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Rheumatoid arthritis (RA) is a chronic inflammatory disease with a higher incidence in older adults. We aimed to analyze the differences in the choice of RA treatment regimens across various age groups. A retrospective cohort study using data from the Ankara Bilkent City Hospital Registry was conducted, involving 3,475 RA patients categorized into three age groups: 18-49, 50-64, and over 65 years. Key variables examined included demographics, comorbidities, and utilization of various treatment modalities, including disease-modifying antirheumatic drugs (DMARDs), tumor necrosis factor-alpha inhibitors (TNFi), targeted synthetic DMARDs (tsDMARDs), and other biological treatments. Statistical analysis was done with Jamovi software. The study found significant differences in drug prescriptions among age groups. Older patients (>65 years) were less likely to be prescribed methotrexate and sulfasalazine but more likely to receive leflunomide and colchicine. A decline in the use of TNFi and tsDMARDs with age was noted, while other biologics were consistently used across all ages. Our findings underscore the impact of age on treatment choices in RA, revealing a tendency towards less aggressive treatment approaches in older patients. We emphasize the importance of re-evaluating current treatment protocols to better accommodate the health needs of the aging RA population and enhance their quality of life. [ABSTRACT FROM AUTHOR]

Introductıon: Celiac disease (CD) is an autoimmune disease caused by gluten ingestion in genetically susceptible individuals. Although gastrointestinal system symptoms are common, extraintestinal symptoms may be seen during the disease course. Due to similar genetic features and pathogenetic pathways for autoimmunity, increasing rheumatological diseases have been reported in CD in recent years. In this study, we aimed to evaluate patients with CD in terms of musculoskeletal symptomatology and presence of rheumatic disease and autoantibody positivity. Methods: The study was designed as a cross-sectional, retrospective cohort study. Between January 2020-2022, 65 patients with CD who were followed-up in the gastroenterology clinic of our hospital and consulted to the rheumatology outpatient clinic for any reason were included in the study. Medical records were reviewed, laboratory and imaging results were recorded. Results: Admission to the rheumatology clinic, the most common symptoms were inflammatory back pain(IBP) (43.1%) followed by xerophthalmia (15.4%). None of the patients with IBP had radiographically active sacroiliitis. In total, concomitant rheumatological diseases were 6 (9.2%): 2 patients (3.1%) had Sjögren's syndrome and one undifferentiated connective tissue disease, systemic lupus erythematosus, psoriatic arthritis and familial Mediterranean fever. Except for the CD autoantibodies, the frequency of anti-nuclear antibodies (ANA) was 38%, and the most common extractable nuclear antigen (ENA) patterns were DFS-70 and SSA. Conclusion: Although the most common symptom is IBP, the absence of radiographic findings of spondyloarthritis in CD patients suggests these to be a non-rheumatological cause associated with CD. On the other hand, CD patients with xerophthalmia and/or ANA positivity may need to be evaluated for connective tissue diseases, especially SjS. [ABSTRACT FROM AUTHOR]

