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Öğe AGREEMENT OF PATIENT AND PHYSICIAN GLOBAL ASSESSMENT OF DISEASE ACTIVITY IN ADULT ONSET STILL'S DISEASE(Bmj Publishing Group, 2016) Kalyoncu, U.; Kasifoglu, T.; Kisacik, B.; Oksuz, M. F.; Omma, A.; Bes, C.; Cinar, M.; Pamuk, O. N.; Kucuksahin, O.; Akar, S.; Aksu, K.; Yildiz, F.; Onat, A. M.; Kanitez, N. A.; Erden, A.; Dalkilic, E.; Ermurat, S.; Hayran, M.Öğe Clinical history for inflammatory back pain in diagnosing ankylosing spondylitis: The sensitivity, specificity and consistency of clinical features(B M J Publishing Group, 2007) Akar, S.; Birlik, M.; Aksu, K.; Kabasakal, Y.; Senocak, O.; Ergor, G.; Akkoc, N.; Onen, F.Öğe COMPARISON OF CHARACTERISTICS OF ANKYLOSING SPONDYLITIS IN ASSOCIATION WITH FAMILIAL MEDITERRANEAN FEVER WITH THOSE OF TYPICAL ANKYLOSING SPONDYLITIS(Bmj Publishing Group, 2014) Solmaz, D.; Akar, S.; Kisacik, B.; Apras, S.; Senel, S.; Onat, A. M.; Kasifoglu, T.; Aksu, K.; Sari, I.; Ozturk, M. A.; Sayarlioglu, M.; Akdogan, A.; Cetin, P.; Akkoc, N.Öğe Epidemiology of Takayasu's arteritis in Turkey(Clinical & Exper Rheumatology, 2016) Birlik, M.; Kucukyavas, Y.; Aksu, K.; Solmaz, D.; Can, G.; Taylan, A.; Akar, S.; Sari, I.; Keser, G.; Onen, F.; Akkoc, N.Objective. To estimate the prevalence and incidence of Takayasu arteritis (TA) among the residents of the city of Izmir, the third largest metropolis in Turkey. Methods. Five tertiary care teaching hospitals, which were the only ones that provided rheumatology specialty care during the study period in the city of Izmir from 2006 through 2010, were invited to take part in the present study. A case search was performed electronically in the information systems of these hospitals using The International Classification of Diseases Tenth Revision (ICD-10) code for Takayasu arteritis (M31.4). The diagnosis was confirmed through chart review by a rheumatologist according to the 1990 American College of Rheumatology (ACR) criteria. Annual prevalence was calculated based on the number of patients that were alive at the end of 2010. Age-and sex-adjusted prevalence rates were standardised according to the 2010 Turkish population, based on 2010 Turkish Census. Results. A total of 41 patients were confirmed to have TA and also to live within the targeted area. The annual prevalence was estimated as 12.8 (95% CI 12.0-13.6) per million; 23.5/million (95% CI 21.9-25.0) in females and 1.9/million (95% CI 1.5-2.4) in males. The prevalence was higher 8.8/million (95% CI 7.7-10.0) in the population >40 years of age. During the study period, the mean annual incidence of TA was estimated as 1.11/million (95% CI 0.54-1.67). Conclusion. The first epidemiologic study of TA in a Turkish population suggests that TA is a relatively common vasculitis in Turkey.Öğe IS THERE ANY ROLE OF IMMUNOGENICITY ON THE RESPONSE TO THE ANTI-TUMOR NECROSIS FACTOR ALPHA THERAPY IN PATIENTS WITH ANKYLOSING SPONDYLITIS: THE FIRST RESULTS OF A PROSPECTIVE COHORT STUDY(Bmj Publishing Group, 2017) Akar, S.; Cinar, M.; Sargin, G.; Karadag, O.; Kinikli, G.; Ozmen, M.; Gercik, O.; Kalyoncu, U.; Yilmaz, S.; Senturk, T.; Keser, G.; Hatemi, G.; Yargucu, F.; Ozguler, Y.; Cefle, A.; Kozaci, D.; Solmaz, D.; Kisacik, B.Öğe A Large-Scale Outbreak of Trichinellosis Caused by Trichinella britovi in Turkey(Wiley, 2009) Akkoc, N.; Kuruuzum, Z.; Akar, S.; Yuce, A.; Onen, F.; Yapar, N.; Ozgenc, O.; Turk, M.; Ozdemir, D.; Avci, M.; Guruz, Y.; Oral, A. M.; Pozio, E.An outbreak of trichinellosis occurred in Izmir, Turkey, between January and March 2004. The outbreak was caused by the consumption of raw meat balls made of beef deceptively mixed with pork infected with Trichinella britovi. A total of 1098 people who had consumed this food either in 14 restaurants or from the street vendors located in three different neighbourhoods, consulted six different healthcare centres with a wide range of clinical signs and symptoms. Of them, 418 (38.1%) patients fulfilled the criteria for the diagnosis of acute trichinellosis. The most commonly observed signs and symptoms were myalgia (89.2%), arthralgia (69.9%) and eyelid (67%) and facial oedema (65.8%). High levels of creatinine kinase (69.3%) and lactate dehydrogenase (93.8%) with leucocytosis (> 10 000/mm(3), 58.9%) and eosinophilia (> 1000/mm(3), 60.5%) were the most prominent laboratory findings. All, but 13 of these patients were treated with mebendazole or albendazole. Based on the physicians' assessments of disease severity, 78 (19%) patients were additionally given prednisolone in whom a significantly more rapid recovery of clinical signs and symptoms (e.g. fever, myalgia, facial and eyelid oedema) was observed, with a rapid improvement in leucocytosis, eosinophilia and muscle enzymes, compared with those, who had not received corticosteroids (P < 0.05). Beef illegally mixed with pork of unknown origin, by a wholesale butcher who had sold this product to restaurants and street vendors at a lower price than the prevailing market price of beef, was the cause of this large-scale outbreak in a country with a predominantly Muslim population.