Browsing by Author "Yilmaz, S"

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    A NEW METHOD FOR STRENGTHENING OF PRECAST INDUSTRIAL STRUCTURES
    Kaplan, H; Yilmaz, S; Çetinkaya, N; Nohutcu, H; Atimtay, E; Gönen, H
    1998 Ceyhan and 1999 Marmara Earthquakes causes extensive damages of the precast industrial structures. This type of structures is important economically. They do not have enough lateral rigidity, lateral load capacity and a rigid diaphragm. Several strengthening techniques have been applied to those type of structures. However, minimization of the disturbance during the strengthening of these structures is an important research issue as considerable economic losses are to be happen while building remains out-of-service. In this study, effectiveness of the strengthening with external shear walls and rigid diaphragm is investigated experimentally. A typical precast concrete frame and a strengthened structure with proposed method are tested under reversed cyclic loads. Experiments showed that proposed method improves lateral stiffness, base shear capacity and provides an efficient diaphragm behavior to the structure.
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    Remote organ injury induced by myocardial ischemia and reperfusion on reproductive organs, and protective effect of melatonin in male rats
    Sahna, E; Türk, G; Atessahin, A; Yilmaz, S; Olmez, E
    Objective: Myocardial ischemia and reperfusion (MI-R) leads to remote organ injury associated with oxidative stress. Melatonin is a well-known antioxidant and free-radical scavenger. This study was conducted to examine whether MI-R causes damage in the testes and sperm quality, and to investigate the possible protective effect of exogenous melatonin on these parameters in an in vivo rat model. Design: Experimental study. Setting: Experimental Research Center, Firat University Medical School, Elazig, Turkey. Patient(s): Eight-week-old male Wistar rats (n = 18). Intervention(s): To produce MI-R, a branch of descending left coronary artery was occluded for 30 minutes, followed by 120-minute reperfusion. Melatonin (10 mg/kg) or vehicle was given 10 minutes before ischemia via the jugular vein. Main Outcome Measure(s): Reproductive organ weights and epididymal sperm concentration, sperm motility, abnormal sperm rate, and testicular-tissue malondialdehyde (MDA) and glutathione (GSH) levels were examined after reperfusion. Result(s): MI-R significantly decreased epididymal sperm motility, and increased the tests-tissue level of MDA, compared to the control group. Administration of melatonin reversed the harmful effects of MI-R significantly. However, MI-R did not change sperm concentration, GSH levels, and reproductive organ weights. Conclusion(s): These findings indicate that MI-R leads to damage of testis and sperm motility, and melatonin protects againsts MI-R-induced reproductive-organ injury. These results may also encourage the use of antioxidants to reduce remove organ injury in the testis after MI-R.
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    Application of Lichtenstein Method in Primary Inguinal Hernia by Under Experienced Surgeons
    Yilmaz, S; Karaköse, O; Yilmaz, IT; Özçelik, KC; Pülat, H; Zihni, I; Duran, A; Uslu, A
    Aim: Lichtenstein technique is a mostly used inguinal hernia repair that provides important advantages to patient Complication and recurrence rates are low for surgeons and it is an easy way to learn and apply. We have explained our results of Lichtenstein method which was applied by our assistant surgeons in order to emphasize that it can be used as a start method in repair of primer inguinal hernia. Material and Method: 154 patients that were operated with Lichtenstein method by our assistant surgeons after being diagnosed with primer inguinal hernia in Izmir Training Research Hospital between February 2008 and February 2011 were included in the study. For all patients, spinal anaesthesia was used as anaesthesia technic. Preoperatif sefazolin Na I gr. iv. was injected. The patients were followed 21 months (843 months) in average. Patients started oral feeding in the operation evening and were allowed mobilisation. Results: 149 of the patients were male and 5 were female and age average was 53,5 (18-83). In 85 patients right inguinal hernia, in 65 patients left inguinal hernia and in 4 patients bilateral inguinal hernia were diagnosed. In exploration, it was detected that there were direct hernia in 62 patients, indirect hernia in 85 patients, pantaloon hernia in 3 patients, bilateral direct hernia in 4 patients. Average stay in hospital was 1,8 days postoperative. Early complications were seen 4,5 % as infection (n=4). sero ma (n=1) urinary retention (n=1) and scrotal edema (n=1). Late term complications were seen 6,4 U's as neuralgia (n=10). Mesh reaction and recurrence weren't detected in any of the patients. Discussion: In our study. Lichtenstein method were applied especially by our underexperienced surgeons. The fact that complication rate was low and no recurrence occured support its easy learning and application. We suggest its usage as a starting method in surgery education and primary inguinal hernia repair.
