Patients were divided into three groups as follows: pre-pandemic (Pre-p: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within 6 months before March 11, 2020); post-pandemic A (Post-p A: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the first 6 months after March 11, 2020); post-pandemic B (Post-p B: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the second 6 months). RESULTS The number of rheumatoid arthritis patients in the Post-p A and B groups decreased by 51% and 48%, respectively, as compared to the Pre-p group similar rates of reduction were also determined in the number of spondyloarthritis patients. The rates of tofacitinib and abatacept use increased in rheumatoid arthritis patients in Post-p period. CONCLUSION The number of rheumatoid arthritis and spondyloarthritis patients starting on biological disease-modifying anti-rheumatic drugs for the first time decreased during the first year of the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Nilüfer Alpay Kanıtez
- Division of Rheumatology, Department of Internal Medicine, Koç University School of Medicine, İstanbul, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ediz Dalkılıç
- Division of Rheumatology, Department of Internal Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - Gezmiş Kimyon
- Division of Rheumatology, Department of Internal Medicine, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Rıdvan Mercan
- Division of Rheumatology, Department of Internal Medicine, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Cemal Bes
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Katip Çelebi University School of Medicine, İzmir, Turkey
| | - Aşkın Ateş
- Division of Rheumatology, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Hakan Emmungil
- Division of Rheumatology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Yavuz Pehlivan
- Division of Rheumatology, Department of Internal Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - Belkıs Nihan Coşkun
- Division of Rheumatology, Department of Internal Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - Burcu Yağız
- Division of Rheumatology, Department of Internal Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - Duygu Ersözlü
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Emel Gönüllü
- Division of Rheumatology, Department of Internal Medicine, Sakarya University School of Medicine, Sakarya, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, Health Sciences University, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Department of Internal Medicine, Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Süleyman Serdar Koca
- Division of Rheumatology, Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey
| | - Uğur Karasu
- Division of Rheumatology, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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11
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Yüce Sarı S, Yılmaz MT, Elmalı A, Kılıç L, Yüce D, Özyiğit G, Cengiz M, Yazıcı G. Turkish translation and validation of the Xerostomia Inventory. Arch Rheumatol 2022; 37:351-360. [PMID: 36589609 PMCID: PMC9791545 DOI: 10.46497/archrheumatol.2022.8702] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives The Xerostomia Inventory (XI) was developed to assess the severity of dryness in patients with xerostomia. It has a long and a short form with three- and five-point Guttman-type response options. In this study, we aimed to translate the XI into Turkish, to assess the validity and reliability of both response options in patients with head & neck cancer (HNC) or Sjögren syndrome (SS), and to select the optimal version for Turkish patients. Patients and methods Between January 2019 and June 2019, the XI was translated into Turkish (XI-T) and applied to patients aged ≥18 years with HNC and SS. All patients were applied two tests including both the three- and five-point options. The internal consistency was assessed by Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Content validity was based on expert opinion and patient reviews. Results A total of 186 patients (109 males, 77 females; median age: 54 years; range, 19 to 78 years) answered the XI-T. The number of patients with HNC and SS was 143 (77%) and 43 (23%), respectively. Median XI-T score was 17 for the three-point, and 24 for the five-point option, respectively. Overall internal consistency was satisfactory for both options (α=0.81 and α=0.89, respectively). Overall test-retest reliability was satisfactory and ICCs ranged between 0.71 and 0.92 for the three-point, and 0.36 and 0.94 for the five-point option, respectively. Assessments based on expert opinions and patient reviews also favored the content validity of the scale. Conclusion The XI-T with both three- and five-point options is a valid and reliable tool to evaluate the presence and severity of dryness in patients with HNC and SS who experience xerostomia. The three-point option is more comprehensible and can be preferred over the five-point option in the Turkish population.
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Affiliation(s)
- Sezin Yüce Sarı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melek Tuğce Yılmaz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Ayşenur Elmalı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gökhan Özyiğit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gözde Yazıcı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Farisoğulları B, Yardımcı GK, Sarı A, Bilgin E, Bölek EÇ, Duran E, Kılıç L, Akdoğan A, Karadağ Ö, Apraş Bilgen Ş, Ertenli Aİ, Kiraz S, Kalyoncu U. Is the impact of biologic agents in enteropathic spondylitis different from other spondylitis? Real life data from the HUR-BIO Registry. Clin Exp Rheumatol 2022; 40:112-119. [DOI: 10.55563/clinexprheumatol/uxcofr] [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: 11/06/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Bayram Farisoğulları
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ertuğrul Çağrı Bölek
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Emine Duran
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Şule Apraş Bilgen
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Sarı A, Bodakçi E, Armağan B, Satış H, Ataş N, Yaşar Bilge NŞ, Bilici Salman R, Yardımcı GK, Babaoğlu H, Kılıç L, Öztürk MA, Haznedaroğlu Ş, Göker B, Kalyoncu U, Kaşifoğlu T, Tufan A. Phenotypic characterization of Familial Mediterranean Fever patients harboring variants of uncertain significance. Turk J Med Sci 2021; 51:1695-1701. [PMID: 33726481 PMCID: PMC8569734 DOI: 10.3906/sag-2011-273] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/14/2021] [Indexed: 11/18/2022] Open
Abstract
Background/aim Familial Mediterranean Fever (FMF) is the prototype of hereditary autoinflammatory disorders and caused by mutations on the MEFV gene located on the short arm of chromosome 16. Although some MEFV variants are clearly associated with disease phenotype, there are numerous variants with unknown clinical association which are termed as variants of uncertain significance (VUS). Here, we present clinical correlations of VUS in a large cohort of adult FMF patients from three tertiary centers located in Central Anatolia. Materials and methods All patients were recruited from FMF in Central Anatolia (FiCA) cohort. Demographic (sex, age at disease onset) and clinical features (disease characteristics, attack frequency, mean colchicine dose, colchicine nonresponsiveness, amyloidosis, and persistent inflammation) of patients with VUS were compared with those harboring pathogenic variants. Disease severity and damage were also evaluated using international severity score for FMF (ISSF) and autoinflammatory disease damage index (ADDI), respectively. Results Among 971 participants included, MEFV gene analysis results were available for 814 patients. Twenty-six (3.2%) patients had single heterozygous VUS and 54 (6.6%) had pathogenic/VUS complex heterozygous variants. Patients with single heterozygous VUS had similar demographic/clinical features, ISSF and ADDI scores compared to those with single heterozygous pathogenic variant (p > 0.05 for all). No difference was observed in the demographic and clinical features of patients with single heterozygous pathogenic mutation and pathogenic/VUS complex heterozygous variant (p > 0.05 for all). ISSF and ADDI scores were lower in pathogenic/VUS complex heterozygous patients than those harboring single pathogenic mutation (p = 0.006 and 0.004, respectively). Conclusion Our findings suggest that patients with single heterozygous VUS has mild FMF phenotype similar to those with single pathogenic mutation. Pathogenic/VUS complex heterozygosity does not lead to a more severe clinical phenotype than having a single pathogenic variant.
