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    Concurrent Fungal Peritonitis in Two Sibling Peritoneal Dialysis Patients: Case Report
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Yilmaz, Tugba; Altunoren, Orcun; Atay, Didem; Ganidagli, Safa; Inanc, Elif; Gorgel, Fazil Ahmet; Kale, Taner
    Fungal peritonitis is an important reason of catheter loss among peritoneal dialysis patients. The most frequently isolated agents are Candida species and some patients do not respond to the treatment and die. Two siblings who lived in the same house and followed-up at our center were admitted to the hospital for peritonitis and both were transferred to hemodialysis as fungal peritonitis was detected. The enabling factor was considered to be poor hygiene. Hygiene is important issue for peritoneal dialysis patients, especially those who live in the same house.
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    Evaluating Secukinumab as Treatment for Axial Spondyloarthritis and Psoriatic Arthritis in Patients with Comorbidities: Multicenter Real-Life Experience
    (Mdpi, 2025) Ocak, Tugba; Yagiz, Burcu; Coskun, Belkis Nihan; Akkuzu, Gamze; Akbas, Ayse Nur Bayindir; Kudas, Ozlem; Inanc, Elif
    Background: Secukinumab is a fully human monoclonal antibody that targets interleukin (IL)-17A and is used to treat axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Treating axSpA and PsA can be challenging in patients with comorbidities. In this multicenter retrospective study, we aimed to evaluate the efficacy and safety of secukinumab treatment in patients with axSpA and PsA who had a history of tuberculosis, multiple sclerosis (MS), or congestive heart failure (CHF). Methods: The study included 44 patients with a diagnosis of axSpA and PsA and a history of tuberculosis, MS, or CHF who received secukinumab treatment at 13 centers in our country. Erythrocyte sedimentation rate, C-reactive protein (CRP), Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score CRP, visual analog scale, and Disease Activity Score-28 CRP markers at months 0, 3, and 12 of secukinumab treatment were analyzed. Alongside this, tuberculosis, MS, and CHF were evaluated at follow-up using clinical assessments and imaging methods such as chest radiographs, brain magnetic resonance, and echocardiography. Results: A statistically significant improvement in inflammatory markers and disease activity scores was observed in patients treated with secukinumab. There was no reactivation in patients with a history of tuberculosis. In most MS patients, the disease was stable, while clinical and radiological improvement was observed in one patient. No worsening of CHF stage was observed in patients with a history of CHF. Conclusions: With regular clinical monitoring, secukinumab may be an effective and safe treatment option for axSpA and PsA patients with a history of tuberculosis, MS, or CHF.
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    Increased Musculoskeletal Surgery Rates During Diagnostic Delay in Psoriatic Arthritis: A Retrospective Cohort Study
    (Mdpi, 2025) Yolbas, Servet; Gunduz, Ilyas; Kara, Mahmut; Cay, Emrah; Yamancan, Guelsah; Yalcin, Nevra; Inanc, Elif
    Background/Objectives: Delayed diagnosis in psoriatic arthritis (PsA) is associated with significant health consequences. We hypothesize that musculoskeletal (MSK) surgery rates may be higher during the diagnostic delay period. This study aimed to compare the frequency of MSK surgeries in PsA patients during the period of diagnostic delay with the frequency of MSK surgeries post-diagnosis. Methods: This retrospective cohort study included PsA patients who fulfilled CASPAR criteria and were followed up on in our outpatient clinic. The pre-diagnosis symptomatic period was considered as the period of diagnostic delay. Data on MSK surgeries were obtained from patient records. The annual number of surgeries was calculated separately for the diagnostic delay and post-diagnosis periods. Results: The study included 84 PsA patients. The mean diagnostic delay in PsA patients was 7.49 years. During this period, 27.4% of patients underwent at least one MSK surgery. The mean annual number of MSK surgeries was significantly higher during the diagnostic delay period compared to the post-diagnosis period (Z = -3.18, p = 0.001, r = 0.35). Conclusions: Following PsA diagnosis, a reduction in MSK surgery rates was observed compared to during the diagnostic delay period. This suggests that inflammatory symptoms in PsA patients, which could have been managed with medical therapy, may have led to avoidable MSK surgeries. These findings highlight the potential for early diagnosis to reduce the rate of musculoskeletal surgery and associated healthcare costs.
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    The Effect of Clinical Knowledge on the Evaluation of Sacroiliac Joint Radiography in Patients with Spondyloarthritis
    (Mdpi, 2025) Zontul, Sezgin; Kaya, Zeynep; Aydogdu, Mesude Seda; Arslan, Ahmet Kadir; Inanc, Elif; Maras Ozdemir, Zeynep; Yolbas, Servet
    Background/Objectives: This study investigates whether a patient's clinical status influences the evaluation of sacroiliac joint (SIJ) radiographs. Methods: The study involved analysing SIJ radiographs of patients diagnosed with spondyloarthritis (SpA) at our clinic. Two rheumatologists working at another centre evaluated the images independently. Three months were allowed to elapse so that the rheumatologists would forget the results of the first evaluation. The radiographs were then re-evaluated in a different order by the same rheumatologists. However, during the second evaluation, the evaluators were also provided with general clinical information about the patients. Inter- and intra-observer agreement were assessed. Results: In the first blinded evaluation of our study, we found moderate-to-substantial agreement between rheumatologists (right kappa: 0.534; p < 0.001; left kappa: 0.609; p < 0.001) and statistically significant interpretation agreement. In the second evaluation, we observed an increase in agreement (kappa increased from 0.534 to 0.774 for the right SIJ and from 0.609 to 0.855 for the left SIJ), and these metrics were also significant. Conclusions: The interpretation of SIJ radiographs showed notable inter-observer variability in the absence of clinical information. Incorporating clinical context significantly improved the agreement between readers. As conventional radiography remains central to spondyloarthritis classification, these findings highlight the value of clinical data in enhancing the reliability of radiographic assessment. To our knowledge, this is the first study to systematically demonstrate the impact of clinical information on inter-observer agreement in SIJ radiograph interpretation.