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Autoimmune rheumatic diseases have their own specific clinical presentation, and can affect multiple systems. Neurological involvement of autoimmune rheumatic diseases may involve both the central and peripheral nervous systems. Inflammation of neural tissue, autoantibody-mediated reactions, and small vessel vasculitis may be effective in the pathogenesis of neuropathy in autoimmune rheumatological diseases. Autoimmune rheumatic disease with pure motor neuron involvement is very rare in the literature. The case is here presented of a 58-year-old female patient who presented with the complaints of increasing pain and weakness in the extremities and was diagnosed with lower motor neuron disease and overlap syndrome. The patient was treated with cyclophosphamide, pulse steroid, hydroxychloroquine and intravenous immunoglobulin. After 3 months of treatment, a significant improvement was observed in the patient's clinical complaints and laboratory parameters. In conclusion, some patients with undiagnosed autoimmune rheumatic diseases may have neurological complaints. Clinicians should investigate patients with such neurological complaints for autoimmune rheumatic diseases.

To compare the effectiveness of ultrasound-guided genicular nerve block (GNB) and physical therapy (PT) in patients with chronic knee osteoarthritis. A prospective randomised study with 102 patients (45–70 years) was performed wherein the patients received ultrasound-guided GNB (n = 51) and PT (n = 51) along with a standard home exercise programme. Scores for pain on a Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 6-min walking test (6MWT) were assessed pre-treatment and at 2- and 12-weeks post-treatment. Both groups were comparable for sociodemographic characteristics. VAS scores (in mm) in the ultrasound-guided GNB group at 0, 2 and 12 weeks were 7.01 ± 1.36; 3.71 ± 2.18; 5.08 ± 2.22 (p < 0.001) and 6.64 ± 1.99; 4.35 ± 1.09; 5.25 ± 1.33, (p < 0.001) in the PT group. While the increase in the 6MWT test in the 2nd week was similar for both groups (p = 0.073), the increase in walking distance was greater in the ultrasound-guided GNB group at 12 weeks (p = 0.046). As compared to PT, ultrasound-guided GNB is beneficial in reducing pain and increasing functional and physical capacity, with greater retention of effects on the physical capacity seen at 12 weeks. Trial registration number: ClinicalTrials.gov (NCT04782401).

This study aimed to detect patients’ characteristics who suffered severe and critical COVID-19 pneumonia admitted to the post-acute COVID-19 rehabilitation clinic in Ankara City Hospital, Physical Medicine and Rehabilitation Hospital and to share our experiences and outcomes of rehabilitation programmes applied. This study was designed as a single-centre, retrospective, observational study. Severe and critical COVID-19 patients, admitted to the post-acute COVID-19 rehabilitation clinic, were included in patient-based rehabilitation programmes, targeting neuromuscular and respiratory recovery. Functional status, oxygen (O2) requirement and daily living activities were assessed before and after rehabilitation. Eighty-five patients, of which 74% were male, were analysed, with the mean age of 58.27 ± 11.13 and mean body mass index of 25.29 ± 4.81 kg/m2. The most prevalent comorbidities were hypertension (49.4%) and diabetes mellitus (34.1%). Of the 85 patients, 84 received antiviral drugs, 81 low-molecular-weight heparin, 71 corticosteroids, 11 anakinra, 4 tocilizumab, 16 intravenous immunoglobulin and 6 plasmapheresis. 78.8% of the patients were admitted to the intensive care unit, with a mean length of stay of 19.41 ± 18.99 days, while those who needed O2 support with mechanic ventilation was 36.1%. Neurological complications, including Guillain–Barre syndrome, critical illness-related myopathy/neuropathy, cerebrovascular disease and steroid myopathy, were observed in 39 patients. On initial functional statuses, 55.3% were bedridden, 22.4% in wheelchair level and 20% mobilised with O2 support. After rehabilitation, these ratios were 2.4%, 4.7% and 8.2%, respectively. During admission, 71 (83.5%) patients required O2 support, but decreased to 7 (8.2%) post-rehabilitation. Barthel Index improved statistically from 44.82 ± 27.31 to 88.47 ± 17.56. Patient-based modulated rehabilitation programmes are highly effective in severe and critical COVID-19 complications, providing satisfactory well-being in daily living activities.

