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Background/aim: Systemic sclerosis (SSc) is an autoimmune disease characterized by microvascular injury, excessive extracellular matrix deposition, and fibrosis in the skin and internal organs. Bacterial and viral infectious agents have been suspected to be contributing factors in the development and progression of the pathologic features of SSc. Materials and methods: In this study, 30 SSc patients who were admitted to the rheumatology unit of the Konya Training and Research Hospital and 30 healthy controls were included. The presence of 9 different antibodies (IgM and IgG) against Helicobacter pylori, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and parvovirus B19 were investigated in sera samples obtained from the 60 participants using an enzyme-linked immunosorbent assay method. The characteristics of current and past infections with H. pylori, CMV, EBV, and parvovirus B19 were evaluated by determining the seropositivity of the tested bacterial and viral agents. Results: The prevalences of H. pylori, CMV, EBV, and parvovirus B19 were determined to be higher in patients with SSc than in the control group. Conclusion: SSc is associated with a higher rate of certain infections, which deserves further investigation in order to assess the role of infections in disease etiology/pathogenesis. [ABSTRACT FROM AUTHOR]

Polyarthritis and panniculitis can be the presenting manifestations of pancreatitis. Early recognition of this triad is critical because of the high mortality rate from pancreatic disease when the diagnosis is delayed. Although this association can be seen at any age, its frequency peaks around the fifth decade of life. We report this case because of the rarity of the association and the high morbidity and mortality in these patients. [ABSTRACT FROM AUTHOR]

Objective: In recent years, increasing attention has been given to the role of reactive oxygen metabolites in the pathogenesis of inflammatory diseases such as rheumatoid arthritis (RA). The aim of this study was to elucidate plasma and especially erythrocyte oxidant and antioxidant status in RA patients and to assess the relationship between disease activity scores (evaluated by Disease Activity Score (DAS) 28 as mild, moderate and severe) and antioxidant status. Materials and Methods: Fasting blood samples were obtained from 50 RA patients and 26 control subjects. DAS28 was used to evaluate the activity. Plasma and erythrocyte levels of malondialdehyde (MDA), xanthine oxidase (XO) and superoxide dismutase (SOD) were investigated in both groups. Results: The plasma levels of MDA and XO and erythrocyte levels of MDA and SOD were significantly higher in RA patients than in control subjects. Although increases in plasma MDA levels in mild and moderate and erythrocyte MDA levels in mild activity groups of RA were not significant (p>0.05), plasma MDA levels in severe (p=0.001) and erythrocyte MDA levels in moderate and severe activity groups of RA were significantly higher (p<0.001). Whereas plasma SOD levels showed no significant change (p=0.241), erythrocyte SOD levels were significantly increased in RA patients (p<0.001). Although increase in erythrocyte SOD activity in mild RA was not significant, it was significant in moderate and severe RA (p=0.002 and p<0.001, respectively). Conclusion: These results suggest that increased plasma and erythrocyte MDA levels in RA patients, especially in those with severe activity, indicate an increased oxidative stress due to inflammation. Nonetheless, an increase particularly in erythrocyte SOD activity in moderate and severe RA patients suggests that the cellular antioxidant system might counterbalance the oxidant status in RA patients. [ABSTRACT FROM AUTHOR]

