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Altıngöz EN, Yenisoy Y, Kapusuz A, Abacar K, Şişman-Kitapçı N, Yay M, Karacaylı U, Alibaz-Öner F, İnanç N, Ergun T, Fortune F, Direskeneli H, Mumcu G. The mediator role of treatment response on oral health related quality of life in Behçet's syndrome. Med Oral Patol Oral Cir Bucal 2023:26319. [PMID: 38150605 DOI: 10.4317/medoral.26319] [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: 08/28/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The aim of the study was to analyse the effects of Treatment Response with oral ulcers on oral health related quality of life in Behçet's syndrome (BS). MATERIAL AND METHODS In the cross-sectional study, 339 BS patients (F/M: 179/160, mean age: 36,13±9,81 years) were included. Data were collected by clinical examinations and patient reported outcome measures (PROMs) regarding Oral Health Impact Profile-14 (OHIP-14) questionnaire and self-reported Treatment Responses coded by a 5-point Likert-type scale (1: symptoms were cured- 5: symptoms were worsened). Moderated Mediation analysis (MA) was used to understand how oral ulcer activity (independent variable; X) influenced OHIP-14 score (outcome variables, Y) through self-reported Treatment Response (M1) and age (M2) as possible mediator variables (M) and disease course (mucocutaneous and musculuskeletal involvement vs. major organ involvement) as a possible moderator variable (W) on these relationships. RESULTS In Moderated MA, OHIP-14 score (Y) was mediated by the presence of oral ulcer (X) (p=0.0000), the negative Treatment Response (M1) (p=0.0001) and being young (M2) (p=0.0053) with mucocutaneous involvement (W)(p=0.0039). CONCLUSIONS Self-reported Treatment Response as an underestimated issue has a Mediator role in relation to oral ulceration on oral health related quality of life in the framework of patient empowerment strategies. Therefore, study results give clues to assist physicians and dentists for better understanding of patients' perspective.
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Affiliation(s)
- E-N Altıngöz
- Faculty of Health Sciences Marmara University, Istanbul, Turkey
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Çevlik T, Kaya Ö, Gül F, Turkal R, İnanç N, Direskeneli H, İlki A, Şirikçi Ö, Haklar G, Cinel İ. Evaluation of the Diagnostic Value of Cell Population Data in Sepsis in Comparison to Localized Infection, Chronic Inflammation, and Noninfectious Inflammation Cases. J Intensive Care Med 2023; 38:382-390. [PMID: 36147030 DOI: 10.1177/08850666221127185] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Sepsis, defined as an increase of 2 points or more in the sequential organ failure assessment score, is a life-threatening organ dysfunction caused by the dysregulated host response to infection. Volume-conductivity-scatter (VCS) parameters of cell counters which are known as cell population data (CPD) have been suggested to be beneficial in diagnosing sepsis. We aimed to evaluate the diagnostic value of CPD parameters in sepsis in comparison to nonsystemic infection cases (NSI) and non-infectious acute and chronic inflammatory conditions. MATERIALS AND METHODS We prospectively included four groups of patients" data: sepsis (n = 66), localized infection (pneumonia, n = 59), chronic inflammation (rheumatoid arthritis, n = 92) and noninfectious inflammation (coronary artery bypass graft operation, n = 56) groups, according to their clinical status and laboratory results. Samples for cell counting and serum markers were collected on the same day of culture collection. VCS parameters were measured by Unicel DxH800 Coulter Cellular Analyzer (Beckman Coulter, USA). RESULTS Mean neutrophil volume (MN-V-NE), was highest in the sepsis group [155(149-168)] compared to the localized infection [148(140-158)], chronic inflammation [144.5(142-149)] and noninfectious inflammation [149(145.2-153.7)] (P = 0.001, P < 0.001, P < 0.001, respectively). Neutrophil volume SD (SD-V-NE) was higher in the sepsis [21(18.8-23.7)], significantly differentiating sepsis from other groups. The area under curves of procalcitonin and hs-C-reactive protein were 0.846 and 0.837, respectively, in the receiver-operating characteristic curves (ROC) . CPD combinations, (SD-V NE + SD-V LY + SD-V MO), (SD-V NE + SD-V MO), and (MN-V NE + SD-V NE + SD-C LY + SD-V MO) had greater AUC values than procalcitonin's. CONCLUSION VCS parameters might be promising for differentiating sepsis and non-sepsis cases. Additionally, obtaining these data routinely makes their prospects promising without any additional cost and time.
