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Resumo Vertebroplastia percutânea e um procedimento intervencionista relativamente seguro, simples e comumente feito para tratar fraturas por compressao vertebral. No entanto, as complicacoes graves relacionadas ao procedimento sao raramente relatadas, incluindo embolia pulmonar, infeccao grave, paraplegia e a ocorrencia de uma nova fratura em vertebra adjacente apos a vertebroplastia. Complicacoes agudas sao geralmente associadas ao procedimento. Apresentamos o caso de bloqueio neuroaxial, feito apos anestesia local com 8 mL de prilocaina a 2%, em uma mulher de 68 anos, submetida a vertebroplastia percutânea apos fratura osteoporotica na vertebra L 1 devido a trauma. De acordo com nossa pesquisa, este e o primeiro caso na literatura.

Introduction: Nailfold capillaroscopy (NFC) is a non-invasive diagnostic test that is mostly used for early diagnosis of collagen tissue diseases (CTDs). We aimed to evaluate whether NFC findings could be a clue for discriminating idiopathic interstitial lung diseases (ILD) from CTD associated ILDs (CTD-ILD). Additionally it was aimed to determine whether NFC could be helpful in discriminating usual interstitial pneumonia (UIP) pattern from non-specific interstitial pneumonia (NSIP) pattern. Materials and Methods: We grouped patients into three main groups: 15 CTD-ILD, 18 idiopathic ILD, and 17 patients in the control group. The CTD-ILD group was split into two subgroups: 8 patients with Sjögren’s syndrome (SJS)-associated ILD and 7 with rheumatoid arthritis (RA)-associated ILD. The idiopathic-ILD group consisted of 10 idiopathic NSIP and 8 IPF patients. The control group consisted of 10 SJS and 7 RA patients without lung disease. None of the patients were on acute exacerbation at the time of examination, and none had Reynaud’s phenomenon. Results: Mean capillary density was significantly reduced only in the CTD-ILD group as compared to the control group (p= 0.006). In subgroup analysis, it was determined that RA-ILD, IPF, and SJSILD subgroups had more severe capillaroscopic abnormalities. Mean capillary density in patients with the UIP pattern was reduced compared to patients with the NSIP pattern and those in the control group; p values were 0.008 and < 0.001, respectively. Conclusion: This study is to be the first describing and comparing the nailfold capillaroscopic findings of patients with NSIP and UIP patterns. NFC findings can be helpful in discriminating UIP patterns from NSIP patterns. But to show its role in differentiating idiopathic disease, more studies with more patients are needed. © 2015, Ankara University. All rights reserved.

Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8 mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L1 vertebra due to trauma. To our knowledge, this is the first case in the literature. Resumo Vertebroplastia percutânea é um procedimento intervencionista relativamente seguro, simples e comumente feito para tratar fraturas por compressão vertebral. No entanto, as complicações graves relacionadas ao procedimento são raramente relatadas, incluindo embolia pulmonar, infecção grave, paraplegia e a ocorrência de uma nova fratura em vértebra adjacente após a vertebroplastia. Complicações agudas são geralmente associadas ao procedimento. Apresentamos o caso de bloqueio neuroaxial, feito após anestesia local com 8 mL de prilocaína a 2%, em uma mulher de 68 anos, submetida à vertebroplastia percutânea após fratura osteoporótica na vértebra L1 devido a trauma. De acordo com nossa pesquisa, este é o primeiro caso na literatura.

