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Öğe Assessment of atrial conduction time in patients with Behcet's disease(Publisaude-Edicoes Medicas Lda, 2014) Cansel, Melunet; Yagmur, Julide; Tasolar, Hakan; Karincaoglu, Yelda; Ermis, Necip; Acikgoz, Nusret; Bayramoglu, AdilObjective: Behcet's disease is characterized by increased inflammatory activity, and there there might be an increased risk of atrial arrhythmia in patients with this disease. Our study is aimed to evaluate a novel method of measuring atrial electromechanical features. expressed as interatrial and intraatrial electromechanical delay by tissue Doppler echocardiography in patients with Behcet's disease. Methods: We evaluated 57 patients (mean age: 36.3 +/- 12.1 years) with Behcet's disease and 34 sex and age matched healthy volunteers (mean age: 38.4 +/- 8.6 years) as control group. P-wave dispersion (PWD) was calculated from the 12-lead surface ECG, interatrial and intraatrial electromechanical delay were measured by tissue Doppler imaging and conventional echocardiography Results: Interatrial electromechanical delay and intraatrial electromechanical delay were prolonged in patients with active Behcet's disease compared with the patients with inactive disease and the controls (p<0.0001, p<0.0001, p=0.013 and p=0.001, respectively). Erythrocyte sedimentation rate and high-sensitivity C-reactive protein values of of patients with active Behcet's were significantly higher than those with inactive Behcet's disease and the controls (p<0.0001 and p<0.0001, respectively). High-sensitivity C-reactive protein and erythrocyte sedimentation rate were correlated with interatrial electromechanical delay in patients with Behcet's disease (r=0.44, p=0.001 and r=0.64, p<0.0001, respectively). Conclusions: The prolongation of atrial electrome-chanical conduction might be related with changes in structure and electrophysiological properties of the atrial myocardium or the conduction system in patients with active Behcet's disease.Öğe Behcet's Disease in Childhood(Deri Zuhrevi Hastaliklar Dernegi, 2009) Karincaoglu, YeldaBehcet's disease is most commonly seen between 20-40 years of age, and is rare among children. There is limited data on demographics of childhood Behcet's disease in the literature. In this paper, the recent literature on incidence, symptoms and signs, common clinical presentation and course of childhood Behcet's disease has been reviewed. (Turkderm 2009; 43 Suppl 2: 69-70)Öğe Brain Perfusion MRI Findings in Patients with Behcet's Disease(Hindawi Publishing Corporation, 2012) Alkan, Alpay; Goktan, Asli; Karincaoglu, Yelda; Kamisli, Suat; Dogan, Metin; Oztanir, Namik; Turan, NergizObjective. To search brain perfusion MRI (pMRI) changes in Behcet's disease (BD) with or without neurological involvement. Materials and Method. The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). Results. There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. Conclusion. Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings.Öğe Co-infection of cyclospora cayetanensis and cryptosporidium parvum in an immunocompetent patient with urticaria without diarrhea: case report(Int Scientific Literature, Inc, 2008) Celik, Tuncay; Karincaoglu, Yelda; Karaman, Ulku; Daldal, Nilgun UlfetBackground: Cyclospora cayetanensis and Cryptosporidium parvum, a coccidian parasites and induce a diarrhea illness of the small intestinal, are the causative agents, a transmitted via contaminated water or food. We aimed to examine the stool of a patient being urticaria without diarrhea. Case Report: In 2007 a six-year-old boy living in Elbistan, non-tropical region in Turkey, was transferred by his parents to the Dermatology policlinic of Inonu University from Elbistan state hospital due to only prolonged pruritic swellings on his body. The patient showed no symptoms such as stomachache, fever, nausea and vomiting. His fecal sample was mild with no trace of mucosa or blood. It was reported that The patient didn't have any allergies such as drug. Laboratory studies on admission were