The psoriatic arthritis impact of disease (PSAID) questionnaire has been developed to measure disease impact on patients with psoriatic arthritis. It was aimed to evaluate its validity and reliability in association with sociodemographic and clinical factors and compare it with disease activity and patient-reported outcome measures in a Turkish psoriatic arthritis population. A prospective observational study was conducted to validate the Turkish version of the PSAID. All consecutive patients with psoriatic arthritis were evaluated between January 2019 and October 2019. Demographic and clinical features were recorded. The PSAID and patient-reported outcome measures were applied to all patients. Interclass and intra-class correlation analyses were performed. Convergent validity and correlation coefficients were used for validity analyses. There were 80 patients with a mean age of 50.2 ± 9.9 years. Cronbach's α value of the PSAID and intra-class correlation were 0.799 and 0.984, respectively. The total median PSAID score was 4.7. Pain, fatigue, ability to work, functional capacity and feeling of discomfort were the five highest-scoring subscales. There was satisfactory internal consistency for each subscale of the PSAID. As disease severity increased from low to high, the PSAID scores significantly increased. There were acceptable correlations between the PSAID and other patient-reported outcome measures. The PSAID is shown to be a reliable and valid questionnaire in Turkish patients with psoriatic arthritis. Good correlation with disease activity and patient-reported outcome measures represent an opportunity to use the PSAID in clinical practice to tailor individualized treatment choices.

Objectives This study aims to evaluate pain, quality of life, and patient satisfaction in parenterally treated patients with postmenopausal osteoporosis (OP). Patients and methods Between May 2016 and January 2018, a total of 138 patients (mean age 63.78 years; range, 50 to 70 years) with postmenopausal OP were retrospectively analyzed. All patients were previously treated with denosumab (DEN) and parenteral forms of bisphosphonates such as zoledronic acid (ZOL) and ibandronate (IBN). The pain severity was evaluated using the Visual Analog Scale (VAS) and Brief Pain Inventory-Short Form (BPI-SF). The quality of life was evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41). For the evaluation of patient satisfaction, a three-item questionnaire including satisfaction with the medication, route, and frequency of administration was applied. Results Of the patients, 50 received DEN, 48 received ZOL, and 40 received IBN treatment. There was no significant difference in any of the pain parameters. All domains of the Qualeffo-41 were similar among the three groups. The patients in the DEN group were more satisfied with their medication (DEN: 88%, ZOL: 43.75%, and IBN: 52.5%), its administration route (DEN: 84%, ZOL: 43.8%, and IBN: 57.5%), and the frequency of its administration (DEN: 84%, ZOL: 56.25%, and IBN: 52.5%) (p=0.0001). Conclusion Neither of the medication showed a superior effect on quality of life. However, patients were more satisfied with medications used in a six-month interval and applied subcutaneously. Of these three treatment options, DEN seems to be a step ahead in terms of patient satisfaction.

OBJECTIVES: This study aims to assess early changes in physical activity and function after total hip arthroplasty (THA) using both subjective and objective methods, and to identify predictors of outcomes of THA. PATIENTS AND METHODS: Between October 2014 and October 2015, a total of 50 patients (14 males, 36 females; mean age 57.1±13.0 years; range, 31 to 75 years) with end-stage primary hip osteoarthritis who were scheduled for THA and 50 age- and sex-matched controls (10 males, 40 females; mean age 52.9±9.3 years; range, 36 to 75 years) were included in the study. Pain was evaluated using the Numeric Rating Scale (NRS), physical function using the Lequesne Index, physical capacity using the Six-Minute Walking Test (6MWT), and physical activity using both International Physical Activity Impact Questionnaire Short Form (IPAQ-SF) and step count monitor. Data at baseline and six weeks and six months were recorded. RESULTS: Pain severity was significantly lower after THA at six weeks and six months (NRS scores: 2.83 and 0.82, respectively; p

