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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 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.

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 Turkey 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, p0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p0.05 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.

Objectives To evaluate the radiological, clinical and functional properties of hand osteoarthritis and to assess their relationship in a Turkish population. Methods The subjects with hand OA recruited into the study from the multi-centre national osteoarthritis cohort by the Turkish League Against Rheumatology (TLAR–OA). The demographic characteristics, body mass index (BMI), smoking, finger ratio,(2nd to 4th finger lenght), grip strengths with Jamar dynamometer, hand pain duration (month), hand pain severity (visual analogue scale; 0–100 mm) were evaluated. The radiological stage of hand OA was assessed according to the Kellgren Lawrence OA staging. The hightest stage among the joints involvement was noted as the OA stage of the hand. The functional disability concerning to hand involvement was assessed with Duruoz Hand Index (DHI). The SPSS 24.0 statistical package was used for analysis. The descriptive analysis was performed for all parameters. Spearman’s correlation coefficient was used to assess the relation between quantitative variables. Results A total of 364 subjects (330 female, 34 male) from 15 centres with mean of age 62.96 (SD: 10.22) were recruited into the study. The mean of BMI was 29.54 (SD: 4.51) and the percentage of smoking person was 6.3%. The mean of 2nd finger to 4th finger ratio of the patients was 0.96 (SD: 0.05). The mean of grip strengths of the right hand and left hand were respectively 15.55 kg (SD: 12.88) and 14.13 kg (SD: 11.39), which is lower than normal population.1 The median pain duration of hand was 24 months (min-max: 1–480 months). The mean VAS score of pain was 5.05 (SD: 2.33). The mean DHI score was 16.82 (SD: 15.53). The patients’ radiological OA involvement stages (2,3 and 4) of right and left hands were respectively 26.1% and 23.6% (stage 2); 22.5% and 20.9% (stage 3); 13.2% and 12.4% (stage 4) according to the Kellgren Lawrence scoring. The radiological stages of right and left hands respectively had poor correlation with VASpain (rho=0.152, p=0.010; rho=0.158, p=0.009); low but significant correlations with Duruoz Hand Index (rho=0.257, p 0.05). Conclusions Although the subjects with hand OA had pain, low grip strenght and hand disability; the radiological findings had meaningful relations with only functional involvement and pain duration in our population. Reference [1] Massy-Westropp N, et al. Hand grip strenght: age and gender stratified normative data in a population-based study. BMC Res Notes2011;4:127. Disclosure of Interest M. T. Duruoz Grant/research support from: ABVIE, Consultant for: NOVARTIS, Speakers bureau: ABDI IBRAHIM, D. Erdem: None declared, T. Tuncer: None declared, L. Altan: None declared, F. Ayhan: None declared, A. Bal: None declared, L. Cerrahoglu: None declared, E. Capkin: None declared, R. Cevik: None declared, D. Dulgeroglu: None declared, S. Gursoy: None declared, S. Hizmetli: None declared, C. Kacar: None declared, E. Kaptanoglu: None declared, T. Kaya: None declared, H. Kocabas: None declared, K. Nas: None declared, S. Ozcakir: None declared, D. Sindel: None declared, O. Sahin: None declared, G. Tasci Bozbas: None declared, C. Tikiz: None declared, H. Ugurlu: None declared

WOS: 000443738600001, PubMed ID: 30632540, Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining >= 70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected. Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.

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.

WOS: 000429930000001, PubMed ID: 29900976, Objectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloarthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation. Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength. Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific evidence. These recommendations will be updated regularly in accordance with current developments.

WOS:000435672000002, PubMed ID: 30207576, 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.

WOS: 000438530500024, Background: The aim of the study is to identify the kind of traditional practices used for the rheumatic diseases in the central Anatolia. Materials and Methods: A total of 440 volunteer patients with chronic rheumatic diseases including osteoarthritis (OA), fibromyalgia, rheumatoid arthritis (RA), spondyloarthropathy (SpA), familial Mediterranean fever (FMF), Behcet's disease (BD), systemic lupus erythematosus (SLE), and mixed connective tissue disease (MCTD) were enrolled in the study. All patients were administered a 36-item questionnaire. Results: Of the patients, 49.3 % were using CAM. Herbal medicine was the most commonly (58.1 %) preferred methods. The CAM was used by 86 (48%) of 179 patients with OA and by 51 (60%) of 85 patients with RA. The difference in the CAM use across the disease groups was not statistically significant (chi(2)=7.343; p=0.290). When the patients using or not using CAM were assessed according to their education status, it was found that CAM was used by 59 (66.3%) of 89 patients with university degree and indicating a statistically significantly higher number of patients from higher education status among the CAM users (chi(2)=17.651; p=0.001). Conclusions: Our study results suggest that among patients with rheumatic disease, patients with RA more commonly resort to the methods of CAM.

