Search

In this study, the gamma dose rates in outdoor air at seventy-seven points around Bolu province were meausured using a counter (Eberline, ESP-2). Radiological hazards were evaluated by estimating the excess lifetime cancer risks caused by external exposure. The gamma dose rates measured varied from 11 to 68 nGyh-1with an average value of 22 nGy h-1. The avarege value of the corresponding outdoor annual effective dose and the excess lifetime cancer risk was found as 27.23 μSv and 0.95x10-4, respectively. These values could be compared to other studies which existed in Turkey and also in the world. [ABSTRACT FROM AUTHOR]

The present paper deals with an extension of approximation properties of generalized sampling series to weighted spaces of functions. A pointwise and uniform convergence theorem for the series is proved for functions belonging to weighted spaces. A rate of convergence by means of weighted moduli of continuity is presented and a quantitative Voronovskaja-type theorem is obtained.

Background: Antiphospholipid Syndrome (APS) is one of the most common acquired causes of hypercoagulability. The 2023 American College of Rheumatology (ACR) / European Alliance of Associations for Rheumatology (EULAR) APS Classification Criteria were specified as new APS classification criteria with high specificity for use in observational studies and research. The primary objective of this study was to evaluate the performance of the 2023 ACR/EULAR APS classification criteria in a real-world rheumatology department., Methods: This is a retrospective, single-center study evaluating the sensitivity and specificity of the 2006 revised Sapporo and 2023 ACR/EULAR APS classification criteria in patients diagnosed with APS through clinical evaluation. A total of 184 patients, 103 of whom were diagnosed with APS, were included in the study., Results: The 2023 ACR/EULAR APS classification criteria demonstrate higher specificity 98.8% (95% CI 93.3-99.8) and positive predictive value (PPV) 98.7% (95% CI 93.2-99.8). The revised Sapporo criteria exhibit higher sensitivity 90.3% (95% CI 83-96.6), negative predictive value (NPV) 88.1% (95% CI 79.4-93.4), and accuracy 90.8% (95% CI 85.7-94.1). When the diagnosis of APS was accepted according to the revised Sapporo criteria, the sensitivity of the 2023 ACR/EULAR APS classification criteria was 77% (95% CI 67.8-84.2), specificity 97.6% (95% CI 91.7-99.3), PPV 97.5% (95% CI 69.3-84.9) and NPV 78.1% (95% CI 69.3-84.9)., Conclusion: The 2023 ACR/EULAR APS classification criteria have low sensitivity and high specificity compared to the revised Sapporo APS classification criteria. The increase in specificity is due to risk assessment in thromboses and strict obstetric and laboratory criteria., Competing Interests: Competing interests: The authors declare no conflict of Interest.

Background/aim: The objective of this study was to demonstrate the commonalities and distinctions between patients with seronegative and seropositive primary Sjögren's syndrome (pSS)., Materials and Methods: The records of 399 patients with pSS seen between January 2010 and June 2023 were retrospectively examined. Patients with negative antiSSA/Ro, antiSSB/La, ANA, and RF antibodies comprised the seronegative group, while patients with at least one positive antibody were included in the seropositive group., Results: The most common clinical features between the groups were arthralgia (81.2%), arthritis (11.5%), hematological involvement (19.8%), and pulmonary involvement (11.8%). In 41 patients (10.3%), no autoantibody positivity was detected. The number of patients with at least one extraarticular involvement was statistically more frequent in the seropositive group (p = 0.011). Dry mouth was found to be more prevalent among seronegative patients (p = 0.003). While hyperimmune gammaglobulinemia exhibited a higher prevalence within the seropositive group (p = 0.004), the occurrence of reduced complement levels was at similar rates in both groups. All deaths were observed exclusively within the seropositive group (17/358, 4.7%). No difference was observed between the two groups concerning mortality (p = 0.237) and malignancies (seropositive group: 9/358, 2.5% vs. seronegative group: 3/41, 7.3%, p = 0.115). There was a statistically significant association between low C4 levels (OR = 2.99 [1.09-8.16], p = 0.045 in model 1, OR = 3.10 [1.14-8.42], p = 0.022 in model 2), and the extraarticular findings., Conclusion: While hematological, renal, pulmonary, and neurological involvements are observed with similar frequency in both seronegative and seropositive pSS patients, the presence of extraarticular manifestations was more common in seropositive patients. Additionally, there was a relationship between extraarticular involvement and low C4 levels., Competing Interests: Disclosure statement: The authors have declared no conflict interest., (© TÜBİTAK.)

