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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]

BACKGROUND: Facet syndrome is defined as pain that arises from any structure of the facet joints, including the fibrous capsule, synovial membrane, hyaline cartilage, and bone. OBJECTIVES: To compare the effectiveness of US-guided and blind injections on clinical outcome in facet syndrome. MATERIALS AND METHODS: Forty-seven patients with the diagnosis of facet syndrome were included. Patients were consecutively randomized into one of the two groups. The patient's history, physical examination and routine laboratory parameters were obtained and diagnose was established based on physical findings. Two injections (mixture of 2 ml of 1% lidocaine hydrochloride and 20 mg of triamcinolone, to a single or maximum two sites depending on the clinical characteristics of the facet joint) were performed with 15 days apart, as blinded or US-guided manner. Clinical outcome assessments were carried out at 0, 2nd and 6th weeks, using Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and State-Trait Anxiety Inventory (STAI). RESULTS: The patients' initial VAS and ODI were not significantly different. When the two groups were compared in the 6th week in terms of VAS scores, improvement was more pronounced in the US-guided injection group (US-guided group (n = 23) before 7.6 (2.2) cm, after 3.0 (1.7) cm, P = 0.0001 vs blind group (n = 24) before 7.2 (1.3) cm, after 5.2 (2.0) cm, P = 0.0001). The improvement in initial and 6th week ODI was statistically significant in the US-guided injection group (P = 0.006). Except STAI I for US-group, trait anxiety scale scores were significant in both groups. CONCLUSION: The US-guided local injections offer better clinical outcome in the treatment of facet syndrome. [ABSTRACT FROM AUTHOR]

Objectives To investigate performance of some of the published psoriatic arthritis ( Ps A) classification criteria as well as Assessment of Spondyloarthritis International Society ( ASAS) criteria for peripheral spondyloarthritis (SpA) in Turkish patients with PsA (in early and late disease subgroups). Methods Patients were recruited using case report forms and physical examination methods proposed by the Anatolian Group for the Assessment in Rheumatic Diseases ( ANGARD). The Moll and Wright (MW), modified Fournie (MF), modified McGonagle (m MG), Vasey and Espinoza (VE), classification of PsA (CASPAR) criteria and ASAS criteria were assessed in patients with PsA who were diagnosed based on expert opinion. Results One hundred and twenty-eight patients with PsA (58 male, 70 female, mean age 41.8 years) were included. Thirty patients were in the early PsA and 98 patients were in the late PsA groups. Diagnostic delay was 2.6 years. In the 15.6% of patients arthritis developed before the skin findings. The proportion of patients fulfilling the MW, MF, m MG, VE, CASPAR and ASAS criteria were at a ratio of 90.6%, 82.8%, 62.5%, 84.4%, 96.1% and 76.5%, respectively. In early PsA (< 12 months disease duration) the proportions were 93.4%, 83.3%, 76.7%, 76.7%, 96.7% and 66.6%, respectively. On the other hand, in late PsA the proportions were 89.8%, 82.6%, 57.1%, 86.7%, 95.9%, 79.5%, respectively. Conclusions Even though the sensitivity of Ps A classification criteria in Turkish patients changes, the CASPAR criteria seems to be more prominent among all criteria for both early and late cases with its high sensitivity. [ABSTRACT FROM AUTHOR]

Objective: Local injections are widely used in patients with a painful shoulder. The aim of this study was to evaluate the possible impact of patients' visual information on the effectiveness of ultrasound (US)-guided local injections on anxiety levels and shoulder pain. Design: A total of 1 51 patients, scheduled for local injection owing to shoulder pain, were randomly assigned into two groups in a consecutive order. Patients in group I (n = 72) were provided information related to US findings and allowed to watch the procedures from the monitor, whereas patients in group II (n = 79) received the injection only without any collaboration. Data were collected from both groups immediately before and after injections through visual analog scale and questionnaire (the State-Trait Anxiety Inventory [STAI] forms 1 and 2). Results: US-guided local injections provided significant improvement of anxiety and pain in both groups, irrespective of providing visual information. Group I and group II comparisons with respect to the visual analog scale, STAI 1, and STAI 2 yielded significant difference only for postinjection STAI 2 in group I (P= 0.006). Intragroup comparisons revealed significant differences between preinjection and postinjection values (group I: visual analog scale, P= 0.001; STAI form 1, P= 0.001; STAI form 2, P= 0.002; group II: visual analog scale, P= 0.001; STAI form 1, P= 0.002; STAI form 2, P= 0.042). There was no significant difference between the groups in terms of postinjection satisfaction levels from the procedures (P= 0.824). Conclusions: Performing US-guided shoulder injections with patient visual information provides positive contributions to coping with pain and anxiety. In particular, the patient collaboration--based US-guided injections have positive consequences on patients' long-standing "trait-anxiety" levels. [ABSTRACT FROM AUTHOR]

Aim: Psoriatic arthritis (PsA) is a chronic, inflammatory disease. The purpose of this study was to examine the association between PsA and comorbid conditions. This is the first study to investigate comorbid diseases in PsA in Turkey. Methods: This study was performed under the auspices of the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) and involved participation by six university research hospitals. Patients diagnosed with and treated for PsA on the basis of clinical, radiological and laboratory findings and expert opinion were monitored using standardized examination methods and jointly prepared forms. Clinical status, accompanying systemic diseases and surgical history were recorded. Results: One hundred and seventy-three patients with PsA (75 male, 98 female, mean age 41.8) and 138 patients with rheumatoid arthritis (RA) (17 male, 121 female, mean age 48.6) and 67 with psoriasis (PsO) (43 male, 24 female, mean age 36.1) were included in the study. No accompanying disease was determined in 72.8% of PsA, 50.0% of RA and 80.6% of PsO groups. In regression analysis, patients with PsA had higher risk for cataract/glaucoma surgery (odds ratio [OR] = 11.99; 95% CI 1.36-105.4, P = 0.025) compared to patients with RA, and higher risk for hypertension (HT) (OR = 4.26; 95% CI 1.27-14.23, P = 0.018) compared to the patients with PsO. Conclusion: Patients with PsA have relatively lower frequency of comorbidities like diabetes mellitus, HT and cataract/glaucoma surgery compared to the patients with RA. The increased risk for having cataract/glaucoma surgery in RA compared to PsA may be particularly attributed to the more prevalent glucocorticoid use in RA. [ABSTRACT FROM AUTHOR]

