Person: ERGUN, SAFİYE ATLAS TÜLİN
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ERGUN
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SAFİYE ATLAS TÜLİN
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Publication Metadata only Psoriasis and the liver: problems, causes and course(WILEY, 2017) SEÇKİN GENÇOSMANOĞLU, DİLEK; Tula, Elona; Ergun, Tulin; Seckin, Dilek; Ozgen, Zuleyha; Avsar, ErolBackground/ObjectivesPsoriasis patients have a higher risk of liver abnormalities such as non-alcoholic fatty liver disease (NAFLD), drug-induced hepatitis, alcoholic hepatitis and neutrophilic cholangitis, than the general population. Associated liver disease limits therapeutic options and necessitates careful monitoring. The aim of the study was to identify liver problems in psoriasis patients and to investigate the underlying causes as well as their course. MethodsThe files of 518 psoriasis patients were retrospectively reviewed. Among these, 393 patients with relevant laboratory data were analysed for liver enzymes and their relation to the known risk factors for liver disease (obesity, diabetes mellitus, alcohol consumption, hepatotoxic medications, dyslipidemia, psoriatic arthritis and infectious hepatitis). ResultsAmong 393 patients, 24% and 0.8% developed liver enzyme abnormalities and cirrhosis, respectively. The most common factors associated with pathological liver enzymes were drugs (57%) and NAFLD (22%). Other rare causes were alcoholic hepatitis, viral hepatitis, neutrophilic cholangitis, autoimmune hepatitis and toxic hepatitis due to herbal therapy. Drug-induced liver enzyme abnormalities were reversible whereas in patients with NAFLD transaminases tended to fluctuate. One patient with herbal medicine-related cirrhosis died of sepsis. ConclusionLiver enzyme abnormalities are common in psoriasis patients and are mostly associated with drugs and NAFLD. Although most cases can be managed by avoiding hepatotoxic medications and close follow up, severe consequences like cirrhosis may develop.Publication Open Access Nodular mucinosis of the breast: A rare entity(MARMARA UNIV, FAC MEDICINE, 2018-06-05) SALMAN, ANDAÇ; Salman, Andac; Cinel, Leyla; Turkoz, Huseyin Kemal; Akbas, Gamze; Ergun, TulinNodular mucinosis of the breast (NMB) is an uncommon disease involving the nipple-areolar region. It usually presents with asymptomatic, subcutaneous masses with indolent growth in women. Here, we report a 43-year-old man presented with a subcutaneous growth on the left nipple. Histopathological examination confirmed the diagnosis of NMB. We report our patient in order to point out this rare disease and think that the recognition of this entity is important for both clinicians and pathologists.Publication Open Access Use of therapist rotation model for eye movement desensitization and reprocessing (EMDR) in a patient with atopic dermatitis(2022-01-01) YANARTAŞ, ÖMER; BUDAK, CANSU; TOPÇUOĞLU, VOLKAN; ERGUN, SAFİYE ATLAS TÜLİN; Yasar A. B., YANARTAŞ Ö., Cam C. S., BUDAK C., Topcuoglu V., ERGUN S. A. T.Atopic dermatitis (AD) is described by lichenification, pruritus and excoriation of the skin. Up to 70% of patients may experience stressful life events before onset of AD. In this study, we aimed to present use of Eye Movement Desensitization and Reprocessing (EMDR) for psychotherapy of an AD patient. Our second goal is to demonstrate the effect of therapist rotation model (TRM) for this group of patients. We used EMDR and TRM based on Van Minnen\"s model. We compared test results including depression, anxiety, and AD disease severity before and after EMDR sessions. Our patient\"s depression and anxiety scores decreased after EMDR therapy. EMDR may be useful for psychogenic component and itching complaint of AD. TRM may be rational, effective and tolerable for these patients.Publication Open Access Oligoclonal T cell expansions in patients with Behçet's disease(2001-12-24) DİRESKENELİ, RAFİ HANER; ERGUN, SAFİYE ATLAS TÜLİN; Direskeneli, H; Eksioglu-Demiralp, E; Kibaroglu, A; Yavuz, S; Ergun, T; Akoglu, TBehçet's disease (BD) is a multisystem disorder with oral and genital ulcers, mucocutaneous, ocular, joint, vascular and central nervous system involvement. In this study, the peripheral T cell repertoire was analysed in patients with BD with MoAbs against T cell receptor (TCR) Vβ gene products in CD4+ and CD8+ T cell compartments, and these were compared with rheumatoid arthritis (RA) patients and healthy controls (HC). In the CD4+ T cell compartment, oligoclonal TCR Vβ expression was observed in 56% of BD (10/18), 71% of RA (5/7) patients and 21% (3/14) of HC. In the CD8+ T cell group 50% of BD (9/18), 57% of RA patients and 28% of HC (4/14) had an oligoclonal TCR repertoire. An increase of TCR Vβ5.1 subset was observed in five BD patients among CD8+ T cells. Other elevations of TCR Vβ subsets were heterogeneously distributed with one to three different Vβ subsets. Our results suggest an antigen-driven oligoclonal increase of T cells in BD. There was no overall increase in any Vβ group to suggest a superantigen effect. Analysis of the responsible antigens causing the increase in T cell subsets may give insights into the aetiopathogenesis of BD and immunomodulation of these T cells may lead to new treatments.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 Open Access Pseudoporphyria in a Peritoneal Dialysis Patient(MULTIMED INC, 2015-03) VELİOĞLU, ARZU; Velioglu, Arzu; Ergun, Tulin; Ozener, CetinPublication Metadata only Autoimmune progesterone dermatitis mimicking fixed drug eruption(2017) SALMAN, ANDAÇ; Salman, Andac; Ergun, TulinPublication 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 Open Access Common femoral vein thickness measurement as a diagnostic test in incomplete behcet's disease(2022-06-01) ALİBAZ ÖNER, FATMA; ERGELEN, RABİA; ERGUN, SAFİYE ATLAS TÜLİN; DİRESKENELİ, RAFİ HANER; Alibaz-Oner F., Ergelen R., Temiz F., Agackiran S. K. , Soydemir E., Ergun T., DİRESKENELİ R. H.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.