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  1. Article ; Online: Behçet's Disease: From Bench To Bedside.

    Sawalha, Amr H / Direskeneli, Haner

    Clinical immunology (Orlando, Fla.)

    2023  Volume 254, Page(s) 109711

    MeSH term(s) Humans ; Behcet Syndrome
    Language English
    Publishing date 2023-07-28
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 1459903-x
    ISSN 1521-7035 ; 1521-6616
    ISSN (online) 1521-7035
    ISSN 1521-6616
    DOI 10.1016/j.clim.2023.109711
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  2. Article ; Online: Pulmonary hypertension in Takayasu's arteritis: Should be monitored closely.

    Direskeneli, Haner

    International journal of cardiology

    2018  Volume 276, Page(s) 238–239

    MeSH term(s) China ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery ; Retrospective Studies ; Takayasu Arteritis
    Language English
    Publishing date 2018-10-28
    Publishing country Netherlands
    Document type Editorial ; Comment
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2018.10.074
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  3. Article ; Online: Common femoral vein wall thickness measurement by Doppler ultrasonography is an accurate diagnostic test for Behçet's Disease both in supine and standing positions.

    Ergelen, Rabia / Kutluğ Ağaçkıran, Seda / Direskeneli, Haner / Alibaz-Oner, Fatma

    Phlebology

    2024  , Page(s) 2683555241235436

    Abstract: Objectives: We recently reported the first controlled Doppler ultrasonography (US) study demonstrating increased common femoral vein (CFV) thickness in Behçet's Disease (BD). Standard lower extremity venous Doppler US is performed in erect position. In ... ...

    Abstract Objectives: We recently reported the first controlled Doppler ultrasonography (US) study demonstrating increased common femoral vein (CFV) thickness in Behçet's Disease (BD). Standard lower extremity venous Doppler US is performed in erect position. In order to confirm accuracy and applicability of method, we measured CFV thickness in both supine and standing positions in this study.
    Method: We included sex and age-matched 42 BD patients and 41 healthy controls (HCs). After routine visits, bilateral CFV thickness was measured with Doppler US both in supine and standing positions.
    Results: Bilateral CFV thickness was significantly higher in BD than in HC. There were no statistically significant differences in measurements of CFV wall thickness between standing and supine positions in both groups.
    Conclusions: CFV measurement by Doppler US is a new and non-invasive diagnostic tool for the diagnosis of BD. Our study confirmed that patient position does not affect CFV wall thickness measurement for diagnosis of BD.
    Language English
    Publishing date 2024-02-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 645172-x
    ISSN 1758-1125 ; 0268-3555
    ISSN (online) 1758-1125
    ISSN 0268-3555
    DOI 10.1177/02683555241235436
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  4. Article: Clinical assessment in Takayasu's arteritis: major challenges and controversies.

    Direskeneli, Haner

    Clinical and experimental rheumatology

    2017  Volume 35 Suppl 103, Issue 1, Page(s) 189–193

    Abstract: Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent controversial issues in the diagnosis, disease assessment and prognosis in TAK are ... ...

    Abstract Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent controversial issues in the diagnosis, disease assessment and prognosis in TAK are discussed in this review. In recent years, conventional angiography, the standard method for the initial diagnosis, seems to have been replaced by the new imaging modalities, such as MRI and 18F-FDG-PET. Less invasive techniques (CT/MRI) are now suggested first, compared to conventional angiography, and MRI is preferable to CT with less contrast load/radiation. Ultrasound is useful for carotid assessment, but being a user-dependent technique, imaging of deeper vessels (subclavian and aorta) are not reliable. 18F-FDG-PET is useful especially in patients with no vascular symptoms/signs, fever of unknown origin or unexplained acute-phase response. MRI and 18F-FDG-PET are also promising for the assessment of disease activity. New tools for disease assessment such as Indian Takayasu Arteritis Score (ITAS2010) aim to better characterise and quantify disease activity. Prognosis is recently possibly getting better with lower mortality, but a substantial damage is present even in early cases. There is a clear need to develop a validated set of outcome measures to be used in clinical trials of TAK. The OMERACT Vasculitis Working Group has taken on this task, finished a Delphi exercise with experts and aims to develop a core set of outcomes for LVV.
    MeSH term(s) Biomarkers/blood ; Biopsy ; Diagnosis, Differential ; Humans ; Predictive Value of Tests ; Prognosis ; Reproducibility of Results ; Severity of Illness Index ; Takayasu Arteritis/blood ; Takayasu Arteritis/diagnostic imaging ; Takayasu Arteritis/pathology ; Takayasu Arteritis/therapy
    Chemical Substances Biomarkers
    Language English
    Publishing date 2017-03
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 605886-3
    ISSN 1593-098X ; 0392-856X
    ISSN (online) 1593-098X
    ISSN 0392-856X
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  5. Article ; Online: Takayasu's arteritis: A new era is approaching.

