Yazar "Yargucu, Figen" seçeneğine göre listele
Listeleniyor 1 - 12 / 12
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Cigarette smoking in primary Sjogren's syndrome: positive association only with ANA positivity(Taylor & Francis Ltd, 2011) Karabulut, Gonca; Kitapcioglu, Gul; Inal, Vedat; Kalfa, Melike; Yargucu, Figen; Keser, Gokhan; Emmungil, Hakan; Gokmen, Nihal Mete; Kocanaogullari, Hayriye; Aksu, KenanSmoking is well known to contribute to the pathogenesis and severity of some systemic autoimmune rheumatic diseases and especially to the production of certain autoantibodies. Primary Sjogren's syndrome (pSS) is an autoimmune disease, affecting primarily the exocrine glands. It may also cause extraglandular involvement in some cases. In this study, we aimed to determine the frequency of smoking habits in our cohort of pSS patients and to investigate whether the frequencies of autoantibody positivity and extraglandular involvement were significantly different between patients with and without smoking. In this cross-sectional study, 207 patients with pSS (F/M 203/4), fulfilling the United States-European Consensus Criteria, and 602 healthy controls (F/M 534/68) were included. Patients and controls were classified into five groups: never smokers, current smokers, former smokers; ever smokers, and passive smokers. The chi(2) and Kruskal-Wallis tests were used for statistical analysis; a p value of less than 0.05 was accepted as statistically significant. While the frequency of current smokers was significantly lower in the pSS group compared with the healthy controls (11.6 vs 22.3%), the frequencies of former smokers (30.4 vs 11.8%), ever smokers (42.0 vs 34.1%), and passive smokers (47.3 vs 37.5%) were significantly higher in the pSS group compared with the healthy controls. In pSS patients, only antinuclear antibody (ANA) positivity was significantly associated with smoking habits, while there was no significant association with other autoantibodies or with the presence of extraglandular involvement. We found that in pSS patients smoking was significantly associated only with ANA positivity. Unlike the deleterious effects of smoking upon disease severity and anti-cyclic citrullinated protein (CCP) antibody production in rheumatoid arthritis, we could not find any association of smoking with extraglandular involvement and/or anti-Ro/anti-La antibody positivity in pSS. These results are indeed in line with the limited number of previous studies reported in the literature. Further studies with higher numbers of pSS patients are required to confirm the seemingly negative association of smoking with pSS.Öğe Corneal Hysteresis, Corneal Resistance Factor, and Intraocular Pressure Measurement in Patients with Scleroderma Using the Reichert Ocular Response Analyzer(Lippincott Williams & Wilkins, 2010) Emre, Sinan; Kayikcioglu, Oezcan; Ates, Halil; Cinar, Esat; Inceoglu, Nehir; Yargucu, Figen; Pirildar, Timur; Oksel, FahrettinPurpose: The Reichert ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with systemic sclerosis (SSc) and to compare with control eyes. Patients and Methods: ORA measurements were performed on the right eyes of 29 patients with SSc (group 1) and 29 healthy people who served as the control group (group 2). Corneal hysteresis, conical resistance factor (CRF), and intraocular pressure [Goldmann correlated (IOPg) and conical compensated] were recorded with ORA. Results: Mean age of patients with SSc and control groups were 51.7 +/- 11.1 and 50.3 +/- 10.8 years, respectively. Mean (+/- SD) of the corneal hysteresis and CRF readings were 9.8 +/- 1.7 versus 9.5 +/- 1.2 mm Hg (P>0.05) and 