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Amaç: Bu çalışmanın amacı Sjögren Sendromlu (SS) hastalarda aleksitimi ile depresyon, anksiyete, yaşam kalitesi, hastalık durasyonu ve inflamatuar belirteçler arasındaki ilişkinin incelenmesidir. Materyal-metot: Çalışmaya yaş ortalaması 51.14±9.42 yıl olan 168 primer SS’li (pSS) birey (145 kadın, 23 erkek) dahil edildi. Aleksitimiyi değerlendirmek için Toronto Aleksitimi Ölçeği, anksiyete ve depresyonu değerlendirmek için Beck Anksiyete ve Depresyon Ölçeği, yaşam kalitesini değerlendirmek için Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Kısa Formu Türkçe Versiyonu kullanıldı. Bulgular: pSS’li bireylere ait aleksitimi ortalaması 53.83±12.61 puan bulundu. Aleksitimi ile anksiyete (r:0.514, p:0.00), depresyon (r:0.522, p:0.00), yaşam kalitesinin ruhsal (r:0.474, p:0.0) ve sosyal (r:0.486, p:0.04) alt parametreleri ve ESR değerleri (r:0.432, p:0.03) arasında düşük ve orta düzeyde anlamlı ilişki bulundu. Sonuç: Bu çalışmanın sonuçlarına göre pSS’li bireylerde aleksitimi arttıkça depresyon, anksiyete ve inflamatuar belirteç düzeyleri artmakta, ruhsal ve sosyal yönden yaşam kalitesi azalmaktadır. Sonuçlarımız iki yönlüdür. Aleksitiminin pSS'de depresif belirtilerin aracılık ettiği göz önünde bulundurularak, pSS’de aleksitimi, depresyon ve anksiyete gibi psikolojik hastalıkların varlığı ile birlikte tedavi için ayrıntılı değerlendirme ve çok boyutlu bir yaklaşıma olan ihtiyacı desteklemektedir.

To compare the clinical features, laboratory findings, and prognosis of Behçet's disease (BD) patients with and without Budd-Chiari syndrome (BCS).This multicenter retrospective study investigated 61 (M/F: 41/20) patients with BD, having coexistent BCS, and 169 (M/F:100/69) BD patients as the control group without BCS from 22 different centers of Turkey diagnosed between 1990 and 2017.Of the total 61 BD patients with BCS, the onset of the first symptom and the median age of diagnosis were earlier in contrast to BD patients without BCS (p = 0.005 and p = 0.007). Lower extremity deep vein and inferior vena cava (IVC) thrombosis were more common in patients with BCS (all; p 0.01) compared to the control group. Mortality was significantly higher in BD-BCS patients with IVC thrombosis than in the controls (p = 0.004). Since most of the cases in our cohort had chronic and silent form of BCS, mortality rate was 14.8%, which was on the lower range of mortality rate reported in literature (14-47%). While all BD-BCS patients received immunosuppressive (IS) agents, only half of them received additional anticoagulant treatments. Among IS agents, interferon treatment was more frequently used in this cohort (19%), compared to other series reported in literature (2.3%).To our knowledge, this is the largest series of BD patients with BCS. Our patients had earlier disease onset and diagnosis, higher frequency of IVC thrombosis, and higher mortality rate, compared to BD patients without BCS. Mortality was significantly higher in BD-BCS patients with IVC thrombosis compared to controls. Key Points • Mortality rate is higher in BD-associated BCS patients with IVC involvement. • Chronic and silent form of BD-associated BCS has a better prognosis. • The main treatment options are corticosteroids and immunosuppressive agents, whereas anticoagulant treatment remains controversial.