WOS: 000418705800012, PubMed ID: 29265024, Background & objectives: It has been shown that joint damage due to subclinical synovitis progresses despite apparent clinical remission in rheumatoid arthritis (RA). Hence, finding more objective methods to investigate subclinical synovitis has become a current issue. Ultrasonography (US) has been among the most investigated methods. This study was conducted to detect whether there was subclinical inflammation in RA patients in clinical remission by power Doppler ultrasonography (PDUS) and to evaluate the effects of this inflammation on upper extremity function. Methods: Forty five RA patients fulfilled the remission criteria of disease activity score 28 using erythrocyte sedimentation rate (DAS28-ESR), were enrolled in the study. Bilateral wrist, 2nd and 3th metacarpophalangeal and proximal interphalangeal joints and 2nd and 5th metatarsophalangeal joints were examined by PDUS. Upper extremity function was assessed with Michigan Hand Outcomes Questionnaire (MHQ) and handgrip strength. The pain was evaluated by visual analogue scale (VAS). Results: In 29 of 45 RA patients in clinical remission, synovitis was detected by PDUS at least in one joint. VAS and DAS28-ESR scores were significantly lower and total MHQ, some subgroup scores of MHQ (overall hand function, activity of daily living and work performance) and grip strength of the dominant hand were higher in patients with PD signal negativity. Interpretation & conclusions: PDUS showed a crucial role in determining the subclinical synovitis. Subclinical synovitis negatively affects the upper extremity function. Ultrasound-defined remission may be considered for good functional status and real remission in patients with RA.

WOS: 000360385500003, PubMed ID: 27708927, Objective: To assess sarcopenia status in women with rheumatoid arthritis (RA). Material and Methods: Thirty female patients with RA and 30 female controls without RA were enrolled in this study. Sarcopenia status in patients with RA was evaluated by assessing body composition using dual X-ray absorptiometry (DXA). C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) were measured, and body mass index (BMI) and Disease Activity Score (DAS28) were calculated. Because sarcopenia differs between men and women, the study groups comprised only females. Results: It was found that skeletal muscle index (SMI) was lower in patients with RA (5.83 +/- 0.807) than in controls (7.30 +/- 1.640). Sarcopenia (in females with an SMI of

WOS: 000276859300003, Objective: Differentiation of rheumatoid arthritis (RA) from other diseases with joint involvement such as hepatitis-C virus (HCV) infection represents a diagnostic problem. In addition to the rheumatoid factor (RF), more specific and sensitive auto-antibodies are under evaluation in recent years with conflicting results. In this study, we tested the diagnostic value of rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) in distinguishing RA from hepatitis C patients. Materials and Methods: Sera of 34 RA patients and 30 hepatitis C patients were tested for RF, anti-CCP anti-MCV. Disease activity was determined by disease activity score (DAS-28) 28 in RA and by modified Knodell score in hepatitis C patients. Extra-articular involvement in RA and rheumatologic involvement in hepatitis C patients were documented. Results: In roc analysis, area under curve (AUC) was the highest in anti-CCP. Sensitivity and specificity was 82% and 53%, 79%, and 96% and 70%, and 73% for RF, anti-CCP and anti-MCV respectively. DAS-28 has a weak correlation with RF (r=0.406), anti-CCP (r=0.433), and anti-MCV (r=0.453). There was no difference between the patients in autoantibody levels regarding extra-articular involvement and DAS-28 in RA, and joint involvement in hepatitis C patients. Conclusion: Anti-MCV antibodies may be useful in distinguishing RA however it seems to have no additional value over anti-CCP or RF in hepatitis C patients. Anti-CCP antibodies are more reliable in diagnosis of RA due to their high specificity. (Turk J Rheumatol 2010; 25: 19-23)

This study consists of 25 graduate theses about piano accompaniment in vocal music which was conducted at the universities of Turkey between the years 1987-2013. The research was realized by survey method. Graduate theses on piano accompaniment in vocal music were browsed and the findings are classified by subject. The results were analyzed by frequency and percentage values, Bu araştırma, Türkiye’de 1987 – 2013 yılları arasında, vokal müzikte piyano eşlik alanında yapılmış 26 lisansüstü tezini kapsamaktadır. Araştırma tarama modelinde desenlenmiştir. Vokal müzikte piyano eşlik alanındaki lisansüstü tezler incelenerek konularına göre sınıflandırılmıştır. Elde edilen veriler nicel veri kapsamında frekans ve yüzdelerle analiz edilmiştir.

Objectives: This study aims to report Turkish League Against Rheumatism s assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of Interest The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial Disclosure The authors received no financial support for the research and/or authorship of this article.

WOS:000366027100001, Objectives: This study aims to report Turkish League Against Rheumatisms assessment on the compliance of European League Against Rheumatism 2013 treatment recommendations for rheumatoid arthritis with practices in Turkish rheumatology clinics and adaptations for Turkey. Patients and methods: Members of Turkish League Against Rheumatism and one rheumatoid arthritis patient voted for the 2013 recommendations of the European League Against Rheumatism for treatment of rheumatoid arthritis in two sessions. An item was changed and voted again only if at least 70% of participants wanted a change. Strength of recommendations was calculated for the items. Strength of recommendations for the changed items in the first and second voting rounds was compared by Wilcoxon signed-rank test. In case of significant difference, the item with higher strength of recommendation was accepted. In case of no difference, the changed item was selected. Results: Three overarching principles and fourteen recommendations were assessed among which the three overarching principles were changed emphasizing the importance of physiatrists as well as rheumatologists for taking care of the patients. Third item was changed by adding composite indices for assessing disease activity. In the ninth recommendation, rituximab was suggested as a first line drug independent of situations like latent tuberculosis or lymphoma, etc. In the 11th recommendation, unlike European League Against Rheumatism, our committee did not suggest any thought about tofacitinib, as then it had not been approved in Turkey. Remaining principles were accepted as the same. Conclusion: Expert opinion of Turkish League Against Rheumatism for treatment of rheumatoid arthritis patients was formed for practices in Turkish clinics. Conflict of Interest The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Financial Disclosure The authors received no financial support for the research and/or authorship of this article.

