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Öğe A case with IGG4-related retroperitoneal fibrosis-periaortitis rapidly diagnosed and dramatically responded to steroid treatment(BioMed Central Ltd., 2015) Karaaslan, Yaşar; Özbalkan Aşlar, Zeynep; Can Sandıkçı, SevinçRetroperitoneal fibrosis is a rare disease characterized by development of fibro-inflammatory tissue, which surrounds and causes compression of the retroperitoneal structures such as abdominal aorta, iliac vessels, vena cava and ureters1. It’s prevalence was reported as 1.4 /100,000 2. It has been recently shown that it is one of the IgG4-related disorders3. Herein, we report a male patient who admitted to emergency department with acute abdominal pain, diagnosed with IgG4-related retroperitoneal fibrosis-periaortitis in a very short time, and both high baseline serum creatinine level as well as abdominal pain requiring opioids on admission improved with steroids.Öğe A randomized trial of colchicine for acute pericarditis(Massachussetts Medical Society, 2014) Karaaslan, Yaşar; Şimşek, İsmailTo the Editor: With regard to the use of colchicine to prevent recurrent pericarditis, Imazio et al. (Oct. 17 issue)(1) might have achieved an even more favorable outcome in their study if they had used a dose of colchicine higher than 0.5 mg per deciliter for patients weighing less than 70 kg. I routinely treat patients with familial Mediterranean fever with 1.2 mg per deciliter regardless of their weight. Of approximately 40 such patients followed for many years while taking colchicine daily, none have reported side effects other than mild and easily managed diarrhea, which occurred in a few.Öğe Behçet disease with vascular involvement: Effects of different therapeutic regimens on the incidence of new relapses(Lippincott Williams and Wilkins, 2015) Alibaz Öner, Fatma; Karadeniz, Aslı; Yılmaz, Sema; Balkarlı, Ayşe; Kimyon, Gezmiş; Yazıcı, Ayten; Çınar, Muhammet; Yılmaz, Sedat; Yıldız, Fatih; Bilge, Şule; Bilgin, Emre; Coşkun, Belkıs; Omma, Ahmet; Çetin, Gözde; Çağatay, Yonca; Karaaslan, Yaşar; Sayarlıoğlu, Mehmet; Pehlivan, Yavuz; Kalyoncu, Umut; Karadağ, Ömer; Kaşifoğlu, Timuçin; Erken, Eren; Pay, Salih; Çefle, Ayşe; Kısacık, Bünyamin; Onat, Ahmet; Çobankara, Veli; Direşkeneli, HanerVascular involvement is one of the major causes of mortality and morbidity in Behcet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n-936, female/male: 347/589, mean age: 37.6 ± 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n - 260) of the patients during followup. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1-204) and ISs, 22 months (1-204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. Asecond vascular event developed in 32.9% (n=86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P=0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P<0.001). During follow-up, a third vascular event developed in 17 (n = 6.5%) patients. The relapse rate was also similar between the patients taking only ISs and AC plus IS treatments after second vascular event (25.3% vs 20.8%, P=0.93). When multivariate analysis was performed, development of vascular relapse negatively correlated with only IS treatments. We did not find any additional positive effect of AC treatment used in combination with ISs in the course of vascular involvement in patients with BD. Severe complications related to AC treatment were also not detected. Our results suggest that short duration of IS treatments and compliance issues of treatment are the major problems in VBD associated with vascular relapses during follow-up. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.Öğe Cognitive Impairment not only in NeuroBehcet but also for all Behcet Disease Phenotypes(2014) Karadağ Sücüllü, Yeşim; Kurt, Pınar; Şahin, Kubilay; Karaaslan, Yaşar; Öztekin, Neşe; Ak, FikriBackground: Cognitive impairment has been reported for Behçet's Disease (BD) patients, but studies are limited. This study is aimed to investigate neurocognitive profile of Neurobehcet Disease (NBD) patients and BD patients without neurologic involvement (BD-only) in comparison to healthy controls (HC). Patients and method: Totally 49 BD patients (11 NBD, 38 BD-only) and 32 HC were included into the study. After neurological evaluation, all subjects were given a comprehensive battery of neuropsychological tests: Self report of neuropsychological condition (by visual analogue scale-VAS, 0-100), RAVLT, Stroop, PASAT, TMT, SDMT, JLOT, DST, COWAT, ACTT, FST. Results: In the comparison of HC to NBD and BD-only subjects, a poorer performance was observed in both group of patients in almost all the neurocognitive tests, except for Stroop interference score. Both group of patients had lower scores on learning, immediate memory, working memory (ACTT), lexical fluency (COWAT) and attention (DST) comparing to healthy subjects (p≤0.003). The differences between NBD and BD-only patients were observed on response inhibition ability (STROOP-spontaneous corrections; p=0.000, and errors;p=0.002) and learning (RAVLT-sum of five trials; p=0.002). NBD patients had further decrease on free recall (RAVLT), complex visual processing (JLOT), information processing speed (PASAT), attention (TMT-B) and psychomotor speed (TMT-A) (p≤0.003). Conclusion: Cognitive functions of not only NBD patients but also BD-only patients were worse than control group. Compared to BD-only patients, NBD patients reveal further impairment on memory and executive functions rather than complex visual perception and verbal attention.Öğe Identification of multiple genetic susceptibility loci in Takayasu arteritis(2013) Saruhan Direskeneli, Güher; Hughes, Travis; Aksu, Kenan; Keser, Gökhan; Coit, Patrick; Aydın, Sibel Z.; Alibaz Öner, Fatma; Karaaslan, YaşarTakayasu arteritis is a rare inflammatory disease of large arteries. The etiology of Takayasu arteritis remains poorly understood, but genetic contribution to the disease pathogenesis is supported by the genetic association with HLA-B*52. We genotyped ?200,000 genetic variants in two ethnically divergent Takayasu arteritis cohorts from Turkey and North America by using a custom-designed genotyping platform (Immunochip). Additional genetic variants and the classical HLA alleles were imputed and analyzed. We identified and confirmed two independent susceptibility loci within the HLA region (r 2 < 0.2): HLA-B/MICA (rs12524487, OR = 3.29, p = 5.57 × 10 -16 ) and HLA-DQB1/HLA-DRB1 (rs113452171, OR = 2.34, p = 3.74 × 10 -9 ; and rs189754752, OR = 2.47, p = 4.22 × 10 -9 ). In addition, we identified and confirmed a genetic association between Takayasu arteritis and the FCGR2A/FCGR3A locus on chromosome 1 (rs10919543, OR = 1.81, p = 5.89 × 10 -12 ). The risk allele in this locus results in increased mRNA expression of FCGR2A. We also established the genetic association between IL12B and Takayasu arteritis (rs56167332, OR = 1.54, p = 2.18 × 10 -8 ). © 2013 The American Society of Human Genetics.Öğe Impact of rheumatoid arthritis in Turkey: A questionnaire study(Clinical and Experimental Rheumatology S.A.S., 2014) Direşkeneli, Haner; Akkoç, Nurullah; Bes, Cemal; Çakır, Necati; Çefle, Ayşe; Çobankara, Veli; Dalkılıç, Ediz; Karaaslan, YaşarObjective: Unmet needs of rheumatoid arthritis (RA) patients regarding physician/patient communication, treatment preferences and quality of life issues were investigated in a Turkish survey study. Methods: The study was conducted with the contribution of 33 rheumatologists, and included 519 RA patients. The study population included patients who had been on biologic therapy for >6 months and were still receiving biologic therapy (BT group), and those who were biologic naive, but found eligible for biologic treatment (NBT group). Of the RA patients, 35.5% initially had a visit to an internal disease specialist, 25.5% to a physical therapy and rehabilitation specialist, and 12.2% to a rheumatology specialist for their RA complaints. The diagnosis of RA was made by a rheumatologist in 48.2% of patients. Results: The majority of RA patients (86.3%) visit their doctor within 15-week intervals. Most of the physician-patient communication focused on disease symptoms (99.0%) and impact of the disease on quality of life (61.8%). The proportion of RA patients who perceived their health status as good/very good/excellent was higher in the BT group than in the NBT group (74.3% vs. 51.5%, p<0.001). However, of those RA patients in the NBT group, only 24.8% have been recommended to start a biologic treatment by their doctors. With respect to dose frequency options, once-monthly injections were preferred (80%) to a bi-weekly injection schedule (8%). Conclusion: In conclusion, RA patients receiving biologic therapy reported higher rates of improved symptoms and better quality of life and seemed to be more satisfied with their treatment in our study. © Clinical and Experimental Rheumatology 2014.