İşletmeler varlıklarını sürdürebilmek için faaliyette bulundukları alanlarla ilgili çevrelerini olumlu veya olumsuz yönde etkilerken kendileri de çevrelerinden etkilenmektedirler. Bu etkileşim, birçok işletmenin çevreye bakışını değiştirerek çevre bilincine sahip olmalarını ve çevre stratejilerini işletme stratejileri ile birleştirmelerine neden olmuştur. Böylece zaman içerisinde çevreye duyarlı tüketicilerin istek ve ihtiyaçlarını en iyi şekilde karşılayabilmek için çevreye en az zarar veren işletme stratejileri kullanılmaya başlanılmıştır. Buradan hareketle tüketicilerin çevreye duyarlı işletmelere ve ürünlerine karşı bakış açılarını belirlemeyi amaçlayan bu çalışmada Karaman il merkezinde yaşayan ve kolayda örnekleme yöntemiyle seçilen 350 katılımcıya anket uygulanmıştır. Elde edilen veriler frekans ve yüzde tabloları, Ki Kare, Mann Whitney U ve Kruskal Wallis testleri ile analiz edilmiştir. Analizler sonucunda, ‘Çevreye Duyarlı Yönetim’ kavramı tüketicilerin büyük çoğunluğu tarafından bilmesine rağmen ‘Sürdürülebilirlik’ kavramının daha az bilindiği gözlemlenmiştir. Yine katılımcıların çevreye zararlı olduğunu öğrendikleri ürünleri almaya devam etmedikleri, çevre dostu ürün satın alarak çevrenin korunmasına katkıda bulunduklarına inandıkları ve çevre sorunlarının çözümü için yapılan yatırımların işletmeler açısından lüks olmadığını düşündükleri, ancak ürün satın almaya karar verirken çevreye dost malzemeden üretilmiş olmasına pek dikkat etmedikleri görülmüştür. Genel olarak katılımcıların, işletmelerin çevre sorunlarına yeterince önem vermediklerine inandıkları, çevre dostu ürün, çevreye duyarlı işletme vb. konularında ise sınırlı oranda bilgiye sahip oldukları anlaşılmıştır., In order to maintain their existence, businesses affect their environment positively or negatively, while they are also affected by their environment. This interaction has caused many businesses to have environmental awareness by changing their view of the environment and to combine their environmental strategies with business strategies. Thus, in order to meet the demands and needs of environmentally conscious consumers in the best way, business strategies that cause the least damage to the environment have been started to be used. From this point of view, in this study, which aims to determine the perspectives of consumers towards environmentally sensitive businesses and their products, a questionnaire was applied to 350 participants living in the city center of Karaman and selected by convenience sampling method. The obtained data were analyzed with Chi-Square, Mann Whitney U and Kruskal Wallis tests. As a result of the analysis, it has been observed that although the concept of 'Environmentally Responsible Management' is known by the majority of consumers, the concept of 'Sustainability' is less known. Again, it was observed that the participants did not continue to buy products that they learned were harmful to the environment, they believed that they contributed to the protection of the environment by purchasing environmentally friendly products, and that the investments made for the solution of environmental problems were not luxurious for businesses, but they did not pay much attention to the fact that they were produced from environmentally friendly materials when deciding to purchase a product. In general, the participants believe that the enterprises do not give enough importance to environmental problems, environmentally friendly products, environmentally sensitive enterprises, etc. It is understood that they have limited knowledge on the subject.

This study aimed to investigate the carpal tunnel syndrome (CTS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA), compare the electrophysiological and ultrasonographic findings and evaluate related variables. Cut-off value of median nerve cross-sectional area (MCSA) was determined for the diagnosis of CTS. 70 RA patients, 39 PsA patients, a control group of 70 healty people were included in this study. Demographic characteristics, disease activity and functional status were recorded. Patients were referred for nerve conduction studies performed according to the American Academy of Neurology standards. Sonographic examination was carried on for MCSA evaluation. The mean age of patients was 51.87 ± 8.47, 50.61 ± 11.33, 49.75 ± 10.52 years and female ratio was 72.9%, 71.8%, 75.7% in RA, PsA and controls, respectively. Electrophysiologically, CTS frequency was found to be 13.2%, 15.4%, 3.5% in RA, PsA, control group, respectively, and a significant difference was found compared to the control group (p

