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Objectives: The study aimed to investigate and compare clinical features, disease activity, and the overall disease burden among psoriatic arthritis (PsA) patients across seven distinct geographic regions in Türkiye. Patients and methods: A multicenter cross-sectional study involving 1,134 PsA patients from 25 referral centers across seven regions was conducted. Demographic and clinical characteristics, comorbidities, joint involvement, extra-articular manifestations, and disease activity measures were evaluated across regions. Results: A total of 1134 PsA patients from seven different geographic regions in Türkiye participated in this study. The highest number of participants was from the Marmara region (n=409), with subsequent representation from Central Anatolia (n=370), Aegean (n=139), Mediterranean (n=60), Black Sea (n=60), Eastern Anatolia (n=60), and Southeastern Anatolia (n=36) regions. There were significant variations in demographic profile, including age, body mass index, age of disease onset, educational status, comorbidities, and family history of both psoriasis and PsA. Clinical features, such as enthesitis, dactylitis, uveitis, and joint involvement, demonstrated significant variation across regions. Additionally, disease activity measures, including pain, patient and physician global assessments, acute phase reactants, disease activity indices, quality of life, and functional status, displayed considerable regional differences. Conclusion: This nationwide study revealed substantial regional diversity in demographic data, clinical characteristics, disease activity, and quality of life among PsA patients in Türkiye. These findings stress the need to customize treatment approaches to address regional needs and to conduct further research to uncover reasons for disparities. It is crucial to enhance region-specific approaches to improve patient care and outcomes for PsA. [ABSTRACT FROM AUTHOR]

Lupus induced by a tumor necrosis factor-alpha inhibitor, namely "Anti-TNF-a-Induced Lupus (ATIL)" is commonly seen in patients with Crohn's disease and Rheumatoid Arthritis; however, it is rarely seen in axial spondyloarthropathy (SpA). Here, four cases of ATIL in patients with axial SpA are presented and discussed in the light of literature data. The files of the patients who used anti-TNF-a drugs regularly for at least one year due to axial SpA were reviewed retrospectively, and four patients with ATIL were analysed. ATIL developed while the first case was using Adalimumab for 6 years, the second was using Infliximab for 5 years, the third was using Infliximab for 7 years, and the fourth was using Adalimumab for 16 years. In all cases, antinuclear antibodies (ANA) and antidouble stranded DNA (anti-dsDNA) values were positive, while none of the cases had hypocomplemen temia. ATIL symptoms were acute mesenteric thrombosis, fever and pleuritis in the first case, arthritis in the small joints of the hand in the second case, deep vein thrombosis, fever, pleuritis and peritoneal fluid accumulation in the third case and malar rash in the fourth one. Anti-TNF-a medication was discontinued in all patients and prednisolone was started. Only in the third case was the switch to another anti-TNF-a agent. Although anti-TNF-a is an effective and common treatment option in patients wi th SpA, these patients should be carefully monitored for side effects such as ATIL. [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]

Tocilizumab is a monoclonal antibody to interleukin-6 that has recently been used in rheumatoid arthritis (RA) treatment. Treatment with tocilizumab may be associated with paradoxical manifestations that are poorly understood. Patients that developed peripheral ulcerative keratitis while on tocilizumab treatment were studied in a case series. It was discovered that this could be a paradoxical side effect or ineffectiveness. Herein, we present a patient with seropositive RA who was followed for 22 years, using tocilizumab for seven years, and who developed peripheral ulcerative keratitis while in remission. Consequently, even in remission, extra-articular involvement can occur in RA patients, and medication-related paradoxical side effects can arise. [ABSTRACT FROM AUTHOR]

Here, a 36-year-old female patient with inflammatory sacroiliitis and simple bone cyst of the ipsilateral iliac bone is presented. Simple bone cysts occur in the developing skeleton, usually asymptomatic; however, they are benign lytic bone lesions that can cause pathological fractures. The prevalence of simple bone cysts in the whole body has been reported as 0.30/100000. Only 2% of these rare cysts are found in the pelvis, and according to our knowledge, it is the first case in which iliac simple bone cyst is seen together with sacroiliitis on the same side. [ABSTRACT FROM AUTHOR]

