Person: MUMCU, GONCA
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MUMCU
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GONCA
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Publication Open Access Presence of Fibromyalgia in Patients with Takayasu's Arteritis(JAPAN SOC INTERNAL MEDICINE, 2013) ALİBAZ ÖNER, FATMA; Alibaz-Oner, Fatma; Can, Meryem; Ilhan, Birkan; Polat, Ozge; Mumcu, Gonca; Direskeneli, HanerObjective Data regarding the frequency of fibromyalgia (FM) in patients with Takayasu's arteritis (TAK) have not been previously reported. We aimed to investigate the frequency of FM in TAK, defined according to the new 2010 ACR Preliminary Diagnostic Criteria for Fibromyalgia. The association between the ACR-1990 and 2010 FM criteria and the effects of patient-reported outcomes (PROs) on FM were also analyzed. Methods We studied 55 patients (age: 42,30 +/- 12,37 years, F/M: 49/6) with TAK and 40 age-and sex-matched controls (age: 41 +/- 10.84 years, F/M: 31/9). All patients were examined for FM tender points by two observers and asked to complete the ACR 2010 FM questionnaire for FM. The SF-36, the Health Assessment Questionnaire (HAQ) and hospital anxiety and depression scales (HADS) were used to assess the quality of life. Thirty patients were reevaluated six months later. Results Seven (12.7%) patients with TAK and four patients with HC (10%) fulfilled the 2010 FM criteria (p=0.682), while three (5.4%) TAK patients and no controls (0%) met the 1990 criteria (p=0.133). FM was found at a significantly higher rate in the active patients than in the inactive patients according to the ACR-2010 FM criteria (p=0.006). The SF-36 physical component scores were significantly lower (p=0.003) and the HAQ scores were significantly higher in the TAK (p=0.006) patients than in the controls. Conclusion The frequency of FM is similar between the general population and patients with TAK. However, the incidence of FM is significantly higher in active patients. The new FM criteria subscales (WPI, SSS) are significantly correlated with scales such as the SF-36, anxiety and depression scales and HAQ in TAK patients, suggesting that, in a minority of patients with FM and TAK, PROs may be affected by the presence of FM.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.Publication Metadata only Moderation analysis exploring associations between age and mucocutaneous activity in Behcet's syndrome: A multicenter study from Turkey(WILEY, 2020) AKSOY, AYSUN; Mumcu, Gonca; Yay, Meral; Karacayli, Umit; Aksoy, Aysun; Tas, Mehmet Nedim; Armagan, Berkan; Sari, Alper; Bozca, Burcin Cansu; Tekgoz, Emre; Temiz Karadag, Duygu; Badak, Suade ozlem; Tecer, Duygu; Yildirim, Alper; Bes, Cemal; Sahin, Ali; Erken, Eren; Cefle, Ayse; Cinar, Muhammet; Yilmaz, Sedat; Alpsoy, Erkan; Boyvat, Ayse; Senel, Soner; Bilge, Sule Yasar; Kasifoglu, Timucin; Karadag, Omer; Aksu, Kenan; Keser, Gokhan; Alibaz-oner, Fatma; Inanc, Nevsun; Ergun, Tulin; Direskeneli, HanerThe aim of the present study was to examine the effects of age on mucocutaneous activity by using moderation analysis in Behcet's syndrome (BS). In this cross-sectional study, 887 BS patients (female : male, 481:406; mean age, 38.4 +/- 10.9 years) followed in 13 tertiary centers in Turkey were included. Mucocutaneous activity was evaluated by using the Mucocutaneous Index (MI) according to sex and disease course. Moderation analysis was performed to test the effect of age on mucocutaneous activity. A moderator variable is a third variable and affects the relationship between independent and outcome variables. Age was chosen as a potential moderator variable (interaction effect), MI score as the outcome variable and sex as an independent variable in the analysis. The moderation analysis tested the effects of age in three steps: whole BS patient group, patients without systemic involvement and those with systemic involvement. The moderation model was only significant in BS patients with systemic involvement (P = 0.0351), and a significant relationship was observed between female sex and MI score (P = 0.0156). In addition, the interaction plot showed that female patients had increased MI scores compared with male patients, especially in the 28-year-old age group (P = 0.0067). Moreover, major organ involvement was newly diagnosed in the majority of these young female BS patients. Our results suggest that the relationship between sex and mucocutaneous activity was moderated by age in the systemic involvement group. Also, increased mucocutaneous activity may be associated with new major organ involvement in young female BS patients with systemic involvement.Publication Open Access The assessment of contributing factors to oral ulcer presence in Behcet's disease: Dietary and non-dietary factors(AVES, 2018-11-27) AKSOY, AYSUN; Iris, Merve; Ozcikmak, Ezgi; Aksoy, Aysun; Alibaz-Oner, Fatma; Inanc, Nevsun; Ergun, Tulin; Direskeneli, Haner; Mumcu, GoncaObjective: The aim of this study was to assess the contributing factors for oral ulcer activity in Behcet's disease (BD). Methods: Ninety-two patients with BD (F/M: 42/50, mean age: 38.7 +/- 10.02 years) participated in this cross-sectional study. Data regarding disease-related factors, smoking patterns, and self-reported dietary/non-dietary triggering factors for