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Öğe Analysis of 275 patients with sarcoidosis over a 38 year period; a single-institution experience(W B SAUNDERS CO LTD, 2007) Demirkök, Sevtap Sipahi; Başaranoğlu, Metin; Akıncı, Eylem Deniz; Karayel, TuncerBackground: Sarcoidosis is a systemic granulomatous disease with unknown etiology. Objectives: We evaluated seasonal variation, demographic, clinical and diagnostic features of sarcoidosis in recently diagnosed symptomatic patients in the whole cohort (275 patients) and in the subgroups according to the estimated disease course (subacute course group vs. chronic course group). We also developed a prediction model to predict the course of sarcoidosis using simple clinical and demographic variables. Material and methods: Two hundred and seventy-five patients with sarcoidosis. Measurements and statistics: Roger's test, chi-square, t-test and multiple logistic regression were used. Results: The distribution of cumulative monthly diagnosis was the lowest in November (fall) (p < 0.01). Seasonal pattern was influenced by age and gender. Constitutional symptoms, stages 2 and 3 diseases and the absence of erythema nodosum were highly significant parameters for chronic course. Using these variables, the developed model had a specificity of 93.1 % and its positive predictive value was 89.5%. Progression of the disease was documented 6.4% in subacute group vs. 32.1% in chronic group (p=0.00001). Preventive effect of smoking was more pronounced in females than in mates in our cohort. Conclusions: Further well-designed and large prospective studies are required to better understand the importance of these findings, and to validate the prediction model presented here. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Analysis of 87 Patients With Lofgren's Syndrome and the Pattern of Seasonality of Subacute Sarcoidosis(Wiley, 2006) Demirkök, Sevtap Sipahi; Başaranoğlu, Metin; Derviş, Emine; Bal, Mert; Karayel, TuncerBackground: Sarcoidosis is a multisystem disease of unknown aetiology. The seasonality of sarcoidosis in symptomatic, recently diagnosed patients with Lofgren's syndrome was evaluated to help better understand the possible causative factor(s) in the pathogenesis of sarcoidosis. Methods: Four hundred and ninety-two consecutive patients with sarcoidosis were investigated. The demographic and clinical features, course of the disease, initial diagnostic methods and both the month and age at initial diagnosis for each patient were analysed. Roger's test for cyclic variation was used to determine the significance of any seasonal variation of incidence. Results: Lofgren's syndrome was diagnosed in 87 patients (18%). The diagnosis of sarcoidosis was delayed in 45% of subjects (mean: 11.2 weeks). The distribution of cumulative monthly presentations peaked in May (spring) and was the lowest in January (winter) and November (autumn) (P < 0.001). The seasonal pattern was also influenced by age and gender (P < 0.05). At the onset, arthralgia was present in 46%, cough or dyspnoea in 37%, constitutional symptoms in 32% and skin lesions in 30% of the patients. Conclusions: In this study, there were differences in the amplitude of the seasonal variation by age and by gender. Well-designed prospective studies are required to better understand the importance of the findings we respect to the pathogenesis of the disease.Öğe Case Study on Drug-Related Adverse Effects of Hepatitis C Therapy(Health Communications Inc, 2006) Başaranoğlu, Metin; Çelebi, Selman; Karaaslan, Hayri; Demir, AliThe case of a 46-year-old woman with chronic hepatitis C who was prescribed subcutaneous pegylated interferon once a week and oral ribavirin once a day is presented. Within 24 h after the first injection to her left arm, the patient developed pruritus and erythematous papules at the injection site and painful papules on her hands. After immediate administration of antihistamines, the pruritus and papules remitted. One wk later, after injection in the right arm, skin lesions and pruritus were seen. After the third injection to the abdomen, the patient developed a rash, and after the fourth and fifth injections to other areas of the abdomen, injection-site papules were seen. The patient had no skin reactions for the next 12 mo, with the exception of injection-site papules. Hepatitis C virus RNA was negative after 12 mo of treatment. Clearly, patience is important during hepatitis C therapy in order to avoid unnecessary examinations and to promote successful outcomes.