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Affiliation(s)
- Tülay Çevlik
- Biochemistry Laboratory, Marmara University Pendik E&R Hospital, Istanbul, Turkey
| | - Özlem Kaya
- Division of Critical Care Medicine, Dept. of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey
| | - Fethi Gül
- Division of Critical Care Medicine, Dept. of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey
| | - Rana Turkal
- Biochemistry Laboratory, Marmara University Pendik E&R Hospital, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Dept. of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Dept. of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
| | - Arzu İlki
- Dept. of Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Önder Şirikçi
- Biochemistry Laboratory, Marmara University Pendik E&R Hospital, Istanbul, Turkey.,Dept. of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
| | - Goncagül Haklar
- Biochemistry Laboratory, Marmara University Pendik E&R Hospital, Istanbul, Turkey.,Dept. of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
| | - İsmail Cinel
- Division of Critical Care Medicine, Dept. of Anesthesiology and Reanimation, School of Medicine, Marmara University, Istanbul, Turkey
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Ergenç İ, Kani HT, Karabacak M, Cömert Özer E, Mehdiyev S, Jafarov F, Abacar KY, Kutluğ Ağaçkıran S, Sevik G, Aslan R, Alibaz Öner F, İnanç N, Atagündüz MP, Seçkin D, Özen Alahdab Y, Ergun T, Direskeneli H, Atuğ Ö, Atug O. RE: Risk of HBV Reactivation in HBsAg Negative and AntiHBc IgG Positive Patients Receiving Biologic Therapy. Turk J Gastroenterol 2023; 34:310. [PMID: 36919837 PMCID: PMC10152175 DOI: 10.5152/tjg.2023.237002] [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] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- İlkay Ergenç
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Haluk Tarık Kani
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Murat Karabacak
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Elif Cömert Özer
- Department of Dermatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Shahin Mehdiyev
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Fuad Jafarov
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Kerem Yiğit Abacar
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Seda Kutluğ Ağaçkıran
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Gizem Sevik
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Rahmi Aslan
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Fatma Alibaz Öner
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Nevsun İnanç
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Mehmet Pamir Atagündüz
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Dilek Seçkin
- Department of Dermatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Yeşim Özen Alahdab
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Özlen Atuğ
- Department of Internal Medicine, Division of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
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Ergenç İ, Kani HT, Karabacak M, Cömert Özer E, Mehdiyev S, Jafarov F, Abacar KY, Kutluğ Ağaçkıran S, Sevik G, Aslan R, Alibaz Öner F, İnanç N, Atagündüz MP, Seçkin D, Özen Alahdab Y, Ergun T, Direskeneli H, Atuğ Ö, Atug O. Biologic Therapy Carries a Very Low Risk of Reactivation in Hepatitis B Surface Antigen-Negative Phase of Hepatitis B. Turk J Gastroenterol 2023; 34:156-160. [PMID: 36445058 PMCID: PMC10081030 DOI: 10.5152/tjg.2022.22196] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The risk of hepatitis B reactivation in hepatitis B surface antigen-negative phase of hepatitis B virus-infected patients exposed to biologic agents is not clear. We aimed to investigate the reactivation rate in hepatitis B surface antigen-negative phase of hepatitis B virus-infected patients after biologic therapy. METHODS Patients followed at gastroenterology, rheumatology, and dermatology clinics with a diagnosis of immune-mediated inflam matory diseases were screened. Immune-mediated inflammatory diseases patients exposed to biologic agents with a negative hepatitis B surface antigen and positive hepatitis B core immunoglobulin G antibody were included in the study. RESULTS We screened 8266 immune-mediated inflammatory disease patients, and 2484 patients were identified as exposed to biologic agents. Two hundred twenty-one patients were included in the study. The mean age was 54.08 ± 11.69 years, and 115 (52.0%) patients were female. The median number of different biologic subtype use was 1 (range: 1-6). The mean biologic agent exposure time was 55 (range: 2-179) months. One hundred and fifty-two (68.8%) patients used a concomitant immunomodulatory agent, and 84 (38.0%) patients were exposed to corticosteroids during biologic use. No hepatitis B reactivation with a reverse seroconversion of hepatitis B surface antigen positivity was seen. Antiviral prophylaxis for hepatitis B was applied to 48 (21.7%) patients. Hepatitis B virus-DNA was screened in 56 (25.3%) patients prior to the biologic exposure. Two patients without antiviral prophylaxis had hepatitis B virus-DNA reactivation with a negative hepatitis B surface antigen during exposure to the biologic agent. CONCLUSION We found 2 reactivations and no hepatitis B surface antigen seroconversion in our cohort. Antiviral prophylaxis for patients exposed to biologic agents may need to be discussed in more detail.