Tezcan, Mehmet Engin/0000-0002-1753-4936; TUFAN, Abdurrahman/0000-0001-6244-9362; SARI, Ismail/0000-0001-7737-4180; YILMAZ, Sedat/0000-0002-4691-3417 WOS: 000436403100017 PubMed: 28992387 ObjectiveApproximately 30-45% of patients with familial Mediterranean fever (FMF) have been reported to have attacks despite colchicine treatment. Currently, data on the treatment of colchicine-unresponsive or colchicine-intolerant FMF patients are limited; the most promising alternatives seem to be anti-interleukin-1 (anti-IL-1) agents. Here we report our experience with the off-label use of anti-IL-1 agents in a large group of FMF patients. MethodsIn all, 21 centers from different geographical regions of Turkey were included in the current study. The medical records of all FMF patients who had used anti-IL-1 treatment for at least 6 months were reviewed. ResultsIn total, 172 FMF patients (83 [48%] female, mean age 36.2 years [range 18-68]) were included in the analysis; mean age at symptom onset was 12.6 years (range 1-48), and the mean colchicine dose was 1.7 mg/day (range 0.5-4.0). Of these patients, 151 were treated with anakinra and 21 with canakinumab. Anti-IL-1 treatment was used because of colchicine-resistant disease in 84% and amyloidosis in 12% of subjects. During the mean 19.6 months of treatment (range 6-98), the yearly attack frequency was significantly reduced (from 16.8 to 2.4; P < 0.001), and 42.1% of colchicine-resistant FMF patients were attack free. Serum levels of C-reactive protein, erythrocyte sedimentation rate, and 24-hour urinary protein excretion (5,458.7 mg/24 hours before and 3,557.3 mg/24 hours after) were significantly reduced. ConclusionAnti-IL-1 treatment is an effective alternative for controlling attacks and decreasing proteinuria in colchicine-resistant FMF patients.

The temporal relationship between the onset of skin psoriasis (Pso) and psoriatic arthritis (PsA) is a long and well-known feature of psoriatic disease. Psoriatic skin lesions emerge years before the development of musculoskeletal manifestations in nearly 75% of PsA patients. While skin and joint manifestations develop within one year in 15-20% of the patients, joint manifestations precede the skin involvement by a year or more in about 10% of the patients (1).

Objectives This study aims to evaluate the frequency of chronic cough due to dryness in the trachea and the relationship between depression and chronic cough in patients with primary Sjogren's syndrome (pSS). Patients and methods Eighty non-smoking patients (7 males, 73 females; mean age 47.6±9.2 years; range 18 to 70 years) with newly diagnosed pSS were included. All patients were evaluated clinically, radiologically, and physiologically. Patients with cough were assessed using the Leicester Cough Questionnaire and visual analog scale. Beck Depression Inventory was used to determine the risk of depression in patients with cough. Patients with asthma, rhinosinusitis, gastrooesophageal reflux, and drug use which cause cough and pulmonary involvement in pSS were excluded. Results Non-productive cough was detected in 30 patients (37.5%). Fourteen patients (17.5%) were admitted to the hospital with cough at least once before the diagnosis of pSS. The median time between onset of symptoms and firm diagnosis was 24 months (25-75 interquartile ranges: 3-60 months). A significant difference was observed in the Beck Depression Inventory scores between patients with and without cough. There was a significant negative relationship between Leicester Cough Questionnaire and Beck Depression Inventory scores. Conclusion Patients with pSS often have symptoms for a long duration that mimic those of more commonly encountered non-specific pulmonary conditions. Xerotrachea should be considered in the differential diagnosis of chronic cough, especially in patients with normal pulmonary function tests and pulmonary imaging.

Muhammet Kazim Erol,1 Ayse Balkarli,2 Ozgur Yucel,1 Yusuf Akar,3 Berna Dogan,1 Elcin Suren1 1Department of Ophthalmology, 2Department of Internal Medicine, Division of Rheumatology, Antalya Education and Research Hospital, 3Department of Ophthalmology, Akdeniz University Medical Faculty, Antalya, Turkey Purpose: This study aimed to evaluate mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) values and their relationship with clinical findings in patients with central serous chorioretinopathy (CSCR).Methods: Overall, 87 patients fulfilling inclusion criteria and 320 age- and sex-matched healthy individuals as controls were included in the study. The CSCR patients (n=87) were classified into 2 groups as acute CSCR (group 1, n=43) and chronic CSCR (group 2, n=44).Results: It was found that NLR (P

Aim To evaluate the sleep quality and the relation of sleep quality with depression, anxiety, fatigue and disease activity in adult patients with familial Mediterranean fever (FMF). Method One hundred and seventy-four FMF patients and 84 age-sex matched healthy individuals were included in this study. The Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF) and the Hospital Anxiety and Depression Index (HADS) were used to assess sleep quality, fatigue, depression and anxiety, respectively. Result FMF patients had significantly higher depression, anxiety, fatigue and PSQI scores than healthy controls. As the severity of the disease increased, scores of total PSQI and its domains increased. Patients with total PSQI score higher than 5 had statistically significantly higher erythrocyte sedimentation rates (ESR), serum C-reactive protein and serum amyloid levels during attacks, more attack numbers in last 3 months and worse fatigue, depression scores. Total PSQI score was positively correlated with inflammatory markers during attacks, attack numbers in the last 3 months and fatigue score. Logistic regression models identified disease duration, ESR during attacks, fatigue, attack numbers in the last 3 months as predictors of poor sleep quality. Conclusion Poor sleep quality is common in adult FMF patients. Anxiety, depression and fatigue are more frequent in FMF patients than healthy individuals. Poor sleep quality is associated with inflammatory marker levels during attacks, fatigue and attack numbers in the last 3 months.