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Affiliation(s)
- Alper Sarı
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdal Bodakçi
- Department of Rheumatology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey
| | - Berkan Armağan
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hasan Satış
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nuh Ataş
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | | | - Reyhan Bilici Salman
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Babaoğlu
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Akif Öztürk
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Şeminur Haznedaroğlu
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Berna Göker
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Timuçin Kaşifoğlu
- Department of Rheumatology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey
| | - Abdurrahman Tufan
- Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
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14
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Bodakçi E, Yaşar Bilge NŞ, Ataş N, Armağan B, Satış H, Sarı A, Bilici Salman R, Kübra Yardımcı G, Babaoğlu H, Kılıç L, Öztürk MA, Göker B, Haznedaroğlu Ş, Kalyoncu U, Tufan A, Kaşifoğlu T. Appendectomy history is associated with severe disease and colchicine resistance in adult familial Mediterranean fever patients. Turk J Med Sci 2021; 51:1706-1711. [PMID: 33460325 PMCID: PMC8569750 DOI: 10.3906/sag-2011-74] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/17/2021] [Indexed: 11/22/2022] Open
Abstract
Background/aim Peritonitis attacks of Familial Mediterranean Fever (FMF) usually requires emergency medical admissions and it’s hard to distinguish a typical abdominal attack from surgical causes of acute abdomen. Therefore, history of abdominal surgery, particularly appendectomy, is very common in patients with FMF. However, history of appendectomy might also give some clues about the course of FMF in the adulthood. This study was to determine whether the history of appendectomy help to anticipate disease course of FMF in the adulthood. Materials and methods All patients recruited from FMF in Central Anatolia (FiCA) cohort, comprising 971 adult subjects. All patients fulfilled the Tel Hashomer criteria. Demographic data, FMF disease characteristics, co-morbid conditions, past medical history, surgical history and disease complications were meticulously questioned and laboratory features and genotype data (if available) were recruited from patient files. Results Appendectomy history was evident in 240 (24.7%) subjects. Disease onset was earlier and peritonitis is strikingly more prevalent (97.1% vs. 89.6%, p < 0.001) in appendectomized patients. These patients had reported almost two fold more frequent attacks in the last year compared to appendix intact patients (median 3.5 vs. 2 attacks, p = 0.001) without a difference in frequency of musculoskeletal and skin attacks. Severe disease was more common (10% vs. 5.9%, p = 0.038) due to involvement of more attack sites throughout the life and more frequent attacks. Appendectomy patients had used higher daily doses of colchicine to control disease (1.43 ± 0.6 mg vs. 1.27 ± 0.52 mg, p = 0.002) but colchicine resistance was also more common in these patients, 15% vs. 6.7% respectively, p < 0.001. Conclusion Appendectomy history is common in FMF patients and associated with frequent serositis attacks in adulthood. These patients require higher colchicine doses with a lower rate of response and more need for Interleukin-1 antagonist therapies.
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Affiliation(s)
- Erdal Bodakçi
- Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Nazife Şule Yaşar Bilge
- Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Nuh Ataş
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Berkan Armağan
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hasan Satış
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Alper Sarı
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Reyhan Bilici Salman
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Babaoğlu
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Akif Öztürk
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Berna Göker
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Şeminur Haznedaroğlu
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdurrahman Tufan
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Timuçin Kaşifoğlu
- Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
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Kalyoncu U, Pehlivan Y, Akar S, Kaşifoğlu T, Kimyon G, Karadağ Ö, Dalkılıç HE, Ertenli Aİ, Kılıç L, Ersözlü D, Bes C, Emmungil H, Mercan R, Ediboğlu ED, Kanıtez N, Bilgin E, Çolak S, Koca SS, Gönüllü E, Küçükşahin O, Coşkun N, Yağız B, Kiraz S. Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic. Turk J Med Sci 2021; 51:1615-1623. [PMID: 33611869 PMCID: PMC8569786 DOI: 10.3906/sag-2012-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/01/2020] [Accepted: 02/21/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis
receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6–9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients’ data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21–73] vs. 44 years [20–79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.
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Affiliation(s)
- Umut Kalyoncu
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Yavuz Pehlivan
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - Servet Akar
- Department of Internal Medicine, Division of Rheumatology, İzmir Katip Çelebi University, Faculty of Medicine, İzmir, Turkey
| | - Timuçin Kaşifoğlu
- Department of Internal Medicine, Division of Rheumatology, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
| | - Gezmiş Kimyon
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ömer Karadağ
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Hüseyin Ediz Dalkılıç
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - Ali İhsan Ertenli
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Duygu Ersözlü
- Department of Internal Medicine, Division of Rheumatology, Ministry of Health Adana City Training and Research Hospital, Adana, Turkey
| | - Cemal Bes
- Department of Internal Medicine, Division of Rheumatology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Hakan Emmungil
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Rıdvan Mercan
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Elif Durak Ediboğlu
- Department of Internal Medicine, Division of Rheumatology, İzmir Katip Çelebi University, Faculty of Medicine, İzmir, Turkey
| | - Nilüfer Kanıtez
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Emre Bilgin
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Süleyman Serdar Koca
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Emel Gönüllü
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Orhan Küçükşahin
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Nihan Coşkun
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - Burcu Yağız
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - Sedat Kiraz
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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Keleşoğlu Dinçer AB, Kılıç L, Erden A, Kalyoncu U, Hazirolan T, Kiraz S, KaradaĞ Ö. Imaging modalities used in diagnosis and follow-up of patients with Takayasu’s arteritis. Turk J Med Sci 2021; 51:224-230. [PMID: 33155792 PMCID: PMC7991884 DOI: 10.3906/sag-2005-70] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/05/2020] [Indexed: 11/24/2022] Open
Abstract
Background/aim Takayasu’s arteritis (TA) is a rare, large-vessel vasculitis of unknown etiology, affecting aortic arch, and its main branches. Noninvasive imaging methods are frequently used in diagnosis and follow-up in Takayasu’s arteritis. Studies investigating optimal timing of follow up imaging are rare. This study is aimed to investigate the radiologic changes in vascular involvements of Takayasu’s arteritis patients one year after diagnosis. Materials and methods Database of our Vasculitis Center was analyzed retrospectively and 97 patients were included into the study. Demographic, clinical, radiological, and therapeutic findings of patients were recorded. Patients with follow-up imaging after approximately one year of diagnosis were recruited into further analysis. Radiological changes and the effect of different immunosuppressive agents on vascular involvements were investigated. Results Mean age and disease duration of patients were 43.0 and 9.0 years. The most commonly used imaging methods/modalities for the diagnosis of TA were computer tomography-angiography (CT-Ang) (58.8%), magnetic resonance-angiography (MR-Ang) (29.9%), and doppler ultrasonography (11.3%). Subclavian and common carotid arteries were the most frequently involved vessels. Fifty-three patients underwent follow-up imaging after one year of diagnosis and, in 64% of patients, same imaging method had been used. MR-Ang (62.3%) and CT-Ang (35.9%) were the most preferred follow-up imaging studies. Sixty-eight percent of patients had stable vascular involvement, 28% had progression, and 4% had regression. No difference was found in radiological changes regarding patients with usage of different immunosuppressive agents (P = 0.634). There was no association between the change in serum acute phase reactants and radiological disease activity. Conclusion The most commonly used imaging modality for the diagnosis of TA was CT-Ang, whereas MR-Ang was the most preferred for follow-up. Almost 30% of TA patients in our Vasculitis Center had progression at around one year concordant with previous literature. A follow-up imaging at around one year of treatment seems feasible in management of TA.