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Affiliation(s)
- İlkay Ergenç
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Haluk Tarık Kani
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Murat Karabacak
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Elif Cömert Özer
- Department of Dermatology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Shahin Mehdiyev
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Fuad Jafarov
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Kerem Yiğit Abacar
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Seda Kutluğ Ağaçkıran
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Gizem Sevik
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Rahmi Aslan
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Fatma Alibaz Öner
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Pamir Atagündüz
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Dilek Seçkin
- Department of Dermatology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Yeşim Özen Alahdab
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Özlen Atuğ
- Division of Gastroenterology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
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Taş S, Antal A, Fuad Durusoy A, Yanartaş M, Yıldız K, Olgun Yıldızeli Ş, Kocakaya D, Mutlu B, Alibaz-Öner F, Direskeneli H, İnanç N, Erkılınç A, Yıldızeli B. Pulmonary Endarterectomy in Patients with Antiphospholipid Syndrome-Associated Chronic Thromboembolic Pulmonary Hypertension. Anatol J Cardiol 2021; 26:394-400. [PMID: 35552176 PMCID: PMC9366407 DOI: 10.5152/anatoljcardiol.2021.1138] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Antiphospholipid syndrome is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis. Chronic thromboembolism is one of the known established pathogenesis of pulmonary hypertension, known as chronic thromboembolic pulmonary hypertension. Pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension. The aim of this study is to evaluate the efficacy and risk of pulmonary endarterectomy in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension. Methods Data were prospectively collected and retrospectively analyzed, for patients who underwent pulmonary endarterectomy between March 2011 and March 2020. Results Seventeen patients (4 male and 13 female) were identified. Thirteen patients had primary antiphospholipid syndrome and 4 had secondary antiphospholipid syndrome. The mean age was 34.82 ± 10.07 years and the mean time interval between the diagnosis and surgery was 26.94 ± 17.35 months. Dyspnea on exertion was the main symptom in all patients. Seven patients had previous deep vein thrombosis, 5 patients had a history of recurrent abortions, and 2 patients had hemoptysis. Following surgery, mean pulmonary artery pressure decreased from 47.82 ± 13.11 mm Hg to 22.24 ± 4.56 mm Hg (P < .001), and pulmonary vascular resistance improved from 756.50 ± 393.91 dyn/s/cm−5 to 298.31 ± 132.84 dyn/s/cm−5 (P < .001). There was no in-hospital mortality with a mean follow-up of 75.29 ± 40.21 months. The functional capacity of all patients improved from 269.46 ± 111.7 m to 490 ± 105.34 m on a 6-minute walking test. Conclusions Pulmonary endarterectomy is a safe and curative treatment in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension. It has a favorable outcome by increasing the quality of life. A multidisciplinary experienced chronic thromboembolic pulmonary hypertension team is critical in the management of these unique patients.