Aim To retrospectively investigate and compare the effects of tumor necrosis factor alpha inhibitors ( TNFi) on hepatic enzymes in ankylosing spondylitis ( AS) patients. Methods A retrospective analysis of the records of 94 AS (66 male, 28 female) patients using TNFi was performed. Patients' clinical data, Bath Ankylosing Spondylitis Disease Activity ( BASDAI) scores, erythrocyte sedimentation rate ( ESR) and C-reactive protein ( CRP) levels were all examined. Liver function test ( LFTs) results of patients before the treatment and 3, 6 and 12 months after treatment with TNFi were investigated. Aspartate transaminase ( AST) and alanine transaminase ( ALT) levels were investigated as indicators of LFTs. Results The TNFi drugs used were infliximab ( n = 28), adalimumab ( n = 32) and etanercept ( n = 34). Pre-treatment values of ESR, CRP and BASDAI scores were 28.3 ± 20.1 mm/h, 1.5 ± 1.2 ng/dL and 5.2 ± 0.8, respectively. Following TNFi use there was a statistically significant decrease in disease activity score ( P = 0.001). There was a significant increase in LFT at the third month evaluation compared to the initial values, while the average value was within normal range (baseline AST 19.6 ± 10.8 U/L, ALT 19.1 ± 6.4 U/L, third month AST 31.3 ± 21.6 U/L, ALT 28.1 ± 18.1 U/L, P = 0.001). Drug group comparison analysis revealed a significant difference in the adalimumab group value at the end of the first year, but no other significant difference in the data for the other months ( P > 0.05). No significant correlation was determined between initial disease activity scores and LFT. Conclusion TNFi use-associated rises in hepatic enzymes were determined compared to pre-treatment but the mean values remained within normal limits. Considering the cases in the literature, in daily practice patients must be carefully monitored for liver function before treatment and at follow-up. [ABSTRACT FROM AUTHOR]

Joint involvement is one of the most frequent clinical complications of acromegaly. The aim of this study was to evaluate the femoral cartilage thicknesses of acromegalic patients using ultrasound (US). Sixty-two patients diagnosed with acromegaly (30 F, 32 M) were included. Patients' demographic and clinical characteristics were recorded. The thickness of the femoral articular cartilage was measured using a 6- to 18-MHz linear probe. Measurements were performed bilaterally from three points (medial condyle, intercondylar area, and lateral condyle). Of the patients, 14 (22.5 %) reported pain in the knee joints. A significantly higher femoral articular cartilage thickness was determined in the patients compared with the controls (all parameters, p < 0.001). US measurements results from all points were consistent, but these values were not correlated with levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Analysis of acromegaly patients as active ( n = 37) or inactive ( n = 25) revealed no significance with respect to femoral cartilage thickness. Acromegalic patients seem to have thicker femoral articular cartilages irrespective of disease activity state. [ABSTRACT FROM AUTHOR]

Objectives: This prospective clinical study aims to evaluate the effectiveness of long-term of anti-tumor necrosis factor-alpha (TNF-α) therapy on arterial stiffness in ankylosing spondylitis. Patients and methods: A total of 28 active ankylosing spondylitis patients (21 males, 7 females; mean age 33.5±9.5 years; range 20 to 52 years) were enrolled. Patients' values for before the initiation of biological therapy and mid-term (24 weeks) evaluation were reported. For further evaluation, this initially reported patients were contacted two years after anti-TNF-α therapy, and their arterial stiffness was assessed by using pulse wave velocity. Results: After two years of anti-TNF-α therapy, despite the significant improvements in patients' symptoms and clinical activity parameters including Bath Ankylosing Spondylitis Disease Activity Index score (4.9±0.9, 1.9±0.5 and 1.8±0.9, p=0.0001), erythrocyte sedimentation rate (35.5±23.1 mm/h, 13.8±9.2 mm/h and 25.0±17.9 mm/h, p=0.0001), and C-reactive protein (2.1±1.6 ng/dL, 0.4±0.3 ng/dL and 0.6±0.9 ng/dL p=0.0001), no significant difference was observed in arterial stiffness parameters (7.9±1.3 meter/second, 7.7±1.3 meter/second and 8.3±1.1 meter/second, p=0.620). Conclusion: In line with the previous 24-week evaluation, the results at two-year follow-up indicates that anti-TNF-α therapy does not improve arterial stiffness in patients with ankylosing spondylitis. [ABSTRACT FROM AUTHOR]

