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Objectives: In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc). Patients and methods: Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9±12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruöz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients. Results: All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p=0.001 and p=0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p<0.001) as HAQ (β=0.397, 0.386, 0.452), SHAQ (β=0.397, 0.448, 0.372), DHI (β=0.446, 0.536, 0.389), PCS (β=-0.417,-0.499, -0.408) and MCS (β=-0.478, -0.441, -0.370) in combined, lcSSc and dcSSc patients respectively. The factors associated with high disability and low QoL scores were forced vital capacity for HAQ (β=-0.172, p=0.002) and SF-36 PCS (β=0.187, p=0.001); disease duration for HAQ (β=0.208, p<0.001), DHI (β=0.147, p=0.006), and SF-36 PCS (β=-0.134, p=0.014); 6-minute walk test for HAQ (β=-0.161, p=0.005) and SF-36 PCS (β=0.153, p=0.009); and modified Rodnan skin score for SHAQ (β=0.250, p<0.001) and DHI (β=0.233, p<0.001) in SSc patients. Diffusing capacity of the lungs for carbon monoxide for HAQ (β=-0.189, p=0.010) and SHAQ (β=-0.247, p=0.002); erythrocyte sedimentation rate for DHI (β=0.322, p<0.001); age for SF-36 PCS (β=-0.221, p=0.003) and body mass index for SF-36 PCS (β=-0.200, p=0.008) and MCS (β=-0.175, p=0.034) were the other variables associated with high disability or low QoL scores in SSc subsets. Conclusion: Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc. [ABSTRACT FROM AUTHOR]

To evaluate bone loss in the early- and late-stage ankylosing spondylitis (AS) patients using posteroanterior (PA) and lateral lumbar and femoral bone mineral density (BMD) measurement methods. Eighty-six AS patients and 50 control subjects were enrolled. PA spine, lateral spine, and femur BMD values of patients and controls were measured. The presence of any syndesmophytes or compression fractures was determined. Patients were divided as early (<10 years) and late stage (≥10 years) according to the onset of the inflammatory pain. Mean PA spinal BMD was similar in patients and controls ( p = 0.460). Femoral and lateral spine BMD values were significantly lower in patients ( p = 0.012 and p = 0.001). When comparing early- and late-stage AS groups, mean PA spinal BMD was found to be lower in the early group ( p = 0.005), while femoral and lateral spinal values were lower (although statistically not significant) in the late group. At least one compression fracture was present in 28 % of patients. Although not statistically significant, mean PA spinal BMD was higher in those with fractures. Femoral and lateral spinal BMD values were significantly lower in the fracture group ( p = 0.034 and p = 0.004). Lateral spinal BMD values were significantly lower in patients with syndesmophytes ( p = 0.004). Bone loss is increased in AS compared with control subjects. The BMD measurement at the lateral lumbar spine reflects bone loss and fracture risk better than PA spine and femoral measurements. [ABSTRACT FROM AUTHOR]

An increased incidence of tuberculosis has been seen in recent years due to factors such as immunocompromising diseases and drug use. There has also been an increase in osteoarticular involvement. In this article, we report a 22-year- old male patient who was diagnosed with tuberculosis of the knee and acromioclavicular joints. Tuberculosis of this joint is very rare, and concomitancy with the knee has not been reported in the literature. The definitive diagnosis was performed by the histopathological examination of a synovial biopsy. The chest radiograph showed cavitation and the magnetic resonance imaging examination showed characteristic demonstrative findings. Antituberculosis drug treatment was started with a satisfactory response. [ABSTRACT FROM AUTHOR]

Objectives: In this study we evaluated the relationships between clinical findings, quality of life and functional disability related to disease activity in patients with ankylosing spondylitis (AS). Patients and methods: Seventy-three patients diagnosed with AS (62 males, 11 females; mean age 33.3±9.5 years; range 17 to 60 years) who fulfilled the modified New York criteria were included in this study. The mean age for female patients was 29.2±7.3 years and for males 34.0±9.7 years. The demographic data of the patients were recorded. The disease activity was assessed using the Bath ankylosing spondylitis disease activity index (BASDAI). The functional disability was evaluated using the Bath ankylosing spondylitis functional index (BASFI). The clinical status was evaluated with the Bath ankylosing spondylitis metrology index (BASMI) and the quality of life was assessed with the Short Form 36 (SF-36). Results: The patients were divided into two groups: patients having a BASDAI score of less than four (BASDAI <4) with mildly active disease (n=34) and patients having a BASDAI score of four or higher (BASDAI ≥4) with moderate-severe disease activity (n=39). The BASFI and BASMI scores were higher in patients with high disease activity (p<0.05), and a significant correlation was found between the BASDAI total score and the BASFI and BASMI scores (p<0.05). Patients with a BASDAI score of <4 had a lower finger floor distance, a higher cervical rotation and modified Schober's measurement values compared with patients with a BASDAI score of ≥4. There was a significant correlation between the BASDAI score and SF-36 subscores of physical function, physical role, bodily pain and emotional role (p<0.05). Conclusion: Clinical findings, functional disability, metrological measurements and quality of life are adversely affected by disease activity in AS. The subgroups of SF-36 subscores related to physical health show a more significant relationship with the disease activity in AS. [ABSTRACT FROM AUTHOR]