Patients with primary Sjogren’s syndrome (pSS) may go undiagnosed or be misclassified due to the insidious nature and wide spectrum of the disease. The available several classification criteria emphasize glandular findings. We aimed to analyze the efficiency of various classification criteria sets in patients diagnosed on the clinical basis by expert opinion and to compare those pSS patients who fulfilled these criteria with those who did not. This is a multicenter study in which 834 patients from 22 university-based rheumatology clinics are included. Diagnosis of pSS was made on the clinical basis by the expert opinion. In this study, we only interviewed patients once and collected available data from the medical records. The European criteria, American-European Consensus Group (AECG) and American College of Rheumatology (ACR) Sjogren’s criteria were applied. Majority of the patients were women (F/M was 20/1). The median duration from the first pSS-related symptom to diagnosis was significantly shorter in men (2.5 ± 2.3 vs 4.3 ± 5.9 years) (p = 0 < 0.016). When the European, AECG and ACR Sjogren’s criteria were applied, 666 patients (79.9%) satisfied at least one of them. In total, 539 patients (64.4%) satisfied the European, 439 (52.6%) satisfied the AECG, and 359 (43%) satisfied the ACR criteria. Among the entire group, 250 patients (29.9%) satisfied all and 168 (20.1%) met none of the criteria. The rates of extraglandular organ involvements were not different between patients who met at least one of the criteria sets and those who met none. There is an urgent need for the modification of the pSS criteria sets to prevent exclusion of patients with extraglandular involvements as the dominant clinical features. © 2017, Springer-Verlag Berlin Heidelberg.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease that manifests itself with joint swelling and pain. Although alexithymia is more commonly seen in painful rheumatic conditions such as RA, there is limited clinical data about the relations with other psychiatric conditions such as depression and anxiety and their impact on quality of life. We aimed to assess the level of alexithymia, depression and anxiety and their effects on quality of life in patients with rheumatoid arthritis. Materials and methods: A hundred forty-eight patients with RA and 100 healthy subjects were included in the study. After physical examination of the patients, Toronto Alexithymia Scale-20 (TAS-20), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were performed to determine levels of alexithymia depression and anxiety, respectively. The World Health Organization Quality of Life Scale Abbreviated Version (WHOQoL-BREF) was used to assess the quality of life. Disease Activity Score Calculator for Rheumatoid Arthritis-28 (DAS-28) was performed to evaluate disease activity. Results: The prevalence of alexithymia was 31.1% in patients with RA. Alexithymia was statistically significantly higher in the RA than the control group (p < 0.05). 41.9% (n=62) of the patients with RA were diagnosed with depression. 20.9% (n=31) of the patients had severe anxiety symptoms. Although there was no statistically significant difference between alexithymia and depression scores, disease activity scores (p > 0.05) in patient with RA. The anxiety scores were significantly higher (p < 0.05) in patients with RA. RA patients manifested poorer scores in all domains of WHOQoL-BREF than the control subjects (p < 0.05). Conclusion: In this clinical trial it has been demonstrated that regardless of disease activity, alexithymia, symptoms of depression and anxiety are more commonly seen in RA patients that can negatively affect the quality of life. Further studies are needed to confirm this association.

KILIC, MESUT/0000-0002-1562-7629 WOS: 000388167000034 PubMed: 27614669 …

Objectives: The frequency of Interleukin-23 receptor (IL-23R) gene polymorphism was previously studied in Ankylosing spondylitis (AS) and Sjögren syndrome (SS). However, it hasn’t been studied in patients AS with SS. Methods: The study included 124 patients with AS, 55 patients with SS and 12 patients with association of AS and SS. Results: It was found that there was an increase in the frequency of rs10889677 gene mutant genotype while a decrease in the frequency of in rs11209032 gene mutant genotype in AS group compared to the healthy controls. In SS group, it was found that there was an increase the frequencies of rs11805303 gene wild genotype and rs2201841 gene wild genotype while a decrease in the frequencies of rs11209032 gene heterozygote genotype and rs10489629 gene mutant genotype when compared to healthy controls. CGCAA haplotype was associated with risk for AS (P=0.0125; RR: 1.32). CGCAG haplotype was associated with protective effect against ankylosing spondylitis (P=0.0042; RR: 0.52). While CTCAA haplotype was found to be protective against SS (P=0.022; RR: 0.46), it was associated with increased risk for association of AS and SS (P=0.0095; RR: 2.79). CTCAG haplotype was associated with protective effect against association of AS and SS (P=0.0151; RR: 0.02). It was observed that TGCGG haplotype increased significantly in SS group compared to the healthy controls and that it was related with increased risk for SS (P=0.032, RR: 2.56). Conclusion: Genotype distribution and genetic diversity vary among ethnic groups. Studies with larger sample size are needed to further clarify this issue. © 2016, E-Century Publishing Corporation. All rights reserved.

