325 results on '"Servet Akar"'
Search Results
2. Radiographic Progression in Sacroiliac Joints in Patients With Axial Spondyloarthritis: Results From a Five‐Year International Observational Study
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Denis Poddubnyy, Joachim Sieper, Servet Akar, Santiago Muñoz‐Fernández, Hildrun Haibel, Torsten Diekhoff, Mikhail Protopopov, Elisabeth Altmaier, Fabiana Ganz, and Robert D. Inman
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Diseases of the musculoskeletal system ,RC925-935 - Abstract
Objective To evaluate progression from nonradiographic (nr‐) to radiographic axial spondyloarthritis (r‐axSpA) over 5 years in patients with recently diagnosed (≤1 year) axSpA fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods A prospsective, observational study (Patients with Axial Spondyloarthritis: Multi‐Country Registry of Clinical Characteristics) was conducted in rheumatology practices in 29 countries. Baseline and follow‐up radiographs of sacroiliac joints were centrally evaluated by three readers according to the grading system of the modified New York criteria for patients initially classified as nr‐axSpA. Radiographic progression from nr‐axSpA to r‐axSpA was evaluated by Kaplan‐Meier analysis. Cox proportional regression analyses for progression from nr‐axSpA to r‐axSpA were also conducted. Results Among 2,165 patients with axSpA, 1,612 (74%) were classified as having r‐axSpA (1,050 [65%]) or nr‐axSpA (562 [35%]) by central reading. Of 246 patients with nr‐axSpA (mean [SD] symptom duration: 4.4 [6.2] years) who had at least one follow‐up sacroiliac joint radiograph, progression from nr‐axSpA to r‐axSpA at any follow‐up visit was observed in 40 patients (16%) over 5 years. Mean time to radiographic progression was 2.4 years (ranging from 0.9 to 5.1 years). Progression to r‐axSpA was associated with male sex (hazard ratio [HR] 3.16 [95% CI 1.22–8.17]), fulfillment of the imaging arm of the ASAS classification criteria (HR 6.64 [1.37–32.25]), and good response to nonsteroidal anti‐inflammatory drugs (HR 4.66 [1.23–17.71]). Conclusion 16% of patients with nr‐axSpA progressed to r‐axSpA within 5 years. Male sex, fulfillment of the imaging arm of the ASAS criteria, and good response to nonsteroidal anti‐inflammatory drugs were predictors of radiographic progression in patients with recently diagnosed axSpA.
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- 2024
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3. Tomographic Fibrosis Score in the Patients with Systemic Sclerosis-Associated Interstitial Lung Disease
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Mustafa Ozmen, Cesur Gumus, Eda Otman, Kazim Ayberk Sinci, Idil Kurut Aysin, Dilek Solmaz, and Servet Akar
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2023
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4. A national, multicenter, secondary data use study evaluating efficacy and retention of first-line biologic treatment with tocilizumab in patients with rheumatoid arthritis in real-life setting: results from TURKBIO registry
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Ayten Yazici, Özlem Özdemir Işık, Ediz Dalkılıç, Süleyman Serdar Koca, Yavuz Pehlivan, Soner Şenel, Nevsun Inanc, Servet Akar, Sema Yılmaz, Özgül Soysal Gündüz, Ayse Cefle, Ömer Fatih Karakaş, and Fatos Onen
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Medicine ,Science - Abstract
Abstract Tocilizumab (TCZ) is a recombinant humanized monoclonal antibody that targets the IL-6 receptor. TCZ found to be efficacious and has a good tolerated safety profile in rheumatoid arthritis (RA) patients. The aim of this study was to describe the disease activity and retention rate in Turkish RA patients who were prescribed TCZ as first-line biologic treatment in a real-world setting. Secondary data obtained from adult RA patients’ files was used in a multicenter and retrospective context. Clinical Disease Activity Index (CDAI), Disease Activity Score in 28 joints with ESR (DAS28-ESR), and retention rates of TCZ were evaluated at related time points. 130 patients (87.7% female) with a mean age of 53 years (SD; 15.0) were included in the study. Mean RA duration was 14 years and median duration of follow-up was 18.5 months. Number of patients with ongoing TCZ treatment at 6, 12, and 24 months were 121 (93%), 85 (65%), and 46 (35%), respectively. Remission rates at 6, 12, and 24 months per CDAI (
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- 2022
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5. The First Effect of COVID-19 Pandemic on Starting Biological Disease Modifying Anti-Rheumatic Drugs: Outcomes from the TReasure Real-Life Database
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Nilüfer Alpay Kanıtez, Sedat Kiraz, Ediz Dalkılıç, Gezmiş Kimyon, Rıdvan Mercan, Ömer Karadağ, Cemal Bes, Levent Kılıç, Servet Akar, Aşkın Ateş, Hakan Emmungil, İhsan Ertenli, Yavuz Pehlivan, Belkıs Nihan Coşkun, Burcu Yağız, Duygu Ersözlü, Emel Gönüllü, Muhammet Çınar, Timuçin Kaşifoğlu, Süleyman Serdar Koca, Uğur Karasu, Orhan Küçükşahin, and Umut Kalyoncu
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2022
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6. A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry
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Fatoş Önen, Gerçek Can, Sedat Çapar, Ediz Dalkılıç, Yavuz Pehlivan, Soner Şenel, Servet Akar, Süleyman Serdar Koca, Abdurrahman Tufan, Ayten Yazıcı, Sema Yılmaz, Nevsun İnanç, İsmail Sarı, Merih Birlik, Dilek Solmaz, Ayşe Cefle, Mehmet Akif Öztürk, Servet Yolbaş, Niels Steen Krogh, Neslihan Yılmaz, Şükran Erten, Cemal Bes, Özgül Soysal Gündüz, Berna Göker, Seminur Haznedaroğlu, Şule Yavuz, Gözde Yildirim Çetin, Fatih Yıldız, Haner Direskeneli, and Nurullah Akkoç
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2022
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7. Prediction of Response to Treatment Using Doppler Signal Positivity Measured by Ultrasound in Rheumatoid Arthritis: A Proof-of-Concept Study
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Ummugulsum Gazel, Gizem Ayan, Dilek Solmaz, Nancy Maltez, Tim Ramsay, Antonio R. Cabral, Servet Akar, and Sibel Zehra Aydin
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2023
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8. Prevalence of pistol-grip deformity in patients with axial spondyloarthritis
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Özgür Tosun, Dilek Solmaz, Gökay Karaca, Mustafa Özmen, Aliye Tosun, Fatih Esad Topal, and Servet Akar
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2021
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9. Investigating the effect of macro-scale estimators on worldwide COVID-19 occurrence and mortality through regression analysis using online country-based data sources
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Servet Akar, Sabri Erdem, Fulya Ipek, Aybars Bars, Volkan Genç, Esra Erpek, Shabnam Mohammadi, and Anıl Altınata
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Medicine - Published
- 2022
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10. Rheumatological Findings in Patients with Breast Cancer
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Figen Tarhan, Gökhan Keser, Ahmet Alacacıoğlu, and Servet Akar
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breast cancer ,rheumatoid arthritis ,systemic lupus erythematosus ,sjögren syndrome ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Medicine - Abstract
Objective: Breast Cancer (BC) is the most frequently diagnosed malignancy worldwide. Not only may BC be associated with rheumatic symptoms and diseases, but also the drugs used in the treatment of this disease, including aromatase inhibitors (AIs), may lead to musculoskeletal system symptoms. In this study, we aimed to investigate the spectrum of rheumatic symptoms and diseases developing in patients with BC having no previous diagnosis of any inflammatory rheumatic disease.Materials and Methods: Patients with a history of BC referring to Rheumatology Outpatient Clinics with complaints of musculoskeletal system symptoms at two centers between 2008 and 2018 were screened retrospectively. Patients with a previous diagnosis of any inflammatory rheumatic diseases before the occurrence of BC were excluded. Demographic data, onset and duration of BC, as well as onset and duration of rheumatic symptoms/diseases were recorded. Relevant laboratory tests, including autoantibodies, available imaging findings and the treatments received were also registered.Results: Mean age of 128 BC patients at the time of admission was found to be 54.76±8.21 years. Mean durations of disease for BC and rheumatic disorders were 85.705±15.507 and 60.84±19.20 months, respectively. Out of 128 BC patients, nearly one third (n: 41; 32.03%), developed an inflammatory rheumatic disease, and rheumatoid arthritis was the most frequent pathology. Nonspecific arthralgia and myalgia were more frequent in patients receiving AIs than those receiving tamoxifen, despite lack of significant difference (p=0.421, p=0.411).Conclusion: Given that nearly one third of the patients developed an inflammatory rheumatic disease, it should be remembered that locomotor symptoms in patients with BC may be caused not only by bone metastasis or paraneoplastic effects, but they may also suggest the presence of associated rheumatic diseases.
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- 2020
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11. The role of smoking in the development and progression of structural damage in axial SpA patients: A systematic review and meta-analysis
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Servet Akar, Yusuf Cem Kaplan, Sertaç Ecemiş, Elif Keskin-Arslan, Önay Gercik, Sercan Gücenmez, and Dilek Solmaz
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2019
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12. The role of mammalian target of rapamycin pathway in the pathogenesis of pauci-immune glomerulonephritis
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Zeki Soypacaci, Ozlem Cakmak, Fulya Cakalagoglu, Onay Gercik, Ibrahim Ertekin, Atilla Uzum, Rifki Ersoy, and Servet Akar
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pauci-immune glomerulonephritis ,mtor protein ,pten protein ,latency associated protein tgf b1 ,pathology ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: The characteristic lesion of pauci-immune glomerulonephritis is focal necrotizing and crescentic glomerulonephritis. The underlying mechanisms in the formation or progression of crescent formation need further investigations. Therefore, we aimed to evaluate the role of mammalian target of rapamycin (mTOR), which might be a potential therapeutic target, in kidney biopsies of patients with pauci-immune glomerulonephritis. Methods: The patients diagnosed as pauci-immune glomerulonephritis at an outpatient nephrology clinic were retrospectively reviewed and those patients who had a kidney biopsy before receiving an immunosuppressive treatment were included in the study. Kidney biopsy specimens were immunohistochemically stained with mTOR, antibodies of phosphatase and tensin homolog (PTEN) and transforming growth factor-β (TGF-β) and scored by an experienced renal pathologist. Results: In total, 54 patients with pauci-immune glomerulonephritis (28 [52%] female) were included. According to the histopathologic examination, 22% of our cases were classified as focal, 33% crescentic, 22% mixed, and 22% as sclerotic. The mTOR was expressed in substantial percentages of glomeruli of patients with pauci-immune glomerulonephritis. However, we observed PTEN expression in all samples and mTOR in all tubulointerstitial areas. mTOR expression was found to be related with the presence of crescentic and sclerotic changes observed in glomeruli and the degree of fibrosis in interstitial areas. Serum creatinine level or response to treatment was not found to be associated with mTOR pathway expression. Conclusion: Our results suggest that mTOR pathway may play role in the pathogenesis of pauci-immune glomerulonephritis, besides targeting this signaling may be an alternative option for those patients.
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- 2019
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13. Exon 2: Is it the good police in familial mediterranean fever?