ABSTRACT. Purpose: To report a rare case of bilateral asymmetrical melanin-like pigments found in the cornea, conjunctiva and sclera. Methods: Systemic investigation with clinical and laboratory analysis. Results: The case was diagnosed as one of alkaptonuria and ocular ochronosis. [ABSTRACT FROM AUTHOR]

The association between spondyloarthritis and cardiovascular (CV) diseases is complex with variable outcomes. This study aimed to assess the prevalence rates of CV diseases and to analyze the impact of CV risk factors on CV disease in patients with spondyloarthritis. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. The prevalence rate of CV disease was 3.0% in patients with spondyloarthritis. Hypertension, dyslipidemia, and cancer history were the independent CV risk factors for CV disease in patients with spondyloarthritis. [ABSTRACT FROM AUTHOR]

Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030–20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567–13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain. [ABSTRACT FROM AUTHOR]

Objectives: Considering that the comorbid situations during the management of Spondyloarthritis (SpA) have been underlined in several recommendations, the main objective of this study was to evaluate the comorbid conditions of Turkish patients with SpA. Patients and methods: This cross-sectional observational study was conducted with 1,242 SpA patients (844 males, 398 females; mean age: 43.9±11.0 years; range, 19 to 81 years) diagnosed according to the modified New York criteria for ankylosing spondylitis or the Assessment of SpondyloArthritis International Society (ASAS) criteria. The patient data were collected from the Biologic and targeted Synthetic antirheumatic drugs Registry (BioStar) between February 1, 2019, and December 29, 2020. Clinical and demographic data, including, age, sex, disease duration, body mass index (BMI), pain, patient's global assessment, physician's global assessment, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and Maastricht Enthesitis Score, were recorded. Comorbid conditions were recorded by filling out a questionnaire according to the clinical history or medical records. Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index scores were calculated from the gathered comorbidity information. Results: Nine hundred thirteen patients had radiographic axial SpA, 153 had nonradiographic axial SpA, and 176 had peripheral SpA. The most common comorbidities were hypertension (HT) (n=167, 13.4%), diabetes mellitus (DM) (n=83, 6.7%), thyroid disorders (n=64, 5.6%), and depression (n=61, 4.9%). The comorbidities and the calculated comorbidity indices were significantly higher in females, in those with a BMI >25 kg/m2, and those over 60 years of age. No relationship was found between smoking and alcohol use and comorbidities. A significantly higher prevalence of HT and DM in peripheral SpA patients and a lower prevalence of thyroid disorders in radiographic axial SpA patients were observed. Conclusion: The most commonly reported comorbidities were HT, DM, thyroid disorders, and depression in SpA patients according to the BioStar database. The frequency of comorbidities and composite comorbidity scores were higher among females, older (>60 years) patients, and overweight (BMI >25 kg/m2) patients. [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]

In this study, it was aimed to investigate the effects of tarantula cubensis extract (TCE) and low-level laser therapy (LLLT) on cancellous and cortical bone repair. A circular unicortical bone defect was created on both the cancellous and cortical regions of the tibia of each subject. The subjects, totaling 54 mature New Zealand rabbits, were randomly allocated into three groups (n:18 each): control, LLLT (Galium-aliminum-arsenide laser at a wavelength of 780 nm and 4 J/cm², 5 min/day) and TCE (1 µg/kg) groups. Relative optic density (ROD) level was higher in the TCE group than the control group on day 28 as radiological (P<0.05). In both cancellous and cortical bone, inflammatory cell densities were less on the 14 and 21st day in the TCE and LLLT groups, bone tissue formation and qualities were higher 7 and 14th days in TCE and LLLT and collagen maturation were higher 28th day in the TCE group as histopathological (P<0.05). In this study, TCE accelerates bone repair as much as LLLT and more than the control group. In conclusion, that TCE is an effective, easier to apply and more economical supportive treatment in bone defects like LLLT. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Türkiye by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results: The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis.Method: Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over 6 months of period, after spinal decompression and fusion. The main outcome measures were motor development of the patients who were evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was made according to American Spinal Injury Association (ASIA).Results: The study population consisted of 47 patients (22 males and 25 females) mean aged 37.9 +/- 18.3 years (range 5-76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6 month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities; truncal and sacrospinal extensors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly (P < 0.001). The self-care and mobility categories of the MBI on admission; were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent.in Conclusion: Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis. [ABSTRACT FROM AUTHOR]

Objectives. – To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis.Methods. – Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over a period of 6 months, after spinal decompression and fusion. The main outcome measures were motor development of the patients was evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was make according to American Spinal Injury Association (ASIA).Results. – The study population consisted of 47 patients (22 males and 25 females) mean age 37.9 ± 18.3 years (range 5–76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6th month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities, truncal and sacrospinal extansors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly (P < 0.001). The self-care and mobility categories of the MBI on admission were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent.Conclusion. – Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis. [Copyright &y& Elsevier]