WOS: 000222806400008, PubMed ID: 15301122, objectives: Regional deficits in cerebral blood flow have been reported in a few studies of fibromyalgia; however, there is no information on the effects of treatment and clinical recovery on these abnormalities. We evaluated the effects of amitriptyline treatment and consequent clinical recovery on cerebral blood flow changes in fibromyalgia. Methods: We assessed cerebral blood flow with a semiquantitative functional brain mapping technique of single-photon emission computed tomography in 14 patients with primary fibromyalgia before and after 3 months of amitriptyline treatment. Patients were followed by visual analog scale, tender point count, and Beek Depression Inventory for clinical improvement. Results: There was statistically significant improvement in visual analog scale and tender point count after treatment. Beck Depression Inventory did not change significantly. Statistically significant blood flow increase in bilateral hemithalami and basal ganglia and decrease in bilateral temporal, left temporo-occipital, and right occipital lobes were observed on single-photon emission computed tomography after treatment. Conclusions: We speculate that these findings could indicate that deficits in cerebral blood flow in fibromyalgia improve parallel to clinical recovery.

Amaç: Fibromiyalji sendromu (FMS) etiyolojisi belli olmayan, yaygın vücut ağrıları, belirli anatomik bölgelerde duyarlılık, azalmış ağrı eşiği, uyku bozuklukları, yorgunluk ve sıklıkla ruhsal sıkıntı ile karakterize eklem dışı roma- tizmal bir hastalıktır. Çeşitli yaklaşımlar denenmesine rağmen etkili bir tedavisi yoktur. FMS ile psikiyatrik bozuk- lukların ilişkisine sıklıkla vurgu yapılmakta ve FMS hastalarında ruhsal travma yaygınlığı dikkat çekmektedir. Kronik ağrılı durumlar için tedavi arayışları giderek daha fazla psikoterapi yaklaşımlarına yönelmiştir. Bu çalış- mada FMS tanısı konan yedi hastanın EMDR yaklaşımı ile tedavisine yanıtları araştırılmıştır. Yöntem: FMS tanısı konmuş 22-41 yaşları arasındaki altı kadın ve bir erkek olgunun tedavi öncesi ve sonrasında duyarlı nokta sayıları (DNS) belirlendi, Vizüel Ağrı Skalasında (VAS) bildirdikleri ağrı düzeyleri kaydedildi. Hastalar tedavi öncesi ve sonrasında Fibromiyalji Etki Anketi (FEA), Beck Depresyon Ölçeği (BDÖ), Travma Değerlendirme Ölçeği (TDÖ), Pittsburg Uyku Kalitesi Ölçeği (PUKÖ), Öfke Tarzı Ölçeğini (SÖÖTÖ) doldurdu. Hastalara varsa yaşadıkları trav- malara yönelik, saptanamadı ise ağrılarına yönelik beş-sekiz seans arasında EMDR tedavisi uygulandı. Bulgular: Tedavi sonunda hastaların bildirdikleri VAS, PUKÖ, FEA, TDÖ, BDÖ puanlarında anlamlı azalma olmuştur. Fizik muayene ile DNS’de anlamlı azalma bulunmuştur. SÖÖTÖ’de sürekli öfke, öfke içe ve öfke dışa puanlarında anlamlı değişme olmazken; öfke kontrol puanında görülen artma anlamlıdır. Tedavi sonunda altıncı olgu dışındaki hastaların FMS ölçütlerini karşılamadığı gözlenmiştir. Sonuç: Bu hasta grubunda FMS tedavisinde EMDR tedavi- sinin etkili olduğu düşünülmektedir. (Anadolu Psikiyatri Derg 2012; 13:75-81), Objective: Fibromyalgia syndrome (FMS) is a nonarticular rheumatic disease with unknown etiology and is characterized by widespread pain, increased tenderness in some anatomical regions, increased pain sensitivity, sleep disorders, fatigue and frequently by psychological distress. Though many approaches have been tried there is no effective treatment for FMS. The relationship between FMS and psychiatric disorders is known, recently some researches point to the frequency of psychological trauma in patients with FMS. The search for treatment for chronic painful conditions has more and more focused to psychotherapeutic approaches. In this study, seven patients diagnosed were attempted to be treated with EMDR approach. Methods: 22-41years aged six women and one man diagnosed with FMS were admitted to the study. Before and after the treatment tender point count was identified and patients scored their pain levels at Visuel Analog Scale. Patients filled in Beck Depression Inventory (BDI), The Posttraumatic Diagnostic Scale (PDS), Pittsburg Sleep Quality Index (PSQI), State-Trait Anger Scale (STAS). If the patients have reported, trauma was focused on, if they have not reported any trauma, pain was focused. Five-eight sessions of EMDR was applied to the patients. Results: After the treatment, there were statistically significant reduction in patient reported VAS, PSQI, FIQ, PDS, and BDI scores.There was signify-cant decrease in tender point counts. Though there was no change in trait anger, anger-in and anger-out subscores of STAS, the increase in anger management subscore was significant. After the treatment, none of the patients met the FMS criteria but one patient (6th patient). Conclusion: EMDR therapy was effective in the treatment of these patients with FMS. (Anatolian Journal of Psychiatry 2012; 13:75-81)