10.0 +/- 1.5 versus 9.2 +/- 1.4 mm Hg (P<0.05), in groups 1 and 2, respectively. Mean (+/- SD) of the IOPg and intraocular pressure corneal-compensated recordings were 15.9 +/- 2.5 versus 14.1 +/- 2.4 mm Hg (P<0.05) and 16.9 +/- 3.2 versus 15.6 +/- 2.9 mm Hg (P>0.05), in groups 1 and 2, respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups. Conclusions: The mean CRF and IOPg values of patients with SSc were higher when compared with normal controls. According to the results of our study, one can conclude that corneal biomechanical properties would be changed in patients with SSc and this can be determined by CRF.Öğe Efficacy of SLZ and MTX (alone or combination) on the treatment of active sacroiliitis in early AS(Springer Heidelberg, 2009) Kabasakal, Yasemin; Kitapcioglu, Gul; Yargucu, Figen; Taylan, Ali; Argin, Mehmet; Gumusdis, GurbuzSacroiliitis is an important sign of spondylarthritis (SpA) of which the prototype disease is ankylosing spondylitis. The radiographic changes required for diagnosing AS occur as late as 8-11 years after the onset of clinical symptoms. Nonsteroid anti-inflammatory drugs (NSAIDs) have been the main treatment for spondylitis of AS. For patients refractory or intolerant to NSAIDs, disease-modifying antirheumatic drugs (DMARDs) have been used as a second-line approach. Sulphasalazine (SLZ) is known as the best DMARD in treatment of peripheral arthritis; also methotrexate (MTX) is currently one of the most widely used DMARDs. But there was no objective information about inflammation of sacroiliac joints during treatment with these DMARDS that are the first places of the beginning point of SpA. For this purpose, in this study, the effect of SLZ and MTX, which are used alone and combination in 6 months, on treatment of active sacroiliitis, which is shown by dynamic magnetic resonance and acute phase reactants in laboratory has been investigated. 55 patients (F:M = 34:21) with active sacroiliitis [mean age = 37.05 + 13.03 year (n = 55)] were evaluated and determined by dynamic magnetic resonance imaging in this study. The better response in the SLZ treatment group than the other two groups has been obtained. Nevertheless, those changes were not statistically found different. In conclusion, the ratio of treatment of active sacroiliitis, especially early period, with SLZ as a DMARD is better than MTX or MTX + SLZ, but this difference is not statistically significant. A prospective study of the treatment of active sacroiliitis by DMARDs may be more illustrative.Öğe Efficacy of SLZ and MTX (alone or combination) on the treatment of active sacroiliitis in early AS(Springer Heidelberg, 2009) Kabasakal, Yasemin; Kitapcioglu, Gul; Yargucu, Figen; Taylan, Ali; Argin, Mehmet; Gumusdis, GurbuzSacroiliitis is an important sign of spondylarthritis (SpA) of which the prototype disease is ankylosing spondylitis. The radiographic changes required for diagnosing AS occur as late as 8-11 years after the onset of clinical symptoms. Nonsteroid anti-inflammatory drugs (NSAIDs) have been the main treatment for spondylitis of AS. For patients refractory or intolerant to NSAIDs, disease-modifying antirheumatic drugs (DMARDs) have been used as a second-line approach. Sulphasalazine (SLZ) is known as the best DMARD in treatment of peripheral arthritis; also methotrexate (MTX) is currently one of the most widely used DMARDs. But there was no objective information about inflammation of sacroiliac joints during treatment with these DMARDS that are the first places of the beginning point of SpA. For this purpose, in this study, the effect of SLZ and MTX, which are used alone and combination in 6 months, on treatment of active sacroiliitis, which is shown by dynamic magnetic resonance and acute phase reactants in laboratory has been investigated. 