The study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) in patients with familial Mediterranean fever (FMF) and to assess the relationships between FMF characteristics and severe COVID-19 outcomes such as hospitalization. The study was planned within a national network of 21 different centers. Demographics, FMF-related clinical and genetic characteristics, and COVID-19 outcomes were obtained. A total of 822 patients with FMF (mean age of 36 years) were included in the study. Fifty-nine of them (7%) had a COVID-19 diagnosis confirmed by real-time PCR test or chest CT findings. Most FMF patients with COVID-19 (58) had mild and moderate disease activity. All patients were on colchicine treatment. However, 8 of them (13.6%) were not compliant with colchicine use and 9 of them (15.3%) were colchicine resistant. Twelve FMF patients with COVID-19 were hospitalized. There were 4 patients requiring oxygen support. COVID-19 related complications were observed in 2 patients (1 thromboembolism, 1 acute respiratory distress syndrome). Hospitalized COVID-19 patients with FMF were older than non-hospitalized patients (median ages: 51 and 31 years, respectively; p: 0.002). Other FMF-related characteristics were similar between the groups. FMF-related characteristics were not found to be associated with poor outcomes in COVID-19. Thus, FMF may not be a risk factor for poor COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. Methods: Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. Results: A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p<.002), fatigue (p<.001), ESR (p<.001), DAS28 (p<.001), BASDAI score (p<.001), PsAQoL (p<.001), HAQ score (p<,01), HAQ-S score (p<.001), anxiety (p<.001), depression (p<.024), FACIT (p<.001) and FiRST (p<.001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p<.001) and PASI score (p<.005) were statistically worse in male patients than in female patients with axial involvement. Conclusion: This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$<300), smoking, late-onset FMF (>20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale. [ABSTRACT FROM AUTHOR]

The aims of this study were to investigate the main clinical and laboratory features, including pregnancy and genetic analysis, of Turkish Familial Mediterranean Fever (FMF) patients and to analyze the relationships between genotypic features, age of disease onset, clinical findings, and disease severity. A study was planned within a national network of 22 different centers. Demographics, clinical and laboratory findings, attack characteristics, drugs, pregnancy and birth history, disease severity, and gene mutation analyses were evaluated. Disease severity, assessed using a scoring system developed by Pras et al., was evaluated in relation to gene mutations and age of disease onset. A total of 979 patients (643 females and 336 males; mean age: 35.92 ± 11.97 years) with FMF were included in the study. Of a total of 585 pregnancies, 7% of them resulted in preterm birth and 18.1% resulted in abortions. During pregnancy, there was no FMF attack in 61.4% of patients. Of the MEditerranean FeVer (MEFV) mutations, 150 (24.3%) cases were homozygous, 292 (47.3%) cases were heterozygous, and 175 (28.4%) were compound heterozygous. Patients with homozygous gene mutations had more severe disease activity, earlier age of disease onset, higher rates of joint and skin involvement, sacroiliitis, and amyloidosis. Patients with compound heterozygous genotype displayed severe disease activity in close resemblance to patients with homozygous mutation. In addition, patients with compound heterozygous mutations had higher rates of protracted febrile myalgia and elevated fibrinogen levels. In 63.9% of compound heterozygous patients, age of onset was < 20 years, with greater disease severity, and high rates of attack frequency and colchicine resistance. Our results suggest that indicators for disease severity include early onset of disease and homozygous gene mutations. Furthermore, patients with compound heterozygous mutations displayed significant presentations of severe disease activity. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine. [ABSTRACT FROM AUTHOR]

Background/aim: In this study, it was aimed to investigate the effects of pulsed electromagnetic field (PEMF) therapy on pain, disability, psychological state, and quality of life in cervical disc herniation. Materials and methods: Patients were randomly divided into two groups, including Group 1, which received a therapy consisting of transcutaneous electrical nerve stimulation (TENS), hot pack (HP), and PEMF, and Group 2, which received a magnetic field (sham magnetic field) without current flow in addition to TENS and HP therapy. Pain was assessed by a visual analog scale (VAS, 0-10 cm). The other outcome measures were function (Neck Pain and Disability Scale), anxiety-depressive mood (Hospital Anxiety and Depression Scale), and quality of life (Nottingham Health Profile). All evaluations were performed at baseline, in the 3rd week, and in the 12th week after treatment. Results: A significant improvement was found in the neck pain, disability, depression, anxiety, and quality of life scores of both groups after treatment when compared to those before treatment. However, in the comparison between changes within groups, significant improvements were determined only in the VAS and Nottingham Health Profile sleep subparameter in the 12th week after treatment compared to those before treatment. Conclusion: PEMF therapy in cervical disc herniation can be used safely in routine treatment in addition to conventional physical therapy modalities. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range, 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range, 16 to 97 years) by trained general practitioners across the country, in 25 provinces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim of this study was to evaluate sleep quality and the related variables in patients with Behçet's disease (BD). Method: One hundred and twelve patients diagnosed with BD and 67 age‐ and gender‐matched healthy controls were enrolled in the study. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of sleep disturbance in all participants. The quality of life (QoL) of all patients were evaluated by Nottingham Health Profile (NHP), and anxiety and depression which were assessed by Hospital Anxiety and Depression Scale (HADS). Results: The patients with BD had significantly higher scores in subjective sleep quality, sleep latency, sleep efficiency, sleep disorder, functional disorder in the morning and total PSQI score compared to the healthy control group. According to Pearson's analysis, there was a significantly higher correlation between the anxiety, depression and all components of NHP scores and the total PSQI score. Logistic regression analyses indicated that genital ulcer and arthritis were predictors for poor sleep quality. Conclusion: Sleep quality is disturbed in patients with BD. The lower quality of sleep is greatly associated with anxiety, depression, QoL, genital ulcers and arthritis. [ABSTRACT FROM AUTHOR]