Bu araştırmada ülkemizdeki romatizmal hastaların alkol kullanım alışkanlıkları değerlendirildi.Hastalar ve yöntemler: Romatoid artrit (RA), ankilozan spondilit (AS) hastalarından ve sağlıklı kontrollerden oluşan toplam 332 denek [185 erkek, 147 kadın; yaş ortalamaları sırası ile 41.2 (%95 GA 39.5-43.0) ve 45.2 (%95 GA 43.4-47.1) yıl], alkol kullanım alışkanlığı olup olmadığına yönelik olarak sorgulandı. Alkol kullanım alışkanlığı olanlardan Michigan Alkolizm Tarama Testi'nin (MATT) Türkçe versiyonunu yanıtlamaları istendi.Bulgular: Deneklerin toplam %37.3'ü alkol kullanıyordu. Erkeklerin yaklaşık %50'si, kadınların ise %20'si alkol tüketim alışkanlığına sahipti. En düşük alkol kullanım oranı RA grubunda (%23.0), en yüksek oran ise sağlıklı kontrol grubunda (%45.6) idi. Ortalama MATT skoru, RA ve AS grupları için sırasıyla 3.02 (%95 GA: 2.36-3.69) ve 3.13 (%95 GA: 1.76-4.5) olarak bulundu ve her iki değer de kontrol grubuna ait değerden istatistiksel olarak anlamlı oranda küçüktü [4.94 (95% GA: 4.14-5.73) p, In this study, we aimed to evaluate alcohol consumption of Turkish rheumatic patients. Patients and methods: A total of 332 subjects [185 males and 147 females; mean ages of 41.2 (95% CI 39.5- 43.0) and 45.2 (95% CI 43.4-47.1) years, respectively] with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and healthy controls were questioned regarding their alcohol habits. Alcohol consumers were asked to fill out the Turkish version of the Michigan Alcoholism Screening Test (MAST). Results: A total of 37.3% of all subjects were alcohol consumers. Nearly 50% of males and 20% of females drank alcohol. Rheumatoid arthritis group had the lowest rate of alcohol consumption (23.0%), while healthy controls had the highest rate (45.6%). The mean MAST scores were 3.02 (95% CI: 2.36-3.69) and 3.13 (95% CI: 1.76-4.5) for the AS and RA groups, respectively, indicating statistically lower rate compared to the healthy controls [4.94 (95% CI: 4.14-5.73) (p

WOS: 000293062500007, PubMed ID: 21886066, Objectives: Balneotherapy has been widely used for treatment of chronic low back pain recently. However there are only a few clinical controlled trials on balneotherapy. The aim of the present study was to evaluate the effects of balneotherapy in patients with chronic low back pain. Methods: Sixty patients with lumbar spondylosis were included in the study. In Group 1, patients received both balneotherapy and physiotherapy and in Group 2, patients received only physiotherapy for three weeks. The intensity of the pain was evaluated by Visual Analog Scale (VAS) and functional disability was scored according to Revised Oswestry Index (ROI). Spinal mobility was assessed by the Schober and lateral flexion tests. Variables were evaluated before and after the three weeks of treatment. Results: The groups were comparable regarding age (P = 0.970) and sex (P = 0.357). There was no statistically significant difference between the two groups for baseline VAS (P = 0.838), Schober test (P = 0.226), and right (P = 0.642) and left (P = 0.674) lateral flexion measurements, and ROI scores (P = 0.798). At the end of the therapy, all clinical parameters significantly improved in patients in both of the groups (P < 0.05). VAS, Schober test, and ROI scores after the therapy were clearly superior in Group 1 in comparison to Group 2 (P < 0.05). Conclusion: The results of the present study reiterate that besides conventional physiotherapy, balneotherapy may be effective in the treatment of patients with chronic low back pain.

WOS: 000306827500034, PubMed ID: 21739129, The aim of this study was to evaluate the bone mineral density (BMD) in familial Mediterranean fever (FMF) and to search the effects of genetic factors, family history of FMF and types of clinical attacks on BMD. Forty-four attack-free patients with FMF and 36 healthy voluntary subjects were included in the study. BMD measurements of lumbar spine and left proximal femur were performed by dual energy X-ray absorptiometry (DEXA). There was no statistically significant difference between patient and control groups regarding median values of lumbar BMD (P = 0.06), lumbar T (P = 0.08) and Z (P = 0.12) scores, femoral neck BMD (P = 0.13), femoral T (P = 0.22) and Z (P = 0.16) scores and total femur BMD (P = 0.14), T (P = 0.19) and Z (P = 0.27) scores. Patients with negative FMF family history had significantly lower femoral neck BMD (P = 0.018), femoral neck T (P = 0.009) and Z (P = 0.01) scores and total femur BMD (P = 0.033) than patients with positive FMF family history. There was no significant difference among the groups regarding mutation characteristic and types of attacks in lumbar BMD, T and Z scores, femoral neck BMD, T and Z scores and total femur BMD, T and Z scores (P > 0.05). We found that the bone loss of patients with FMF is not different from that of the controls. The increased bone loss in the patients with negative family history for FMF should be further investigated with larger patient groups taking into consideration of the risk factors related to family history for osteoporosis.