55 patients (F:M = 34:21) with active sacroiliitis [mean age = 37.05 + 13.03 year (n = 55)] were evaluated and determined by dynamic magnetic resonance imaging in this study. The better response in the SLZ treatment group than the other two groups has been obtained. Nevertheless, those changes were not statistically found different. In conclusion, the ratio of treatment of active sacroiliitis, especially early period, with SLZ as a DMARD is better than MTX or MTX + SLZ, but this difference is not statistically significant. A prospective study of the treatment of active sacroiliitis by DMARDs may be more illustrative.Öğe Evaluation of Ocular Surface and Meibomian Glands in Patients With Scleroderma(Lippincott Williams & Wilkins, 2021) Adiguzel, Seyma; Palamar, Melis; Yargucu, Figen; Oksel, Fahrettin; Yagci, AysePurpose: To evaluate the prevalence of dry eye and meibomian gland dysfunction in patients with scleroderma. Methods: A total of 32 patients with scleroderma (study group) and 31 healthy subjects (control group) were enrolled. Besides routine ophthalmologic evaluation, Schirmer 1 test, tear break-up time, tear osmolarity, ocular surface staining with fluorescein (Oxford score), and Ocular Surface Disease Index (OSDI) score, meibomian gland dysfunction evaluation (foamy tears, telangiectasia of the eyelid, eyelid contour abnormalities, and meibomian plugs), and meibography were performed. Results: Sixty-four eyes of 32 patients with scleroderma and 62 eyes of 31 healthy individuals were evaluated. Mean ages of the study group was 48.34 +/- 9.73 years (21-62 years) and of the control group was 45.84 +/- 4.42 years (38-54 years) (P = 0.067). Mean duration of systemic sclerosis or scleroderma in study group was 9.78 +/- 7.40 years (1-30 years). Mean tear break-up time was shorter in study group than that in the control group (P < 0.0005). No statistical differences were detected for osmolarity, OSDI score, and Schirmer 1 values between groups (P = 0.051, P = 0.053, and P = 0.358, respectively). The prevalence of grade 1 and higher Oxford score was higher in the study group (P < 0.0005). Upper meiboscores of grade 1 and higher were found to be more common in the study group than those in the control group (P = 0.036). The presence of foamy tears and telangiectasia of the eyelids were significantly higher in the study group (P = 0.002 and P = 0.002, respectively). OSDI score was the only significantly correlated data with disease duration (Spearman rho coefficient = 0.396, P = 0.001). Conclusions: Evaporative type dry eye is more common in patients with scleroderma than the healthy population.Öğe Hypothermia during the infusion of cryopreserved autologous peripheral stem cell causes electrocardiographical changes: Report of two cases(Wiley-Liss, 2006) Sahin, Fahri; Turk, Ugur Onsel; Yargucu, Figen; Donmez, Ayhan; Cagirgan, SeckinCurrently, autologous peripheral stem cell transplantation used as a therapeutic modality in the treatment of various hematological malignancies is gaining more popularity day by day. In this method, the patient's own peripheral stem cells are collected by a proper method and stored at -80 degrees C until they are reinfused into the patient after being rewarmed in water bath at 37 degrees C. A number of complications have been reported related to reinfusion of the cryopreserved cells into the patient. These may include noncardiovascular complications such as nausea, vomiting, flushing, abdominal pain, chest discomfort, and headache, as