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Affiliation(s)
- Serpil Taş
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
- Corresponding author:Serpil Taş✉
| | - Arzu Antal
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | | | - Mehmed Yanartaş
- Department of Thoracic Surgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Kübra Yıldız
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
- Public Health Sciences, Gaziantep University, Gaziantep, Turkey
| | - Şehnaz Olgun Yıldızeli
- Department of Pulmonology and Intensive Care, School of Medicine, Marmara University, İstanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonology and Intensive Care, School of Medicine, Marmara University, İstanbul, Turkey
| | - Bülent Mutlu
- Department of Cardiology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Fatma Alibaz-Öner
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Nevsun İnanç
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Atakan Erkılınç
- Department of Anesthesia, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Bedrettin Yıldızeli
- Department of Thoracic Surgery, School of Medicine, Marmara University, İstanbul, Turkey
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Mumcu G, Yay M, Karaçaylı Ü, Aksoy A, Taş MN, Armağan B, Sarı A, Bozca BC, Tekgöz E, Temiz Karadağ D, Badak SÖ, Tecer D, Yıldırım A, Bes C, Şahin A, Erken E, Cefle A, Çınar M, Yılmaz S, Alpsoy E, Boyvat A, Şenel S, Bilge ŞY, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H. Moderation analysis exploring associations between age and mucocutaneous activity in Behçet's syndrome: A multicenter study from Turkey. J Dermatol 2020; 47:1403-1410. [PMID: 32981075 DOI: 10.1111/1346-8138.15553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/19/2020] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to examine the effects of age on mucocutaneous activity by using moderation analysis in Behçet's syndrome (BS). In this cross-sectional study, 887 BS patients (female : male, 481:406; mean age, 38.4 ± 10.9 years) followed in 13 tertiary centers in Turkey were included. Mucocutaneous activity was evaluated by using the Mucocutaneous Index (MI) according to sex and disease course. Moderation analysis was performed to test the effect of age on mucocutaneous activity. A moderator variable is a third variable and affects the relationship between independent and outcome variables. Age was chosen as a potential moderator variable (interaction effect), MI score as the outcome variable and sex as an independent variable in the analysis. The moderation analysis tested the effects of age in three steps: whole BS patient group, patients without systemic involvement and those with systemic involvement. The moderation model was only significant in BS patients with systemic involvement (P = 0.0351), and a significant relationship was observed between female sex and MI score (P = 0.0156). In addition, the interaction plot showed that female patients had increased MI scores compared with male patients, especially in the 28-year-old age group (P = 0.0067). Moreover, major organ involvement was newly diagnosed in the majority of these young female BS patients. Our results suggest that the relationship between sex and mucocutaneous activity was moderated by age in the systemic involvement group. Also, increased mucocutaneous activity may be associated with new major organ involvement in young female BS patients with systemic involvement.
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Affiliation(s)
- Gonca Mumcu
- Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Meral Yay
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey
| | - Ümit Karaçaylı
- Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, Ankara, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Mehmet Nedim Taş
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Burçin Cansu Bozca
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Duygu Temiz Karadağ
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Suade Özlem Badak
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Duygu Tecer
- Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey
| | - Alper Yıldırım
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Cemal Bes
- Istanbul Bakırköy Dr. Sadi Konuk Education and Research Hospital, Rheumatology Clinic, Istanbul, Turkey
| | - Ali Şahin
- Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey
| | - Eren Erken
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Gulhane Medical Faculty, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Erkan Alpsoy
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Ayşe Boyvat
- Department of Dermatology, Medical School, Ankara University, Ankara, Turkey
| | - Soner Şenel
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Gökhan Keser
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology Department, Medical School, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
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Mumcu G, Yay M, Aksoy A, Taş MN, Armağan B, Sarı A, Bozca BC, Tekgöz E, Karadağ DT, Badak SÖ, Tecer D, Bes C, Şahin A, Erken E, Cefle A, Çınar M, Yılmaz S, Karaçaylı Ü, Alpsoy E, Şenel S, Yaşar Bilge Ş, Kaşifoğlu T, Karadağ Ö, Aksu K, Keser G, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H. Predictive factors for work-day loss in Behçet's syndrome: A multi-center study. Int J Rheum Dis 2019; 23:240-246. [PMID: 31858715 DOI: 10.1111/1756-185x.13771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this multi-center study was to assess predictive factors for work-day loss as an indirect cost element in Behçet's syndrome (BS). METHODS In this cross-sectional, multi-center study, 834 BS patients (F/M: 441/393, age mean: 38.4 ± 10.9 years) were included. Data were collected by a questionnaire regarding treatment protocols, disease duration, smoking pattern, frequency of medical visits during the previous year and self-reported work-day loss during the previous year. RESULTS Work-day loss was observed in 16.2% of patients (M/F: 103/32). The percentages of being a smoker (81.8%), using immunosuppressive (IS) medications (82%), and having disease duration <5 years (74%) were higher in male patients with work-day loss (P < .05). The majority of males (90.9%) had more than four clinic visits during the previous year. Moreover, the mean work-day loss (30.8 ± 57.7 days) was higher in patients with vascular involvement (56.1 ± 85.9) than those without (26.4 ± 50.6 days) (P = .046). In addition, increased frequency of ocular involvement (25.9%) was also observed in patients with work-day loss compared to others (8.6%) (P = .059). CONCLUSION Work-day loss was associated with both vascular and ocular involvement. Close associations were observed among male gender, early period of the disease, frequent medical visits, being a smoker and treatment with IS medications in patients with work-day loss.