Öğe Is osteoporosis a real disease?(Clinical and Experimental Rheumatology S.A.S., 2014) Karaaslan, Yaşar; Şimşek, İsmail[No abstract available]Öğe The association between the parenchymal neurological involvement and posterior uveitis in Behçet's syndrome(Clinical and Experimental Rheumatology S.A.S., 2016) Bitik, Berivan; Tufan, Abdurrahman; Şahin, Kubilay; Sucullu Karadağ, Yeşim; Can Sandıkçı, Sevinç; Mercan, Rıdvan; Ak, Fikri; Karaaslan, Yaşar; Öztürk, Mehmet Akif; Göker, Berna; Haznedaroğlu, SeminurObjective. Behçet's syndrome (BS) is a systemic vasculitis, which may involve multiple organ systems simultaneously. Clinical findings in BS often fit into well-recognised patterns, such as the association between papulo-pustular skin lesions and arthritis. We have recently observed a distinct pattern, in which a subtype of neuro-Behçet's syndrome (NBS) is often preceded by specific ophthalmic manifestations of the disease process. The purpose of this study is to evaluate the association between the parenchymal subtype of NBS and posterior uveitis (PU). Methods. We retrospectively reviewed the clinical records of 295 patients with BS, who met the international classification criteria for BS, diagnosed at two major rheumatology clinics from 2010 to 2014. Patient demographics, ophthalmic examinations, clinical and radiologic patterns of neurological involvement were recorded. Manifestations of BS were classified as PU, NBS, vascular involvement, and arthritis. The association between clinical findings was analysed for statistical significance. Results. Of the 295 patients, 100 had PU and 44 had NBS. 30 patients had parenchymal NBS and 14 had vascular NBS. Patients with PU were significantly more likely to have neurological involvement compared to those without PU (p < 0.001; odds ratio: 3.924; 95% CI: 1.786-8.621). Rate of posterior uveitis was higher in patients with parenchymal NBS when compared to patients with vascular NBS, vascular BS or arthritis (63.3%, 21.4%, 22% and 4.2% respectively, p < 0.001). Conclusion. Our findings suggest a clinically and statistically significant association between posterior uveitis and parenchymal type of neurologic involvement in BS. The development of posterior uveitis in a patient with previously diagnosed BS should be recognised as a "warning sign" for predisposition to neurologic involvement. These patients should be informed about the possible signs and symptoms of neurological involvement, which can cause very rapid and irreversible damage unless recognised and treated immediately. © Clinical and Experimental Rheumatology 2016.Öğe The prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in patients with thyroid autoimmunity(MEDİTAGEM Ltd. Şti., 2016) Omma, Ahmet; Can Sandıkçı, Sevinç; Omma, Tülay; Karaaslan, YaşarAmaç: Anti-CCP antikorları romatoid artritin (RA) tanı koydurucu belirteçlerinden bir tanesi olmakla birlikte sistemik lupus eritematozus (SLE), primer Sjögren sendromu (pSS) gibi diğer hastalıklarda da saptanabilmektedir. Yetişkinlerde tiroid otoimmünitesi (TO) ve anti-CCP pozitifliğiyle ilgili günümüze kadar herhangi bir veri yayınlanmamıştır. Biz bu çalışmada yetişkin TO olan hastalarda anti-CCP pozitifliği yaygınlığını saptamayı amaçladık. Yöntem ve Gereçler: Ocak 2010-Ekim 2014 tarihleri arasında anti-CCP, RF ve anti-tiroid peroksidoz (anti-TPO) ve/veya TSH reseptör antikoru (TRAb) istenen 1282 hastanın kayıtları tıbbi kayıt sisteminden retrospektif olarak incelendi. TO, tanısı tiroid otoantikorlarının normal değerlerinin üst sınırının üzerinde saptanması ile kondu. RF ve anti-CCP pozitifliği değerler normal aralığın üzerinde olduğu zaman düşünüldü. Bulgular: TO olan grupta,TPO-Ab, TRAb, CCP ve RF pozitifliği sırasıyla 332 (%99), 7 (%2), 44 (%13), ve 78 (%23) olarak saptandı. TO olmayan grupta 70 kişide Anti-CCP pozitifliği (%7.4) ve 378 kişide RF pozitifliği (%20) saptandı. Anti-CCP pozitiflik oranı TO olan grupta TO olmayan gruba göre anlamlı olarak daha yüksek saptandı (%13 vs.%7.4, p<0.001). Ancak RF pozitifliği yönünden gruplar arasında anlamlı olarak fark yoktu. Sonuç: Bizim çalışmamız TO olan hastalarda anti-CCP prevalansının arttığını göstermiştir. Bu da bize Anti-CCP antikorlarının RA'ya ek olarak TO olanlarda da görülebileceğini düşündürür.
