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Objective: The definition of geriatric patient (GP) includes individuals aged 60 and over. Therefore, it may be necessary for rheumatologists to be aware of the problems they may encounter when planning the treatment of this privileged group and to have guidelines to guide doctors in arranging the treatment of rheumatological diseases. The aim of this study is to examine whether there are specific recommendations for GP in the rheumatology treatment guidelines published to date. Methods: The treatment guidelines of the he European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR), published between 1970 and 2022, were reviewed in detail by two rheumatologists in terms of specific recommendations for GP. In these guidelines, recommendations for the age range (=60 years), recommendations containing keywords, and items that seem to be relevant to elderly patients were noted. Results: Within the scope of the study, 38 EULAR and 11 ACR treatment guidelines were reviewed. In total, 6 (12.2%) guidelines were found to have special recommendations for elderly patients. Guidelines with specific recommendations were EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis, Points to consider for the development, evaluation and implementation of mobile health applications for self-management in patients with rheumatic diseases, 2019 update of EULAR recommendations for Vaccination in Adult Patients with Autoimmune Inflammatory Rheumatic Diseases, EULAR Recommendations for prevention and management of osteoporotic fractures, EULAR Points to consider for monitoring (detection/prevention) comorbidities in inflammatory rheumatic diseases, 2015 Recommendations for the management of polymyalgia rheumatica: An EULAR/ACR collaborative initiative. Conclusion: Few recommendations specific to GP have been found in treatment guidelines. Further clinical trials should be planned to contribute to the management of medical and non-medical treatment of elderly patients. [ABSTRACT FROM AUTHOR]

Objective: There is an ongoing debate about when and how we should screen rheumatoid arthritis (RA) patients for lung involvement and little is known about the importance of patients' comorbidities as a risk factor for RA lung involvement. The aim of this study is to reveal the demographic, clinical, and comorbid factors associated with positive lung computed tomography (CT) findings associated with RA. /Methods: We screened all RA patients followed at our rheumatology clinic and included those who had a thoracic CT within the past year. We divided the patients into two groups (positive or negative) according to thoracic CT findings. We compared the two groups in terms of demographic, clinical, and comorbid characteristics. We then performed multivariate analysis with a model that includes significantly different features in univariate analyses to find the amount of risk attributed to the factors for positive thoracic CT. Results: We included 76 RA patients who had thoracic CT. Of these, 43 (56.5%) had positive findings related to RA in thoracic CT. Male gender (p=0.008), anti-cyclic citrullinated peptide antibody positivity (p=0.04), and thyroid diseases (p=0.03) were found significantly more common in the patients with positive thoracic CT findings. Additionally, multivariate analyses found male gender [odds ratio (OR) 7.79, 95% confidence interval (CI) 1.69-35.69] and thyroid diseases (OR 6.17, 95% CI 1.56-24.32) were related to positive CT findings. Conclusion: In this study conducted in our cohort, we found that male gender and thyroid disease were risk factors for positive thoracic CT findings associated with RA. Clinicians may consider these factors when classifying RA patients for lung involvement and planning thoracic CT for screening. [ABSTRACT FROM AUTHOR]

Since induction motors are the most used motors in the industry, the starting time of the motor is of great importance for different applications. Especially large currents drawn during the movement of heavy loads cause various problems in the motor. Different methods are used to limit the starting time and the current drawn in the induction motor. In this study, the effects of rotor slot height, air gap length, and different rotor slot geometries on induction motor's starting time were investigated. Motor design was made with the RMxprt program, and MATLAB-Simulink model was created using obtained parameters from Rmxprt, and then the starting times of the motors were obtained. In addition, the oscillations in the number of speeds were examined for each motor model. 13 kW, 400 V, 3 phase squirrel cage induction motor was used in the models. [ABSTRACT FROM AUTHOR]