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Şule Yaşar Bilge, Dilek Solmaz, Soner Şenel, Hakan Emmungil, Levent Kılıç, Sibel Yılmaz Öner, Fatih Yıldız, Sedat Yılmaz, Duygu Ersözlü Bozkırlı, Müge Aydın Tufan, Sema Yılmaz, Veli Yazısız, Yavuz Pehlivan, Cemal Beş, Gözde Yıldırım Çetin, Şükran Erten, Emel Gönüllü, Fezan Şahin, Servet Akar, Kenan Aksu, Umut Kalyoncu, Haner Direskeneli, Eren Erken, Bünyamın Kısacık, Mehmet Sayarlıoğlu, Muhammed Çınar, Timuçin Kaşifoğlu, and İsmail Sarı
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2019
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14. COVID-19 Among Patients With Inflammatory Rheumatic Diseases
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Sinem Nihal Esatoglu, Koray Tascilar, Hakan Babaoğlu, Cemal Bes, Berna Yurttas, Servet Akar, Ozlem Pehlivan, Cansu Akleylek, Duygu Tecer, Emire Seyahi, Tuba Yuce-Inel, Nilufer Alpay-Kanitez, Erdal Bodakci, Emre Tekgoz, Seda Colak, Ertugrul Cagri Bolek, Suleyman Serdar Koca, Umut Kalyoncu, Ozan Cemal Icacan, Serdal Ugurlu, Hande Ece Oz, Vedat Hamuryudan, Gulen Hatemi, the Turkish Society for Rheumatology COVID-19 Registry Investigators, Ayse Cefle, Ali Karakas, Derya Kaskari, Samet Karahan, Dilek Tezcan, Abdurrahman Tufan, Ayse Ayan, Levent Kılıc, Salim Donmez, Mustafa Erdogan, Veli Yazisiz, Edip Gokalp Gok, Ahmet Eftal Yucel, Elif Dincses Nas, Gezmiş Kimyon, Gunay Sahin Dalgic, Hakan Erdem, Kerem Yigit Abacar, Ridvan Mercan, Omer Karadag, Onay Gercik, Suleyman Ozbek, Sebnem Gider, Semih Gulle, Sibel Osken, Sedat Kiraz, Timucin Kasifoglu, Fatma Alibaz-Oner, Izzet Fresko, Ali Akdogan, and Neslihan Yilmaz
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COVID-19 ,rheumathoid diseases ,SARS CoV-2 ,DMARDs ,biologic DMARDs ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundThe course of novel coronavirus disease 2019 (COVID-19) has been of special concern in patients with inflammatory rheumatic diseases (IRDs) due to the immune dysregulation that may be associated with these diseases and the medications used for IRDs, that may affect innate immune responses.ObjectiveIn this cohort study, we aimed to report the disease characteristics and variables associated with COVID-19 outcome among Turkish patients with IRDs.MethodsBetween April and June, 2020, 167 adult IRD patients with COVID-19 were registered from 31 centers in 14 cities in Turkey. Disease outcome was classified in 4 categories; (i) outpatient management, (ii) hospitalization without oxygen requirement, (iii) hospitalization with oxygen requirement, and (iv) intensive care unit (ICU) admission or death. Multivariable ordinal logistic regression analysis was conducted to determine variables associated with a worse outcome.Results165 patients (mean age: 50 ± 15.6 years, 58.2% female) were included. Twenty-four patients (14.5%) recovered under outpatient management, 141 (85.5%) were hospitalized, 49 (30%) required inpatient oxygen support, 22 (13%) were treated in the ICU (17 received invasive mechanic ventilation) and 16 (10%) died. Glucocorticoid use (OR: 4.53, 95%CI 1.65-12.76), chronic kidney disease (OR: 12.8, 95%CI 2.25-103.5), pulmonary disease (OR: 2.66, 95%CI 1.08-6.61) and obesity (OR: 3.7, 95%CI 1.01-13.87) were associated with a worse outcome. Biologic disease-modifying antirheumatic drugs (DMARDs) do not seem to affect COVID-19 outcome while conventional synthetic DMARDs may have a protective effect (OR: 0.36, 95%CI 0.17-0.75). Estimates for the associations between IRD diagnoses and outcome were inconclusive.ConclusionsAmong IRD patients with COVID-19, comorbidities and glucocorticoid use were associated with a worse outcome, while biologic DMARDs do not seem to be associated with a worse outcome.
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- 2021
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15. Role of the mTOR pathway in minor salivary gland changes in Sjogren’s syndrome and systemic sclerosis
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Zeki Soypaçacı, Zeynep Zehra Gümüş, Fulya Çakaloğlu, Mustafa Özmen, Dilek Solmaz, Sercan Gücenmez, Önay Gercik, and Servet Akar
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Target of rapamycin proteins ,mTOR pathway ,Sjogren’s syndrome ,Systemic sclerosis ,PTEN protein ,Human ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background To examine the activity of the mammalian target of rapamycin (mTOR) pathway and its regulators, transforming growth factor (TGF)-β1 and phosphatase and tensin homolog (PTEN), in minor salivary gland biopsies of Sjogren’s syndrome (SS) and systemic sclerosis (SSc) patients. Methods We retrospectively evaluated SS, SSc, and SS-SSc overlap patients admitted to our outpatient rheumatology clinic between January 2007 and December 2015 who underwent a minor salivary gland biopsy. Patient demographics and some clinical features were obtained from hospital records. Immunohistochemistry was used to analyze total mTOR, total PTEN, and TGF-β1 expression in the biopsied tissues. The biopsy specimens were also examined for the presence and degree of fibrosis. Results Minor salivary gland biopsies of 58 SS, 14 SSc, and 23 SS-SSc overlap patients were included in the study. There was no significant difference in mTOR expression between these groups (P = 0.622). PTEN protein was expressed in 87.2% of patients with SS, 57.9% with overlap syndrome, and 100% of the SSC patients, and these differences were statistically different (P = 0.023). Although ductal epithelial TGF-β1 expression was similar between the groups (P = 0.345), acinar cell expression was found to be more frequent in the SSc (72.7%) and overlap patients (85.7%) in comparison with the SS cases (58.2%; P = 0.004). Conclusion mTOR may be one of the common pathways in the pathology of both SS and SSc. Hence, there may be a role for mTOR inhibitors in the treatment of both diseases. Additionally, PTEN and TGF-β1 expression may be a distinctive feature of SSc.
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- 2018
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16. Genome-wide association study in Turkish and Iranian populations identify rare familial Mediterranean fever gene (MEFV) polymorphisms associated with ankylosing spondylitis.
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Zhixiu Li, Servet Akar, Handan Yarkan, Sau Kuen Lee, Pınar Çetin, Gerçek Can, Gökce Kenar, Fernur Çapa, Omer Nuri Pamuk, Yavuz Pehlivan, Katie Cremin, Erika De Guzman, Jessica Harris, Lawrie Wheeler, Ahmadreza Jamshidi, Mahdi Vojdanian, Elham Farhadi, Nooshin Ahmadzadeh, Zeynep Yüce, Ediz Dalkılıç, Dilek Solmaz, Berrin Akın, Salim Dönmez, İsmail Sarı, Paul J Leo, Tony J Kenna, Fatos Önen, Mahdi Mahmoudi, Matthew A Brown, and Nurullah Akkoc
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Genetics ,QH426-470 - Abstract
Ankylosing spondylitis (AS) is a highly heritable immune-mediated arthritis common in Turkish and Iranian populations. Familial Mediterranean Fever (FMF) is an autosomal recessive autoinflammatory disease most common in people of Mediterranean origin. MEFV, an FMF-associated gene, is also a candidate gene for AS. We aimed to identify AS susceptibility loci and also examine the association between MEFV and AS in Turkish and Iranian cohorts. We performed genome-wide association studies in 1001 Turkish AS patients and 1011 Turkish controls, and 479 Iranian AS patients and 830 Iranian controls. Serum IL-1β, IL-17 and IL-23 cytokine levels were quantified in Turkish samples. An association of major effect was observed with a novel rare coding variant in MEFV in the Turkish cohort (rs61752717, M694V, OR = 5.3, P = 7.63×10(-12)), Iranian cohort (OR = 2.9, P = 0.042), and combined dataset (OR = 5.1, P = 1.65×10(-13)). 99.6% of Turkish AS cases, and 96% of those carrying MEFV rs61752717 variants, did not have FMF. In Turkish subjects, the association of rs61752717 was particularly strong in HLA-B27-negative cases (OR = 7.8, P = 8.93×10(-15)), but also positive in HLA-B27-positive cases (OR = 4.3, P = 7.69×10(-8)). Serum IL-1β, IL-17 and IL-23 levels were higher in AS cases than controls. Among AS cases, serum IL-1β and IL-23 levels were increased in MEFV 694V carriers compared with non-carriers. Our data suggest that FMF and AS have overlapping aetiopathogenic mechanisms. Functionally important MEFV mutations, such as M694V, lead to dysregulated inflammasome function and excessive IL-1β function. As IL-1 inhibition is effective in FMF, AS cases carrying FMF-associated MEFV variants may benefit from such therapy.
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- 2019
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17. Fetuin-A is related to syndesmophytes in patients with ankylosing spondylitis: a case control study
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Tugba Tuylu, Ismail Sari, Dilek Solmaz, Didem Leyla Kozaci, Servet Akar, Necati Gunay, Fatos Onen, and Nurullah Akkoc
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Ankylosing Spondylitis ,Bone Formation ,Fetuin-A ,Dickkopf-1 Protein Human ,Sclerostin Protein Human ,Bone Morphogenetic Protein 7 ,Medicine (General) ,R5-920 - Abstract
OBJECTIVES: New bone formation is one of the hallmark characteristics of ankylosing spondylitis, which is thereby associated with syndesmophytes. Fetuin-A is a molecule that is abundantly found in calcified tissues and it shows high affinity for calcium phosphate minerals and related compounds. Considering the role of fetuin-A in the regulation of calcified matrix metabolism, we compared the fetuin-A levels in ankylosing spondylitis patients with syndesmophytes with those in patients without syndesmophytes and in healthy controls. We also studied other biomarkers that are thought to be related to syndesmophytes. METHODS: Ninety-four patients (49 patients without syndesmophytes, 67.3% male, 40.7±8.7 years; 45 patients with syndesmophytes, 71.1% M, 43.9±9.9 years) and 68 healthy controls (44.2±10.6 years and 70.6% male) were included in this study. Syndesmophytes were assessed on the lateral radiographs of the cervical and lumbar spine. The serum levels of fetuin-A, dickkopf-1, sclerostin, IL-6, high-sensitivity C-reactive protein and bone morphogenetic protein-7 were measured with an enzyme-linked immunosorbent assay. RESULTS: Patients with syndesmophytes had significantly higher levels of fetuin-A compared with patients without syndesmophytes and controls (1.16±0.13, 1.05±0.09 and 1.08±0.13 mg/ml, respectively). However, fetuin-A was not different between the patients without syndesmophytes and controls. Bone morphogenetic protein-7 was significantly lower; dickkopf-1 was significantly higher in patients with ankylosing spondylitis compared with controls. The sclerostin concentrations were not different between the groups. In regression analysis, fetuin-A was an independent, significant predictor of syndesmophytes. CONCLUSION: Our results suggest that fetuin-A may a role in the pathogenesis of bony proliferation in ankylosing spondylitis.
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- 2014
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18. Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?
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Ismail Sari, Yusuf Ziya Igci, Gercek Can, Ali Taylan, Dilek Solmaz, Bulent Gogebakan, Servet Akar, Zeynep Eslik, Giray Bozkaya, and Nurullah Akkoc
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Ankylosing Spondylitis ,Endothelial Nitric Oxide Synthase ,Nitric Oxide ,Inflammation ,Atherosclerosis ,Medicine (General) ,R5-920 - Abstract
OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region) and 786 Glu298Asp (rs1799983, exon 7). Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.
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- 2013
19. Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?
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Ismail Sari, Yusuf Ziya Igci, Gercek Can, Ali Taylan, Dilek Solmaz, Bulent Gogebakan, Servet Akar, Zeynep Eslik, Giray Bozkaya, and Nurullah Akkoc
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ankylosing spondylitis ,endothelial nitric oxide synthase ,nitric oxide ,inflammation ,atherosclerosis ,Medicine (General) ,R5-920 - Abstract
OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region) and 786 Glu298Asp (rs1799983, exon 7). Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.
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20. The awareness of physicians using biological agents in treatment about hepatitis B virus reactivation
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Şenel YURTSEVER, Bilal Olcay PEKER, Süreyya GÜL YURTSEVER, Bahriye PAYZİN, Servet AKAR, Yüksel KÜÇÜKZEYBEK, Firdevs TOPAL, Elif SARITAŞ YÜKSEL, and Yeşim BECKMANN
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General Earth and Planetary Sciences ,General Environmental Science - Abstract
Objective: As long as immunosuppressive treatments are widely used, careful monitoring of HBVr is essential. We aimed to measure the awareness of Turkish physicians of certain specialties about the risk of hepatitis B virus reactivation (HBVr), HBV screening methods, prophylactic treatment practices and personal experiences in treating patients with biological agents. Methods: An electronic questionnaire link containing 21 questions about demographics and their applications to HBVr was sent to participants working in the various specialties across the country. Results: 227 participants took our survey (Female: 52.4%, n:119, Male: 47.6%, n:108), and consisted of 70 Hematologists, 65 Rheumatologists, 38 Gastroenterologists, 33 Oncologists, and 21 Dermatologists. We obtained extremely different results. It was found that all specialties are aware that the use of biological agents can cause HBVr (97.8%, n:222/227). Biological agents were used in 96% of the participants and HBVr was detected in 53.7% (Hematologist: 74.3%, Rheumatologist: 53.8%, Oncologist: 45.5%, Gastroenterologist: 44.7%, Dermatologist: 14.3%, p< 0.001). The general opinion was that, screening tests should be used (Gastroenterologist: 47.4%, p< 0.001) and 55.1% awared of how to monitor HBVr (Gastroenterologist: 65.8%, p = 0.06). The duration of antiviral prophylaxis was answered correctly in 70.4% (Hematologist: 82.6%, p = 0.01), the parameters of screening tests in 95.2% (Gastroenterologist: 97.4%, p = 0.52) and the highest risk of reactivation in 93% (Rheumatologist: 96.9%, p = 0.15) and the agent with the highest risk of reactivation in 82.8% of participants (Hematologist: 94.3%, p< 0.001). Conclusion: The opinions of different the clinical disciplines vary according to the profile of patients. Gastroenterologists' perspective on HBVr follow-up and treatment differs markedly from that of other clinical disciplines. However, to create general awareness and manage HBVr, guidelines for specific patient groups are definitely needed.