Chronic inflammation that contributes to the deterioration of the mechanical form of both the vascular wall and the function of endothelial has been shown to cause vascular dysfunction in patients with human immunodeficiency virus (HIV). Nailfold videocapillaroscopy (NVC) is a noninvasive and simple technique used to analyze dermal microvasculature. The aims of our study were to detect the morphological and functional properties of microcirculation in HIV-positive patients utilizing NVC and to compare the results with those obtained from healthy individuals and investigate whether these changes had supported any correlation with HIV. In this prospective study, 51 male HIV-positive patients were the subjects and 59 male healthy individuals made up the control group. Capillaroscopic findings, obtained from both groups by NVC, were evaluated. Tortuosity, a capillaroscopic finding, was significantly higher in the group with HIV (

BackgroundGout is a clinical syndrome that occurs as an inflammatory response to increased concentration of uric acid and monosodium urate crystals. Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease with autosomal recessive inheritance. The Mediterranean fever (MEFV) gene is responsible for FMF and encodes pyrin that suppresses the inflammatory response. Most of the FMF-related mutations have been identified in exon 2 (e.g., E148Q and R202Q) and exon 10 (M680I, M694V, M694I and V726A) of the MEFV gene, and each missense mutation is known to increase production of interleukin-1, a proinflammatory cytokine. Our aim was to investigate effects of MEFV variant alleles on the manifestations of gout. MethodsSeventy-one patients diagnosed with gout (age: 61.73 11.73 years, F/M: 14/57) and 50 healthy subjects (age: 61.48 11.97, F/M: 10/40) as controls were included in this study. ResultsMEFV variant alleles were found in 24 (33.8%) of the gout patients and in 13 (26%) of the control subjects; the difference was not statistically significant. In the gout patients with a MEFV variant allele, the interval between the first two attacks was shorter (P = 0.014), and the platelet count was higher (P = 0.026), compared to the patients without a variant allele. In addition, the patients with a MEFV variant allele showed the higher incidence of tophus (8.5% vs. 1.4%) (P = 0.005) and the higher number of attacks per year (P = 0.001). ConclusionWe propose that a variant allele of the MEFV gene may be responsible for the severity of gout.

OBJECTIVES To evaluate the frequency of sexual dysfunction and associated factors in patients with central serous chorioretinopathy (CSCR). MATERIAL AND METHODS Fifty-eight CSCR patients who met the inclusion criteria and 99 age- and sex-matched healthy controls were prospectively investigated for sexual dysfunction and associated factors. All participants were investigated using the Beck Depression Inventory (BDI), Beck Anxiety Scale (BAS), and the15-question Index of Erectile Function-15 (IIEF-15) and by extensive examination of CSCR, associated factors, and confounding factors. RESULTS The mean ages of the patient and control groups were 46.95±11.27 and 45.3±10.93 years, respectively (p=0.370). The erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall sexual satisfaction scores of the patient group were significantly lower than those of the control group (p

Annual European Congress of Rheumatology -- JUN 14-17, 2017 -- Madrid, SPAIN, WOS: 000413181401012, …

Aim: Gout is a clinical syndrome with increased uric acid concentration, which is caused by inflammatory response against monosodium urate (MSU) crystals. In gout, neutrophils are involved in inflammatory response and neutrophil activation is dependent on local cytokine production. Mean platelet volume (MPV) and neutrophillymphocyte ratio (NLR) are considered as inflammatory markers in several diseases and it is reported that they may have prognostic significance. Inthe current literature, there is no study evaluating MPV and NLR in gout. In this retrospective study, we investigated the role of MPV and NLR in determining inflammation in gout disease. Material and Method: In this retrospective study, 106 patients with gout (91 men and 15 women) meeting the inclusion criteria based on patient records and 148 age- and sex-matched healthy controls (128 men and 20 women) were included. Laboratory data during attacks (group I) and intercritical period (group II) were collected for the patient group. Results: Mean age was 59.46±12.93 years in the patient group and 59.00±11.33 years in the control group. Age at first attack was 52.00±12.77 years and mean time interval between first 2 attacks was 6.00±5.52 months. There was tophus in 9 patients (8.5%) and family history of gout in 17 patients (16.0%). Compared to groupII (intercritical period) and the control, no significant difference in MPV levels was found in groupI (during attack). MPV was similar among the three groups. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were found to be significantly higher in group I compared to group II. There was significant difference in NLR among three groups. When classified according to the presence of tophus, it was seen that MPV and NLR were similar in both groups. Discussion: The finding of increased NLR during attacks and intercritical period show that patients with gout are subjected to chronic inflammation. Thus, NLR can be a simple, inexpensive, and useful diagnostic marker in gout. Studies comparing cytokine levels with NLR will be helpful in elucidating this topic.