In the texts of the Oghuz Kagan Epic in Uyghur and Persian there are information about the Khalaj. In particular, Islamic geographers and scholars among 10th and 14th centuries gave information about the tribe in question. In the mentioned sources, Khalajs are in the form of "Khalach, Khalaj, Khilji, Khalaji." Khalajs were among first Turkic groups living in Tokharistan region. The word "Khalaj" was first used in the last quarter of the 7th century in the two Bactrian documents in the Samangan province in the south of Amu Darya. The name "Khalaj" is in the form of "Xalaso" in the Bactrian documents. They are identified with the names "Hedaluozhi"-"Gedaluozhi" in Xin Tangshu, the Chinese source. They are called "Hitivira Kharalaca" on the coins in Brahmi. There are various opinions on the origins of the Khalaj. In particular, the information provided on that they are the same as the "Karluq" tribe and that they are the remains of the Ephthalites are of great importance. Apart from these views, there are historians who stated that they belonged to the "Oghuz.". [ABSTRACT FROM AUTHOR]

Objective: Rheumatologic diseases have systemic features. So, almost all medical specialities can refer some of their patients to rheumatology. There is 0.22 rheumatologists per a hundred thousand persons in Turkey. Suitability of patient referrals to rheumatology outpatient clinics may relate to early diagnosis and timely treatment of the patients with rheumatologic diseases. In this study, we aimed to determine the main clinical features of referred patients to the rheumatology clinic and frequency of final diagnosis of them. Methods: We enrolled 739 patients who were referred to Kartal Lütfi Kırdar Training and Research Hospital Rheumatology outpatient clinic in the recent year. We obtained patient name, age, gender, reason for referral, final diagnosis and referral physician information from the patient files. Results: Articular signs were found as the most common reason for referral. 392 (53.1%) patients were diagnosed with rheumatologic diseases. Osteoarthritis was the most frequent diagnosis. Signs, laboratory parameters and provisional diagnosis in referral forms were similar in both patients with rheumatologic and non-rheumatologic diseases. Conclusion: Early diagnosis and treatment is the essential for rheumatologic diseases. Referring patients to rheumatology with high sensitivity contributes early diagnosis and helps for prevention of complication. Also, correct referral process may reduce inappropriate application to rheumatology clinics. Articular signs, high acute phase reactants and positive auto-antibodies were the most common reasons for referring. Most frequent diagnosis was osteoarthritis. [ABSTRACT FROM AUTHOR]

Belonging to the period of Second Turkic Kaghanate (682-745) the Orkhon Inscriptions let erected in behalf of Bilge Kaghan's brother Kül Tigin and himself in 732 and 735 respectively. The first monument let erected by Kaghan upon the death of his brother, and the latter one by his own son after his death. The person who speaks in both inscriptions is Bilge Kagan personally. Yollugh Tigin wrote both inscriptions with his nickname "atïsï". In the scholarly community, it suggested that Orkhon Inscriptions have a type of "commemorative", also it has been said that Kagan conveyed some information about the history of the Turkic Kaghanate and given some advices to "Turkish Nation". However, in the article, we will show that judging by the historical process this is not true and either inscriptions are a kind of "order, edict, and decree". Because, either itself in the inscriptions, or in edicts (firmans) of many later Turkish states are mentioned phrases in the meaning of "my order, my edict, my command".) In the Orkhon Inscriptions this phrase has the word "sabïm" (lit. my word, that is "my command"), in the firmans of the later Turkish rulers, for instance in the letters / edicts of Uzun Hasan Beg of Akkoyunlu, it has a word "sözümüz" (lit. our words, that is, "our order") and finally"buyurdum ki" (lit. I ordered that) in the edicts of the sultans of Ottoman Empire. Likewise, in edicts of the rulers of Chingizid and Timurid periods, the word "üge manu" (lit. myword) is mentioned with the same meaning but in Mongolian. In this article, it will be explained with the examples that this matter how progresses diplomatically throughout history. [ABSTRACT FROM AUTHOR]