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- 2023
21. Mortality in psoriatic arthritis patients, changes over time, and the impact of COVID-19: results from a multicenter Psoriatic Arthritis Registry (PsART-ID)
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Abdulsamet Erden, Gizem Ayan, Levent Kilic, Dilek Solmaz, Sibel Bakirci, Gezmis Kimyon, Esen Kasapoglu Günal, Atalay Dogru, Ozun Bayindir, Ediz Dalkilic, Cem Özisler, Servet Akar, Gözde Yildirim Cetin, Emine Figen Tarhan, Orhan Küçüksahin, Ahmet Omma, Emel Gonullu, Fatih Yildiz, Emine Duygu Ersozlu, Muhammed Cinar, Abdurrahman Tufan, Seval Pehlevan, Serpil Ergulu Esmen, Sema Yilmaz, Tuncay Duruoz, Timucin Kasifoglu, Veli Yazısız, Kenan Aksu, Sibel Zehra Aydin, Umut Kalyoncu, and Erden A., AYAN G., KILIÇ L., Solmaz D., Bakirci S., Kimyon G., Günal E. K., DOĞRU A., Bayindir O., DALKILIÇ H. E., et al.
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Internal Diseases ,Internal Medicine Sciences ,Klinik Tıp ,Pandemic ,COVID-19 ,Dahili Tıp Bilimleri ,General Medicine ,CLINICAL MEDICINE ,Sağlık Bilimleri ,İmmünoloji ve Romatoloji ,İç Hastalıkları ,Clinical Medicine (MED) ,Tıp ,Immunology and Rheumatology ,Rheumatology ,Psoriatic arthritis ,Health Sciences ,Medicine ,Klinik Tıp (MED) ,Mortality ,Romatoloji ,ROMATOLOJİ - Abstract
© 2023, The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).Background: This study aimed to assess the mortality of PsA before and during the COVID-19 pandemic. Methods: From the prospective, multicenter PsART-ID (Psoriatic Arthritis Registry-International Database), patients from Turkey were analyzed by linking the registry to the Turkish Cause of Death Registry. The outcome of interest was death from any cause, pre-pandemic (since the onset of registry—March 2014–March 2020), and during the pandemic (March 2020–May 2021). The crude mortality rate and standardized mortality ratio (SMR) were determined. Results: There were 1216 PsA patients with a follow-up of 7500 patient-years. Overall, 46 deaths (26 males) were observed. In the pre-pandemic period, SMR for PsA vs the general population was 0.95 (0.61–1.49), being higher in males [1.56 (0.92–2.63)] than females [0.62 (0.33–1.17)]. The crude mortality rate in PsA doubled during the pandemic (pre-pandemic crude mortality rate: 5.07 vs 10.76 during the pandemic) with a higher increase in females (2.9 vs 8.72) than males (9.07 vs 14.73). Conclusion: The mortality in PsA was found similar to the general population in the pre-pandemic era. The mortality rates in PsA doubled during the pandemic. Whether PsA patients have more risk of mortality than the general population due to COVID-19 needs further studies.Key Points• Decrease in mortality in PsA might be expected with the more effective treatment options and better disease control.• A crude mortality rate is comparable to the general population and not increased until the pandemic.• Currently, there is a 2-fold increase in crude mortality rate possibly due to the COVID-19.
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- 2023
22. Assessing dyspnea-related kinesiophobia in patients with systemic sclerosis (SSc): validity and reliability of Turkish Breathlessness Beliefs Questionnaire for SSc
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Oğuz Ustun, Deniz Bayraktar, Idil Kurut Aysin, Devrim Can Sarac, Emre Alp Akatay, Sercan Gucenmez, Eda Otman, Mustafa Ozmen, and Servet Akar
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Rheumatology ,General Medicine - Abstract
The respiratory system is often affected by systemic sclerosis (SSc), a connective tissue disease characterized by fibrosis, vasculopathy, and inflammation. As a result, especially exertional dyspnea may occur in SSc patients. Evaluation of attitudes towards dyspnea is important in terms of preventing negative consequences such as kinesiophobia. However, no validated tool is available for assessing dyspnea-related kinesiophobia for patients with SSc. The aim of the present study was to perform the Turkish validation of the Breathlessness Beliefs Questionnaire for SSc (BBQ-SSc), which was adapted from the Tampa Kinesiophobia Scale, and to investigate its relationships with physical and clinical characteristics.Fifty patients with SSc (47 females) were included in the study. The patients were evaluated regarding pulmonary function tests, respiratory muscle strength, patient-reported dyspnea, quality of life related to respiratory problems, mood, and fatigue. The patients were re-evaluated 1 week later for the test-retest reliability of the BBQ-SSc.Internal consistency (Cronbach's alpha: 0.862) and test-retest validity (ICC: 0.831; 95% CI: 0.702-0.907) of the 12-item Turkish BBQ-SSc were found to be good. Principal component analysis confirmed the two-dimensional structure of the questionnaire. The scores of the questionnaire were associated with duration of illness, patient-reported dyspnea, quality of life related to respiratory problems, mood, and fatigue (p 0.05).According to our results, the 12-item Turkish BBQ-SSc is a reliable and valid tool to assess dyspnea-related kinesiophobia in SSc patients. Key Points • There are no structured tools available for assessing dyspnea-related kinesiophobia in patients with systemic sclerosis (SSc) • The 12-item Turkish Breathlessness Beliefs Questionnaire for SSc (BBQ-SSc) is a reliable and valid tool to assess dyspnea-related kinesiophobia in SSc patients.
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- 2022
23. Peripheral T-cell lymphoma mimicking granulomatosis with polyangiitis
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Elif Durak Ediboğlu, Dilek Solmaz, Sermin Özkal, Nezahat Karaca Erdoğan, and Servet Akar
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Rheumatology - Published
- 2023
24. Systemic Sclerosis Quality of Life Questionnaire (SScQoL): translation into Turkish and assessing its psychometric properties
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Devrim Can Sarac, Deniz Bayraktar, Nurten Gizem Tore, Idil Kurut Aysin, Eda Otman, Israfil Inanc, Serife Demirbas, Berfin Coskun, Kubra Erol, Oguz Ustun, Emre Alp Akatay, Deran Oskay, Sercan Gucenmez, Mustafa Ozmen, and Servet Akar
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Rheumatology ,General Medicine - Published
- 2023
25. Hydroxychloroquine might reduce mortality in patients with systemic sclerosis
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Eda Otman, Sercan Gucenmez, Dilek Solmaz, Servet Akar, and Mustafa Ozmen
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Rheumatology - Published
- 2023
26. Subclinical Alterations in Retinal Layers and Microvascular Structures with OCTA in ANCA-Associated Vasculitides
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Yusuf Ziya Güven, Fahrettin Akay, Berkay Akmaz, Dilek Solmaz, Önay Gercik, and Servet Akar
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Ophthalmology ,Immunology and Allergy - Abstract
Using OCTA, investigate the capillary network and retinal layers in granulomatosis with ANCA associated vasculitis (AAV) patients who did not manifest apparent ocular involvement and compare the findings with healthy subjects.The present study, which is designed as a prospective and case-control study, includes 22 AAV patients and 35 control participants. OCTA parameters were noted.In most of the regions, AMT, RNFL and GC-IPL thicknesses were significantly lower in the AAV group than in the control group. While the vascular indices were lower in the AAV group, except for the center 1 mm region, the FAZ parameters were similar between the two groups.In AAV patients, subclinical changes in the retinal layers and superficial vascular plexus have been shown. In the future maybe a non-invasive method such as OCTA will become available in scoring systems for prognosis determination in AAV.
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- 2022
27. Derivation and validation of adult Still Activity Score (SAS)
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Mutlu Hayran, Kenan Aksu, Hakan Emmungil, Emre Bilgin, Cemal Bes, Abdulsamet Erden, Ediz Dalkilic, Servet Akar, Ahmet Omma, Orhan Küçükşahin, Selime Ermurat, Umut Kalyoncu, Nilüfer Alpay Kanıtez, Timuçin Kaşifoğlu, Fatih Yildiz, and Muhammet Cinar
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History ,medicine.medical_specialty ,Ferritin ,Scoring system ,Adult-onset Still?s disease ,Polymers and Plastics ,business.industry ,Ethics committee ,Arthralgia ,Industrial and Manufacturing Engineering ,Helsinki declaration ,Disease Course ,Rheumatology ,Informed consent ,Internal medicine ,Clinical-Manifestations ,Linear regression ,Disease activity score ,medicine ,Test performance ,Derivation ,Ordered logit ,Business and International Management ,business ,Multicenter - Abstract
Background/Aim: Adult-onset Still’s disease (AOSD) is a multi-systemic, autoinflammatory disorder. Several activity scores have been proposed but none of them have been adopted universally. Our aim was to create a clinician-friendly activity scoring system by using simple clinical and laboratory parameters. Methods: AODS patients according to Yamaguchi criteria were included in this cross-sectional, multi-center study. Derivation and validation cohorts were constituted. Demographic, clinical and laboratory evaluation at study visit; patients’, and physicians’ global assessments of disease activity (both VAS/ Likert scale) were recorded. To develop the score; ordinal logistic regression model was used to determine independent predictors of patient’ global assessments of disease activity. Clinically and statistically significant variables were weighted according to regression coefficients. Then, performance of the score was tested on the validation cohort. Results: Total of 197 consecutive AOSD patient (125 in derivation, 72 in validation cohorts) were included. Final Still Activity Score was fever (2 points), arthralgia (2 points, plus 1 point if arthritis was present in ≥2 joints), neutrophilia≥65% (1 point) and ferritin≥350 ng/mL (1 point) (maximum of 7 points). The SAS yielded an AUC value of 0.98(0.96-1.00) in the derivation cohort and 0.91(95%CI:0.85-0.98) in the validation cohort to discriminate high AOSD activity from moderate-inactive AOSD. Correlation of SAS with PtGA was 83% for the derivation cohort and 76% for the validation cohort. Conclusions: SAS has shown a good test performance to distinguish active AOSD patients from the others. SAS may be a useful method for evaluating disease activity of AOSD patients in daily practice. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The present study was conducted in compliance with the Helsinki Declaration and was approved by the Local Ethics Committee of Hacettepe University (GO- 20/824). A written informed consent form was completed by all participants.
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- 2023
28. Investigating the lower extremity–related anaerobic exercise capacity and functional status in adult patients with familial Mediterranean fever
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Servet Akar, S. Gucenmez, Merve Eylul Acar, Deniz Bayraktar, Devrim Can Saraç, Umut Ziya Kocak, Dilek Solmaz, and Nurullah Buker
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Adult ,Male ,medicine.medical_specialty ,Exercise Tolerance ,Adult patients ,business.industry ,Chair stand test ,Familial Mediterranean fever ,Walking ,medicine.disease ,Familial Mediterranean Fever ,Walking distance ,Functional Status ,Lower Extremity ,Rheumatology ,medicine ,Physical therapy ,Humans ,Functional status ,In patient ,Anaerobiosis ,Muscle Strength ,business ,Anaerobic exercise ,Wingate test - Abstract
Objectives No studies examined the lower extremity–related anaerobic exercise capacity or functional status in adult patients with FMF. Methods Twenty-four patients with FMF (12 males) and 24 age–sex-matched healthy controls (13 males) were included in the study. Lower extremity–related anaerobic exercise capacity was assessed by using Wingate Anaerobic Test. Lower extremity–related functional status was examined by using 9-Step Stair Climb Test, 10-Repetition Chair Stand Test, and Six-Minute Walking Distance. Muscle strength of hip flexors, hip extensors, knee flexors, and knee extensors were evaluated by using a hand-held dynamometer. Results Patients with FMF had significantly poorer results in all anaerobic exercise capacity parameters and functional status assessments (P 0.05). Both average and peak anaerobic exercise capacities correlated significantly with all muscle strength measurements, 9-Step Stair Climb Test, 10-Repetition Chair Stand Test times, and Six-Minute Walk Distances (P Conclusion Lower extremity–related anaerobic exercise capacity and functional status seem to be diminished in adult patients with FMF. Evaluating these parameters may be beneficial for planning more appropriate and individualized treatment regimens such as patient education and exercise counselling for patients with FMF.