Objective: The aim of the study was to investigate levels of homocysteine (Hcy), folate, vitamin B12, interleukin-6 (IL-6) and Tumor necrosis factor-alpha (TNF-α) and to assess relationship between Hcy levels and inflammatory mediators including IL-6 and TNF-α in untreated patients with rheumatoid arthritis (RA).Methods: The study included 55 women including 30 newly diagnosed and untreated female RA patients and 25 age-matched healthy individuals as controls.Results: Erythrocyte sedimentation rate (ESH), C-reactive protein (CRP), IL-6 and TNF-α levels were significantly higher in RA patients than controls (p0.05). There were no significant correlations between Hcy levels and acute phase reactants or inflammatory mediators (p>0.05).Conclusion: Both mediators such as IL-6 and TNF-α and hyper-homocysteinemia are associated with atherosclerotic cardiovascular diseases. There was no significant correlation between Hcy levels and inflammatory mediators, although levels of these molecules were elevated in RA. Both inflammatory mediators and Hcy may cause an increase in athero­sclerotic cardiovascular disorders through diverse pathways. J Clin Exp Invest 2016; 7 (2): 163-167

Objective: The objective of the study is to evaluate the relation of gout with osteoporosis and serum osteocalcin (OC) levels. Material and methods: Seventy-five patients diagnosed with gout and 55 controls were included in the study. Comorbid conditions and drugs associated with osteoporosis were excluded. The T and Z scores from lumbar spine (L2-L4) and femur (neck, ward, trochanter, total) were determined by dual-energy X-ray absorptiometry (DXA). OC levels were measured by enzyme-linked immunosorbent assay. Results: Osteoporosis according to T scores of lumbar vertebrae L2-L4 was found to be significantly higher in patients with gout compared to the control group (p = 0.02). Lumbar spine T-score was -1.6 in gout group and -1.0 in controls. OC level was 7.9 ng/mL in the gout group and 18.9 ng/mL in the control group. There was a significant difference (p < 0.001). In addition, mean OC level was 12.4 +/- 6.9 ng/mL in the patients diagnosed with osteoporosis and 17.2 +/- 10.6 ng/mL in the patients that were classified as normal and a significant difference was established between the two groups (p = 0.03). A significant negative correlation was found between OC level and body mass index, age, and age at first attack. Similarly, femoral T-score established a negative correlation with parathyroid hormone, age, age at first attack, and allopurinol dose. Conclusion: Serum OC level can be a useful marker in the assessment of bone turnover and clinicians should keep osteoporosis in mind in gout patients. C1 [Dogru, Atalay] Dr Ersin Arslan Training & Res Hosp, Dept Internal Med, Div Rheumatol, TR-27010 Gaziantep, Turkey. [Balkarli, Ayse] Antalya Training & Res Hosp, Dept Internal Med, Div Rheumatol, Antalya, Turkey. [Karatay, Cemile Canan] Pamukkale Univ, Dept Internal Med, Denizli, Turkey. [Cobankara, Veli] Pamukkale Univ, Dept Internal Med, Div Rheumatol, Denizli, Turkey. [Sahin, Mehmet] Suleyman Demirel Univ, Dept Internal Med, Fac Med, Div Rheumatol, Isparta, Turkey.