The immunogenicity of vaccines decreases over time, causing a need for booster doses. This study aimed to present the long-term (Day 84) immunogenicity results of the double-blind, randomized, controlled, phase II Hybrid COV-RAPEL TR Study (NCT04979949), in which the TURKOVAC or CoronaVac vaccines were used as a booster after the second dose of primary vaccination with CoronaVac. A total of 190 participants from the Hybrid COV-RAPEL TR Study, who had both Day 28 and Day 84 immunogenicity results, were included. The immunogenicity on Day 84, regarding the neutralizing antibody positivity (Wuhan and Delta variants) and anti-spike immunoglobulin (Ig) G (IgG) antibody positivity, was compared between TURKOVAC and CoronaVac vaccine arms according to sex and age groups. Overall, antibody positivity showed a slight decrease on Day 84 vs. Day 28, but was not different between TURKOVAC and CoronaVac arms either for sexes or for age groups. However, TURKOVAC produced better antibody response against the Delta variant than CoronaVac, while CoronaVac was superior over TURKOVAC regarding neutralizing antibody positivity in the 50–60 years age group, regardless of the variant. A single booster dose, after the completion of the primary vaccination, increases antibody positivity on Day 28 which persists until Day 84 with a slight decrease. However, an additional booster dose may be required thereafter, since the decrease in antibody titer may be faster over time. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic has been affecting the whole world by increasing morbidity and mortality rates day by day. Treatment algorithms have been attempted as parallel to the increasing experience with COVID‐19. In the pathogenesis of this virus pro‐inflammatory cytokine storm has been called to have the main role. The right timing should be made for treatments. We proposed IL‐ 1 blocking by anakinra in seventeen COVID‐19 patients at high risk of worsening. Patients were assessed according to HScore, SOFA (Sequential Organ Failure Assessment Score = SOFA), MuLBSTA Score (multilobular infiltration, hypo‐lymphocytosis, bacterial coinfection, smoking history, hyper‐tension, and age), Brescia‐COVID respiratory severity scale (BCRSS). In our study, the mortality rate was 17.6%. Consequently, 1 (5.9%) patient was receiving low‐flow oxygen supply, 3 (17.6%) patients needed no longer oxygen supply and 10 (58.8%) patients were discharged from the hospital. According to the results of our study in the manner of general evaluation; we found that SOFA, MuLBSTA, and BCRSS scores were one step ahead according to HScore being insufficient to determine early phases of the disease. In our opinion, the prominent factors that emphasize the use of anakinra could be listed as comorbidity, risk, or presence of secondary infection, ongoing malignant disease. However, the other factors that enhance the use of anakinra in the situation of viremia also could be sorted as no response to full dose antivirals, antiviral side effects, or no success to antiviral treatment. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the effect of desensitizing agents containing different amounts of fluoride on the shear bond strength of a dual polymerized resin cement and a resin-modified glass ionomer cement (RMGIC) to dentin., Material and Methods: One hundred human molars were mounted in acrylic resin blocks and prepared until the dentin surface was exposed. The specimens were treated with one of four desensitizing agents: Bifluorid 12, Fluoridin, Thermoline and PrepEze. The remaining 20 specimens served as untreated controls. All groups were further divided into 2 subgroups in which a dual polymerized resin cement (Bifix QM) or a resin-modified glass ionomer cement (AVANTO) was used. The shear bond strength (MPa) was measured using a universal testing machine at a 0.5 mm/min crosshead speed. The data were analyzed statistically with a 2-way ANOVA, Tukey HSD test and regression analysis (alpha=0.05). The effect of the desensitizing agents on the dentin surface was examined by scanning electron microscopy., Results: The fluoride-containing desensitizing agents affected the bond strength of the resin-based cements to dentin (p<0.001). PrepEze showed the highest bond strength values in all groups (p<0.001)., Conclusion: Regression analysis showed a reverse relation between bond strength values of resin cements to dentin and the amount of fluoride in the desensitizing agent (p<0.05).

Objective: To evaluate the preemptive effects of diclofenac sodium, in combination with remifentanil and ketamine., Methods: A prospective, randomized, double blind, placebo-controlled trial was carried out at the Hacettepe University Hospital, Ankara, Turkey from September to December 2004. Forty-three, American Society of Anesthesiology physical status group I-II women, aged >18 years, who would undergo both diagnostic and operative laparoscopic surgery were randomly assigned into 2 groups. All patients received intraoperative 0.1 microg x kg(-1)min(-1) remifentanil infusion. Diclofenac (1 mg x kg(-1) intramuscular) was administered, 20 minutes before the operation. Ketamine (0.8 mg x kg(-)1 intravenously) was administered 5 minutes before the skin incision and at completion of skin closure. We divided the patients into 2 groups; Group I (diclofenac + remifentanil + ketamine), Group II (remifentanil + ketamine). Pain was evaluated postoperatively using the visual analogue scale (VAS) while global satisfaction by verbal rating scale (VRS)., Results: All 43 female patients have a mean +/- SD age of 32.3 +/- 6.5 years, height of 163 +/- 5.3 cm, and weight of 62.9 +/- 9.5 kg. The VAS and VRS scores and also time to first analgesic request were not different between the groups. In all groups, >98% of the patients were satisfied or very satisfied., Conclusion: We have not found any preemptive or additive effect of diclofenac sodium with the concomitant use of ketamine.