Objectives: This study aims to investigate the rate of type D personality in Turkish patients with fibromyalgia (FM) and evaluate its associations with clinical parameters of FM as well as its effects on health-related quality of life (HRQoL).Patients and methods: The study included 100 patients with FM (14 males, 86 females; mean age 34.6 +/- 7.4 years; range, 22 to 49 years) fulfilling 1990 American College of Rheumatology diagnostic criteria and 50 healthy controls (9 males, 41 females; mean age 32.6 +/- 6.5 years; range, 21 to 50 years). Type D personality was assessed using the type D scale-14 (DS-14). FM disease severity was determined by Fibromyalgia Impact Questionnaire (FIQ), functional status by Stanford Health Assessment Questionnaire (HAQ), and HRQoL by Nottingham Health Profile (NHP). Severity of pain and fatigue were measured by visual analog scale (VAS).Results: The frequency of type D personality was 33% in FM patients and 12% in controls (odds ratio=3.612, 95% confidence interval 1.398-9.333) (p=0.006). Type D FM patients scored higher in tender point count (TPC), FIQ, HAQ, VAS-pain and all NHP subgroups except energy (p

Aim of the work: To evaluate the quality of life (QoL) in Familial Mediterranean Fever (FMF) patients, and determine its association with fatigue, depression, disease severity and other clinical parameters. Patients and methods: Sixty FMF patients were included. QoL was assessed by Short Form-36 (SF-36), depression by Hamilton Depression Scale (HDS), and fatigue by Fatigue severity scale (FSS). Disease severity score and Mutations of the Mediterranean fever (MEFV) gene were assessed. Results: The mean age of patients was 33.73 ± 9.81 years and disease duration 14.6 ± 12.1 years. They were 35 females and 25 males. FMF patients scored significantly higher in FSS (29.9 ± 17.6) and HDS (15.1 ± 8.5) compared to the control (10.6 ± 7.1 and 6.3 ± 9.4; p

Introduction: Immune mechanisms have been implemented to have a role in the pathogenesis of Behçet’s disease (BD) and vitamin D has been shown to have a regulatory role in the immune system function. Aim: To evaluate the vitamin D levels of BD patients and its relationship between clinical findings and disease activity of BD. Material and methods: Sixty-eight patients with BD and 70 age- and sex-matched controls were examined retrospectively. Demographic features, vitamin D levels for both groups and clinical findings, disease activity, drug usage for BD patients were examined from their medical reports. Disease activity was calculated for each patient according to Krause’s BD activity assessment. Results: Mean vitamin D levels of patients and controls were 15.35 ±7.18 ng/ml and 18.44 ±5.79 ng/ml, respectively. Vitamin D levels were significantly lower in BD patients than in controls (p = 0.006). Mean vitamin D levels of active and inactive BD cases were 15.68 ±7.31 ng/ml and 15.08 ±7.17 ng/ml, respectively (p = 0.73). Disease activity of patients using and not using vitamin D was similar (p = 0.51). Conclusions : Significantly lower levels of vitamin D were observed in BD patients. Our results indicate that there is no correlation between BD activity and a vitamin D level. Together with these, vitamin D replacement treatment was found to have no effect on disease activity.

