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Öğe Acute-phase response after radioiodine treatment in hyperthyroidism(LIPPINCOTT WILLIAMS & WILKINS, 2007) Sari, Oktay; Tunc, Recep; Kisakol, Gurcan; Dostbil, Zeki; Serdengecti, MustafaPurpose: Acute-phase response is an innate body defense seen during acute illnesses and involving the increased production of certain blood proteins termed acute-phase proteins. There are limited data about acute-phase response after radioiodine therapy. This study is designed to determine whether acute-phase response changes after radioiodine therapy. Materials and Methods: Twenty-six hyperthyroid patients were included in this study, aged between 25 and 69 years (mean, 47.7 +/- 10.5, 18 females and 8 males). All patients were given radioiodine therapy (8-15 mCi). Leukocyte, hemoglobin, platelet, erythrocyte sedimentation rate, and C-reactive protein (CRP) were measured before radioiodine therapy and after 24 hours, 72 hours, 1 week, 1 month, and 3 months. Free T3, free T4, TSH, thyroglobulin (Tg), antithyroid antibody, and antimicrosomal antibody (AMA) were measured before radioiodine therapy and after 1 and 3 months. Results: Mean CRP levels were 3.74, 3.90, 4.29, 5.71, 3.85, and 5.41 mg/L, respectively. There was a significant difference between the initial and the first-week results. Mean Tg levels were 68.15, 143.90, and 77.00 ng/mL, respectively, with a significant difference between the initial and the first-month and third-month results. Mean AMA levels were 158.80, 178.85, and 636.25 IU/mL, respectively, demonstrating a significant difference between the initial and the third-month and first- and third-month results. Conclusion: We have shown that radioiodine therapy causes an increase in CRP, Tg, and AMA levels. We conclude that radioiodine treatment is a cause of the increase in the CRP, Tg, and AMA levels in hyperthyroid patients.Öğe Apremilast for Behcet's Syndrome - A Phase 2, Placebo-Controlled Study(MASSACHUSETTS MEDICAL SOC, 2015) Hatemi, Gulen; Melikoglu, Melike; Tunc, Recep; Korkmaz, Cengiz; Ozturk, Banu Turgut; Mat, Cem; Merkel, Peter A.BACKGROUND Oral ulcers, the hallmark of Behcet's syndrome, can be resistant to conventional treatment; therefore, alternative agents are needed. Apremilast is an oral phosphodiesterase-4 inhibitor that modulates several inflammatory pathways. METHODS We conducted a phase 2, multicenter, placebo-controlled study in which 111 patients with Behcet's syndrome who had two or more oral ulcers were randomly assigned to receive 30 mg of apremilast twice daily or placebo for 12 weeks. This regimen was followed by a 12-week extension phase in which the placebo group was switched to apremilast and a 28-day post-treatment observational follow-up phase. The patients and clinicians were unaware of the study assignments throughout the trial. The primary end point was the number of oral ulcers at week 12. Secondary outcomes included pain from these ulcers (measured on a 100-mm visual-analogue scale, with higher scores indicating worse pain), the number of genital ulcers, overall disease activity, and quality of life. RESULTS The mean (+/- SD) number of oral ulcers per patient at week 12 was significantly lower in the apremilast group than in the placebo group (0.5 +/- 1.0 vs. 2.1 +/- 2.6) (P<0.001). The mean decline in pain from oral ulcers from baseline to week 12 was greater with apremilast than with placebo (-44.7 +/- 24.3 mm vs. -16.0 +/- 32.5 mm) (P<0.001). Nausea, vomiting, and diarrhea were more common in the apremilast group (with 22, 9, and 12 incidents, respectively, among 55 patients) than in the placebo group (with 10, 1, and 2 incidents, respectively, among 56 patients), findings that were similar to those in previous studies of apremilast. There were two serious adverse events in patients receiving apremilast. CONCLUSIONS Apremilast was effective in treating oral ulcers, which are the cardinal manifestation of Behcet's syndrome. This preliminary study was neither large enough nor long enough to assess long-term efficacy, the effect on other manifestations of Behcet's syndrome, or the risk of uncommon serious adverse events.Öğe Apremilast For The Treatment Of Behcet's Syndrome: A Phase II Randomized, Placebo-Controlled, Double-Blind Study(WILEY-BLACKWELL, 2013) Hatemi, Gulen; Melikoglu, Melike; Tunc, Recep; Korkmaz, Cengiz; Ozturk, Banu Turgut; Mat, Cem; Merkel, Peter A.[Abstract not Available]Öğe Effect of Apremilast on Quality of Life and Physical Function in Patients with Behcet's Syndrome.(WILEY-BLACKWELL, 2014) Hatemi, Gulen; Melikoglu, Melike; Tunc, Recep; Korkmaz, Cengiz; Ozturk, Banu Turgut; Mat, Cem; Merkel, Peter A.