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Abstract Tofacitinib is a targeted JAK inhibitor used to treat rheumatoid arthritis. Despite some recent safety concerns, it is considered effective and safe with appropriate patient selection. Between May 2015 and May 2024, data were retrospectively analyzed from 112 patients with a diagnosis of RA in a tertiary care hospital who had received tofacitinib for at least 1 month, with or without prior biologic DMARDs. The mean disease duration was 12 years, and the median duration of tofacitinib use was 32.5 months. The p‐value for all disease activity parameters evaluated for effectiveness between the 1st‐ and 3rd‐month visits was

Abstract Background Anti-rheumatic drugs can increase the predisposition to infection, and patients may be unaware of continuing their treatment during the COVID-19 pandemic. Objective This study aimed to assess whether patients maintain their treatment for rheumatic conditions during the pandemic period and determine the factors responsible for discontinuation. Methods Patients were randomly selected from the prospectively collected database of our tertiary referral center. The patients were interviewed by telephone through a standardized closed-ended questionnaire, which is targeting the continuity of the treatment plan and the considerations related to the individual choice. The patients were asked whether they hesitated to visit the hospital for follow-up or intravenous drug administration. Results A total of 278 patients completed the questionnaire. While 62 of the patients (22.3%) had reduced or interrupted the treatment, only 11 patients (3.9%) stopped the treatment completely. A significant difference was observed between the duration of illness and the discontinuation of treatment. (p = 0.023) There was a significant difference in disease activity between the group that stopped treatment and continued treatment. (p = 0.001) There was no statistically significant difference in other demographic characteristics. One hundred thirty-five patients (48.6%) made the treatment decision by themselves, and 80% continued the treatment. Reasons for stopping the treatment were anxiety (48.4%), not being able to go to the hospital for intravenous treatment (45.1%), and not being able to find the drug (6.5%). Conclusion Since patients with long-term illnesses were found to be significantly more likely to stop their treatment, this group of patients should be monitored.

Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.

Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.

Background/Objectives: Our aim was to validate the performance of the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for antiphospholipid syndrome (APS), published in 2023, in an APS cohort. Methods: A total of 193 patients, 83 with APS (secondary APS, n = 45; primary APS, n = 38) and 110 without APS (systemic lupus erythematosus (SLE), n = 100; others, n = 10), were included in this study. The performance (sensitivity, specificity and area under the curve (AUC)) of the 2023 ACR/EULAR classification criteria for APS was evaluated and the agreement with the revised Sapporo criteria was compared using the kappa test. Results: In our cohort, the sensitivity and specificity of the 2023 ACR/EULAR classification criteria for APS were 73% and 94%, respectively (AUC: 0.836, 95% CI: 0.772–0.899), while the sensitivity and specificity of the revised Sapporo criteria were 66% and 98%, respectively (95% CI: 0.756–0.888). The performance of the two sets of criteria in our cohort was significantly consistent and significant (p < 0.001). When the sensitivity, specificity and ROC curve analysis were performed again by excluding livedo racemosa, the sensitivity of the new criteria in our cohort was 62% and the specificity was 100% (AUC: 0.813, 95% CI: 0.746–0.881). Conclusions: Although the newly published criteria broaden the scope of APS classification by including clinical findings other than thrombosis and obstetric criteria, their sensitivity in our cohort was low. On the other hand, we found that the specificity of the criteria in our cohort reached 100% when livedo findings were excluded.

Patients with axial spondyloarthritis (axSpA) who receive immunosuppressive therapy are at risk of infection due to impaired immune function and immunosuppressive medication. Vaccination plays a crucial role in preventing infections in this population. However, vaccination rates and factors influencing vaccination uptake in axSpA patients still need to be adequately studied. This study was designed to determine the vaccination rates of vaccines covered by health insurance in this particular group in Turkey and attitudes towards vaccines and infections. This survey included 199 patients with axSpA who visited our outpatient clinic in June, July, and August 2023 and received biologic and targeted synthetic disease-modifying antirheumatic drugs. The mean age of the participants was 43.7 ± 0.7 years, and the majority were male (66.3%). The majority of the patients were vaccinated against COVID-19 (85.4%), followed by hepatitis B (41.2%), influenza (20.1%), and pneumococcal pneumonia (10.5%). While awareness of COVID-19 vaccination was widespread (100%), knowledge of other vaccines was lower (hepatitis B 80.9%, influenza 70.3%, pneumococcal 60.3%, respectively). Educational interventions targeting patients and healthcare professionals are needed to improve vaccination rates in this population. Our findings emphasize the need for strategies to increase vaccination rates in axSpA patients receiving immunosuppressive therapy. Removing barriers to vaccination and raising awareness of the importance of vaccination are critical to optimizing vaccination practices in this vulnerable population.