Background and Objectives: Health-related quality of life (HRQOL) is important to measure as it is an indication of outcome after stroke. Our objectives were to assess HRQOL in patients 3 months after stroke and to identify factors that predict HRQOL in stroke survivors. Patients and Methods: This cross-sectional study included 67 first-ever stroke patients hospitalized in the Ministry of Health Ankara Diskapi Yildirim Beyazit Education and Research Hospital Physical Therapy and Rehabilitation Clinic. HRQOL was measured by means of the Stroke Impact Scale-16 (SIS-16). Patients were characterized by age, sex, duration of education, comorbidities, stroke type, affected side, concordance (pa-retic arm=dominant hand), cognitive function (Mini-Mental State Examination [MMSE]), and functional status (Functional Independence Measure [FIM]). We used a linear regression model to examine the influence of de-mographic and clinical characteristics on the different SIS-16 domains. Results: The mean (SD) for age of the 67 patients was 62.03 (13.22) years (range, 33 to 81 years). The MMSE and FIM scores were significantly correlated with the SIS-16 score (P< .001). Linear regression analysis showed that age and functional status were the major independent determinants affecting HRQOL (P=.002 and P< .001,respectively). Conclusion: In this study, we found that age and functional status had a powerful influence on HRQOL. Comprehensive therapy programs aimed to improve HRQOL should focus on improving functional disability,particularly in older stroke patients. There is a need for long-term follow-up studies in stroke patients throughout all recovery stages to evaluate HRQOL in more detail.

Aim: Nail involvement is common in psoriatic arthritis. This study assesses clinical characteristics, nail psoriasis prevalence, and impact of nail psoriasis on disease activity in patients with psoriatic arthritis (PsA). Method: This cross‐sectional multicenter study was conducted by the Turkish League Against Rheumatism using PsA patients recruited from 25 centers. Demographic and clinical characteristics of PsA patients, such as disease activity measures, quality of life, and nail involvement findings were assessed during routine follow‐up examinations. Patients were divided into two groups according to the presence or absence of nail psoriasis and compared using the χ2 test or Fisher exact test for categorical variables and the t‐test or Mann‐Whitney U test for continuous variables. Results: In 1122 individuals with PsA, 645 (57.5%) displayed nail psoriasis. The most frequent features of fingernails were ridges (38%), followed by pitting (21%) and onycholysis (19%). More females were present in both groups (with and without nail psoriasis; 64% vs 67%, P < 0.282). Patients with nail psoriasis were older, indicated more pain and fatigue, experienced greater swelling, tender joint counts, and skin disease severity, and had a higher disease activity score compared with those without nail psoriasis (all P < 0.05). Conclusion: We demonstrate an increased prevalence of nail psoriasis observed in patients with psoriatic arthritis. Patients with nail involvement experience increased disease activity, lower quality of life, and diminished mental and physical status compared with those without nail involvement. [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]

The primary objective of this study was to assess the quality of life (QoL) in spinal cord injury (SCI) survivors. Secondary objectives were to determine the effects of various sociodemographic and clinical characteristics on QoL. This cross-sectional study included 54 patients with SCI. The Turkish version of the Short-Form-36 Health Survey was used to assess health-related QoL. Functional status was measured with Functional Independence Measure. Higher values were obtained in younger individuals for bodily pain, in paraplegic patients for physical functioning, role-physical, social functioning, and role-emotional. Moreover, it was observed that functional status correlated well with physical functioning, role-physical, social functioning, and role-emotional. Among the complications investigated, bladder incontinence is related to low health-related QoL in most domains. SCI may interfere with some health domains of QoL according to the patient's age, neurologic levels, functional status and presence of complications, mainly bladder incontinence.

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]