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    A NEW STRONG FLOOR-REACTION WALL SYSTEM WITHOUT GALLERY FOR EXPERIMENTAL STUDIES IN STRUCTURAL MECHANICS
    Kaplan, H; Gönen, H; Nohutcu, H; Çetinkaya, N; Yilmaz, S
    Strong floors and reaction walls are important elements of structural mechanics laboratories. They should be designed before the construction of the laboratory building for efficiency. They have a gallery used for the anchorage of the test models and storage of test equipment. In this paper, a strong floor without a gallery has been designed for an existing laboratory facility. The anchorage system has been designed to fix the model structures to the strong floor. Design issues of strong floor and reaction floor systems are mentioned in the scope of the paper. The construction of the system is simple and economical and provides a comfortable environment for experimental studies.
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    A New Version Darboux Vector and Characterization Some Special Curves According to Type-2 Bishop Frame in R3
    Yilmaz, S; Savci, UZ
    In this paper, we introduce a new Darboux vector and Darboux helix a curve according to type-2 Bishop frame in . We defined a new Darboux vector in term of type-2 Bishop frame in . We introduce a new spherical indicatrix, Darboux helix and constant precession of the curve type-2 Bishop in Euclidean 3-space. We give new characterization between Darboux helix and general helix. Apart from, the following characterization is given. The curve is an inclined curve if and only if the arc length of the Darboux spherical indicatrix of the is constant. Finally we illustrate one example of our main results.
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    A Src/Abl kinase inhibitor, bosutinib, downregulates and inhibits PARP enzyme and sensitizes cells to the DNA damaging agents
    Kirmizibayrak, PB; Ilhan, R; Yilmaz, S; Gunal, S; Tepedelen, BE
    Background: Poly(ADP-ribosyl)ation (PARylation) catalyzed mainly by PARP1 is a highly regulated posttranslational modification associated with several pathways in cellular physiology and genotoxic deoxyribonucleic acid (DNA) damage response. PAR polymers and PARP enzyme function in DNA integrity maintenance and several PARP inhibitors have entered clinical phase studies for cancer therapies. Material and methods: The effect of bosutinib, a dual Src/Abl kinase inhibitor, on PARylation was fluorometrically measured. The cytotoxic and chemosensitizing effects were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The levels of DNA repair proteins and PARP enzyme were examined by immunoblotting. Results: In this study, bosutinib is characterized as a novel PARP inhibitor. Bosutinib inhibited oxidative stress-induced cellular PARylation and nuclear foci formation by downregulating PARP1 levels. Bosutinib was found to be more cytotoxic on Capan1 cells with BRCA2 mutation. Furthermore by acting as a chemosensitizer, bosutinib enhanced the cytotoxicity of doxorubicin (DOXO) and etoposide (ETP) by decreasing phosphorylation of DNA repair enzymes checkpoint kinase 1 (Chk1) and ataxia-telangiectasia mutated (ATM). Conclusion: By inhibition of both PARP and DNA damage checkpoint kinases, bosutinib increased the phospho-H2AX levels, an early indicator of DNA double strand breaks.