[Abstract not Available]Öğe HLA-B27 Subtypes ın Turkish Patients with Ankylosing Spondylitis and Healthy Controls(Springer Heidelberg, 2012) Acar, Muradiye; Cora, Tulin; Tunc, Recep; Acar, HasanThe aim of this study was to determine human leukocyte antigen (HLA)-B27 subtypes frequency in ankylosing spondylitis (AS) and related spondyloartropathy (SpA) patients. Therefore, we investigated the differences in HLA-B27 subtypes between HLA-B27-positive patients and controls. Sixty six patients were included in this study (51 AS and 15 SpA). Thirty-five individuals were diagnosed with leukemia or chronic renal failure, and their donors without any rheumatological problem (no SpA history) were selected as the control group. HLA-B27 subtyping was performed by PCR-SSP (polymerase chain reaction with sequence-specific primer) method in serologically HLA-B27-positive 46 AS patients, 9 SpA patients and control group. When the frequency of HLA-B27 was 4.5% in Turkish population, this frequency was 90.2% in AS patients. Four different HLA-B27 subtypes found in AS patients were B*2705 (65.2%), B*2702 (26.1%), B*2704 (6.5%) and B*2707 (2.2%). In SpA patients, B*2705 and B*2702 found in equal frequency. Five B27 alleles were identified in our control group: B*2705 (54.3%), B*2702 (31.4) %, B*2703 (2.9%), B*2704 (2.9%) and B*2702/B*2705 (8.5%). Both in the patient group and in the control group, we also observed B*2705 as most frequent allele, and B*2702 was second common allele. Our results show that the frequency of HLA-B27 subtypes is not significantly different between patients and controls (P > 0.10).Öğe Intraobserver and interobserver agreements of leg circumference measurements by tape measure based on 3 reference points(SAGE PUBLICATIONS INC, 2007) Tunc, Recep; Caglayan-Tunc, Aygul; Kisakol, Gurcan; Unler, Gulhan Kanat; Hidayetoglu, Taha; Yazici, HasanThe objective of this study was to evaluate the intraobserver and interobserver agreements in tape measurements of the ankle and calf circumference with due emphasis on the 3 main reference points, the patella, the tibial tuberosity, and the medial malleolus. The leg circumference at 2 locations was measured in 66 patients in the mornings of 2 consecutive days by 6 observers. Finally, a blinded couple measured leg circumferences at a line created on calves with a ballpoint pen of 68 outpatients to calculate interobserver agreement for lined regions. Leg circumference measurement was accepted as correct when the difference was less than 0.6 cm in 2 occasions. Intraobserver and interobserver agreements were calculated as the percentage of correct measurements. Chi-square test was used to compare intraobserver and interobserver agreements for each reference point. At the calf region, intraobserver and interobserver agreements based on the tibial tuberosity (88% and 81 %) were better than those of the patella (65% and 57%) and the medial malleolus (73% and 65%). On the other hand, at above the ankle region, the agreements (79% and 62%) were also better than those of the patella (60% and 43%) and nearly the same as those of the medial malleolus (86% and 65%). Finally, interobserver agreement of the measurements at the created line with ballpoint pen (96%) was better when compared to those of the tibial tuberosity (81%), the patella (57%), and medial malleolus (65%) (p = 0.005, p < 0.001, and p < 0.001, respectively). The results of this study suggest that the tibial tuberosity as a reference point for leg circumference measurement has better intraobserver and interobserver agreements than those of the patella and the medial malleoli.Öğe Partially thrombosed multiple pulmonary artery aneurysm secondary to Behcet disease(HINDAWI LTD, 2015) Guler, Ibrahim; Odev, Kemal; Tunc, Recep[Abstract not Available]Öğe Remitting Seronegative Symmetrical Synovitis With Pitting Edema in a Patient With Kaposi Sarcoma(LIPPINCOTT WILLIAMS & WILKINS, 2008) Oezdemir, Mustafa; Engin, Burhan; Tunc, Recep; Mevlitoglu, Inci[Abstract not Available]Öğe Systemic onset juvenile rheumatoid arthritis presenting with absence of B lymphocytes(SPRINGER, 2007) Artac, Hasibe; Alp, Hayrullah; Keles, Sevgi; Reisli, Ismail; Tunc, RecepJuvenile rheumatoid arthritis (JRA) is a complex disease involving the interactions of several cell populations with different mediators. Herein, we report a five-year-old girl with systemic-onset JRA. At admission, peripheral blood flowcytometric analysis showed the percentages of CD19(+)and CD20(+) stop B cells were < 1%. These values returned to normal on the tenth day of steroid treatment. This is the first report of JRA presented with absence of B lymphocytes in the literature and suggested that lymphocytes subset analysis could change with treatment in patients with JRA. Different clinical signs and symptoms reflecting aspects of JRA are critical for the etiology of the disease and to identify new strategies for treatment.