Aim: Previous studies have shown that rheumatoid arthritis and aging are independent risk factors for decreased hand grip strength. However, little is known about how coexisting rheumatoid arthritis would affect the reduced hand grip strength in the elderly population. Therefore, the aims of this study were to compare the hand grip strength of elderly female rheumatoid arthritis patients with controls and to investigate the factors associated with hand grip strength in the patients with rheumatoid arthritis.Material and Methods: This cross-sectional study included 45 elderly women with rheumatoid arthritis and 43 age-matched controls. All subjects were provided with self-reported questionnaires measuring physical disability, anxiety and depression, sleep quality, cognitive impairment, and fatigue severity. Hand grip strength was measured with hand dynamometer. The disease activity was assessed by the Disease Activity Score.Results: There were no significant differences in values of age, body mass index, physical disability, anxiety and depression, sleep quality, cognitive impairment, fatigue severity, and grip strength between the groups. Disease period, physical disability, and disease activity were variables which showed statistically significant negative correlation with grip strength in rheumatoid arthritis patients. In further linear regression analysis, it is found that only long disease duration was associated with decreased grip strength.Conclusion: Rheumatoid arthritis does not seem to significantly affect aging-related muscle strength loss. Disease duration was found to be the only independent factor associated with hand grip strength in elderly rheumatoid arthritis patients., Amaç: Önceki çalışmalar romatoid artritin ve yaşlanmanın, azalmış el kavrama gücü için bağımsız risk faktörleri olduğunu göstermiştir. Bununla birlikte, bir arada var olan romatoid artritin yaşlı popülasyondaki azalmış el kavrama gücünü nasıl etkileyeceği konusunda çok az şey bilinmektedir. Bu nedenle, bu çalışmanın amaçları, yaşlı kadın romatoid artritli hastaların el kavrama gücünü kontrollerle karşılaştırmak ve romatoid artrit hastalarında el kavrama gücü ile ilişkili faktörleri araştırmaktır.Gereç ve Yöntemler: Bu kesitsel çalışmaya 45 romatoid artritli yaşlı kadın ve 43 yaşa göre eşleştirilmiş kontrol dahil edildi. Tüm deneklere fiziksel özürlülük, anksiyete ve depresyon, uyku kalitesi, bilişsel bozulma ve yorgunluk şiddetini ölçen kendi kendine bildirilen anketler verildi. El kavrama gücü, el dinamometresi ile ölçüldü. Hastalık aktivitesi, Hastalık Aktivite Skoru ile değerlendirildi.Bulgular: Gruplar arasında yaş, vücut kitle indeksi, fiziksel özürlülük, anksiyete ve depresyon, uyku kalitesi, bilişsel bozulma, yorgunluk şiddeti ve kavrama gücü değerleri açısından anlamlı fark yoktu. Hastalık süresi, fiziksel özürlülük ve hastalık aktivitesi romatoid artrit hastalarında kavrama kuvveti ile istatistiksel olarak anlamlı düzeyde negatif korelasyon gösteren değişkenlerdi. Sonraki doğrusal regresyon analizinde, sadece uzun hastalık süresinin kavrama kuvvetinin azalması ile ilişkili olduğu bulundu.Sonuç: Romatoid artrit, yaşlanmaya bağlı kas kuvveti kaybını önemli ölçüde etkilemiyor gibi görünmektedir. Hastalık süresi, yaşlı romatoid artrit hastalarında el kavrama gücü ile ilişkili tek bağımsız faktör olarak bulunmuştur.

OBJECTIVES: This study aims to assess the prevalence of generalized joint hypermobility (GJH) in school children in relation to scoliosis and to identify musculoskeletal problems. PATIENTS AND METHODS: This cross-sectional study included 822 school children (413 males, 409 females; mean age 12.2±1.3 years; range, 10 and 15 years). Demographic characteristics of all children were recorded. The presence of GJH was assessed by the Beighton score (≥4 was considered joint hypermobility). Scoliosis screening consisted of forward bend test (FBT) and measurement of angle of trunk rotation (ATR). Positive FBT or ATR ≥5° was referred to a portable X-ray device. The presence of musculoskeletal complaints was determined by a questionnaire. RESULTS: Children’s Body Mass Index (BMI) was 19.6±4.1. GJH was diagnosed in 151 subjects (18.4%). No significant association was detected between sex and hypermobility. Joint hypermobility was inversely correlated with age and BMI. Scoliosis was found in 43 subjects (5.2%) and all of them except one girl had mild scoliosis. The most common scoliosis pattern was a single left thoracolumbar curve. Seventy-three subjects (8.9%) had Cobb angle under 10°, with a potential for progression. Among subjects having GJH, the most common clinical finding was pes planus (34.3%) and the most common clinical symptom was ankle sprain (31.3%). CONCLUSION: Similar to that found in children from many countries, GJH is a common clinical condition in Turkish children. GJH should be assessed in the differential diagnosis of adolescents with musculoskeletal complaints for effective treatment and reducing morbidity. GJH should be considered in adolescents with scoliosis, which may be an important aspect in treatment.