Amaç: Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) romatoid artrit tedavisindeki yeni gelişmeleri ve ülkemizin ekonomik koşullarını göz önünde bulundurarak, RA tedavisine yönelik ulusal tedavi önerileri geliştirmeyi amaçlamıştır ve bu amaçla, fikirlerini almak için ulusal uzmanlara danışmıştır.Gereç ve yöntemler: Bu alanda deneyimli olan sekiz romatolog ve 15 fizik tedavi uzmanı TRASD'nin RA tedavisi önerilerinin geliştirilmesine katkıda bulunmuştur. Uzmanlar kurulu, EULAR 2010'da yer alan RA'nın sentetik ve biyolojik hastalık modifiye edici antiromatizmal ajanlarla (DMARD'ler) tedavi önerilerini baz alarak, uzman görüşlerinin de yer aldığı bir "Türkiye RA Tedavi Önerileri" oluşturulmasını planlamıştır. Toplantının ardından, Medline ve Cochrane, Embase ve Türk Tıp Dizini veritabanlarında farmakolojik tedavi önerileri için 2009 ile 2010 yılları arasını, non-farmakolojik tedavi için ise 2007 ile 2010 yılları arasını kapsayan aramalar gerçekleştirilerek sistematik bir literatür taraması yürütülmüştür. Bu işlem EULAR 2010 önerilerine dahil edilen çalışmalara ilave olarak yapılmıştır. Tüm makaleler incelenmiştir, içerikler özetlenmiştir, kanıt seviyeleri belirlemiştir ve Delphi işlemi başlatılmıştır.Bulgular: Beş ana prensip ve bir non-farmakolojik tedavi yöntemiyle birlikte 16 genel öneri sıralanmıştır. Tüm öneriler konusunda uzlaşıya varılmıştır ve önerilerin kuvvet seviyeleri oylanmıştır.Sonuç: Türkiye'deki RA tedavisine yönelik öneriler oluşturulmuştur. Bu ulusal önerilerin fizik tedavi ve rehabilitasyon uzmanlarına (fizyatri uzmanlarına) romatologlara ve aile hekimlerine yönelik bir kılavuz olarak işlev görmesi amaçlanmıştır ve önerilerin düzenli şekilde güncellenmesi gerekmektedir., Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions. Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope "Recommendations for the Management of RA in Turkey" based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated. Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon. Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated.

Amaç: Bu çalışmanın amacı RA'li hastalarda hastalık aktivitesi, radyolojik eklem hasarı, fonksiyonel bozukluk veekstraartiküler tutulum ile RF izotipleri ve Siklik Sitrulin Peptit antikoru (anti- CCP) arasındaki ilişkiyi araştırmaktır.Materyal ve Metod: Çalışmaya RA tanılı 45 gönüllü hasta ile diz osteoartrit tanılı 41 gönüllü hasta dahil edildi.Çalışmaya alınan tüm olguların akut faz reaktantları, RF, RF izotipleri (RF- IgA, RF- IgG, RF- IgM) ve anti- CCPdeğerleri çalışıldı. RA' lı hastalarda hastalık aktivitesi, radyolojik eklem hasarı, fonksiyonel bozukluk ve ekstraartiküler tutulum değerlendirildi.Bulgular: RA'lı hasta grubunda anti- CCP %71,1'lik oranla ve RF %57,8'lik oranla pozitif bulundu. RF- IgM, ensık gözlenen RF izotipi olup, RA'lı hastaların % 66,7'de pozitif bulundu. RA tanısı için RF ve anti- CCP'nin özgüllüğü %98'di ve RF izotiplerinin özgüllüğünden yüksekti. Anti- CCP'nin duyarlılığı %71'lik oranla en yüksekti. RF,RF- IgM RF- IgA ve RF- IgG'nin duyarlılıkları sırayla %58, %67, %42 ve %53'dü. RA'lı hasta grubu hastalıkaktivitesi, fonksiyonel bozukluk, radyolojik eklem hasarı ve ekstraartiküler tutulum varlığına göre gruplandırıldığında otoantikor değerleri açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu (P>0.05).Sonuçlar: Anti- CCP ve RF- IgM, RA tanısı için yüksek özgüllüğe sahip olsalar da, otoantikorlar hastalık prognozunu belirlemede etkili bulunmamışlardır. Bu nedenle hastalık tanısı konulduğunda otoantikor pozitifliğinigözönünde bulundurmaksızın tedavinin planlanması gerektiğini düşünmekteyiz, Objective: The aim of the study was to search the relationship of rheumatoid factor (RF) isotypes and anti- cyclic citrullinated peptide (anti- CCP) with disease activity, radiological joint damage, functional impairment and extra- articular involvement in patients with rheumatoid arthritis (RA).Materials and Methods:Volunteer 45 patients with RA and 41 patients with knee osteoarthritis were included in the study. RF, RF isotypes (RF- IgA, RF- IgG, IgM), anti- CCP and acute phase reactants werestudied in all subjects. Disease activity, radiological joint damage, functional impairment and extra- articularinvolvement were evaluated in patients with RA. Results: Anti- CCP and RF were found 71.1 % and 57.8%, respectively in patients with RA. RF- IgM, the mostfrequent RF isotype, was found in 66.7% of patients. The specificities of RF and anti- CCP were 98% and werehigher than the specificities of RF isotypes for the diagnosis of the disease. The sensitivity of anti- CCP was thehighest with a ratio of 71%. Sensitivities of RF, RF- IgM, RF- IgA and RF- IgG were 58%, 67%, 42% and 53% respectively. When the patients were grouped according to the severity of disease activity, functional impairment, radiological joint damage, and thepresence of extra- articular involvement, there was no statistically significant difference between the groups regarding autoantibody levels (P>0.05).Conclusion:Though some of them have high specificities like anti- CCP and RF- IgM, these autoantibodies were not found effective in predicting the prognosis so we suggest that, aggressive treatment should be planned as far as RA is diagnosed without taking the presence ofthe autoantibodies into account.