Background/aim: The aim of the study was to investigate the effect of systemic sclerosis (SSc) on quality of life and sexual function in female patients., Materials and Methods: The study included 30 sexually active female patients with SSc and 30 healthy control subjects. For all participants in both the patient and control groups, the female sexual index and SF-36 forms were completed and a detailed medical and sexual history was taken., Results: The mean age was 45.03 ± 9.22 years in the SSc group and 44.6 ± 11.52 years in the control group (P = 0.87). The SF-36 scores in the patient group were significantly lower than those in the control group. Sexual dysfunction was found in 26/30 (86.6%) of the SSc patients and in 6/30 (20%) of the control group (P = 0.0001). Significant differences were determined between the groups with respect to sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and pain. There was no significant relationship between the subgroups of SSc patients, duration of disease, lung involvement, and FSFI scores., Conclusion: Sexual dysfunction and lower health quality are common problems in female patients with systemic sclerosis.

Background/aims: To establish the prevalence of the single nucleotide polymorphisms (SNPs) of endoplasmic reticulum aminopeptidase 1 (ERAP1), IL-23 receptor (IL-23R), signal transducer and activator of transcription 3 (STAT-3) and Janus kinase 2 (JAK-2) in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) in a Turkish population., Materials and Methods: A total of 562 subjects who presented at the Ankara University internal medicine departments of rheumatology and gastroenterology outpatient clinics were recruited in this study, including 365 patients with AS, 197 patients with IBD and 230 healthy controls. ERAP1, IL-23R, STAT-3 and JAK-2) were genotyped in competitive allele-specific polymerase chain reactions., Results: The ERAP1 (rs26653) polymorphism was found to increase the disease risk in patients with AS and IBD compared with the control group (p=0.02 and p=0.01, respectively). In addition, this polymorphism revealed a significant relationship with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI) in patients with AS (r=0.829, p < 0.001 and r=0.731, p < 0.001, respectively)., Conclusion: The ERAP1 gene polymorphism might be a risk factor in the pathogenesis of AS and IBD. In contrast, IL-23R gene polymorphisms may serve a protective role in AS and IBD.

Objectives: This study aims to investigate whether the protein tyrosine phosphatase non-receptor type 22 (PTPN22) C1858T gene polymorphism plays a role in the pathogenesis of familial Mediterranean fever (FMF) through T-lymphocyte activation., Patients and Methods: We conducted a case-control study with 180 FMF patients (68 males, 112 females; mean age 38.2±1.6 years; range 16 to 81 years) and 184 healthy controls (86 males, 98 females; mean age 32.9±9.2 years; range 18 to 58 years). The PTPN22 C1858T polymorphism (rs2476601) was genotyped by polymerase chain reaction restriction fragment length polymorphism. In patients with FMF, clinical features, disease severity score, the frequencies of amyloidosis, positive family history, and Mediterranean fever gene mutations were determined., Results: The frequencies of heterozygous genotype (CT) were 4.5% in FMF patients and 2.8% in healthy controls, respectively. The frequencies of polymorphic homozygous genotypes (TT) were 0.5% in both FMF patients and healthy controls. There were no statistically significant differences in the frequencies of CT and TT genotypes between FMF patients and healthy controls (odds ratio: 1.65, 95% confidence interval: 0.53-5.14, p>0.05 for CT genotype). The frequencies of clinical features, sex, amyloidosis, positive family history, Mediterranean fever gene mutations, and disease severity score were not significantly different between the patients., Conclusion: The distribution of PTPN22 C1858T polymorphism did not reveal any association with FMF in a Turkish population., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Objective: The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis., Material and Methods: Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included. The case report form (CRF) consisted of demographic data, rheumatic diseases, treatment profiles, transaminase levels, viral hepatitis serological markers, and HBV viral load. The reactivation of HBV was defined as the abrupt rise in HBV replication by an increase in serum HBV DNA levels in a patient with a previously inactive HBV infection., Results: In total, the data of 101 (female 50.5%) patients were included (76 patients with inactive HBV carriers and 25 patients with chronic HBV infection). The mean age of patients was 44±12 years, and the mean follow-up duration was 31±22 months. Of the 101 patients, 70 (69.3%) received antiviral treatment. HBV reactivation was detected in 13 of 76 (17.1%) patients with inactive HBV carriers. HBV reactivation was observed less frequently, not although significantly, in those patients receiving antiviral prophylaxis compared with those not receiving prophylaxis [5/41 (12.2%) vs. 8/33 (24.2%), p=0.17]. Forty-two patients (31 patients had inactive HBV carriers) were using anti-tumor necrosis factor agents. HBV reactivation was detected in 6 of the 31 (19.3%) patients. Twenty-five patients had chronic hepatitis, and five (20%) of them had not received antiviral prophylaxis. HBV viral loads were persistently elevated in 7 (28%) of 25 patients (three patients under and four patients not under antiviral treatment)., Conclusion: HBV reactivation was observed in approximately 17% of patients under immunosuppressive treatments. HBV reactivation was more frequently observed in those who did not receive antiviral prophylaxis.