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Affiliation(s)
| | - Levent Kılıç
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tuncay Hazirolan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sedat Kiraz
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer KaradaĞ
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Akça ÜK, Sökmen O, Bölek EÇ, Demir S, Kılıç L, Çevik IÜ, Bilginer Y. A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related. Turk J Pediatr 2021; 63:522-526. [PMID: 34254500 DOI: 10.24953/turkjped.2021.03.022] [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] [Indexed: 06/13/2023]
Abstract
BACKGROUND The adverse effects of tumor necrosis factor alpha inhibitors (TNFi) are well characterized but rare adverse events are increasing day by day. CASE We presented an 18-year-old girl with rheumatoid factor positive polyarticular juvenile idiopathic arthritis (JIA) who developed fever, headache, and nausea after the second dose of adalimumab. In addition to her suspicious complaints for meningitis, she had bilateral papilledema and partial abducens nerve palsy. Leptomeningeal contrast enhancement was noted in magnetic resonance imaging (MRI) of the brain. Brain MRI venography was normal. The cerebrospinal fluid (CSF) opening pressure was high but CSF analysis was normal. She was diagnosed with non-infectious subacute meningitis. Since brain biopsy was not performed, no definite distinction could be made between TNFi related aseptic meningitis or cerebral involvement of JIA. Due to the onset of neurological complaints after initiation of adalimumab treatment and rare cerebral involvement in JIA, the drug-associated aseptic meningitis was likely to be responsible in our patient. Adalimumab was discontinued and methylprednisolone followed by methotrexate treatment were initiated. Her symptoms resolved and control brain MRI was normal. CONCLUSION Pediatric rheumatologists should be aware of this potentially severe side effect of anti-TNF treatment.
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Affiliation(s)
- Ümmüşen Kaya Akça
- Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Okan Sökmen
- Departments of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ertuğrul Çağrı Bölek
- Departments of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Selcan Demir
- Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Departments of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Işın Ünal Çevik
- Departments of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Bilginer
- Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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18
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Bilgin E, Farisoğulları B, Armağan B, Sarı A, Yardımcı GK, Bölek EÇ, Kılıç L, Akdoğan A, Bilgen ŞA, Karadağ Ö, Ertenli Aİ, Kiraz S, Kalyoncu U. Predictors of drug retention and treatment response in axial spondyloarthritis patients treated with certolizumab: real-life results from the HURBIO registry. Clin Exp Rheumatol 2020; 38:609-614. [PMID: 31498074] [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: 04/16/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To assess the real-life retention rate of certolizumab and factors related to retention of certolizumab. METHODS We analysed all patients who received at least 1 dose of certolizumab and were registered in the HURBIO database. Patients with at least 1 control visit were included in efficacy analysis. Drug retention rates were calculated using the Kaplan-Meier method and predictors of drug retention was determined by Cox proportional hazard model. Factors predicting BASDAI50 response at first visit were analysed by the logistic regression analysis. Reasons of switching and discontinuation were also determined. RESULTS A total of 325 (AS (76%), female 55%) patients were recruited. Median follow-up while receiving certolizumab was 13 (4.7-22.7) months. At 1 year, overall certolizumab retention rate was 72.5%. Predictors of poor certolizumab retention were: Current or ex-smoker [HR 1.11 (0.70-1.76), p=0.65], high CRP levels [HR 0.72 (0.45-1.16), p=0.18], biologic-naïve [HR 0.81 (0.49-1.32), p=0.39] and good BASDAI50 response at first control visit [HR 0.54 (0.30-0.96), p=0.04]. Mean duration from starting certolizumab to the first control visit was 3 (3-6) months. Predictors of poor BASDAI50 response: Presence of nr-axSpa [RR 2.12 (1.01-4.51), p=0.05], female gender [RR 2.14 (1.20-3.82), p=0.01] and history of biologic therapy [RR 3.52 (1.95-6.33), p<0.001]. The most common causes of drug switch were primary failure and drug side-effects. CONCLUSIONS In this study, good BASDAI50 response at first visit seems to be a strong predictor of higher retention of certolizumab in patients with axial spondyloarthritis.
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Affiliation(s)
- Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Bayram Farisoğulları
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Gözde K Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Ertuğrul Ç Bölek
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Şule A Bilgen
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - A İhsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
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Aydın SZ, Kimyon G, Özişler C, Tarhan EF, Günal EK, Küçük A, Omma A, Solmaz D, Ersözlü ED, Yıldız F, Tufan MA, Çınar M, Mercan R, Yavuz Ş, Alhussain FA, Erden A, Can M, Çetin GY, Kılıç L, Bakırcı S, Al Osaimi N, Kalyoncu U. Psoriasis Symptom Inventory (PSI) as a patient-reported outcome in mild psoriasis: Real life data from a large psoriatic arthritis registry. Eur J Rheumatol 2020; 7:64-67. [PMID: 31922480 DOI: 10.5152/eurjrheum.2019.19126] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Our aim is to test the validity of the Psoriasis Symptom Inventory (PSI), a patient-reported outcome, to assess the psoriasis severity within the scope of rheumatology. METHODS Within the PsA international database (PSART-ID), 571 patients had PSI, while 322 of these also showed body surface area (BSA). Correlations between PSI, BSA, and other patient- and physician-reported outcomes were investigated. RESULTS There was a good correlation between PSI and BSA (r=0.546, p<0.001), which was even higher for mild psoriasis (BSA<3 (n=164): r=0.608, p<0.001). PSI significantly correlated with fatigue, pain, and patient and physician global parameters (p<0.001). CONCLUSION PSI has a good correlation with other patient- and physician-reported outcomes, and our findings support its use in rheumatology practice.
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Affiliation(s)
- Sibel Zehra Aydın
- Division of Rheumatology, Department of Internal Medicine, University of Ottawa School of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Gezmiş Kimyon
- Division of Rheumatology, Department of Internal Medicine, Hatay Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Cem Özişler
- Division of Rheumatology, Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Emine Figen Tarhan
- Division of Rheumatology, Department of Internal Medicine, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Esen Kasapoğlu Günal
- Division of Rheumatology, Department of Internal Medicine, İstanbul Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Adem Küçük
- Division of Rheumatology, Department of Internal Medicine, Meram University School of Medicine, Konya, Turkey
| | - Ahmet Omma
- Division of Rheumatology, Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Dilek Solmaz
- Division of Rheumatology, Department of Internal Medicine, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey
| | | | - Fatih Yıldız
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Müge Aydın Tufan
- Division of Rheumatology, Department of Internal Medicine, Başkent University, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Rıdvan Mercan
- Division of Rheumatology, Department of Internal Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Şule Yavuz
- Division of Rheumatology, Department of Internal Medicine, Marmara University, İstanbul, Turkey
| | - Fatıma Arslan Alhussain
- Division of Rheumatology, Department of Internal Medicine, İstanbul Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Meryem Can
- Division of Rheumatology, Department of Internal Medicine, Marmara University, İstanbul, Turkey
| | - Gözde Yıldırım Çetin
- Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Bakırcı
- Division of Rheumatology, Department of Internal Medicine, University of Ottawa School of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Noura Al Osaimi
- Division of Rheumatology, Department of Internal Medicine, University of Ottawa School of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
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Erdem O, Erol S, Aydoğan A, Subaşı B, Kılıç L. The relationship between participation to social activities, life satisfaction, isolation on aged. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.463] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
This study was conducted to determine the relationship between the participation of people living in the nursing homes to social activities and their life satisfaction, social isolation and loneliness.
Methods
The study was performed between January 2017 and April 2018 in three nursing homes using the cross-sectional research design. The study population consisted of 310 elderly people in total, 118 women, 192 men, who were over 65 years of age and had no mental and communication problems. Ninety percent of the population was reached. The data were collected by using a questionnaire, Standardized Mini Mental Test, Satisfaction with Life Scale (SWLS), Social Isolation Scale (SIS) and Loneliness Scale for Elderly People (LSEP). Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis variance analysis and Spearman correlation analysis were used in data analysis.