notable, with PLT of 434 units/L, EO of 4.4 units/L, ASO of 148 units/L, CRP of 3 units/L, AST of 25 units/L, ALT of 12 units/L, and Total IgE of 75 IU/mL. Otology serum and Prick tests revealed negative results. Moreover the patient was found to have no allergic reactions to any food, tree, grass, mold, and animals. The organisms were identifi ed as C. cayetanensis and C. parvum in the stool sample. After treated with Metronidazole and Azithromycin. Fecal specimen were examined. As a result no sign of the parasites were observed and urticaria complaints disappeared. Conclusions: This report is the first case that have seen co-infection of cyclosporiasis and cryptosporidiasis in an immunocompetent patient who have urticaria complaints and without diarrhea. It is believed that these parasites are likely to cause allergic reactions among patients who have constant urticaria complaints, can not develop immunological reaction to various allergens, and have high total IgE antibodies.Öğe A demodicosis case which responded to systemic ivermectin(John Libbey Eurotext Ltd, 2009) Karincaoglu, Yelda; Miman, Ozlem; Kalayci, Bulent; Aycan, Ozlem Makbule; Atambay, Metin[Abstract Not Available]Öğe Demographic and clinical properties of juvenile-onset Behcet's disease: A controlled multicenter study(Mosby-Elsevier, 2008) Karincaoglu, Yelda; Borlu, Murat; Toker, Sernra Cikman; Akman, Ayse; Onder, Meltem; Gunasti, Suhan; Usta, AysegulBackground: Behcet's disease (BD) is a multisystemic inflammatory disorder Of unknown origin. The disease usually occurs between the second and the fourth decades, whereas it is uncommon in children. Objective. In this multicenter study, we aimed to describe the demographic and clinical features along with severity in juvenile- versus adult-onset 131). Methods: Patients with initial symptoms at age 16 years or younger were considered as having juvenileonset 131). In all, 83 patients with juvenile-onset BID (38 male and 45 female; mean age 19.6 +/- 7.6 years) and 536 with adult-onset (>16 years) BD (293 male and 243 female; mean age 39.2 +/- 10.1 years) who fulfilled the classification criteria of the International Study Group for BD were involved in the study. Results: Familial cases were more frequent in juvenile-onset compared with adult-onset BD (19% vs 10.3%; P=.017). The mean age of disease onset was 12.29 +/- 3.54 years in juvenile-onset 131) and 31.66 +/- 8.71 years in adult-onset 131). Mucocutaneous lesions and articular symptoms were the most commonly observed manifestations in both groups. The frequency of disease manifestations was not different between juvenile and adult-onset BID, except neurologic and gastrointestinal involvement, which were higher in juvenileonset 131) than adult-onset BD (P =.027 and P =.024, respectively). Oral ulcer was the most common onset manifestation of both juvenile-onset (86.74%) and adult-onset (89-55%) BD. The frequencies of onset manifestations of 131) were similar, except genital ulcer, which was higher in adult-onset 131) (P =.025). Limitations: Our study consisted of patients with 131) mainly applying to dermatology and venerology departments. Therefore, it can be speculated that this Study includes rather a milder spectrum of the disease. Conclusions: Although the clinical spectrum of juvenile-onset BD seems to be similar to adult-onset BD, the frequency of severe organ involvement was higher. Because of the higher prevalence of familial cases in juvenile-onset BD, it can be speculated that genetic factors may favor early expression of the disease with severe organ involvement.