well as cardiovascular complications like arrhythmias, hypotension, and hypertension. Hypothermia related to rapid infusion has been reported as the main factor underlying the cardiovascular complications. Electrocardiographic findings of hypothermia include sinusal bradycardia, prolonged QT and PR intervals, widened QRS complexes, and J wave, which is a ECG abnormality characterized by supraventricular and ventricular arrhythmias. We here present two cases of giant J wave caused by hypothermia during infusion of cryopreserved autologous peripheral stem cell that is detected by ECG and regressed after infusion ceased.Öğe Longitudinal Myelitis As The First Manifestation of Systemic Lupus Erythematosus(Journal Neurological Sciences, 2009) Celebisoy, Nese; Gulec, Feray; Bayrakci, Adem; Yargucu, FigenAcute longitudinal myelitis (ALM) as the initial manifestation of systemic lupus erythematosus (SLE) has been reported in just two cases. We herein present the third case associated with antiphospholipid antibodies with an unfavorable outcome. All patients with ALM should be tested for SLE and urgent treatment with intravenous pulse methylprednisolone and cyclophosphamide must be started. Alternative treatment trials must also be established as there are patients with permanent neurologic disability like ours despite appropriate therapy.Öğe Phenotypes Determined by Cluster Analysis and Their Survival in the Prospective European Scleroderma Trials and Research Cohort of Patients With Systemic Sclerosis(Wiley, 2019) Sobanski, Vincent; Giovannelli, Jonathan; Allanore, Yannick; Riemekasten, Gabriela; Airo, Paolo; Vettori, Serena; Cozzi, Franco; Distler, Oliver; Matucci-Cerinic, Marco; Denton, Christopher; Launay, David; Hachulla, Eric; Cerinic, Marco Matucci; Guiducci, Serena; Walker, Ulrich; Kyburz, Diego; Lapadula, Giovanni; Iannone, Florenzo; Distler, Oliver; Maurer, Britta; Jordan, Suzana; Becvar, Radim; Sierakowsky, Stanislaw; Bielecka, Otylia Kowal; Cutolo, Maurizio; Sulli, Alberto; Valentini, Gabriele; Cuomo, Giovanna; Vettori, Serena; Siegert, Elise; Rednic, Simona; Nicoara, Ileana; Kahan, Andre; Allanore, Yannick; Vlachoyiannopoulos, Panayiotis; Montecucco, Carlo; Caporali, Roberto; Stork, Jiri; Inanc, Murat; Carreira, Patricia E.; Novak, Srdan; Czirjak, Laszlo; Varju, Cecilia; Chizzolini, Carlo; Kucharz, Eugene J.; Kotulska, Anna; Kopec-Medrek, Magdalena; Widuchowska, Malgorzata; Cozzi, Franco; Rozman, Blaz; Mallia, Carmel; Coleiro, Bernard; Gabrielli, Armando; Farge, Dominique; Wu, Chen; Marjanovic, Zora; Faivre, Helene; Hij, Darin; Dhamadi, Roza; Airo, Paolo; Hesselstrand, Roger; Wollheim, Frank; Wuttge, Dirk M.; Andreasson, Kristofer; Martinovic, Duska; Balbir-Gurman, Alexandra; Braun-Moscovici, Yolanda; Trotta, Francesco; Lo Monaco, Andrea; Hunzelmann, Nicolas; Pellerito, Raffaele; Bambara, Lisa Maria; Caramaschi, Paola; Morovic-Vergles, Jadranka; Black, Carol; Denton, Christopher; Damjanov, Nemanja; Henes, Joerg; Ortiz Santamaria, Vera; Heitmann, Stefan; Krasowska, Dorota; Seidel, Matthias; Hasler, Paul; Burkhardt, Harald; Himsel, Andrea; Bajocchi, Gianluigi; Nuova, Arcispedale Santa Maria; Salvador, Maria Joao; Pereira Da Silva, Jose Antonio; Stamenkovic, Bojana; Stankovic, Aleksandra; Selmi, Carlo Francesco; De Santis, Maria; Marasini, Bianca; Tikly, Mohammed; Ananieva, Lidia P.; Denisov, Lev N.; Mueller-Ladner, Ulf; Frerix, Marc; Tarner, Ingo; Scorza, Raffaella; Puppo, Francesco; Engelhart, Merete; Strauss, Gitte; Nielsen, Henrik; Damgaard, Kirsten; Szucs, Gabriella; Szamosi, Szilvia; Zea Mendoza, Antonio; de la Puente, Carlos; Sifuentes Giraldo, Walter