Objectives: This study aims to assess the role of several diagnostic tests and tools, immune markers, and the association between serum pro-brain natriuretic peptide levels and other parameters in patients with collagen tissue disorders with pulmonary involvement., Patients and Methods: In this prospective study, 62 patients (17 males, 45 females; mean age 58.1±13.6 years; range 24 to 87 years) with pulmonary involvement of connective tissue disorders were evaluated using several functional parameters (six-minute walking test, serum pro-brain natriuretic peptide, echocardiographic measurement of the pulmonary pressure, respiratory functional parameters, and blood pressure measurement), bronchoalveolar lavage differential cytology and/or flow cytometric analysis., Results: Duration of disease was 7.6 years. Diagnoses included rheumatoid arthritis (38.7%), scleroderma (38.7%), primary Sjögren's syndrome (16.1%), mixed collagen tissue disorder (4.8%), and systemic lupus erythematosus (1.6%). Pulmonary hypertension was present in 38.7% of the patients with the highest incidence of rheumatoid arthritis showing reduced respiratory functions, partial oxygen pressure, and six-minute walk distance, as well as increased serum pro-brain natriuretic peptide and neutrophilic alveolitis., Conclusion: High serum pro-brain natriuretic peptide levels and neutrophilic alveolitis may provide diagnostic clues for a possible diagnosis of pulmonary hypertension and impaired respiratory functions., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Objectives: Behçet's disease (BD) is a chronic, multisystemic disorder characterised by recurrent oral aphtous ulcers, genital ulcers and ocular inflammation. Vasculitis and thrombotic events are the most important causes of mortality. Vena cava thrombosis, pulmonary artery aneurysms, Budd-Chiari syndrome, peripheral artery aneurysms, dural sinus thrombosis and abdominal aorta aneurysms are the other less common vascular manifestations of BD. Cardiac involvement in BD is a rare and life-threatening complication. The aim of this study was to assess the clinical characteristics and outcome of patients with BD who have intracardiac thrombus., Methods: The hospital files of BD patients followed by rheumatology clinics of four medical centres (Ankara University, Ege University, Hacettepe University and Eskişehir Osmangazi University Hospitals) were retrospectively evaluated. Data included patients' demographic and clinical features, laboratory findings and outcome. All patients fulfilled three or more of the International Study Group Criteria for BD., Results: Twenty-two patients with intracardiac thrombus were evaluated. The mean age of patients with intracardiac thrombosis was 29.1 yrs (22-44) and there was a male predominance with a ratio of 20:2. Cardiac involvement was the first clinical manifestation of BD in 9 of the 22 patients. Initial symptoms of the patients were fever (n=18, 81%), dyspnea (n=9, 40%) chest pain (n=9, 40%) and haemoptysis (n=7, 31.8%). Sixteen patients (72%) had pulmonary arteritis and 10 (45%) patients had venous system lesions included deep vein, inferior vena cava and hepatic vein. Intra-cardiac thrombus were found only in the right cavities in 17 patients (77%), only in the left cavities in 2 patients (9%), and in both left and right cavities of the heart in 3 patients (13.6%). Once the cardiac lesion was diagnosed as a complication of BD, high dose (1mg/kg/d) prednisone (n=22, 100%) plus cyclophosphamide (n=18, 81%) or azathioprine (n=3, 13.6%) and warfarin (n=8, 36.3% (after the elimination of pulmonary aneurysm) therapy for anticoagulation was initiated. Four patients (18%) had high dose prednisone plus cyclophosphamide plus interferon-α (IFN-α) combination treatment and two patients (n=2, 9%) had high dose prednisone plus cyclophosphamide or plus azathioprine combination treatment. After treatment, the intra-cardiac thrombus disappeared in 13 cases and the size of the thrombus reduced in 7 cases. One patient died because of recurrent intra-cardiac thrombus and massive pulmonary arteritis in the emergency department., Conclusions: Intracardiac thrombus in BD is more common in young men. The right side of the heart is usually involved and cardiac involvement is often accompanied by pulmonary artery occlusion possibly due to pulmonary arteritis. Early and aggressive immunosuppressive and/or anticoagulation therapy are life-saving.