Results
The mean age of the elderly subjects was 74.10 ± 7.57 years, and 61.9% were male and 38.1% were female. Elderly subjects’ SWLS and LSEP scores were below the median, and their SIS score was above the median value. Elderly people without disabilities, who can meet their own needs, do not feel alone, stay in the healthcare facility of their own accord, are satisfied with the services healthcare facility and with life, do sports, go to cinema and theater in their free time and go out more often had high SWLS median values and low SIS and LSEP values (p < 0,05). Examining scale correlations, a moderate and negative correlation between SWLS and SIS (r= -,59; p=,000) a highly significant and negative correlation between SWLS and LSEP (r= -,70; p=,000) and a positive, statistically moderately significant correlation between SIS and LSEP (r=, 65; p=, 00) were found.
Conclusions
Life satisfaction increases and social isolation and loneliness decreases when elderly people living in nursing homes participate in social activities.
Key messages
Loneliness of elderly individuals can be reduced by increasing participation in social activities. Social isolation of elderly individuals can be reduced by increasing participation in social activities.
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Affiliation(s)
- O Erdem
- Nurisng Department, Public Health Nursing, Marmara University Faculty of Health Sciences, Istanbul, Turkey
| | - S Erol
- Nurisng Department, Public Health Nursing, Marmara University Faculty of Health Sciences, Istanbul, Turkey
| | - A Aydoğan
- Nurisng Department, Public Health Nursing, Marmara University Faculty of Health Sciences, Istanbul, Turkey
| | - B Subaşı
- Nurisng Department, Public Health Nursing, Marmara University Faculty of Health Sciences, Istanbul, Turkey
| | - L Kılıç
- Nurisng Department, Public Health Nursing, Marmara University Faculty of Health Sciences, Istanbul, Turkey
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Akdoğan A, Erden A, Fırat Şentürk E, Kılıç L, Sarı A, Armağan B, Karadağ Ö, Kiraz S. Capillaroscopic findings in Turkish Takayasu arteritis patients. Turk J Med Sci 2019; 49:1303-1307. [PMID: 31648432 PMCID: PMC7018322 DOI: 10.3906/sag-1812-223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/11/2019] [Indexed: 12/11/2022] Open
Abstract
Background/aim Abnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet’s disease, Henoch–Schönlein purpura, and Wegener’s granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA). Materials and methods We studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds. Results The median capillary density of TA patients was 9 (range: 9–11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04). Conclusion Capillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process.
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Affiliation(s)
- Ali Akdoğan
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esra Fırat Şentürk
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Berkan Armağan
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sedat Kiraz
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Oral F, Bilgin E, Bölek EÇ, Yardımcı GK, Kılıç L. Comment on: Intravenous cyclophosphamide vs rituximab for the treatment of early diffuse scleroderma lung disease: open label, randomized, controlled trial. Rheumatology (Oxford) 2019; 58:925. [DOI: 10.1093/rheumatology/kez033] [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] [Accepted: 01/18/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Fatma Oral
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ertuğrul Çağrı Bölek
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Bilge ŞY, Solmaz D, Şenel S, Emmungil H, Kılıç L, Öner SY, Yıldız F, Yılmaz S, Bozkırlı DE, Tufan MA, Yılmaz S, Yazısız V, Pehlivan Y, Beş C, Çetin GY, Erten Ş, Gönüllü E, Şahin F, Akar S, Aksu K, Kalyoncu U, Direskeneli H, Erken E, Kısacık B, Sayarlıoğlu M, Çınar M, Kaşifoğlu T, Sarı İ. Exon 2: Is it the good police in familial mediterranean fever? Eur J Rheumatol 2019; 6:34-37. [PMID: 30489254 PMCID: PMC6459332 DOI: 10.5152/eurjrheum.2018.18115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/25/2018] [Accepted: 08/08/2018] [Indexed: 11/22/2022] Open
Abstract
Objective Familial Mediterranean fever (FMF) is the most common autoinflammatory disease. Most of the identified disease-causing mutations are located on exon 10. As the number of studies about the effect of the exonal location of the mutation and its phenotypic expression is limited, we aimed to investigate whether the exonic location of the Mediterranean fever (MEFV) mutation has an effect on the clinical manifestation in patients with FMF. Methods Study population was derived from the main FMF registry that included 2246 patients from 15 different rheumatology clinics. We categorized the mutations according to their exon locations and retrieved the clinical and demographic information from the database. Results Patients having the MEFV mutations on exon 2 or 10 (n:1526) were divided into three subgroups according to the location of the MEFV mutations: Group 1 (exon 2 mutations), Group 2 (exon 10 mutations), and Group 3 (both exon 2 and exon 10 mutations). Group 2 patients were of a significantly younger age at onset, and erysipel-like erythema, arthritis, amyloidosis, and a family history of FMF were more common in this group. Conclusion Patients with FMF and exon 10 mutations show more severe clinical symptoms and outcome. Exon 2 mutations tend to have a better outcome.
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Affiliation(s)
- Şule Yaşar Bilge
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Dilek Solmaz
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Soner Şenel
- Division of Rheumatology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hakan Emmungil
- Division of Rheumatology, Department of Internal Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Yılmaz Öner
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Fatih Yıldız
- Division of Rheumatology, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Gülhane Military School of Medicine, Ankara, Turkey
| | - Duygu Ersözlü Bozkırlı
- Division of Rheumatology, Department of Internal Medicine, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Müge Aydın Tufan
- Division of Rheumatology, Department of Internal Medicine, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Sema Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Selçuk University School of Medicine, Konya, Turkey
| | - Veli Yazısız
- Division of Rheumatology, Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Yavuz Pehlivan
- Division of Rheumatology, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Cemal Beş
- Division of Rheumatology, Department of Internal Medicine, Abant İzzet Baysal University School of Medicine, Bolu, Turkey
| | - Gözde Yıldırım Çetin
- Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Şükran Erten
- Division of Rheumatology, Department of Internal Medicine, Ankara Training and Research Hospital, Ankara, Turkey
| | - Emel Gönüllü
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Fezan Şahin
- Department of Biostatistics, Eskisehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Department of Internal Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Eren Erken
- Division of Rheumatology, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | | | - Mehmet Sayarlıoğlu
- Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Muhammed Çınar
- Division of Rheumatology, Department of Internal Medicine, Gülhane Military School of Medicine, Ankara, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - İsmail Sarı
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Bilgin E, Hayran M, Erden A, Armağan B, Sarı A, Kılıç L, Akdoğan A, Karadağ Ö, Bilgen ŞA, Kiraz S, Ertenli İ, Kalyoncu U. Proposal for a simple algorithm to differentiate adult-onset Still’s disease with other fever of unknown origin causes: a longitudinal prospective study. Clin Rheumatol 2019; 38:1699-1706. [DOI: 10.1007/s10067-019-04455-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/24/2018] [Accepted: 01/24/2019] [Indexed: 12/21/2022]
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Bilgin E, Ozarli İ, Kılıç L, Bölek EÇ, Yardımcı GK, Karadağ Ö. Some concerns from Turkey. Ann Rheum Dis 2018; 79:e15. [DOI: 10.1136/annrheumdis-2018-214739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/15/2018] [Indexed: 11/04/2022]
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Kalyoncu U, Taşcılar EK, Ertenli Aİ, Dalkılıç HE, Bes C, Küçükşahin O, Kaşifoğlu T, Alpay Kanıtez N, Emmungil H, Kimyon G, Yaşar Bilge NŞ, Akar S, Atagündüz MP, Koca SS, Ateş A, Yazısız V, Terzioğlu E, Ersözlü ED, Tufan MA, Çınar M, Mercan R, Şahin A, Erten Ş, Pehlivan Y, Yılmaz S, Keleşoğlu Dinçer AB, Gerçik Ö, Coşkun BN, Yağız B, Kaymaz Tahra S, Aksoy A, Karadağ Ö, Kılıç L, Kiraz S. Methodology of a new inflammatory arthritis registry: TReasure. Turk J Med Sci 2018; 48:856-861. [PMID: 30119164 DOI: 10.3906/sag-1807-200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis
patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid
arthritis (RA) and spondyloarthritis (SpA) patients. Methodology Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the
database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that
operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the
TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure)
with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features,
comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the
patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers’ records. Finally, a
high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.
