Search

features and course of coronavirus disease 2019 (COVID-19) in individuals with rheumatic disease. Materials and Methods: This retrospective study was carried out at the Erciyes University rheumatology outpatient clinic from July 1 to August 1, 2021. The demographic and clinical data and summarized COVID-19 history, clinical course of COVID-19, fatigue, and pain levels of patients with rheumatic disease were obtained from our institutional electronic registration database and patient files. Results: Recruited participants were 106 individuals (83% female, %17 male) with rheumatic disease who had been confirmed by laboratory tests to have COVID-19 and recovered from the COVID-19 infection. Their mean age and body mass index (BMI) were 48.69±11.5 years and 29.89±6.76 kg/m2, respectively. Additionally, 21 (19.8%) had been hospitalized, and five (4.7%) had been admitted to the intensive care unit. The most common rheumatic diseases were axial spondyloarthritis (40; 37.7%) and rheumatoid arthritis (26 cases; 24.5%). Patients who received conventional synthetic disease-modifying drugs (csDMARDs) reportedly experienced more pain, fatigue, and headaches than those in the biologic agent and non-steroidal anti-inflammatory drug (NSAID) groups. Conclusion: Our study results reveal similar symptoms and hospitalization rates among patients with rheumatic disease who recovered from COVID-19 and received either csDMARDs, biologic agents, or NSAIDs. However, patients in the csDMARD group reported more pain, fatigue, and headache compared to the other groups.

Objectives: In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc). Patients and methods: Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9±12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruöz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients. Results: All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p=0.001 and p=0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p Conclusion: Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc.

The aim of this study is to present a general picture of patients who applied to the rheumatology outpatient clinic in the first 16 months of the COVID-19 pandemic. Patients who applied to the rheumatology outpatient clinic between March 2020 and August 2021 were included in the study. Patients’ clinical and demographic characteristics, the received drug treatments at their last admissions, and the outpatient clinic visits of patients within the specified 16-month period were evaluated retrospectively. A total of 869 patients were included, and their mean age was 48.51 ± 12.84 years; of these, 658 (75.71%) were female and 211 (24.29%) were male. The most common disease diagnosis was rheumatoid arthritis (29.57%). The average number of hospital visits in 2021 was significantly higher than in 2020. Also, patients who received both biological disease-modifying antirheumatic drugs (bDMARDs) and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)/immunosuppressives had a significantly higher number of admissions than those who did not (for all, p

Background To evaluate corneal topography and densitometry features in patients with polycystic ovary syndrome (PCOS) and compare them with healthy individuals. Methods 53 eyes of 53 female patients diagnosed with PCOS and 53 eyes of 53 age-matched female volunteers were analyzed in the study. In addition to the detailed ophthalmological and gynecological examination, anterior segment analysis was performed using Pentacam. A complete analysis of aberrometric, keratometric, topometric, and, densitometric values between the groups was performed, and the results were outlined. Results According to the results, although Kmax-front, Kmean-front, ISV, IVA, IHA, BAD_D and PI-Avg values were slightly higher in PCOS group along with a slight thinning in the thinnest location, there was no statistically significant difference between the groups. Moreover, correlation analysis between PCOS clinical parameters and keratometric/topometric/aberrometric data were found to be almost normal. Yet, when Pentacam tomography maps of all cases are examined in detail, mild ectatic changes were observed in 5 cases in PCOS group. Furthermore, a significant increase in thickness across all densitometry values except anterior (10–12 mm), central (10–12 mm), and total (10–12 mm) was found in PCOS group. Conclusions Our study showed that an intensification of corneal densitometry values ​​and various changes in keratometry data implying ectasia can be observed in patients with PCOS. Prospective studies with larger patient series are needed to reveal any potential relationship between PCOS and corneal abnormalities.

© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.Aim: Nail involvement is common in psoriatic arthritis. This study assesses clinical characteristics, nail psoriasis prevalence, and impact of nail psoriasis on disease activity in patients with psoriatic arthritis (PsA). Method: This cross-sectional multicenter study was conducted by the Turkish League Against Rheumatism using PsA patients recruited from 25 centers. Demographic and clinical characteristics of PsA patients, such as disease activity measures, quality of life, and nail involvement findings were assessed during routine follow-up examinations. Patients were divided into two groups according to the presence or absence of nail psoriasis and compared using the χ2 test or Fisher exact test for categorical variables and the t-test or Mann-Whitney U test for continuous variables. Results: In 1122 individuals with PsA, 645 (57.5%) displayed nail psoriasis. The most frequent features of fingernails were ridges (38%), followed by pitting (21%) and onycholysis (19%). More females were present in both groups (with and without nail psoriasis; 64% vs 67%, P < 0.282). Patients with nail psoriasis were older, indicated more pain and fatigue, experienced greater swelling, tender joint counts, and skin disease severity, and had a higher disease activity score compared with those without nail psoriasis (all P < 0.05). Conclusion: We demonstrate an increased prevalence of nail psoriasis observed in patients with psoriatic arthritis. Patients with nail involvement experience increased disease activity, lower quality of life, and diminished mental and physical status compared with those without nail involvement.

Objective: Currently, concerning the evaluation of psoriatic arthritis (PsA), there is no agreement on a standardized composite index for disease activity that includes all relevant domains. The present study sought to assess the rates of remission (REM)/low disease activity (LDA) and disease states [minimal disease activity (MDA), very low disease activity (VLDA)] as defined by diverse activity scales (DAPSA, DAS28-ESR) in an attempt to display discrepancies across these assessment tools for peripheral PsA. Methods: The study involved 758 patients (496 females, 262 males; mean age 47,1 years) with peripheral PsA who were registered to the Turkish League Against Rheumatism (TLAR) Network. The patients were assessed using the DAS28-ESR, DAPSA, MDA, and VLDA. The overall yield of each scale was assessed in identifying REM and LDA. The presence or absence of swollen joints was separately analysed. Results: The median disease duration was 4 years (range 0-44 years). According to DAPSA and DAS28-ESR, REM was achieved in 6.9% and 19.5% of the patients, respectively. The rates of MDA and VLDA were 16% and 2.9%, respectively. Despite the absence of swollen joints, a significant portion of patients were not considered to be in REM (296 (39.1%) patients with DAS28-ESR, 364 (48%) with DAPSA, and 394 (52%) with VLDA). Conclusion: Patients with peripheral PsA may be assigned to diverse disease activity levels when assessed with the DAS28-ESR, DAPSA, MDA and VLDA, which would inevitably have clinical implications. In patients with PsA a holistic approach seems to be necessary which includes other domains apart from joint involvement, such as skin involvement, enthesitis, spinal involvement, and patient-reported outcomes. © 2021 Société française de rhumatologie