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- 2021
29. Effect of cervical stabilization exercises on cervical position error in patients with axial spondyloarthritis: a randomized controlled pilot study
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Hande Ece Oz, Gozde Duran, Deniz Bayraktar, Mete Kara, Dilek Solmaz, and Servet Akar
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Rheumatology - Abstract
To investigate the effect of cervical stabilization exercises on cervical position error in patients with axial spondyloarthritis (axSpA).Thirty-nine patients with axSpA were randomly allocated to two groups as exercise group (n = 20, 11 males) and control group (n = 19, 12 males). The exercise group performed a progressive home-based cervical stabilization exercise program, while the control group did not receive any exercise intervention. To control exercise adherence and progression, text messages and video instructions were delivered via a freeware and cross-platform messaging service on a weekly basis. All patients were evaluated regarding physical characteristics, disease activity (Bath Ankylosing Spondylitis Disease Activity Index), functional status (Bath Ankylosing Spondylitis Functional Index), and spinal mobility (Bath Ankylosing Spondylitis Metrology Index). Cervical position error was evaluated in flexion, extension, rotation, and lateral flexion directions. All evaluations were performed at baseline and after 6 weeks.Baseline physical and disease-related characteristics were similar between the groups (p 0.05). After 6 weeks, significant improvements were observed in cervical position error in all directions in the exercise group (p 0.05), whereas no improvements were detected in the control group (p 0.05).A 6-week home-based cervical stabilization exercise program seems to be beneficial for improving impaired cervical proprioception in patients with axSpA.ZIEL: Ziel der Arbeit war es, die Wirkung von Übungen zur Stabilisierung der Halswirbelsäule auf deren zervikaler Positionsfehler bei Patienten mit axialer Spondyloarthritis (axSpA) zu untersuchen.Dazu wurden 39 Patienten mit axSpA randomisiert in 2 Gruppen eingeteilt, eine Übungsgruppe (n = 20, 11 m.) und eine Kontrollgruppe (n = 19, 12 m.). Die Übungsgruppe führte ein stufenweise aufbauendes Heimprogramm zur Halswirbelsäulenstabilisierung durch, während die Kontrollgruppe keine Übungsintervention erhielt. Um die Einhaltung der Übungen und ihren Fortschritt zu kontrollieren, wurden wöchentlich Textnachrichten und Videoanleitungen über einen freien und plattformübergreifenden Messagerdienst gesendet. Sämtliche Patienten wurden hinsichtlich körperlicher Merkmale, Krankheitsaktivität (Bath Ankylosing Spondylitis Disease Activity Index), funktionellem Status (Bath Ankylosing Spondylitis Functional Index), und Wirbelsäulenbeweglichkeit (Bath Ankylosing Spondylitis Metrology Index) untersucht. Zervikale Positionsfehler der Halswirbelsäule wurden in Flexion, Extension, Rotation und Lateralflexion beurteilt. Alle Untersuchungen wurden zu Anfang der Studie und nach 6 Wochen durchgeführt.Die körperlichen und krankheitsbezogenen Merkmale zu Anfang waren zwischen den beiden Gruppen ähnlich (p 0,05). Nach 6 Wochen wurden in der Übungsgruppe signifikante Verbesserungen der zervikalen Positionsfehler der Halswirbelsäule in allen Richtungen festgestellt (p 0,05), während in der Kontrollgruppe keine Verbesserungen zu beobachten waren (p 0,05).Ein 6‑wöchiges häusliches Übungsprogramm zur Stabilisierung der Halswirbelsäule scheint vorteilhaft zu sein, um die beeinträchtigte zervikale Propriozeption bei Patienten mit axSpA zu verbessern.
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- 2022
30. The prevalence of Sjögren’s syndrome and sicca symptoms in patients with systemic sclerosis and alpha-smooth muscle actin expression in biopsy specimens from minor salivary glands
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Vedat Gerdan, Merih Birlik, Sülen Sarioğlu, Dilek Solmaz, Gerçek Can, Fatos Onen, Servet Akar, Gökçe Kenar, Ozgul Soysal, and Nurullah Akkoc
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Adult ,Male ,medicine.medical_specialty ,Biopsy ,Salivary Glands, Minor ,Gastroenterology ,Sialadenitis ,Scleroderma ,Fibrosis ,Internal medicine ,Prevalence ,Humans ,Medicine ,Outpatient clinic ,Aged ,Scleroderma, Systemic ,Salivary gland ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Actins ,Rheumatology ,stomatognathic diseases ,Cross-Sectional Studies ,Sjogren's Syndrome ,medicine.anatomical_structure ,Cohort ,Female ,business - Abstract
Background/aim: This study aimed to investigate the prevalence of sicca symptoms and secondary Sjogren's syndrome (SjS) in patients with systemic sclerosis (SSc). Also this study aimed to evaluate the expression of alpha-smooth muscle actin (alpha-SMA) in minor salivary gland (MSG) specimens, a possible marker of fibrosis responsible for myofibroblastic transformation. Materials and methods: Patients with SSc who were followed in Rheumatology outpatient clinic at a university hospital evaluated. The questionnaire of sicca symptoms and classification of SjS were evaluated according to the American-European Consensus Group (AECG) criteria. Histopathologic evaluations were done in MSG specimens investigating the presence of focal lymphocytic sialadenitis and glandular fibrosis, also assessing the expression of alpha-SMA. Results: This cross-sectional study included 102 patients with SSc [91 females (89%), mean age 52.5 +/- 12 years]. In this cohort 76 (75%) patients had sicca symptoms and 36 (35.3%) patients fulfilled the AECG criteria for SjS; all with limited form. Having SjS found to be associated with older age and the presence of positive anti-SS-A antibodies. On histopathologic examinations, glandular fibrosis was observed in 67 (80%) and lymphocytic sialadenitis was detected in 38 (45%) patients; but only 7 samples were positive for alpha-SMA. Conclusion: This study suggested sicca symptoms were found to be very common among patients with SSc. Also secondary SjS was detected in nearly one-third of patients with SSc; especially in limited subtype. Anti SS-A positivity and older age were detected as predictors for SjS. Histopathologic evaluations showed significant glandular fibrosis but rare alpha-SMA staining in patients with SSc.
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- 2021
31. Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic
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Orhan Küçükşahin, Servet Akar, Emel Gönüllü, Duygu Ersözlü, Sedat Kiraz, Gezmiş Kimyon, Hakan Emmungil, Umut Kalyoncu, Ali İhsan Ertenli, Nihan Coşkun, Emre Bilgin, Rıdvan Mercan, Yavuz Pehlivan, Omer Karadag, Hüseyin Dalkiliç, Cemal Bes, Süleyman Serdar Koca, Burcu Yağız, Nilüfer Alpay Kanıtez, Timuçin Kaşifoğlu, Seda Colak, Elif Durak Ediboglu, Levent Kilic, İç Hastalıkları, Kanıtez, Nilüfer Alpay (ORCID 0000-0003-1185-5816 & YÖK ID 239432), Kalyoncu, Umut, Pehlivan, Yavuz, Akar, Servet, Kaşifoğlu, Timuçin, Kimyon, Gezmiş, Karadağ, Ömer, Dalkılıç, Ediz, Ertenli, Ali İhsan, Kılıç, Levent, Ersözlü, Duygu, Beş, Cemal, Emmungil, Hakan, Mercan, Rıdvan, Ediboğlu, Elif Durak, Bilgin, Emre, Çolak, Seda, Koca, Süleyman Serdar, Gönüllü, Emel, Küçükşahin, Orhan, Coşkun, Nihan, Yağız, Burcu, Kiraz, Sedat, Koç University Hospital, and School of Medicine
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rheumatoid arthritis ,Male ,Bath ankylosing spondylitis disease activity index ,Inflammatory arthritis ,polymerase chain reaction ,very elderly ,health status ,Disease ,Arthritis, Rheumatoid ,Cohort Studies ,rituximab ,adalimumab ,Pandemic ,middle aged ,disease modifying antirheumatic drug ,Health Assessment Questionnaire ,Prospective Studies ,Registries ,golimumab ,Aged, 80 and over ,register ,Ankylosing Spondylitis Disease Activity Score ,secukinumab ,adult ,medication compliance ,Simplified Disease Activity Index ,Biologic DMARDs ,General Medicine ,spondyloarthritis ,Middle Aged ,cohort analysis ,aged ,female ,spondylarthritis ,Rheumatoid arthritis ,drug withdrawal ,Antirheumatic Agents ,young adult ,Rituximab ,Female ,biologic DMARDs ,medicine.drug ,prospective study ,Adult ,medicine.medical_specialty ,abatacept ,hydroxychloroquine ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Visual analogue scale ,COVID-19 ,Spondyloarthritis ,salazosulfapyridine ,methotrexate ,Article ,Medication Adherence ,tocilizumab ,coronavirus disease 2019 ,Young Adult ,remission ,Internal medicine ,medicine ,DAS28 ,Humans ,human ,Pandemics ,Aged ,leflunomide ,business.industry ,SARS-CoV-2 ,pandemic ,questionnaire ,General and internal medicine ,visual analog scale ,medicine.disease ,major clinical study ,Discontinuation ,certolizumab pegol ,Bath ankylosing spondylitis functional index ,antirheumatic agent ,observational study ,erythrocyte sedimentation rate ,business ,infliximab ,Crohn Disease Activity Index ,etanercept ,disease activity - 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., Hacettepe Rheumatology Society
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- 2021
32. Investigating performance-based hand functions in patients with systemic sclerosis
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Emre Alp Akatay, Deniz Bayraktar, Eda Otman, Oguz Ustun, Idil Kurut Aysin, Devrim Can Sarac, Busranur Atalay, Irem Ramazanoglu, Ilyas Tekin, Tugba Kurum, Sercan Gucenmez, Mustafa Ozmen, and Servet Akar
- Subjects
Rheumatology - Abstract
Systemic sclerosis (SSc) is a connective tissue disorder characterized by collagen deposits in various organs. Skin involvement is one of the most common symptoms and along with vascular damage, may deteriorate hand functions. However, the status of hand functions has generally been investigated using patient-reported measures in patients with SSc. The aim of the present study was to investigate performance-based hand functions in patients with SSc using the Sollerman Hand Function Test (SHFT).A total of 39 patients with SSc (33 females) were included in the study. Twenty-four patients were classified as limited cutaneous SSc (lcSSc), while 15 patients were classified as diffuse cutaneous SSc (dcSSc). Hand-related physical characteristics were evaluated using the Modified Hand Mobility in Scleroderma Test, grip strength, and pinch strengths. The Duruoz Hand Index (Cochin Hand Functional Disability Scale), Disability of Arm, Shoulder, and Hand Questionnaire, Health Assessment Questionnaire, and Scleroderma Health Assessment Questionnaire were used as patient-reported measures. Performance-based hand functions were evaluated using SHFT.No significant differences were observed between lcSSc and dcSSc subtypes regarding performance-based and patient-reported hand functions (p 0.05). SHFT scores significantly correlated with hand-related physical characteristics and patient-reported hand functions (p 0.05). The highest correlation was determined between SHFT and the Duruoz Hand Index (rho: -0.652, p 0.001).According to our results, performance-based hand functions seem not to be affected by disease subtype. Performance-based hand functions may partially be captured by the patient-reported outcomes, especially the Duruoz Hand Index, in patients with SSc.ZIEL: Die systemische Sklerose (SSc) ist eine Bindegewebserkrankung, welche durch Kollagenablagerungen in verschiedenen Organen gekennzeichnet ist. Eines der häufigsten Symptome stellt die Hautbeteiligung dar, die in Kombination mit einer Gefäßschädigung auch die Funktionen der Hand beeinträchtigen kann. Allgemein wurde allerdings der Status der Handfunktionen bisher mittels Parametern gemäß den subjektiven Angaben von SSc-Patienten untersucht. Ziel der vorliegenden Studie war es, die leistungsbezogenen Handfunktionen bei Patienten mit SSc anhand des Sollerman Hand Function Test (SHFT) zu ermitteln.Dazu wurden 39 Patienten mit SSc (davon 33 Frauen) in die Studie einbezogen; bei 24 Patienten wurde die Erkrankung als limitierte kutane SSc (lcSSc) eingestuft, während sie bei 15 Patienten als diffuse kutane SSc (dcSSc) klassifiziert wurde. Handbezogene körperliche Merkmale wurden mithilfe des Modified Hand Mobility in Scleroderma Test, der Griffstärke und Kneifkraft beurteilt. Der Duruoz Hand Index (Cochin Hand Functional Disability Scale), Disability of Arm, Shoulder, and Hand Questionnaire, Health Assessment Questionnaire und der Scleroderma Health Assessment Questionnaire wurden als Parameter der subjektiven Angaben von Patienten eingesetzt. Die leistungsbasierten Handfunktionen wurden mittels SHFT beurteilt.Zwischen den Subtypen lcSSc und dcSSc wurden keine signifikanten Unterschiede in Bezug auf leistungsbasierte Handfunktionen und Handfunktionen nach patientenbezogenen Angaben (p 0,05) festgestellt. Die SHFT-Werte waren in signifikanter Weise mit den handbezogenen körperlichen Merkmalen und den Handfunktionen nach Patientenangaben korreliert (p 0,05). Dabei wurde die höchste Korrelation zwischen SHFT und dem Duruoz Hand Index (rho: −0,652; p 0,001) festgestellt.Den vorliegenden Ergebnissen zufolge scheinen die leistungsbasierten Handfunktionen nicht vom Krankheitssubtyp beeinflusst zu werden. Leistungsbasierte Handfunktionen bei Patienten mit SSc können mittels der von Patienten berichteten Ergebnisse erfasst werden, insbesondere mit dem Duruoz Hand Index.
