Browsing by Author "Uslu, S"
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Item Case report: Coexistence of takotsubo syndrome and severe mononeuritis multiplex in rheumatoid vasculitisAcar, EA; Uslu, S; Gemici, YI; Cetin, N; Temiz, P; Gündüz, OSItem Melorheostosis: A rare disease of the boneKarakas, A; Uslu, SItem Reactive Arthritis Following COVID-19 Vaccination: Report of Three CasesTasgöz, C; Acar, EA; Sülükcü, S; Uslu, S; Gündüz, OSSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 19 (COVID-19) pandemic, which has affected the entire world. The development of COVID-19 vaccines has helped to slow the spread of the virus. However, as with vaccines against other infectious diseases, adverse events can occur with COVID-19 vaccines. Here we present 3 cases of acute arthritis following COVID-19 vaccination and a comprehensive review of the existing literature.Item 'Pencil-in-cup' deformity in systemic sclerosis-rheumatoid arthritis overlap syndromeAcar, EA; Uslu, S; Gündüz, OS; Pirildar, TItem Evaluation of lacrimal gland vascularization using superb microvascular imaging: A potential diagnostic tool in Sjögren's syndromeSalbas, CS; Uslu, S; Salbas, EObjectives :The aim of this study is to evaluate the superb microvascular imaging (SMI) findings of the lacrimal glands for the sonographic diagnosis of primary Sj & ouml;gren's syndrome (pSS). Methods :Twenty-one patients with pSS and 20 healthy groups were evaluated. Dry eye symptoms and their effects on vision-related functions were evaluated with McMonnies and Ocular Surface Disease Index (OSDI) questionnaires. Lacrimal glands were evaluated by power Doppler ultrasonography (PDUS), colour Doppler ultrasonography (CDUS), and SMI. Results :Dry eye symptoms, as determined by McMonnies and OSDI, were significantly more severe in patients with pSS than in the control group (P = .001 and P = .021, respectively). Lacrimal gland vascular activity rates and hypoechoic areas were significantly higher in pSS patients compared to the control group (P < .05). The detection rates of the degree of vascularity in the lacrimal glands of patients with pSS were higher with SMI compared to CDUS and PDUS. In addition, SMI positively correlated with CDUS, PDUS, OSDI, and McMonnies. Conclusions: Evaluation of the lacrimal gland by the SMI was found to be excellent in predicting the likelihood of individuals having pSS compared to CDUS and PDUS. This technique may serve as a reliable and noninvasive adjunctive tool for assessing the degree of lacrimal vascularity in pSS.Item Concurrent breast cancer and IgG4-related orbital pseudotumor in a manInel, TY; Uslu, S; Bajin, MS; Onen, FItem Salt-and-pepper appearance of the skin in systemic sclerosisTasgöz, FC; Acar, EA; Kaçar, M; Gündüz, ÖS; Uslu, SItem Assessment of liver and kidney function in patients with ankylosing spondylitis on long-term non-steroidal anti-inflammatory drug therapySueluekcue, S; Uslu, SObjective. This study aimed to analyze the status of liver [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and kidney (serum creatinine) function in ankylosing spondylitis (AS) patients assuming continuously non-steroidal anti-inflammatory drugs (NSAIDs) alone over a long period. Methods. Between 2013 and 2022, there were records of 385 AS patients. Of them, 56 were receiving only NSAIDs, and the files of these patients were retrospectively analyzed. Demographic and clinical characteristics were collected. Blood tests, including serum creatinine, AST, and ALT, were assessed at each visit. Results. Of the 56 patients, 39 were male. The mean age was 45.30 years, and the follow-up period was 9.80 years. Of them, 44.6% used indomethacin, 26.8% naproxen, 17.9% diclofenac, 5.4% acemetacin, 3.6% meloxicam, and 1.8% celecoxib. The mean baseline serum creatinine was 0.71 mg/dL. The mean baseline serum AST and ALT were 19.6 u/L and 22.9 u/L, respectively. Baseline creatinine, AST, and ALT were not statistically significantly different between sexes. There was a statistically significant difference between mean creatinine concentrations at baseline and at year 3. One patient on naproxen discontinued treatment due to elevated creatinine. The creatinine level decreased during the patient's follow-up. Liver enzymes above 3 times the normal value were not seen in any