Amaç: B12 vitamini ve folik asit eksikliklerinin, homosistein düzeyini arttırdıkları, ayrıca tam olarak açıklanamayan mekanizmalarla inflamasyona katkıda bulundukları ve kandaki düzeylerinin akut faz reaktanlarına benzer şekilde değişiklik gösterdiği bildirilmiştir. Bu retrospektif çalışmada aksiyal spondilartrit (akSpA) hastalarında vitamin B12 ve folik asit düzeyleri ile hastalık aktivitesi ve akut faz yanıtları arasındaki ilişki araştırılmıştır.Gereç ve yöntem: Çalışmaya ASAS/EULAR 2009 sınıflama kriterlerine göre akSpA tanısı almış hastalar alındı. Hastaların demografik verileri, akut faz yanıtları, BASDAI değerleri, vitamin B12, folik asit düzeyleri poliklinik elektronik kayıt sisteminden elde edildi. Hastalar vitamin B12 düzeyleri 350 pg/ml altı ve 350 pg/ml üstü olarak iki gruba ayrıldı. Grupların karşılaştırılmasında kategorik veriler ki-kare testi, sayısal veriler bağımsız örneklem t-testi, korelasyon analizi pearson korelasyon analizi ile yapıldı. Bulgular: Toplam 178 akSpA hastasının 103’ü (%57.86) kadın ve 75’i erkek idi. Hastaların ortalama yaş, vitamin B12 ve folk asit düzeyleri sırasıyla 43.18±11.20, 365.05±144.79 pg/ml ve 8.8±6.75ng/ml idi. Vitamin B12 düzeyi yüksek ve düşük olan gruplar arasında; yaş, cinsiyet, vitamin B12, folik asit, akut faz yanıtları ve hastalık aktivitesi arasında istatistiksel olarak anlamlı fark yoktu (p> 0.05). Yapılan pearson korelasyon analizinde vitamin B12 ile hastalık aktivitesi arasında zayıf bir korelasyon vardı (p:0.032).Sonuç: Bu çalışmada akSpA hastalarında vitamin B12 düzeyleri ile hastalık aktivitesi arasında negatif yönlü bir korelasyonun olduğu, ayrıca folik asit düzeyleri ile hastalık aktivitesi arasında bir ilişki olmadığı gösterilmiştir., Objective: It has been reported that vitamin B12 and folic acid deficiencies increase the level of homocysteine, also contribute to inflammation by unexplained mechanisms, and their blood levels vary similarly to acute phase reactants. In this retrospective study, the relationship between vitamin B12 and folic acid levels, disease activity and acute phase responses in patients with axial spondylarthritis (akSpA) was investigated.Materials and methods: Patients diagnosed with akSpA according to the ASAS/EULAR 2009 classification criteria were included in the study. Demographic data, acute phase responses, BASDAI values, vitamin B12, folic acid levels of the patients were obtained from the outpatient electronic recording system. Patients were divided into two groups as vitamin B12 levels below and above 350pg/ml. In the comparison of the groups, categorical data were made by chi-square test, numerical data were made by independent sample t-test, and correlation analysis was performed by Pearson correlation analysis.Results: 103 (57.86%) of a total of 178 akSpA patients were female and 75 were male. The mean age, vitamin B12 level and folk acid level of the patients were 43.18±11.20, 365.05±144.79 pg/ml and 8.8±6.75ng/ml, respectively. There was no statistically significant difference between the groups with high and low vitamin B12 levels, age, gender, vitamin B12, folic acid, acute phase responses and disease activity (p> 0.05). In the pearson correlation analysis, there was a weak correlation between vitamin B12 and disease activity (p:0.032).Conclusion: In this study, it was shown that there is a negative correlation between vitamin B12 levels and disease activity in akSpA patients, and there is no relationship between folic acid levels and disease activity.

Sjögren sendromu (SjS) glandüler ve ekstraglandüler manifestasyonlara sahip kronik otoimmün bir hastalıktır. Sistemik tutulumlardan etkilenen organlardan bir tanesi de akciğerdir. Pulmoner yapılardaki tutulum hava yolu anormallikleri veya intersitisyel akciğer hastalığı şeklinde görülebilir. Ayrıca, primer SjS’li hastaların bilgisayarlı toraks tomografisinde oldukça değişik paternlerde kistik değişiklikler saptanabilir. Kistik akciğer hastalığı SjS’li hastaların %20 kadarında görülür ve boyutları genellikle 3 cm den daha azdır. Bu yazıda SjS tanılı bir hastanın intersitisyel akciğer hastalığına eşlik eden kistik tutulum örneği güncel literatür eşliğinde sunulmaktadır., Sjögren's syndrome (SjS) is a chronic autoimmune disease with glandular and extra glandular manifestations. One of the organs affected by systemic involvement is the lung. Involvement of pulmonary structures can be seen as airway abnormalities or interstitial lung disease. In addition, cystic changes in quite different patterns can be detected on thorax computed tomography in patients withprimary SjS. Cystic lung disease occurs in up to 20% of patients with SjS and is usually less than 3 cm in size. In this article, an example of cystic involvement accompanying interstitial lung disease in a patient with SjS is presented in the light of current literature.

This article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) ? of 30 kg/m2 were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Şahin, Nilay (Balikesir Author), Objectives: This study aims to compare the clinical characteristics, disease activity, and quality of life (QoL) of patients with psoriatic arthritis (PsA) who use biological and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in a nationwide cohort throughout Turkey. Patients and methods: A total of 961 patients (346 males, 615 females; mean age: 46.9+/-12.2 years; range, 18 to 81 years) with PsA according to the classification criteria for PsA were included in the study. The patients demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and Short Form-36 scores were all recorded. Results: Of the patients, 23% underwent biological DMARD (bDMARD) monotherapy, 42% underwent conventional synthetic DMARD (csDMARD) monotherapy, 10% underwent a csDMARD combination therapy, and 10% underwent a combination bDMARD and csDMARD treatment. The Visual Analog Scale (VAS pain), patient global assessment, physician global assessment, and BASDAI scores were found to be lower among patients using combination treatment of csDMARD and bDMARD, while the swollen joint count was found to be lower among patients using bDMARD. The PsAQoL score was found to be the lowest among patients not using any medication and the highest among those using bDMARD. Conclusion: In our study, patients with PsA were successfully treated with both csDMARD and bDMARD monotherapy. When the biological treatments used for PsA were compared with csDMARD, it was found that biological treatments had a positive effect on both disease activity and the QoL. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment.