Introduction: Familial Mediterraneanfever (FMF) is a hereditary autoinflammatorydisease that includes recurrent episodesof serosal inflammation, with accompanying fever. Thiol/disulfidehomeostasis, marker of oxidative stress, is associated with an increase in inflammatory cytokines in many inflammatory diseases. The aim was toevaluate the dynamicthiol/disulfide homeostasis in patients with FMF duringattack free period.Material and method: In our study, 60 patients with FMF duringattack free period, 60 patients with AnkylosingSpondylitis (AS)during inactive period and 60 age-and sex matched controls were included. Nativethiol, total thiol and disulfide levels were measured by using the Erel andNeselioglu method. Result: Total thiol and disulfide levels were found to be significantlylower in FMF group compared to healthy controls. Native thiol levels weredetected to be significantly higher in FMF group compared to AS group. However,no significant difference was observed in total thiol levels between FMF and ASgroup. Ratios obtained using plasma native thiol, total thiol, and disulfidelevels differed significantly between the FMF, AS and the control groups.Conclusion: The lower thiol level of FMFgroup compared to AS and controls suggests that the thiol / disulfide balanceis affected differently in diseases with different pathophysiology. Althoughthe disease is in clinically inactive period, inflammation may continue atdifferent levels in different rheumatic diseases., Amaç:Ailesel Akdeniz Ateşi (AAA), ateş ile birlikte tekrarlayan serozal inflamasyonataklarını içeren, kalıtsal bir otoinflamatuar hastalıktır. Oksidatif stresinbelirteci Tiyol / disülfid homeostazı, birçok inflamatuar hastalıktainflamatuar sitokinlerde artış ile ilişkilidir. Çalışmamızın amacı atak dışıdönemde AAA olan hastalarda dinamik tiyol / disülfid homeostazisinideğerlendirmektir.Materyal-Method: Çalışmamıza atak dışı dönemde 60 AAA' li,60 inaktif dönemde Ankilozan Spondilit (AS)’ li hasta ve 60 yaş ve cinsiyet olarakbenzer kontrol grubu dahil edildi. Erel ve Neselioğlu yöntemi kullanılarak nativtiyol, total tiyol ve disülfid düzeyleri ölçüldü.Bulgular:AAA grubunda total tiyol ve disülfid düzeyleri sağlıklı kontrollere göreanlamlı derecede düşük bulundu. AAA grubunda nativ tiyol düzeylerinin ASgrubuna göre anlamlı olarak yüksek olduğu saptandı. Bununla birlikte, AAA ve ASgrubu arasında total tiyol düzeylerinde anlamlı bir farklılık izlenmedi. Plazmanativ tiyol, total tiyol ve disülfid seviyeleri kullanılarak elde edilenoranlar, AAA, AS ve kontrol grupları arasında önemli ölçüde farklıydı.Sonuç:AAA hastalarında AS ve control grubunagöre düşük tiyol düzeyi saptanması, farklı patofizyolojiye sahip hastalıklardatiyol / disülfid dengesinin farklı şekilde etkilendiğini düşündürmektedir.Hastalık klinik olarak inaktif bir dönemde olmasına rağmen, farklı romatizmalhastalıklarda inflamasyon farklı düzeylerde devam edebilir.