patient. Conclusions. Based on real-world data, long-term use of NSAIDs has generally not led to acute liver and kidney injury or progressive impairment of hepatorenal function requiring discontinuation of treatment.Item Heerfordt's syndrome: a rare manifestation of neurosarcoidosisSahinoglu, I; Uslu, SItem Role of the C-reactive Protein-to-Albumin Ratio in Assessing Disease Activity in Elderly Patients With Rheumatoid ArthritisUslu, S; Tasgöz, FCObjective: Nowadays, one measure that is more helpful in assessing the level of inflammation than either Creactive protein (CRP) or albumin alone is the C-reactive protein-to-albumin ratio (CAR). Our study set out to assess the CAR in elderly individuals with rheumatoid arthritis (RA) and its correlation with other parameters. Methods: Included in the research were patients who were being followed up on for RA between January 2021 and January 2024 and categorized according to their age at the time of enrolment and assigned to one of two groups: younger patients, defined as <60 years of age, and those aged 360 years, who were recorded as elderly patients. The clinical evaluation of the patients and laboratory data measured for each patient included age, gender, disease duration, medications, CRP, erythrocyte sedimentation rate (ESR), albumin, neutrophil-to-lymphocyte ratio (NLR), and CAR. Disease activity was assessed with the disease activity score 28 (DAS 28)-ESR. The health assessment questionnaire was used to measure the functional status. Results: Ninety-four patients (<60 years: 58 and 360 years: 36) were included. The mean age of the elderly patients was 65.80 +/- 5.33 years. Female predominance was similar in both the RA groups (<60 years: 50 patients (86.2%) vs. 360 years: 31 (86.1%)). The distribution of biological and disease-modifying drugs did not significantly differ between the groups. With the exception of albumin, there was no statistically significant difference between the groups for ESR, CRP, CAR, NLR, or DAS28-ESR. Elderly patients with a DAS28-ESR of 2.6 and above had a statistically significant higher CAR than the remission group (3.44 +/- 3.73 vs. 2.71 +/- 5.73, respectively). There was no statistically significant difference in the NLR value of elderly patients with a DAS28-ESR of 2.6 and above compared to the remission group (3.06 +/- 2.95 vs. 2.65 +/- 1.38, respectively). In addition, CAR was positively correlated with ESR, CRP, and DAS28-ESR (r = 0.726, p < 0.001; r = 0.954, p < 0.001; r = 0.339, p = 0.043, respectively). However, there was no discernible correlation between CAR and HAQ, NLR, or disease duration. Conclusion: In elderly RA patients, our study demonstrated the correlation between CAR and inflammatory biomarkers and the DAS28-ESR. According to this, CAR may prove to be a useful biomarker for assessing inflammation and disease activity in clinical settings.Item Evaluation of irritable bowel syndrome in patients with systemic sclerosis based on Rome IV criteriaTuncel, ET; Sahinoglu, I; Uslu, SObjectives The gastrointestinal system is the second most frequently affected organ system in patients with systemic sclerosis (SSc). Patients with SSc experience gastrointestinal dysmotility due to pathophysiological changes, including alterations in intestinal microbiota, inflammation, fibrosis, vascular ischaemia, and muscle atrophy. The aim of this study was to determine the prevalence of functional gastrointestinal disorders in patients with SSc. Material and Methods This study included 66 patients with SSc. Demographic data, including age, gender, and clinical findings, were recorded. The Rome IV criteria were used to assess gastrointestinal complaints. Results A total of 66 (F=61, M=5) patients (limited cutaneous SSc (lcSSc=31), diffuse cutaneous SSc (dcSSc=35)) were included in this study. In lcSSs patients, the prevalence of functional dyspepsia, irritable bowel syndrome (IBS), constipation, and diarrhoea was 29.0%, 12.9%, 6.5% and 3.2%, respectively, whereas in dcSSc, the prevalence of these disorders was 37.1%, 8.6%, 8.6%, and 0.0%, respectively. There was no statistically significant difference regarding the presence of functional gastrointestinal disorders between lcSSc and dcSSc patients. When patients with SSc were compared based on functional gastrointestinal disorders, no significant