Person: DİRESKENELİ, RAFİ HANER
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
DİRESKENELİ
First Name
RAFİ HANER
Name
26 results
Search Results
Now showing 1 - 10 of 26
Publication Metadata only Femoral vein wall thickness measurement: A new diagnostic tool for Behcet's disease(OXFORD UNIV PRESS, 2021) ALİBAZ ÖNER, FATMA; Alibaz-Oner, Fatma; Ergelen, Rabia; Yildiz, Yasin; Aldag, Mustafa; Yazici, Ayten; Cefle, Ayse; Koc, Ertan; Esen, Bahar Artim; Mumcu, Gonca; Ergun, Tulin; Direskeneli, HanerObjectives. Diagnosing Behcet's disease (BD) is a challenge, especially in countries with a low prevalence. Recently, venous wall thickness (VWT) in lower extremities has been shown to be increased in BD patients. In this study, we aimed to investigate the diagnostic performance of common femoral vein (CFV) thickness measurement in BD and whether it can be used as a diagnostic tool. Methods.. Patients with BD (n=152), ankylosing spondylitis (n=27), systemic vasculitides (n=23), venous insufficiency (n=29), antiphospholipid syndrome (APS; n=43), deep vein thrombosis due to non-inflammatory causes (n=25) and healthy controls (n=51) were included in the study. Bilateral CFV thickness was measured with ultrasonography by a radiologist blinded to cases. Results. Bilateral CFV thickness was significantly increased in BD compared with all control groups (P < 0.001 for all). The area under the receiver operating characteristic curve for bilateral CFV thicknesses in all comparator groups was >0.95 for the cut-off value (0.5 mm). This cut-off value also performed well against all control groups with sensitivity rates >90%. The specificity rate was also >80% in all comparator groups except APS (positive predictive value: 79.2-76.5%, negative predictive value: 92-91.8% for right and left CFV, respectively). Conclusion. Increased CFV thickness is a distinctive feature of BD and is rarely present in healthy and diseased controls, except APS. Our results suggest that CFV thickness measurement with ultrasonography, a non-invasive radiological modality, can be a diagnostic tool for BD with sensitivity and the specificity rates higher than 80% for the cut-off value >= 0.5mm.Publication Metadata only Behcet's disease in patients with chronic myelogenous leukemia: Possible role of interferon-alpha treatment in the occurrence of Behcet's symptoms(SPRINGER VERLAG, 1997) DİRESKENELİ, RAFİ HANER; BudakAlpdogan, T; Demircay, Z; Alpdogan, O; Direskeneli, H; Ergun, T; Bayik, M; Akoglu, TTwo patients with chronic myelogenous leukemia (CML) who developed characteristic features of Behcet's disease (ED) during alpha-interferon (IFN-alpha) treatment and another patient who had a diagnosis of ED preceding CML are presented. In the first two patients, features of ED appeared 6 months after the initiation of IFN-alpha treatment; they included recurrent oral aphthae, genital ulceration, arthritis, folliculitis, and a positive skin pathergy test. The third patient, however, had a diagnosis of Behcet's disease 4 years before diagnosis of Philadelphia-positive CML. We prospectively examined the skin pathergy reaction in a group of patients with CML, multiple myeloma, and hairy cell leukemia both before and after IFN-alpha treatment and found two additional patients with CML who developed a positive skin pathergy test following IFN-alpha treatment.Publication Metadata only Thalidomide has both anti-inflammatory and regulatory effects in Behcet's disease(SPRINGER, 2008) DİRESKENELİ, RAFİ HANER; Direskeneli, H.; Ergun, T.; Yavuz, S.; Hamuryudan, V.; Eksioglu-Demiralp, E.Thalidomide is shown to be an effective treatment for mucocutaneous symptoms of Behcet's disease (BD). In this study, the effects of thalidomide on peripheral blood mononuclear cells were investigated ex vivo. In an open prospective study, ten patients were given 200 mg/day thalidomide for 12 weeks and cluster of differentiation 4 (CD4), CD8, CD11a, CD11b, CD16, CD18, CD28, CD44, CD45RO, CD45RA, CD56, CD120a and gamma delta+ T cells were analysed with flow cytometry at 0, 3, 7, 30 and 90 days. Two patients were excluded from the analysis for attacks of uveitis within the first 2 weeks. At day 7, tumour necrosis factor-alpha (TNF-alpha) receptor+ (CD120a; 12% vs 5%), CD8/CD11b+ (12% vs 6%) and CD16/CD56+ (16% vs 9%) cells decreased in BD patients compared to day 0. On the other hand, CD4+CD45RO+ T cells (24% vs 34%) at day 30 and gamma delta+ T cells (11% vs 21%) at day 90 increased after treatment. These results suggest that thalidomide tends to decrease TNF-alpha receptor levels, CD8/CD11b+ T cells and natural killer cells in early treatment and increases CD4+CD45RO+ memory T and gamma delta+ T cells later in BD.Publication Metadata only Oral health is a mediator for disease severity in patients with Behcet's disease: A multiple mediation analysis study(WILEY, 