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- 2022
33. Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study
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Zara Izadi, Milena A Gianfrancesco, Gabriela Schmajuk, Lindsay Jacobsohn, Patricia Katz, Stephanie Rush, Clairissa Ja, Tiffany Taylor, Kie Shidara, Maria I Danila, Katherine D Wysham, Anja Strangfeld, Elsa F Mateus, Kimme L Hyrich, Laure Gossec, Loreto Carmona, Saskia Lawson-Tovey, Lianne Kearsley-Fleet, Martin Schaefer, Samar Al-Emadi, Jeffrey A Sparks, Tiffany Y-T Hsu, Naomi J Patel, Leanna Wise, Emily Gilbert, Alí Duarte-García, Maria O Valenzuela-Almada, Manuel F Ugarte-Gil, Lotta Ljung, Carlo A Scirè, Greta Carrara, Eric Hachulla, Christophe Richez, Patrice Cacoub, Thierry Thomas, Maria J Santos, Miguel Bernardes, Rebecca Hasseli, Anne Regierer, Hendrik Schulze-Koops, Ulf Müller-Ladner, Guillermo Pons-Estel, Romina Tanten, Romina E Nieto, Cecilia N Pisoni, Yohana S Tissera, Ricardo Xavier, Claudia D Lopes Marques, Gecilmara C S Pileggi, Philip C Robinson, Pedro M Machado, Emily Sirotich, Jean W Liew, Jonathan S Hausmann, Paul Sufka, Rebecca Grainger, Suleman Bhana, Monique Gore-Massy, Zachary S Wallace, Jinoos Yazdany, Brahim Dahou, Gimena Gómez, Karen Roberts, Roberto M Baez, Vanessa V Castro Coello, María J Haye Salinas, Federico N Maldonado, Alvaro A Reyes, Gelsomina Alle, Hernán Maldonado Ficco, Romina Nieto, Carla Gobbi, Yohana Tissera, Cecilia Pisoni, Alba Paula, Juan A Albiero, Maria M Schmid, Micaela Cosatti, Maria J Gamba, Carlevaris Leandro, María A Cusa, Noelia German, Veronica Bellomio, Lorena Takashima, Mariana Pera, Karina Cogo, Maria S Gálvez Elkin, María A Medina, Veronica Savio, Romina Rojas Tessel, Rodolfo P Alamino, Marina L Werner, Sofía Ornella, Luciana Casalla, Maria de la Vega, María Severina, Mercedes García, Luciana Gonzalez Lucero, Cecilia Romeo, Sebastián Moyano, Tatiana Barbich, Ana Bertoli, Andrea Baños, Sandra Petruzzelli, Carla Matellan, Silvana Conti, Maria A Lazaro, Gustavo F Rodriguez Gil, Fabian Risueño, Maria I Quaglia, Julia Scafati, Natalia L Cuchiaro, Jonathan E Rebak, Susana I Pineda, María E Calvo, Eugenia Picco, Josefina G Yanzi, Pablo Maid, Debora Guaglianone, Julieta S Morbiducci, Sabrina Porta, Natalia Herscovich, José L Velasco Zamora, Boris Kisluk, Maria S Castaños Menescardi, Rosana Gallo, María V Martire, Carla Maldini, Cecilia Goizueta, Sabrina S de la Vega Fernandez, Carolina Aeschlimann, Gisela Subils, Eva Rath, Yves Piette, Mieke Devinck, Bea Maeyaert, Francinne Machado Ribeiro, Sandra L Euzebio Ribeiro, Marcelo Pinheiro, Sebastián Ibáñez, Anne-Marie Chassin Trubert, Lingli Dong, Lui Cajas, Marko Barešić, Branimir Anić, Melanie-Ivana Ćulo, Tea A Pavelić, Kristina K Stranski, Boris Karanovic, Jiri Vencovsky, Marta Píchová, Maria Filkova, Hesham Hamoud, Dimitrios Vassilopoulos, Gabriela M Guzman Melgar, Ho So, Márta Király, Mahdi Vojdanian, Alexandra Balbir Gurman, Fatemah Abutiban, Julija Zepa, Inita Bulina, Loreta Bukauskiene, Beatriz E Zazueta Montiel, Angel A Castillo Ortiz, Erick Zamora Tehozol, David Vega Morales, Diana Cervántes Rosete, Eduardo Martín Nares, Tatiana S Rodriguez Reyna, Marina Rull Gabayet, Deshiré Alpízar Rodríguez, Fedra Irazoque, Xochitl Jimenez, Lenny Geurts van Bon, Theo Zijlstra, Monique Hoekstra, Nasra Al Adhoubi, Babur Salim, Enrique Giraldo, Ariel Salinas, Manuel Ugarte Gil, Jarosław Nowakowski, Richard Conway, Rachael Flood, Geraldine McCarthy, Ioana Felea, Ileana Filipescu, Simona Rednic, Laura Groseanu, Maria M Tamas, Vanda Mlynarikova, Martina Skamlova, Martin Zlnay, Dagmar Mičeková, Lubica Capova, Zelmira Macejova, Emőke Šteňová, Helena Raffayova, Gabriela Belakova, Eva Strakova, Marieta Senčarová, Soňa Žlnayová, Anna Sabová, Daniela Spisakova, Mária Oetterová, Olga Lukacova, Martina Bakosova, Alojzija Hocevar, Natalia de la Torre Rubio, Juan J Alegre Sancho, Montserrat Corteguera Coro, Juan C Cobeta Garcia, Maria C Torres Martin, Jose Campos, Jose A Gomez Puerta, Gozd K Yardimci, Servet Akar, Ozan C Icacan, Selda ÇELİK, Viktoriia Vasylets, Su-Ann Yeoh, Claire Vandevelde, Sasha Dunt, Jane Leeder, Elizabeth Macphie, Rosaria Salerno, Christine Graver, Katie Williams, Sheila O'Reilly, Kirsty Devine, Jennifer Tyler, Elizabeth Warner, James Pilcher, Samir Patel, Elena Nikiphorou, Laura Chadwick, Caroline M Jones, Beverley Harrison, Lucy Thornton, Diana O'Kane, Lucia Fusi, Audrey Low, Sarah Horton, Shraddha Jatwani, Sara Baig, Hammad Bajwa, Vernon Berglund, Angela Dahle, Walter Dorman, Jody Hargrove, Maren Hilton, Nicholas Lebedoff, Susan Leonard, Jennifer Morgan, Emily Pfeifer, Archibald Skemp, Jeffrey Wilson, Anne Wolff, Eduardo Cepeda, Derrick Todd, Denise Hare, Cassandra Calabrese, Christopher Adams, Arezou Khosroshahi, Adam Kilian, Douglas White, Melanie Winter, Theodore Fields, Caroline Siegel, Nicole Daver, Melissa Harvey, Neil Kramer, Concetta Lamore, Suneya Hogarty, Karen Yeter, Faizah Siddique, Byung Ban, Tamar Tanner, Eric Ruderman, William Davis, Robert Quinet, Evangeline Scopelitis, Karen Toribio, Tameka Webb Detiege, Jerald Zakem, Khurram Abbass, Gilbert Kepecs, Lilliam Miranda, Michael Guma, Ammar Haikal, Sushama Mody, Daric Mueller, Arundathi Jayatilleke, JoAnn Zell, Alison Bays, Kathryn Dao, Fatemeh Ezzati, Deborah Parks, David Karp, Guillermo Quiceno, Izadi, Z, Gianfrancesco, M, Schmajuk, G, Jacobsohn, L, Katz, P, Rush, S, Ja, C, Taylor, T, Shidara, K, Danila, M, Wysham, K, Strangfeld, A, Mateus, E, Hyrich, K, Gossec, L, Carmona, L, Lawson-Tovey, S, Kearsley-Fleet, L, Schaefer, M, Al-Emadi, S, Sparks, J, Hsu, T, Patel, N, Wise, L, Gilbert, E, Duarte-Garcia, A, Valenzuela-Almada, M, Ugarte-Gil, M, Ljung, L, Scire, C, Carrara, G, Hachulla, E, Richez, C, Cacoub, P, Thomas, T, Santos, M, Bernardes, M, Hasseli, R, Regierer, A, Schulze-Koops, H, Muller-Ladner, U, Pons-Estel, G, Tanten, R, Nieto, R, Pisoni, C, Tissera, Y, Xavier, R, Lopes Marques, C, Pileggi, G, Robinson, P, Machado, P, Sirotich, E, Liew, J, Hausmann, J, Sufka, P, Grainger, R, Bhana, S, Gore-Massy, M, Wallace, Z, Yazdany, J, Dahou, B, Gomez, G, Roberts, K, Baez, R, Castro Coello, V, Haye Salinas, M, Maldonado, F, Reyes, A, Alle, G, Maldonado Ficco, H, Gobbi, C, Paula, A, Albiero, J, Schmid, M, Cosatti, M, Gamba, M, Leandro, C, Cusa, M, German, N, Bellomio, V, Takashima, L, Pera, M, Cogo, K, Galvez Elkin, M, Medina, M, Savio, V, Rojas Tessel, R, Alamino, R, Werner, M, Ornella, S, Casalla, L, de la Vega, M, Severina, M, Garcia, M, Gonzalez Lucero, L, Romeo, C, Moyano, S, Barbich, T, Bertoli, A, Banos, A, Petruzzelli, S, Matellan, C, Conti, S, Lazaro, M, Rodriguez Gil, G, Risueno, F, Quaglia, M, Scafati, J, Cuchiaro, N, Rebak, J, Pineda, S, Calvo, M, Picco, E, Yanzi, J, Maid, P, Guaglianone, D, Morbiducci, J, Porta, S, Herscovich, N, Velasco Zamora, J, Kisluk, B, Castanos Menescardi, M, Gallo, R, Martire, M, Maldini, C, Goizueta, C, de la Vega Fernandez, S, Aeschlimann, C, Subils, G, Rath, E, Piette, Y, Devinck, M, Maeyaert, B, Machado Ribeiro, F, Euzebio Ribeiro, S, Pinheiro, M, Ibanez, S, Chassin Trubert, A, Dong, L, Cajas, L, Baresic, M, Anic, B, Culo, M, Pavelic, T, Stranski, K, Karanovic, B, Vencovsky, J, Pichova, M, Filkova, M, Hamoud, H, Vassilopoulos, D, Guzman Melgar, G, So, H, Kiraly, M, Vojdanian, M, Balbir Gurman, A, Abutiban, F, Zepa, J, Bulina, I, Bukauskiene, L, Zazueta Montiel, B, Castillo Ortiz, A, Zamora Tehozol, E, Vega Morales, D, Cervantes Rosete, D, Martin Nares, E, Rodriguez Reyna, T, Rull Gabayet, M, Alpizar Rodriguez, D, Irazoque, F, Jimenez, X, Geurts van Bon, L, Zijlstra, T, Hoekstra, M, Al Adhoubi, N, Salim, B, Giraldo, E, Salinas, A, Ugarte Gil, M, Nowakowski, J, Conway, R, Flood, R, Mccarthy, G, Felea, I, Filipescu, I, Rednic, S, Groseanu, L, Tamas, M, Mlynarikova, V, Skamlova, M, Zlnay, M, Micekova, D, Capova, L, Macejova, Z, Stenova, E, Raffayova, H, Belakova, G, Strakova, E, Sencarova, M, Zlnayova, S, Sabova, A, Spisakova, D, Oetterova, M, Lukacova, O, Bakosova, M, Hocevar, A, de la Torre Rubio, N, Alegre Sancho, J, Corteguera Coro, M, Cobeta Garcia, J, Torres Martin, M, Campos, J, Gomez Puerta, J, Yardimci, G, Akar, S, Icacan, O, Celik, S, Vasylets, V, Yeoh, S, Vandevelde, C, Dunt, S, Leeder, J, Macphie, E, Salerno, R, Graver, C, Williams, K, O'Reilly, S, Devine, K, Tyler, J, Warner, E, Pilcher, J, Patel, S, Nikiphorou, E, Chadwick, L, Jones, C, Harrison, B, Thornton, L, O'Kane, D, Fusi, L, Low, A, Horton, S, Jatwani, S, Baig, S, Bajwa, H, Berglund, V, Dahle, A, Dorman, W, Hargrove, J, Hilton, M, Lebedoff, N, Leonard, S, Morgan, J, Pfeifer, E, Skemp, A, Wilson, J, Wolff, A, Cepeda, E, Todd, D, Hare, D, Calabrese, C, Adams, C, Khosroshahi, A, Kilian, A, White, D, Winter, M, Fields, T, Siegel, C, Daver, N, Harvey, M, Kramer, N, Lamore, C, Hogarty, S, Yeter, K, Siddique, F, Ban, B, Tanner, T, Ruderman, E, Davis, W, Quinet, R, Scopelitis, E, Toribio, K, Webb Detiege, T, Zakem, J, Abbass, K, Kepecs, G, Miranda, L, Guma, M, Haikal, A, Mody, S, Mueller, D, Jayatilleke, A, Zell, J, Bays, A, Dao, K, Ezzati, F, Parks, D, Karp, D, Quiceno, G, and Repositório da Universidade de Lisboa
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health care disparity ,Immunology ,air pollution ,cohort analysi ,mortality rate ,Autoimmune Disease ,Article ,coronavirus disease 2019 ,biocontainment ,Rheumatology ,male ,cardiovascular disease ,environmental factor ,death ,geographic distribution ,Immunology and Allergy ,follow up ,controlled study ,human ,population density ,outcome assessment ,rheumatic disease ,diabetes mellitu ,adult ,Prevention ,market ,temperature ,mortality ,United Kingdom ,Europe ,aged ,female ,workplace ,Good Health and Well Being ,human development ,particulate matter 2.5 ,statistical analysi ,North America ,incidence ,life expectancy ,social aspect ,COVID-19 Global Rheumatology Alliance Registry ,observational study ,demographic - Abstract
Published by Elsevier Ltd., Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally. Methods: In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death. Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01-1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10-1·30]; p, MAG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K01 AR070585 and K24 AR074534 [JY]). KDW is supported by the Department of Veterans Affairs and the Rheumatology Research Foundation Scientist Development award. JAS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, and P30 AR072577), the Rheumatology Research Foundation (K Supplement Award and R Bridge Award), the Brigham Research Institute, and the R. Bruce and Joan M. Mickey Research Scholar Fund. NJP is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32-AR-007258). AD-G is supported by grants from the Centers for Disease Control and Prevention and the Rheumatology Research Foundation. RH was supported by the Justus-Liebig University Giessen Clinician Scientist Program in Biomedical Research to work on this registry. JY is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155).