We report the case of a male patient with limited cutaneous systemic sclerosis (SSc) that was complicated with severe digital ischemia, resistant to medical treatment. Due to the lack of treatment response, further laboratory and imaging studies were conducted. Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. After successful anticoagulation no further recurrences of digital ischemia were seen. An underlying etiology in SSc patients with treatment resistant digital ischemic necrosis should be suspected for accompanying antiphospholipid syndrome (APS).

The study was aimed to evaluate the possible effects of dexamethasone on oxidant/antioxidant status in kidney tissues of rats administered mercuric chloride (HgCl2). Thirty male Wistar-albino rats were enrolled in this study. Rats were divided into 4 groups: G1 (n=7) underwent no therapy (control group), G2 (n=8) received HgCl2 + physiological saline, G3 (n=7) dexamethasone (DM) + physiological saline and G4 (n=8) received HgCl2 + DM. HgCl2 was injected subcutaneously into rats in the G2 and G4 on the first day of the study. Dexamethasone was injected intraperitoneally into rats in the G3 and G4 for 3 days. Malondialdehyde (MDA) levels, catalase (CAT), glutathione peroxidase (GSH-Px), xanthine oxidase (XO) and superoxide dismutase (SOD) activities were evaluated in the kidney tissues. Serum creatinine levels were also measured. Xanthine oxidase activity was increased in the G2 compared to the control group. Catalase activity in the control group was significantly higher compared to the other groups. In the histopathological examination of kidneys, there was a tubular degeneration in G2 and G4. It was concluded that HgCl2 administration may cause oxidative stress through increasing XO and decreasing CAT activities. Dexamethasone injection may partially protect the rat kidneys against oxidative reactions by preventing the increase in XO activity (Tab. 1, Ref. 33).

Background & Objective: Systemic sclerosis (SSc) is a connective tissue disease characterized vascular damage and fibrosis. The aim of this study was to investigate the possible relation between systemic sclerosis and paraoxonase which is an antioxidant enzyme on the HDL., Methods: Twenty nine patients with SSc and 16 healthy subjects (control group) participated in the study. Plasma cholesterol levels, anti-centromere antibody (ACA) levels and paraoxonase (PON) activities were measured., Results: Lower level of high-density lipoprotein (HDL) cholesterol was observed in ACA negative SSc patients than in controls. Paraoxonase activity in ACA positive patients was however found to increase relative to control and ACA negative patient groups., Interpretation & Conclusion: Our findings suggested that low HDL level in ACA negative SSc patients might be one of the factors leading to some vascular problems, and increased PON activity in ACA positive SSc group might have some role in the limitation of cutaneous sclerotic process observed in these patients. However, these preliminary findings need to be confirmed with a larger sample.

Objective: To investigate malondialdehyde (MDA) and nitric oxide (NO) levels in the erythrocytes from patients with systemic sclerosis (SSc)., Subjects and Methods: Twenty-nine patients diagnosed as having SSc and 16 volunteer healthy subjects (as control group) participated in the study. Fasting blood samples were obtained from the patients and healthy subjects in anticoagulated tubes (with EDTA), and the erythrocytes were separated. The MDA and NO levels were measured in the erythrocyte sediments by the spectrophotometric method., Results: The levels of MDA and NO were elevated in the erythrocyte sediments of the patients as compared to those of the control group (1.037 +/- 0.125 vs. 0.951 +/- 0.114 mumol/g Hb, respectively, p = 0.047 for MDA, and 0.340 +/- 0.071 vs. 0.209 +/- 0.074 mmol/g Hb, respectively, p < 0.001 for NO). A weak positive correlation was also observed between MDA and NO levels (r = 0.30, p = 0.15 in the patient group, and r = 0.27, p = 0.49 in the control group)., Conclusions: Our results show higher levels of MDA and NO in the erythrocytes of patients with SSc than normal subjects., ((c) 2008 S. Karger AG, Basel)