A 40-year-old male patient was admitted with shortness of breath and chest pain. Ventilation/perfusion scan showed high risk for pulmonary embolism, and portal thrombosis was observed with portal magnetic resonance (MR) angiography. Active renal involvement, pancytopenia, and hemolytic anemia were also observed. Laboratory tests for lupus anticoagulant, antinuclear antibody, and anti-double-stranded DNA were positive. After other possible diagnoses were excluded, connective tissue disease and possible catastrophic antiphospholipid syndrome (CAFS) were diagnosed. The patient had all high-risk factors of CAFS. After diagnosis, a total of 6 grams of pulsatile steroids, intravenous immunoglobulin, plasma exchange, and anticoagulation was administered. Blood and kidney function improved with aggressive treatment. Parenteral cyclophosphamide, oral steroid therapy, and anticoagulation was initiated as maintenance therapy. [ABSTRACT FROM AUTHOR]

History of studies on the Silkroad begins with Zhang Qian, a famous Chinese ambassador in the East, in the second half of the 2nd century BC in the East, and with Maes Titianus, a Greek trader in the West in the early years of the 1st century AD. In the Antiquity and Early Middle Ages, the Silkroad began to its journey from Antiochia in the West through the territories of Northern Mesopotamia and Iran and then the Western and Eastern Turkestan in Central Asia and finished in Chang'an and Loyang, the two capitals of China in the East. The course of this route through Iranian territory generally stayed closed during the times of the states founded in Iran, such as Parthians and Sasanians because they liked to getting more profits from the silk trade and other products. At the end, the Roman trade with the East through the Red Sea was prevented by the Sasanians towards 570s, and Justinus II, the Byzantine Emperor had to pass the route through the northern regions of the Aral Lake and the Black Sea, negotiating with the rulers of the 1st Turkic Kaganate. [ABSTRACT FROM AUTHOR]

Amaç: Sistemik enflamatuvar hastalıklarda, hastalık patogenezinde rol oynayan ve/veya hastalık aktivitesine bağlı değişim gözlenen sitokinlere ve tedavilere bağlı metabolik sendrom daha sık gözlenmektedir. Multi-sistemik bir enflamatuvar hastalık olan sarkoidozda da metabolik sendromun daha sık gözlendiğini gösteren çalışma mevcuttur. Ancak tedaviden bağımsız, yeni tanı sarkoidoz hastalarında metabolik sendrom sıklığı değerlendirilmemiştir. Bu çalışmada amaç sarkoidoz hastalığı olan bireylerde tanı anında dahi metabolik sendrom daha sık gözlenir hipotezinin sınanmasıdır. Yöntem: Sarkoidoz tanısını yeni almış ve sarkoidoz ile ilişkili herhangi bir tedavi almamış 133 hasta çalışmaya dahil edilmiştir. Bu hastaların metabolik sendrom sıklığı, yaş (indeks hastanın yaşı ± sarkoidoz hastalarının standart sapması) ve cinsiyet olarak eşleşmiş 133 kontrol hastası ile karşılaştırılmıştır. Metabolik sendrom tanısı NCEP-ATP III sınıflama kriterlerine göre konmuştur. Devamlı değişkenler Mann-Whitney U testi ve kategorik değişkenler ki-kare testi ile karşılaştırılmıştır. P<0,05 istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Her iki grupta 95 (%71,4)'şer kadın hasta bulunmaktaydı. Her iki grubun yaş ortalaması benzer olarak bulunmuştur (p=0,14). Sarkoidoz grubunda 37 %(27,8) hastaya, kontrol grubunda ise 9 (%6,8) hastaya metabolik sendrom tanısı konmuştur. Metabolik sendrom sıklığı anlamlı olarak yeni tanı sarkoidoz hastalarında kontrol grubuna daha fazla bulunmuştur (risk oranı: 5,3, CI: %95 2,4-11,5, p<0,001). Sonuç: Bu çalışma sonucunda, birçok enflamatuvar hastalıkta gözlendiği üzere yeni sarkoidoz hastalarında da tedaviden bağımsız olarak metabolik sendromun daha sık gözlendiği tespit edilmiştir. Bu açıdan primer hastalık tedavisi yanında, kardiyovasküler hastalık riski ile ilişkili olan metabolik sendrom açısından da hastaların yakın takibi uygun olacaktır. [ABSTRACT FROM AUTHOR]