Objectives: This prospective clinical study aims to evaluate the effectiveness of long-term of anti-tumor necrosis factor-alpha (TNF-α) therapy on arterial stiffness in ankylosing spondylitis. Patients and methods: A total of 28 active ankylosing spondylitis patients (21 males, 7 females; mean age 33.5±9.5 years; range 20 to 52 years) were enrolled. Patients' values for before the initiation of biological therapy and mid-term (24 weeks) evaluation were reported. For further evaluation, this initially reported patients were contacted two years after anti-TNF-α therapy, and their arterial stiffness was assessed by using pulse wave velocity. Results: After two years of anti-TNF-α therapy, despite the significant improvements in patients' symptoms and clinical activity parameters including Bath Ankylosing Spondylitis Disease Activity Index score (4.9±0.9, 1.9±0.5 and 1.8±0.9, p=0.0001), erythrocyte sedimentation rate (35.5±23.1 mm/h, 13.8±9.2 mm/h and 25.0±17.9 mm/h, p=0.0001), and C-reactive protein (2.1±1.6 ng/dL, 0.4±0.3 ng/dL and 0.6±0.9 ng/dL p=0.0001), no significant difference was observed in arterial stiffness parameters (7.9±1.3 meter/second, 7.7±1.3 meter/second and 8.3±1.1 meter/second, p=0.620). Conclusion: In line with the previous 24-week evaluation, the results at two-year follow-up indicates that anti-TNF-α therapy does not improve arterial stiffness in patients with ankylosing spondylitis. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the socio-demographic and clinical characteristics oj patients with psoriatic arthritis (PsA) and to examine their effects on quality of life. Material and Method: 37 patients with PsA and 30 healthy controls were included in the study. To determine disease activity, clinical [disease activity score (DAS28), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)] and laboratory [Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] parameters were used. To evaluate quality of life, the Nottingham health profile (NHP) and Short form-36 (SF-36) were used. Results: The mean age of the patients was 43.9±11.2 years. The diagnostic delay time had a median of 1 year (min-max-0-18). We examined NHP. NHP scores showed that NHP pain, physical activity, tiredness and social isolation of PsA patients were higher than for control subjects. We evaluated SF-36. SF-36 scores indicated that physical function, physical role limitation, body pain, overall health, vitality and emotional role limitation were significantly decreased in PsA patients compared to control subjects. Correlation analysis was performed; Statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with disease activity parameters (DAS-28, BASDAI, ESR and CRP). Furthermore, statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with diagnostic delay time. Conclusion: We determined that quality of life was less in patients with PsA compared to control subjects. In addition, we have also found that disease activity and prolongation of diagnostic delay are associated with quality of life. [ABSTRACT FROM AUTHOR]

To evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents. Our study included patients with inflammatory rheumatic diseases from 23 centers, who were followed up with biological therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients, 2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had other inflammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were identified as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients (0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be 2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements. [ABSTRACT FROM AUTHOR]

Being one of the conditions presenting with patellar pain, Hoffa's syndrome is characterized with inflammation of the fat tissue in the patellar region. In advanced stage, this may lead to transformation of the fibrocartilage tissue and ossification of the infrapatellar fat pad. Some cases can be associated with tumors or tumor-like conditions. In this article, we describe a 72-year-old female case suffering from knee pain for a long time and discuss the end-stage Hoffa's disease and function of the infrapatellar fat pad in the light of literature. [ABSTRACT FROM AUTHOR]

Being one of the conditions presenting with patellar pain, Hoffa's syndrome is characterized with inflammation of the fat tissue in the patellar region. In advanced stage, this may lead to transformation of the fibrocartilage tissue and ossification of the infrapatellar fat pad. Some cases can be associated with tumors or tumor-like conditions. In this article, we describe a 72-year-old female case suffering from knee pain for a long time and discuss the end-stage Hoffa's disease and function of the infrapatellar fat pad in the light of literature. [ABSTRACT FROM AUTHOR]

To determine plasma homocysteine levels in ankylosing spondylitis (AS) and their correlation with disease activity measurements. To examine the effects of different treatment modalities on homocysteine levels. One hundred eight patients diagnosed with AS according to New York criteria and 65 healthy individuals matched in terms of age and gender were enrolled in the study. Patients were given detailed physical examinations. The Bath AS Disease Activity Index (BASDAI) was used for disease activity, the Bath AS Metrology Index (BASMI) for spinal mobility, the Bath AS Functional Index (BASFI) to determine functional status and the Bath AS Radiological Index (BASRI) for radiological analysis. Sedimentation rate (ESR) and C reactive protein (CRP) levels, acute phase reactants, were measured. Plasma homocysteine levels, serum interleukin (IL) -6 and serum tumor necrosis factor- α (TNF- α) levels were investigated using the enzyme-linked immunosorbent assay (ELISA) method. Plasma homocysteine levels in AS patients were statistically significantly lower compared with those in the healthy control group ( P = 0.0001). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity (BASDAI ≤4 and >4). No statistically significant correlation was determined between homocysteine level and disease activity parameters, radiological score and functional indices. A significant negative correlation was, however, established between age and homocysteine level in the AS group ( P < 0.05, r = −0.426). Plasma homocysteine was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment employed. [ABSTRACT FROM AUTHOR]

Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disease that often leads to cardiovascular complications including aortic regurgitation and conduction disturbances. Left ventricular (LV) systolic asynchrony is defined as loss of the simultaneous peak contraction of corresponding cardiac segments. The aim of this study was to evaluate LV systolic asynchrony noninvasively in patients with AS by using tissue synchrony imaging (TSI). Methods: Asynchrony was evaluated in 77 AS patients (61 male, mean age 36.4 ± 10 years) and 40 controls (35 male, mean age 39.1 ± 8.2 years). All study population underwent a comprehensive echocardiographic evaluation including TSI. The time to regional peak systolic velocity (Ts) during the ejection phase in LV was measured from TSI images by the six-basal and six-midsegmental model, and four TSI parameters of systolic asynchrony were computed. Results: The baseline demographic and echocardiographic characteristics were similar between the patients enrolled and controls. All TSI parameters of LV asynchrony were prolonged in patients with AS compared to controls: the standard deviation (SD) of the 12 LV segments Ts (39.6 ± 19.6 vs. 24.7 ± 11.6, P < 0.001); the maximal difference in Ts between any 2 of the 12 LV segments (122.1 ± 52.9 vs. 82.2 ± 38.6, P < 0.001); the SD of the six basal LV segments (33.5 ± 20.2 vs. 23 ± 13.3, P = 0.008); and the maximal difference in Ts between any two of the six basal LV segments (84.6 ± 48.1 vs. 60.4 ± 34.6, P = 0.008). The asynchrony parameters were significantly correlated with index of myocardial performance (Tei index) and peak systolic mitral annular velocity. Conclusion: TSI showed presence of LV systolic asynchrony in patients with AS which may account for the cardiovascular complications of AS. (Echocardiography 2012;29:661-667) [ABSTRACT FROM AUTHOR]