    Direskeneli, Haner

    Presse medicale (Paris, France : 1983)

    2017  Volume 46, Issue 7-8 Pt 2, Page(s) e177

    Language English
    Publishing date 2017-07
    Publishing country France
    Document type Editorial
    ZDB-ID 120943-7
    ISSN 2213-0276 ; 0032-7867 ; 0755-4982 ; 0301-1518
    ISSN (online) 2213-0276
    ISSN 0032-7867 ; 0755-4982 ; 0301-1518
    DOI 10.1016/j.lpm.2017.08.006
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  6. Article ; Online: Biologic treatments in Behçet's disease.

    Alibaz-Öner, Fatma / Direskeneli, Haner

    European journal of rheumatology

    2021  Volume 8, Issue 4, Page(s) 217–222

    Abstract: Behçet's disease (BD) significantly increases morbidity and mortality, especially in young men. While vascular involvement is the most frequent cause of mortality, ocular involvement, which can cause visual loss, is the most important cause of morbidity ... ...

    Abstract Behçet's disease (BD) significantly increases morbidity and mortality, especially in young men. While vascular involvement is the most frequent cause of mortality, ocular involvement, which can cause visual loss, is the most important cause of morbidity in BD. Immunosuppressive treatment is the mainstay for major organ involvement. However, despite optimal immunosuppressive treatment, relapses and disease-related damage develop in a subgroup of patients, especially among those with ocular or vascular involvement. With the recent understanding of the immuno-pathogenesis, biologic treatments targeting potential pathogenic cells, cytokines or pathways are better optimized in BD. Data from large series showed that tumor necrosis factor-α inhibitors and interferon-α are effective and safe treatment options for the treatment of refractory and major organ involvement, such as ocular, neurologic, vascular, and gastrointestinal. Anakinra and ustekinumab also seem to be promising agents for refractory mucocutaneous disease. IL-1 inhibitors and tocilizumab may be alternatives for the treatment of patients with refractory eye involvement. Still, randomized controlled trials of biologic agents, especially for the treatment of major organ involvement, are insufficient, and further prospective, long-term follow-up studies are needed to clarify the efficacy, safety, and optimal treatment duration of biologic agents in BD.
    Language English
    Publishing date 2021-03-15
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2873727-1
    ISSN 2148-4279 ; 2147-9720
    ISSN (online) 2148-4279
    ISSN 2147-9720
    DOI 10.5152/eurjrheum.2020.20138
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  7. Article ; Online: Advances in the Treatment of Behcet's Disease.

    Alibaz-Oner, Fatma / Direskeneli, Haner

    Current rheumatology reports

    2021  Volume 23, Issue 6, Page(s) 47

    Abstract: Purpose of review: To assess current management of Behcet's disease (BD). Controversies on therapeutic approaches to different manifestations, whether conventional immunosuppressives (IS) or biologic agents, should be chosen, and options for refractory ... ...

    Abstract Purpose of review: To assess current management of Behcet's disease (BD). Controversies on therapeutic approaches to different manifestations, whether conventional immunosuppressives (IS) or biologic agents, should be chosen, and options for refractory disease are discussed.
    Recent findings: Glucocorticoids are still the main agents for remission-induction and azathioprine the first-line conventional IS in maintenance phase to prevent relapses of major organ involvement. Apremilast is shown to be a safe and effective option approved by the FDA for oral ulcers. Large case series confirmed the efficacy and safety of TNFα inhibitors and Interferon-α. Promising results are observed with IL-1 inhibitors, ustekinumab, secukinumab, and tocilizumab for refractory BD. Although both conventional IS and biologic agents are effectively used to suppress inflammation in BD, there is still an unmet need for clear therapeutic strategies in the management for different manifestations. Further controlled studies with new biologic agents, anticoagulants and the benefit of concomitant IS usage with biologics are needed to optimize the management of BD.
    MeSH term(s) Anticoagulants ; Azathioprine/therapeutic use ; Behcet Syndrome/drug therapy ; Glucocorticoids/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Remission Induction
    Chemical Substances Anticoagulants ; Glucocorticoids ; Immunosuppressive Agents ; Azathioprine (MRK240IY2L)
    Language English
    Publishing date 2021-05-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057357-1
    ISSN 1534-6307 ; 1523-3774
    ISSN (online) 1534-6307
    ISSN 1523-3774
    DOI 10.1007/s11926-021-01011-z
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  8. Article ; Online: Increased inferior vena cava wall thickness as a sign of extensive venous inflammation in Behçet's Disease.