Background This single-center, retrospective study aims to analyze the sociodemographic, injury characteristics, and the total number of lost working days of patients undergoing hand flexor tendon repair and to identify factors predicting reoperation. Methods Hand flexor tendon repairs conducted using a four-strand modified Kessler core suture with early rehabilitation from January 2013 to December 2016 were included in this study. The variables evaluated in this study were patient sociodemographic and injury characteristics, number of lost working days, and reoperations because of rupture and/or adhesion formation. Injury severity was determined using Modified Hand Injury Severity Scoring (MHISS). Binary logistic regression analysis was conducted to identify the predictors of reoperation. Results A total of 194 patients were included in this study, who had experienced 329 tendon injuries. Participants were young (mean age, 31.8), mostly male (79.4%), and mostly blue-collar workers (50.0%). Most patients had a zone 2 injury affecting a single digit of the dominant hand. The mean MHISS value was 46.6, and the mean time to return to work was 114.0 days. A total of 37 (19.1%) patients required reoperation because of rupture and/or adhesion formation. Smoking, zone 2 injury, and high MHISS value were negative predictors of reoperation. Conclusion To minimize the need for reoperation, surgeons and rehabilitation teams should take special care of patients with zone 2 injuries, high MHISS values, and smoking history.

Background: Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. Methods: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. Results: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. Conclusion: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation.

The aim of this article is two-fold: (i) to demonstrate the relation between vitamin D deficiency and dry eye and impaired tear function; and (ii) to investigate the possible associations among clinical parameters of hypovitaminosis D with dry eye parameters.Fifty premenopausal women with vitamin D deficiency (serum vitamin D levels20 ng/mL) and 48 controls were included. Participants were assessed by Schirmer's test, tear break-up time test (TBUT), ocular surface disease index (OSDI), Stanford Health Assessment Questionnaire (HAQ), fatigue severity scale (FSS), and visual analogue scale-pain (VAS-pain).Lower scores in Schirmer's test and TBUT, and higher in OSDI were detected in patients with vitamin D deficiency than in controls (P0.05). FSS was negatively correlated with Schirmer's test (r = -0,29; P = 0.038) and TBUT scores (r = -0,43; P = 0.002); VAS-pain was negatively correlated with TBUT scores (r = -0.32; P = 0.023). HAQ scores showed no significant correlation with dry eye parameters (P0.05). Vitamin D level was negatively correlated with OSDI (r = -0.49; P0.001), and positively with Schirmer's test (r = 0.45; P = 0.001) and TBUT scores (r = 0.30; P = 0.029).Dry eye and impaired tear function in patients with vitamin D deficiency may indicate a protective role of vitamin D in the development of dry eye, probably by enhancing tear film parameters and reducing ocular surface inflammation. Patients with vitamin D deficiency should be evaluated for dry eye syndromes.

The aim of the present study was to examine the presence of fibromyalgia (FM) in elderly adults and to evaluate the impact of the severity of FM on quality of life.A total of 100 patients between 65 and 80 years of age were included. The main admission diagnosis of the patients was recorded. Presence of FM was evaluated based on 1990 American College of Rheumatology (ACR) diagnostic criteria. The FM group was comprised of 31 patients fulfilling these criteria, and the remaining 69 patients composed the non-FM group. Tender point count (TPC) and common symptoms were recorded. FM disease severity was assessed using Fibromyalgia Impact Questionnaire (FIQ). Nottingham Health Profile (NHP) was used to evaluate quality of life. Pain severity was measured using Visual Analog Scale (VAS).Rate of FM was found to be 31%. FM patients scored significantly higher on pain, sleep, social isolation, and emotional reactions subgroups of NHP when compared to controls (p0.05). TPC and FIQ were not affected by gender difference (p0.05), but reduced with increasing age (p0.01). FIQ and TPC were found to be correlated with only the pain and emotional reactions subgroups of NHP (p0.01). There was no statistically significant correlation between FIQ and TPC and the physical mobility, sleep, energy, and social isolation subgroups of NHP (p0.05).Although FM is known as a disease of young and middle-aged women, our study indicates that its prevalence increases with age. FM is associated with poor quality of life in terms of pain, sleep, social, and emotional functions.