Objective. The availability of new-generation drugs has provided significant success reflected by disease activity markers and clinical status in AS, but controversial reports necessitate further assessment of associated increased risk of cardiovascular burden that might persist. Hence this prospective clinical study evaluated the effectiveness of a 24-week anti-TNF-α therapy on vascular stiffness [pulse wave velocity (PWV)] in AS.Methods. A total of 28 active AS patients (21 males, 7 females) were enrolled before the start of biologic therapy. Demographic and clinical characteristics were recorded. Arterial stiffness was assessed using PWV. Patients were evaluated before and 24 weeks after anti-TNF-α therapy.Results. The mean disease duration was 8.4 (4.9) years. After 24 weeks of anti-TNF-α therapy, despite significant improvements in patients’ symptoms and clinical activity parameters, including BASDAI score [4.9 (0.9) vs 1.9 (0.5), P = 0.0001], ESR [35.5 (23.1) vs 13.8 (9.2) mm/h, P = 0.0001) and CRP level [2.1 (1.6) vs 0.4 (0.3) ng/dl, P = 0.0001], no significant change was seen in arterial stiffness parameters [7.9 (1.3) vs 7.7 (1.3) m/s, P = 0.412]. Significant correlation was determined between arterial stiffness and age, systolic blood pressure and high-density lipoprotein cholesterol levels.Conclusion. Despite significant improvement in markers of disease activity, anti-TNF-α therapy does not seem to improve arterial stiffness, a significant AS-associated cardiovascular burden. Thus, when treating AS, significant end-points other than DASs should also be considered, and any hidden threat like arterial stiffness should be addressed further. [ABSTRACT FROM PUBLISHER]

Rheumatoid arthritis (RA [MIM 180300]) is a complex, polygenic inflammatory autoimmune disease, resulting from interactions between genetic and environmental factors. Some of the RA-associated HLA-DRB1 alleles have shared epitope, but their distribution varies among different racial/ethnic groups. This study was aimed at investigating the distribution of HLA-DRB1 alleles in patients with RA in eastern Black Sea region of Turkey. DNA samples of 320 patients with RA and 360 healthy controls were studied for the determination of HLA-DRB1 allele distribution using PCR-SSP method. The allele frequencies of HLA-DRB1*01, *04, and *09 were higher in patients with RA compared with the controls ( P < 0.005, P < 0.0001, and P < 0.01, respectively). On the other hand, in patients with RA, HLA-DRB1*13 allele was lower than the controls ( P < 0.001). Of the HLA-DRB1*04 subgroups, *0401 (40.83% vs. 18.75%, P < 0.001) was the most frequent allele in patients with RA, while DRB1*0402 (30.00% vs. 12.50%, P < 0.005) allele in the controls. HLA-DRB1 allele frequencies in the patients with RA and the controls showed Hardy-Weinberg rule compliance. Results of this study indicate that HLA-DRB1*01, *04, and *09 alleles were associated with RA, and HLA-DRB1*13 was protective allele against RA. Among the subgroups of HLA-DRB1*04, *0401 was detected to be RA associated, while *0402 was being protective. These results have some differences compared with previous reports originating from other regions of Turkey. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate any relationship between peripheral neuropathy and anti-TNF-α therapy used in ankylosing spondylitis (AS). Thirty-nine patients monitored in our clinic with a diagnosis of AS and without neuropathic symptoms were enrolled in the study. Patients were divided into two groups. The first consisted of 21 patients using biological agents for more than one year. The control group was made up of 18 patients of similar age and demographic characteristics receiving non-biological therapy. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were calculated, and sedimentation rate and C-reactive protein (CRP) levels measured. Motor and sensory nerve conduction analysis for the median, tibial, and sural nerves was performed. The nerve conduction results of the biological therapy group were then compared with those of the non-biological therapy group. Thirty-nine patients with a mean age of 37.05 ± 8.1 were enrolled. Patients were divided into two groups, depending on drugs used. The first group (using anti-TNF-α) consisted of 21 patients with a mean age of 42.2 ± 8.8, and the second (the non-biological group) of 18 patients with a mean age of 35.8 ± 7.5. There was no statistically significant difference between the groups in terms of age, sex, drug use, or duration of disease ( p = 0.052, p = 0.55, p = 0.33, and p = 0.72, respectively). Sedimentation rate, CRP, and BASDAI scores were statistically significantly higher in the second group ( p = 0.04, p = 0.03, and p = 0.009, respectively). No statistically significant difference was determined in any parameters at nerve conduction analysis between the two groups ( p > 0.05). There was a positive correlation between sedimentation rate and median sensory conduction velocity ( p = 0.02, r = 0.48) and tibial conduction velocity ( p = 0.07, r = 0.43). A negative correlation was determined between duration of disease and median distal motor latency ( p = 0.22, r = −0.37) and between length of drug use and median sensory conduction velocity ( p = 0.02, r = −0.38). There was no significant correlation between other clinical and demographic data and nerve conduction parameters. No effect on nerve conduction of biological agents in AS patients without neurological symptoms was determined. Clinicians should be alert for signs and symptoms, suggesting neuropathy in patients given anti-TNF-α. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to estimate the prevalence of ankylosing spondylitis (AS) in the Eastern Black Sea region of Turkey.Method: The study was conducted by The Department of Physical Medicine and Rehabilitation, Karadeniz Technical University Medical Faculty, in the urban area in the Eastern Black Sea region of Turkey, which has a population of 459,021 (according to the 2000 national census). A total of 4031 subjects over 20 years-old were enrolled, using the sampling method; 2025 (50.7 %) men and 2006 (49.3 %) women were included in the study. A survey consistent with Modified New York Criteria 1987 was used to diagnose AS in patients. The survey was applied and evaluated by two physical medicine residents and 8 trained medical students. Suspected cases were invited to our clinic.Result: Forty one out of fifty patients suspected with AS attended our out- patient clinic. Following physical examination, laboratory tests and radiological investigations of those individuals with suspected AS, 10 ones were diagnosed as AS. 9 of 10 patients were male and 1 patient was female. Patients’ mean age was 40.5 ± 8.4 years. The prevalence was estimated to be 0.25 % (95% CI: 0.09 %-0.40 %). It was 0.44 % in men (95 % CI: 0.15-0.73) and 0.05 % in women (95 % CI: 0.0-0.15) according to gender distribution.Conclusion: The study had value of regional features for evaluating for epidemiology of AS in Turkey. The prevalence of AS was found to be as 0.25 %. A male predominance was noted among AS patients in the study. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to estimate the prevalence of ankylosing spondylitis (AS) in the Eastern Black Sea region of Turkey.Method: The study was conducted by The Department of Physical Medicine and Rehabilitation, Karadeniz Technical University Medical Faculty, in the urban area in the Eastern Black Sea region of Turkey, which has a population of 459,021 (according to the 2000 national census). A total of 4031 subjects over 20 years-old were enrolled, using the sampling method; 2025 (50.7 %) men and 2006 (49.3 %) women were included in the study. A survey consistent with Modified New York Criteria 1987 was used to diagnose AS in patients. The survey was applied and evaluated by two physical medicine residents and 8 trained medical students. Suspected cases were invited to our clinic.Result: Forty one out of fifty patients suspected with AS attended our out- patient clinic. Following physical examination, laboratory tests and radiological investigations of those individuals with suspected AS, 10 ones were diagnosed as AS. 9 of 10 patients were male and 1 patient was female. Patients’ mean age was 40.5 ± 8.4 years. The prevalence was estimated to be 0.25 % (95% CI: 0.09 %-0.40 %). It was 0.44 % in men (95 % CI: 0.15-0.73) and 0.05 % in women (95 % CI: 0.0-0.15) according to gender distribution.Conclusion: The study had value of regional features for evaluating for epidemiology of AS in Turkey. The prevalence of AS was found to be as 0.25 %. A male predominance was noted among AS patients in the study. [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]