KILIC, MESUT/0000-0002-1562-7629 WOS: 000375056400014 PubMed: 26922648 Purpose: This study aimed to compare the results of the two different treatment regimens (percutaneous vertebroplasty (PV) and conservative treatment (CT)) regarding to efficacy, quality of life, functional and radiological results in patients with acute osteoporotic vertebral compression fractures (OVF). Methods: The study comprised 83 patients who presented with complaints of OVF associated with osteoporosis and were treated with CT (37) or PV (46). All patients were evaluated according to preoperative and postoperative visual analogue scale (VAS), Oswestry disability index (ODI) and plain radiographs. Results: All patients in VP group reported a significant decrease in pain at 1st day postoperative. While Pain relief and functional outcomes were significantly better in PV group than CT at 1st and 3rd months according to VAS and ODI scores, there were no statistically significant differences between the groups at 6th months follow-up. The mean preoperative local sagittal Cobb angle (LSCA) and the mean vertebra corpus mid-level height (MVCH) were 42.3 degrees and 14.6 mm in the PV group, while they were measured as 39.8 degrees and 15.7 mm in CT group, respectively. 15.6 degrees decreasing the LSCA and 10.2 mm increasing MVCH were noted in the PV group at the 6th month follow-up. While LSCA increased 19.1 degrees and MVCH decreased 7.6 mm in CT group at same time period (p < 0.001). Conclusions: Compared to the CT group, PV provides a rapid decrease of pain and an early return to daily life activities. Although improvement was observed on the radiological findings following treatment in the PV group, PV may not enhance the quality of life in patients with acute OVF at 6th months follow up. (C) 2016 Elsevier Ltd. All rights reserved.

Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications. Forty patients were referred to another center without any treatment (12.8 %), and referral rate is most common among the primary care physicians (28.8 %). Colchicine was more commonly used for attack prophylaxis than allopurinol. Ninety-two patients had never been treated with allopurinol (28.8 %). Allopurinol prescription was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. Recommendation of diet and life style modifications was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. The rates of life style modification recommendation and long-term allopurinol prescription were 83.7 and 77.6 %, respectively, among the rheumatologists. Both acute and chronic management of gout is suboptimal in Turkey especially among the primary care physicians and orthopedists. Moreover, chronic treatment is even suboptimal among rheumatologists.

Vascular involvement is one of the major causes of mortality and morbidity in Behçet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n = 936, female/male: 347/589, mean age: 37.6 ± 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n = 260) of the patients during follow-up. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1–204) and ISs, 22 months (1–204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. A second vascular event developed in 32.9% (n = 86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P = 0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P

Background Clinical observations suggest that vitamin D may influence fibromyalgia etiology. FMS and vitamin D deficiency share a similar symptom profile; the relationship between these conditions is unclear. Vitamin D receptor is a crucial mediator of the symptoms of vitamin D deficiency. Thus, vitamin D receptor gene polymorphisms or haplotypes may contribute to vitamin D resistance. Objectives This study evaluated the clinical relationship between FMS and vitamin D gene among Turkish FMS patients. Methods 73 patients with FMS were diagnosed according to the ACR 2010 criteria; the control group included 61 healthy unrelated volunteers. The rs2228570 (Fok I), rs1544410 (Bsm I), rs7975232 (Apa I) and (rs731236) Taq I polymorphisms were examined using PCR-RFLP. Results In individual SNP analyses, none of the snps have been found to be associated with FMS (p values are 0.491, 0.477, 0.207, and 0.736 respectively). However, it has been detected that there is a strong association between haplotypes of VDR gene polymorphisms and FMS. As a result of this study, the effect of haplotypes is shown to be both risky and protective. P value of risk haplotypes ATC (rs2228570, rs1544410, rs7975232) is 0,015 (26,5%) and TTT is 0,0068 (12,8%). The p value of collected risk haplotypes (ATC, TTT) is 0,006 (39,3%) and (ATC, TGT, and TTT) 0,000009 (58,7%). Frequent protective haplotype TTC is 0,0385 (6,8%). The p value of collected protective haplotypes (ATT, TCG, and TTC) is 0,008 (38%). Conclusions The present study is the first study evaluating VDR gene in patients with FMS. Our results suggest that haplotypes in VDR are strongly associated with fibromyalgia expressing both risk and protective effect. Our findings may help guide future research needed to define the role of vitamin D in FMS. Disclosure of Interest None declared