2019) AKSOY, AYSUN; Yay, Meral; Celik, Zulal; Aksoy, Aysun; Alibaz-Oner, Fatma; Inanc, Nevsun; Ergun, Tulin; Direskeneli, Haner; Mumcu, GoncaObjectivesThe aim of the study was to examine whether oral health as an infection focus could mediate disease course in patients with Behcet's disease (BD). MethodsIn the study, oral health of 194 BD patients was examined at baseline and follow-up periods. The reasons for last dental visits were recorded as tooth extraction or regular control visits/planned treatments at the end of follow-up period. The Behcet's disease severity score was calculated with higher scores indicating a more severe course. Mediation analysis was carried out to assess the effects of oral health on disease severity score at follow-up period in the study. ResultsDental and periodontal indices were found to be higher at follow-up visit compared to those of baseline (P<0.05). Disease severity score was found to be higher in males (5.32.4) compared to females (4.4 +/- 2.5) in the whole group (P=0.005). Moreover, patients having tooth extraction at their last dental visit and patients with dental caries had a more severe disease course (5.4 +/- 2.4; 5.5 +/- 2.5) compared to others (4.2 +/- 2.3; 4.4 +/- 2.4; P<0.0001). In multiple mediation analysis, disease severity score was a dependent variable and was directly mediated by male gender (B=-0.8822, P=0.0145) and indirectly mediated through the presence of dental caries (B=0.9509 P=0.0110) and need of tooth extraction (B=0.8758, P=0.0128). ConclusionBoth presence of dental caries and need of tooth extraction were observed to be effective mediators for a more severe disease course in BD. Therefore, better oral health should be aimed to eliminate microbial factors, which are a part of pathogenic processes.Publication Metadata only Elevated serum chemokine levels in Behcet's disease with uveitis(SPRINGER-VERLAG, 2003) DİRESKENELİ, RAFİ HANER; Bozkurt, N; Kazokoglu, H; Yavuz, S; Bavbek, T; Direskeneli, HPublication Metadata only PTPN22 gene polymorphism in Behcet's disease(WILEY, 2007) DİRESKENELİ, RAFİ HANER; Sahin, N.; Bicakcigil, M.; Atagunduz, P.; Direskeneli, H.; Saruhan-Direskeneli, G.A functional single nucleotide polymorphism (SNP) of PTPN22 gene encoding the protein tyrosine phosphatase has been reported to be associated with autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus and type I diabetes. PTPN22 R620W polymorphism has a wide variation of allelic frequencies among different populations. This polymorphism is investigated in Turkish patients with Behcet's disease (BD), a systemic vasculitis with immune activation. DNA samples from 134 patients with BD and 177 healthy controls are genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism method for the SNP (rs2476601, A/G) of PTPN22 gene. Polymorphic region was amplified by PCR and digested with XcmI enzyme. The frequency of heterozygous genotype (AG) was 5.1% (9/177) in control group, whereas polymorphic allele was not present in the whole BD group (P = 0.012, OR 0.65, 95% confidence interval 0.0-1.1). Both the lower prevalence in the general population and the absence in BD show the limited role of PTPN22 polymorphism in the pathogenesis of autoimmunity in Turkey.Publication Metadata only Clinical and immunological effects of azithromycin in Behcet's disease(WILEY, 2005) MUMCU, GONCA; Mumcu, G; Ergun, T; Elbir, Y; Eksioglu-Demiralp, E; Yavuz, S; Atalay, T; Direskeneli, HBACKGROUND: The aim of this study was to evaluate the effects of azithromycin on mucocutaneous manifestations, oral health and immune response in Behcet's disease (BD). METHODS: Eight BD patients with active mucocutaneous symptoms were treated with azithromycin for 4 weeks. Oral health, clinical manifestations and in vitro interleukin (IL)-12, interferon (IFN)-gamma, IL-10 and monocyte chemotactic protein (MCP)-1 responses were evaluated before and after treatment. RESULTS: The number of folliculitic lesions, healing time of oral ulcers and scores of plaque indexes (PLIs) were lower after azithromycin treatment (P < 0.05). Scores of PLIs correlated positively with the healing time of oral ulcers (P = 0.02). Although a trend towards increased stimulated IL-10 responses with azithromycin was observed, no statistically significant difference was found. Stimulated and unstimulated MCP-1, IFN-gamma and IL-12 responses were similar before and after treatment (P > 0.05). CONCLUSION: Azithromycin was observed to be effective in decreasing folliculitic lesions and fastening the healing time of oral ulcers in BD.Publication Metadata only Differential expression of toll-like receptor 6 on granulocytes and monocytes implicates the role of microorganisms in Behcet's disease etiopathogenesis(SPRINGER, 2008) DİRESKENELİ, RAFİ HANER; Yavuz, Sule; Elbir, Yesim; Tulunay, Aysin; Eksioglu-Demiralp, Emel; Direskeneli, HanerThe objective of this study was to investigate the expressions of toll-like receptors on neutrophils and