Kent parkları kentsel yaşam kalitesinin artırılmasında insanlara sunduğu çeşitli aktivitelerle önemli bir yer tutmaktadır. Her yaş grubuna hitap eden, bireylerin tek başına ya da grup olarak etkinlikler düzenlemesine fırsat sağlayan ve bitkisel materyal ile bir bütünlük arz eden kent parkları; tasarlanmış yeşil alanlardır. Tokat ili Niksar ilçesinde bulunan Ayvaz Parkı, kentlilerin yıllardır kullandığı Ayvaz doğal mineral su kaynağının da yer aldığı bir alandır. Park mevcut durumda fiziksel olarak bozulmuş, eski ve yetersiz donatılarıyla bakımsız haldedir. Alan için hazırlanan peyzaj tasarım projesiyle, Ayvaz Parkı’nı eski önemine ve kullanım düzeyine ulaştırmak ve fiziksel yapısında iyileştirme yapmak hedeflenmiştir. Bu hedef doğrultusunda, kentin kimliğini de pekiştirecek ve kültüre sahip çıkan bir proje konsepti benimsenmiştir. Çalışmada bu kapsamda ilk olarak 1/1000 ölçekli imar planı üzerinden alana ait proje altlığı çıkarılmıştır. Daha sonra arazi sörveyi kapsamında; yerinde gözlem ve anket çalışması yapılmıştır. Arazi çalışmaları sırasında elde edilen veriler ışığında Google Earth görüntüleri üzerinden mevcut durum analizi yapılmıştır. Alanın olumlu ve olumsuz yönleri GZFT analizi ile değerlendirilmiştir. Yapılan tüm değerlendirmeler ve görüşmelerle alan kullanımına ilişkin ihtiyaç programı oluşturulmuştur. Stüdyo ortamında yapılan eskiz çalışmaları sonrasında Ayvaz Parkı Peyzaj Tasarım Projesi hazırlanmıştır. Projenin çizimi ve görselleştirmesinde; AutoCad 2017, Photoshop CS5, Sketch Up ve Lumion yazılımları kullanılmıştır. Projenin sonuçları bitkisel uygulama projesi, yapısal uygulama projesi, kesit-detay çizimleri ve üç boyutlu modellemeler şeklinde sunulmuştur. Ayvaz Park Peyzaj Tasarım Projesi; kent ile alanın doğal ve kültürel peyzaj özelliklerinin korunması, geliştirilmesi ve sürdürülebilir kullanımı açısından önem taşımakta, bu özelliklerin kent kimliği desteklenerek gelecek nesillere aktarılması konusunda da katkı sağlamaktadır.

WOS: 000511872800013, PubMed: 31773391, Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.

Bu çalışmada Tokat ili Niksar ilçesinde bulunan Sulugöl ve çevresi çalışma alanı olarak ele alınmıştır. Çalışmada, kentsel alanlar ve yakın çevresinde yer alan su kaynaklarının kent ekolojisine sağladığı katkıların artırılması ile doğal ve kültürel özelliklerinin korunmasına yönelik bir peyzaj tasarım önerisi geliştirilmiştir. Çalışmanın amacı, alanın mevcut potansiyelini geliştirirken koruma-kullanma dengesinin kurulmasıdır. Çalışmada 1/1000 ölçekli imar planı üzerinde proje alanı tanımlanmış, yerinde gözlem çalışmaları ve Google Earth’ten alınan görüntüler yardımıyla alanın mevcut durumu tanımlanmıştır. Arazi çalışmaları sırasında, belediye yetkilileri ve yerel halk ile görüşmeler yapılarak ihtiyaç ve beklentiler belirlenmiştir. Elde edilen veriler ışığında alan potansiyeli değerlendirilmiştir. Çalışmada peyzaj tasarımının temel aşamaları olan sorun tanımlama, sörvey, leke, avan ve kesin peyzaj tasarım projesinin oluşturulması aşamaları yapılmıştır. Çalışmada peyzaj tasarımının oluşturulması, projelerin çizimi ve görselleştirmesinde AutoCad 2017, Photoshop CS5, Sketch Up ve Lumion yazılımları kullanılmıştır. Projenin sonuçları bitkisel tasarım projesi, yapısal uygulama projesi ve detaylar şeklinde sunulmuştur., In this study, Sulugöl located in Niksar district of Tokat province was chosen as the study area. In this study, a landscape design proposal was developed in order to increase the contribution of water resources to urban ecology and to protect its natural and cultural characteristics. The aim of the study was to establish the balance of protection and use while developing the existing potential of the area. In the study, the project area was defined on a 1/1000 scale development plan and the current status of the area was defined with the help of on-site observations and images taken from Google Earth. During the area studies, the needs and expectations were determined by interviews with the municipal authorities and local people. The area potential was evaluated within the data obtained. In this study, AutoCad 2017, Photoshop CS5, Sketch Up and Lumion software were used for the creation of landscape design, drawing and visualization of projects. The results of the study were presented in the form of plant design project, structural application project.

Keskin, Yasar/0000-0003-4457-5917; KILIC, Erkan/0000-0003-4355-4356; Yurdakul, Ozan Volkan/0000-0003-4567-8133; cuzdan, nihan/0000-0001-7238-657X; gezer, halise hande/0000-0001-8790-304X; alkan, hakan/0000-0001-8461-9131 WOS:000541406200002 PubMed: 32564159 Fatigue is a substantial problem in patients with psoriatic arthritis (PsA) that needs to be considered in the core set of domains. This study aimed to evaluate fatigue and its relationship with disease parameters, functional disability, anxiety, depression, quality of life, and correlation with disease activity as determined by various scales. A total of 1028 patients (677 females, 351 males) with PsA who met the CASPAR criteria were included [Turkish League Against Rheumatism (TLAR) Network multicenter study]. The demographic features and clinical conditions of the patients were recorded. Correlations between fatigue score and clinical parameters were evaluated using the Disease Activity Score 28 (DAS28), Disease Activity in Psoriatic Arthritis (DAPSA), Clinical DAPSA (cDAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Fibromyalgia Rapid Screening Tool (FiRST), minimal disease activity (MDA), and very low disease activity (VLDA). Fatigue was assessed with the Functional Assessment of Chronic Illness Therapy (FACIT-F) and a 10-point VAS (VAS-F). The mean age of the patients was 47 (SD: 12.2) years, and the mean disease duration was 6.4 (SD: 7.3) years. The mean VAS-F score was 5.1 (SD: 2.7), with fatigue being absent or mild, moderate, and severe in 12.8%, 24.6%, and 62.5% of the patients, respectively. Fatigue scores were significantly better in patients with DAS28 remission, DAPSA remission, cDAPSA remission, MDA, and VLDA (p < 0.001). Fatigue scores significantly increased with increasing disease activity levels on the DAS28, DAPSA, and cDAPSA (p < 0.001). VAS-F scores showed correlations with the scores of the BASDAI, BASFI, PsAQoL, HAD-A, FiRST, pain VAS, and PtGA. FiRST scores showed fibromyalgia in 255 (24.8%) patients. FACIT-F and VAS-F scores were significantly higher in patients with fibromyalgia (p < 0.001). In regression analysis, VLDA, BASDAI score, FiRST score, high education level, HAD-Anxiety, and BMI showed independent associations with fatigue. Our findings showed that fatigue was a common symptom in PsA and disease activity was the most substantial predictor, with fatigue being less in patients in remission, MDA, and VLDA. Other correlates of fatigue were female gender, educational level, anxiety, quality of life, function, pain, and fibromyalgia.