Öğe Elevated Oxidative Stress Markers and its Relationship With Endothelial Dysfunction in Behcet Disease(Sage Publications Inc, 2011) Acikgoz, Nusret; Ermis, Necip; Yagmur, Julide; Cansel, Mehmet; Karincaoglu, Yelda; Atas, Halil; Cuglan, BilalBehcet's disease (BD) is a multisystemic disorder characterized by endothelial dysfunction. However, the relationship between oxidative stress and endothelial function has not been clearly shown. We investigated the relationship between oxidative stress markers and endothelial function in patients with BD. Patients with BD (n = 40) having active disease and sex-and age-matched 40 controls were included. Endothelial function was assessed by flow-mediated dilatation (FMD) technique. Serum gammaglutamyltransferase (GGT) and high-sensitive C-reactive protein levels (hsCRP) were measured in all participants. Brachial artery FMD was significantly lower in patients with BD than in controls. Gamma-glutamyltransferase and hsCRP levels were higher in patients with BD than in controls. Also, GGT and hsCRP levels were inversely correlated with endothelial function. Oxidative stress markers are elevated in patients with BD having active disease. This may be one of the reasons behind the vasculitis in active BD.Öğe Evaluation of 60 Patients with Pilonidal Sinus Treated with Laser Epilation after Surgery(Wiley-Blackwell Publishing, Inc, 2010) Oram, Yasemin; Kahraman, Ferayi; Karincaoglu, Yelda; Koyuncu, ErkanBACKGROUND The surgical treatments for pilonidal sinus disease often result in recurrences, and the patients risk requiring multiple surgical interventions. OBJECTIVE To evaluate the role of alexandrite laser hair removal after surgery in pilonidal sinus disease. METHODS Sixty patients who underwent surgical treatment of pilonidal sinus disease and were treated with a 755-nm alexandrite laser after surgery between 1999 and 2007 were examined retrospectively. The charts were reviewed, and the patients were interviewed on the telephone about their post-laser period and recurrence. The laser parameters, patient history, and surgical details were recorded. RESULTS The overall recurrence rate was 13.3%, after a mean follow-up period +/- standard error of the mean of 4.8 +/- 0.3 years. The mean number of laser treatment was 2.7 +/- 0.1. Seventy-five percent of the recurrences were detected after a follow-up period of 5 to 9 years. Fifty percent of the recurrent cases had drainage and secondary intention before the laser epilation. CONCLUSION Our results strongly suggest that laser hair removal after surgical interventions in pilonidal sinus disease decreases the risk of recurrence over the long term. The authors have indicated no significant interest with commercial supporters.Öğe Incontinentia pigmenti: a case report and literature review(Turkish J Pediatrics, 2009) Emre, Sinan; Firat, Yezdan; Gungor, Serdal; Firat, Ahmet Kemal; Karincaoglu, YeldaIncontinentia pigmenti (IP) is a rare, X-linked dominant disorder that presents at or soon after birth with characteristic cutaneous signs. The eyes and central nervous system are the next most commonly affected systems. We aimed to describe the ophthalmological, neurological and radiodiagnostic findings of a patient with IP and bilateral retinal detachment. Clinical and laboratory findings of a four-month-old female baby who did not have light fixation and had neurological maturation retardation are presented. Characteristic skin lesions of IP were noted especially at the extremities, bilaterally. On neurological examination, motor and mental maturation were retarded and axial hypotonia was noted. Bilateral retinal detachment was the cause of absent eye fixation noted during ophthalmologic examination, and the detachments were also documented by ultrasonography and magnetic resonance imaging (MRI). Otologic examination was normal. Focal left frontal lobe atrophy, corpus callosum hypoplasia and prominence of right hemisphere were also noted on MRI. MR spectroscopy revealed negative lactate peak at the involved left frontal lobe. Bilateral retinal detachment is a probable finding in IP and patients with neurological symptoms should be investigated for associated sight- threatening ocular pathologies.