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    Subjective cognitive assessments and N-back are not correlated, and they are differentially affected by anxiety and depression
    Yapici-Eser, H; Yalcinay-Inan, M; Kucuker, MU; Kilciksiz, CM; Yilmaz, S; Dincer, N; Kilic, O; Ercan, AC; Aydemir, O
    Cognitive function (CF) is a core feature related to all psychiatric disorders. However, self-report scales of CF (SRSC) may not always correlate with CF's objective measures and may have different mediators. Tools to select for evaluating CF in diverse psychiatric populations and their determinants need to be studied. In this study, we aimed to assess the association of SRSC (Perceived Deficit Questionnaire-Depression (PDQ-D), and World Health Organization's Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) and its inattentiveness subscale) with Letter-N-back as an objective measure of CF, and to analyze their association with psychopathology. Two hundred nine (131 nonclinical, and 78 clinical with a psychiatric diagnosis of ICD10 F31-39 [mood disorders excluding Bipolar I] or F40-F49 [neurotic, stress-related or psychosomatic disorder] categories) participants were evaluated with PDQ-D, ASRS, Beck Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI), and N-back. Both groups' data were included in the analysis. PDQ-D showed a small correlation with N-back scores, whereas ASRS showed no correlation. PDQ-D and ASRS showed a large correlation. Age and BAI scores significantly predicted both PDQ-D and ASRS, whereas the cognitive subscale of BDI predicted PDQ-D, but not ASRS. Only BAI scores predicted N-back results. The mediation model revealed that 2-back scores of N-back task directly affects PDQ-D scores, independent of BDI scores. However, the cognitive subscale of BDI moderated 2-back and PDQ-D association. On the contrary, BAI scores significantly mediated the association of 2-back scores with PDQ-D. The direct effect of 2-back scores in PDQ-D was insignificant in the mediation of BAI scores. Our study validates the discordance between SRSC and an objective measurement of CF. Anxiety may affect both self-report and objective measurement of CF, whereas depressive thought content may lead to higher cognitive dysfunction reports in nondemented participants.
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    Perioperative immunonutrition ameliorates the postoperative immune depression in patients with gastrointestinal system cancer (prospective clinical study in 42 patients)
    Ates, E; Yilmaz, S; Erkasap, S; Ihtiyar, E; Kaya, Y; Pehlivan, T; Ustuner, Z; Yasar, B; Kiper, H
    Cancer surgery is a major challenge for patients to develop immune depression in postoperative period. Several cytokines can depress immune cell subpopulations. Increased cytokine response after surgery is assumed to arise mainly from lipooxygenase pathway acting on membrane arachidonic acid. Therefore; investigators focused their efforts to alter the membrane fatty acid profile by changing the nutritional regimen with epsilon-3 fatty acid supplementation and encouraging results were obtained after surgery. Despite the theoretical and clinical advantage of enteral nutrition many surgeons remain committed to parenteral nutrition for feeding of patients due to maintain bowel rest and fear of anastomosis leakage at the postoperative period. Several studies investigating role of the postoperative immunonutrition reported that beneficial immunological changes were associated with reduction of infectious complications. Interestingly; these findings were observed at least five days after the surgery in which the highest incidence of complications was seen. In this prospective study including 42 patients eligible for curative gastric or colon cancer surgery; we investigated the beneficial effect of enteral immunonutrition (EEN) compared to total parenteral hyperalimentation (TPN) beginning from the preoperative period. Cortisol and CRP levels as stress parameters significantly increased one day after surgery in both groups but they rapidly returned to (on POW) preoperative baseline level in EEN group whereas these values remained high in the TPN group. Additionally a significant decrease in natural killer (NK) cells and CD8+ levels were observed in both groups. However they recovered on PODS in EEN group and on POD6 in TPN group. CD4+ subset remained almost same as preoperative value in the TPN group whereas it increased from (%) 40.14 to 46.40, 51.29 and 54.7 on PO 6(th) hr, POD3 and POD6 in the EEN group. Our findings suggest that preoperative nutrition via the enteral route provided better regulation of postoperative immune system restoration than parenteral nutrition. On the basis of our findings we recommend enteral immunonutrition to be started at the preoperative period rather than postoperatively before a major operation whenever the enteral route is feasible.