Objectives To investigate performance of some of the published psoriatic arthritis ( Ps A) classification criteria as well as Assessment of Spondyloarthritis International Society ( ASAS) criteria for peripheral spondyloarthritis (SpA) in Turkish patients with PsA (in early and late disease subgroups). Methods Patients were recruited using case report forms and physical examination methods proposed by the Anatolian Group for the Assessment in Rheumatic Diseases ( ANGARD). The Moll and Wright (MW), modified Fournie (MF), modified McGonagle (m MG), Vasey and Espinoza (VE), classification of PsA (CASPAR) criteria and ASAS criteria were assessed in patients with PsA who were diagnosed based on expert opinion. Results One hundred and twenty-eight patients with PsA (58 male, 70 female, mean age 41.8 years) were included. Thirty patients were in the early PsA and 98 patients were in the late PsA groups. Diagnostic delay was 2.6 years. In the 15.6% of patients arthritis developed before the skin findings. The proportion of patients fulfilling the MW, MF, m MG, VE, CASPAR and ASAS criteria were at a ratio of 90.6%, 82.8%, 62.5%, 84.4%, 96.1% and 76.5%, respectively. In early PsA (< 12 months disease duration) the proportions were 93.4%, 83.3%, 76.7%, 76.7%, 96.7% and 66.6%, respectively. On the other hand, in late PsA the proportions were 89.8%, 82.6%, 57.1%, 86.7%, 95.9%, 79.5%, respectively. Conclusions Even though the sensitivity of Ps A classification criteria in Turkish patients changes, the CASPAR criteria seems to be more prominent among all criteria for both early and late cases with its high sensitivity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fibromyalgia syndrome (FMS) is a non-articular rheumatic disorder of unclear etiology, characterized by widespread body pain, fatigue and, psychological complaints OBJECTIVES: To investigate the serum levels of neuron-specific enolase (NSE) in patients with FMS and to evaluate the relationship between cognitive function, quality of life and psychological state. MATERIALS AND METHODS: Fifty-five female patients diagnosed with fibromyalgia according to the American College of Rheumatology (ACR) classification criteria, and 40 healthy female subjects were enrolled in the study. Life quality scale [(Fibromyalgia Impact Questionnaire (FIQ)], psychological state (Beck Depression Scale), and cognitive dysfunction (mini mental test, clock drawing test) scales were used for patients and control subjects. Serum NSE levels were studied using the ECLIA method. RESULTS: No significant differences were found in the serum NSE levels between the FMS patients and the control subjects (p> 0.05). Life quality and psychological state scores were found to be higher in FMS patients relative to the control group (p< 0.001). However, no significant differences were detected in cognitive function (p> 0.05). Significant correlations were not found between the serum NSE levels and quality of life, psychological state and cognitive functions (p> 0.05). CONCLUSION: No significant difference was determined between the groups in terms of NSE levels. Further studies, including larger series, should be carried out to clarify this relationship. [ABSTRACT FROM AUTHOR]

BACKGROUND: Subacromial impingement syndrome (SIS) is characterized by pain and disability of shoulder. Various treatment methods have been used for SIS. OBJECTIVES: The aim of our study was to evaluate efficacy of therapeutic ultrasound (US) on pain, disability, anxiety, depression, sleep quality and quality of life in patients with SIS. METHODS: Patients with SIS were randomly divided into two groups, including the group 1 (continuous US group; 3 MHz, 1.5 W/cm2, n = 26) and group 2 (sham US group, n = 24). Additionally, transcutaneous electrical nerve stimulation (TENS) + exercise program were added in both groups. Pain and disability of the shoulder were assessed by the Shoulder Pain and Disability Index (SPADI), while anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Quality of life was evalutaed by the Nottingham Health Profile (NHP). Patients were evaluated at baseline and after end of three weeks. RESULTS: Both groups had significantly improvements in terms of SPADI-pain, SPADI-disability, SPADI-total, NHP-pain and NHP-sleep scores after the three weeks interventions. There were significantly improvements in the Group 1 in terms of PSQItotal, and NHP-physical activity. Group 2 had significantly improvements in terms of anxiety-HADS, depression-HADS and NHP-emotional reaction scores. In the inter-group comparison, there were no significantly differences in the change scores were observed in any domains of SPADI scores, anxiety, depression and sleep scores, or any NHP scores. CONCLUSIONS: Our study showed that US does not have any benefits on SIS. TENS + exercise program are not effective on anxiety, depression and fatigue, however TENS + exercise program are effective on pain, disability and sleep disturbance in patients with SIS. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Patients and methods: Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age sex-and body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Results: Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulqaris patients than controls. Conclusion: This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21 6% versus 5.3%, respectively). [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (−CRP) and ASDAS-erythrocyte sedimentation rate (−ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA. [ABSTRACT FROM AUTHOR]