Alberto; Midtvedt, Oyvind; Reiseter, Silje; Garen, Torhild; Hachulla, Eric; Launay, David; Valesini, Guido; Riccieri, Valeria; Ionescu, Ruxandra Maria; Opris, Daniela; Groseanu, Laura; Wigley, Fredrick M.; Cornateanu, Roxana Sfrent; Ionitescu, Razvan; Gherghe, Ana Maria; Soare, Alina; Gorga, Marilena; Bojinca, Mihai; Mihai, Carina; Milicescu, Mihaela; Sunderkoetter, Cord; Kuhn, Annegret; Sandorfi, Nora; Schett, Georg; Distler, Joerg H. W.; Beyer, Christian; Meroni, Pierluigi; Ingegnoli, Francesca; Mouthon, Luc; De Keyser, Filip; Smith, Vanessa; Cantatore, Francesco Paolo; Corrado, Ada; Ullman, Susanne; Iversen, Line; von Muehlen, Carlos Alberto; Bohn, Jussara Marilu; Lonzetti, Lilian Scussel; Pozzi, Maria Rosa; Eyerich, Kilian; Hein, Ruediger; Knott, Elisabeth; Wiland, Piotr; Szmyrka-Kaczmarek, Magdalena; Sokolik, Renata; Morgiel, Ewa; Madej, Marta; Houssiau, Frederic A.; Jose Alegre-Sancho, Juan; Krummel-Lorenz, Brigitte; Saar, Petra; Aringer, Martin; Guenther, Claudia; Westhovens, Rene; de Langhe, Ellen; Lenaerts, Jan; Anic, Branimir; Baresic, Marko; Mayer, Miroslav; Uprus, Maria; Otsa, Kati; Yavuz, Sule; Granel, Brigitte; Radominski, Sebastiao Cezar; Mueller, Carolina de Souza; Azevedo, Valderilio Feijo; Jimenez, Sergio; Busquets, Joanna; Agachi, Svetlana; Groppa, Liliana; Chiaburu, Lealea; Russu, Eugen; Popa, Sergei; Zenone, Thierry; Pileckyte, Margarita; Stebbings, Simon; Highton, John; Mathieu, Alessandro; Vacca, Alessandra; Sampaio-Barros, Percival D.; Yoshinari, Natalino H.; Marangoni, Roberta G.; Martin, Patricia; Fuocco, Luiza; Stamp, Lisa; Chapman, Peter; O'Donnell, John; Solanki, Kamal; Doube, Alan; Veale, Douglas; O'Rourke, Marie; Loyo, Esthela; Li, Mengtao; Mohamed, Walid Ahmed Abdel Atty; Rosato, Edoardo; Amoroso, Antonio; Gigante, Antonietta; Oksel, Fahrettin; Yargucu, Figen; Tanaseanu, Cristina-Mihaela; Popescu, Monica; Dumitrascu, Alina; Tiglea, Isabela; Foti, Rosario; Chirieac, Rodica; Ancuta, Codrina; Furst, Daniel E.; Villiger, Peter; Adler, Sabine; van Laar, Jacob; Kayser, Cristiane; Eduardo, Andrade Luis C.; Fathi, Nihal; Hassanien, Manal; de la Pena Lefebvre, Paloma Garcia; Rodriguez Rubio, Silvia; Valero Exposito, Marta; Sibilia, Jean; Chatelus, Emmanuel; Gottenberg, Jacques Eric; Chifflot, Helene; Litinsky, Ira; Emery, Paul; Buch, Maya; Del Galdo, Francesco; Venalis, Algirdas; Butrimiene, Irena; Venalis, Paulius; Rugiene, Rita; Karpec, Diana; Saketkoo, Lesley Ann; Lasky, Joseph A.; Kerzberg, Eduardo; Montoya, Fabiana; Cosentino, Vanesa; Limonta, Massimiliano; Brucato, Antonio Luca; Lupi, Elide; Rosner, Itzhak; Rozenbaum, Michael; Slobodin, Gleb; Boulman, Nina; Rimar, Doron; Couto, Maura; Spertini, Francois; Ribi, Camillo; Buss, Guillaume; Kahl, Sarah; Hsu, Vivien M.; Chen, Fei; McCloskey, Deborah; Malveaux, Halina; Pasquali, Jean Louis; Martin, Thierry; Gorse, Audrey; Guffroy, Aurelien; Poindron, VincentObjective Systemic sclerosis (SSc) is a heterogeneous connective tissue disease that is typically subdivided into limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) depending on the extent of skin involvement. This subclassification may not capture the entire variability of clinical phenotypes. The European Scleroderma Trials and Research (EUSTAR) database includes data on a prospective cohort of SSc patients from 122 European referral centers. This study was undertaken to perform a cluster analysis of EUSTAR data to distinguish and characterize homogeneous phenotypes without any a priori assumptions, and to examine survival among the clusters obtained. Methods A total of 11,318 patients were registered in the EUSTAR database, and 6,927 were included in the study. Twenty-four clinical and serologic variables were