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- 2022
34. An improved understanding of sex and gender is crucial for precision rheumatology
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Helena Marzo-Ortega, Victoria Navarro-Compán, Servet Akar, Uta Kiltz, Zoë Clark, and Elena Nikiphorou
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Male ,Sex Factors ,Rheumatology ,Data Collection ,Humans ,Female ,General Medicine ,Precision Medicine - Published
- 2022
35. Metabolic syndrome is associated with increased cardiovascular risk and disease damage in patients with Takayasu arteritis
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Burçin Sağlam, Sema Kaymaz‐Tahra, Gökçe Kenar, Sinem Kocaer, Ahmet Omma, Abdulsamet Erden, Mete Kara, Ayten Yazıcı, Ayşe Cefle, Önay Gerçik, Servet Akar, Kenan Aksu, Gökhan Keser, Handan Yarkan Tuğsal, Fatoş Önen, Sevil Kamalı, Fatma Alibaz‐Öner, Haner Direskeneli, Nilüfer Alpay‐Kanıtez, and Sağlam B., Kaymaz-Tahra S., Kenar G., Kocaer S., Omma A., Erden A., Kara M., Yazıcı A., Cefle A., Gerçik Ö., et al.
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Adult ,Male ,RHEUMATOLOGY ,Klinik Tıp ,MULTICENTER ,Middle Aged ,CLINICAL MEDICINE ,Clinical Medicine (MED) ,metabolic syndrome ,vasculitis ,Cross-Sectional Studies ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Risk Factors ,cardiovascular disease ,Humans ,Female ,Klinik Tıp (MED) ,ROMATOLOJİ ,Takayasu arteritis - Abstract
Objective: Metabolic syndrome (MetS) is one of the preventable risk factors for cardiovascular disease (CVD). The aim of this study was to investigate the effect of MetS on CVD and cumulative organ damage in a multi-center, large cohort of patients with Takayasu arteritis (TAK). Methods: This is a cross-sectional study involving 192 consecutive TAK patients from seven tertiary rheumatology centers in Turkey. Clinical data of TAK patients fulfilling the 1990 American College of Rheumatology classification criteria were collected from medical records. They were evaluated for risk factors of CVD, disease activity, damage, and MetS at their last visits. Results: A total of 192 consecutive TAK patients were included in this study. One hundred and fifty-eight (82%) were female, the mean age was 43.3 +/- 13 years, and mean disease duration was 13.5 +/- 9.3 years. MetS was detected in 50 (26%) of the patients and CVD was detected in 28 (14.6%). The presence of MetS was detected as an independent risk factor for CVD (P < 0.001). In addition, the mean vasculitis damage index of the group with MetS was significantly higher than in the other patients (4.5 +/- 3.3 vs 3.2 +/- 2.2, respectively, P = 0.004). Conclusion: The presence of MetS in TAK is associated with increased CVD and disease damage. Awareness and management of MetS can improve disease prognosis in patients with TAK.
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- 2022
36. Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis
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Ferda Bilgir, Servet Akar, and G. Kabadayi
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musculoskeletal diseases ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Abatacept ,medicine.medical_treatment ,Immunology ,medicine.disease ,Organ transplantation ,Hypersensitivity reaction ,Rheumatoid arthritis ,medicine ,Immunology and Allergy ,Premedication ,Adverse effect ,business ,Anaphylaxis ,medicine.drug ,Desensitization (medicine) - Abstract
Abatacept is a fusion protein that blocks T cell activation. It is used in a variety of conditions including organ transplantation, immune deficiency, and autoimmune diseases. Even though abatacept-induced adverse events are observed, hypersensitivity reactions are rare. Desensitization protocols that can be implemented in the case of hypersensitivity reactions are present in the literature for many biological agents. However, a desensitization protocol for abatacept has not yet been established. Our patient, who was started on one of the biological agents, abatacept, for rheumatoid arthritis due to insufficient response to disease- modifying antirheumatic drugs, developed immediate hypersensitivity reaction with the first dose. Since it was planned to continue the treatment, abatacept desensitization was performed. The rapid desensitization protocol performed with prior premedication was successful and the patient was able to receive subsequent doses of abatacept using the same protocol. Keywords: Abatacept, anaphylaxis, desensitization
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- 2021
37. Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study
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Sharon A. Chung, Gökhan Keser, Ayten Yazici, Zeynep Ozbalkan, R. Maughan, Servet Akar, Fatma Alibaz-Oner, Nurullah Akkoc, Kathleen McKinnon-Maksimowicz, Patrick Coit, Güher Saruhan-Direskeneli, Chris Wallace, Omer Karadag, Muge Bicakcigil, Antoine G. Sreih, Ahmet Mesut Onat, Paul A. Monach, Ying Sun, Kenan Aksu, Carol A. Langford, Mehmet Akif Ozturk, Izzet Fresko, Eren Erken, Lindsay Lally, Lindsy J. Forbess, Christian Pagnoux, Ayse Cefle, Ediz Dalkilic, Timothy J. Vyse, Veli Cobankara, Peter C. Grayson, Guillermo Reales, David Cuthbertson, Philip Seo, Gozde Yildirim Cetin, Curry L. Koening, Sibel P. Yentür, Yaşar Karaaslan, Lourdes Ortiz-Fernández, Nilufer Alpay-Kanitez, Bunyamin Kisacik, Xiufang Kong, Sibel Zehra Aydin, Enrico Tombetti, Sule Yavuz, Lindi Jiang, Fatos Onen, Allan P. Kiprianos, Nurşen Düzgün, Nader Khalidi, Justin C. Mason, Huiyong Chen, Aşkın Ateş, Angelo A. Manfredi, Murat Inanc, Sevil Kamali, Sema Kaymaz-Tahra, Steven R. Ytterberg, Timuçin Kaşifoğlu, Emire Seyahi, Elena Baldissera, Deborah S. Cunninghame-Graham, Sedat Kiraz, Jason M. Springer, Peter A. Merkel, Haner Direskeneli, Jonathan D. Wren, Kenneth J. Warrington, Carol A. McAlear, Amr H. Sawalha, Huseyin T. E. Ozer, Wallace, Chris [0000-0001-9755-1703], Apollo - University of Cambridge Repository, Ortiz-Fernandez, Lourdes, Saruhan-Direskeneli, Guher, Alibaz-Oner, Fatma, Kaymaz-Tahra, Sema, Coit, Patrick, Kong, Xiufang, Kiprianos, Allan P., Maughan, Robert T., Aydin, Sibel Z., Aksu, Kenan, Keser, Gokhan, Kamali, Sevil, Inanc, Murat, Springer, Jason, Akar, Servet, Onen, Fatos, Akkoc, Nurullah, Khalidi, Nader A., Koening, Curry, Karadag, Omer, Kiraz, Sedat, Forbess, Lindsy, Langford, Carol A., McAlear, Carol A., Ozbalkan, Zeynep, Yavuz, Sule, Cetin, Gozde Yildirim, Alpay-Kanitez, Nilufer, Chung, Sharon, Ates, Askin, Karaaslan, Yasar, McKinnon-Maksimowicz, Kathleen, Monach, Paul A., Ozer, Huseyin T. E., Seyahi, Emire, Fresko, Izzet, Cefle, Ayse, Seo, Philip, Warrington, Kenneth J., Ozturk, Mehmet A., Ytterberg, Steven R., Cobankara, Veli, Onat, Ahmet Mesut, Duzgun, Nursen, Bicakcigil, Muge, Yentur, Sibel P., Lally, Lindsay, Manfredi, Angelo A., Baldissera, Elena, Erken, Eren, Yazici, Ayten, Kisacik, Bunyamin, Kasifoglu, Timucin, Dalkilic, Ediz, Cuthbertson, David, Pagnoux, Christian, Sreih, Antoine, Reales, Guillermo, Wallace, Chris, Wren, Jonathan D., Cunninghame-Graham, Deborah S., Vyse, Timothy J., Sun, Ying, Chen, Huiyong, Grayson, Peter C., Tombetti, Enrico, Jiang, Lindi, Mason, Justin C., Merkel, Peter A., Direskeneli, Haner, Sawalha, Amr H., Ortiz-Fernandez, L., Saruhan-Direskeneli, G., Alibaz-Oner, F., Kaymaz-Tahra, S., Coit, P., Kong, X., Kiprianos, A. P., Maughan, R. T., Aydin, S. Z., Aksu, K., Keser, G., Kamali, S., Inanc, M., Springer, J., Akar, S., Onen, F., Akkoc, N., Khalidi, N. A., Koening, C., Karadag, O., Kiraz, S., Forbess, L., Langford, C. A., Mcalear, C. A., Ozbalkan, Z., Yavuz, S., Cetin, G. Y., Alpay-Kanitez, N., Chung, S., Ates, A., Karaaslan, Y., McKinnon-Maksimowicz, K., Monach, P. A., Ozer, H. T. E., Seyahi, E., Fresko, I., Cefle, A., Seo, P., Warrington, K. J., Ozturk, M. A., Ytterberg, S. R., Cobankara, V., Onat, A. M., Duzgun, N., Bicakcigil, M., Yentur, S. P., Lally, L., Manfredi, A. A., Baldissera, E., Erken, E., Yazici, A., Kisacik, B., Kasifoglu, T., Dalkilic, E., Cuthbertson, D., Pagnoux, C., Sreih, A., Reales, G., Wallace, C., Wren, J. D., Cunninghame-Graham, D. S., Vyse, T. J., Sun, Y., Chen, H., Grayson, P. C., Tombetti, E., Jiang, L., Mason, J. C., Merkel, P. A., Direskeneli, H., Sawalha, A. H., Ege Üniversitesi, [Belirlenecek], Imperial College Healthcare NHS Trust- BRC Funding, and İç Hastalıkları
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Male ,0301 basic medicine ,genetic association ,PROTEIN ,Integrin ,Genome-wide association study ,Disease ,DISEASE ,vasculitis ,Genetic Risk ,ACTIVATION ,0302 clinical medicine ,LEFLUNOMIDE ,Polymorphism (computer science) ,CRITERIA ,GWAS ,skin and connective tissue diseases ,11 Medical and Health Sciences ,Genetics (clinical) ,Genetics & Heredity ,Genetics ,PSORIASIS ,genetic risk scroe ,Classification ,HLA ,Polydom ,Female ,Vasculitis ,Leflunomide ,epigenetic ,vasculitis genetic association ,POLYDOM ,Activation ,GENETIC RISK ,Human leukocyte antigen ,Biology ,eQTL ,Polymorphism, Single Nucleotide ,Article ,CLASSIFICATION ,03 medical and health sciences ,medicine ,Psoriasis ,Humans ,Genetic Predisposition to Disease ,cardiovascular diseases ,Tıp uygulaması ,Genetic association ,030203 arthritis & rheumatology ,Protein ,[No Keywords] ,Case-control study ,06 Biological Sciences ,Inflammatory Bowel Diseases ,medicine.disease ,Criteria ,Takayasu Arteritis ,030104 developmental biology ,[No Keyword] ,Case-Control Studies ,Expression quantitative trait loci ,chromatin interaction ,INTEGRIN ,Genome-Wide Association Study - Abstract
Takayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 x 10(-s)) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets., National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) [R01 AR070148]; National Institute of Arthritis and Musculoskeletal and Skin DiseasesUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) [U54 AR057319, U01 AR51874 04]; National Center for Research ResourcesUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Research Resources (NCRR) [U54 RR019497]; Office of Rare Diseases Research of the National Center for Advancing Translational Sciences; Imperial College, National Institute for Health Research, Biomedical Research Centre; Wellcome TrustWellcome TrustEuropean Commission [WT107881]; Medical Research CouncilUK Research & Innovation (UKRI)Medical Research Council UK (MRC)European Commission [MC_UU_00002/4], This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health grant R01 AR070148 to A.H.S. The Vasculitis Clinical Research Consortium has received support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (U54 AR057319 and U01 AR51874 04), the National Center for Research Resources (U54 RR019497), and the Office of Rare Diseases Research of the National Center for Advancing Translational Sciences. J.C.M., A.P.K., and R.M.M. acknowledge support from the Imperial College, National Institute for Health Research, Biomedical Research Centre. C.W. and G.R. acknowledge support from The Wellcome Trust (WT107881) and the Medical Research Council (MC_UU_00002/4). This work was supported by the use of study data downloaded from the dbGaP website, under dbGaP: phs000272.v1.p1, phs000431.v2.p1, phs000583.v1.p1, and phs000444.v1.p1.
