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Öğe Behçet hastalığı ile takipli hastalarda obstetrik süreçlerin retrospektif değerlendirmesi(Galenos Yayınevi, 2023) Deniz, Rabia; Deniz, Ferdanur; Kalem, Gizem Şirin; Özgür, Duygu Sevinç; Akkuzu, Gamze; Karaalioğlu, Bilgin; Yıldırım, Fatih; İnce, Burak; Kalkan, Kübra; Kalkan, Kübra; Bes, CemalAmaç: Behçet hastalığı (BH), her iki cinsiyeti de etkileyen ve genellikle üreme çağında tanı konulan multisistemik bir vaskülittir. Bu çalışmada, BH ile gebelik arasındaki ilişkiyi hem maternal hem de fetal açıdan araştırmayı amaçladık. Yöntem: Bu retrospektif, tek merkezli, tanımlayıcı çalışmada 18 Behçet hastasının toplam 61 gebeliği incelendi. Klinik ve demografik veriler, hasta yaşı, hastalık öyküsü, obstetrik öykü, gebelik sonucu ve hem maternal hem de fetal komplikasyonlara ilişkin kayıtlardan elde edildi. Hatırlama yanlılığını önlemek için, her hastanın yalnızca son gebeliği, hastalık aktivitesi ve gebelik sırasında ilaç kullanımı veya revizyonu açısından değerlendirildi. Bulgular: Hastaların tanı anındaki ortanca yaşı 25 ve ilk gebelik yaşı 24,5 idi. Gebelikte ortanca BH süresi 3,5 yıldı. Sadece bir hastanın gebelik için in vitro fertilizasyon desteği gerekti. Tüm hastalar son gebelikten önce remisyondaydı. On dört (%77,8) hastada gebelikte herhangi bir semptom görülmezken, geri kalan 3 hastada mukokutanöz ve 1 hastada vasküler aktivite mevcuttu. Canlı doğum oranı %74,1, abortus %20,7, preterm doğum %11,6, preeklampsi %5,6 olup, doğumsal fetal anomali izlenmedi. Sonuç: Gebelikte vasküler komplikasyonlar dışında majör organ tutulumu tanımlanmadı. Sağlıklı gebeliklere kıyasla daha yüksek abortus oranları gözlemlendi. Obstetrik morbidite ve fetal sonuçlarda BH ilişkili olumsuzluk görülmedi. BH gebelik başlangıcı için bir kontrendikasyon olmayıp, gebelik öncesi hastalık aktivitesinin kontrolü, potansiyel teratojenik ajanların revizyonu ve olası komplikasyonlar açısından hastaların sık takibi riskleri en aza indirmek için önemlidir.Öğe Evaluating of atherosclerosis in rheumatoid arthritis patients with carotid intima media thickness and lipoprotein phospholipase A2 activity(BMJ Publishing Group, 2014) Bes, Cemal; Gürel, Selma; Buğdaycı, Güler; Dikbaş, Oğuz; Soy, Mehmet[Abstract Not Available]Öğe Hepatosplenomegaly and pernicious anaemia(Journal of Clinical and Diagnostic Research, 2014) Ulaş, Turgay; Yi?it Karakaş, Emel; Bes, Cemal; Borlu, Fatih; Büyükhatipo?lu, HakanSir,Pernicious anaemia (PA) is the end stage of atrophic gastritiswhich results in the loss of parietal cells in the fundus and bodyof the stomach. Loss of parietal cells is associated with the failureof intrinsic factor production and results in vitamin B12 deficiencyand megaloblastic anaemia. Only two cases of splenomegalycoexisting with PA have been reported, but both splenomegaly andhepatomegaly has not been reported yet [1,2]. In this report, weaimed to describe a patient with hepatosplenomegaly due to PA.To the best of our knowledge this is the first documented case ofhepatosplenomegaly due to PA and totally resolved by vitamin B12therapy.Öğe Is chills an independent predictor factor for familial mediterranean fever severity score?(BMJ Publishing Group, 2014) Bes, Cemal; Çağatay, Yonca; Ulaş, Turgay; Soy, Mehmet[Abstract Not Available]Öğe Retrospective evaluation of obstetric processes in patients with familial mediterranean fever's disease: the three years experience of a tertiary rheumatology clinic(2024) Deniz, Rabia; Deniz, Ferdanur; Ekmen, Şevket Ali; Sevinç Özgür, Duygu; Akkuzu, Gamze; Karaalioğlu, Bilgin; Bes, CemalObjectives: Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disease affecting both genders in reproductive age. In this study, we aimed to investigate the relation between FMF and pregnancy on both maternal and fetal aspects. Material and methods: In this retrospective, single-center, descriptive study we analysed total of 95 pregnancies of 40 FMF patients. Clinical and demographic data were obtained from patients’ records. To prevent recall bias, only the last pregnancy of each patient was evaluated for disease activity and use or revision of medications during pregnancy. Results: The median age of the patients at diagnosis was 22 and the first pregnancy age was 26 years. The median duration of FMF at last pregnancy was 8 (0–23) years. Eight (20%) patients had at least 1 pregnancy via assisted reproductive techniques (IVF), while 34 (85%) patients had at least 1 spontaneous pregnancy. While 32 patients were in remission (80%) before pregnancy, 8 were clinically active (20%). Improvement in clinical course and attack frequency during pregnancy was observed in 23 patients (57.5%), stable course in 10 (25.0%), and worsening in 7 (17.5%). The rate of live birth was 70.0%, abortus was 28.9%, preterm labor was 8.1%, pre-eclampsia was 5.0%, and only 1 achondroplasia as congenital fetal abnormality was observed. Conclusion: FMF did not constitute a contraindication for pregnancy. The most important obstetric problems, complications, and negative fetal outcomes in the course of pregnancy are increased IVF requirement, abortion, and cesarean rates. There is no increase in the risk of congenital malformations due to FMF itself or use of colchicine.Öğe Tocilizumab treatment in severe COVID-19: A multicenter retrospective study with matched controls(Springer Heidelberg, 2022) Mert, Ali; Vahaboğlu, Haluk; Arslan, Ferhat; Batirel, Ayşe; Saraçoğlu, Kemal Tolga; Baştuğ, Aliye; Çağatay, Atahan; Irmak, İlim; Telli Dizman, Gülçin; Ertenli, İhsan; Altunal, Lütfiye Nilsun; Ertürk Şengel, Buket; Bayram, Mehmet; Omma, Ahmet; Amikishiyev, Shirkhan; Aypak, Adalet; Bes, Cemal; Bölükçü, Sibel; İçten, Sacit; Topeli, Arzu; Bektaş, Murat; Arslan, Birsen Yiğit; Öztürk, Sinan; Çomoğlu, Şenol; Aydın, Selda; Küçükşahin, Orhan; İçaçan, Ozan Cemal; İnce, Burak; Aghamuradov, Sarvan; Yalçın Mutlu, Melek; Şimşek, Funda; Emre, Salih; Üstün, Cemal; Ergen, Pınar; Aydın, Özlem; Koç, Meliha Meriç; Sevindik, Ömür Gökmen; Odabaşı, Zekaver; Korten, Volkan; Bodur, Hürrem; Güner, Rahmet; Ünal, Serhat; Koçak, Mehmet; Gül, AhmetCoronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case–control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching.Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion–exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels.
