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Objectives: This study aimed to evaluate the frequency of fibromyalgianess, fibromyalgia syndrome (FS), and widespread pain in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and their relationship with clinical and demographic parameters. Patients and methods: This cross-sectional multicenter trial was performed in 14 centers across Türkiye between June 2018 and November 2019. Out of 685 patients recruited from the accessible population, 661 patients (342 RA, 319 AS; 264 males, 397 females; mean age: 48.1±12.9 years; range, 17 to 88 years) met the selection criteria. In these cohorts, those who did not meet the criteria for FS and had widespread pain (widespread pain index =7) were evaluated as a separate group. Clinical status and demographic parameters of patients in both cohorts were evaluated as well as the evaluations of RA and AS patients with widespread pain (widespread pain index =7) and RA and AS patients with FS groups. In addition, correlations between polysymptomatic distress scale (PSD) scores and Visual Analog Scale (VAS), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and Disease Activity Score using 28 joint counts for RA patients and VAS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) for AS patients were analyzed. Results: Frequencies of patients with FS and patients who had PSD scores =12 were 34.1% and 44.4% in all RA patients, respectively. Moreover, FS and PSD scores =12 were found in 29.2% and 36.9% of all AS patients, respectively. PSD scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. SDAI and CDAI scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. Similarly, PSD scores of AS patients with FS were higher than all AS patients and AS patients with widespread pain. ASDAS-erythrocyte sedimentation rate and BASDAI scores of AS patients with FS were found higher than all AS patients and AS patients with widespread pain. Conclusion: Disease activity scores, including pain in RA and AS, were higher in the presence of FS or fibromyalgianess. It may be related to clinical parameters, but cohort studies with long-term follow-up are needed to reveal causality. Additionally, to avoid overtreatment, coexistence of fibromyalgianess should be kept in mind in patients who have inflammatory diseases such as RA and AS, particularly with intractable widespread pain. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain. [ABSTRACT FROM AUTHOR]

Objectives: Considering that the comorbid situations during the management of Spondyloarthritis (SpA) have been underlined in several recommendations, the main objective of this study was to evaluate the comorbid conditions of Turkish patients with SpA. Patients and methods: This cross-sectional observational study was conducted with 1,242 SpA patients (844 males, 398 females; mean age: 43.9±11.0 years; range, 19 to 81 years) diagnosed according to the modified New York criteria for ankylosing spondylitis or the Assessment of SpondyloArthritis International Society (ASAS) criteria. The patient data were collected from the Biologic and targeted Synthetic antirheumatic drugs Registry (BioStar) between February 1, 2019, and December 29, 2020. Clinical and demographic data, including, age, sex, disease duration, body mass index (BMI), pain, patient's global assessment, physician's global assessment, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and Maastricht Enthesitis Score, were recorded. Comorbid conditions were recorded by filling out a questionnaire according to the clinical history or medical records. Charlson Comorbidity Index and Rheumatic Disease Comorbidity Index scores were calculated from the gathered comorbidity information. Results: Nine hundred thirteen patients had radiographic axial SpA, 153 had nonradiographic axial SpA, and 176 had peripheral SpA. The most common comorbidities were hypertension (HT) (n=167, 13.4%), diabetes mellitus (DM) (n=83, 6.7%), thyroid disorders (n=64, 5.6%), and depression (n=61, 4.9%). The comorbidities and the calculated comorbidity indices were significantly higher in females, in those with a BMI >25 kg/m2, and those over 60 years of age. No relationship was found between smoking and alcohol use and comorbidities. A significantly higher prevalence of HT and DM in peripheral SpA patients and a lower prevalence of thyroid disorders in radiographic axial SpA patients were observed. Conclusion: The most commonly reported comorbidities were HT, DM, thyroid disorders, and depression in SpA patients according to the BioStar database. The frequency of comorbidities and composite comorbidity scores were higher among females, older (>60 years) patients, and overweight (BMI >25 kg/m2) patients. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the impact of the Coronavirus Disease 2019 (COVID-19) on inflammatory rheumatic diseases (IRD) by comparing them with non-IRD (nIRD) and healthy controls (HC). Materials and Methods: In this cross-sectional study, subjects were screened for contact with COVID-19, new-onset symptoms, and adherence to precautionary measures against COVID-19. The Impact of Event Scale-Revised (IES-R) and Depression Anxiety and Stress Scales (DASS-21) were used to evaluate the psychological effect of the pandemic and health status. Additionally, therapy adherence and clinical characteristics were noted. Results: A total of 279 subjects were recruited (IRD 47.3%; nIRD 29.7%). The number of patients who believed that the risk of COVID-19 increased due to their diseases or received therapy was higher in IRD than nIRD (38.6% vs 7.2%). Maintaining physical distancing was highest in the IRD and lowest in HC (p=0.037). Approximately 40% of the patients discontinued or extended the dose interval of Tumor Necrosis Factor Inhibitor (TNFi) without obtaining physician's advice. DASS-21 anxiety, depression and stress rates were lowest in IRD. COVID-19 contact history was an independent risk factor for DASS-21 stress and anxiety, while female gender was an independent risk factor for DASS-21 anxiety. Conclusion: Confirmed COVID-19 infection was similar in HC, IRD, and nIRD. HC were substantially more likely to experience mental health issues than other groups. Most patients with IRD discontinued or extended the ongoing treatment without physician's recommendation during the COVID-19 outbreak. Therefore, patient adherence and disease control could be improved through closer monitoring and recognition of early signs of psychological discomfort during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Türkiye by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results: The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to quantitatively assess the profile of the choroidal thickness (ChT) in patients with ankylosing spondylitis (AS) using optical coherence tomography (OCT), and to examine whether the posterior eye segment abnormalities in active AS patients are reversible by infliximab therapy. Patients and methods: Thirty-one patients with AS (22 males, 9 females; mean age: 39.6±12.3 years; range, 22 to 68 years) and 24 healthy controls (16 males, 8 females; mean age: 40.8±8.9 years; range, 35 to 61 years) were enrolled between October 2014 and March 2016. Patients' clinical and demographic characteristics were recorded. Using OCT, we performed retinal nerve fiber layer (RNFL) thickness, ganglion cell complex, and ChT measurements in AS patients before and six months after the initiation of infliximab therapy, and in healthy controls. Results: At baseline, patients with AS had higher ChT (mean±standard deviation: 347.5±114.4 µm) compared to healthy controls (322.1±62.8 µm), although this did not reach statistical significance level (p=0.283). At six months after the first measurement, the mean ChT was significantly decreased (under infliximab therapy: 326.5±99.7 µm vs. before: 347.5±114.4 µm, p=0.018) in AS group, while no significant change was observed in the control group (p=0.102). RNFL thickness in the AS group was significantly decreased after six months of treatment with infliximab (p=0.008). Conclusion: By evaluating the posterior eye segment of patients with AS using OCT, this study has demonstrated that active AS patients had higher ChT. The significant reduction in this ChT after infliximab therapy may be mediating the established effective suppressing action of infliximab on uveitis attacks. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice. [ABSTRACT FROM AUTHOR]