used for clustering. Results Clustering analyses provided a first delineation of 2 clusters showing moderate stability. In an exploratory attempt, we further characterized 6 homogeneous groups that differed with regard to their clinical features, autoantibody profile, and mortality. Some groups resembled usual dcSSc or lcSSc prototypes, but others exhibited unique features, such as a majority of lcSSc patients with a high rate of visceral damage and antitopoisomerase antibodies. Prognosis varied among groups and the presence of organ damage markedly impacted survival regardless of cutaneous involvement. Conclusion Our findings suggest that restricting subsets of SSc patients to only those based on cutaneous involvement may not capture the complete heterogeneity of the disease. Organ damage and antibody profile should be taken into consideration when individuating homogeneous groups of patients with a distinct prognosis.Öğe Predictors of disease worsening defined by progression of organ damage in diffuse systemic sclerosis: a European Scleroderma Trials and Research (EUSTAR) analysis(Bmj Publishing Group, 2019) Becker, Mike; Graf, Nicole; Sauter, Rafael; Allanore, Yannick; Curram, John; Denton, Christopher P.; Khanna, Dinesh; Matucci-Cerinic, Marco; Pena, Janethe de Oliveira; Pope, Janet E.; Distler, Oliver; Matucci-Cerinic, Marco; Guiducci, Serena; Walker, Ulrich; Jaeger, Veronika; Bannert, Bettina; Lapadula, Giovanni; Becvarare, Radim; Cutolo, Maurizio; Valentini, Gabriele; Siegert, Elise; Rednic, Simona; Allanore, Yannick; Montecucco, C.; Carreira, Patricia E.; Novak, Srdan; Czirjak, Laszlo; Varju, Cecilia; Chizzolini, Carlo; Allai, Daniela; Kucharz, Eugene J.; Cozzi, Franco; Rozman, Blaz; Mallia, Carmel; Gabrielli, Armando; Bancel, Dominique Farge; Airo, Paolo; Hesselstrand, Roger; Martinovic, Duska; Balbir-Gurman, Alexandra; Braun-Moscovici, Yolanda; Hunzelmann, Nicolas; Pellerito, Raffaele; Caramaschi, Paola; Black, Carol; Damjanov, Nemanja; Henes, Joerg; Ortiz Santamaria, Vera; Heitmann, Stefan; Seidel, Matthias; Pereira Da Silva, Jose Antonio; Stamenkovic, Bojana; Selmi, Carlo Francesco; Tikly, Mohammed; Denisov, Lev N.; Mueller-Ladner, Ulf; Engelhart, Merete; Hachulla, Eric; Riccieri, Valeria; Ionescu, Ruxandra Maria; Mihai, Carina; Sunderkoetter, Cord; Kuhn, Annegret; Schett, Georg; Distler, Joerg; Meroni, Pierluigi; Ingegnoli, Francesca; Mouthon, Luc; De Keyser, Filip; Smith, Vanessa; Cantatore, Francesco Paolo; Corrado, Ada; Ullman, Susanne; Iversen, Line; Pozzi, Maria Rosa; Eyerich, Kilian; Hein, Ruediger; Knott, Elisabeth; Wiland, Piotr; Szmyrka-Kaczmarek, Magdalena; Sokolik, Renata; Morgiel, Ewa; Madej, Marta; Jose Alegre-Sancho, Juan; Krummel-Lorenz, Brigitte; Saar, Petra; Aringer, Martin; Guenther, Claudia; Anne, Erler; Westhovens, Rene; De langhe, Ellen; Lenaerts, Jan; Anic, Branimir; Baresic, Marko; Mayer, Miroslav; Uprus, Maria; Otsa, Kati; Yavuz, Sule; Radominski, Sebastiao Cezar; Mueller, Carolina de Souza; Azevedo, Valderilio Feijo; Popa, Sergei; Zenone, Thierry; Stebbings, Simon; Highton, John; Mathieu, Alessandro; Vacca, Alessandra; Stamp, Lisa; Chapman, Peter; O'Donnell, John; Solanki, Kamal; Doube, Alan; Veale, Douglas; O'Rourke, Marie; Loyo, Esthela; Li, Mengtao; Rosato, Edoardo; Amoroso, Antonio; Gigante, Antonietta; Oksel, Fahrettin; Yargucu, Figen; Tanaseanu, Cristina-Mihaela; Popescu, Monica; Dumitrascu, Alina; Tiglea, Isabela; Foti, Rosario; Visalli, Elisa; Benenati, Alessia; Amato, Giorgio; Ancuta, Codrina; Chirieac, Rodica; Villiger, Peter; Adler, Sabine; Dan, Diana; de la Pena Lefebvre, Paloma Garcia; Rodriguez Rubio, Silvia; Valero