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    The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)
    Ercan, ES; Polanczyk, G; Ardic, UA; Yuce, D; Karacetin, G; Tufan, AE; Tural, U; Aksu, H; Aktepei, E; Arman, AR; Basgülk, S; Bilac, O; CosKunm, M; Celik, GG; Demirkaya, SK; Dursun, BO; Durukan, I; Fidan, T; Fis, NP; Gençoglan, S; Gökçen, C; Görker, I; Görmez, V; Gündogdu, OY; Gurkan, CK; Hergüner, S; Hesapçioglu, ST; Kandemir, H; Kiliç, BG; Kilinçaslan, A; Mutluer, T; Nasiroglu, S; Özcan, ÖÖ; Öztürk, M; Öztop, D; Sapmad, SY; Süren, S; Sahin, N; Tahiroglu, AY; Toros, F; Ünal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yüce, M; Yüksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, ÖH; Çakir, ED; Çeri, V; Demir, NÜ; Dinç, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NÇ; Özdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, Ç; Uran, P; Uysal, T; Üneri, Ö; Yilmaz, S; Yilmaz, SS; Açikel, B; Aktas, H; Alaca, R; Aliç, BG; Almaidan, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PÇ; Bayram, Ö; Bektas, ND; Berberoglu, KK; Bostan, R; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Çakan, Y; Demir, I; Demir, N; Demirdögen, EY; Dogan, B; Dönmez, YE; Dönder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gök, EE; Güler, G; Güles, Z; Günes, S; Günes, A; Günay, G; Özgür, BG; Güven, G; Goksoy, SC; Horozcu, H; Irmak, A; Isik, U; Kahraman, Ö; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kiliçaslan, F; Kinay, D; Kocael, O; Koç, EB; Mutlu, RK; Lushi-San, Z; Nalbant, K; Okumus, N; Özbek, F; Özdemir, FA; Özdemir, H; Özkan, S; Özyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertçelik, M; Sevgen, FH; Sevince, O; Süleyman, F; Shamkhalova, Ü; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Türk, T; Uçar, HN; Uçar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N
    Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
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    Prevalence of Childhood Affective disorders in Turkey: An epidemiological study
    Karacetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tufan, AE; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gencoglan, S; Gokcen, C; Gokten, ES; Gorker, I; Gormez, V; Gundogdu, OY; Gurkan, CK; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Mutluer, T; Nasiroglu, S; Ozcan, OO; Ozturk, M; Sapmaz, SY; Suren, S; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yuce, M; Yuksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, OH; Cakir, ED; Ceri, V; Demir, NU; Dinc, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NC; Ozdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, C; Uran, P; Uysal, T; Uneri, OS; Yilmaz, S; Yilmaz, SS; Acikel, B; Aktas, H; Alaca, R; Alic, BG; Almbaidheen, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PC; Bayram, O; Bektas, ND; Berberoglu, KK; Bostan, R; Cakan, Y; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Demir, I; Demir, N; Demirdogen, EY; Dogan, B; Donmez, YE; Donder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gok, EE; Goksoy, SC; Guler, G; Gules, Z; Gunay, G; Gunes, S; Gunes, A; Guven, G; Horozcu, H; Irmak, A; Isik, U; Kahraman, O; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kilicaslan, F; Kinay, D; Koc, EB; Kocael, O; Mutlu, RK; San, Z; Nalbant, K; Okumus, N; Ozbek, F; Ozdemir, FA; Ozdemir, H; Ozgur, BG; Ozkan, S; Ozyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertcelik, M; Sevgen, FH; Sevince, O; Shamkhalova, U; Suleyman, F; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Turk, T; Ucar, HN; Ucar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N; Ercan, ES
    Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the The Epidemiology of Childhood Psychopathology in Turkey (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.
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    The Efficacy and Safety of CT-P13 as First-line and Subsequent-line Therapy in Patients with Ankylosing Spondylitis: Real-life Data from TURKBIO Cohort
    Uslu, 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, I
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    Efficacy and Safety of CT-P13 as First- and Second-Line Treatment in Patients with Ankylosing Spondylitis
    Uslu, 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, I
    Background/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.
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    Assessing safety and efficacy of TNFi treatment in late onset ankylosing spondylitis: a TURKBIO registry study
    Uslu, 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, F
    Clinical 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.
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    Efficacy and Safety of Secukinumab in the Treatment of Axial Spondyloarthritis: Real-Life Data from TURKBIO Cohort
    Gulle, S; Karakas, A; 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, I
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    A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry
    Önen, F; Can, G; Çapar, S; Dalkiliç, E; Pehlivan, Y; Senel, S; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanç, N; Sari, I; Birlik, M; Solmaz, D; Cefle, A; Öztürk, MA; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, ÖS; Göker, B; Haznedaroglu, S; Yavuz, S; Çetin, GY; Yildiz, F; Direskeneli, H; Akkoç, N
    Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018. Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treatments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens. Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a conventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31. Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.