To determine the relationship between serum leptin levels and disease activity in systemic sclerosis (SSc). A total of 60 subjects (30 controls and 30 patients) were included. The inflammatory markers and leptin levels were evaluated and body mass index (BMI) was measured for both groups. The assessment of the skin involvement was performed based on the modified Rodnan skin score (mRSS). Disease activity was evaluated according to the Valentini scleroderma disease activity index. There was a significant difference between the patient and control groups in terms of BMI ( p < 0.05); however there was no difference with regards to age and gender ( p > 0.05). Valentini scores and mRSS were determined to be significantly higher in active patients ( n = 14) than in inactive patients ( n = 16) ( p < 0.05). No significant difference was determined between groups in terms of leptin levels ( p > 0.05). However, leptin levels were significantly lower in active patients than in inactive patients ( p < 0.05). We found a significant positive correlation between serum leptin and BMI ( p < 0.05), and leptin and serum C3 levels ( p < 0.05); no relationship was detected between leptin and other parameters. Leptin can be used as an activity marker in SSc. Further studies, including larger series, should be carried out to clarify this relationship. [ABSTRACT FROM AUTHOR]

Objective: Endothelial dysfunction and vasculopathy are crucial pathogenic factors in systemic sclerosis. Increased concentrations of plasma asymmetric dimethylarginine (ADMA) may also contribute to endothelial dysfunction in patients with systemic sclerosis. We evaluated the relationship between ADMA and aortic elastic properties in patients with systemic sclerosis. Material and Method: Plasma ADMA levels were measured in 30 patients with systemic sclerosis (28 females, mean age 40.7±11.6) and 30 healthy subjects (27 females, mean age 40.6±13). Aortic stiffness was determined with echocardiography. Results: In patients with systemic sclerosis, the mean value of ADMA was 0.53±0.13µmol/l compared with 0.46±0.15 µmol/l for control group. Systolic blood pressure, pulse pressure and aortic 'strain were found to be higher in patients with systemic sclerosis (p=0.027, p=0.048, p=0.037, respectively), diyastolic blood pressure and aortic distensibility was found lower in systemic sclerosis (p=0.039, p=0.045, respectively). There was no significant correlations between ADMA and aortic 'strain'. Conclusion: ADMA serum levels were increased in patients with systemic sclerosis, but no significant correlation was found between ADMA and aort's elastic structure (aortic 'strain', distensibility, and aortic stiffness index). [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the relationship between the sleep quality and the disease-related variables, functional status, quality of life, and depressive symptoms in patients with systemic sclerosis (SSc). Forty-eight patients diagnosed with SSc and 42 healthy control subjects were enrolled in the study. The demographic and clinical characteristics of the patients such as the Raynaud's phenomenon, SSc subtype, digital ulcers, gastrointestinal and lung involvement, and disease activity were recorded. All patients were assessed using the short form 36 (SF-36) quality of life scale, the health assessment questionnaire and the beck depression inventory. Generalized pain and fatigue were assessed with the Visual Analoge Scale. For the evaluation of the sleep disturbance, the SSc and control groups were assessed with the help of the Pittsburgh Sleep Quality Index (PSQI). The patients with SSc had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance, daytime dysfunction domains, and in terms of the total PSQI score compared to the healthy control group ( p < 0.05). According to the results of spearman's analysis, there was a significantly higher correlation between the generalised pain, fatigue, depressive symptoms, functional status, and physical score of the SF-36 and the sleep disturbance ( p < 0.01). There was also a significantly lower correlation between the menopause status, dyspnoea, gastroesophageal reflux, dysphagia, the mental score of the SF-36, and the sleep disturbance ( p < 0.05). The sleep quality is disturbed in patients with SSc. The lower quality of sleep is especially associated with the pain, fatigue, depressive symptoms, and functional status. [ABSTRACT FROM AUTHOR]