Background/Objectives YouTube is increasingly being used as an educational tool and is a substantial source of information. This study aimed to assess the quality of the most viewed YouTube videos pertaining to familial Mediterranean fever (FMF). Methods A search on YouTube was conducted on January 13, 2022, using the keywords: “familial Mediterranean fever treatment,” “familial Mediterranean fever colchicine,” and “familial Mediterranean fever colchicine opacalcium.” Two rheumatologists independently evaluated the relevance and accuracy of the videos. Redundant or irrelevant videos were excluded. The educational value of YouTube videos was assessed using the Global Quality Scale (GQS). Comparative analyses of video parameters across different cohorts were performed. To assess the reliability and quality of the videos, a modified version of the DISCERN scale and the GQS were employed. Results Out of the 59 videos reviewed, 43 (72.9%) were of high quality, 10 (16.9%) were of medium quality, and 6 (10.2%) were of low quality. Upon comparing parameters among groups, no significant disparities were observed in terms of daily views, daily favorites, daily dislikes, or daily comments (p > 0.05). GQS scores for usefulness and modified DISCERN scores showed significant differences among groups (p

Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever and serositis. Blood-based biomarkers determined in FMF patients during attack-free periods could be used to predict the risk of amyloidosis and the severity of the disease. The recently defined pan-immune-inflammation value (PIV) comprises four distinct subsets of blood cells and serves as an easily accessible and cost-effective marker. The objective of this study was to assess the role of PIV in predicting amyloidosis and moderate-to-severe disease. Clinical characteristics and laboratory values during the attack-free period were retrospectively analyzed in 321 patients over 18 years of age diagnosed with familial Mediterranean fever (FMF). In our tertiary adult rheumatology outpatient clinic, disease severity and laboratory markers were evaluated during the first attack-free interval. At baseline, patients with amyloidosis were excluded. Patients were categorized based on the presence of amyloidosis and the severity of the disease. When focusing on amyloidosis in receiver operating characteristic (ROC) analysis, optimal cut-off values for pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio were determined as ≥518.1, ≥2.3, and ≥127.2, respectively. In multivariate analysis, PIV, C-reactive protein (CRP), and the presence of the M694V homozygous mutation emerged as independent risk factors for both amyloidosis and moderate-to-severe disease. Additionally, NLR was identified as an independent risk factor for amyloidosis, while red blood cell distribution width was associated with moderate-to-severe disease. In patients with FMF, especially in the presence of the M694V homozygous mutation, CRP and PIV may be useful in predicting both amyloidosis and moderate-to-severe disease.

Introduction: Chronic inflammatory diseases (CIDs) are lifelong complex disorders that affect quality of life, and this study aimed to summarize 5 years of experience with a multidisciplinary approach for these complex diseases as a result of medical council meetings. Methods: Hospital-based, medical records review study was conducted. A total of 45 monthly medical council meetings were held between 2014-2019 with the participation of the rheumatology, dermatology and gastroenterology departments of the same university. Patients with complex conditions that were seen in each department's own polyclinic composed the council. This study only included 308 patients referred by the rheumatology group. Results: Females made up 66.5 % of the 308 patients. The median age was 45 (19-77). PsA (psoriatic arthritis) and other SPA (spondyloarthritis) patients composed 49.3% of the total. A total of 68.18% of the patients were presented only to consult with the dermatology department. The most common reason for presenting patients was to discuss options for treatment (41.5%). The diagnosis of psoriasis was confirmed in 48 of 67 (71.6%) patients who presented with a pre-diagnosis. The diagnosis was changed in 34.74% of the patients, whereas the diagnosis became completely different in 11.36% of the patients. Conclusions: Many patients with challenging diagnosis and treatment processes are encountered in daily practice. The combination of different disciplines makes it possible to provide more rapid and effective solutions. In this study, we aimed to emphasize the increasing importance of such multidisciplinary approaches

Hairy cell leukemia (HCL) is a rare chronic lymphoproliferative disease. LSV is characterized by inflammation of small vessels. Its association is rare in the literature and HCL can be seen in LSV etiology, although the relationship between the 2 diseases is far from clear. Here, we aimed to present a case with constitutional symptoms, palpable purpuric lesions on the body and diagnosed as HCL from bone marrow biopsy.

Introduction: We aimed to investigate the predictive effect of serum M30 and M65 antigens on long-term prognosis in patients with advanced stage lung cancer before and after the first dose of chemotherapy. Methods: Fourty eight patients with advanced stage lung cancer were included in the study. Demographic data and histopathological characteristics of the patients were recorded. Serum levels of M30 and M65 were studied in 48 patients before chemotherapy, and in 43 patients both before and 48 hours after chemotherapy. Long-term survival was evaluated using Kaplan-Meier curves. The effect of high or low M30, M65 levels and M30/M65 ratio on long-term survival was investigated. Results: The mean age of the patients at the time of diagnosis was 57.52 ± 9.38 years. Fourty six of the 48 patients were men. While M30 value before chemotherapy was 163.23 ± 112.30 U/l; It was measured as 249.74 ± 266.67 U/l 48 hours after chemotherapy (p

Introduction: Male breast cancer constitutes less than 1% of all cases of breast cancer. In this study, we analyzed clinical and pathological features of male breast cancer cases, which had been followed up and treated at our institution.Material and Method: The data regarding the main clinicopathological features of the male breast cancer patients were retrieved from the patients’ records retrospectively.Results: A total of 16 patients were included in the analysis with a median age of 60 (41-75). The most common cell type was infiltrating ductal carcinoma, comprising 81.3 % of all cases. Most patients were staged as locally advanced (50% – stage 3) at the time of diagnosis. Estrogen and/or progesterone receptor positivity were found in 13 patients (81.3%). HER2 status could be examined in 9 patients, and 4 patients (25%) found to be positive for HER2 overexpression. Overall survival was 3(1-12) years and disease-free survival was 2 (1-8) years.Discussion: Despite the increasing knowledge about breast cancer in women, little is known in case of male breast cancer management. Therefore, there is a strong need to perform randomized studies for the treatment of male breast cancer.