Öğe PDCD1 polymorphisms are not associated with Takayasu's arteritis in Turkey(Clinical & Exper Rheumatology, 2012) Direskeneli, H.; Tuna-Erdogan, E.; Gunduz, F.; Bandurska-Luque, A.; Alparslan, B.; Kebe, M.; Uyar, F. A.; Bicakcigil, M.; Aksu, K.; Kamali, S.; Ozbalkan, Z.; Ates, A.; Karadag, O.; Ozer, H. T. E.; Akar, S.; Onen, F.; Seyahi, E.; Onat, A. M.; Aydin, S. Z.; Yilmaz, N.; Cefle, A.; Cobankara, V.; Tunc, E.; Ozturk, M. A.; Fresko, I.; Karaaslan, Y.; Akkoc, N.; Yucel, A. E.; Kiraz, S.; Keser, G.; Inanc, M.; Saruhan-Direskeneli, G.Objectives. Takayasu's arteritis (TA) is a chronic arterial inflammation of unknown etiology involving mainly the aorta and its major branches. Based on the associations of programmed death-1 (PD-1) protein encoding gene (PDCD1) with connective tissue diseases and vasculitides, PDCD1 polymorphisms are studied for susceptibility to TA in this study. Methods. The study group is made up of TA patients (n=229) fulfilling the 1990 ACR classification criteria and compared to 193 healthy controls (HC). PD-1.3, PD-1.5 and PD-1.6 single nucleotide polymorphisms of PDCD1 gene are genotyped by polymerase chain reaction and restriction analysis (PCR-RFLP). Results. The distribution of PD-1.5 polymorphism in TA patients and HC revealed a similar presence of TT genotype in patients and controls (13.3% vs. 11.4%). PD-1.3 and PD-1.6 were less polymorphic and did not differ between the groups. Rare AA genotype of PD-1.3 (1.4% vs. 1.0%) and AG genotype of PD-1.6 was again similarly (22.4% vs. 19.2%) present in TA and HC. Conclusion. PD-1.3, 1.5 and 1.6 polymorphisms of PDCD1 gene, which were shown to be associated with various autoimmune disorders and vasculitides, are not associated with a susceptibility to TA in Turkish population.Öğe PREVALENCE OF TAKAYASU'S ARTERITIS IN IZMIR, TURKEY: A MULTICENTER STUDY(Bmj Publishing Group, 2013) Kucukyavas, Y.; Aksu, K.; Solmaz, D.; Can, G.; Taylan, A.; Akar, S.; Sari, I.; Birlik, M.; Onen, F.; Akkoc, N.Öğe Takayasu's arteritis in Turkey - clinical and angiographic features of 248 patients(Clinical & Exper Rheumatology, 2009) Bicakcigil, M.; Aksu, K.; Kamali, S.; Ozbalkan, Z.; Ates, A.; Karadag, O.; Ozer, H. T. E.; Seyahi, E.; Akar, S.; Onen, F.; Cefle, A.; Aydin, S. Z.; Yilmaz, N.; Onat, A. M.; Cobankara, V.; Tunc, E.; Ozturk, M. A.; Fresko, I.; Karaaslan, Y.; Akkoc, N.; Yuecel, A. E.; Kiraz, S.; Keser, G.; Inanc, M.; Direskeneli, H.Objective. Takayasu's arteritis (TA) is a chronic, inflammatory vasculitis affecting the aorta and its major branches. Although it is more, prevalent in Far-East Asia, the distribution of the disease is worldwide with different vascular involvement patterns and clinical manifestations. The objective of this study was to evaluate the demographic, clinical, angiographic and prognostic features of TA patients in Turkey. Methods. Clinical and angiographic findings of 248 TA patients (228 female, 27 male)followed at 15 Rheumatology Centers were prospectively evaluated according to a predefined protocol. Results. The mean age was 40.1 years (30.2 years at the clinical onset). Clinical manifestations included constitutional symptoms in 66%, absent or diminished pulses in 88%, bruits in 77%, extremity pain in 69%, claudication in 48%, hypertension in 43% and cerebrovascular accidents (CVA) in 18% of the patients. Renal artery stenosis, aortic regurgitation and pulmonary hypertension were present in 26%, 33% and 12%, respectively. According to the new angiographic classification, type V (50.8%) and Type I (32%) were the most frequent types of involvement. Corticosteroids were the main treatment in 93% of the patients alone (9%) or in combination with immunosuppressive agents (84%). Most frequently preferred immunosuppressive agents were methotrexate (63%), azathioprine (22%) and cyclophosphamide (13%). Remission was observed at least once in 94% of the patients and sustained remission in 71% during follow-up. Conclusion. The demographical, clinical and angiographic findings of TA patients in our series were similar to those reported from Japan, Brazil and Colombia. Combination therapies with immunosuppressive agents were the preferred choice of treatment in Turkey.