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

Aim Hand joints are the main target in rheumatoid arthritis (RA) and hand involvement in terms of thickening of the skin and contractures are also well known in systemic sclerosis (SSc). Assessment of hand function in SSc is generally an overlooked entity with respect to RA. Therefore the aim of this study was to compare hand functions and potential influence of functional loss on patients' overall physical functions, health-related quality of life (HRQoL) and psychological status in RA and SSc. Methods Age- and gender-matched adult patients with SSc and RA were consecutively recruited. Patients' hand functions were evaluated by using the Duruoz Hand Index (DHI), and hand span and hand grip strength were measured. Patients were evaluated for disease-specific and generic outcome measures including disease activity parameters and HRQoL measures. Results Fifty patients (44 female, six male) with SSc and 51 (45 female, six male) with RA were included. Despite similar functioning and HRQoL, patients with RA had higher visual analog scale-pain and body mass index. In both groups DHI revealed similar functional loss and correlated with various measurements related to HRQoL. In SSc, hand span, grip strength and modified Rodnan skin score had major influences on hand functions. Conclusion Assessment of hand function is an important component in the clinical evaluation of patients with RA and SSc. Loss of hand functions is an important feature contributing negatively to the overall physical status and HRQoL in patients with SSc and may be more frequent and important than expected.

Tüketim toplumunu oluşturan insanların, ihtiyaçları ve yaşam alanları arasında bir denge kurulması gerekmektedir. Sürdürülebilirlik kavramı, yaşanabilirlik kavramından ayrı düşünülemez hale gelmiştir. Bu durumu takip eden yıllarda, çevre/doğa üzerindeki olumsuz etkilerin en aza indirgenmesi ve günümüz kaynaklarının geleceğe aktarılması adına geri dönüşüm, sıfır atık, minimalizm ve ileri dönüşüm gibi kavramlar ortaya çıkmıştır. İlerleyen teknoloji ve hızlı nüfus artışına bağlı olarak tüketimin artmasıyla oluşan atık miktarının azaltılmasında, kullan-at şeklinde ilerleyen doğrusal ekonominin yerini kaynakların daha uzun süre kullanıldığı ve yeniden dönüşümü esas alan döngüsel ekonominin almasında “İleri Dönüşüm” bir araç olarak karşımıza çıkmaktadır. Bu çalışmada, Bartın Üniversitesi Peyzaj Mimarlığı Bölümü öğretim elemanları ve öğrencilerinin katılımıyla bir atölye çalışması gerçekleştirilmiştir. Atölye sonucu elde edilen ürünler, kullanılan ana materyallerine (plastik, metal, ahşap, cam, tekstil ve kâğıt) göre sınıflandırılarak ileri dönüşüm kapsamında değerlendirilmiştir. Sonuç olarak çevresel kaynakların sürdürülebilirliği bağlamında; hammadde ve enerji korunumunu gözeten uygulamaların yaşam aktivitelerine entegre edilmesi önem taşımaktadır. Böylelikle yaşanabilir sağlıklı çevrelerin ve peyzajların devamlılığına katkı sağlanmaktadır.

Background: Psoriatic arthritis (PsA), a chronic rheumatic disease associated with reduced quality of life. Obesity is an important clinical problem which may interfere with loss of functioning and quality of life. Obesity is usually an overlooked entity in patients with PsA. Several studies were invastigated prevalence and the impact of obesity on disease activity in patients with PsA, however relationship between psychological status and quality of life have not been evaluated comparatively. Objectives: To assess the impact of obesity on quality of life, psychological status and clinical parameters in patients with PsA. Methods: Patients with PsA were recruited who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism-NETWORK (TLAR-NETWORK) derived from 24 different centers of our country.Patients with BMI ≥30 kg/m2 were considered obese. Differences among patients with or without obesity were assessed.VAS fatigue, psychological status and health related quality of life measures [SF-36; HAQ; Psoriatic arthritis quality of life (PsAQoL); Hospital Anxiety and Depresson Scale], FACIT-Fatigue, DAS28, BASDAI, BASFI, BASMI, Maastrich Ankylosing Spondylitis Enthesitis Score (MASES) and Psoriasis area severity index (PASI) scores were compered between this groups. Results: A total 1130 patients with PsA (36.0% male, 64.0% female) included in this study. In this cohort 37.6% obese and 62.4% non-obese. The presence of peripheral arthritis, enthesitis, dactylitis, uveitis and spine involvement, PASI scores as well as MASES scores were quite similar between patients with and without obesity. Obese patients had significantly higher scores in VAS fatigue and disease activity, poorer QoL and physical functions compared to non-obese patients (p Conclusion: Obesity associated with the risk of depression and anxiety, fatigue, poorer QoL and higher disease activity.These findings suggest that obesity should be considered while assessing patients with PsA. References [1] Li W,Han J,Qureshi AA.Obesity and risk of incident psoriatic arthritis in US women.Ann Rheum Dis.2012Aug;71(8):1267-72. [2] Klingberg E,Bilberg A,Bjorkman S, et al.Weight loss improves disease activity in patients with psoriatic arthritis and obesity:an interventional study.Arthritis Res Ther.2019Jan11;21(1):17 Disclosure of Interests: Kevser Gok: None declared, Kemal Nas: None declared, Erkan Kilic: None declared, Betul Sargin: None declared, Sevtap Acer Kasman: None declared, Hakan Alkan: None declared, Nilay Sahin: None declared, Gizem Cengiz: None declared, Nihan Cuzdan: None declared, Ilknur Albayrak Gezer: None declared, Dilek Keskin: None declared, Cevriye Mulkoglu: None declared, Hatice Resorku: None declared, Ismihan Sunar: None declared, Ajda Bal Hasturk: None declared, Mehmet Tuncay Duruoz Grant/research support from: Abvie, Speakers bureau: Novartis, AMGEN, Abdi Ibrahim, Ilko, Okan Kucukakkas: None declared, Ozan Volkan Yurdakul: None declared, Meltem Alkan Melikoglu: None declared, Yildiray Aydin: None declared, Figen Ayhan: None declared, Hatice Bodur: None declared, Mustafa Calis: None declared, Erhan Capkin: None declared, Gul Devrimsel: None declared, SAMI HIZMETLI: None declared, Ayhan Kamanli: None declared, Yasar Keskin: None declared, Hilal Kocabas: None declared, Oznur Kutluk: None declared, Nesrin Sen: None declared, Omer Faruk Sendur: None declared, ibrahim tekeoglu: None declared, Murat Toprak: None declared, Sena Tolu: None declared, Tiraje Tuncer: None declared