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Apraş Bilgen Ş, Kalyoncu U, Erden A, Canpolat U, Kılıç L, Karadağ Ö, Aytemir K, Kiraz S, Akdoğan A, Ertenli İ. Assessment of subclinical atherosclerosis in psoriatic arthritis patients without clinically overt cardiovascular disease or traditional atherosclerosis risk factors. Turk Kardiyol Dern Ars 2018; 46:358-365. [PMID: 30024392 DOI: 10.5543/tkda.2018.36169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Cardiovascular disease (CVD) is more prevalent in almost all patients with chronic inflammatory musculoskeletal diseases than in their healthy counterparts. The aim of this study was to assess the presence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA) in comparison with patients with rheumatoid arthritis (RA) and healthy controls. METHODS A total of 30 patients with PsA, 30 patients with RA, and 30 healthy controls were enrolled in this parallel group study. Demographic, clinical, and laboratory data of the groups were recorded. The Disease Activity Score-28 tool was used for joint assessment. The erythrocyte sedimentation rate and C-reactive protein level were measured as acute phase reactants. Flow-mediated dilatation (FMD) and carotid intima media thickness (CIMT) were also measured in all participants. RESULTS The median duration of disease in patients with PsA was 60 months (range: 8-216 months). A total of 22 of 30 (73.3%) PsA patients had a diagnosis of psoriasis and 13 (48.1%) had active disease. The study groups were similar with regard to age, gender, and body mass index data. In all, 23 (76.7%) of the PsA patients and 5 (16.7%) of the RA patients were using an anti-tumor necrosis factor alpha therapy (p<0.001). The FMD percentage was significantly smaller in both the PsA and the RA patients than in the healthy controls (p<0.001). The median CIMT was greater in the RA patients compared with the PsA patients and the healthy controls (p=0.008). There was no significant difference in FMD or CIMT between patients with and without an active joint lesion. CONCLUSION Endothelial functions were impaired in PsA, as in RA, in the absence of conventional risk factors or overt CVD. This finding may show a potential association between PsA, atherosclerosis, and CVD.
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Affiliation(s)
| | | | | | - Uğur Canpolat
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Erden A, Bilgin E, Kılıç L, Sarı A, Armağan B, Büyükaşık Y, Kalyoncu U. Remission of relapsing polychondritis after successful treatment of myelodysplastic syndrome with azacitidine: a case and review of the literature. Drug Metab Pers Ther 2018; 33:105-108. [PMID: 29715182 DOI: 10.1515/dmpt-2018-0002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/10/2018] [Accepted: 03/04/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Relapsing polychondritis (RP) is a rare autoimmune disorder, and myelodysplastic syndrome (MDS) is accompanied by RP at variable rates. Herein, we report a case with RP and MDS who responded dramatically to 5-azacitidine for MDS. CASE PRESENTATION With conventional immunosuppressive treatment, our patient had several episodes of different side effects, including infections. With the diagnosis of MDS and initiation of azacitidine treatment, all the manifestations of RP disappeared, and remission was achieved for MDS. Although he had relapses of either RP or MDS after several years of azacitidine treatment, all relapses were controlled well with the initiation of azacitidine treatment every time. CONCLUSIONS Azacitidine should be kept in mind as a treatment option for RP patients with MDS.
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Affiliation(s)
- Abdulsamet Erden
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
| | - Emre Bilgin
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
| | - Levent Kılıç
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
| | - Alper Sarı
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
| | - Berkan Armağan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
| | - Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Umut Kalyoncu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey
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Şeyhoğlu E, Erden A, Kılıç L, Karadağ Ö, Akdağlı SA, Akdoğan A, Kalyoncu U. Pulmonary aspergillosis after treatment with infliximab in Still's disease and a literature review of Still's disease and pulmonary aspergillosis. Eur J Rheumatol 2018; 5:75-78. [PMID: 29657880 DOI: 10.5152/eurjrheum.2016.15081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The use of anti-tumor necrosis factor alpha (anti-TNF-α) agents has increased during the past decade in rheumatology practice. Opportunistic infections have been reported with anti-TNF-α agents in clinical trials and post-marketing usage. Aspergillus infection is a rare opportunistic infection that is associated with immunosuppression, and there are reported cases of pulmonary aspergillosis in various rheumatic diseases treated with anti-TNF-α agents. Here, we present the first case of pulmonary aspergillosis associated with infliximab treatment in a patient with Still's disease.
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Affiliation(s)
- Emrah Şeyhoğlu
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdülsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sevtap Arıkan Akdağlı
- Department of Medical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Akdoğan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Soyuöz A, Karadağ Ö, Karaağaç T, Kılıç L, Bilgen ŞA, Özcebe Oİ. Therapeutic plasma exchange for refractory SLE: A comparison of outcomes between different sub-phenotypes. Eur J Rheumatol 2017; 5:32-36. [PMID: 29657872 DOI: 10.5152/eurjrheum.2017.17088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 05/23/2017] [Accepted: 07/03/2017] [Indexed: 12/18/2022] Open
Abstract
Objective Therapeutic plasma exchange (TPE) offers an alternative therapeutic modality for patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). However, there is conflicting evidence regarding its efficacy in different sub-phenotypes. This study aimed to investigate the main clinical characteristics and outcomes of patients with different phenotypes of SLE and APS treated with TPE at a tertiary care center. Methods The database of the Blood and Apheresis Unit between 2001 and 2013 was screened for patients with SLE and primary APS. SLE disease activity index (SELENA-SLEDAI), the indications for treatment, complications, and outcomes were obtained from a review of medical records and phone calls. A total of 24 patients (SLE: 20, APS: 4) were recruited for the study. Results Mean ages of SLE (M/F: 1/19) and primary APS (PAPS) patients (M/F: 2/2) were 32.4±12.89 and 52.0±10.7 years, respectively. The main indications for TPE were hematologic, neurologic, and pulmonary involvement and APS-related symptoms. TPE was preferred in eight patients because of leucopenia and co-infection. SLEDAI was significantly decreased after TPE (16.7±8.3 before vs. 8.8±3.1 after, p=0.001). Both primary APS and SLE-related catastrophic APS (CAPS) patients had completely responded to TPE. The success rate of TPE in patients with thrombocytopenia was lower than patients with hemolytic anemia. The median (IQR 25%-75%) number of TPE sessions was 6.5 (5-10.5). In total, five patients experienced TPE-related major adverse events (catheter infections in three patients, bleeding in one patient, and hypotension in one patient). The median (IQR 25%-75%) follow-up time was 33.5 (6.75-81.25) months. In total, four patients died during follow up, of which three died during the period of TPE administration. Conclusion Our data suggest that CAPS and other APS-related problems respond well to the TPE treatment. TPE should be kept in mind for the treatment of patients with other features of SLE, especially those resistant to other agents and in the presence of leucopenia.