Amaç: Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) romatoid artrit tedavisindeki yeni gelişmeleri ve ülkemizin ekonomik koşullarını göz önünde bulundurarak, RA tedavisine yönelik ulusal tedavi önerileri geliştirmeyi amaçlamıştır ve bu amaçla, fikirlerini almak için ulusal uzmanlara danışmıştır.Gereç ve yöntemler: Bu alanda deneyimli olan sekiz romatolog ve 15 fizik tedavi uzmanı TRASD'nin RA tedavisi önerilerinin geliştirilmesine katkıda bulunmuştur. Uzmanlar kurulu, EULAR 2010'da yer alan RA'nın sentetik ve biyolojik hastalık modifiye edici antiromatizmal ajanlarla (DMARD'ler) tedavi önerilerini baz alarak, uzman görüşlerinin de yer aldığı bir "Türkiye RA Tedavi Önerileri" oluşturulmasını planlamıştır. Toplantının ardından, Medline ve Cochrane, Embase ve Türk Tıp Dizini veritabanlarında farmakolojik tedavi önerileri için 2009 ile 2010 yılları arasını, non-farmakolojik tedavi için ise 2007 ile 2010 yılları arasını kapsayan aramalar gerçekleştirilerek sistematik bir literatür taraması yürütülmüştür. Bu işlem EULAR 2010 önerilerine dahil edilen çalışmalara ilave olarak yapılmıştır. Tüm makaleler incelenmiştir, içerikler özetlenmiştir, kanıt seviyeleri belirlemiştir ve Delphi işlemi başlatılmıştır.Bulgular: Beş ana prensip ve bir non-farmakolojik tedavi yöntemiyle birlikte 16 genel öneri sıralanmıştır. Tüm öneriler konusunda uzlaşıya varılmıştır ve önerilerin kuvvet seviyeleri oylanmıştır.Sonuç: Türkiye'deki RA tedavisine yönelik öneriler oluşturulmuştur. Bu ulusal önerilerin fizik tedavi ve rehabilitasyon uzmanlarına (fizyatri uzmanlarına) romatologlara ve aile hekimlerine yönelik bir kılavuz olarak işlev görmesi amaçlanmıştır ve önerilerin düzenli şekilde güncellenmesi gerekmektedir. Objectives: Taking new developments in the management of rheumatoid arthritis (RA) and the economic conditions of our country into account, the Turkish League Against Rheumatism (TLAR) aimed to develop national treatment recommendations for the management of RA; thus, they consulted with national experts for their opinions. Materials and methods: Eight rheumatologists and 15 physiatrists experienced in the field contributed to the development of the TLAR recommendations for the management of RA. The expert committee planned to develope "Recommendations for the Management of RA in Turkey" based on EULAR 2010 recommendations for the management of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in light of expert opinions. Following the meeting, a systematic literature review was performed by searching the Medline and Cochrane, Embase, and Turkish Medical Index databases between 2009 and 2010 for pharmacological treatment recommendations and between 2007 and 2010 for non-pharmacological treatment recommendations. This was done in addition to the studies included in the EULAR 2010 recommendations. All articles were examined, their contents were summarized, their levels of evidence were determined, and the Delphi process was initiated. Results: Sixteen general recommendations were listed along with five main principles and one non-pharmacological treatment method. A consensus was reached for all recommendations, and their strength levels were voted upon. Conclusion: Recommendations were formed for the management of RA in Turkey. These national recommendations are intended to guide physical medicine and rehabilitation specialists (physiatrists), rheumatologists, and family physicians and should be regularly updated.

WOS: 000276277300020, PubMed ID: 20228604, Familial Mediterranean fever (FMF) is an autoinflammatory disorder characterized by recurrent febrile polyserositis and arthritis attacks. Accompanying seronegative spondyloarthropathy has been reported in FMF in addition to its own joint involvement. However, the coexistence of FMF with juvenile idiopathic arthritis (JIA) is very rare, only three cases with severe joint involvement and mortal outcome have been reported in the literature. Here, we present another case with FMF and JIA with osteoporosis, successfully treated with etanercept with a four-year follow-up.

International Congress of Elderly Health (Geriatrics 2006) -- APR 02-06, 2006 -- Istanbul, TURKEY, WOS: 000247588000016, PubMed ID: 17551388, …

Spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare autosomal recessive skeletal dysplasia affecting primarily the articular cartilage. Here we present a nine-year-old girl from Middle Anatolia (Sivas) with SEDT-PA. Her complaints were pain and progressive deformity of the joints. She had a short stature with increased thoracic kyphosis and lumbar lordosis. The range of motion was limited in the spine and the peripheral joints and she had deformities. Radiologic examination revealed generalized platyspondyly and irregularity of the vertebral endplates. There was minimal joint space narrowing at proximal interphalangeal joints, but there were no bone erosions. Metaphyses were widened and epiphyses were squared in other joints with generalized osteopenia and severe osteoarthritic changes prominent in hips. Laboratory examination revealed a mild increase in acute phase reactants. Genetic disorders like SEDT-PA may also have rheumatological involvement, so they should be kept in mind in differential diagnosis of inflammatory joint diseases.