Background: Psoriatic arthritis (PsA) can lead to significant mental burden affecting several aspects of life in majority of patients. Mental health problems, such as depression and anxiety may result in poor treatment adherence and difficulty in coping with disease burden. Objectives: The aim of this study is to determine the risk factors associated with clinically significant depression and anxiety in patients with PsA. Methods: The data from 1128 patients with PsA who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism (TLAR)-Network derived from 25 investigating centers. All of the patients underwent clinical, radiological and also laboratory assessment by using standardized protocol. The associations between psychological variables and clinical parameters were assessed by univariate and multivariate analyses. Results: Of the 1128 patients with PsA (the mean age 46.9 ±12.2,%64 F), 574 (%50.9) had high risk for depression (HADS-D score ≥7) and 270 (%23.9) for anxiety (HADS-A score ≥10). By univariate analysis, the highest odds ratio (OR) associated with both depression and anxiety were SF36-MCS Conclusion: This large nationwide database indicated that higher disease activity, functional disability, fibromyalgia (FMS), poor health related quality of life as well as structural damage were estimated as the important risk factors for mental disorders in PsA. Disclosure of Interests: Gamze Kilic: None declared, Kemal Nas: None declared, Erkan Kilic: None declared, ibrahim tekeoglu: None declared, Betul Sargin: None declared, Sevtap Acer Kasman: None declared, Hakan Alkan: None declared, Nilay Sahin: None declared, Gizem Cengiz: None declared, Nihan Cuzdan: None declared, Ilknur Albayrak Gezer: None declared, Dilek Keskin: None declared, Cevriye Mulkoglu: None declared, Hatice Resorlu: None declared, Sebnem Ataman: None declared, Ajda Bal: None declared, Mehmet Tuncay Duruoz Grant/research support from: Abvie, Speakers bureau: Novartis, AMGEN, Abdi Ibrahim, Ilko, Okan Kucukakkas: None declared, Ozan Volkan Yurdakul: None declared, Meltem Alkan Melikoglu: None declared, Yildiray Aydin: None declared, Figen Ayhan: None declared, Hatice Bodur: None declared, Mustafa Calis: None declared, Erhan Capkin: None declared, Gul Devrimsel: None declared, SAMI HIZMETLI: None declared, Ayhan Kamanli: None declared, Kevser Gok: None declared, Yasar Keskin: None declared, Hilal Kocabas: None declared, Oznur Kutluk: None declared, Nesrin Sen: None declared, Omer Faruk Sendur: None declared, Murat Toprak: None declared, Sena Tolu: None declared, Tiraje Tuncer: None declared

Meydanlar toplanma, buluşma ve geçiş alanı olma özellikleri ile tarihten günümüze, kamusal dış mekânlar arasında; herhangi bir sınıf ayrımı olmaksızın insanlar tarafından sosyalleşmek amacıyla en çok kullanılan alanlardır. Meydanlar kentlere kent olma niteliğini katan önemli yapı taşlarındandır. Bir kent meydanının, herkes için erişilebilir, güvenli, kimlikli ve okunabilir olma özelliklerine sahip olması beklenmektedirCumhuriyet Meydanı, peyzaj mimarlığı açısından değerlendirildiğinde alanın meydan kavramını karşılamadığı görülmektedir. Çalışmada; meydanın işlevsel-estetik yönden tasarım eksikliklerinin saptanması ve öneriler sunulması amaçlanmıştır.Cumhuriyet Meydanı (6000 m²), Batı Karadeniz Bölgesi’nin Bartın ilinde yer almaktadır. Gelişim süreci devam etmekte olan Bartın’ın nüfusu TÜİK (2018) verilerine göre 193.577’dir. Alanda; mekânsal algılanma ve alan kullanımları arasındaki uyum açısından eksiklikler bulunmaktadır. Bununla birlikte; aktivite çeşitliliği, kentsel donatı ve bitkisel materyal yetersizliği de göze çarpmaktadır.Sonuç olarak Bartın Kenti’nin odağında bulunan bu alanın, meydan niteliğini ön plana çıkaracak 3 farklı peyzaj tasarımı yapılmıştır. Tasarım aşamasında “Erişilebilir, Güvenli, Kimlikli ve Okunabilir” olma ilkeleri ön planda tutulmuştur. Bu tasarımların kente estetik ve işlevsel açıdan katkı sağlaması, kentsel simgeleri barındırması ve kullanıcıya toplanma-buluşma-geçiş alanı oluşturması beklenmektedir. Squares are the most used areas among public outdoor spaces for socializing by people without any class distinction for gathering, meeting and transition areas from past to present. Almost every city has a square. The squares are important corner stones that make a city be a city. It is expected that an urban square will have the characteristics of being accessible, secure, identifiable and legible for all.When it is evaluated in terms of landscape architecture discipline, it is seen that Cumhuriyet Square does not fully meet the concept of square. In the study, it is aimed to identify the design deficiencies of the field in the functional-aesthetic direction and to offer suggestions.Cumhuriyet Square (6000 m²) is located in the Bartın province of the West Black Sea Region. The population of Bartın, whose development process is still ongoing, is 193.577 according to TUİK (2018) data. In the field; there are deficiencies in terms of spatial perception and the harmony between area usage. However; activity diversity, urban equipment and lack of plant material are also striking.As a result, 3 different landscape designs of this area, which is located in the center of Bartın, have been made to bring the square into the forefront. The principles of being "Accessible, Secure, Identity, and Legible" during the design phase are kept on the frontline. These designs are expected to contribute to the city in terms of aesthetic and functionality, as well as to and create a space for user gathering-meeting-transition including urban symbols.

Annual European Congress of Rheumatology (EULAR) -- JUN 12-15, 2019 -- Madrid, SPAIN, WOS: 000472207102501, Background PsA is a chronic musculoskeletal disease. The prevalence of axial involvement in PsA varies according to the duration of the disease. In early stage the incidence varies between 5% and 28%, but it increases up to 25-70% in later stages of the disease. In the literature, there is limited data on the differences in disease activity, functional status and quality of life of men and women with axial PsA., European League Against Rheumatism

Meydanlar toplanma, bulusma ve gecis alani olma ozellikleri ile tarihten gunumuze, kamusal dis mekânlar arasinda; her hangi bir sinif ayrimi olmaksizin insanlar tarafindan sosyallesmek amaciyla en cok kullanilan alanlardir. Kentlerde yasayan ya da yasamayan, ziyaretci olarak gelen ya da sadece o kentten gecen her kullaniciya acik mekânlardir. Hemen her kentin bir meydani vardir. Meydanlar kentlere kent olma niteligini katan onemli yapi taslarindandir. Bir kent meydaninin, herkes icin erisilebilir, guvenli, kimlikli ve okunabilir olma ozelliklerine sahip olmasi beklenmektedir. Bartin Cumhuriyet Meydani, peyzaj mimarligi acisindan degerlendirildiginde alanin meydan kavramini karsilamadigi gorulmektedir. Bu calismada; Cumhuriyet Meydani’nin islevsel-estetik yonden tasarim eksikliklerini saptamak ve oneriler sunmak amaclanmistir. Calisma alani olarak secilmis olan Cumhuriyet Meydani, Bati Karadeniz Bolgesi’nin Bartin ilinde yer almaktadir. Gelisim sureci halen devam etmekte olan Bartin’in nufusu TUIK (2018) verilerine gore 193.577’dir. Calisma alani, kent merkezinde yer almakta olup yaklasik 6000 m² alan buyuklugune sahiptir. Alanda; mekânsal algilanma ve alan kullanimlari arasindaki uyum acisindan eksiklikler bulunmaktadir. Bununla birlikte; aktivite cesitliligi, kentsel donati ve bitkisel materyal yetersizligi de goze carpmaktadir. Calismada, mevcut meydan ve dogusundaki kamu hizmet binalarinin (Adliye ve Defterdarlik) ortak kullanim alanlari birlikte degerlendirilmistir. Sonuc olarak Bartin Kenti’nin odaginda bulunan bu alanin, meydan niteligini on plana cikaracak 3 farkli peyzaj tasarimi yapilmistir. Tasarim asamasinda “Erisilebilir, Guvenli, Kimlikli ve Okunabilir” olma ilkeleri on planda tutulmustur. Bu tasarimlarin kente estetik ve islevsel acidan katki saglamasi, kentsel simgeleri barindirmasi ve kullaniciya toplanma-bulusma-gecis alani olusturmasi beklenmektedir.