differences were observed between the groups in terms of mean age, disease duration, smoking, lung involvement, and presence of body mass index >= 25. Conclusion Alterations in gut microbiota and inflammatory changes have been proposed as contributing factors in IBS. Chronic inflammatory diseases, such as SSc, may therefore predispose individuals to its development. In our study, IBS was found in 10.7% of the SSc patients. To identify patients at high risk of IBS, further studies are required.Item Crowned dens syndrome: a rare yet intriguing condition of the spineAcar, EA; Tasgöz, FC; Uslu, S; Gündüz, OSItem Fabry disease in familial Mediterranean fever according to the severity of the diseaseUslu, S; Kabadayi, G; Kisa, PT; Inel, TY; Arslan, Z; Arslan, N; Akar, S; Onen, F; Sari, IObjectives: Mutations in the a-galactosidase A (GLA) gene result in Fabry disease (FD), a rare metabolic condition. FD patients present with heterogeneous clinical manifestations, which may overlap with systemic diseases including familial Mediterranean fever (FMF). The aim of this study was to determine the frequency of FD in patients with mild and severe FMF and to prevent misdiagnosis by increasing clinicians' awareness. Methods: Based on Tel-Hashomer criteria, the study included a total of 91 FMF patients. Patients were divided into two groups according to the number of recurrent clinical episodes or failure to respond to maximum therapy: those with mild and severe forms of the disease. GLA gene mutations and a-GLA enzyme activity were assessed. Records of MEFV mutations, therapies and demographic characteristics were kept. Results: FD testing was performed on a cohort of 91 FMF patients, 54.9% had mild FMF, 45.1% had severe FMF, and only one patient in the mild FMF subgroup tested positive for FD. The patient was a 39-year-old woman with a history of recurrent abdominal pain, distal limb pain and fever. She had low GLA enzyme activity and a heterozygous GLA gene mutation. Conclusions: Our findings suggest that FD should be considered in the differential diagnosis of FMF, especially in individuals with unusual symptoms. (c) 2024 Sociedad Espaoola de Reumatologoa (SER), Colegio Mexicano de Reumatologoa (CMR) y Elsevier Espaoa, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Item The Efficacy and Safety of CT-P13 as First-line and Subsequent-line Therapy in Patients with Ankylosing Spondylitis: Real-life Data from TURKBIO CohortUslu, S; Gulle, S; Can, G; Senel, S; Capar, S; Dalkilic, HE; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Yolbas, S; Krough, NS; Yilmaz, N; Erten, S; Bes, C; Soysal, O; Ozturk, MA; Haznedaroglu, S; Yavuz, S; Direskeneli, H; Onen, F; Sari, IItem Efficacy and Safety of CT-P13 as First- and Second-Line Treatment in Patients with Ankylosing SpondylitisUslu, S; Gülle, S; Sen, G; Capar, S; Senel, S; Dalkilic, E; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Direskeneli, H; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, OS; Oztürk, MA; Haznedaroglu, S; Yavuz, S; Onen, F; Sari, IBackground/Objectives: CT-P13 is a biosimilar version of infliximab, a monoclonal antibody. In individuals with ankylosing spondylitis (AS), CT-P13 has been shown to be effective and to have a well-tolerated safety profile. The aim of this study was to evaluate the long-term drug persistence, safety, and efficacy of infliximab biosimilar CT-P13 in patients with AS undergoing first-line (1st-line) and later (>= 2nd-line) treatment in clinical practice. Methods: We performed an observational cohort study that included AS patients based on the biological drug database in the TURKBIO Registry between 2014 and 2021. The patients were divided into two groups: those receiving CT-P13 as first-line treatment or as a switch (>= 2nd-line) from another TNF inhibitor (TNFi). Standard disease activity metrics were used to assess the effectiveness of CT-P13, and drug retention rates were investigated. Results: There were 179 AS patients using CT-P13 (47.4% male, mean age: 42.9 +/- 11.3 years). Of these patients, 123 (68.7%) were receiving CT-P13 as a first-line treatment. The mean length of treatment was 3.5 years. CT-P13 drug retention rates in the general patient population were 58.6% and 48.2% in the first-line and >= second-line treatment, respectively, after 3 years of