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- 2021
38. The reflection of disease progression in axial spondylarthritis to the imaging
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Dilek Solmaz and Servet Akar
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Optics ,business.industry ,Disease progression ,Reflection (physics) ,Medicine ,business ,Spondylarthritis - Published
- 2020
39. Grip endurance in patients with rheumatoid arthritis: Its relationship between clinical characteristics, upper extremity functional disability, and quality of life
- Author
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Dilek Solmaz, Eda Otman, Melissa Köprülüoğlu, Ilknur Naz, and Servet Akar
- Subjects
Arthritis, Rheumatoid ,Upper Extremity ,Disability Evaluation ,Cross-Sectional Studies ,Rheumatology ,Hand Strength ,Quality of Life ,Humans ,Pain - Abstract
The study's aim was to investigate the relationship of grip strength and endurance with clinical characteristics, upper extremity functional disability, and quality of life in rheumatoid arthritis (RA) patients.We included 45 RA patients and 37 healthy controls in this cross-sectional study. All participants were evaluated using the maximal gripping test, static and dynamic grip endurance test, the Disability of Arm, Shoulder Hand Questionnaire, and Short Form-36, and sociodemographic and clinical characteristics were recorded.Moderate to strong correlations were found between functional disability and all of the grip-related variables. Physical, emotional, and social function sub-scores were correlated with grip strength on both sides and dynamic endurance on the dominant side.The study highlights grip-related variables associated with disability of the upper extremity. The grip strength was related to hand-wrist pain but not other clinical characteristics. Furthermore, grip strength on both sides and dynamic grip endurance on the dominant side were associated with some quality of life sub-scores. While therapists create a rehabilitation plan for RA patients, based on our findings, it may be beneficial to maximize therapeutic benefits on daily life and quality of life.
- Published
- 2022
40. The impact of gender and sex on diagnosis, treatment outcomes and health-related quality of life in patients with axial spondyloarthritis
- Author
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Helena Marzo-Ortega, Victoria Navarro-Compán, Servet Akar, Uta Kiltz, Zoë Clark, and Elena Nikiphorou
- Subjects
Male ,Treatment Outcome ,Rheumatology ,Spondylarthritis ,Quality of Life ,Humans ,Female ,Spondylitis, Ankylosing ,General Medicine ,Axial Spondyloarthritis - Abstract
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic condition, historically considered a predominantly male disease. However, increasing evidence suggests a more equal prevalence between men and women. Of the limited research conducted to date, it is apparent that gender differences exist in terms of time to diagnosis, treatment outcomes and health-related quality of life (HRQoL). Despite this, women are underrepresented in clinical trials and most studies do not stratify by gender to identify potential differences in terms of disease manifestations and treatment response. In this perspectives article, we reflect on the potential biological and social factors contributing to these differences and propose three key areas of education and research that should be prioritised in order to address the unmet needs of female patients with axSpA, namely: (1) to identify ways to increase awareness of disease occurrence in female patients among healthcare professionals (HCPs), (2) to improve understanding of gender differences in disease manifestation and outcomes, and (3) to conduct gender-stratified clinical trials with a representative sample of female patients.
- Published
- 2022
41. Evaluation of subclinical retinopathy and angiopathy with OCT and OCTA in patients with systemic lupus erythematosus
- Author
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Idil Kurut, Dilek Solmaz, Berkay Akmaz, Servet Akar, Yusuf Ziya Güven, Onay Gercik, Mehmed Uğur Işık, Fahrettin Akay, and G. Kabadayi
- Subjects
medicine.medical_specialty ,genetic structures ,Angiopathy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Retinal Diseases ,Ophthalmology ,Humans ,Lupus Erythematosus, Systemic ,Medicine ,Prospective Studies ,Fluorescein Angiography ,skin and connective tissue diseases ,Subclinical infection ,business.industry ,Retinal Vessels ,Hydroxychloroquine ,Retinal ,medicine.disease ,eye diseases ,Ganglion ,Cross-Sectional Studies ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,Maculopathy ,sense organs ,business ,Perfusion ,Tomography, Optical Coherence ,030217 neurology & neurosurgery ,medicine.drug ,Retinopathy - Abstract
To evaluate the choroidal and retinal layers with optical coherence tomography (OCT) and retinal microvascular structures with optical coherence tomography angiography (OCTA) in systemic lupus erythematosus (SLE) patients. In this prospective, cross-sectional and comparative study, a total of 35 SLE patients and 35 healthy control participants were included. SLE patients who were using hydroxychloroquine (HCQ) and/or immunosuppressive agents are evaluated with OCT and OCTA. SLE patients who have no HCQ maculopathy observed in OCT were included in the patient group. Mean macular thickness and ganglion cell inner plexiform layer (GC-IPL) thicknesses were thinner in the patient group. When the parameters obtained with OCTA were evaluated, vessel (VD) and perfusion density (PD) were significantly lower in the patient group. Central foveal thickness and foveal avascular zone parameters were negatively correlated. In addition, VD and PD, and GC-IPL thicknesses were positively correlated. Application of OCTA for the evaluation of microvasculature in SLE patients may be useful in subclinical changes.
- Published
- 2020
42. Does Nasal Secretion Decrease in Sjögren Syndrome and Does This Affect Nasal Function?
- Author
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Servet Akar, Onay Gercik, G. Kabadayi, Erdem Eren, and Koray Balcı
- Subjects
Adult ,Male ,Olfactory system ,Nasal cavity ,Bodily Secretions ,medicine.medical_specialty ,Mucociliary clearance ,Olfaction ,Sjögren syndrome ,Affect (psychology) ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Internal medicine ,Statistical significance ,Nose Diseases ,otorhinolaryngologic diseases ,medicine ,Humans ,030223 otorhinolaryngology ,030203 arthritis & rheumatology ,business.industry ,Middle Aged ,medicine.disease ,eye diseases ,Smell ,stomatognathic diseases ,Cross-Sectional Studies ,Sjogren's Syndrome ,medicine.anatomical_structure ,Otorhinolaryngology ,Mucociliary Clearance ,Female ,Nasal administration ,Nasal Cavity ,business - Abstract
Objective Sjogren syndrome is a systemic inflammatory disease causing gland dysfunction. Few (and contradictory) reports on the mucosal effects of Sjogren syndrome have appeared. Here, we objectively demonstrate nasal dryness in Sjogren syndrome patients and explore the effect of such dryness on olfaction. Methods Thirty-four consecutive patients with primary Sjogren syndrome were enrolled in this cross-sectional study. The control group consisted of 21 age- and sex-matched volunteers. Medical histories and nasal findings were recorded. The Connecticut Chemosensory Clinical Research Center test was used to evaluate olfactory function. All subjects underwent mucucociliary clearance analysis (the saccharin test and peak nasal inspiratory flowmetry). The intranasal Schirmer test was used to evaluate the nasal cavity. Results The nasal Schirmer test scores were 8.4 mm (right) and 8 mm (left) (P = .041, P = .016, respectively, compared to controls). The Chi-squared test revealed significant differences (compared to controls) in nasal dryness (P = .001), postnasal drip (P = .04), and smell (a decrease) (P = .005). Neither olfactory function nor mucociliary clearance differed between the groups. We noted a trend toward a positive correlation between olfactory function and the nasal Schirmer score but statistical significance was not attained. Conclusion The intranasal Schirmer test objectively showed that Sjogren syndrome patients exhibited nasal cavity dryness; this is useful in terms of follow-up. This did not affect olfactory function. Level of evidence 4 Laryngoscope, 131:370-373, 2021.
- Published
- 2020
43. Evaluation of serum level of the vascular endothelial growth factor and osteocalcin in patients with ankylosing spondylitis
- Author
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Hale Bulbul, Sadettin Uslu, Servet Akar, Didem Kozaci, Dilek Solmaz, Neslihan Edeer Karaca, and Gerçek Can
- Subjects
medicine.medical_specialty ,Ankylosing spondylitis ,biology ,business.industry ,medicine.disease ,Vascular endothelial growth factor ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Internal medicine ,Osteocalcin ,biology.protein ,Medicine ,In patient ,business - Published
- 2020
44. Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study
- Author
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G. Kabadayi, Mehmet Uğur Işik, Fahrettin Akay, Servet Akar, Onay Gercik, Idil Kurut, Yusuf Ziya Güven, Dilek Solmaz, and Berkay Akmaz
- Subjects
Adult ,Male ,Retinal Ganglion Cells ,Intraocular pressure ,medicine.medical_specialty ,Radiography ,Nerve fiber layer ,03 medical and health sciences ,chemistry.chemical_compound ,Nerve Fibers ,0302 clinical medicine ,Optical coherence tomography ,Ophthalmology ,Spondylarthritis ,medicine ,Humans ,Retina ,medicine.diagnostic_test ,business.industry ,Retinal ,Middle Aged ,Ganglion ,Cross-Sectional Studies ,medicine.anatomical_structure ,chemistry ,Case-Control Studies ,030221 ophthalmology & optometry ,Mann–Whitney U test ,Female ,sense organs ,business ,Tomography, Optical Coherence ,030217 neurology & neurosurgery - Abstract
The aim of this study is to evaluate the retinal and choroidal structures in r- and nr-axSpA patients using spectral domain optical coherence tomography (SD-OCT) and to compare changes with healthy controls. In this cross-sectional study, 70 axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 healthy control subjects were included. Choroidal thickness (ChT), macular thickness, retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) were measured by SD-OCT. For ChT values, seven lines at nasal and temporal were drawn at 500-μm intervals, centering the subfoveal sclerochoroidal junction. Analysis of the data was performed with the SPSS program. Mann–Whitney U test was performed for comparison of non-normally distributed continuous data; Student’s t test was used for normal distributed data. No significant difference was observed between 70 (66% male; mean age 39.7 ± 10.4 years) axSpA patients (50 radiographic and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2 years) healthy control subjects (p 0.417). R-axSpA and nr-axSpA groups and control group were similar in terms of spherical equivalent, intraocular pressure, axial length, and body mass index (p 0.574, p 0.874, p 0.918, p 0.344, respectively). While mean macular and GCC thicknesses were significantly lower in the patient group than in the healthy group, there was no significant difference between the two groups in terms of RNFL thickness. The present study showed that there was no significant relationship between markers and scores indicating disease activity and ChT, MT, RNFL, and GCC thicknesses. However, an increase in choroidal thickness and involvement of the retinal layers has also been demonstrated in patients with spondyloarthritis. In addition, the relationship between disease activity and retinal layer involvement is remarkable in the r-axSpA group.
- Published
- 2020
45. Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis
- Author
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Mehmet Tokaç, Onay Gercik, Dilek Solmaz, Sadık Volkan Emren, Emre Özdemir, Nihan Kahya Eren, Zeynep Yapan Emren, G. Kabadayi, Ersin Çağrı Şimşek, and Servet Akar
- Subjects
030203 arthritis & rheumatology ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Ankylosing spondylitis ,Univariate analysis ,Ejection fraction ,business.industry ,Case-control study ,Speckle tracking echocardiography ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Cardiology ,Original Article ,BASFI ,business ,lcsh:RC581-607 ,BASDAI ,Subclinical infection - Abstract
OBJECTIVE: To evaluate whether there is any difference between radiographic axial spondyloarthritis (r-axSpA), also termed ankylosing spondylitis (AS), and non-radiographic (nr-) axSpA, with respect to subclinial myocardial dysfunction using speckle tracking echocardiography (STE). METHODS: This was a cross-sectional case control study. We included 72 patients with AS, 38 patients with nr-axSpA, and 56 age-matched healthy subjects. Patients with cardiac disease and cardiac risk factors affecting STE were excluded. The disease burden evaluated by the BASDAI, BASFI, BAS-G, and ASAS-HI scores were comparable in both the r- and nr-axSpA groups. A detailed echocardiographic examination including the M-mode, Doppler, and STE was applied to whole study population. RESULTS: Duration of the disease, the use of an anti-TNFα agent, and CRP levels were higher in patients with AS. Although the AS, nr-axSpA, and control groups had similar ejection fraction values (59±5.2, 60±4.6, 60±4.6, respectively, and p=0.499), the global longitudinal peak systolic strain (GLS) (20.5±3.3, 21.1±3.5, and 22.3±2.4, respectively, and p
- Published
- 2020
46. Tuberculin skin test before biologic and targeted therapies: does the same rule apply for all?
- Author
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Ufuk İlgen, Ömer Karadağ, Hakan Emmungil, Orhan Küçükşahin, Süleyman Serdar Koca, Abdülsamet Erden, Cemal Bes, Nilüfer Alpay Kanıtez, Ediz Dalkılıç, Servet Akar, Rıdvan Mercan, Muhammet Çınar, Timuçin Kaşifoğlu, Emel Gönüllü, Gezmiş Kimyon, Duygu Ersözlü, Pamir Atagündüz, Levent Kılıç, İhsan Ertenli, Veli Yazısız, Aşkın Ateş, Sedat Kiraz, Umut Kalyoncu, and Ilgen U., KARADAĞ Ö., Emmungil H., KÜÇÜKŞAHİN O., KOCA S. S., ERDEN A., Bes C., Kanitez N. A., DALKILIÇ H. E., AKAR S., et al.