06.03.2018 tarih ve 30352 sayılı Resmi gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır. Kırsal alanlar sahip oldukları doğal/fiziksel ve kültürel özellikleriyle, kentleşme baskısı altında olan önemli kaynaklardır. Kentleşme hızla devam ederken kırsal alanlar, kırsallık özelliklerini koruyabilmeli ve kır-kent ilişkisi içinde özgün kırsal peyzaj kimlikleriyle var olabilmelidir. Yasal-yönetsel boyutta yapılan değişiklikler, kentlere göç verilmesine sebep olan eksik uygulamalar ve yoğun kentleşmeden kaçan yerli turistlerin oluşturduğu baskılar nedeniyle, bu yerleşimler ve kırsal kimlik tehdit altındadır. Bu araştırmada; turizm potansiyeli olan ve kırsallık özelliğini koruyan bir yerleşim esas alınarak, tehdit altında olan kırsal kimliği korumaya yönelik bir model oluşturulması amaçlanmıştır. Bu amaç doğrultusunda; Ankara İli'ne bağlı Nallıhan İlçesi-Beydili Mahallesi (Köyü) çalışma alanı olarak seçilmiştir. Nallıhan İlçesi, özgün kırsal kimliği ile kültürel yapısını korumayı başarmış ve turizm potansiyeli bakımından zengin bir yerdir. İlçe merkezine 40 km. uzaklıkta olan Beydili Mahallesi de, sahip olduğu doğal/fiziksel ve kültürel değerlerinin yanı sıra turizm olanakları ve geleneksel kültürlerine bağlılıklarıyla İlçe'nin diğer mahallelerinden farklılaşarak öne çıkmıştır. Bu kapsamda Beydili Mahallesi'nin kültürel yapısını, sorunlarını ve mevcut turizm potansiyelini doğal ve kültürel peyzaj bileşenlerinin analiz edilmesiyle ortaya koymak hedeflenmiştir. Bu bileşenlerle kırsal peyzaj kimliği ilişkisi kurularak, kırsal alanlarda sürdürülebilirliğin sağlanması için, alanın mevcut turizm potansiyeli çerçevesinde çalışmalar yapılmıştır. Bu doğrultuda çalışma genel olarak; veri toplama, analiz, sürdürülebilirlik göstergelerinin ve alt ölçütlerin belirlenmesi ile değerlendirme ve sonuçlar olmak üzere 4 aşamada gerçekleştirilmiştir. Öncelikle, kültürel peyzaj bileşenleri gruplandırılmıştır. Literatür, arazi, anket, Hızlı Kırsal Değerlendirme ve Zihin Haritası Değerlendirme çalışmaları ile alan analizleri yapılmıştır. Alandaki mevcut turizm potansiyeline göre turizm çeşitleri belirlenerek alan; Güçlü Yönler, Zayıf Yönler, Fırsatlar ve Tehditler Analizi aracılığıyla değerlendirilmiştir. Sürdürülebilirlik göstergeleri ile alt ölçütleri 3 temel boyutuyla belirlenmiş ve puanlanmıştır. Buna göre hesaplamalar yapılmıştır. Göstergeler ve alt ölçütleri, öncelikle Beydili Mahallesi'nin mevcut durumuna göre değerlendirilerek puanlanmıştır. Daha sonra, alandaki turizm potansiyeline göre belirlenmiş turizm çeşitleri – gastronomi turizmi, kültür turizmi, doğa turizmi, yayla turizmi ve inanç turizmi – göz önünde bulundurularak uzmanlar tarafından puanlanmıştır. Alanın mevcut durumu değerlendirilirken göstergeler ve alt ölçütleri, 1 (var) ve 0 (yok) şeklinde puanlanmıştır. Uzmanların göstergeleri puanlamasına bağlı olarak her bir turizm çeşidi için ayrı ayrı hesaplamalar yapılmış ve en yüksek puanı alan yayla turizmi (39 puan) olmuştur. Toplam puanların birbirine yakın çıkması, alandaki turizm potansiyelinin çeşitliliğinin değerlendirilmesi gerektiğini ortaya koymuştur. Sonuç olarak; alanda kırsal peyzaj kimliğinin sürdürülebilirliğinin sağlanması için yapılacak çalışmalarda, yayla turizmine yönelik uygulamaların desteklenmesi için tüm turizm çeşitlerine yönelik önerilerde bulunulmuştur. Tüm çalışmalar sonucu, model sınıflamasından "Sembolik Model" türüne uygun olarak çalışmanın aşamalarını ve bu aşamalar arasında kurulan bağlantıyı içeren "Kırsal Kimlik Koruma Modeli" oluşturulmuştur. Üretilecek plan kararlarının, doğal ve kültürel değerlerin birlikte ele alınarak irdelenmesi esasına göre oluşturulması ve kültürel koruma temelinde yürütülmesi gerektiği unutulmamalıdır. Bu çalışmayla oluşturulmuş Kırsal Kimlik Koruma Modeli'nin; benzer alanlarda yapılacak çalışmalarda göz önünde bulundurulduğu takdirde, kırsal alanların sürdürülebilirliğine ve kalkınarak gelişmesine katkı sunacağı düşünülmektedir. Rural areas are important sources under the pressure of urbanization with their natural/physical and cultural characteristics. As urbanization continues rapidly, rural areas should be able to maintain their rurality characteristics and be able to exist in their rural-urban relation with their original rural landscape identities. These settlements and rural identity are under threat because of the changes made at the legal-administrative level, the lack of practices leading to immigration to the cities, and the pressures of local tourists fleeing from intense urbanization. In this study; it is aimed to create a model to protect the threatened rural identity based on a settlement that has tourism potential and maintains its rural character. For this purpose; Nallıhan District-Beydili Quarter (formerly Village) of Ankara Province has been selected as study area. Nallıhan District has preserved its cultural structure with its original rural identity and is a place rich in terms of tourism potential. Furthermore, Beydili Quarter, which is 40 km. away from the District center, has distinguished itself from other quarters due to its natural/physical and cultural values, as well as its tourism facilities and its adherence to traditional cultures. In this context, it is aimed to reveal the cultural structure, problems and existing tourism potential of Beydili Quarter by analyzing the natural and cultural landscape components. Studies have been carried out on existing tourism potential of the area by establishing a rural landscape identity relationship with these components in order to ensure sustainability in rural areas. In this line, the study has been carried out in 4 phases in general: data collection, analysis, determination of sustainability indicators and sub-criteria, and evaluation and results. Firstly, cultural landscape components have been grouped. Field analysis have been conducted with literature, field survey, questionnaire, Rapid Rural Appraisal and Mind Map Evaluation studies. According to the existing tourism potential in the area, determining the types of tourism, area have been conducted through Strengths, Weaknesses, Opportunities and Threats Analysis. Sustainability indicators and sub-criteria were determined and have been scored by 3 main dimensions. Accordingly, calculations have been made. Indicators and sub-criteria have been scored primarily according to the current status of the Beydili Quarter. Later, tourism types that are determined according to the tourism potential of the area – gastronomic tourism, cultural tourism, nature tourism, highland tourism and religious tourism – have been scored by experts accordingly. When the current status of the field is evaluated, the indicators and sub-criteria are scored as 1 (exists) and 0 (non-exists). Depending on the scoring of the experts' scores, each type of tourism has been calculated separately and the highest score is highland tourism (39 points). The fact that the total scores are close to each other proved that the diversity of the tourism potential in the area should be utilized. As a result; suggestions have been made for all types of tourism in order to support the practices for highland tourism in studies on providing the sustainability of rural landscape identity in the field. As a result of all study, in accordance with the "Symbolic Model" from the model classification, "Rural Identity Protection Model" which includes the phases of the study and the link between these phases has been set. It should not be forgotten that the plan decisions to be made should be based on consideration of natural and cultural values together and should be carried out on the basis of cultural protection. Rural Identity Protection Model that is set with this study is thought to contribute to the sustainability and development of rural areas if they are considered in the studies to be done in similar areas.