Öğe Increased Mean Platelet Volume in Behcet's Disease with Thrombotic Tendency(Tohoku Univ Medical Press, 2010) Acikgoz, Nusret; Karincaoglu, Yelda; Ermis, Necip; Yagmur, Juelide; Atas, Halil; Kurtoglu, Ertugrul; Cansel, MehmetThe relationship between Behcet's disease (BD) and platelet aggregation has not sufficiently been investigated yet. Mean platelet volume (MPV) is a marker of platelet function, and the increase in MPV has been identified as an independent risk factor of recurrent vascular events. BD is characterized by a relapsing vasculitis of the venous as well as arterial thrombosis. However, the precise pathogenic mechanisms underlying thrombotic tendency in BD are not known. We hypothesized that there might be an association between thrombotic complication and MPV in these patients. Therefore, we investigated activation of platelets in patients with BD using a simple marker, MPV, the most accurate measure of platelet size. A total of 60 patients with BD and 40 age- and gender-matched controls were included. The BD patients were divided into subgroups based on the presence (n = 22) or absence of thrombosis (n = 38) and clinically active (n = 30) or inactive (n = 30) state. MPV was higher in patients with BD than controls (8.14 +/- 0.8 vs. 7.48 +/- 0.3 fl, p = 0.001). Among BD patients, MPV was larger in patients with thrombosis than those without thrombosis (8.45 +/- 1.0 vs. 7.96 +/- 0.7 fl, p = 0.038). However, there was no significant difference in MPV between BD patients with active and inactive states. The increase in MPV is independent of the disease activity, and the presence of thrombosis is associated with higher MPV in BD patients. Therefore, antiplatelet therapy may be useful to prevent thrombotic complications in BD patients.Öğe Kaposi's varicelliform eruption complicating irritant contact dermatitis(Professional Medical Publications, 2012) Sener, Serpil; Bayram, Hatice Gamze; Karincaoglu, Yelda; Senol, MustafaKaposi's varicelliform eruption (KVE) or eczema herpeticum is a disseminated viral infection superimposed on pre-existing dermatosis. It is frequently caused by Herpes simplex and certain other viruses. It may result on life-threatening viraemia with multiorgan involvement and secondary infections. We report a 34-year old female patient with KVE which is caused by herpes virus developed on irritant contact dermatitis because of its rare occurrence.Öğe Liken Planusta Oral Asitretin Tedavisinin Klinik Etkinligi ve Remisyon Süresine Etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2002) Karincaoglu, Yelda; Kandi, Basak; Esrefoglu, MuammerLiken planus (LP) deri, mukoz membranlar ve saçli deriyi etkileyen, kasintili inflamatuar bir hastaliktir. LP tanisi konulan 10 hastaya, günde 50mg asitretin verilerek bu monoterapinin etkinligi degerlendirildi. Sonuçta asitretinin LP tedavisinde alternatif bir tedavi olabilecegi kanaatine varildi.Öğe The ocular surface in the Behcet's disease patient(Canadian Ophthal Soc, 2012) Gunduz, Abuzer; Cumurcu, Tongabay; Demirel, Ersin Ersan; Akpolat, Nusret; Karincaoglu, YeldaObjective: Evaluation of the morphological changes in conjunctival surface epithelial cells with impression cytology in Behget's disease patients. Patients: A total 01 89 eyes of 89 subjects were included. These consisted of 56 patients with inactive Behget's disease (group 1) and a control group of 33 age- and sex-matched subjects (group 2). Methods: Schirmer-I and break-up time (BUT) tests were used to evaluate the tear film of the subjects. Impression cytology was used to evaluate morphological changes of the conjunctival surface epithelial cells. The results of the 2 groups were compared. Results: The mean Schirmer-I test result was 8.59 +/- 4.83 in group 1 and 14.52 +/- 6.38 in group 2. There was a statistically significant difference between the 2 groups for this test (p = 0.001). The mean BUT test value was 10.05 +/- 3.26 in group 1 and 13.64 +/- 4.28 in group 2. There was a statistically significant difference between the 2 groups for this test (p = 0.001). The mean impression cytology score was 1.65 +/- 0.90 in group 1 and 1.39 +/- 0.96 in group 2. There was no statistically significant difference between the 2 groups when the cytology grade score was compared (p = 0.227). We found no statistically significant difference for age, gender, disease duration, systemic drug use, Schirmer-I, BUT, and impression cytology degrees between the Behget's disease patients with and without ocular involvement (p > 0.05). Conclusions: We found that there was a statistically significant difference between Behget's disease patients and normal subjects regarding the ocular film layer, but no difference regarding conjunctival surface epithelial morphology.