Background/aims: Three missense mutations clustered on the carboxyl-terminal portion of the MEFV gene (M680I, M694V, and V726A) have been observed in over 80% of affected alleles in several ethnic groups of familial Mediterranean fever patients. Several immunologic abnormalities were found both in cellular and humoral components in Mediterranean fever patients. Those observations have pointed the way for analysis of the HLA region in Mediterranean fever. We intended to compare HLA DR/DQ alleles with those major mutations in the MEFV gene in Mediterranean fever patients., Methods: The distribution of MEFV gene mutations and HLA-DR, HLA-DQ alleles were analyzed in 40 index Turkish Mediterranean fever patients, 28 family members and 42 healthy controls. M680I, M694V, and V726A mutations were studied by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) analysis. HLA-DR and DQ allele subgroups were studied using SSP-PCR technique., Results: A total of 37 (92.5%) patients in 40 Mediterranean fever index patients were found to carry one of the three missense mutations. The HLA-DR4 allele frequency was significantly higher in the Mediterranean fever patient group. When comparisons were made between Mediterranean fever mutations and HLA allele frequencies, M694V mutation with HLA DR3, DR11/5 and DR 13/6 and M680I mutation with DR7 allele subgroups were statistically significant. DQ6/1, DQ7/3, and DQ8/3 allele with M694V, DQ2 allele with M680I, and DQ6/1 with V726A mutations were also statistically significant., Conclusions: Our results indicate a relationship between some HLA-DR/DQ alleles and MEFV mutations in Mediterranean fever patients. We suggest HLA-DR/DQ alleles and their role in the pathogenesis of Mediterranean fever need further analysis and comparative studies.

Skin prick testing (SPT) is widely used in the assessment of allergic disorders. Different SPT techniques are widely used. The aim of this study was to compare the response to SPT using a multiple lancet device (MLD) with the results of a single lancet (SL). Fifty patients with allergic rhinitis were included in this study. Initially, SPT was performed by a SL technique. After one week SPT was repeated using the MLD on all patients. The patients were tested with a panel containing 19 specific allergens including grass pollen, tree pollen, house dust mites, weed pollen allergen extracts, histamine and a negative control. The skin responses were recorded after 15 minutes for each device by measuring the diameter of the wheal and the erythema. The skin wheal responses for grass pollen, tree pollen, weed pollen and house dust mite allergen extracts obtained using the SL were generally significantly larger than those using the MLD. The comparison between the MLD and the SL methods revealed that SPT was positive with SL and negative with MLD in 176 tests (15.3%), and on the contrary SPT was positive with MLD and negative with SL in only 13 tests (1%). In conclusion, we claim that SPT using SL shows a higher degree of sensitivity and reproducibility.

The acute effects of active and passive ascent to high altitude on plasma volume (PV) and rates of synthesis of albumin and fibrinogen have been examined. Measurements were made in two groups of healthy volunteers, initially at low altitude (550 m) and again on the day after ascent to high altitude (4,559 m). One group ascended by helicopter (air group, n = 8), whereas the other group climbed (foot group, n = 9), so that the separate contribution of physical exertion to the response could be delineated. PV was measured by dilution of (125)I-labeled albumin, whereas synthesis rates of albumin and fibrinogen were determined from the incorporation of isotope into protein after injection of [ring-(2)H(5)]phenylalanine. In the air group, there was no change in PV at high altitude, whereas, in the foot group, there was a 10% increase in PV (P < 0.01). Albumin synthesis (mg. kg(-1). day(-1)) increased by 13% in the air group (P = 0.058) and by 32% in the foot group (P < 0.001). Fibrinogen synthesis (mg. kg(-1). day(-1)) increased by 40% in the air group (P = 0.068) and by 100% in the foot group (P < 0.001). Hypoxia and alkalosis at high altitude did not differ between the groups. Plasma interleukin-6 was increased modestly in both groups but C-reactive protein was not changed in either group. It is concluded that increases in PV and plasma protein synthesis at high altitude result mainly from the physical exercise associated with climbing. However, a small stimulation of albumin and fibrinogen synthesis may be attributable to hypobaric hypoxia alone.