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Objective: Our aim was to identify the relationship of osteoporosis (OP) risk factors with bone mineral density (BMD) in patients admitted our outpatient clinic in Trabzon. Materials and Methods: Two hundred one patients with OP or osteopenia were included in this study. Sociodemographic characteristics of the patients were recorded and a standardized interview was employed by the researcher physician. BMD values were measured by dual energy X-ray absorptiometry at lumbar spine and femoral neck. Results: The mean age of the patients was 61.47±10.57 years (182 females/19 males). One hundred fifteen patients (57.2%) were osteoporotic and 86 (42.8%) were osteopenic. A significant negative correlation was found between age and femoral neck T scores. The number of pregnancies showed a significant negative correlation with lumbar T scores. Body mass index and daily tea consumption showed a negligible positive correlation with femoral neck T scores. No association was found between age at menarche, age at menopause, total lactation duration, daily calcium intake and T scores of lumbar spine and femoral neck. Conclusions: Identification of regional OP risk factors may be useful for the OP risk management of patients in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between radiographic features (osteophytes, disc space narrowing) in patients with lumbar spine degenerative changes and body mass index (BMI), with quantitative methods. Material and Method: One-hundred and three women with lumbar spine degenerative changes who had lower back pain were included in the study Patients were divided into two groups according to their BMI. Pain and functional status of patients were evaluated using visual analog scale (VAS) and Roland Morris Questionnaire (RMQ), respectively. The size of osteophytes and disc space narrowing were calculated on lateral roentgenogram of the lumbar vertebrae by using computer based stereological methods. Results: No significant correlation was detected between the BMI and radiological findings. But, there was a positive correlation between the osteophyte surface area and RMQ, and VAS and RMQ (p<0.05). Conclusion: No significant correlation was detected between the BMI and radiographic findings in lumbar spine degenerative changes. To our knowledge, this is the first study quantitatively assessing the association between radiographic findings and BMI in lumbar spine degenerative changes. [ABSTRACT FROM AUTHOR]

Objective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study. The Bath AS Disease Activity Index (BASDA1) was used for disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-a (TNF-a) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) can affect vertebras and joints bearing weight. It can resemble clinic signs, radiological and laboratory findings of rheumatoid arthritis (RA) involving peripheral joints. TB can make rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) positive, which are used in the diagnosis of RA arthritis. Therefore, this causes some difficulties in clinic diagnosis. Additionally, the diagnostic problems in TB arthritis can be more complicated. We aimed to attract attention to this situation by presenting a case of TB arthritis in which anti-CCP and RF are positive. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to investigate the effectiveness of amitriptyline versus venlafaxine before and after treatment in female patients diagnosed with Fibromyalgia Syndrome (FMS). We also examined drop out due to adverse events. Methods: The study was carried out with 56 FMS patients who applied to Physical Therapy and Rehabilitation outpatient clinics of Karadeniz Technical University Medical School. All consecutive patients gave written informed consent. The subjects had been randomized into amitriptyline (25-75 mg/day) and venlafaxine (75 mg/day) groups with 28 patients each. Visual Analog Scale (VAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Fibromyalgia Impact Questionnaire (FIQ) were completed at the start and at the eighth week of the study. FIQ scores changes were used to determine the efficacy. Adverse event tolerability was based on dropout rates. Results: Both amitriptyline and venlafaxine were associated with significantly improves scores on the VAS, BAI, BDI and FIQ at the end of study. Treatment with amitriptyline was associated with significantly more drop out than treatment with venlafaxine. Conclusion: Both amitriptyline and venlafaxine found were to be effective treatments for FMS. While no efficacy differences were found, safety profile favored venlafaxine. [ABSTRACT FROM AUTHOR]