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    UNINTENTIONAL MONOTHERAPY IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING TOFACITINIB AND DRUG SURVIVAL RATE OF TOFACITINIB
    Inanc, N; Abacar, K; Ozturk, MA; Tufan, A; Karadeniz, H; Sari, I; Can, G; Erez, Y; Pehlivan, Y; Dalkiliç, E; Ocak, T; Cefle, A; Yazici, A; Senel, A; Akar, S; Ediboglu, ED; Koca, SS; Sagir, RP; Yilmaz, S; Gulcemal, S; Gündüz, ÖS; Basibüyük, CS; Alkan, S; Cesur, TY; Onen, F
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    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
    Yazici, A; Isik, ÖÖ; Dalkiliç, E; Koca, SS; Pehlivan, Y; Senel, S; Inanc, N; Akar, S; Yilmaz, S; Gündüz, ÖS; Cefle, A; Karakas, ÖF; Onen, F
    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 (<2.8) and DAS28-ESR (<2.6) scores were 61.5, 44.6, 30%, and 54.6, 40.8, 27.7%, respectively. Both CDAI and DAS28-ESR scores significantly improved at 6, 12 and 24 months (p<0.001 for both). At 24 months, 23 patients (17.6%) discontinued TCZ, of whom majority (17/23) were due to unsatisfactory response. Retention rates of TCZ at 6, 12, and 24 months were 93, 84.3, and 72.2%, respectively. In this real-world study, TCZ as a first-line biologic therapy was found to be efficacious and showing high retention rates. These real-world study results are in line with previous randomized studies.
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    A multicenter study of radiologically isolated syndrome in children and adolescents: Can we predict the course?
    Yilmaza, D; Teber, S; Gueltutan, P; Yildirim, M; Bektas, Ö; Alikiliç, D; Güngör, M; Kara, B; Öncel, I; Dilek, TD; Saltik, S; Kanmaz, S; Yilmaz, S; Tekgül, H; Çavusoglu, D; Karaoglu, P; Yilmaz, Ü; Orak, SA; Güngor, O; Anlar, B
    Objectives: To evaluate clinical characteristics, imaging features and etiological profile of Radiologically Isolated Syndrome (RIS) along with clinical and radiological follow-up.Methods: Demographic, clinical and radiological data of patients younger than 18 years fulfilling the criteria for RIS were retrospectively analyzed. RIS was defined by the detection of lesions meeting the revised 2010 McDonald Criteria for dissemination in space on magnetic resonance imaging (MRI) in the absence of any symptoms of demyelinating disease or an alternative cause for the MRI findings.Results: There were total 69 patients (38 girls, 31 boys). The median age at index MRI was 15.7 years, and median follow-up time was 28 months. The most common reason for neuroimaging was headache (60.9%). A first clinical event occurred with median 11 months in 14/69 (20%) of cases. Those with oligoclonal bands (OCB) in cerebrospinal fluid (CSF) and follow-up longer than 3 years were more likely to experience a clinical event (p<0.05): 25% of those with OCB manifested clinical symptoms within the first year and 33.3% within the first two years compared to 6.3% and 9.4%, respectively in those without OCB. Radiological evolution was not associated with any variables: age, sex, reason for neuroimaging, serum 25-hydroxyvitamin D level, elevated IgG index, OCB positivity, total number and localization of lesions, presence of gadolinium enhancement, achievement of 2005 criteria for DIS and duration of follow-up.Conclusion: Children and adolescents with RIS and CSF OCB should be followed-up for at least 3 years in order to detect any clinical symptoms suggestive of a demyelinating event. Because disease-modifying treatments are not approved in RIS and no consensus report justifies their use especially in pediatric RIS, close follow-up of OCB-positive patients is needed for early recognition of any clinical event and timely initiation of specific treatment.
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    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 REGISTRY
    Uslu, 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, F
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    Biological treatment in elderly and young patients with ankylosing spondylitis: TURKBIO real-life data results
    Uslu, 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, F
    Objectives: 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.