Son yıllarda, inmeli hastalarda prognozun akut faz reaktanları ve lezyon büyüklüğü ile ilişkili olabileceği öne sürülmüştür, ancak literatürde bu konuda birbirinden farklı sonuçlar vardır. Bu çalışmanın amacı inmeli hastalarda, erken dönemdeki fonksiyonel prognozun lezyon büyüklüğü ve akut faz reaktanları ile ilişkisini araştırmaktır. Akut iskemik inme tanısı konmuş olan 64 hastada ilk 24 saat içinde serum C-reaktif protein, fibrinojen, ve serüloplazmin düzeyleri ölçüldü. Tüm hastalara beyin tomografisi çekildi. Hastaların fonksiyonel durumları yatışlarının ilk 24 saati içinde ve olaydan 3 ay sonra Barthel İndeksi ile değerlendirildi. Üçüncü ay Barthel indeksi ile birinci gün Barthel indeksi arasında pozitif, üçüncü ay Barthel indeksi ile C-reaktif protein, serüloplazmin, lezyon büyüklüğü ve yaş arasında ise negatif korelasyon bulundu. Lezyon büyüklüğü ile C-reaktif protein arasında da pozitif korelasyon saptandı (p, Lesion size and acute phase reactants have been claimed to predict the prognosis in stroke, recently. However, there are contradictory results in the literature. The aim of this study was to evaluate the relationship between the lesion size, acute phase reactants, and early functional outcome after ischemic stroke. In 64 patients with acute ischemic stroke, serum C-reactive protein, fibrinogen and ceruloplasmin levels were studied in the first 24 hours of the event. All patients underwent brain scanning with tomography. Functional status of the patients were evaluated with Barthel Index in the first 24 hours and after 3 months. There was a positive correlation between the 3rd month and 1st day Barthel Index, whereas there was a negative correlation between the 3rd month Barthel Index and C-reactive protein, ceruloplasmin, lesion size and age. There was also a positive correlation between the C-reactive protein level and the lesion size (p

Ankilozan spondilit, seronegatif SpA grubu içinde sık görülen ve disabiliteye yol açabilen bir hastalıktır. Ancak pek çok ülkede olduğu gibi ülkemizde de bu hastalığın görülme sıklığı ile ilgili yapılmış yeterli çalışma yoktur. Bunedenle üniversitemiz öğrencilerinde ankilozan spondilit görülme sıklığını araştırmayı amaçladık. Cumhuriyet Üniversitesi’nde öğrenim gören 10161 öğrenciyi temsil eden 712 kişilik bir örneklem grubuna anket formu uygulandı ve pozitif yanıt veren 74 öğrenci klinik ve radyolojik muayeneye davet edildi. Ankilozan spondilit klasifikasyonu modifiye New York kriterlerine göre yapıldı. Çalışmamızda genel prevalansımız % 0.14, cinse (erkek) özel prevalansımız ise %0.24 olarak saptanmıştır., Ankylosing spondylitis is a common form of seronegative spondyloarthropathies which may lead to disability. However, there are not satisfactory data concerning the prevalence in our country just as in many others. So we aimed at searching the prevalence of ankylosing spondylitis among our university students. A sample of 712 cases representing 10161 students attending to Cumhuriyet University were given a questionnaire form and those 74 students answered positively were invited for clinical and radiological examination. Classification of ankylosing spondylitis was made according to the modified New York criteria. The prevalence and sex-specific (male) prevalence of ankylosing spondylitis among the university students were found to be 0.14% and 0.24%, respectively.

WOS: 000231943400004, PubMed ID: 16167164, The relation of diffuse idiopathic skeletal hyperostosis (DISH) and diabetes mellitus (DM) has been frequently reported. However, there is little knowledge about its prevalence in DM. The purpose of this study was to determine that prevalence and whether it differs from that of controls. The prevalence of DISH was investigated in 133 patients with DM and 133 nondiabetic controls matched for sex, age, and weight. Radiologic criteria were used for diagnosis. Erythrocyte sedimentation rate, fasting blood glucose levels, glycolized hemoglobin, triglyceride, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein, calcium, uric acid, alkaline phosphatase, phosphorus, insulin, and insulin-like growth factor-1 (IGF1) levels of both groups were compared. The prevalence of DISH (12%) was higher in patients with DM than the control group (6.8%), but there was no statistically significant difference. The average age of the patients diagnosed with DISH (63.36 +/- 9.27) was significantly higher than that of the others (54.21 +/- 12.12) (P < 0.05). There was no significant difference between the DISH patients and the others in other parameters examined. We found no statistically significant difference in the prevalence of DISH between patients with DM and controls. We suggest that the factors thought to be responsible for the etiopathogenesis of DISH such as DM, insulin, and insulin-like growth factor-1 be investigated further.

WOS: 000224096900004, PubMed ID: 14523571, Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism.

Henoch-Shönlein purpurası sıklıkla çocuklarda görülen bir küçük damar vaskülitidir. Ağır organ tutulumlarının % 2'den az olduğu bildirilmiştir. Burada gastrointestinal ve renal tutulumlu erişkin bir Henoch-Schönlein Purpura olgusu sunulmuştur., Henoch-Schönlein purpura is a small vessel vasculitis, commonly seen in children. Severe organ invol-vement is reported to be less than 2 %. Here we present an adult Henoch-Schönlein Purpura case with gastrointestinal and renal involvement.