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Affiliation(s)
- Aynur Soyuöz
- Division of Haemotology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ömer Karadağ
- Division of Haemotology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tülay Karaağaç
- Blood and Apheresis Unit of Hacettepe University School of Medicine Hospital, Ankara, Turkey
| | - Levent Kılıç
- Division of Haemotology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Şule Apraş Bilgen
- Division of Haemotology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Osman İlhami Özcebe
- Division of Haemotology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.,Blood and Apheresis Unit of Hacettepe University School of Medicine Hospital, Ankara, Turkey
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Kalyoncu U, Bayindir Ö, Ferhat Öksüz M, Doğru A, Kimyon G, Tarhan EF, Erden A, Yavuz Ş, Can M, Çetin GY, Kılıç L, Küçükşahin O, Omma A, Ozisler C, Solmaz D, Bozkirli EDE, Akyol L, Pehlevan SM, Gunal EK, Arslan F, Yılmazer B, Atakan N, Aydın SZ. The Psoriatic Arthritis Registry of Turkey: results of a multicentre registry on 1081 patients. Rheumatology (Oxford) 2016; 56:279-286. [PMID: 27794533 DOI: 10.1093/rheumatology/kew375] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 01/19/2016] [Revised: 09/09/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim was to assess the characteristics of PsA, find out how well the disease is controlled in real life, demonstrate the treatments and identify the unmet needs. METHODS The PsA registry of Turkey is a multicentre Web-based registry established in 2014 and including 32 rheumatology centres. Detailed data regarding demographics for skin and joint disease, disease activity assessments and treatment choices were collected. RESULTS One thousand and eighty-one patients (64.7% women) with a mean (sd) PsA duration of 5.8 (6.7) years were enrolled. The most frequent type of PsA was polyarticular [437 (40.5%)], followed by oligoarticular [407 (37.7%)] and axial disease [372 (34.4%)]. The mean (sd) swollen and tender joint counts were 1.7 (3) and 3.6 (4.8), respectively. Of these patients, 38.6% were on conventional synthetic DMARD monotherapy, 7.1% were on anti-TNF monotherapy, and 22.5% were using anti-TNF plus conventional synthetic DMARD combinations. According to DAS28, 86 (12.4%) patients had high and 105 (15.2%) had moderate disease activity. Low disease activity was achieved in 317 (45.7%) patients, and 185 (26.7%) were in remission. Minimal disease activity data could be calculated in 247 patients, 105 of whom (42.5%) had minimal disease activity. The major differences among sexes were that women were older and had less frequent axial disease, more fatigue, higher HAQ scores and less remission. CONCLUSION The PsA registry of Turkey had similarities with previously published registries, supporting its external validity. The finding that women had more fatigue and worse functioning as well as the high percentage of active disease state highlight the unmet need in treatment of PsA.
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Affiliation(s)
- Umut Kalyoncu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara
| | - Özün Bayindir
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ege University, Izmir
| | - Mustafa Ferhat Öksüz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Uludag University, Bursa
| | - Atalay Doğru
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University, Isparta
| | - Gezmiş Kimyon
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Gaziantep University, Ankara
| | - Emine Figen Tarhan
- Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University School of Medicine, Izmir
| | - Abdulsamet Erden
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara
| | - Şule Yavuz
- Istanbul Florence Nightingale Hospital, Department of Rheumatology, Istanbul Bilim University
| | - Meryem Can
- Department of Rheumatology, Fatih Sultan Mehmet Education and Research Hospital, İstanbul
| | - Gözde Yıldırım Çetin
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Sutcu Imam University, Kahramanmaras
| | - Levent Kılıç
- Department of Rheumatology, Yildirim Beyazit University, Yenimahalle Education and Research Hospital, Ankara
| | - Orhan Küçükşahin
- Faculty of Medicine, Atatürk Education and Research Hospital Department of Rheumatology, Yıldırım Beyazit University
| | - Ahmet Omma
- Department of Rheumatology, Ankara Numune Training and Research Hospital
| | - Cem Ozisler
- Department of Rheumatology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara
| | - Dilek Solmaz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Namik Kemal University, Tekirdag
| | | | - Lütfi Akyol
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ondokuz Mayıs University, Samsun
| | | | | | - Fatos Arslan
- Istanbul Medeniyet University, Goztepe Training and Research Hospital
| | - Barış Yılmazer
- Department of Rheumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul
| | - Nilgun Atakan
- Faculty of Medicine, Department of Dermatology, Hacettepe University, Ankara, Turkey
| | - Sibel Zehra Aydın
- Division of Rheumatology, University of Ottawa, Ottawa, Ontario, Canada
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Pamuk ÖN, Kalyoncu U, Aksu K, Omma A, Pehlivan Y, Çağatay Y, Küçükşahin O, Dönmez S, Çetin GY, Mercan R, Bayındır Ö, Çefle A, Yıldız F, Balkarlı A, Kılıç L, Çakır N, Kısacık B, Öksüz MF, Çobankara V, Onat AM, Sayarlıoğlu M, Öztürk MA, Pamuk GE, Akkoç N. A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients. Rheumatol Int 2016; 36:945-53. [DOI: 10.1007/s00296-016-3500-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/16/2016] [Indexed: 12/21/2022]
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Kalyoncu U, Emmungil H, Onat AM, Yılmaz S, Kaşifoglu T, Akar S, İnanç N, Yıldız F, Küçükşahin O, Karadağ Ö, Mercan R, Bes C, Yazısız V, Yılmazer B, Özmen M, Erten Ş, Şenel S, Yazıcı A, Taşçılar K, Kalfa M, Kiraz S, Kısacık B, Pehlivan Y, Kılıç L, Şimşek İ, Çefle A, Akkoç N, Direskeneli H, Erken E, Turgay M, Öztürk MA, Soy M, Aksu K, Dinç A, Ertenli İ. Current antiviral practice and course of Hepatitis B virus infection in inflammatory arthritis: a multicentric observational study (A + HBV study). Eur J Rheumatol 2015; 2:149-154. [PMID: 27708953 DOI: 10.5152/eurjrheum.2015.0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/04/2014] [Accepted: 07/02/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis. MATERIAL AND METHODS Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included. The case report form (CRF) consisted of demographic data, rheumatic diseases, treatment profiles, transaminase levels, viral hepatitis serological markers, and HBV viral load. The reactivation of HBV was defined as the abrupt rise in HBV replication by an increase in serum HBV DNA levels in a patient with a previously inactive HBV infection. RESULTS In total, the data of 101 (female 50.5%) patients were included (76 patients with inactive HBV carriers and 25 patients with chronic HBV infection). The mean age of patients was 44±12 years, and the mean follow-up duration was 31±22 months. Of the 101 patients, 70 (69.3%) received antiviral treatment. HBV reactivation was detected in 13 of 76 (17.1%) patients with inactive HBV carriers. HBV reactivation was observed less frequently, not although significantly, in those patients receiving antiviral prophylaxis compared with those not receiving prophylaxis [5/41 (12.2%) vs. 8/33 (24.2%), p=0.17]. Forty-two patients (31 patients had inactive HBV carriers) were using anti-tumor necrosis factor agents. HBV reactivation was detected in 6 of the 31 (19.3%) patients. Twenty-five patients had chronic hepatitis, and five (20%) of them had not received antiviral prophylaxis. HBV viral loads were persistently elevated in 7 (28%) of 25 patients (three patients under and four patients not under antiviral treatment). CONCLUSION HBV reactivation was observed in approximately 17% of patients under immunosuppressive treatments. HBV reactivation was more frequently observed in those who did not receive antiviral prophylaxis.