Objective: The assessment of depression and quality of life (QoL) in mothers of children with cerebral palsy ( CP) and a comparison to mothers of healthy children. Patients and Methods: Forty-nine children with CP and their mothers and 30 mothers with healthy children were included. The type of CP in children and their functional levels were identified with the Gross Motor Functional Classification System (GMFCS). The depression status of mothers was evaluated with the Beck Depression Inventory (BDI) and quality of life (QoL) was evaluated with the Nottingham Health Profile (NHP). Results: The mean age of children with CP was 66.20 ±43.73 months. 28 children were diplegic, 1 was hémiplégie and 20 were quadriplegic. Most of the children were level 2 (20) and 3 (17) according to the GMFCS. The mean age of the mothers of the patient group were found as 35.75 ±7.44, and the mean age of the control group mothers was 33.80 ±7.21. BDI and NHP scores and internianiage rate and decrease in the level of income were found significantly higher in patient group (p<0.05). There were no significant correlation between GMFCS, type of CP and BDI, NHP scores in mothers. Conclusion: Impaired QoL and depression levels were found higher in mothers of children with CP. This process is not influenced by the child's functional level and the type of CP. [ABSTRACT FROM AUTHOR]

The purpose of the present study is to compare male patients with the fibromyalgia syndrome (FMS) with healthy individuals in terms of the sexual function. For the purposes of this study, 37 sexually active male FMS patients and 30 healthy controls were enrolled. The demographic data of the patients were recorded, and the widespread pain observed in FMS was graded with the help of the visual analogue scale (VAS 0-100 mm). Sexual function was assessed according to the international index of erectile function (IIEF) scoring system. The disease-related quality of life was measured with the help of the Short Form-36 quality of life questionnaire (SF-36 QoL). Levels of anxiety and depression observed in the patients were graded through the Hospital Anxiety and Depression Scale (HADS). Patients with FMS had significantly lower scores in each of the five domains of the IIEF in comparison with the healthy control group ( p < 0.001). Patients' age and widespread pain were negatively correlated with the IIEF scores ( p < 0.05). The SF-36 scores (physical functioning, role limitations due to physical problems, pain and general health perception) were observed to be positively correlated with the IIEF scores ( p < 0.05). No significant relationship has been observed between the scores obtained from the domains of IIEF and the psychological status ( p > 0.05). FMS leads to an impairment in the sexual function in male patients, which is especially strongly associated with the age, widespread pain and the quality of life. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate sleep quality in patients with ankylosing spondylitis (AS) and to evaluate the relationship of the disease parameters with sleep disturbance. Eighty AS patients (60 males and 20 females) fulfilling the modified New York criteria, and 52 age- and gender-matched controls (33 males and 19 females) were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured by visual analogue scale. The disease activity and functional status were assessed by the Bath AS disease Activity Index and the Bath AS Functional Index. The Bath AS Metrology Index was used to evaluate mobility restrictions, and the Bath AS Radiology Index was employed to evaluate the radiological damage. The psychological status and quality of life were assessed with the hospital anxiety-depression scale and AS quality of life scale. The patients with AS had significantly more unfavourable scores in the subjective sleep quality, habitual sleep efficiency domains ( p < 0.001) and the total PSQI score ( p < 0.05). Poor sleep quality (total PSQI score) was positively correlated with increased pain, poor quality of life, higher depressed mood, higher disease activity and mobility restrictions. Pain was also an independent contributor to poorer sleep quality ( p = 0.002). The sleep quality is disturbed in patients with AS. The lower quality of sleep is greatly associated with the pain, disease activity, depression, quality of life and increased limitation of mobility. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF ( p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF ( p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis ( p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients with AS. This impairment in the sexual function is especially correlated with the BASFI and BASMI among the clinical and laboratory parameters. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The HLA-DRB1 gene plays an important role in the genetic predisposition to rheumatoid arthritis. The anti-citrullinated protein antibody (ACPA) is known to be associated with the susceptibility to rheumatoid arthritis (RA), as well as the severity of the disease. The aim of this study is to determine the HLA genes that are associated with the severity of the RA measured by seropositivity, functional status, radiological damage and the anti-modified citrullinated vimentin (MCV) levels. MATERIAL AND METHOD: Ninety-six patients diagnosed with rheumatoid arthritis and a control group consisting of 84 healthy individuals were enrolled in the study. The HLA-DRB1 type and subtypes were specified using the polymerase chain reaction with sequence-specific primers (PCR-SSP). The association of the HLA-DRB1 type and subtypes with seropositivity, anti-MCV levels, functional status and anatomical joint damage were explored using the modified Larsen scoring method. RESULTS: The DRB1*01, DRB1*04, DRB1*07, DRB1*10, DRB1*11 and DRB1*15 alleles were found to be related with higher anti-MCV levels (p< 0.05). The DRB1*11 type and the DRB1*1001 subtype were observed to be associated with poor functional status (Stages 3-4). The DRB1*0801 subtype was associated with lower anti MCV levels (OR=8.35, p=0.02). DRB1*04 type and DRB1*0405 subtypes were related with radiological damage (OR=0.52 and 0.25; p=0.04 and 0.03, respectively). No significant relationship was observed between the RF seropositivity and the HLA-DRB1 alleles. CONCLUSION: This study revealed the association between the HLA alleles and seropositivity, functional status, anti-MCV levels and radiological damage in patients in the Southeast Anatolian region of Turkey. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The HLA-DRB1 gene plays an important role in the genetic predisposition to rheumatoid arthritis. The anti-citrullinated protein antibody (ACPA) is known to be associated with the susceptibility to rheumatoid arthritis (RA), as well as the severity of the disease. The aim of this study is to determine the HLA genes that are associated with the severity of the RA measured by seropositivity, functional status, radiological damage and the anti-modified citrullinated vimentin (MCV) levels. MATERIAL AND METHOD: Ninety-six patients diagnosed with rheumatoid arthritis and a control group consisting of 84 healthy individuals were enrolled in the study. The HLA-DRB1 type and subtypes were specified using the polymerase chain reaction with sequence-specific primers (PCR-SSP). The association of the HLA-DRB1 type and subtypes with seropositivity, anti-MCV levels, functional status and anatomical joint damage were explored using the modified Larsen scoring method. RESULTS: The DRB1*01, DRB1*04, DRB1*07, DRB1*10, DRB1*11 and DRB1*15 alleles were found to be related with higher anti-MCV levels (p< 0.05). The DRB1*11 type and the DRB1*1001 subtype were observed to be associated with poor functional status (Stages 3-4). The DRB1*0801 subtype was associated with lower anti MCV levels (OR=8.35, p=0.02). DRB1*04 type and DRB1*0405 subtypes were related with radiological damage (OR=0.52 and 0.25; p=0.04 and 0.03, respectively). No significant relationship was observed between the RF seropositivity and the HLA-DRB1 alleles. CONCLUSION: This study revealed the association between the HLA alleles and seropositivity, functional status, anti-MCV levels and radiological damage in patients in the Southeast Anatolian region of Turkey. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the levels of osteoprotegerin (OPG), nuclear factor kappa B receptor activator ligand (RANKL), cathepsin K in patients with rheumatoid arthritis (RA) and the relation between these parameters and bone mineral density (BMD). Materials and methods: Totally 90 cases including 30 postmenopausal and healthy women, 30 with postmenopausal osteoporosis and 30 with postmenopause RA were enrolled in the study. The serum RANKL, OPG and cathepsin K were measured by ELISA method. Results: The levels of serum RANKL and OPG in the patients with postmenopausal RA were found significantly higher compared to the postmenopausal healthy women whereas the rate of serum OPG/RANKL was found significantly lower. In addition, the rate of OPG and OPG/ RANKL were significantly lower in patients with postmenopausal RA compared to the postmenopausal osteoporosis, whereas the level of serum RANKL was significantly higher. Positive correlation was detected between bone densities of lumbar spine (LS), femur neck (FN) and the rate of OPG/RANKL in patients with postmenopausal RA. Also negative correlation was detected between LS and FN bone densities and RANKL levels. Conclusions: The system of RANKL/RANK/OPG may have a role in osteoporosis and RA pathogenesis and the rate of OPG/RANKL might be a significant determiner of bone density. [ABSTRACT FROM AUTHOR]