The aim of this study was to comparatively evaluate oxidative status of ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor (TNF) or non-steroid anti-inflammatory drugs (NSAID). Forty-seven patients with AS and 27 healthy controls were enrolled. Of these, 23 were on anti-TNF (group 1) and 24 on NSAIDs (group 2). Groups 1 and 2 were consisted of matched patients with respect to age, gender, body mass index, disease duration, C-reactive protein, erythrocyte sedimentation rate, total cholesterol, and Bath Ankylosing Spondylitis Disease Activity Index. Mean duration of treatment for patients in group 1 was 12.6 ± 6.8 months. Serum total antioxidative status (TAS) and total oxidative status (TOS) levels were determined using new automated methods. Oxidative stress index (OSI) was calculated. The groups' carotid intima-media thicknesses (IMT-C) were also measured using ultrasonography. Group 1 had the highest TAS and lowest TOS levels. The TOS levels of group 1 was lower than the control, while group 2 being higher than controls. The difference in TOS levels between group 1 and group 2 was statistically significant ( p = 0.040). OSI values were highest in group 2 and lowest in group 1. There was no significant correlation between oxidant/antioxidant parameters and IMT-C for group 1 ( r = −0.30, p = 0.198 for OSI; r = 0.22, p = 0.366 for TAS; r = −0.22, p = 0.361 for TOS). This is the first study to evaluate total oxidative/antioxidative status in patients with AS on anti-TNF agent. These results clearly indicate positive effects of anti-TNF treatment on oxidative status of AS patients. The limited effects of NSAIDs compared with controls may be due to excess impaired oxidative status in the patients in this study. [ABSTRACT FROM AUTHOR]

Reflex sympathetic dystrophy (RSD) is characterized by severe pain, swelling, autonomic dysfunction and usually affects extremities following trauma. In this case we report a 16-year-old female patient who had undergone several operations on the distal of the right lower extremity over a period of 1.5 years. During the follow-up she was determined to have adolescent osteomalacia (primary vitamin D deficiency) and RSD findings at the right lower extremity. We also examined reports in the literature concerning the probable initiator role of vitamin D deficiency among the mechanisms of RSD occurrence. This is the first report of primary vitamin D deficiency accompanied by RSD in an adolescent with multiple fractures. [ABSTRACT FROM AUTHOR]

A 50-year-old man presented with a complaint of low-back pain and widespread joint pain for the previous 20 years. Conventional radiography revealed wide areas of calcification in the intervertebral discs and degenerative changes in the peripheral joints. A diagnosis of ochronosis was made by the observation of bluish-brown pigmentation in the nose and ears, dark urine colors following alkalization, and high levels of homogentisic acid in the urine. Ochronosis should be considered in the differential diagnosis of patients with chronic low-back pain regarding features of widespread calcification in the intervertebral discs at radiography and bluish-brown pigmentation in the nose and ears. [ABSTRACT FROM AUTHOR]