Exposito, Marta; Sibilia, Jean; Chatelus, Emmanuel; Gottenberg, Jacques Eric; Chifflot, Helene; Litinsky, Ira; Del Galdo, Francesco; Venalis, Algirdas; Saketkoo, Lesley Ann; Lasky, Joseph A.; Kerzberg, Eduardo; Montoya, Fabiana; Cosentino, Vanesa; Limonta, Massimiliano; Brucato, Antonio Luca; Lupi, Elide; Spertini, Francois; Ribi, Camillo; Buss, Guillaume; Martin, Thierry; Guffroy, Aurelien; Poindron, Vincent; Chung, Lori; Schmeiser, Tim; Zebryk, Pawel; Riso, Nuno; Riemekasten, Gabriela; Rezus, Elena; Puttini, Piercarlo SarziObjectives Mortality and worsening of organ function are desirable endpoints for clinical trials in systemic sclerosis (SSc). The aim of this study was to identify factors that allow enrichment of patients with these endpoints, in a population of patients from the European Scleroderma Trials and Research group database. Methods Inclusion criteria were diagnosis of diffuse SSc and follow-up over 12 +/- 3 months. Disease worsening/organ progression was fulfilled if any of the following events occurred: new renal crisis; decrease of lung or heart function; new echocardiography-suspected pulmonary hypertension or death. In total, 42 clinical parameters were chosen as predictors for the analysis by using (1) imputation of missing data on the basis of multivariate imputation and (2) least absolute shrinkage and selection operator regression. Results Of 1451 patients meeting the inclusion criteria, 706 had complete data on outcome parameters and were included in the analysis. Of the 42 outcome predictors, eight remained in the final regression model. There was substantial evidence for a strong association between disease progression and age, active digital ulcer (DU), lung fibrosis, muscle weakness and elevated C-reactive protein (CRP) level. Active DU, CRP elevation, lung fibrosis and muscle weakness were also associated with a significantly shorter time to disease progression. A bootstrap validation step with 10 000 repetitions successfully validated the model. Conclusions The use of the predictive factors presented here could enable cohort enrichment with patients at risk for overall disease worsening in SSc clinical trials.Öğe Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort(Bmj Publishing Group, 2019) Wu, Wanlong; Jordan, Suzana; Graf, Nicole; Pena, Janethe de Oliveira; Curram, John; Allanore, Yannick; Matucci-Cerinic, Marco; Pope, Janet E.; Denton, Christopher P.; Khanna, Dinesh; Distler, Oliver; Matucci-Cerinic, Marco; Guiducci, Serena; Walker, Ulrich; Jaeger, Veronika; Bannert, Bettina; Lapadula, Giovanni; Becvarare, Radim; Cutolo, Maurizio; Valentini, Gabriele; Siegert, Elise; Rednic, Simona; Allanore, Yannick; Montecucco, C.; Carreira, Patricia E.; Novak, Srdan; Czirjak, Laszlo; Varju, Cecilia; Chizzolini, Carlo; Allai, Daniela; Kucharz, Eugene J.; Cozzi, Franco; Rozman, Blaz; Mallia, Carmel; Gabrielli, Armando; Bancel, Dominique Farge; Airo, Paolo; Hesselstrand, Roger; Martinovic, Duska; Balbir-Gurman, Alexandra; Braun-Moscovici, Yolanda; Hunzelmann, Nicolas; Pellerito, Raffaele; Caramaschi, Paola; Black, Carol; Damjanov, Nemanja; Henes, Joerg; Ortiz Santamaria, Vera; Heitmann, Stefan; Seidel, Matthias; Pereira Da Silva, Jose Antonio; Stamenkovic, Bojana; Selmi, Carlo Francesco; Tikly, Mohammed; Denisov, Lev N.; Mueller-Ladner, Ulf; Engelhart, Merete; Hachulla, Eric; Riccieri, Valeria; Ionescu, Ruxandra Maria; Mihai, Carina; Sunderkoetter, Cord; Kuhn, Annegret; Schett, Georg; Distler, Joerg; Meroni, Pierluigi; Ingegnoli, Francesca; Mouthon, Luc; De Keyser, Filip; Smith, Vanessa; Cantatore, Francesco Paolo; Corrado, Ada; Ullman, Susanne; Iversen, Line; Pozzi, Maria