Objective: Fibromyalgia (FM) is a nonarticular rheumatic disorder with an unknown etiology which is characterized by diffuse musculoskeletal pain, tenderness on specific anatomical points and psychological discomfort. There isn't any standardized treatment regime. In recent years some nonpharmacological applications have been come in prominence. These are, hydrotherapy, balneotherapy and massage. In this study, we compared effectiveness and side effects of amitriptyline and hydrotherapy which were used in the treatment of fibromyalgia. Patients and Methods: A total of 51 female patients with FM were included. They were randomly divided into two groups. Group 1 (n=20) took 15 session hydrotherapy along three weeks, group 2 took (n=31) 10 mg/day amitriptyline for eigth weeks. Both groups were examined at the beginning and at the end of the treatment, third and sixth month. The number of tender points (NTP) were evaluated by digital pressure. Likert scoring system were used to assess pain intensity, morning stiffness, skin sensitivity, sleep disturbances, fatigue and muscle spasm. Hamilton Depression Scale (HDRS) and Fibromyalgia Impact Questionnaire (FIQ) were used to evaluate psychologic condition and physical and functional capacity, respectively. Results: In group 2, significant improvement was found in pain, sleep disturbance, fatigue, NTP, FIQ and HDRS values at the end of the treatment. In group 1 significant improvement was obtained in all measurements except skin sensitivity and HDRS. This improvement prolonged up to 3 months in pain, morning stiffness, fatigue, NTP and FIQ. When the two groups were compared there was a significant improvement in hydrotherapy group in pain, sleep disturbance and FIQ at the end of the treatment. Conclusion: Effectiveness of hydrotherapy is more and longer than amitriptyline. When the adverse effects of tricyclic antidepressants are considered, it will be useful to prefer any regimen which has no advers effect. (Rheumatism 2007; 22: 91-6). [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to evaluate alcohol consumption of Turkish rheumatic patients. Patients and methods: A total of 332 subjects [185 males and 147 females; mean ages of 41.2 (95% CI 39.5- 43.0) and 45.2 (95% CI 43.4-47.1) years, respectively] with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and healthy controls were questioned regarding their alcohol habits. Alcohol consumers were asked to fill out the Turkish version of the Michigan Alcoholism Screening Test (MAST). Results: A total of 37.3% of all subjects were alcohol consumers. Nearly 50% of males and 20% of females drank alcohol. Rheumatoid arthritis group had the lowest rate of alcohol consumption (23.0%), while healthy controls had the highest rate (45.6%). The mean MAST scores were 3.02 (95% CI: 2.36-3.69) and 3.13 (95% CI: 1.76-4.5) for the AS and RA groups, respectively, indicating statistically lower rate compared to the healthy controls [4.94 (95% CI: 4.14-5.73) (p<0.001)]. An analysis of the MAST scores by categories revealed that most of the alcohol abusers / alcoholics were in the healthy control group. Conclusion: Our results showed that alcohol consumption, an important public health problem, has not been regarded as a major issue for the patients with rheumatic diseases. Further studies are required to evaluate the potential factors which may play a role in the alcohol consumption habits of rheumatic patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a skin disorder that is associated with arthritis. Sacroiliac joint involvement is considered to be less frequent than the other types of psoriatic arthritis. Additionally, the psoriatic sacroiliitis is considered to be asymmetric in general. We aimed to define the frequency and type of sacroiliac involvement in patients with psoriasis. Patients with psoriasis were included the study. Characteristics of skin, nail and articular involvement were noted. Psoriasis area and severity index was calculated. Antero-posterior pelvic X-rays were obtained and graded by two rheumatologists and a radiologist independently. One hundred and thirty-three patients were included. Thirty-seven of patients (27%) have articular involvement symptomatically. The sacroiliac joint involvement was observed in 34 (26%) of patients. More than one-half of sacroiliac involvement was bilateral while less than one-half was in symptomatic patients regarding sacroiliitis. Fifty-seven percentages of all patients have psoriatic nail involvement. Sacroiliac joint involvement did not show any significant association with psoriatic nail involvement or the severity of skin disease. We found higher frequency of sacroiliac joint involvement and bilateral sacroiliitis in patients with psoriasis. This is in contrast to present information about the association of psoriasis and sacroiliitis. These findings need confirmation by further studies and with more sophisticated techniques such as magnetic resonance imaging. [ABSTRACT FROM AUTHOR]

Objective: To compare grip strength and isokinetic shoulder abduction- adduction maximal muscle strength and to assess the correlation between hand grip strength (HGS) and shoulder strength in primer fibromyalgia patients with healthy controls. Patients and Methods: One hundred patient and 50 healthy women were included in this study. The patient's complaint duration and number of tender points were recorded. The visual analog scale was used for the assessment of pain. Beck depression scale and Fibromyalgia Impact Questionnaire (FIQ) were calculated. Handgrip strength was measured using a handgrip dynamometer and the highest value of sequential 3 measurements was recorded. Isokinetic shoulder abduction-adduction maximal muscle strength was measured at 60 and 180 degrees/sec. All patients' dominant side was assessed. The strength was calculated as the mean of five consantric isokinetic repetations. Results: There was no statistical difference between patients and the control group in age and body mass index (BMI). The mean HGS was 0,41±0,10 and 0,62±0,13 in the fibromyalgia and the healthy group respectively. The mean HGS and shoulder abduction-adduction maximal muscle strength were significantly lower in the fibromyalgia group than the healthy subjects (p<0,001). Whereas a positive correlation was found between HGS and age, BMI and shoulder abduction- adduction maximal muscle strength, a negative correlation was recorded between complaint duration, VAS and FIQ. Conclusion: Hand grip strength may be a simple and effective method to determine muscle performance of the upper extremity. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population.The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle).RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses.CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard. [ABSTRACT FROM AUTHOR]

Behcet’s disease is a multisystemic disorder that the main pathological defect is vasculitis and superior vena cava syndrome (SVCS) caused by vasculopathy is a rare manifestation of the disease. Although successful results of endovascular surgery were observed in some cases, medical therapy may have priority among the treatment alternatives because of the high risk of surgery due to the lesional localization of the vessel. In this report, a Behcet’s disease case with SVCS and 18 months’ follow-up data with medical therapy is presented. [ABSTRACT FROM AUTHOR]