Objectives Patients with nonradiographic axial spondyloarthritis (nr-axSpA) and radiographic axSpA/ankylosing spondylitis (AS) have similar burden of disease; however, the potential influence of pain characteristics including the neuropathic pain (NeP) component has not been assessed yet. The aim of this study was first to assess frequency of NeP component in patients with axSpA and second to assess the potential influence of NeP on burden of disease. Methods Adult patients who met the Assessment of SpondyloArthritis International Society classification criteria for axSpA were consecutively recruited. Patients were evaluated using the Douleur Neuropathique en 4 Questions interview and painDETECT questionnaire and subgrouped as patients with and without NeP. Results Neuropathic pain component was present in 31.4% of patients with axSpA categorized according to Douleur Neuropathique en 4 Questions (31.6% in nr-axSpA vs 31.3% in AS, P = 0.964) and in 33.5% of patients categorized according to painDETECT (35.1% in nr-axSpA vs 32.8% in AS, P = 0.762). Pain characteristics were quite similar between patients with nr-axSpA and AS. Women tented to have more frequent NeP. Patients with NeP component had significantly higher scores in visual analog scale of pain, patient and physician global, fatigue, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score using C-reactive protein, depression, anxiety scores, and physical functions; poorer quality of life (QoL); and similar frequency of fibromyalgia compared with patients without NeP component. In multivariable analysis, having NeP was associated with QoL measures (Ankylosing Spondylitis Quality of Life and Short-Form 36 physical component score) and visual analog scale of fatigue. Conclusions Nearly one third of patients with axSpA may have NeP component regardless of having nr-axSpA or AS. Neuropathic pain component may contribute worsened QoL and poorer patient-reported outcome data and should be kept in mind during patient evaluation.

Objective: Although the prevalence of peripheral and extra-articular disease in ankylosing spondylitis (AS) has been assessed in many studies, data on non-radiographic axial spondyloarthritis (nr-axSpA) is scanty. The aim of this study was first, to compare radiographic-axSpA/AS (r-axSpA/AS) and nr-axSpA concerning peripheral arthritis and extra-articular manifestations (EAMs), and second, to assess potential differences between patient subgroups with or without EAMs regarding disease burden. Methods: Data was extracted from our single center axSpA database. Patients having at least one of the EAMs (uveitis and/or inflammatory bowel disease (IBD) and/or psoriasis) were compared to those who did not have EAMs. Patients’ clinical data including disease activity, functional and psychological status, physical limitations, quality of life (QoL) and magnetic resonance imaging of sacroiliac joints (SIJ MR) were evaluated. Results: Patients with nr-axSpA (n=193) were younger, had female predominance, better functional and physical status, higher frequency of bone edema in SIJ MR and peripheral arthritis but similar QoL, prevalence of HLA B27 and EAMs compared to r-axSpA/AS (n=352). The prevalence of current or ever uveitis (14.5 vs 15.3%, p=0.791), psoriasis (6.2 vs 5.4%, p=0.689) or IBD (4.1 vs 3.4%, p=0.663) in nr-axSpA and r-axSpA/AS were similar. In both subgroup of patients, EAMs positive and negative patients had similar functional status and QoL, as well as disease activity and laboratory parameters. Conclusion: Patients with nr-axSpA and r-axSpA/AS have similar prevalence of EAMs and clinical burden of disease. Having EAMs does not have a major influence on clinical parameters and patient reported outcome measures in nr-axSpA and r-axSpA/AS.

The main goal in the countries which have not completed their development progress is industrialization and development just as soon as possible. Therefore, negative effects of industrialization and development on envi ronment and/or nature cannot be mostly discussed adequately. One of the planning approach instruments that targets sustainability, Environmental Impact Assessment (EIA) is used in many countries effectively. But in recent years, that has understood; EIA is an impact assessment instrument that contains defensive preventions only on the basis of projects and this situation has caused some concerns against EIA. In this direction, Strategical Environmental Assessment (SEA) exists as the final point of the instruments which are formed to provide sustainable development . In this study; the importance and the requirement of effectively taking a role of landscape architectures that have ecological based job, in the SEA workings which isn’t have got a legal status in Turkey yet, are emphasized by reviewing the relations between EIA and SEA concepts.

Bu çalışmada, araştırma alanı olarak seçilenBartın İli’nin Amasra İlçesi’ne bağlı Ahatlar Yerleşimi’nde kırsal peyzajkimliği kaybedilmeden alanda sürdürülebilir kalkınma anlayışıyla “Ekoturizmnasıl geliştirilebilir?” sorusuna yanıt aranmıştır. Çalışma; veri toplama,analiz, değerlendirme ve sonuç-öneriler olmak üzere 4 aşamadagerçekleştirilmiştir. Ahatlar’a ilişkin temel özelliklerin; Ahatlar TabiatParkı, Amasra manzarasına hâkim seyir noktaları, ahşap el sanatları/atölyelerive yöresel pazar ürünleri olduğu saptanmıştır. Sonuç olarak Ahatlar’da yapılanekoturizm çalışmalarında kırsal özelliklerin desteklenerek yörenin yerindekalkındırılması amacıyla her birinde bir özelliğin baskın olduğu ekoturizmsenaryoları oluşturulmuştur: “Amasra’nın Balkonu”, “Ahşap Atölyeleri”, “YöreselPazar”., In this study, the answer to the question"How can ecotourism be developed?” with the concept of sustainabledevelopment in the field without losing rural landscape identity has beensought in a case of a settlement which is selected as a study area, Ahatlar Villagethat is located in Amasra District of Bartın Province. This study involves fourmain stages as data collection, analysis, evaluation and results-suggestions.In the phase of evaluating the analysis results, main features of Ahatlar arefound to be as follows: Ahatlar Nature Park, sightseeing points in Amasrascenery, wooden handicrafts / workshops and local bazaar products. As a result,in ecotourism studies in Ahatlar, ecotourism scenarios have been built in whicheach one is dominant in order to support the rural characteristics and developthe place in the region: "Amasra's Balcony", "Wooden Workshops","Local Bazaar".