monocytes in Behcet's disease (BD). Forty-two patients with BD were included in the study. Baseline and stimulated cells with heat shock protein-60 (HSP-60), lipopolysaccharide (LPS) and crude extract of Streptococcus sanguis (SS) were analyzed for toll-like receptor-1, -2, -4 and -6 expressions using flow cytometer. Results were confirmed using semi-quantitative PCR technique. The mean frequency of TLR-6 expressing granulocytes in BD patients was significantly lower than in controls (4.2 +/- 0.6 vs. 9.2 +/- 0.6 and 8.0 +/- 1.4, BD vs. rheumatoid arthritis (RA) and healthy control (HC); P < 0.05). TLR-6 expressing granulocyte population was enhanced after stimulation with HSP-60 and SS (20 +/- 0.5 and 12.8 +/- 0.6, respectively). Decreased TLR-2 expression was noted in monocytes of BD patients after stimulation with HSP-60 and LPS (71.0 +/- 0.5 and 73.0 +/- 0.5; P < 0.02, for both antigens). Functional abnormalities of these receptors or different activation cascades by different microorganisms are associated with disease pathogenesis in Behcet's disease.Publication Metadata only NALP3 Q705K Gene Polymorphism Frequency in Behcet's Disease Patients in Turkey(TURKISH SOC IMMUNOLOGY, 2016) DİRESKENELİ, RAFİ HANER; Yilmaz, Fergun; Ergun, Tulin; Bicakcigil, Muge; Sahin, Nilufer; Direskeneli, Haner; Direskeneli, GuherObjectives: This study aims to investigate Q705K polymorphism in NALP3 gene in Behcet's disease (BD). Patients and methods: This case-control study included 180 BD patients (92 males, 88 females; mean age 36.6 +/- 11.3 years; range 21 to 56 years) and 168 healthy controls (92 males, 76 females; mean age 34.9 +/- 13.2 years; range 22 to 55 years). Cellular deoxyribonucleic acid was isolated from peripheral blood using standard procedures. Patients and the controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism method for NALP3 Q705K gene polymorphism. Polymorphic region was amplified by polymerase chain reaction and digested with BsgI enzyme. Genotype frequencies between the groups were compared by K2-square, Fisher's exact, and chi-square tests. Results: All BD patients had oral ulcers. Of the patient group, genital ulcers were present in 78%, folliculitis in 66.3%, vascular involvement in 31.2%, uveitis in 66.1%, and neurological manifestations in 7.5%. Of the control group, homozygous genotype was present in 1.2% (n=2) and heterozygous genotype in 11.3% (n=19), whereas of the patient group, homozygous genotype was present in 1.1% (n=2) and heterozygous genotype in 8.3% (n=16), without a statistically significant difference between the groups. Comparison of allele frequencies between two groups did not reveal a statistically significant difference (5.5% and 6.8%, respectively). Subgroup analysis according to ocular, mucocutaneous, vascular, articular, and neurologic involvement also revealed no statistical differences. Conclusion: According to our findings, distribution of NALP3 Q705K gene polymorphism shows no significant difference between patient and control groups in terms of disease susceptibility and system involvements in BD in Turkey.Publication Metadata only Does illness perception associate with disease symptoms in Behcet's disease?(SPRINGER-VERLAG ITALIA SRL, 2019) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Yagar, Fedayi; Alibaz-Oner, Fatma; Inanc, Nevsun; Direskeneli, Haner; Ergun, TulinThis study aims to assess the relationship between illness perception and disease course and symptoms in Behcet disease (BD). One hundred ten consecutive BD patients (F/M 50/60, mean age 38.5 +/- 9.88years) and 57 patients with Psoriasis as a disease control group (F/M 28/29, mean age 48.12 +/- 15.52) are included in this cross-sectional study. Illness perception is evaluated using a revised version of the Illness Perception Questionnaire (IPQ-R). In IPQ-R, the identity score reflecting the number of symptoms is higher in BD patients with musculoskeletal involvement than the others (6.77 +/- 2.91 vs. 5.08 +/- 3.3, respectively, p=0.007). The consequences score for musculoskeletal involvement (19.52 +/- 7.03) and timeline (acute/chronic) score for eye involvement (26.67 +/- 4.32) are also higher compared to patients without them (16.37 +/- 5.82 and 22.09 +/- 8.68) (p=0.011 and p=0.038), reflecting negative beliefs about the illness. The score of psychological attribution is higher in patients with psoriasis than BD (p=0.039), whereas the other subgroup scores are lower in patients with psoriasis compared to those of BD (p<0.05). This study provides a patient's perspective in the disease management process of BD using the IPQ-R questionnaire. A patient's own personal beliefs and emotional responses to their symptoms might affect the outcome measures, especially with musculoskeletal symptoms and eye involvement in BD. However, psychological attribution is found to be a prominent issue in psoriasis.
- «
- 1 (current)
- 2
- 3
- »