Our aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician's global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR = 6.84), HAQ-S (OR = 1.76), VAS pain score (OR = 1.03) and ESR (OR = 1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR = 1.36) and ASQoL (OR = 1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate quality of life (QoL) and related variables in patients with ankylosing spondylitis (AS), a chronic inflammatory disease of the spine. Methods: Nine-hundred and sixty-two patients with AS from the Turkish League Against Rheumatism AS Registry, who fulfilled the modified New York criteria, were enrolled. The patients were evaluated using the Assessment of SpondyloArthritis International Society core outcome domains including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), fatigue (BASDAI-question 1), pain (last week/spine/due to AS), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and two QoL questionnaires (the disease-specific ASQoL and generic the Short Form-36 [SF-36]). Results: The mean ASQoL score was 7.1 ± 5.7. SF-36 subscales of general health, physical role and bodily pain had the poorest scores. ASQoL was strongly correlated with disease duration, BASDAI, fatigue, BASFI, BASMI, BASRI, MASES, pain and SF-36 subscales ( P < 0.001). SF-36 subscales were also strongly correlated with BASDAI and BASFI. Advanced educational status and regular exercise habits positively affected QoL, while smoking negatively affected QoL. Conclusions: In patients with AS, the most significant variables associated with QoL were BASDAI, BASFI, fatigue and pain. ASQoL was noted to be a short, rapid and simple patient-reported outcome (PRO) instrument and strongly correlated with SF-36 subscales. [ABSTRACT FROM AUTHOR]

Objectives: It has been reported that increased sempathic nerve system activity due to infalammatory stress and it cause disturbance of heart rate variability (HRV) in rheumatoid arthritis (RA). In this study, it was assessed cardiac sempatovagal activity by noninvasive parameters such as HRV in patients with RA. Materials and methods: 49 patients with RA and age-matched 28 healthy subjects as control group were enrolled to this study. Clinical and laboratory parameters of all subjects were assessed and 24-hour electrocardiographic Holter monitoring were performed to all of them. Results: Minimum, maximum and mean heart rate were significantly higher while mean RR interval were significantly lower in patients with RA when compared with controls. In addition, among time domain HRV parameters, SDNN, SDANN ve triangular index were significantly lower in patients with RA (p<0.05, p<0.01, p<0.01, respectively). In correlation analysis, it was not found a significant association between HRV parameters and age, sex, duration and activity of disease, inflammatory markers, supraventricular or ventricular extrasystole (VES). There were only significant negative associations between VES and pNN50, SDANN and RMSDD. But, there was no independent correlation between these parameters. Conclusion: Non-invasive parameters such as HRV may have a modest role in assessment of cardiovascular risk and prediction of sudden cardiac death risk, in addition to the traditional risk factors, in patients with RA. However, to reach to the more accurate decision, there are need to carry out larger and long term studies which include different patients groups. [ABSTRACT FROM AUTHOR]