Öğe Prevalence and consultation behavior of self-reported rectal bleeding by face-to-face interview in an Asian community(KARGER, 2008) Başaranoğlu, Metin; Çelebi, Selman; Ataseven, Hüseyin; Rahman, Süheyla; Deveci, S. Erhan; Açık, YaseminBackground and Aim: Although rectal bleeding is a common gastrointestinal symptom, there are very few community-based studies, and all of these studies were conducted in the West. So far the epidemiologic characteristics of rectal bleeding have not been defined in an Asian country. We aimed to characterize self-reported rectal bleeding and its association with functional bowel disorders in Turkey. Factors affecting healthcare-seeking behavior were reviewed as well. Subjects and Methods: In this study, 760 subjects were chosen randomly. Questionnaires were completed by nurses during face-to-face interviews with each participant. Results: Of the 707 (93%) subjects included in this study, 9.5% had functional dyspepsia, 8.6% had irritable bowel syndrome (IBS), 24.5% had functional constipation, and 13.8% had functional abdominal bloating. The prevalence of rectal bleeding in the previous year was 14.7%. The recent onset of rectal bleeding was 2.7%. Rectal bleeding was more common among subjects younger than 45 years. Subjects who had functional constipation or constipation-dominant IBS reported rectal bleeding more frequently than others. The rate of consultation was only 41.3% among the subjects with rectal bleeding. Subjects aged >= 45 years and who had marked bleeding or bleeding more than twice a day or fear of cancer sought healthcare more frequently than others. Conclusion: Rectal bleeding is as common a symptom in Turkey as in Western countries. Advanced age and fear of cancer were independent predictors of consultation behavior in this group.Öğe Seasonal variation of the onset of presentations in stage 1 sarcoidosis(WILEY, 2006) Demirkök, Sevtap Sipahi; Başaranoğlu, Metin; Akbilgiç, OğuzSarcoidosis is a chronic disease with an unknown aetiology. Our aim was to evaluate the pattern of seasonality of stage 1 sarcoidosis subjects who had symptoms by all cases, by age and by both genders. In this study, we used Roger's test for cyclic variation to prove that this seasonal variation was more than chance. Four hundred ninety-two consecutive patients with sarcoidosis who presented different clinical symptoms were included in this retrospective cohort study. According to the chest X-ray examinations, 185 patients had stage 1, while 307 patients in control group had stage 0, 2, 3 and 4 sarcoidosis. The demographic features, presenting clinical features, course of the disease, initial diagnostic methods and both the month and the age at the initial diagnosis for each patient were analysed on chart reviews. Roger's test for cyclic variation was used to determine the significance of any seasonal variation of incidence. Otherwise, t-test was used. The distribution of cumulative monthly presentations for patients with stage 1 peaked in April (108% above the average) and was lowest in October, November and December (48% below the average) (p < 0.001). Seasonality of the control group peaked in May (84% above the average) and was lowest in August (69% below the average) (p < 0.001). The seasonal pattern of subjects within both groups was influenced by some age groups and by both genders (p < 0.05). Some differences in the amplitude of the seasonal variation by age and by both genders increase the possibility of interactions among age, gender and the disease. Further well-designed and prospective studies are required to better understand the importance of our findings and the pathogenesis of the disease.Öğe A Splenic Hydatid Cyst Case Presented With Lumbar Pain(Japan Soc Internal Medicine, 2006) Çelebi, Selman; Başaranoğlu, Metin; Karaaslan, Hayri; Demir, AliA splenic hydatid cyst is a rare clinical entity from among abdominal hydatid cysts, even in endemic countries. Here, a case with lumbar pain due to a giant splenic hydatid cyst is presented. The importance of this case is that the patient presented at the clinic with only lumbar pain. Initial direct abdominal plain radiography showed a giant abdominal calcification in the spleen and further examinations revealed involvement of three organs: spleen, lung, and liver.