oral ulcer activity were collected by a questionnaire. Treatment protocol was categorized as mild and intensive groups associated with organ involvements. Results: A mild treatment protocol was more common in females (52.4% vs 20%) than in males (p=0.002). During the last three months, the number of oral ulcers in female patients was higher in the mild treatment group (6.4 +/- 6.5) than in the intensive treatment group (3.3 +/- 4.9) (p=0.045). In patients with active oral ulcers (n=63), rate of being a non-smoker was also higher in females (86.7% vs 63.6%) than in males. Daily frequency of tooth brushing was 1.2 +/- 0.8 in patients with BD, and was higher in females (1.5 +/- 0.9 vs 0.9 +/- 0.6) (p=0.001). Stress and fatigue (78.3%) were reported as the most frequent triggering factors for oral ulcer presence in patients with BD. A total of 148 different dietary factors associated with oral ulcer presence were reported in the study. Conclusion: A mild treatment protocol and being a non-smoker were found to be the contributing factors associated with oral ulcer activity in patients with BD. Being motivated for oral hygiene and being non-smokers were positive health behaviors observed in females. Irrespective of gender, stress and fatigue were defined as the most common self-reported triggering factors for oral ulcer presence in BD. In addition, the roles of some dietary factors were also reported.Publication Metadata only Unmet need in Behcet's disease: most patients in routine follow-up continue to have oral ulcers(SPRINGER LONDON LTD, 2014) ALİBAZ ÖNER, FATMA; Alibaz-Oner, Fatma; Mumcu, Gonca; Kubilay, Zeynep; Ozen, Gulsen; Celik, Gulce; Karadeniz, Asli; Can, Meryem; Oner, Sibel Yilmaz; Inanc, Nevsun; Atagunduz, Pamir; Ergun, Tulin; Direskeneli, HanerThe clinical course of Behcet's disease (BD) as a multisystemic disorder with a remitting-relapsing nature is insufficiently explored. As complete remission should be aimed in all inflammatory diseases, we investigated the frequency of complete remission in patients with BD followed in long-term, routine practice. In this retrospective study, 258 patients with BD who were regularly followed in outpatient clinics were assessed. The demographic and clinical data for active organ manifestations and treatment protocols were evaluated, and complete remission for this study was defined as no sign of any disease manifestation in the current visit and the preceding month. Two hundred fifty-eight patients with BD (F/M 130/128, mean age 41.1 +/- 11.5 years) were included to the study. Mucocutaneous disease was present in 48.4 % (n = 125). Mean visit number was 6.8 +/- 2.7, and mean follow-up duration was 45.8 +/- 36.5 months. Patients were clinically active in 67.2 % (n = 1,182) of the total visits (n = 1,757), which increased to 75.6 % (68.1-90.3) when the month preceding the visit was also included. The most common active manifestation was oral ulcers (39.4-63.2 %) followed by other mucocutaneous manifestations and musculoskeletal involvement. When multivariate analysis was performed, oral ulcers, which are the main cause of the clinical activity, negatively correlated with immunosuppressive treatments (beta = -0.356, p < 0.000) and age (beta = -0.183, p = 0.04). It is fairly difficult to achieve complete remission in BD with current therapeutic regimens. The reluctance of the clinician to be aggressive for some BD manifestations with low morbidity, such as mucocutaneous lesions and arthritis, might be influencing the continuous, low-disease activity state, especially due to oral ulcers, in BD patients.Publication Metadata only The assessment of work productivity and activity impairment in Behcet's disease(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2017) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Lehimci, Fadime; Fidan, Ozlem; Guk, Hulya; Alpar, Ugur; Unal, Ali Ugur; Erturk, Zeynep; Alibaz Oner, Fatma; Inanc, Guzide Nevsun; Ergun, Safiye Atlas Tulin; Direskeneli, Rafi HanerBackground/aim: The aim of this study was to assess the relationships between the course of Behcet's disease (BD), disease-specific fears, and work productivity and activity impairment. Materials and methods: In this cross-sectional study, 110 consecutive BD patients were included. The Work Productivity and Activity Impairment questionnaire was used. Results: In the group of employed patients, 30.41% had missed work during the previous week. The mean percentages of daily activity impairment were higher in patients with musculoskeletal involvement (39.81 +/- 33.61%) compared to those without (23.48 +/- 32.45%) (P = 0.008). A greater decrease in working hours was observed in patients with eye involvement (45.52 +/- 15.29 h) compared to those without (54.15 +/- 15.29 h) (P = 0.007). More of the male patients (67.8%) were afraid of losing their jobs compared to females (30%) (P = 0.000). Conclusion: The highest levels of lost productivity and the most severe effects on daily life are consequences of eye and musculoskeletal involvement in the study population. More effective therapeutic approaches are required to improve the working lives of patients with BD. Moreover, male patients had a higher fear of losing their jobs, suggesting a match between the expected clinical course and the predictions of BD patients.