Öğe Pemphigus: Epidemiology and Pathogenesis(Deri Zuhrevi Hastaliklar Dernegi, 2008) Karincaoglu, YeldaPemphigus, a group of bullous diseases affecting the oral mucosa and the skin, is caused by antibody-mediated autoimmune reaction to desmogleins (Dsg), desmosomal transmembrane glycoproteins, leading to acantholysis. Pemphigus has a worldwide distribution but the incidence in patients of Jewish origin is higher. The disease has a peak incidence of occurrence between the 4th and 6th decades. While various environmental factors have been implicated as triggering agents, HLA association is probably the most important predisposing factor Pemphigus, is caused by antibody-mediated autoimmune reaction to desmosomal cadherins, Dsg1, and Dsg3. Recent molecular studies have shown that acantholysis can occur also in the presence of antibodies against 9 alpha nicotinic acetylcholine receptor. Pemphigus is currently divided into three distinct varieties, i.e., pemphigus vulgaris (PV), pemphigus foliaceus (PF) and other variants of pemphigus, depending on clinical features, the level of separation in the epidermis, and immunologic characteristics of auto-antigens. Blistering pathogenesis differ for each of the types of pemphigus. PV is characterized by IgG autoantibodies against Dsg 3, whereas the target of PF is Dsgl, although about 50% of PV patients also have Dsg1 autoantibodies. Lesion distribution is related to the location of the antigen (Dgs 3 and/or Dgs 1) in the epithelium and specific autoantibody production. This article reviews the epidemiology and pathogenesis of pemphigus. (Turkderm 2008; 42 Suppl 1: 1-4)Öğe Pulsed Dye Laser in the Treatment of Nail Psoriasis(Lippincott Williams & Wilkins, 2010) Oram, Yasemin; Karincaoglu, Yelda; Koyuncu, Erkan; Kaharaman, FerayiBACKGROUND The treatment options for nail psoriasis have been limited, and the management of nail psoriasis has been challenging for physicians. OBJECTIVES To evaluate the effect of pulsed dye laser (PDL) in the treatment of nail psoriasis. METHODS Psoriatic nails of five patients were treated using PDL (595 nm) once monthly for 3 months. The pulse duration was 1.5 ms, the beam diameter was 7 mm, and the laser energy was 8.0 to 10.0 J/cm2. Clinical efficacy was statistically evaluated according to Nail Psoriasis Severity Index (NAPSI) score differences before and after the treatment. RESULTS Statistical analysis of NAPSI scores before and after treatment showed significant difference (p <.05, paired t-test). The nail bed lesions, particularly onycholysis and subungual hyperkeratosis, responded best to the treatment. LIMITATIONS Limitations include the lack of blinding and comparison and the small number of patients. CONCLUSION PDL might be an alternative treatment for nail psoriasis. The authors have indicated no significant interest with commercial supporters.Öğe Relationship between serum homocysteine levels and structural-functional carotid arterial abnormalities in inactive Behcet's disease(Via Medica, 2018) Ozdemir, Ramazan; Yagmur, Julide; Acikgoz, Nusret; Cansel, Mehmet; Karincaoglu, Yelda; Ermis, Necip; Pekdemir, HasanBackground: Behcet's disease (BD) is a chronic autoimmune disorder with symptoms manifesting from an underlying vasculitis. Since the disease activity is correlated with characteristic vascular endothelial dysfunction, BD places individuals at increased risk of cardiovascular diseases, such as atherosclerosis. Hyperhomocysteinaemia is an independent risk factor for arteriosclerotic vascular diseases. Aim: This study was designed to investigate how plasma homocysteine (Hcy) affects the structural and functional properties of the carotid artery in humans. Methods: Sixty-eight BD patients with subclinical atherosclerosis and 40 healthy controls