Rosa; Eyerich, Kilian; Hein, Ruediger; Knott, Elisabeth; Wiland, Piotr; Szmyrka-Kaczmarek, Magdalena; Sokolik, Renata; Morgiel, Ewa; Madej, Marta; Jose Alegre-Sancho, Juan; Krummel-Lorenz, Brigitte; Saar, Petra; Aringer, Martin; Guenther, Claudia; Anne, Erler; Westhovens, Rene; De Langhe, Ellen; Lenaerts, Jan; Anic, Branimir; Baresic, Marko; Mayer, Miroslav; Uprus, Maria; Otsa, Kati; Yavuz, Sule; Radominski, Sebastiao Cezar; Mueller, Carolina de Souza; Azevedo, Valderilio Feijo; Popa, Sergei; Zenone, Thierry; Stebbings, Simon; Highton, John; Mathieu, Alessandro; Vacca, Alessandra; Stamp, Lisa; Chapman, Peter; O'Donnell, John; Solanki, Kamal; Doube, Alan; Veale, Douglas; O'Rourke, Marie; Loyo, Esthela; Li, Mengtao; Rosato, Edoardo; Amoroso, Antonio; Gigante, Antonietta; Oksel, Fahrettin; Yargucu, Figen; Tanaseanu, Cristina-Mihaela; Popescu, Monica; Dumitrascu, Alina; Tiglea, Isabela; Foti, Rosario; Visalli, Elisa; Benenati, Alessia; Amato, Giorgio; Ancuta, Codrina; Chirieac, Rodica; Villiger, Peter; Adler, Sabine; Dan, Diana; de la Pena Lefebvre, Paloma Garcia; Rodriguez Rubio, Silvia; Valero Exposito, Marta; Sibilia, Jean; Chatelus, Emmanuel; Gottenberg, Jacques Eric; Chifflot, Helene; Litinsky, Ira; Del Galdo, Francesco; Venalis, Algirdas; Saketkoo, Lesley Ann; Lasky, Joseph A.; Kerzberg, Eduardo; Montoya, Fabiana; Cosentino, Vanesa; Limonta, Massimiliano; Brucato, Antonio Luca; Lupi, Elide; Spertini, Francois; Ribi, Camillo; Buss, Guillaume; Martin, Thierry; Guffroy, Aurelien; Poindron, Vincent; Chung, Lori; Schmeiser, Tim; Zebryk, Pawel; Riso, Nuno; Riemekasten, Gabriela; Rezus, Elena; Puttini, Piercarlo SarziObjectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) >= 7, valid mRSS at 12 +/- 3 months after baseline and >= 1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS >5 and >= 25% from baseline to 12 +/- 3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline >= 10% (53.6% vs 34.4%; p<0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (<= 22/51) or short disease duration (<= 15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline >= 10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice.Öğe Radiological incomplete thymus involution in systemic sclerosis(Oxford Univ Press, 2009) Oksel, Fahrettin; Tarhan, Figen; Bayraktaroglu, Selen; Savas, Recep; Yargucu, Figen; Keser, GoekhanMethods. Sixty-three female SSc patients (diffuse/limited: 49/14), all having pulmonary high-resolution CT (HRCT) scans, taken previously for evaluating lung involvement were included. At the time of the scans, mean age and disease duration of the patients were 50.1 8.5 and 10.2 7.8 years, respectively. As the control group, 45 age-matched female patients, having normal pulmonary HRCT scans taken previously for evaluating non-specific symptoms, were included. Results. Frequency of incomplete thymus involution was significantly higher in SSc patients (12/63; 19) compared with the control group (2/45; 4.4; P 0.022). In SSc patients with pulmonary fibrosis, incomplete thymus involution was significantly lower (3/38; 7.9) than those without pulmonary fibrosis (9/25; 36; P 0.007). Conclusion. The present study shows significantly higher frequency of radiological incomplete thymus involution in SSc compared with normal controls. Furthermore, less common occurrence of pulmonary fibrosis in SSc patients with incomplete thymus involution deserves attention. These findings may have some implications regarding the possible role of thymic abnormalities at least in some patients with SSc.Öğe Romatoid artritli hastalarda sosyoepidemiyolojik faktörlerin yaşam kalitesine etkisi(Ege Üniversitesi, 2007) Yargucu, Figen; Oksel, Fahrettin[Abstarct Not Available]