Browsing by Author "Keser, G"

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    Comparison of 18F-FDG PET/CT findings with current clinical disease status in patients with Takayasu's arteritis
    Karapolat, I; Kalfa, M; Keser, G; Yalçin, M; Inal, V; Kumanlioglu, K; Pirildar, T; Aksu, K
    Objective. 18F-fluorodeoxyglucosepositron emission tomography/computed tomography (18F-FDG PET/CT) scanning has been proposed as a new tool to assess disease activity in Takayasu arteritis (TA). We investigated whether 18F-FDG PET/CT findings were consistent with current clinical disease status in patients with TA. Methods. In this cross sectional study, 22 patients with TA were enrolled. Clinical disease activity was assessed by the combination of National Institutes of Health (NIH) criteria, Disease Extent Index-Takayasu (DEI-Tak) score, physician global assessment and 18F-FDG PET/CT scans. Results. At the time 18F-FDG PET/CT scans were taken, the majority of the patients (17122) were using immunosuppressive (IS) drugs, and only four patients had clinically active disease. 18F-FDG PET/CT scans confirmed the presence of active vasculitic lesions in those four patients. In 16 out of 18 patients who were accepted to be in clinical remission, 18F-FDG PET/CT scans were also normal. There were only two patients with discordant results, i.e. active 18F-FDG PET/CT findings despite the lack of clinical activity. Interestingly, clinical exacerbation occurred four weeks later in one of them. Overall sensitivity and specificity of 18F-FDG PET/CT findings for clinical activity were 100% and 88.9%, respectively. Conclusion. We found that 18F-FDG PET/CT findings were generally consistent with clinical disease status in TA. Although use of IS drugs certainly impairs diagnostic accuracy of 18F-FDG PET/CT in TA, this imaging method may still have a potential for confirming remission or detecting disease activity in patients with TA receiving treatment.
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    Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study
    Ortiz-Fernández, L; Saruhan-Direskeneli, G; Alibaz-Oner, F; Kaymaz-Tahra, S; Coit, P; Kong, XF; Kiprianos, AP; Maughan, RT; Aydin, SZ; Aksu, K; Keser, G; Kamali, S; Inanc, M; Springer, J; Akar, S; Onen, F; Akkoc, N; Khalidi, NA; Koening, C; Karadag, O; Kiraz, S; Forbess, L; Langford, CA; McAlear, CA; Ozbalkan, Z; Yavuz, S; Çetin, GY; Alpay-Kanitez, N; Chung, S; Ates, A; Karaaslan, Y; McKinnon-Maksimowicz, K; Monach, PA; Ozer, HTE; Seyahi, E; Fresko, I; Cefle, A; Seo, P; Warrington, KJ; Ozturk, MA; Ytterberg, SR; Cobankara, V; Onat, AM; Duzgun, N; Bicakcigil, M; Yentür, SP; Lally, L; Manfredi, AA; Baldissera, E; Erken, E; Yazici, A; Kisacik, B; Kasifoglu, T; Dalkilic, E; Cuthbertson, D; Pagnoux, C; Sreih, A; Reales, G; Wallace, C; Wren, JD; Cunninghame-Graham, DS; Vyse, TJ; Sun, Y; Chen, HY; Grayson, PC; Tombetti, E; Jiang, LD; Mason, JC; Merkel, PA; Direskeneli, H; Sawalha, AH
    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.
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    Platelet-activating factor and P-selectin activities in thrombotic and nonthrombotic Behcet's patients
    Tunc, SE; Aksu, K; Keser, G; Oksel, F; Doganavsargil, E; Pirildar, T; Turk, T; Terzioglu, E; Huseyinov, A
    Objective: The aim of this study was to compare plasma Platelet-activating factor (PAF) and P-selectin (CD62P) activities in Behcet's disease patients with and without thrombosis. Methods: In this cross-sectional and descriptive study, 30 consecutive Behcet's patients were included, 15 of them with venous thrombosis. All patients were also divided into two subgroups according to the presence or absence of clinical activity. Plasma PAF levels, basal and Ca++ ionophore (A23187)-induced leukocyte (cellular) PAF activities, and platelet-rich plasma Delta CD62P activity (the mean fluorescent density difference between CD62P phycoerythrin-positive and -negative stains) were evaluated. Results: In the thrombotic group, plasma PAF (P=0.001), basal leukocyte PAF (P=0.017), induced leukocyte PAF (P=0.024), and Delta CD62P (P=0.023) levels were significantly higher than in the nonthrombotic group. In the whole group of Behcet's patients, there was a positive correlation between plasma PAF and Delta CD62P levels (r=0.533, P=0.002). When we compared clinically active and inactive patients with respect to the above parameters, there was no significant difference, irrespective of thrombosis. Plasma PAF (P=0.001), basal leukocyte PAF (P=0.004), and Delta CD62P (P=0.038) levels were significantly higher in the presence of both clinical activity and thrombosis than of clinical activity alone. Conclusion: Platelet-activating factor and CD62P may contribute to endothelial injury and thrombosis development in Behcet's disease. These two parameters seem related to the presence of thrombosis rather than clinical activity.
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    Impact of rheumatoid arthritis in Turkey: a questionnaire study
    Direskeneli, H; Akkoç, N; Bes, C; Çakir, N; Çefle, A; Çobankara, V; Dalkiliç, E; Dinç, A; Ertenli, T; Gül, A; Hamuryudan, V; Inanç, M; Kalyoncu, U; Karaaslan, Y; Kasifoglu, T; Keser, G; Keskin, G; Kisacik, B; Kiraz, S; Masatlioglu, S; Onat, AM; Özbek, S; Öztürk, MA; Pamuk, ÖN; Pay, S; Pirildar, T; Sayarlioglu, M; Senel, S; Sentürk, T; Tasan, D; Terzioglu, E; Yazici, A; Yücel, E
    Objective Unmet needs of rheumatoid arthritis (RA) patients regarding physician/patient communication, treatment preferences and quality of life issues were investigated in a Turkish survey study. Methods The study was conducted with the contribution of 33 rheumatologists, and included 519 RA patients. The study population included patients who had been on biologic therapy for >6 months and were still receiving biologic therapy (BT group), and those who were biologic naive, but found eligible for biologic treatment (NBT group). Of the RA patients, 35.5% initially had a visit to an internal disease specialist, 25.5% to a physical therapy and rehabilitation specialist, and 12.2% to a rheumatology specialist for their RA complaints. The diagnosis of RA was made by a rheumatologist in 48.2% of patients. Results The majority of RA patients (86.3%) visit their doctor within 15-week intervals. Most of the physician-patient communication focused on disease symptoms (99.0%) and impact of the disease on quality of life (61.8%). The proportion of RA patients who perceived their health status as good/very good/excellent was higher in the BT group than in the NBT group (74.3% vs. 51.5%, p<0.001). However, of those RA patients in the NBT group, only 24.8% have been recommended to start a biologic treatment by their doctors. With respect to dose frequency options, once-monthly injections were preferred (80%) to a bi-weekly injection schedule (8%). Conclusion In conclusion, RA patients receiving biologic therapy reported higher rates of improved symptoms and better quality of life and seemed to be more satisfied with their treatment in our study.