underwent carotid sonography and Doppler ultrasound to measure carotid artery intima-media thickness (C-IMT) and carotid stiffness and distensibility (indicating elasticity). Total Hcy level was determined by enzyme-linked immunosorbent assay. For analysis, the BD patients were sub-grouped according to hyperhomocysteinaemia (>15 mu mol/L). Results: The patients with BD were found to have increased C-IMT and beta stiffness and decreased distensibility. In addition, hyperhomocysteinaemia was significantly correlated with these detrimental changes in the carotid artery, possibly raising the risk of these patients developing atherosclerosis. Conclusions: These findings suggest a potential mechanism of atherosclerosis in BD and highlight the processes that future research should focus on to address identification and prophylactic treatment of BD patients at risk of cardiovascular disease.Öğe Response: Is Mean Platelet Volume Increased in Behcet's Disease with Thrombosis?(Tohoku Univ Medical Press, 2010) Acikgoz, Nusret; Karincaoglu, Yelda; Ermis, Necip; Yagmur, Julide; Atas, Halil; Kurtoglu, Ertugrul; Cansel, Mehmet[Abstract Not Available]Öğe Subclinical left ventricular dysfunction in Behcet's disease assessed by two-dimensional speckle tracking echocardiography(Oxford Univ Press, 2011) Yagmur, Julide; Sener, Serpil; Acikgoz, Nusret; Cansel, Mehmet; Ermis, Necip; Karincaoglu, Yelda; Tasolar, HakanAims The aim of this study was to evaluate the left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) in order to provide the early detection of myocardial dysfunction in patients with Behcet's disease (BD). We also aimed to examine the relationship between LV systolic strain and N-terminal pro-B type natriuretic peptide (NT-proBNP), which is a cardiac biomarker of ventricular dysfunction. Methods and results Longitudinal and circumferential systolic strain assessed by STE was obtained in 32 BD patients and 27 age-matched controls. NT-proBNP levels were also measured in all subjects. Regional and mean longitudinal strain (-17.8 +/- 2.7 vs. -20.5 +/- 1.8%; P < 0.0001) was significantly lower in BD patients when compared with the healthy controls. Whereas regional and mean circumferential strain values (-22.0 +/- 1.6 vs. -22.2 +/- 2.3%; P = 0.62) did not reveal a significant difference between the patients and the controls. NT-proBNP was significantly higher in the patients than in the controls (65.18 +/- 84.51 vs. 30.84 +/- 14.75 pg/mL; P = 0.003). Linear regression analyses revealed only NT-proBNP as the independent correlate of mean LV longitudinal strain (R = 0.603, P = 0.001). Conclusion Longitudinal myocardial systolic function assessed by STE, which is a sensitive marker of subclinical ventricular dysfunction is impaired in BD. Increased NT-proBNP levels may be a sign of subclinical ventricular dysfunction in these patients.Öğe Vitiligo Koebnerized by Behcet Disease Genital Ulceration(Adis Int Ltd, 2009) Karincaoglu, Yelda; Kalayci, Bulent; Tepe, BirgulA 50-year-old man was diagnosed with Behcet disease (BD) on the basis of an 8-year history of episodes of recurrent oral aphthous ulcers, papulopustular lesions on physical examination, and a positive pathergy test. Two years prior to diagnosis of BD, vitiligo had also been diagnosed on the basis of hypo-pigmented lesions on the scrotum following genital ulceration. To our knowledge, this is the first case of incidental coexistence of BD and vitiligo, and, furthermore, the first case of koebnerization of genital ulceration of BD.Öğe Vulvar vestibular papillomatosis(Deri Zuhrevi Hastaliklar Dernegi, 2012) Bilgic, Ozlem; Karincaoglu, Yelda; Sahin, Nurhan AkdoganVestibular papillomatosis (VP) is a benign, asymptomatic anatomical condition present in approximately 1% of women. It is characterized by linear, pink, smooth or filiform papules symmetrically distributed on the vulva. The clinical resemblance of VP to genital warts may lead to unnecessary laboratory tests and treatments. This report presents four cases of VP in order to call attention to this entity (Turkderm 2012; 46: 220-2)