Ultrasonography (USG) is becoming increasingly important in visualizing the musculoskeletal system. It is used as a diagnostic guide and in local injection procedures but is less frequently applied in visualizing deep joints and injections. The purpose of this study is to describe the results of USG-guided facet joint injection in a 19-year-old male patient with low back pain for the preceding year and a preliminary diagnosis of facet syndrome, together with a review of the literature. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a systemic, chronic and inflammatory disease of uncertain etiology particularly affecting the spine and sacroiliac joints. At present, biological agents are used in cases resistant to treatment. However, there are safety problems regarding the use of these agents in patients with chronic viral hepatitis. We report a case monitored with a diagnosis of AS whose inactive HBV (hepatitis B virus) carrier state improved with antitumor necrosis factor-α (anti-TNF) treatment (infliximab). [ABSTRACT FROM AUTHOR]

Hypertrophic osteoarthropathy is characterized by digital clubbing and periosteal reaction of long bones. Most cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia, and gastrointestinal polyps. We report a 19-year-old man presenting wıth arthritis, broadening of the fingers and clubbing of the fingers and toes for the previous 3 years. The ankles and knees were swollen. X-rays showed periosteal apposition. The search for a secondary cause remained negative. In cases of arthralgia/arthritis together with clubbed fingers, consideration must be given to hypertrophic osteoarthropathy. The primary or idiopathic form is rare and has a good prognosis. [ABSTRACT FROM AUTHOR]

Sjogren’s syndrome and ankylosing spondylitis can occur either alone or in conjunction with other disorders. In this article we report a female patient afflicted with ankylosing spondylitis and Sjogren’s syndrome. [ABSTRACT FROM AUTHOR]

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]

The article describes the case of a 21-year-old man who presented with right-side low back pain. He was diagnosed with facet syndrome due to the fluid observed in the right lumbar four to five facet joint on magnetic resonance imaging. Treatment consisted of conservative and interventional approaches including joint injection and radiofrequency treatment where fluoroscopy or computed tomography guidance is necessary.

Background/aim: The purpose of this study was to investigate possible effects of anti-TNF alpha therapy on cardiorespiratory fitness and physical functional capacity of patients with ankylosing spondylitis (AS). Materials and methods: Twenty-eight AS patients meeting the modified New York criteria with active disease state and an equivalent number of healthy individuals as the control were prospectively enrolled. Physical working capacity and aerobic exercise capacity of the participants were determined by using cardiopulmonary exercise tests, performed before and 4 months after initiation of anti-TNF alpha therapy. Results: The mean age of the patients was 37 ± 9.1 years, and mean duration of disease was 8.9 ± 7.6 years. Patients with AS exhibited significantly lower aerobic exercise capacity (VO2peak: 21.2 ± 5.5 vs. 27.2 ± 6.6 ml/kg/min, P = 0.001), maximum power output (110.4 ± 34.8 vs. 153 ± 39.8 W, P = 0.0001), and exercise duration (16.3 ± 2.6 vs. 19.6 ± 2.9 min, P = 0.0001) than the healthy controls. When patients were reevaluated after 4 months of anti-TNF alpha therapy, significant improvement was obtained in patients' aerobic capacity, maximum power output, and exercise duration. Conclusion: Results from this study indicate that in addition to inflammatory parameters and quality of life index, even short-term anti-TNF alpha therapy results in significant improvement in cardiopulmonary health status as objectively reflected by peak VO2, maximum work rate, and exercise duration. [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]

Arterial stiffness (AS) has a detrimental effect on cardiovascular system particularly on left ventricle (LV). The aim of the study was to evaluate the impact of AS on LV functions in patients with rheumatoid arthritis (RA). Forty patients with RA and 25 age-sex matched control subjects (mean age 48.5 ± 6.3 vs. 45.1 ± 6.9 years, respectively, p = 0.06) were enrolled in study. AS was assessed by carotid-femoral pulse wave velocity (CF-PWV) and heart rate corrected augmentation index (AIx@75) measured by applanation tonometry (SphygmoCor). LV function was evaluated using tissue Doppler-derived myocardial performance index (MPI) from lateral mitral annulus. CF-PWV (28.3 ± 10.3 vs. 21.8 ± 9.3 m/s, p = 0.03), AIx@75 (10.2 ± 2.3 vs. 9.2 ± 1, %, p = 0.01) and MPI (0.46 ± 0.12 vs. 0.36 ± 0.1, p < 0.001) were significantly higher in patients with RA than in controls. LV MPI was found to be significantly positive correlated with CF-PWV, AIx@75, and ESR ( r = 0.360, p = 0.005; r = 0.334, p = 0.009; r = 0.293, p = 0.023, respectively). Arterial stiffness parameters including CF-PWV and AIx@75 are associated with subclinical left ventricular dysfunction in patients with RA. [ABSTRACT FROM AUTHOR]

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]