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Affiliation(s)
- Gonca Mumcu
- Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Meral Yay
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Mehmet Nedim Taş
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Berkan Armağan
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Burçin Cansu Bozca
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Emre Tekgöz
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Duygu Temiz Karadağ
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Suade Özlem Badak
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Duygu Tecer
- Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey
| | - Cemal Bes
- Rheumatology Clinic, Istanbul Bakırköy Dr.Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Ali Şahin
- Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey
| | - Eren Erken
- Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Muhammet Çınar
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Sedat Yılmaz
- Gulhane Medical Faculty, Division of Rheumatology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Ümit Karaçaylı
- Gulhane Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Erkan Alpsoy
- Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
| | - Soner Şenel
- Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey
| | - Şule Yaşar Bilge
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey
| | - Ömer Karadağ
- Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey
| | - Kenan Aksu
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Gökhan Keser
- Division of Rheumatology, Medical School, Ege University, Izmir, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology Department, Medical School, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey
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Mumcu G, Yağar F, Alibaz-Öner F, İnanç N, Direskeneli H, Ergun T. Does illness perception associate with disease symptoms in Behçet's disease? Intern Emerg Med 2019; 14:691-697. [PMID: 30506212 DOI: 10.1007/s11739-018-1983-y] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
This study aims to assess the relationship between illness perception and disease course and symptoms in Behçet disease (BD). One hundred ten consecutive BD patients (F/M 50/60, mean age 38.5 ± 9.88 years) and 57 patients with Psoriasis as a disease control group (F/M 28/29, mean age 48.12 ± 15.52) are included in this cross-sectional study. Illness perception is evaluated using a revised version of the Illness Perception Questionnaire (IPQ-R). In IPQ-R, the identity score reflecting the number of symptoms is higher in BD patients with musculoskeletal involvement than the others (6.77 ± 2.91 vs. 5.08 ± 3.3, respectively, p = 0.007). The consequences score for musculoskeletal involvement (19.52 ± 7.03) and timeline (acute/chronic) score for eye involvement (26.67 ± 4.32) are also higher compared to patients without them (16.37 ± 5.82 and 22.09 ± 8.68) (p = 0.011 and p = 0.038), reflecting negative beliefs about the illness. The score of psychological attribution is higher in patients with psoriasis than BD (p = 0.039), whereas the other subgroup scores are lower in patients with psoriasis compared to those of BD (p < 0.05). This study provides a patient's perspective in the disease management process of BD using the IPQ-R questionnaire. A patient's own personal beliefs and emotional responses to their symptoms might affect the outcome measures, especially with musculoskeletal symptoms and eye involvement in BD. However, psychological attribution is found to be a prominent issue in psoriasis.
