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The aim of this study was to determine the frequency of sarcopenia at the time of diagnosis in patients with rheumatoid arthritis (RA), assessing disease activity and factors that may be associated with sarcopenia and observe effects of treatment on sarcopenia.A prospective study was conducted with patients who have newly diagnosed RA. Patients were evaluated twice, at the time of diagnosis and 3 mo after the initiation of treatment. Demographic data, anthropometric measurements, disease activity scores, and sarcopenia status were recorded. Sarcopenia was evaluated with grip strength and bioelectric impedance. The results were compared with healthy volunteers.The age at onset of RA was 50.6 ± 14.6 y. Handgrip strength (P0.001), skeletal muscle mass (P = 0.009), and skeletal muscle mass index (P = 0.032) were reduced in patients with RA but not in the control group. The frequency of sarcopenia in RA at onset of diagnosis was 31.5%. There was a significant decrease in the rate of sarcopenia after 3 mo of treatment (31.5 versus 8.7%; P = 0.046).Sarcopenia was found in approximately one-third of the patients with newly diagnosed RA in our study. With treatment, sarcopenia improved significantly. Patients with RA should be evaluated in terms of sarcopenia in addition to evaluating joint and extraarticular findings at the time of diagnosis. Early detection and treatment planning may improve quality of life.

Background Intravenous immunoglobulins (IVIg) have been used in management of severe Covid-19. Here in this study, we report our single-center experience regarding IVIg treatment in management of severe Covid-19. Materials and Method Among hospitalized adult Covid-19 patients between April 1 and December 31, 2020, patients with confirmed diagnosis of Covid-19 who had Brescia-COVID respiratory severity scale score ≥ 3, hyperinflammation and received IVIg treatment in addition to standard of care were retrospectively investigated. We grouped IVIg recipients into three according to reasons for IVIg administration: Group 1 patients requiring anti-inflammatory treatment but complicated with secondary infection and/or sepsis , group 2 patients with Covid-19 related complications including progressive disease refractory to other anti-inflammatory agents, myocarditis, adult multisystem inflammatory syndrome, hemophagocytic lymphohystiocytosis like syndrome and group 3 patients with other complications non-specific to Covid-19. Mortality and clinical data was compared among groups. Results A total of 46 IVIg recipients were enrolled. Group 1 comprised 17 (36.9%), group 2 comprised 18 (39.1%) and group 3 comprised 11 (23.9%) patients. No significant differences in means of age, gender and comorbidities were observed among groups. Mortality was significantly lower in group 3 when compared to group 1 (64.7% vs 18.2%, p = 0.016) and close to significance when compared to group 2 (50% vs 18.2% p = 0.087). Conclusions IVIg seemed to be used mostly in severe, refractory and complicated cases in our population. As a rescue agent in severe cases refractory to other anti-inflammatory strategies, 33.7% survival rate was observed with IVIg.

The immune system restrains benign melanocytic lesions, however the relationship between immunosuppression and changes in nevi is not known.We sought to investigate the development of new nevi in patients using immunosuppressive agents, to evaluate any size or dermoscopic changes in existent nevi, and to evaluate any risk of developing melanoma.There were 266 melanocytic lesions in 103 patients undergoing immunosuppressive therapy and 180 melanocytic lesions matched for age, sex, race, and Fitzpatrick skin type in 60 healthy control subjects.Nevus counts increased from baseline in the treatment group (P .001) as did nevus size (P = .046) but the increase compared with the control group only remained statistically significant for nevus numbers (P = .001). There was a statistically significant appearance of dermoscopic changes in the nevi of immunosuppressed patients compared with healthy control subjects (P .001). Ten lesions were excised including 6 because of significant dermoscopic change during treatment and all were benign.Follow-up duration was short and the number of patients was small.Immunosuppressive therapy was associated with increased nevus counts and changed dermoscopic appearance but as none of the changed and subsequently excised nevi were malignant, continued monitoring for invasive features is a reasonable alternative to excision.

Aim In systemic sclerosis (SSc), this single-centre study aimed to define the frequency and association of pulmonary arterial hypertension (PAH), occurring either alone in SSc-PAH or together with interstitial lung disease (ILD-PH). Material-Methods SSc cases between the years 1990-2011 were reviewed, retrospectively. Patients' clinical, laboratory findings, Modified Rodnan Skin Score and Medsger score, 6-minute walk distance (6MWD), carbon monoxide diffusion test (DL CO ), echocardiography, thorax HRCT, and right heart catheterisation findings were recorded. Results One hundred and forty-one cases (F/M:124/17, diffuse cutaneous SSc (DcSSc)/limited cutaneous SSc (LcSSc): 84/57) were included in the study with the mean age of 52.70±15.17 years and disease duration of 107.07±99.44 months. PaO 2 , FEV1 and FVC were lower in DcSSc (p CO and 6MWD did not differ significantly, between the two forms. Ground glass opacity (64.7%) and interlobular septal thickening (58.8%) were the most frequent findings on HRCT of such subjects. PAH was detected in 34 subjects (24.1%). Seven of them had SSc associated PAH (SSc-PAH) and 27 ILD-PH. Both frequencies were similar between DcSSc and LcSSc. Mean sPAP was higher in SSc-PAH. Conclusion PAH was observed in approximately one fourth of patients; therefore advanced cardio-pulmonary investigation should be routinely performed in the SSc patients' management.