Objectives: This study aims to investigate ultrasound examination findings of cartilage, tendon and nerve structures in patients with acromegaly and assess whether imaging findings have any association with the clinical and laboratory features of the patients. Patients and methods: The study included 38 diagnosed acromegaly patients (18 males, 20 females; mean age 45.6±10.4 years; range 28 to 63 years) and 21 control subjects (8 males, 13 females; mean age; 43.1±7.4 years; range 29 to 58 years) similar for age, sex and body mass index. Patients' clinical characteristics and laboratory parameters were recorded. The cross sectional area of median nerve, flexor pollicis longus and Achilles tendon, and humeral cartilage thickness were bilaterally assessed by ultrasound. Results: Arthralgia was present in 13 patients (34.9%) and 11 (28.9%) had paresthesia in the hands. Thickness of humeral cartilage and the cross sectional area of median nerve, flexor pollicis longus tendon and Achilles tendon was significantly higher in acromegaly patients compared with controls (p<0.001). While measurements performed with ultrasound were correlated among themselves, no significant correlation was present between ultrasound measurements and growth hormone and insulin-like growth factor-1. When acromegaly patients were analyzed as active (n=22) and inactive (n=16), no significant difference was determined in the parameters with the exception of median nerve measurements. Conclusion: Ultrasound examination revealed significantly different cartilage, tendon and nerve parameters in acromegaly patients compared to the control group. Median nerve cross sectional area was significantly greater in active patients compared to inactive patients. [ABSTRACT FROM AUTHOR]

Purpose: To investigate posterior segment (PS) findings in the eye in patients with ankylosing spondylitis (AS). Methods: Eighty-four patients with AS and 63 healthy controls were enrolled. PS evaluations were performed using optical coherence tomography (OCT). Foveal thickness, peripapillary retinal nerve fiber layer thickness, macular volume, ganglion cell complex, and choroidal thickness (CT) values were compared between the groups . Results: Mean CT was higher in patients with AS (326.5 ± 71.5 µm) than in the healthy controls (286.2 ± 59.5 µm) ( p = 0.001). There was no significant difference between patients with AS and the healthy control group in terms of other OCT parameters. There was also no significant correlation between CT, AS activity index, and disease duration. Conclusions: This is the first study to evaluate effects of AS on CT. CT was high in patients with AS compared to healthy controls. [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]

Aim: The aim of this study was to investigate the associations between human leukocyte antigen (HLA)-DRB1 alleles with genetic susceptibility to rheumatoid arthritis (RA) and production of antibodies against cyclic citrullinated peptide (anti-CCP antibody) and rheumatoid factor (RF) in Turkish RA patients. Methods: We studied 291 RA patients and 253 controls. Genotyping was performed by polymerase chain reaction with sequence-specific oligonucleotide probes hybridization method. Serum levels of anti-CCP antibody, IgM-RF and high sensitive C-reactive protein titers were measured by commercial kits using immunological methods. Results: We found that HLA-DRB1*04 and *09 alleles were associated in anti-CCP+ and anti-CCP+ RA patients ( P < 0.0001 and P < 0.001, respectively), while DRB1*01 and *04 were determined to be higher in RF+ RA patients ( P < 0.001 and P < 0.0001, respectively). Moreover, DRB1*11 and DRB1*13 alleles were determined to be lower in RF and anti-CCP/RF+ RA patients ( P < 0.001 for both). HLA-DRB1*04 was identified as a common responsible allele for susceptibility to the disease in anti-CCP, RF and anti-CCP/RF− RA patients ( P = 0.0018, P = 0.0004 and P = 0.0023, respectively). HLA-DRB1*13 allele alone was found to be protective against to anti-CCP+ and RF− RA ( P = 0.0003 and P = 0.006, respectively). On the contrary, there was no protective allele in anti-CCP/RF− RA as well as anti-CCP− RA patients. Conclusion: This study indicates that associate and protective HLA-DRB1 allele distributions are different in autoantibody (anti-CCP or RF or anti-CCP/RF)+ RA and autoantibody− RA patients, with exceptions of DRB1*04 and DRB1*13. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate the sociodemographic and clinical characteristics as well as the quality of life of patients with fibromyalgia (FM). Materials and Methods: A total of 37 female patients diagnosed with FM and 31 healthy females were included into the study. Individuals were asked about their demographic characteristics. The number of sensitive points (NSP), skin fold sensitivity, cutaneous hyperemia and reticular skin changes of patients and healthy controls were evaluated during physical examination. Individuals were evaluated for pain severity using the Visual Analogue Scale (VAS), for psychological states using the Beck Depression Scale (BDS), for quality of life using the Short Form-36 (SF-36) and for functional status using the Fibromyalgia Impact Questionnaire (FIQ). Results: The mean age of FM patients was 39.2±6.5 years versus 39.1±6.2 years in the controls. The most frequently encountered FM symptoms were fatigue (94.6%), sleep disturbances (86.5%) and anxiety (86.5%). Differences between FM patients and controls were statistically significant for NSP (p=0.001), VAS (p=0.001), FIQ (p=0.001), BDS (p=0.001) and SF-36 (p=0.003), and FIQ subgroups were also different between the two groups (p<0.001). In the SF-36 survey, FM patients were different from the control in the physical function (p=0.001), pain (p=0.005), general health (p=0.017), physical fitness (p=0.003), and mental health (p=0.008) portions of the survey. Conclusion: Fibromyalgia has distinct clinical features that lead to low functional capacity and quality of life. Thus, patients' sociodemographic characteristics and the evaluation of their quality of life may be important in the diagnosis and monitoring of treatment progress. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that is associated with increased cardiovascular burden. The aim of this study was to investigate vascular structural and functional changes in patients with AS, with special emphasis on the effects of different treatment modalities, through evaluation of level of vascular stiffness (pulse wave velocity [PVW]) and carotid intima media thickness (IMT-C). Methods: A total of 67 AS patients, and age, sex, body mass index (BMI) smoking status, lipid profiles and blood pressure-matched healthy control subjects (n =34) were studied. Of these, 34 patients were on anti-TNF alpha and 33 on non steroid anti inflammatory drugs (NSAIDs). The IMT-C and PWV values of the right common carotid artery were measured by high-resolution ultrasound. Results: The AS patients (n =67) had significantly higher PWV values than the controls [9.0±1.49m/sec vs. 8.27±0.90m/sec, P =0.004; 95% confidence interval (CI), −1.22 to −0.24]. Multiple stepwise linear regression analysis revealed that PWV could only be explained by systolic blood pressure (P <0.05) and IMT (P <0.05) in AS. Even though IMT-C in anti-TNF alpha treated group was higher compared to the NSAID treated group, it was not statistically significant (P =0.5). Conclusion: PWV was found to be higher in AS patients than in the control group, and there was no significant difference between the average PWV values of AS patients treated with anti -TNF alpha or NSAIDs. [Copyright &y& Elsevier]