Amaç: Bu çalışmanın amacı diz osteoartritli yaşlı hastalarda yorgunluk düzeylerini araştırmak, yorgunluğun depresyon ve radyolojik evre, fonksiyonel durum ve ağrı gibi klinik parametrelerle ilişkisini değerlendirmek ve yaşam kalitesi üzerine etkisini saptamaktı.Materyal ve Metot: Çalışmaya diz osteoartritli, 65-80 yaşları arasında seksen hasta (60 kadın, 20 erkek) alındı. Osteoartritin radyolojik evresi, Kellgren-Lawrence evreleme skalası ile saptandı. Western Ontario ve McMasters Üniversiteleri Osteoartrit İndeksi [Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC)] fonksiyonel durumu belirlemede kullanıldı. Yorgunluk Semptom Envanteri [Fatigue Symptom Inventory (FSI)] yorgunluğu, Nottingham Sağlık Profili [Nottingham Health Profile (NHP)] yaşam kalitesini ve Beck Depresyon Skalası [Beck Depression Scale (BDS) ] ise depresyonu değerlendirmede kullanıldı. Ağrı şiddeti, Görsel Analog Skala [Visual Analog Scale (VAS)]- ağrı ile ölçüldü. Bulgular: Hastalar günlük ağrı biçimlerinişu şekilde ifade ettiler: daha çok akşamları yorgun (%30), tam olarak yorgun değil (%21,3), daha çok sabahları yorgun (%20), sabit bir günlük ağrı biçimi yok (%17,5), daha çok öğleden sonraları yorgun (%11,3). FSI’nın yorgunluk şiddeti, yorgunluk süresi ve yaşam kalitesine etkisi alt grupları WOMAC, VAS-ağrı, BDS ve NHP’nin ağrı, enerji ve emosyonel reaksiyonlar alt grupları ile belirgin olarak koreleydi (p0,05). Lojistik regresyon analizi; radyolojik evrelerin FSI üzerine anlamlı etkisini ortaya koydu (p, Objectives: Aims of the present study were to investigate fatigue in the patients with knee osteoarthritis, to evaluate association of fatigue with depression and clinical parameters such as radiological grade, functional status and pain; and to determine its impact on quality of life.Materials and Methods: Eighty patients (60 women, 20 men) with knee osteoarthritis, aged between 65 and 80 were included in the study. Radiological grade of osteoarthritis was determined by Kellgren-Lawrence grading scale. Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC) was used for assessing functional status. Fatigue Symptom Invento (FSI) was used for evaluating fatigue, Nottingham Health Profile (NHP) for quality of life, and Beck Depression Scale (BDS) for depression. Pain severity was measured by using Visual Analog Scale (VAS)-pain.Results: Patients reported their daily patterns of fatigue as follows: mostly fatigued in the evenings (30%), not at all fatigued (21.3%), mostly fatigued in the mornings (20%), no consistent daily pattern of fatigue (17.5%), mostly fatigued in the afternoons (11.3%). Intensity of fatigue, duration of fatigue and interference with quality of life subgroups of FSI were found to be significantly correlated with WOMAC, VAS-pain, BDS, and pain, energy, and emotional reactions subgroups of NHP (p0.05) Logistic regression analysis revealed the significant impact of radiological grades on FSI (p

Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever, peritonitis, synovitis, pleuritis, and erysipelas-like skin lesions. Sjogren’s syndrome is a chronic autoimmune disorder characterized by dry eyes, dry mouth, and musculoskeletal involvement. Ankylosing spondylitis is an autoinflammatory rheumatic disease which affects mainly the axial skeleton. To our knowledge, coexistence of familial Mediterranean fever with ankylosing spondylitis and Sjogren’s syndrome has not been reported previously in the literature. In this article, we report an unusual case of three autoinflammatory diseases in one patient.