Bu çalışmanın amacı, romatoid artritli (RA) hastalarda serum kas enzim düzeyleri ile hastalık aktivite ölçümleri arasındaki ilişkiyi araştırmaktı. Çalışmaya yaş, boy, kilo ve vücut kitle indeksi açısından birbirleriyle kıyaslanabilecek 25 RA hastası ile 16 sağlıklı kadın kontrol alındı. Tüm deneklerde serum kreatinin kinaz (CK), CK-MB, laktik dehidrogenaz (LDH) ölçümleri yapıldı ve ek olarak izoenzim tetkikleri ile CK ve LDH elektroforez çalışmaları yapıldı. Bu tetkiklerden elde edilen veriler eritrosit sedimentasyon hızı, CRP, hassas eklem sayısı, şiş eklem sayısı ve görsel analog skalada ağrı düzeyi gibi hastalık aktivite belirteçleri ile karşılaştırmalı olarak incelendi. Bu verilere ek olarak, egzersiz düzeyi, serum RF düzeyi, kortikosteroid kullanımı, deformite varlığı ve şiş eklem sayısı açısından da grup içi analiz gerçekleştirildi. Sonuç olarak sadece CK düzeyleri arasında anlamlı bir fark saptandı (p, The aim of this study was to evaluate the association of serum levels of muscle enzymes with disease activity measures in patients with rheumatoid arthritis. Twenty-five patients with rheumatoid arthritis (RA) and 16 healthy female controls with comparable age, height, weight and body mass index were enrolled in this study. Serum creatine kinase (CK) and CK-MB, lactic dehydrogenase (LDH) were measured and isoenzyme determination, CK and LDH electrophoresis were performed in all subjects, and those values were compared with disease activity measures (erythrocyte sedimentation rate, CRP, tender joint count and swollen joint count, and pain assessment by visual analogue scale). Subgroup analysis regarding exercise level, serum rheumatoid factor level, corticosteroid use, presence of deformity or swollen joints was also made. Only the CK levels were significantly different (p

Sülfasalazin (SSZ) seronegatif spondiloartropatilerde (SpA) etkin ve güvenilir bir hastalık modifiye edici ajan olarak bilinmektedir. Bu çalışma, SSZ'in periferik ve aksiyel tutulum üzerindeki etkinliğini araştırmak amacıyla planlandı. Çalışmaya 11 kadın, 30 erkek olmak üzere toplam 41 hasta alındı. Hastaların tanıları, hastalık süreleri, aile öyküleri, ekstra-artiküler tutulumları, sabah tutukluğu süresi, VAS, ilaca bağlı yan etkiler, hastaların ilaca uyumu, ilaçtan yararlanma oranları ve kullanılan diğer ilaçlar kaydedildi. Hastalara fizik muayene yapılarak tutulan ve aktif olan eklemler saptandı. Laboratuvar parametreleri olarak hastalığın aktivitesini ve ilaç yan etkilerini yansıtabilecek tam kan sayımı, eritrosit sedimentasyon hızı, CRP, karaciğer ve böbrek fonksiyon testleri, tam idrar analizleri ve HLA-B27 doku antijeni çalışıldı. Fizik muayene ve laboratuar değerlendirmeleri SSZ başlanmadan önce ve tedavinin dördüncü ayında yapıldı. Tüm grup göz önüne alınarak yapılan değerlendirmede, klinik etkinlik tedavi öncesi ve tedavinin dördüncü ayında aktif olan eklem sayısı, sabah tutukluğu ve VAS değerleri arasındaki istatistiksel olarak anlamlı fark ile desteklendi (p, Sulphasalasine (SS) is known to be an effective and safe disease modifying drug in seronegative spodyloarthropathies (SpA). This study was planned to investigate the effectiveness of SS on peripheral and axial involvement. A total of 41 patients were involved in the study, being 11 female and 30 male. The diagnosis of the patients, family history, extra-articular involvement, early morning stiffness, VAS, adverse drug reactions of the SS, compliance of the patients to SS, the ratio of the patients' benefit from SS, and the other drugs were recorded. The affected and active joints were determined by physical examination. The laboratory parameters like complete blood count, ESR, CRP, liver and kidney function tests, urinary analysis and HLA-B27 tissue antigen which could reflect the activity of the disease and adverse drug reactions were studied. Physical examination and laboratory evaluation were performed before the SSwas given and at the 4th month of the treatment. Regarding the whole group, clinical effectiveness was supported by the statistically significant differences between the values of active joint count, early morning stiffness, and VAS (p

Background Rheumatoid Arthritis (RA) has different clinical phenotypes. RA with co-existing fibromyalgic features has been termed as fibromyalgic- RA (FRA). Fatigue is a common symptom in rheumatological diseases. Objectives The aim of this study is to evaluate the effects of biological and conventional Disease-Modifying Anti-Rheumatic Drugs (DMARD) on fatigue in FRA patients. Methods Thirty (30) RA patients who met the 2010 ACR/EULAR classification criteria were enrolled in the study. Patients who had other possible causes of fatigue were excluded. The ones who met the ACR 1990 criteria for fibromyalgia were grouped in FRA group. The FRA and non- fibromyalgic RA (non-FRA) groups were divided into subgroups according to the medications used as biological-DMARD and conventional-DMARD subgroups. Fatigue was evaluated via Multidimensional Assessment of Fatigue scale (MAF) and disease activity was assessed by using Disease Activity Score-28 (DAS 28). Results The mean MAF total score of RA patients was 21.35±15.82. Eight (26.7%) of the RA patients had co-existing FMS (FRA group). The mean MAF total score in FRA group was statistically higher than the the non-FRA group (36.56±7.10, 15.81±14.45 respectively) (p Conclusions Fatigue is common in RA. Fatigue becomes more prominent if there is co-existing fibromyalgia. In non-FRA patients fatigue is correlated with the disease activity however such a correlation is absent for FRA patients. In non-FRA patients biological DMARD usage improved fatigue when compared with the conventional- DMARD therapy. However biological DMARD did not have additional benefit on fatigue in FRA patients when compared with the conventional DMARD group. When dealing with fatigue in RA patients possibility of co-existing fibromyalgia must be taken into account for treatment success. Disclosure of Interest None Declared