Amaç: Behçet hastalığı (BH) rekkürrenaftözstomatit, üveit, genital ülserler ve cilt lezyonlarıyla karakterize bit hastalıktır. BH gelişiminde; bir çok antijenin uyarısına bağlı olarak çeşitli sitokinlerin salınımı sonucu, nötrofillerin aktivasyonunun rol oynadığı gösterilmiştir. Tam kan sayımındaki nötrofilllerin lenfositlere oranı (N/L) inflamatuvar hastalıklar, maligniteler, koroner arter hastalığı gibi çeşitli hastalıklarla ilgili araştırmaların hedefindeki popüler bir parametredir. Bu çalışmada BH'danötrofil lenfosit oranının tanı ve takipteki kullanılabilirliğini tespit etmeyi amaçladık. Yöntem: Çalışmamızda Ocak 2013-Ağustos 2013 tarihleri arasında Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi Romatoloji Polikliniğince takip edilen, enfeksiyonu olmayan 30 Behçet tanılı ve 30 sağlıklı kontrol grubu retrospektif olarak değerlendirildi, hastaların N/L oranı hesaplanarak iki grup kıyaslandı. Ayrıca Behçet hastalarında C-reaktif protein (CRP) ve sedimentasyon değerlerinin N/L oranı ile korelasyonu hesaplandı. Sayısal veriler medyan olarak belirtildi. Sayısal verilerin karşılaştırılmasında Mann-Whitney-U testi, korelasyonunda ise Spearman korelasyon testi kullanıldı. Bulgular: Çalışmaya alınan Behçet grubunda 21'i (%70) kadın, 9'u (%30) erkek 30 hasta; kontrol grubundada 21'i (%70) kadın, 9'u (%30) erkek 30 hasta mevcuttu. Behçet grubundaki hastaların yaşlarının medyanı 38.5 (29.75-42.75), 2. gruptaki hastaların medyanı 40.0 (23.0-55.5) olarak hesaplandı ve aralarındaki fark anlamlı bulunmadı (p>0.05). Çalışmamızdaki Behçet hastaların hiçbirinde aktif organ tutulumu gözlenmemekteydi. Behçet grubunda N/L oranı medyanı 1.962 (1.310-2.338), kontrol grubunda ise 1.997 (1.407-2.406) olarak hesaplandı. iki grup arasında N/L oranı farkı anlamlı bulunmadı (p>0.05). Behçet grubunda CRP ile N/L oranı arasındaki korelasyon anlamlı bulundu (r=0.462, p=0.010). Sedimentasyon değeri ile N/L oranı arasında korelasyon gözlenmedi (r=0.151, p=0.436). Sonuç: Çalışmamızda Behçet hastalarının aktif organ tutulumunun olmaması nedeni ile kontrol grubu ile, N/L oranı açısından farklılık tespit edilmemiş olabilir. Buna rağmen Behçet hastalarında CRP ile N/L oranındaki korelasyon BH'daki inflamatuvar sürecin N/L oranı artışı ile takip edilebilirliği yorumuna neden olmaktadır. Organ tutulumu sırasında farklılık saptanıp saptanamayacağı ise ileri çalışmalarda değerlendirilmelidir. [ABSTRACT FROM AUTHOR]