The article describes the case of an intracranial and intramedullary tuberculoma with intravertebral abscess manifestation under anti-tuberculous treatment. Tuberculosis (TB) is still an essential pathological entity in developed countries. Of the patients with TB, 0.5-2% of patients acquire tuberculosis of central nervous system (CNS).

Amaç: Sjögren sendromu (SS), gözyaşı ve tükrük bezlerinin etkilenmesine bağlı ağız ve göz kuruluğu semptomlarm görüldüğü bir sendromdur. SS 'de akciğer, böbrek ve santral sinir sistemi (SSS) gibi diğer sistemler de etkilenebilir. Nöromyelitis Op-tika spekturum Hastablk (NMOSD), optik sinir ve spinal kordun etkilendiği, tekrarlayıcı, nadir ve şiddetli idiyopatik otoim-mun enflamatuar bir hastabktır. Bulaıuk görme veya görme kaybı, özellikle alt ekstremitede güç ve duyu kaybı, ağrı ve mesane kontrolünün bozulması gibi yalanmaları olur. Astrositlerin ayaksı çıkmalarındaki aquaporin -4'e karşı gelişen, Anti-aqu-aporin 4 antikoru (anti-AQP-4 Ak) hastalığının patogenezinde ve tanısında önemli bir antikordur. Yapılan çalışmalarda SS ile NMOSD birlikteliği gösterilmiştir. Biz bu olgu sunumunda, kuruluk semptomları olmadan nörolojik belirtileri olan NMOSD tamlı hastanın rehabilitasyon sürecinde SS tanısını da alması nedeniyle, NMOSD ayrı bir hastalık mı, yoksa SS'nin bir komplikasyonu mu olup olmadığını tartıştık. Olgu: Otuz üç yaşında hayan hasta, Nisan 2017 tarihinde aniden haşlayan ve giderek artan her ild bacakta güçsüzlük, idrar tutamama şikayeti oluyor. Ayrıca SS'nin hem ağız ve göz kuruluk gihi glandüler tutuluma bağlı kuruluk semptomları hem diğer ekstraglandüler tutulum olmaksızın sfüıkter inkontinansı, duyu bozukluğu ve görmede azalma gihi SSS tutulum semptomları gelişiyor. Yapılan ltetldk ve tahlillerde, anti-AQP-4, ANA, SS/B ve Anti- Ro-52 antikorlar pozitif, Torakal MR'ın-da T7-T8 seviyesinde daha belirgin myelopatik değişiklikler saptandı. Tülcrük bezi biyapsissi sonucu SS ile uyumluydu. Hastaya SS ve NMOSD tamlan kondu. Beş gün boyunca 1 gram/gün intravenöz metilprednizon tedavisi veriliyor. Pulse steroid tedavisi sonrası şikayetleri geriliyor, idamesinde azati-oprin 150 mg/gün tedavisi haşlanıyor, tekrar atak geçeren ve Azotiopirine yanıtsızlık gelişen hastaya rituksimab tedavisi baş-laıuyırve semptomlarında iyileşme oluyor. Sonuç: SS olgularında NMOSD'nin daha sık göründüğü bulunmuştur. Ancak NMOSD olgularında özgü otoantikorlar varlığı nedeniyle NMOSD, SS'nin doğrudan nörolojik bir komplikasyonu kabul edilmemektedir. Ayrıca hu durumun yüksek hastalık aktivitesi olarak değerlendirilmemesi gerektiği de belirtilmektedir. Bu nedenle S S taıulı olguların nörolojik tutulum yönünden takip ve tedaviye karar vermede NMOSD tanısı akılda bulundurulmalı ve uygun hastalarda anti-AQP-4 Ak. istenmelidir. Sonuç: SS olgularında NMOSD'nin daha sık göründüğü bulunmuştur. Ancak NMOSD olgularında özgü otoantikorlar varlığı nedeniyle NMOSD, SS'nin doğrudan nörolojik bir komplikasyonu kabul edilmemektedir. Ayrıca bu durumun yüksek hastabk aktivitesi olarak değerlendirilmemesi gerektiği de belirtilmektedir. Bu nedenle S S tamlı olguların nörolojik tutulum yönünden takip ve tedaviye karar vermede NMOSD tanısı akılda bulundurulmalı ve uygun hastalarda anti-AQP-4 Ak. istenmelidir. [ABSTRACT FROM AUTHOR]