follow-up. The most common reason for CT-P13 treatment discontinuation was lack of efficacy. The first-line CT-P13 group had statistically substantially higher ASAS20/40 response rates at three and six months. Nonetheless, both groups' response rates at one year were comparable. Conclusions: In this real-world data analysis, AS patients who were TNFi na & iuml;ve (1st-line) and subsequently treated (>= 2nd-line) with CT-P13 showed encouraging drug retention rates with acceptable long-term effectiveness and safety.Item Assessing safety and efficacy of TNFi treatment in late onset ankylosing spondylitis: a TURKBIO registry studyUslu, S; Gulle, S; Sen, G; Cefle, A; Yilmaz, S; Kocaer, SB; Inel, TY; Koca, SS; Yolbas, S; Ozturk, MA; Senel, S; Inanc, N; Dalkilic, HE; Gunduz, OS; Tufan, A; Akar, S; Birlik, AM; Sari, I; Akkoc, N; Onen, FClinical data on the use of tumour necrosis factor inhibitors (TNFi) in late-onset ankylosing spondylitis (LoAS) are limited. The present study aimed to evaluate efficacy, safety, and treatment adherence associated with the initial use of TNFi therapy in biologic naive patients diagnosed with LoAS. Patients whose age of onset was >= 45 years and < 45 years were classified as having LoAS and YoAS, respectively, based on the age of symptom onset. There were 2573 patients with YoAS and 281 LoAS. Baseline disease activity measures were similar between the groups. No significant differences were seen between the two groups in response to treatment and in remaining on the first TNFi at 6, 12 and 24 months. In the LoAS group, the analysis showed that TNFi discontinuation was linked to VAS pain score (HR 1.04; 95% CI 1.01-1.06). Patient groups had similar rates of adverse events (YoAS: 8.7% vs. LoAS: 11.7%). In both biologic naive LoAS and YoAS patients, the study showed that the initial TNFi therapy was equally effective and safe.Item THE EFFICACY AND SAFETY OF ANTI-TNF A TREATMENT IN ANKYLOSING SPONDYLITIS PATIENTS WITH LATE ONSET COMPARED TO THOSE WITH ADULT ONSET; THE DATA FROM TURKBIO REGISTRYUslu, S; Can, G; Cefle, A; Yilmaz, S; Kocaer, SB; Inel, TY; Gülle, S; Koca, SS; Yolbas, S; Öztürk, MA; Senel, S; Inanc, N; Dalkiliç, E; Soysal, O; Tufan, A; Akar, S; Birlik, M; Sari, I; Akkoc, N; Onen, FItem Biological treatment in elderly and young patients with ankylosing spondylitis: TURKBIO real-life data resultsUslu, S; Gülle, S; Urak,Ö; Sen, G; Dalkiliç, E; Senel, S; Akar, S; Inanç, N; Cefle, A; Avsar, AK; Yolbas, S; Yilmaz, S; Gündüz, OS; Sari, I; Birlik, M; Akkoç, N; Önen, FObjectives: This study aims to investigate the effect of age on disease activity and biological treatment in patients with ankylosing spondylitis (AS). Patients and methods: A total of 811 AS patients registered in the TURKBIO registry database between 2011 and 2019 were categorized according to their age at the time of entry into the registry and assigned to one of two groups: young patients, defined as <60 years of age (n=610), and those aged >= 60 years (n=201) were recorded as elderly patients. Demographic, clinical, and laboratory characteristics, along with disease activity markers and other follow-up parameters, as well as current and prior treatments, were electronically recorded during each visit using open -source software. Results: The mean age of the elderly patients was 67 +/- 5.8 years, while the mean age of the younger patients was 49.2 +/- 10.9 years. Male predominance was lower in the older AS group compared to the younger AS group (p=0.002). During follow-up period, 397 patients (comprising 318 young and 79 elderly individuals) had a history of using at least one biological disease -modifying agent (bDMARD). There was no significant difference between the groups in terms of DMARD and bDMARD-use distributions. First tumor necrosis factor inhibitor (TNFi) retention rates were found to be similar in both groups over 10 years of follow-up. Adverse events were found to be similar in young (19.9%) and elderly (26.8%) AS patients. Conclusion: Research in the TURKBIO cohort reveals that both older and younger patients with AS exhibited similar disease activity levels with comparable treatment approaches. Moreover, the results of TNFi treatments in elderly patients were the same as those observed in younger patients, with no notable increase in safety concerns.