Amaç:Ailesel Akdeniz Ateşi (AAA), ateş ile birlikte tekrarlayan serozal inflamasyonataklarını içeren, kalıtsal bir otoinflamatuar hastalıktır. Oksidatif stresinbelirteci Tiyol / disülfid homeostazı, birçok inflamatuar hastalıktainflamatuar sitokinlerde artış ile ilişkilidir. Çalışmamızın amacı atak dışıdönemde AAA olan hastalarda dinamik tiyol / disülfid homeostazisinideğerlendirmektir.Materyal-Method: Çalışmamıza atak dışı dönemde 60 AAA' li,60 inaktif dönemde Ankilozan Spondilit (AS)’ li hasta ve 60 yaş ve cinsiyet olarakbenzer kontrol grubu dahil edildi. Erel ve Neselioğlu yöntemi kullanılarak nativtiyol, total tiyol ve disülfid düzeyleri ölçüldü.Bulgular:AAA grubunda total tiyol ve disülfid düzeyleri sağlıklı kontrollere göreanlamlı derecede düşük bulundu. AAA grubunda nativ tiyol düzeylerinin ASgrubuna göre anlamlı olarak yüksek olduğu saptandı. Bununla birlikte, AAA ve ASgrubu arasında total tiyol düzeylerinde anlamlı bir farklılık izlenmedi. Plazmanativ tiyol, total tiyol ve disülfid seviyeleri kullanılarak elde edilenoranlar, AAA, AS ve kontrol grupları arasında önemli ölçüde farklıydı.Sonuç:AAA hastalarında AS ve control grubunagöre düşük tiyol düzeyi saptanması, farklı patofizyolojiye sahip hastalıklardatiyol / disülfid dengesinin farklı şekilde etkilendiğini düşündürmektedir.Hastalık klinik olarak inaktif bir dönemde olmasına rağmen, farklı romatizmalhastalıklarda inflamasyon farklı düzeylerde devam edebilir., Introduction: Familial Mediterraneanfever (FMF) is a hereditary autoinflammatorydisease that includes recurrent episodesof serosal inflammation, with accompanying fever. Thiol/disulfidehomeostasis, marker of oxidative stress, is associated with an increase in inflammatory cytokines in many inflammatory diseases. The aim was toevaluate the dynamicthiol/disulfide homeostasis in patients with FMF duringattack free period.Material and method: In our study, 60 patients with FMF duringattack free period, 60 patients with AnkylosingSpondylitis (AS)during inactive period and 60 age-and sex matched controls were included. Nativethiol, total thiol and disulfide levels were measured by using the Erel andNeselioglu method. Result: Total thiol and disulfide levels were found to be significantlylower in FMF group compared to healthy controls. Native thiol levels weredetected to be significantly higher in FMF group compared to AS group. However,no significant difference was observed in total thiol levels between FMF and ASgroup. Ratios obtained using plasma native thiol, total thiol, and disulfidelevels differed significantly between the FMF, AS and the control groups.Conclusion: The lower thiol level of FMFgroup compared to AS and controls suggests that the thiol / disulfide balanceis affected differently in diseases with different pathophysiology. Althoughthe disease is in clinically inactive period, inflammation may continue atdifferent levels in different rheumatic diseases.

Background/aim: Determining the severity of systemic sclerosis related interstitial lung disease (SSc-ILD) is based on clinical and radiological findings, inflammation marker levels, and carbon monoxide diffusing capacity of the lung (DLCO). Recently studies are ongoing for objective and easy markers. Neutrophil/lymphocyte ratio (NLR) is shown to be a good marker for inflammation in recent clinical trials. In this study, we aimed to identify the possible relationship between NLR and carbon monoxide transfer coefficient (KCO) of SSc-ILD patients. Materials and methods: Fifty-nine patients with systemic sclerosis (SSc) were enrolled in the study. We used high-resolution computed tomography for diagnosis and used DLCO to evaluate degree of lung involvement. Complete blood cell counts and acute phase reactants were included as laboratory assessments. Results: NLR values were significantly higher in the SSc-ILD group (3.66 ± 1.32 vs. 2.85 ± 1.12, P = 0.01) and correlated negatively with KCO. The NLR cut-off value was 3.21, its sensitivity was 81%, and its specificity was 81%. Conclusion: NLR level may serve as a marker of lung involvement in the presence of ILD in patients with SSc.

Background and Objectives. Nailfold capillaroscopy is an easy and noninvasive technique used to investigate dermal microvasculature. Traditional investigations of vascularity do not detect changes until they are well-established in type 2 diabetics. The objective of the current study was to evaluate nailfold capillaries in type 2 diabetes mellitus patients and to determine the association of retinopathy with changes in the nailfold capillaries.Materials and Methods. Capillaroscopic findings by nailfold capillaroscopy and fundoscopic examinations were assessed in 216 patients with type 2 diabetes mellitus and 101 healthy controls included in this prospective study.Results. Retinopathy was detected in 43.05% of diabetic patients (n=93). Capillaroscopic findings including tortuosity (p<0.001), bushy capillary (p<0.001), neoformation (p<0.001), bizarre capillary (p<0.001), microhemorrhage (p=0.001), capillary ectasia (p=0.002), and aneurysm (p=0.004) were significantly higher in diabetic group than control group. In logistic regression analysis, only tortuosity was shown significant (OR, 2.16;p=0.036). There was also a significant relation between diabetes duration and most of the capillaroscopic findings.Conclusion. Capillaroscopic changes were found to be correlated with diabetic retinopathy, in particular with longer disease duration in our study. Capillaroscopic imaging could be a useful new technique for assessment of diabetic microvascular changes.