Amac: Ankilozan spondilit (AS) hastalarindaki komorbiditeleri ve klinik parametrelerle iliskisini degerlendirmeyi amacladik. Hastalar ve Yontem: Calismaya 110 AS hastasi dahil edildi. Hastalik aktivitesi Bath Ankilozan Spondilit Hastalik Aktivite Indeksi [Bath Ankylosing Disease Activity Index (BASDAI)] ile, fonksiyonel durum Bath Ankilozan Spondilit Fonksiyonel Indeks [Bath Ankylosing Spondylitis Functional Index (BASFI)] ile, spinal mobilite Bath Ankilozan Spondilit Metroloji Indeksi [Bath Ankylosing Spondylitis Metrology Index (BASMI)] ile ve yasam kalitesi ise Nottingham Saglik Profili [Nottingham Health Profile (NHP)] ile degerlendildi. Bulgular: Hastalarin %28,18’inde komorbidite saptandi. Bunlar sirasi ile peptik ulser (20,91%), hipertansiyon (%20), akciger hastaligi (%15,45), diabetes mellitus (%13,64), osteoporoz (%10,91), iskemik kalp hastaligi (%10), bobrek hastaliklari (Ig A nefropatisi ve renal papiller nekroz, %1,82) ve kanserler (papiller tiroid kanseri ve renal hucreli kanser, %1,82) idi. Komorbiditesi bulunan hastalar BASDAI, BASMI, BASFI, VAS-agri ve NHP’nin agri, fiziksel mobilite ve enerji alt gruplarinda belirgin olarak yuksek skorlama gosterdiler (p

Amaç: Bu çalışma Kronik Yaygın Ağrı’lı (KYA) kadınlarda ağrı şiddeti ve genel yorgunlukla ilişkili faktörleri incelemek amacıyla yapıldı. Gereç ve yöntem: KYA’lı 104 hasta dahil edildi. Yaş ortalaması 40.28±10.82 yıldı. Hem ağrı şiddeti hem de genel yorgunluk görsel analog skalası kullanılarak değerlendirildi. Hastane Anksiyete ve Depresyon Ölçeği anksiyete ve depresyon bulgularını tanımlamak için kullanıldı. Üç farklı anket (boş zaman aktivitesi, iş ve evde fiziksel aktivite) fiziksel aktivite düzeylerini tanımlamak için kullanıldı. Sonuçlar: Anksiyete skoru ağrı eşiğini etkileyen en yaygın faktördü (p=0.003). Diğer taraftan, orta düzeydeki evdeki fiziksel aktivite (p=0.027), işteki fiziksel aktivite (p=0.008) ve anksiyete skoru (p=0.027) genel yorgunluğu etkileyen anlamlı faktörlerdi. Tartışma: Sonuçlarımız anksiyetenin KYA’lı kadınlarda ağrı ve genel yorgunluğu etkileyen en önemli faktör olduğunu göstermiştir. Bu sonuçlar ağrı, yorgunluk ve anksiyete özelliklerinin ayrıca değerlendirilmesinin gerekli olduğu düşüncesini desteklemektedir.

Vitamin D deficiency is one of the most important risk factors in the development of osteoporosis. Recently, vitamin D deficiency is more frequently encountered than expected in Mediterranean countries, which are sunny most of the time. Our country is one of these sunny countries and here, we investigated the effect of outfitting style on bone mineral density (BMD) and plasma vitamin D levels in women aged between 30-40 years.Eighty women, aged between 30 and 40 years, were included in the study. They were divided into two groups, depending on their dress selection. Group-1 consisted of 40 cases with an open clothing style, while the 40 women in group-2, preferred the covered clothing style. Women were questioned in terms of the risk factors for osteoporosis. Levels of plasma 25(OH)2 vitamin D3 and parathormone (PTH) were tested along with routine blood analyses. BMD of Lumbar 1-4, femur neck, trochanter, and Ward's triangle were measured.In group-2, number of pregnancies and body mass index (BMI) was statistically significantly higher (p0.05). When the laboratory parameters were compared, in group-2, only levels of plasma 25 (OH)2 vitamin D3 was significantly lower than group-1 (p0.05). There was no significant difference among groups in terms of BMD. In group-2, there was a positive correlation between BMI and BMD at L1-4, hip, femur neck, and trochanter regions (p0.01, 0.01, 0.05, and 0.05, respectively).Traditional clothing style leads to vitamin D deficiency in women. In order to meet vitamin D need, the face, arm and leg regions of the body should be exposed to one minimal erythemal dose (MED; i.e., slight redness of the skin) of sunlight, at least two or three times a week. We believe that these cases should be more closely monitored for bone loss, especially during postmenopausal period, which is considered as a risky term in terms of osteoporosis development.