Objective: Patients with sarcoidosis may present with cutaneous lesions or other systemic involvement, particularly pulmonary. In this study, we investigated our hypothesis that the clinical course of sarcoidosis patients who present with skin involvement be different. Methods: Fifty-two sarcoidosis patients who applied to our rheumatology outpatient clinic were included in the study. Data on demographics, smoking status, angiotensin converting enzyme (ACE) level at the time of diagnosis, other organ involvement and lung involvement stages were collected. We then compared the clinical and demographic characteristics of patients with and without skin involvement and patients with skin involvement at first presentation, and others separately. Results: While the initial involvement was lung involvement in 28 (53.5%) patients, 19 (36.5%) patients applied to the clinic with skin involvement as a presenting feature. In 23 (44.2%) patients, skin involvement was present at any time during the disease. In our study, the most common skin involvement was erythema nodosum observed in 9 patients (17.3%). Demographic and clinical findings of patients presenting with skin findings did not differ significantly from other patients. High ACE levels were more common in patients without skin involvement than in patients with skin involvement. Conclusion: Even if the clinical course does not differ in sarcoidosis patients presenting with cutaneous involvement, it is important to recognize the cutaneous manifestations of sarcoidosis. We would like to emphasize that detailed physical examination is important, as easily overlooked, small and asymptomatic lesions are the most appropriate site for histopathological diagnosis of sarcoidosis. [ABSTRACT FROM AUTHOR]

Amaç: Sarkoidoz nonkazeifiye granülomlarla karakterize, nedeni bilinmeyen, en sık akciğer tutulumu yapan, multisistemik bir hastalıktır. Deri lezyonları sarkoidoz olan hastaların %15-20'sinde izlenirken yaklaşık 1/3'inde ilk hastalık belirtisi olarak ortaya çıkar, sistemik tutulum olmaksızın yalnızca deri sarkoidozu olarak da ortaya çıkabilir.Bu yazıda topikal takroli-mus tedavisine iyi yamt veren, makopapuler görünümlü kuta-nöz periokuler sarkoidozlu bir olgu sunulmuştur. Olgu: Kırkyedi yaşında erkek hasta her iki göz çevresindeki lez-yonları için dermatoloji bölümüne başvurusunda yapılan cilt biyopsisi "non-nekrotizan granülomatöz inflamasyon" uyumlu bulgular saptanması üzerine Romatoloji polikliniğine yönlendirilmiş. Patolojik olarak EZN boyamada basil lehine bulgu, Pas boyaması ile fungal mikroorganizma lehine bulgu ve yabancı cisim varlığı izlenmedi. Yapılan fizik muayenede bilateral göz çevresinde makopapuler görünümlü lezyonlar mevcuttu. Solunum sistem muayenesi olağandı, hepatomegali saptanmadı. La-boratuvar bulgularında hemogram, karaciğer ve böbrek fonksi-yon testleri, serum kalsiyum seviyesi, eritrosit sedimentasyon hızı, CRP normal sınırlarda saptandı. Serum ACE düzeyi 36.2 U/L ( 8-52 U/L) saptandı. Çekilen PA akciğer grafisi ve toraks BT(de aktif sarkoidoz tutulumuna ait bulgu saptanmadı. Batın US'de hepatomegali saptanmadı. Göz hekimi tarafından değerlendirilen hastada sarkoidoz göz tutulumu bulgusu saptanmadı. Cilt tutulumu açısından dermatoloji hekimi tarafından değerlendirilen hastada iç organ tutulumu saptanmadığı için lokal takroliıuus tedavisi başlandı. Tedavinin ikinci ayında cilt lez-yonları geriledi. Laboratuvar bulguları normal sınırlarda idi. Dermatoloji hekimi ile görüşülerek bir ay daha takrolimus tedavisinin devamına ve sonrasında kontrolü önerildi. Sonuç: Sarkoidozda kutanöz lezyonlar histopatolojik incelemede nonkazeifiye granülomların görüldüğü özgül lezyonlar (rna-kopapüler, plak, nodül, lupus perniyo) ve reaktif olarak gelişen histopatolojik olarak granülomların izlenmediği özgül olmayan deri lezyonları (eritema nodozum) olmak üzere ikiye ayrılır. Kutanöz sarkoidozda tedavi genelde topikal, intralezyoner veya sistemik steroidler, topikal takrolimus ayrıca tetrasiklin türevleri, antimalaryal ilaçlar (klorokin ve hidroksiklorokin), metot-reksat, TNF-α inhibitörleri, izotretinoin ve pentoksifilin de başarılı sonuçlar vermektedir. [ABSTRACT FROM AUTHOR]