Objectives This study aims to compare the levels of fatigue in patients with rheumatoid arthritis (RA) and systemic sclerosis (SSc) and to assess the potential influence of fatigue on clinical variables. Patients and methods Age- and sex-matched adult patients with SSc (n=50; 6 males, 44 females; mean age 47.7 years; range 23 to 72 years) and RA (n=51; 6 males, 45 females; mean age 50.8 years; range 23 to 71 years) were consecutively recruited. Patients were examined and evaluated for disease specific and generic outcome measures including disease activity parameters, physical functions, psychological status, and health related quality of life measures. Level of fatigue was assessed by Fatigue Severity Scale and Multidimensional Assessment of Fatigue scale. These were interviewed by the same experienced physician who was blind to clinical data. Results Patients had similar educational and smoking status, as well as functioning and health related quality of life. However, patients with RA declared higher levels on visual analog scale-pain (p=0.012) and higher body mass index than patients with SSc (p

Familial Mediterranean fever (FMF) is the most common hereditary auto-inflammatory (periodic fever) syndrome, and usually successfully treated with colchicine. However, nearly 5-10% of FMF cases are resistant or intolerant to colchicine and treatment options are highly restricted in these cases. Biologics including anakinra, canakinumab, rilonacept, etanercept, infliximab, interferon-alpha, and tocilizumab are shown to have efficacy to control FMF attacks. Tofacitinib, a Janus kinase (JAK) inhibitor, is an orally administered non-biologic disease modifying anti-rheumatic drug for the treatment of rheumatoid arthritis (RA). Herein we report a female patient with coexisting RA and colchicine resistant FMF whose FMF attacks and disease activity were completely controlled after treatment with tofacitinib, a small-molecule JAK3 inhibitor.

Background Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by progressive destruction of inflamed joints leading to severe disability and functional loss. Systemic sclerosis is a multisystem autoimmune disease characterized by vasculopathy, diffuse fibrosis of skin and various internal organs. Pain is usually an overlooked entity in patients with SSc compared to RA. Objectives To compare pain characteristics particularly in terms of neuropathic pain (NeP) and to assess the possible impact of neuropathic component on functioning, physical and mental components of health related quality of life (HRQoL) in patients with RA and SSc. Methods Patients who met ACR/EULAR criteria for SSc and RA were recruited. Patients with prior diagnosis or taking medications for NeP, mood disorders, uncontrolled diabetes or neurological disorders or taking any biologic agents for their treatments were excluded. Patients were examined and evaluated for disease specific and generic outcome measures including disease activity parameters, physical functions, psychological status and health related quality of life measures (SF-36; HAQ; Hospital Anxiety and Depresson Scale, HADS). The DN4 interview and PainDetect questionnaire were applied by the same experienced physician who was blind to patients clinical and outcome data. Patients with a score ≥4 in DN4 were considered as “probable NeP”; between 13–18 or ≥19 in PainDetect were considered as “possible” or “likely NeP”, respectively. Results Fifty patients (44 F, 6 M) with SSc and fifty-one (45 F, 6 M) with RA were included. Patients had similar age and similar gender, educational and smoking status, as well as functioning and HRQoL. However, patients with RA declared more severe pain on VAS-pain (p=0.012), and higher body mass index than patients with SSc (p 0.05) according to DN4 scores. According to PainDetect questionnaire, possible NeP was detected in 12.0% vs 15.7%, whereas 16.0% vs 17.6% had likely NeP in SSc and RA, respectively (p>0.05). Neuropathic characteristics of pain were similar in SSc and RA defined as burning, electric shock, tingling, pins and needles, and itching except for numbness and painful cold which were significantly more prevalent in patients with SSc (%50.0 vs %25.5, p=0.011 and %50.0 vs %19.6, p=0.001; respectively). In SSc patients with or without NeP component had similar functioning and HRQoL measures. However, having NeP component revealed a heavier burden of disease regarding functioning, HRQoL and psychometric components patients with RA. Conclusions The NeP component was similar in patients with RA and SSc. However NeP was associated a heavier burden of disease in patients with RA. Disclosure of Interest None declared

Background Rheumatoid arthritis (RA) and systemic sclerosis (SScl) are two different forms of connective tissue diseases associated with significant morbidity. While fatigue is not required for a diagnosis of RA or SScl persistent fatigue is an important clinical problem which may interfere with loss of functioning and health related quality of life (HRQoL) and contribute to the increased disease burden. Several studies compared these two diseases in terms of clinical, laboratory and imaging aspects, however level of fatigue has not been evaluated comparatively. Objectives The aim of this study was to compare levels of fatigue in RA and SSc and to assess potential influence of fatigue on clinical variables. Methods Patients meeting the ACR/EULAR criteria for SSc and RA with an age more than 18 were consecutively recruited. Patients with a prior diagnosis of psychiatric disorders or fibromyalgia or taking medications for these disorders, or with uncontrolled diabetes, neurological disorders or taking any kind of biologic agents were excluded. Patients were examined and evaluated for disease specific and generic outcome measures including disease activity parameters, physical functions, psychological status and health related quality of life (HRQoL) measures. Level of fatigue was assessed by Fatigue Severity Scale (FSS) and Multidimensional Assessment of Fatigue (MAF) scale. These were interviewed by the same experienced physician who was blind to clinical data. Results Fifty patients (44 F, 6 M) with SSc and fifty-one (45 F, 6 M) with RA were included. Patients had similar age and similar gender, educational and smoking status, as well as functioning and HRQoL. However, patients with RA declared higher levels on VAS-pain (p=0.012), and higher body mass index than patients with SSc (p Conclusions Fatigue is a major problem in patients with RA and SSc. This is the first report comparing these two diseases in terms of fatigue and its correlates. Patients with RA and SSc should be carefully evaluated for fatigue by using valid scales and the impact of fatigue on clinical measures should not be overlooked. Disclosure of Interest None declared

Gelisim surecini tamamlamamis ulkelerde temel hedef mumkun oldugunca kisa surede sanayilesme ve gelismedir. Bu nedenle cogu zaman sanayilesme ve gelismenin cevreye ve/veya dogaya olabilecek olumsuz etkileri yeterince tartisilmamaktadir. Surdurulebilirligi hedefleyen planlama yaklasiminin araclarindan birisi olarak Cevresel Etki Degerlendirmesi (CED) bircok ulkede etkin olarak kullanilmaktadir. Fakat son yillarda, CED’in yalnizca proje bazinda koruyucu onlemler iceren bir etki degerlendirme araci oldugu gorulmus ve bu durum CED’e karsi birtakim endiseleri dogurmustur. Bu dogrultuda surdurulebilir kalkinmanin saglanmasi icin olusturulan araclarin son noktasi olarak Stratejik Cevresel Degerlendirme (SCD) kavrami ortaya cikmistir. Bu calismada; Turkiye’de henuz yasal bir statuye sahip olmayan SCD calismalarinda, ekolojik tabanli bir meslek sahibi olan peyzaj mimarlarinin etkin olarak yer almasinin gerekliligi ve onemi, CED ve SCD kavramlari arasindaki iliski incelenerek vurgulanmistir