Çalışmada 25 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. Psoriatic arthritis (PsA) may affect different joints, including the spine. The prevalence of spinal involvement is variable depending on the definition and a subset of patients have been identified in cohorts that do not have clinical features of axial disease and yet have imaging findings. Still, there is not a consensus on how and when to screen axial disease. In this study, we aimed to investigate factors associated with being underdiagnosed for axial psoriatic arthritis (axPsA) and its impacts on outcomes. Disease features and outcomes of axPsA according to the physician (n=415) were compared with patients with imaging findings only (sacroiliitis fulfilling the modified New York criteria, n=112), using data from a real-life PsA registry. Patients with imaging findings only were more frequently women (83/220 (37.7%) vs 29/122 (23.8%); p=0.008). This group also had higher peripheral disease activity (imaging only vs clinical AxPsA: mean (SD) tender joint count 5.3 (6.1) vs 3.3 (4.7), swollen joint count 1.9 (2.9) vs 1.2 (2.4); p

Background: Synaptosomal-associated protein 25 (SNAP-25) may be contribute to the pathogenesis of fibromyalgia Syndrome (FMS) by affecting the release of neurotransmitters. Objectives: We aimed to investigate the relationship between the SNAP-25 gen (DdeI = rs1051312 and MnlI = rs3746544) polymorphism and the temperament and character traits. Methods: A total of 85 female patients diagnosed with FMS and 70 age-matched healthy female subjects were enrolled into the study. The Temperament and Character Inventory (TCI) were performed on all the patients. SNAP-25 gene polymorphism was determined in the patients group and controls group. Results: No significant difference between groups was found regarding the distribution of SNAP-25 MnlI polymorphism (p > 0.05), but it was seen that the frequency of TC genotype for DdeI gene was higher in the patients group (p < 0.05). Increased hazard avoidance was found in the patients group (p < 0.05). When TCI scores were assessed in terms of SNAP-25 gene polymorphism, no statistically significant relationship was detected between the TT, TG, GG genotypes for MnlI gen and TCI scores (p > 0.05). However, increased hazard avoidance was detected in patients with TC genotype for DdeI gene compared to patients without such genotype. Discussion: SNAP-25 might be an etiological factor in FMS pathogenesis and might affect personality traits of FMS patients by mediating neurotransmitter release.

WOS: 000380854200011, PubMed ID: 26834222, Objective. To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/ American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study. Methods. Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated. Results. Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%-93%) compared with the new clinical criteria in discriminating PMR from all other controls. Conclusion. The new 2012 EULAR/ ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria.

Objective.To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases.Methods.Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics.Results.We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4–48) and bladder cancer was 8 years (6–10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis.Conclusion.Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.

Objective: The role of vitamin D in the etiopathogenesis of fibromyalgia and non-specific musculoskeletal pain is controversial. In our study, we aimed to investigate the effect of vitamin D therapy on quality of life in patients with fibromyalgia. Materials and Methods: Seventy patients diagnosed with fibromyalgia and 65 age- and sex-matched controls were included in the study. Patients were grouped as deficient (30 ng/mL) according to the levels of vitamin D. Vitamin D replacement was performed for patients with deficiencies and inadequacies. Before and after vitamin D therapy, patients filled in the assessment tools, fibromyalgia impact questionnaire (FIQ), Arizona sexual experience scale (ASEX), Beck depression inventory (BDI), visual analog scale (VAS), and short form-36 (SF-36). Results: Vitamin D deficiencies and inadequacies were observed in 60% of the patients (n=42). Among patients with low and normal levels of vitamin D, no statistically significant difference was observed in their values. In scales examined after vitamin D replacement therapy, statistically significant differences were observed in the FIQ, BDI, VAS, and SF-36 compared with pre-treatment. Conclusion: Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia. Vitamin D supplementation may improve the quality of life in patients with fibromyalgia. © 2017 by the Atatürk University School of Medicine.

Background/aim: The aim of this study was to evaluate and determine the relationships (if any) among pain, depression levels, fatigue, sleep quality, and quality of life in patients with rheumatoid arthritis (RA) aged 65 years and over, and to compare the results with those of RA patients under 65 years of age. Materials and methods: The study included 52 patients with RA aged 65 years and over (Group 1) and 84 patients with RA under 65 years of age (Group 2). Pain, depression levels, fatigue, sleep quality, quality of life, and disease activity of all of the participants were evaluated using a visual analog scale (VAS), the Beck Depression Inventory (BDI), the Checklist Individual Strength (CIS), the Pittsburgh Sleep Quality Index (PSQI), the Short Form-36 (SF-36), and the Disease Activity Score-28, respectively. Results: When the two groups were compared, higher scores for the VAS, BDI, total CIS, and PSQI were found in Group 1 compared to Group 2 (P = 0.003, P = 0.003, P = 0.007, and P = 0.001, respectively). The SF-36 subscales of the physical component summary and mental component summary were not statistically significantly different between the two groups (P > 0.05). Conclusion: This study evaluated the situation in elderly patients with RA and showed that pain, depression level, fatigue, and sleep quality worsen with age.