    Ağaçkıran, Seda Kutluğ / Sünbül, Murat / Doğan, Zekeriya / Direskeneli, Haner / Alibaz-Oner, Fatma

    Clinical rheumatology

    2024  Volume 43, Issue 4, Page(s) 1355–1362

    Abstract: Introduction/objectives: Behçet's disease (BD) affects both arterial and venous vessels. We have previously shown that common femoral vein wall thickness (WT) is increased in BD and can be used as a diagnostic test. However, there is limited data ... ...

    Abstract Introduction/objectives: Behçet's disease (BD) affects both arterial and venous vessels. We have previously shown that common femoral vein wall thickness (WT) is increased in BD and can be used as a diagnostic test. However, there is limited data assessing large veins. Therefore, this study seeks to assess inferior vena cava wall thickness (IVC) by transthoracic echocardiography (TTE) in BD compared to healthy controls (HC).
    Methods: Age- and gender-matched 70 BD patients and 51 HC were included. IVC wall thickness and common femoral vein WT were measured by TTE and Doppler ultrasonography, respectively. All examinations were performed on the same day as the clinical assessment.
    Results: The mean IVC wall thickness of BD patients was significantly higher than HC (2.9 mm (0.3) vs 2.6 mm (0.3), p < 0.001). Patients with mucocutaneous involvement (2.8 mm (0.3)) and major organ involvement (2.9 mm (0.3)) had significantly thicker walls compared to HC (p = 0.003, p < 0.001, respectively). IVC wall thickness was higher in patients with vascular involvement compared to those with nonvascular major organ involvement (3.1 mm (0.3) vs 2.8 mm (0.2), p = 0.04). There was a moderate correlation between IVC and common femoral vein WT (r = 0.49 for the right, r = 0.43 for the left, p = 0.01 for both).
    Conclusion: This study shows that venous wall inflammation is not limited to lower extremity veins and is also present in IVC walls of BD patients regardless of IVC involvement. Vascular wall inflammation is probably a widespread vascular event of all venous walls in BD. Key Points • Venous wall inflammation is not limited to lower extremity veins and is present also in IVC wall in Behçet's disease. • Extensive venous wall inflammation in Behçet's disease includes large venous structures despite not being clinically involved.
    MeSH term(s) Humans ; Behcet Syndrome/complications ; Behcet Syndrome/diagnostic imaging ; Vena Cava, Inferior/diagnostic imaging ; Inflammation/diagnostic imaging ; Femoral Vein/diagnostic imaging ; Lower Extremity/diagnostic imaging
    Language English
    Publishing date 2024-02-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-024-06911-w
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  9. Article: Esophagus Dilation and Quality of Life in Adults with Scleroderma and Concomitant Obstructive Sleep Apnea.

    Yakut, Tugce / Cinar, Caner / Karakurt, Sait / Direskeneli, Haner / Yalcinkaya, Yasemin / Peker, Yüksel

    Journal of clinical medicine

    2024  Volume 13, Issue 7

    Abstract: 1) ...

    Abstract (1)
    Language English
    Publishing date 2024-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm13071884
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  10. Article: Innate and Adaptive Responses to Heat Shock Proteins in Behcet's Disease.

    Direskeneli, H

    Genetics research international

    2013  Volume 2013, Page(s) 249157

    Abstract: Behcet's disease (BD) is a systemic, chronic inflammatory disorder with both innate and adaptive immune responses. Heat shock proteins (HSP) are highly conserved molecules in different species with scavenger activity and involved in correct folding of ... ...

    Abstract Behcet's disease (BD) is a systemic, chronic inflammatory disorder with both innate and adaptive immune responses. Heat shock proteins (HSP) are highly conserved molecules in different species with scavenger activity and involved in correct folding of newly synthesized proteins. T and B cell responses against HSPs are observed in BD patients in both αβ and γδ T-cell populations. 60-kD HSP (HSP60) is also shown to be recognized by pattern recognition receptors such as toll-like receptors (TLR) and is suggested to be an endogenous "danger" signal to the immune system with rapid inflammatory cytokine releases and enhancement of adaptive Th1-type responses. Elucidating the exact role of HSPs in BD pathogenesis might pave the way to less toxic therapeutic approaches to BD, such as antibacterial therapies and immunomodulation.
    Language English
    Publishing date 2013-12-31
    Publishing country Egypt
    Document type Journal Article ; Review
    ZDB-ID 2662558-1
    ISSN 2090-3162 ; 2090-3154
    ISSN (online) 2090-3162
    ISSN 2090-3154
    DOI 10.1155/2013/249157
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