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Affiliation(s)
- Umut Kalyoncu
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Emmungil
- Department of Internal Medicine, Division of Rheumatology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ahmet Mesut Onat
- Department of Internal Medicine, Division of Rheumatology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Gülhane Military Faculty of Medicine, Ankara, Turkey
| | - Timuçin Kaşifoglu
- Department of Internal Medicine, Division of Rheumatology, Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
| | - Servet Akar
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Nevsun İnanç
- Department of Internal Medicine, Division of Rheumatology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Yıldız
- Department of Internal Medicine, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Orhan Küçükşahin
- Department of Internal Medicine, Division of Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Diyarbakır Goverment Hospital, Diyarbakır, Turkey
| | - Rıdvan Mercan
- Department of Internal Medicine, Division of Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Cemal Bes
- Department of Internal Medicine, Division of Rheumatology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Veli Yazısız
- Department of Internal Medicine, Division of Rheumatology, Antalya University Faculty of Medicine, Antalya, Turkey
| | - Barış Yılmazer
- Department of Internal Medicine, Division of Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Mustafa Özmen
- Department of Internal Medicine, Division of Rheumatology, İzmir Atatürk Training and Research Hospital, İzmir, Turkey
| | - Şükran Erten
- Department of Internal Medicine, Division of Rheumatology, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
| | - Soner Şenel
- Department of Internal Medicine, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ayten Yazıcı
- Department of Internal Medicine, Division of Rheumatology, Sakarya Education and Research Hospital, Sakarya, Turkey
| | - Koray Taşçılar
- Department of Internal Medicine, Division of Rheumatology, Cerrahpaşa University, Faculty of Medicine, İstanbul, Turkey
| | - Melike Kalfa
- Department of Internal Medicine, Division of Rheumatology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Sedat Kiraz
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bünyamin Kısacık
- Department of Internal Medicine, Division of Rheumatology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Yavuz Pehlivan
- Department of Internal Medicine, Division of Rheumatology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İsmail Şimşek
- Division of Rheumatology, Gülhane Military Faculty of Medicine, Ankara, Turkey
| | - Ayşe Çefle
- Department of Internal Medicine, Division of Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Nurullah Akkoç
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Eren Erken
- Department of Internal Medicine, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Murat Turgay
- Department of Internal Medicine, Division of Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Akif Öztürk
- Department of Internal Medicine, Division of Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Soy
- Department of Internal Medicine, Division of Rheumatology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Kenan Aksu
- Department of Internal Medicine, Division of Rheumatology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayhan Dinç
- Division of Rheumatology, Gülhane Military Faculty of Medicine, Ankara, Turkey
| | - İhsan Ertenli
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Aydın S, Yılmazer B, Bayındır Ö, Aksu K, Dalkılıç E, Öksüz M, Tarhan E, Can M, Küçükşahin O, Kimyon G, Akyol L, Onat A, Kısacık B, Erden A, Omma A, Ersözlü Bozkırlı E, Özişler C, Gönüllü E, Solmaz D, Çınar M, Yıldırım Çetin G, Aydın Tufan M, Kılıç L, Erten S, Kaşifoğlu T, Akar S, Kasapoğlu Günal E, Erbasan F, Yıldız F, Kabasakal Y, Kalyoncu U. SAT0582 Psoriasis Symptom Inventory is a Valid Patient-Reported Instrument for the Assessment of Skin Severityin Psoriatic Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kalyoncu U, Yılmazer B, Bayındır Ö, Aksu K, Dalkılıç E, Öksüz M, Tarhan E, Can M, Küçükşahin O, Kimyon G, Akyol L, Onat A, Kısacık B, Erden A, Omma A, Ersözlü Bozkırlı E, Özişler C, Gönüllü E, Masatlıoğlu Pehlevan S, Solmaz D, Çınar M, Yıldırım Çetin G, Tufan A, Aydın Tufan M, Kılıç L, Erten S, Kaşifoğlu T, Özgen M, Kasapoğlu Günal E, Arslan F, Pay S, Kabasakal Y, Aydın S. AB0829 Demographics of Patients with New-Onset Psoriatic Arthritis: Real Life Data from an Inception Cohort: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Aydın S, Yılmazer B, Bayındır Ö, Aksu K, Dalkılıç E, Öksüz M, Tarhan E, Can M, Küçükşahin O, Kimyon G, Akyol L, Onat A, Kısacık B, Erden A, Omma A, Ersözlü Bozkırlı E, Özişler C, Gönüllü E, Masatlıoğlu Pehlevan S, Aydın Tufan M, Solmaz D, Yıldırım Çetin G, Kılıç L, Erten S, Kaşifoğlu T, Şenel S, Kasapoğlu Günal E, Kabasakal Y, Sayarlıoğlu M, Kalyoncu U. AB0827 Hydroxychloroquine Does not Increase Psoriasis in Psoriatic Arthritis: Time on Drug Analysis Based on Real Life Data. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kalyoncu U, Yılmazer B, Bayındır Ö, Aksu K, Dalkılıç E, Öksüz M, Tarhan E, Can M, Küçükşahin O, Kimyon G, Akyol L, Onat A, Kısacık B, Erden A, Omma A, Ersözlü Bozkırlı E, Özişler C, Gönüllü E, Masatlıoğlu Pehlevan S, Solmaz D, Çınar M, Yıldırım Çetin G, Tufan A, Aydın Tufan M, Kılıç L, Erten S, Kaşifoğlu T, Kobak S, Şenel S, Akar S, Yılmaz S, Kasapoğlu Günal E, Sayarlıoğlu M, Kabasakal Y, Aydın S. SAT0583 Performance of Different Inflammatory Back Pain Criteria in Psoriatic Arthritis with Chronic Low Back Pain: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Karayusuf L, Akdoğan A, Kılıç L, Karadağ Ö, Kalyoncu U, Apraş Bilgen Ş, Ertenli İ, Kiraz S. Evaluation of association between capillaroscopic findings and organ involvements in Turkish systemic sclerosis patients. ACTA ACUST UNITED AC 2015. [DOI: 10.2399/raed.14.81300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tayfur Ö, Kılıç L, Karadağ Ö, Akdoğan A, Kerimoğlu Ü, Uzun Ö. Tuberculous bursitis of the greater trochanter mimicking ankylosing spondylitis. Eur J Rheumatol 2015; 2:31-32. [PMID: 27708917 DOI: 10.5152/eurjrheumatol.2015.0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/14/2014] [Accepted: 08/24/2014] [Indexed: 11/22/2022] Open
Abstract
Tuberculous trochanteric bursitis (TTB) is a rare condition that accounts for 1% of musculoskeletal tuberculosis cases. Extrapulmonary TB is usually diagnosed late because of reduced diagnostic suspicion, particularly in the absence of signs of systemic infection. Herein, we report a case of right hip pain that was misdiagnosed as ankylosing spondylitis. The patient had a history of inflammatory back pain with morning stiffness. However, HLA-B27 was negative. Sacroiliac magnetic resonance imaging (MRI) revealed a giant multiloculated collection (27×16×10 cm). Percutaneous drainage was performed and Mycobacterium tuberculosis was observed in fluid culture. The patient was treated by drainage along with antituberculosis therapy. After 1 year of antituberculosis therapy, control MRI revealed total resolution of the large fluid collection. It is important to emphasize that fever or general symptoms are absent in patients with TTB, as observed in the present case. In endemic countries, TTB should be kept in mind in the differential diagnosis of a patient presenting with chronic hip pain without fever, weight loss, and constitutional symptoms.