Objective: The role of vitamin D in the etiopathogenesis of fibromyalgia and non-specific musculoskeletal pain is controversial. In our study, we aimed to investigate the effect of vitamin D therapy on quality of life in patients with fibromyalgia. Materials and Methods: Seventy patients diagnosed with fibromyalgia and 65 age-and sex-matched controls were included in the study. Patients were grouped as deficient (30 ng/mL) according to the levels of vitamin D. Vitamin D replacement was performed for patients with deficiencies and inadequacies. Before and after vitamin D therapy, patients filled in the assessment tools, fibromyalgia impact questionnaire (FIQ), Arizona sexual experience scale (ASEX), Beck depression inventory (BDI), visual analog scale (VAS), and short form-36 (SF-36). Results: Vitamin D deficiencies and inadequacies were observed in 60% of the patients (n=42). Among patients with low and normal levels of vitamin D, no statistically significant difference was observed in their values. In scales examined after vitamin D replacement therapy, statistically significant differences were observed in the FIQ, BDI, VAS, and SF-36 compared with pre-treatment. Conclusion: Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia. Vitamin D supplementation may improve the quality of life in patients with fibromyalgia.

The role of vitamin D in the etiopathogenesis of fibromyalgia and non-specific musculoskeletal pain is controversial. In our study, we aimed to investigate the effect of vitamin D therapy on quality of life in patients with fibromyalgia.Seventy patients diagnosed with fibromyalgia and 65 age- and sex-matched controls were included in the study. Patients were grouped as deficient (20 ng/mL), inadequate (20-30 ng/mL), and sufficient (30 ng/mL) according to the levels of vitamin D. Vitamin D replacement was performed for patients with deficiencies and inadequacies. Before and after vitamin D therapy, patients filled in the assessment tools, fibromyalgia impact questionnaire (FIQ), Arizona sexual experience scale (ASEX), Beck depression inventory (BDI), visual analog scale (VAS), and short form-36 (SF-36).Vitamin D deficiencies and inadequacies were observed in 60% of the patients (n=42). Among patients with low and normal levels of vitamin D, no statistically significant difference was observed in their values. In scales examined after vitamin D replacement therapy, statistically significant differences were observed in the FIQ, BDI, VAS, and SF-36 compared with pre-treatment.Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia. Vitamin D supplementation may improve the quality of life in patients with fibromyalgia.D vitamininin fibromiyalji ve nonspesifik kas-iskelet sistemi ağrılarının etyopatogenezindeki rolü tartışmalıdır. Çalışmamızda fibromiyalji hastalarında D vitamini tedavisinin yaşam kalitesi üzerine etkisini araştırmayı amaçladık.Çalışmaya fibromiyalji tanısı konulan 70 hasta ve yaş-cinsiyet olarak benzer 65 kişi kontrol grubu olarak dahil edildi. D vitamini düzeylerine göre hastalar, eksiklik (20 ng/mL), yetersizlik (20–30 ng/mL) ve yeterli (30 ng/mL) olarak gruplandırıldı. Eksiklik ve yetersizlik saptanan hastalar için D vitamini replasmanı yapıldı. D vitamini tedavisinden önce ve sonra, hastalar yaşam kalitesi formları olan fibromiyalji etkilenme anketi (FEA), Arizona cinsel yaşantılar ölçeği (ACYÖ), Beck depresyon ölçeği (BDÖ), Vizüel Analog skala (VAS) and Kısa form-36 (KF-36) ile değerlendirildi.D vitamini eksikliği ve yetersizliği hastaların % 60’ında (n=42) gözlendi. D vitamini düşük ve normal hastalar arasında yaşam kalitesi açısından istatistiksel fark saptanmadı. D vitamini replasman tedavisinden sonra yapılan incelemelerde FEA, BDÖ, VAS ’ya göre ağrı skoru ve KF-36’ da tedavi öncesi ile karşılaştırıldığında istatistiksel olarak anlamlı farklılıklar gözlendi.D vitamini eksikliği fibromyalji patogeneziyle bağlantılı görünmektedir. Fibromyalji hastalarında D vitamin replasmanı yapmak hayat kalitesini yükseltebilir.