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DİRESKENELİ, RAFİ HANER

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DİRESKENELİ

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RAFİ HANER

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2023 - 20242
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Author: ALİBAZ ÖNER, FATMA × Subject: Dahili Tıp Bilimleri ×

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    PublicationOpen Access
    Does decision tree analysis predict oral ulcer activity-related factors in patients with Behçet's syndrome?
    (2023-10-01) ÇANDERELİ, ZEHRA ÖZGE; ŞİŞMAN KİTAPÇI, NUR; AKSOY, AYSUN; ŞAHİN, ALİ; ALİBAZ ÖNER, FATMA; İNANÇ, GÜZİDE NEVSUN; DİRESKENELİ, RAFİ HANER; MUMCU, GONCA; ÇANDERELİ Z. Ö., Arslan T., Özdamar Ö., Yay M., Karaçayli Ü., ŞİŞMAN KİTAPÇI N., Adesanya A., AKSOY A., Belem J. M. F. M., Taş M. N., et al.
    OBJECTIVES: The study aimed to identify the interactions among treatment protocols and oral ulcer activity related factors in patients with Behçet\"s syndrome (BS) using the Classification and Regression Tree (CART) algorithm. METHODS: In this cross-sectional study, 979 patients with BS were included from16 centres in Turkey, Jordan, Brazil and the United Kingdom. In the CART algorithm, activities of oral ulcer (active vs. inactive), genital ulcer (active vs. inactive), cutaneous involvement (active vs. inactive), musculoskeletal involvement (active vs. inactive), gender (male vs. female), disease severity (mucocutaneous and musculoskeletal involvement vs. major organ involvement), smoking habits (current smoker vs. non-smoker), tooth brushing habits (irregular vs. regular), were input variables. The treatment protocols regarding immunosuppressive (IS) or non-IS medications were the target variable used to split from parent nodes to purer child nodes in the study. RESULTS: In mucocutaneous and musculoskeletal involvement (n=538), the ratio of IS use was higher in patients with irregular toothbrushing (ITB) habits (27.1%) than in patients with regular toothbrushing (RTB) habits (14.2%) in oral ulcer activity. In major organ involvement (n=441), male patients with ITB habits were more likely treated with IS medications compared to those with RTB habits (91.6% vs. 77.6%, respectively). CONCLUSIONS: Male BS patients on IS who have major organ involvement and oral ulcer activity with mucocutaneous and musculoskeletal involvement have irregular toothbrushing habits. Improved oral hygiene practices should be considered to be an integral part for implementing patient empowerment strategies for BS.
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    PublicationOpen Access
    Frequency and the effects of spondyloarthritis-spectrum disorders on the clinical course and management of Takayasu arteritis: an observational retrospective study
    (2024-01-01) DİRESKENELİ, RAFİ HANER; ALİBAZ ÖNER, FATMA; Abacar K., Kaymaz-Tahra S., Bayındır Ö., İnce B., Kutu M. E., YAZICI A., Ediboğlu E. D., Demirci-Yıldırım T., Ademoğlu Z., Omma A., et al.
    Objectives: Extravascular findings of Takayasu arteritis (TAK) often share features with the spondyloarthritis (SpA) spectrum of disorders. However, the characteristics of this overlap and its effect on the vascular manifestations of TAK are not fully known. Therefore, we aimed to investigate the frequency of SpA-related features in TAK patients. Material and methods: In this observational retrospective study, 350 patients with TAK classified according to ACR 1990 criteria, from 12 tertiary rheumatology clinics, were included and evaluated for the presence of axSpA, IBD, or psoriasis. Demographic, clinical features, angiographic involvement patterns, disease activity, and treatments of TAK patients with or without SpA were analyzed. Results: Mean age was 45.5 ± 13.6 years and mean follow-up period was 76.1 ± 65.9 months. Among 350 patients, 31 (8.8%) had at least one additional disease from the SpA spectrum, 8 had IBD, 8 had psoriasis, and 20 had features of axSpA. In the TAK-SpA group, TAK had significantly earlier disease onset, compared to TAK-without-SpA (p = 0.041). SpA-related symptoms generally preceded TAK symptoms. Biological treatments, mostly for active vasculitis, were higher in the TAK-SpA group (70.9%) compared to TAK-without-SpA (27.9%) (p < 0.001). Vascular involvements were similar in both. Conclusion: Our study confirmed that diseases in the SpA spectrum are not rare in TAK. Vascular symptoms appeared earlier in such patients, and more aggressive therapy with biological agents was required in the TAK-SpA group, suggesting an association between TAK and SpA spectrum. (Table presented.)