In this experimental study the effect of alendronate (Aln) sodium on spinal fusion, that was given preoperatively or postoperatively, was compared both mechanically and histologically in ovariectomized rats. The research question was "Does application time of alendronate sodium effect the spinal fusion in ovariectomized rats?''.Fifty female Wistar rats with a mean weight of 200 g and an average age of 12 weeks were ovariectomized according to the standard procedure. The rats were randomized into three groups nine weeks after ovariectomy. Group 1: spinal arthrodesis and saline weekly for six weeks postoperatively; group 2: spinal arthrodesis and Aln sodium 1 µgr/kg/week for six weeks postoperatively; group 3: Aln sodium 1 µgr/kg/week for six weeks preoperatively, then one week later spinal arthrodesis was done. The rats were sacrificed six weeks after fusion surgery and their vertebrae were evaluated by manual palpation, mechanical testing machine and histomorphometric analysis.Fusion rates obtained by manual palpation were 50%, 17.6% and 55.5% in group 1, 2 and 3, respectively (p0.05). Mean values of fusion tissues in mechanical evaluation were 498±20.7, 481±23.7 and 480±26.2 (MPa) accordingly (p0.05). Compared with group 1, delayed endochondral ossification and more cartilage matrix among bone grafts were seen in group 2 and 3 in histological evaluation.Application time of the Aln sodium didn't significantly affect the lumbar spinal fusion rates in ovariectomized rats. In histological evaluation, delayed endochondral ossification was seen in Aln sodium-treated groups.

2nd International Conference on Education and New Learning Technologies (EDULEARN) -- JUL 05-07, 2010 -- Barcelona, SPAIN, WOS: 000318781702055, The "How to Listen Classical Music" conferences serve to the goal of spreading the classical music out. The target group of these conferences is the students from elementary education, high schools and universities from different fields. The conference has already lectured in several cities in Turkey by the creator (Dr. Ozan Tunca) as well as the volunteers. It is also lectured in educational foundations and made a big effect on those institutions. These conferences also address the people who alienated from classical music caused by the lack of knowledge about classical music. Overall, it reached almost 4000 people in our country. The main subjects that held on these conferences are about what the classical music is, why and how we should listen. It also contributes how we should approach the classical music and what we can feel if we have more information about it. The example music pieces will be played from CD's and images will be shown with PowerPoint program. The lecture is prepared as clear as possible to understand and it is designed quite far from technical terms. As a volunteer of these conferences, I intend to indicate that the classical music for young people is significant for their future cultural accumulation. I also aim to prove these effects by expressing the audience's own thoughts.

In the presented case, we report gastrointestinal stromal tumor (GIST) in a patient using adjuvant imatinib in whom isolated metastasis to anterior tibial muscle as first recurrence was diagnosed. A 66-year-old woman was diagnosed with GIST on October 2012 and was followed up with adjuvant imatinib until June 2014. In this time, there was a nodular and fixed lesion with 1.5-2 cm of diameter in right lateral pre-tibial area. The lesion was resected, and it was reported as GIST metastasis by pathologist. GIST metastasis to muscle under knee is a generally unexpected area for any tumor metastasis. In modern treatment era, due to the increasing survival of the patients with GIST using targeted therapy, the metastatic pattern and behavior of GIST may be changing.

Background Behcet9s disease (BD) is a multisystem inflammatory disease with oral and genital ulcers. It was classified as one of the seronegative arthritis in sixties and seventies due to occurrence of oral ulcers, arthritis, uveitis, and erythema nodosum like symptoms. The prevalence of sacroilitis was detected as 65% with conventional radiography in early reports. However in a controlled study, prevalence of sacroilitis was reported as 35% which was comparable with the healthy control group. Magnetic resonance imaging (MRI) is the most sensitive method for detection of sacroiliitis in patients with spondyloarthropathies. Objectives In this study we aim to determine the prevalence of sacroiliitis in patients with Behcet disease by using MRI and compare with the healthy control group. Methods Fifty patients (25 M, 25 FM) having Behcet9s disease according to international Behcet9s disease study group classification criteria were included into the study. Fifty healthy people (25 M, 25 FM) who did not have any musculoskeletal symptom were taken as control group. Medical history was taken and physical examination was performed for both study and control groups. Subjects in control group who had musculoskeletal symptoms were excluded from the study. Routine laboratory tests were obtained from the study group. Sacroiliac joint MRI exams were taken for both study and control groups and evaluated by two radiologists who were blinded to the subjects. Results Sacroiliitis were detected in seven (14%) patients with BD and in eight (16%) subjects in the control group. There was no statistically significant difference between two groups for the prevalence and presence of active and chronic findings of sacroiliitis (p>0.05). No correlation was detected between acute phase reactants andsacroiliitis in patients with Behcet9s disease. Conclusions This is the first study which researches the prevalence of sacroiliitis by using MRI in patients with Behcet9s disease. Although Behcet9s disease has symptoms of spondyloarthropaties the prevelance of sacroiliitis which is most important clinical finding of spondyloarthropathy is not different from the healthy control group. Acknowledgements This study was supported by Pamukkale University Scientific Research Projects Coordination Unit Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4085