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Affiliation(s)
- Gonca Mumcu
- Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
| | - Fedayi Yağar
- Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Tulin Ergun
- Department of Dermatology, School of Medicine, Marmara University, Istanbul, Turkey
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9
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İris M, Özçıkmak E, Aksoy A, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H, Mumcu G. The assessment of contributing factors to oral ulcer presence in Behçet's disease: Dietary and non-dietary factors. Eur J Rheumatol 2018; 5:240-243. [PMID: 30501850 PMCID: PMC6267742 DOI: 10.5152/eurjrheum.2018.18094] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/08/2018] [Indexed: 12/14/2022] Open
Abstract
Objective The aim of this study was to assess the contributing factors for oral ulcer activity in Behçet’s disease (BD). Methods Ninety-two patients with BD (F/M: 42/50, mean age: 38.7±10.02 years) participated in this cross-sectional study. Data regarding disease-related factors, smoking patterns, and self-reported dietary/non-dietary triggering factors for oral ulcer activity were collected by a questionnaire. Treatment protocol was categorized as mild and intensive groups associated with organ involvements. Results A mild treatment protocol was more common in females (52.4% vs 20%) than in males (p=0.002). During the last three months, the number of oral ulcers in female patients was higher in the mild treatment group (6.4±6.5) than in the intensive treatment group (3.3±4.9) (p=0.045). In patients with active oral ulcers (n=63), rate of being a non-smoker was also higher in females (86.7% vs 63.6%) than in males. Daily frequency of tooth brushing was 1.2±0.8 in patients with BD, and was higher in females (1.5±0.9 vs 0.9±0.6) (p=0.001). Stress and fatigue (78.3%) were reported as the most frequent triggering factors for oral ulcer presence in patients with BD. A total of 148 different dietary factors associated with oral ulcer presence were reported in the study. Conclusion A mild treatment protocol and being a non-smoker were found to be the contributing factors associated with oral ulcer activity in patients with BD. Being motivated for oral hygiene and being non-smokers were positive health behaviors observed in females. Irrespective of gender, stress and fatigue were defined as the most common self-reported triggering factors for oral ulcer presence in BD. In addition, the roles of some dietary factors were also reported.
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Affiliation(s)
- Merve İris
- Marmara University School of Medicine, İstanbul, Turkey
| | - Ezgi Özçıkmak
- Marmara University School of Medicine, İstanbul, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Gonca Mumcu
- Deparment of Health Management, Faculty of Health Sciences, Marmara University, İstanbul, Turkey
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Kaner G, İnanç N, Seremet Kürklü N, Atalay N. The effect of nutrition training on clinical findings and anthropometric measurements of children with celiac disease. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1563] [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: 11/27/2022]
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11
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Mumcu G, Alibaz-Öner F, Öner SY, Özen G, Atagündüz P, İnanç N, Köksal L, Ergun T, Direskeneli H. Oral ulcer activity in Behcet's disease: Poor medication adherence is an underestimated risk factor. Eur J Rheumatol 2017; 4:109-112. [PMID: 28638682 PMCID: PMC5473444 DOI: 10.5152/eurjrheum.2017.160094] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/10/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behçet's disease (BD) patients. MATERIAL AND METHODS The study group included 330 BD patients (F/M: 167/163, mean age: 38.5±10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of "0" to "8" with high scores indicating better adherence. Low adherence was defined as <6 points on MMAS-8. RESULTS Over half of the group had active oral ulcers (n=219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39±3.24) than in the rest of the female group (1.28±2.05; p=0.023). Although a similar trend was also observed in male patients (2.14±3.3 vs. 1.81±2.31), a significant relationship was not observed (p=0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p=0.04). CONCLUSION Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.
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Affiliation(s)
- Gonca Mumcu
- Department of Health Management, Marmara University School of Health Sciences, İstanbul, Turkey
| | - Fatma Alibaz-Öner
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Sibel Yılmaz Öner
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Gülsen Özen
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Pamir Atagündüz
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Nevsun İnanç
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Leyla Köksal
- Department of Health Management, Marmara University School of Health Sciences, İstanbul, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey
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12
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Arslan M, Soylu M, Kaner G, İnanç N, Başmısırlı E. Evaluation of malnutrition detected with the Nutritional Risk Screening 2002 (NRS-2002) and the quality of life in hospitalized patients with chronic obstructive pulmonary disease. Hippokratia 2016; 20:147-152. [PMID: 28416912 PMCID: PMC5388516] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Patients with severe chronic obstructive pulmonary disease (COPD) have impaired quality of life, but the relationship between their nutritional status and quality of life has not been established. The aim of this study was to determine the relationship between quality of life and nutritional status in hospitalized COPD patients. METHODS Demographic data, quality of life and nutritional status of 90 inpatients with a mean age of 68.76 ± 10.85 years were enrolled in the study. The Nutritional Risk Screening 2002 (NRS-2002) tool was used to evaluate their nutritional status. The quality of life was assessed using the Short Form-36 (SF-36) questionnaire. The correlation analysis was used for the relationship between SF-36 subscales and nutritional status variables. RESULTS Of the 90 COPD patients included in the study, 54.4 % were men, and 45.6 % were women. Moderate, severe, and very severe COPD were detected in 37.8 %, 38.9 %, and 23.3 % of the patients, respectively. At risk of malnutrition were 55.6 % of the 90 COPD patients, whereas 44.4 % were not. The scores for physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function subscales were lower in the patients at risk of malnutrition (p <0.001). There was a statistically significant negative correlation between malnutrition score and the subscores of SF-36 related to physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function (p <0.001). CONCLUSIONS COPD patients were found to have a high risk of malnutrition that adversely affects their quality of life. Therefore, the evaluation of the nutritional status of COPD patients should be an integral part of their clinical treatment plans aiming towards improving their quality of life. Hippokratia 2016, 20(2):147-152.