- Subjects
Internal Diseases ,Quantiferon-Tb-Gold ,Sağlık Bilimleri ,İmmünoloji ve Romatoloji ,İç Hastalıkları ,Clinical Medicine (MED) ,Arthritis, Rheumatoid ,Interferon-Gamma Release Tests ,INFECTION ,Immunology and Allergy ,Klinik Tıp (MED) ,CLASSIFICATION CRITERIA ,ROMATOLOJİ ,Clinical-Practice Guidelines ,Klinik Tıp ,Rheumatoid-Arthritis ,QUANTIFERON-TB-GOLD ,GAMMA RELEASE ASSAYS ,Gamma Release Assays ,Tıp ,Antirheumatic Agents ,Medicine ,CLINICAL-PRACTICE GUIDELINES ,Romatoloji ,Infection ,Adult ,Immunology ,Immunology and Rheumatology ,Rheumatology ,Latent Tuberculosis ,Health Sciences ,Spondyloarthritis ,Spondylarthritis ,Humans ,DISEASE-CONTROL ,Classification Criteria ,Biological Products ,Internal Medicine Sciences ,Tuberculin Test ,Arthritis ,Italian Society ,Dahili Tıp Bilimleri ,CLINICAL MEDICINE ,ACTIVE TUBERCULOSIS ,Active Tuberculosis ,RHEUMATOID-ARTHRITIS ,Disease-Control ,Logistic Models ,ITALIAN SOCIETY ,Interferon-gamma Release Tests - Abstract
This study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guerin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT-GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT-GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT-GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.
- Published
- 2022
47. Pregnancy in Takayasu's arteritis has a high risk of hypertension-related fetomaternal complications: A retrospective study of a Turkish cohort
- Author
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Fatma Alibaz-Oner, Gökhan Keser, Kenan Aksu, Nilufer Alpay-Kanitez, Sema Kaymaz Tahra, Duygu Ersözlü, Ayten Yazici, Osman Faruk Bayramlar, Abdulsamet Erden, Sinem Burcu Kocaer, Onay Gercik, Mete Kara, Gökçe Kenar, Haner Direskeneli, Fatos Onen, Servet Akar, Ahmet Omma, and Mehmet Gokhan Gonenli
- Subjects
Adult ,Vasculitis ,medicine.medical_specialty ,Turkey ,Takayasu's arteritis ,Pregnancy Complications, Cardiovascular ,Outcomes ,Preeclampsia ,Rheumatology ,Pre-Eclampsia ,medicine ,Humans ,Risk factor ,Single-Center Experience ,Pregnancy ,Eclampsia ,business.industry ,Obstetrics ,Pregnancy Outcome ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Cohort ,Female ,pregnancy ,business ,Cohort study ,Takayasu arteritis - Abstract
Background This study aimed to examine fetomaternal outcomes in pregnant women in a large Turkish Takayasu arteritis (TAK) cohort and to evaluate the effects of pregnancy on the disease in those patients. Methods This is a cohort study involving 296 pregnancies of 112 TAK patients from 8 tertiary rheumatology centers in Turkey. Pregnancies were divided into 2 groups as pre-d (before disease onset) and post-d (after disease onset). In addition, post-d pregnancies were further divided into 2 subgroups according to fetomaternal complications (FMC) development status. Finally, patients were grouped into those with and without a history of pregnancy after disease onset. Results In post-d pregnancies, rates of worsening hypertension, new-onset hypertension, and preeclampsia were higher than in pre-d pregnancies (0.9% vs 16%, P < .001, 0.5% vs 5.3%, P = .012, and 0% vs 4%, P = .013, respectively). Patients with FMC were more likely to have renal artery involvement (65% vs 21%, P = .003). The patients who had post-d were younger, had longer disease duration, and had more relapses number than other patients (P < .001, P = .028, P = .016, respectively). Vasculitis Damage Index (VDI) results were similar in patients with or without post-d pregnancies. Conclusion Pregnancies after disease onset were found to be associated with HT and preeclampsia/eclampsia. HT-related FMCs are increased in TAK, and patients with renal artery involvement are at higher risk. The number of relapses increases in patients who become pregnant after disease onset, but pregnancy was not an independent risk factor for relapse. Pregnancy after the onset of disease had no negative effect on VDI.
- Published
- 2022
48. Quality of life, disease activity and preferences for administration routes in rheumatoid arthritis: a multicentre, prospective, observational study
- Author
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Haner Direskeneli, Omer Karadag, Askin Ates, Abdurrahman Tufan, Nevsun Inanc, Serdar S Koca, Gozde Y Cetin, Servet Akar, Muhammet Cinar, Sedat Yilmaz, Neslihan Yilmaz, Ediz Dalkilic, Cemal Bes, Baris Yilmazer, Ali Sahin, Duygu Ersözlü, Mehmet E Tezcan, Nesrin Sen, Gokhan Keser, Umut Kalyoncu, Berkan Armagan, Basak Hacibedel, Kerem Helvacioglu, Teoman Y Cesur, Canberk S Basibuyuk, Serdar Alkan, Levent Mert Gunay, and DİRESKENELİ R. H. , KARADAĞ Ö., ATEŞ A., TUFAN A., Inanc N., Koca S. S. , Cetin G. Y. , Akar S., Cinar M., Yilmaz S., et al.
- Subjects
Internal Diseases ,Turkish Version ,advanced treatment ,Epidemiology ,Satisfaction ,Drug-Treatment ,Sağlık Bilimleri ,İmmünoloji ve Romatoloji ,İç Hastalıkları ,Clinical Medicine (MED) ,Immunology and Rheumatology ,Medication Adherence ,Validity ,Rheumatology ,Patient Preferences ,Health Sciences ,Compliance-Questionnaire ,Klinik Tıp (MED) ,Adaptation ,ROMATOLOJİ ,ESR ,Internal Medicine Sciences ,Klinik Tıp ,DAS ,Dahili Tıp Bilimleri ,CLINICAL MEDICINE ,Reliability ,switch ,Tıp ,quality of life ,Medicine ,Romatoloji ,RA ,patient preference - Abstract
Objective We aimed to evaluate quality of life (QoL), disease activity, compliance to treatment, patient and physician preferences for route of administration (RoA), status of health and pain in RA patients starting advanced treatments or needing a switch, and the factors associated with patient preferences. Methods A multicentre, prospective, observational and 1-year follow-up study was conducted, between 2015 and 2020, in adult RA patients using advanced treatments for the first time or needing a switch in their current treatments. All the data collected were entered into electronic case report forms. DAS in 28 joints with ESR [DAS28-4(ESR)], EuroQol 5-Dimensional Questionnaire (EQ-5D), HAQ Disability Index (HAQ-DI), Compliance Questionnaire for Rheumatology (CQR-19), Work Productivity and Activity Impairment Instrument (WPAI) and Patient Global Assessment-Visual Analogue Scale (PGA-VAS) questionnaires were used for longitudinal assessments. Results Four hundred and fifty-nine patients were enrolled. Three hundred and eight patients (67.1%) attended the final study visit at 12 months and were included for comparative analyses. Irrespective of RoA, the disease activity and QoL improved significantly at 12 months, whereas compliance worsened. At baseline and 12 months, EQ-5D and DAS28-4(ESR) scores were significantly correlated (P < 0.001). The WPAI scores changed significantly in favour of better outcomes over 12 months after initiation of advanced treatment or switching (P < 0.001). A higher proportion of patients preferred an oral RoA, in comparison to physicians (53.6% vs 31.4%; P < 0.001). Patient and physician RoA preferences were independent of gender, age, disease duration, advanced treatment type and the EQ-5D-3L, DAS28-4(ESR), HAQ-DI, PGA-VAS and CQR-19 scores at baseline. Conclusion The oral route was more frequently preferred by patients compared with physicians, although patients' preference rates showed a slight increase towards the end of the treatment, which might be an important factor for RA outcomes. Better control of disease activity and QoL were achieved at 12 months, regardless of RoA. Lay Summary What does this mean for patients? People with rheumatoid arthritis (RA) and their physicians can have different views throughout the patient journey, whether deciding the main treatment objective, switching a drug or deciding the route of drug administration. However, data are limited in this area. For this purpose, we have conducted a survey study to identify differences between the views of patients and physicians on the management of RA. In this study, we have shown that RA medication compliance decreases over time, irrespective of medication route. This is similar to other studies. We also spotted that there are different routes of drug adminstration (RoA) preferred: a higher proportion of patients preferred an oral RoA compared with physicians (53.6% vs 31.4%, respectively). Patient and physician RoA preferences were not related to gender, age, disease duration, treatment type and disease activity. By surveying patients and physicians at the same time, we have identified their differences better compared with previous studies. Patient preferences should have a major impact on disease management, and the results of this study might encourage patients to discuss their thoughts and preferences with their clinicians to achieve a better outcome., Pfizer; Pleksus CRO Inc., Pfizer has supported funding of this manuscript. Editorial/medical writing support was provided by Pleksus CRO Inc., and it was funded by Pfizer.
- Published
- 2022
49. mTOR pathway and its role in rheumatologic diseases
- Author
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Zeki Soypacaci, Servet Akar, and Zeynep Zehra Gümüş
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Cancer research ,medicine ,business ,PI3K/AKT/mTOR pathway ,Rheumatology - Published
- 2019
50. Clinical and laboratory factors associated with the bamboo spine in patients with axial spondyloarthritis: are there clues for the bamboo spine?
- Author
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Pamir Atagündüz, Sedat Kiraz, Servet Akar, Orhan Küçükşahin, Abdulsamet Erden, Aysun Aksoy, Belkis Nihan Coşkun, Burcu Yağiz, Cemal Bes, Nilüfer Alpay Kanitez, Levent Kilic, Ömer Karadağ, Timuçin Kaşifoğlu, Hakan Emmungil, Muhammet Cinar, Gezmiş Kimyon, Veli Yazisiz, Aşkın Ateş, Duygu Ersözlü, Emel Gönüllü, Rıdvan Mercan, İhsan Ertenli, Umut Kalyoncu, and Atagündüz P., KİRAZ S., Akar S., KÜÇÜKŞAHİN O., Erden A., AKSOY A., COŞKUN B. N., YAĞIZ B., Bes C., Alpay Kanitez N., et al.
- Subjects
Internal Diseases ,Immunology ,Life Sciences (LIFE) ,Sağlık Bilimleri ,İmmünoloji ve Romatoloji ,İç Hastalıkları ,Clinical Medicine (MED) ,Immunology and Rheumatology ,Rheumatology ,Yaşam Bilimleri ,Health Sciences ,ALERJİ ,Immunology and Allergy ,Klinik Tıp (MED) ,ROMATOLOJİ ,Internal Medicine Sciences ,Klinik Tıp ,İmmünoloji ,Temel Bilimler ,Life Sciences ,Dahili Tıp Bilimleri ,CLINICAL MEDICINE ,Tıp ,ALLERGY ,Yaşam Bilimleri (LIFE) ,Medicine ,İmmünoloji ve Alerji ,Natural Sciences ,Romatoloji - Abstract
OBJECTIVES: To analyse the clinical and laboratory factors associated with bamboo spine. METHODS: Data of patients fulfilling the 2009 ASAS classification criteria for axial spondyloarthritis, registered in the national, multicentre, longitudinal, and observational database of TReasure was analysed. Radiographs were assessed using the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Data of patients with a bamboo spine (Group 1) was compared to data derived from patients with a longstanding disease of at least 15 years but no syndesmophytes (Group 2). RESULTS: Out of the 5060 patients, 1246 had eligible radiographs. There were 111 patients (8.9%) with a bamboo spine. Male sex was more common among patients with bamboo spine. The median BMI of 27.7 (25.8-31.1) in Group1 was higher than the BMI of 25.9 (22.9-29.2) in Group 2 (p
- Published
- 2021
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