Search

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: 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]

Objective: Scientific progress can be directly measured by the growth of the scientific archive. To our knowledge, there has never been a systematic evaluation of the number and properties of the publications of rheumatologists. In this paper, we aimed to evaluate the properties of these papers. Material and Methods: All papers that were published between 2000 and 2011 by at least one rheumatologist author and that were indexed in Science Citation Index Expanded were evaluated. For this purpose, we used the ISI web of knowledge web of science software. Results: Original articles were the most common document type. Most of the papers were published in rheumatology journals. From the point of the number of published papers, the top 3 countries were United States, England, and Germany; the top 3 journals were Annals of Rheumatic Diseases, Rheumatology, and Arthritis and Rheumatism, and the top 3 institutes are Harvard University, Leiden University, and The Imperial College of Science, Technology. Moreover, the publications of rheumatologists increased annually between 2000 and 2011. Conclusion: This paper is an overview of the publications of rheumatologists between 2000 and 2011.The results indicate an increasing trend of scientific productivity for rheumatologists. The outcomes about countries, institutions, and journals are in concordance with the general medical publication trends. More than half of the publications written by rheumatologist were published by rheumatology journals. We consider only quantitative data about publications; new research is required to qualitatively evaluate the data. [ABSTRACT FROM AUTHOR]

Background. Systemic amyloidosis is a potentially fatal condition, unless diagnosed and treated before development of irreversible organ damage. Demonstration of amyloid deposits within tissue biopsies is only definitive diagnostic method, which makes appropriate selection of biopsy site essential. Herein, we evaluated efficacy of minimally invasive minor salivary gland biopsy (MSGB) for the diagnosis of amyloidosis. Methods. We analyzed 37 biopsies taken from 35 patients. Suggestive findings for amyloidosis were significant proteinuria, renal impairment, refractory diarrhea, neuropathy, and restrictive cardiomyopathy. Minor salivary gland was the initial biopsy site in all subjects. When MSGB was negative but there was a high suspicion for amyloidosis, a kidney, duodenum, or rectal biopsy was performed for further investigation. Results. Mean age of patients was 45.4 and 21 were female. In 11 patients amyloidosis was diagnosed with MSGB. In overall 18 patients were diagnosed with amyloidosis. Sixteen of them were identified as being of AA type and two were AL type amyloidosis. The sensitivity of minimally invasive MSGB is 61.1% for diagnosing amyloidosis in this study. Conclusion. MSGB is a safe and simple method for the diagnosis of amyloidosis which can be performed in an outpatient setting. We suggest extensive use of this minimally invasive method. [ABSTRACT FROM AUTHOR]