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Affiliation(s)
- M Arslan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Hacettepe, Ankara, Turkey
| | - M Soylu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
| | - G Kaner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Izmir Katip Çelebi, Izmir, Turkey
| | - N İnanç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
| | - E Başmısırlı
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
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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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Mumcu G, İnanç N, Özdemir FT, Tulunay A, Ekşioğlu-Demiralp E, Ergun T, Direskeneli H. Effects of azithromycin on intracellular cytokine responses and mucocutaneous manifestations in Behçet's disease. Int J Dermatol 2013; 52:1561-6. [DOI: 10.1111/ijd.12144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gonca Mumcu
- Department of Health Informatics and Technologies; Faculty of Health Sciences; Marmara University; Istanbul Turkey
| | - Nevsun İnanç
- Department of Rheumatology; Faculty of Medicine; Marmara University; Istanbul Turkey
| | | | - Aysın Tulunay
- Department of Immunology; Faculty of Medicine; Istanbul Turkey
| | | | - Tülin Ergun
- Department of Dermatology; Faculty of Medicine; Marmara University; Istanbul Turkey
| | - Haner Direskeneli
- Department of Rheumatology; Faculty of Medicine; Marmara University; Istanbul Turkey
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Can M, Alibaz-Öner F, Yılmaz-Öner S, Atagündüz P, İnanç N, Direskeneli H. Accelerated infusion rates of rituximab are well tolerated and safe in rheumatology practice: a single-centre experience. Clin Rheumatol 2012; 32:87-90. [PMID: 23053686 DOI: 10.1007/s10067-012-2094-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 08/08/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
Abstract
Due to the possible risk of infusion reactions of rituximab (RTX), a slow infusion rate (total infusion time, 255 min) is suggested for rheumatological use. However, especially in oncology field, accelerated infusion of RTX is reported to be well tolerated and safe. The aim of our study was to evaluate whether accelerated infusion rates of RTX would similarly be safe and tolerable in rheumatoid arthritis (RA) patients and other off-label rheumatological indications. All patients treated with RTX for RA and other autoimmune diseases between May 2011 and January 2012 were recruited to the study. Each treatment course consisted of two RTX 1,000 mg infusions, 2 weeks apart. Total time of the infusion for the first cycle was 255 min. Second and subsequent infusions were administered over 120 min as follows: 0-30 min, 100 mg; 30-60 min, 200 mg; 60-90 min, 300 mg; and 90-120 min, 400 mg. The Clinical Trials Classification of Adverse Events (CTCAE) version 4.3 was used to categorise side effects. The study population comprised 68 patients [F/M, 59:9; mean age, 52.4 (10.6) years]: 60 with RA, 4 with systemic lupus erythematosus (SLE), 1 with non-Hodgkin's lymphoma with SLE and 3 with vasculitis. A total of 77 fast infusions were administered. Eleven patients (16.2 %) had taken a fast infusion at the first course. A total of nine patients experienced at least one AE. Seven patients had a reaction on the first infusion (infusion-related reaction (IRR)), two patients on the second infusion and one patient on both infusions. When graded from 1 to 5 according to CTCAE v. 4.3, grade 1 IRRs were observed in a total of seven patients and grade 2 IRR in three patients. In this study of fast infusions, adverse events after RTX were mostly mild and seem to be well tolerated. Faster rituximab infusion times seem to be safe and might be incorporated into routine practice.
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Affiliation(s)
- Meryem Can
- School of Medicine, Deparment of Rheumatology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey.
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