Browsing by Author "Yilmaz, Sema"

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Axial Psoriatic Arthritis: The İmpact Of Underdiagnosed Disease On Outcomes İn Real Life
(2018) Aydin, Sibel Zehra; Kucuksahin, Orhan; Kilic, Levent; Dogru, Atalay; Bayindir, Ozun; Ozisler, Cem; Omma, Ahmet; Tarhan, Emine Figen; Erden, Abdulsamet; Kimyon, Gezmis; Can, Meryem; Dalkilic, Ediz; Yavuz, Sule; Ureyen, Sibel Bakirci; Gunal, Esen Kasapoglu; Alhussain, Fatima Arslan; Akyol, Lutfi; Balkarli, Ayse; Yilmaz, Sema; Cinar, Muhammet; Aydin, Muge Tufan; Solmaz, Dilek; Mercan, Ridvan; Erten, Sukran; Kalyoncu, Umut; 29948352
Psoriatic arthritis (PsA) may affect different joints, including the spine. The prevalence of spinal involvement is variable depending on the definition and a subset of patients have been identified in cohorts that do not have clinical features of axial disease and yet have imaging findings. Still, there is not a consensus on how and when to screen axial disease. In this study, we aimed to investigate factors associated with being underdiagnosed for axial psoriatic arthritis (axPsA) and its impacts on outcomes. Disease features and outcomes of axPsA according to the physician (n=415) were compared with patients with imaging findings only (sacroiliitis fulfilling the modified New York criteria, n=112), using data from a real-life PsA registry. Patients with imaging findings only were more frequently women (83/220 (37.7%) vs 29/122 (23.8%); p=0.008). This group also had higher peripheral disease activity (imaging only vs clinical AxPsA: mean (SD) tender joint count 5.3 (6.1) vs 3.3 (4.7), swollen joint count 1.9 (2.9) vs 1.2 (2.4); p<0.001 for both comparisons) and was less often treated using TNF inhibitors (16.1 vs 38.2%; p<0.001) than patients who were classified as axPsA. Patient-reported outcomes were similar in both groups. PsA patients, especially women with more severe peripheral disease, have a higher risk of being underdiagnosed for axPsA. The severity of peripheral symptoms may be a risk factor to mask the spinal features of PsA.
Criteria Sets for Primary Sjogren's Syndrome Are Not Adequate for Those Presenting with Extraglandular Organ Involvements As Their Dominant Clinical Features
(2017) Kabasakal, Yasemin; Kitapcioglu, Gul; Karabulut, Gonca; Tezcan, Mehmet; Balkarli, Ayse; Aksoy, Adem; Yavuz, Aule; Yilmaz, Sema; Kasifoglu, Timucin; Kalyoncu, Umut; Dalkilic, Ediz; Tufan, Abdurrahman; Mercan, Ridvan; Yildiz, Fatih; Senturk, Taskin; Onen, Fatos; Bes, Cemal; Erken, Eren; Tunc, Ercan; Kamali, Sevil; Tarhan, Emine; Yazici, Ayten; Duzgun, Nursen; Bicakcigil, Muge; Yilmaz, Sedat; Ozmen, Mustafa; Ocal, Lale; Alibaz-Oner, Fatma; Solmaz, Dilek; Cobankara, Veli; Nalbant, Selim; Gunal, Esen Kasapoglu; Kaskari, Derya; Goker, Berna; https://orcid.org/0000-0002-0125-8746; 28289872; H-7637-2016
Patients with primary Sjogren's syndrome (pSS) may go undiagnosed or be misclassified due to the insidious nature and wide spectrum of the disease. The available several classification criteria emphasize glandular findings. We aimed to analyze the efficiency of various classification criteria sets in patients diagnosed on the clinical basis by expert opinion and to compare those pSS patients who fulfilled these criteria with those who did not. This is a multicenter study in which 834 patients from 22 university-based rheumatology clinics are included. Diagnosis of pSS was made on the clinical basis by the expert opinion. In this study, we only interviewed patients once and collected available data from the medical records. The European criteria, American-European Consensus Group (AECG) and American College of Rheumatology (ACR) Sjogren's criteria were applied. Majority of the patients were women (F/M was 20/1). The median duration from the first pSS-related symptom to diagnosis was significantly shorter in men (2.5 +/- 2.3 vs 4.3 +/- 5.9 years) (p = 0 < 0.016). When the European, AECG and ACR Sjogren's criteria were applied, 666 patients (79.9%) satisfied at least one of them. In total, 539 patients (64.4%) satisfied the European, 439 (52.6%) satisfied the AECG, and 359 (43%) satisfied the ACR criteria. Among the entire group, 250 patients (29.9%) satisfied all and 168 (20.1%) met none of the criteria. The rates of extraglandular organ involvements were not different between patients who met at least one of the criteria sets and those who met none. There is an urgent need for the modification of the pSS criteria sets to prevent exclusion of patients with extraglandular involvements as the dominant clinical features.
Thrombotic Microangiopathy in Allogeneic Stem Cell Transplantation in Childhood
(Başkent Üniversitesi, 2010-09) Erbey, Fatih; Tanyeli, Atila; Uckan, Duygu; Cetin, Mualla; Yilmaz, Sema; Kuskonmaz, Baris; Bayram, Ibrahim
Objectives: We define the incidence, risk factors, and mortality rates for the occurrence of thrombotic microangiopathy in 50 children who underwent transplants between January 2006 and June 2008 at 2 Turkish pediatric centers. Materials and Methods: The diagnosis of thrombotic microangiopathy was done according to the reports of International Working Group in 2007. Results: Fifty patients (27 male and 23 female; age range, 3 months to 18 years) were included. Patients with malignant and nonmalignant diseases were 13 (26%) and 37 (74%). Myeloablative and nonmyeloablative conditioning regimens were used in 29 (58%) and 21 patients (42%). Bone morrow was used as the source of stem cells in 32 patients (62%) and peripheral blood was used in 18 patients (36%). Thrombotic microangiopathy was seen in 3 of 50 cases (6%). Thrombotic microangiopathy developed in 3 of 18 patients in whom peripheral blood was used as the source of stem cells while none of 32 patients who had bone marrow as the source developed thrombotic microangiopathy (P < .05). Conclusions: Using peripheral blood as a source of stem cells is a risk factor for development of thrombotic microangiopathy.