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Affiliation(s)
- Öykü Tayfur
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ömer Karadağ
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Akdoğan
- Department of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ülkü Kerimoğlu
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ömrüm Uzun
- Department of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Bitik B, Kılıç L, Küçükşahin O, Şahin K, Tufan A, Karadağ Ö, Pay S, Ateş A, Ucar M, Tutar H, Karaaslan Y, Yilmaz S, Ertenli AI, Konuk O, Turgay M, Goker B. Retro-orbital granuloma associated with granulomatosis with polyangiitis: a series of nine cases. Rheumatol Int 2014; 35:1083-92. [DOI: 10.1007/s00296-014-3179-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
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Abstract
OBJECTIVE Our aim was to report our experience with inflammatory myositis. MATERIAL AND METHODS In total, 60 patients were evaluated retrospectively, and 43 of them (71.7%) were female. The median age was 45 (17-81). Of all patients, 33 (55%) were diagnosed as polymyositis, 22 (36.6%) as dermatomyositis (classical, amyopathic, and malignancy-associated), and 5 (8.33%) as undifferentiated myositis. The 3 patients with malignancy-associated dermatomyositis had lung cancer, nasopharyngeal carcinoma, and endometrial cancer. Two patients with polymyositis had a history of low-grade gastric mixed tumor and thymoma but were diagnosed 7 and 12 years ago, and no recurrences have been reported during the routine controls. RESULTS All patients, other than two with malignancy-associated dermatomyositis, were treated via immunosuppressive agent, and the third patient with lung cancer was diagnosed later and gave up immunosuppressive therapy. Thirty-nine (65%) of the patients were treated via oral low-dose steroid, and 19 (31.7%) were treated via intravenous high-dose pulse steroid therapy. All patients were treated with steroid, which was tapered by time, and 23 (38.3%) were treated with azathioprine, 6 (10%) were treated with cyclophosphamide, 3 (5%) were treated with methotrexate, and 6 (10%) were treated with isolated steroid therapy at the time of diagnosis. The median follow-up period was 37 (2-135) months. Six patients (10%) have died-3 due to myocardial infarction, 1 due to septic shock, 1 due to malignancy, and 1 with an unknown reason. The 5-year survival rate was 76.9%, and the 10-year survival rate was 40%. CONCLUSION Other than the high ratio of PM in our series, all other results were compatible with the literature. We faced few resistant diseases; therefore, biologic agents were used rarely.
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Affiliation(s)
- Metin Işık
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Şule Bilgen
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İsmail Doğan
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Emmungil H, Yaşar Bilge NŞ, Küçükşahin O, Kılıç L, Okutucu S, Gücenmez S, Kalyoncu U, Kaşifoğlu T, Turgay M, Aksu K. A rare but serious manifestation of Behçet's disease: intracardiac thrombus in 22 patients. Clin Exp Rheumatol 2014; 32:S87-S92. [PMID: 25068833] [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: 04/09/2014] [Accepted: 07/01/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Behçet's disease (BD) is a chronic, multisystemic disorder characterised by recurrent oral aphtous ulcers, genital ulcers and ocular inflammation. Vasculitis and thrombotic events are the most important causes of mortality. Vena cava thrombosis, pulmonary artery aneurysms, Budd-Chiari syndrome, peripheral artery aneurysms, dural sinus thrombosis and abdominal aorta aneurysms are the other less common vascular manifestations of BD. Cardiac involvement in BD is a rare and life-threatening complication. The aim of this study was to assess the clinical characteristics and outcome of patients with BD who have intracardiac thrombus. METHODS The hospital files of BD patients followed by rheumatology clinics of four medical centres (Ankara University, Ege University, Hacettepe University and Eskişehir Osmangazi University Hospitals) were retrospectively evaluated. Data included patients' demographic and clinical features, laboratory findings and outcome. All patients fulfilled three or more of the International Study Group Criteria for BD. RESULTS Twenty-two patients with intracardiac thrombus were evaluated. The mean age of patients with intracardiac thrombosis was 29.1 yrs (22-44) and there was a male predominance with a ratio of 20:2. Cardiac involvement was the first clinical manifestation of BD in 9 of the 22 patients. Initial symptoms of the patients were fever (n=18, 81%), dyspnea (n=9, 40%) chest pain (n=9, 40%) and haemoptysis (n=7, 31.8%). Sixteen patients (72%) had pulmonary arteritis and 10 (45%) patients had venous system lesions included deep vein, inferior vena cava and hepatic vein. Intra-cardiac thrombus were found only in the right cavities in 17 patients (77%), only in the left cavities in 2 patients (9%), and in both left and right cavities of the heart in 3 patients (13.6%). Once the cardiac lesion was diagnosed as a complication of BD, high dose (1mg/kg/d) prednisone (n=22, 100%) plus cyclophosphamide (n=18, 81%) or azathioprine (n=3, 13.6%) and warfarin (n=8, 36.3% (after the elimination of pulmonary aneurysm) therapy for anticoagulation was initiated. Four patients (18%) had high dose prednisone plus cyclophosphamide plus interferon-α (IFN-α) combination treatment and two patients (n=2, 9%) had high dose prednisone plus cyclophosphamide or plus azathioprine combination treatment. After treatment, the intra-cardiac thrombus disappeared in 13 cases and the size of the thrombus reduced in 7 cases. One patient died because of recurrent intra-cardiac thrombus and massive pulmonary arteritis in the emergency department. CONCLUSIONS Intracardiac thrombus in BD is more common in young men. The right side of the heart is usually involved and cardiac involvement is often accompanied by pulmonary artery occlusion possibly due to pulmonary arteritis. Early and aggressive immunosuppressive and/or anticoagulation therapy are life-saving.
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Affiliation(s)
- Hakan Emmungil
- Division of Rheumatology, Department of Internal Medicine, Ege University, Izmir, Turkey.
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Emmungil H, Yaşar Bilge N, Küçükşahin O, Kılıç L, Okutucu S, Gücenmez S, Kalyoncu U, Kaşifoğlu T, Turgay M, Aksu K. FRI0473 A Rare but Life-Threatening Presentation of BehÇEt's Disease: Intra-Cardiac Thrombus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Karakulak UN, Maharjan N, Aladağ E, Kılıç L, Akdoğan A, Kaya EB, Tokgözoğlu L. A New Electrocardiographic Parameter in Scleroderma Patients with and Without Pulmonary Hypertension: Tp-E/Qtc Ratıo. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Karakulak UN, Maharjan N, Aladağ E, Kılıç L, Akdoğan A, Kaya EB, Tokgözoğlu L. Factors That Affect Pulmonary Artery Pressure in Scleroderma Patients with Pulmonary Hypertensıon. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Karakulak UN, Maharjan N, Aladağ E, Kılıç L, Akdoğan A, Kaya EB, Tokgözoğlu L. Risk factors and Predictors in the Development of Pulmonary Hypertension in Scleroderma Patients. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Karakulak U, Şahiner M, Kılıç L, Akdogan A, Fatihoglu Ş, Maharjan N, Kaya E, Aytemir K, Oto A. OP-040 AMBULATORY ARTERIAL STIFFNESS INDEX IN PATIENTS WITH RHEUMATOID ARTHRITIS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70041-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Işık M, Kılıç L, Doğan I. Recurrent uveitis due to sildenafil usage in a patient with Behçet's disease. Rheumatol Int 2011; 33:803. [PMID: 22095394 DOI: 10.1007/s00296-011-2246-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 10/22/2011] [Indexed: 12/01/2022]
Abstract
Behçet's disease (BD) may cause uveitis and retinal vasculitis in nearly half of the patients. Uveitis is one of the most serious complications that can lead to blindness. Sildenafil (Viagra(R)) and the other phosphodiesterase type 5 (PDE5) inhibitors are the first-line options for the treatment of erectile dysfunction, but transient visual symptoms and serious ocular side effects have been reported in PDE5 inhibitor users. Herein, we report a case with BD who applied to our outpatient unit with recurrent uveitis after sildenafil therapy.
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Affiliation(s)
- Metin Işık
- Department of Internal Medicine, Hacettepe University Hospital, Sihhiye, Ankara, Turkey.
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