Résumé: Objectif: La spondylarthrite ankylosante (SA) est une maladie de système chronique inflammatoire associée à des risques cardiovasculaires en cours d’évaluation. Le but de cette étude était d’étudier les modifications vasculaires structurelles et fonctionnelles chez les patients atteints de SA, en insistant particulièrement sur les effets de différentes modalités de traitement, au moyen de l’évaluation de la rigidité vasculaire (vitesse de l’onde de pouls [VOP]) et de l’épaisseur intima-média carotidienne (EIM-C). Méthodes: Soixante-sept patients atteints de SA, ont été étudiés : âge, sexe, indice de masse corporelle (IMC), statut tabagique, profil lipidique et pression artérielle et appariés avec des patients témoins (n =34). Parmi eux, 34 patients étaient sous anti-TNF-alpha et 33 sous anti-inflammatoires non stéroïdiens (AINS). Les valeurs de l’EIM-C et de la VOP de l’artère carotide commune droite furent mesurées par résolution ultra-sons. Résultats: Les patients SA (n =67) présentaient des VOP significativement plus élevées que les témoins (9,0±1,49m/sec vs 8,27±0,90m/sec, p =0,004 ; intervalle de confiance à 95 % [IC], –1,22 à –0,24). De multiples analyses de régression linéaire pas à pas ont révélé que la VOP pouvait être expliquée uniquement par la pression artérielle systolique (p <0,05) et l’EIM (p <0,05) dans la SA. Bien que l’EIM-C dans le groupe traité par anti-TNF-alpha était supérieure à celle du groupe traité par AINS, la différence n’était toutefois pas significative. Conclusion: Une VOP supérieure à été observée chez les patients atteints de SA en comparaison aux patients du groupe témoin. Il n’existait pas de différence significative entre les valeurs moyennes de VOP des patients SA traités par anti-TNF-alpha ou AINS. [Copyright &y& Elsevier]

Aim: The aim of this study was to estimate the prevalence of rheumatoid arthritis (RA) in the eastern Black Sea region of Turkey. Method: The study was carried out between March 2003 and March 2005 by the Karadeniz Technical University Medical Faculty Department of Physical Medicine and Rehabilitation in the urban area in the eastern Black Sea region of Turkey, which has a population of 459 021 (according to the 2000 national census). A total of 6103 subjects, 20 years old or over, were selected by the sampling method; 3023 (49.5%) women and 3080 (50.5%) men were included in the study. The diagnosis of RA was performed based on fulfilling the American College of Rheumatology (ACR) criteria. Results: Fifty-nine patients were diagnosed with RA according to the ACR criteria, of which 11 were male and 48 female. The prevalence of RA was 1% (95% CI: 0.75-1.25) in the general population, 1.6% (95% CI: 1.15-2.05) in women and 0.35% (95% CI: 0.14-0.56) in men. The female/male ratio was 4.3 : 1.0, showing that RA prevalence was statistically significantly higher in women ( P < 0.005). Conclusion: Our study demonstrates that RA is a common disease in Turkish society. [ABSTRACT FROM AUTHOR]

A 42-year-old housewife was admitted to our clinic because of shoulder pain. At X-ray and CT, multiple calcifications and ossifications were seen in the subscapular bursa and glenohumeral joint. MRI findings were consistent with synovial chondromatosis. Surgical treatment was planned but the patient refused. Thus conservative treatment was initiated for pain relief. The shoulder joint is a rare localization in this disorder. Although our patient's symptoms resolved with conservative treatment, we think that it would be better to perform surgical treatment because of the increased size and number of loose bodies and minimal or moderate chondral damage. [ABSTRACT FROM AUTHOR]

Osteitis condensans ilii (OCI) is a benign pathology causing chronic back and hip pain. Although the definitive cause is uncertain, mechanical stress is a significant factor in the development of the disease. Bilateral involvement of the sacroiliac joint is typical. We describe a case of unilateral OCI with unilateral sclerosis observed at radiography in a 34-year-old patient presenting with chronic back and hip pain, together with a review of the literature. [ABSTRACT FROM AUTHOR]

Background/aim: This study aimed to evaluate the diagnostic efficacy of vertebral Hounsfield unit (HU) values on routine contrastenhanced abdominal computed tomography (CT) scans for the assessment of osteoporosis using dual-energy X-ray absorptiometry (DXA) T-scores as a reference standard. Materials and methods: A total of 111 consecutive patients who underwent contrast-enhanced abdominal CT examination for any indication and DXA within a 6-month period were retrospectively analyzed. The CT attenuation values of trabecular bone in HUs were measured in axial and sagittal planes from lumbar vertebrae 1-4 (L1-L4). The correlation between the DXA T-scores and HU values measured on the CT scans was evaluated by Pearson's correlation test. Areas under the curves (AUCs) were calculated by receiver operating characteristic analysis for diagnostic proficiency, and threshold values were determined. Paired t-test and Bland-Altman plot test were used to evaluate the correlation between axial and sagittal HU values. Results: There was a strong correlation between the DXA T-scores and HU values of all the lumbar vertebrae (P < 0.001). The highest correlation was for the L3 vertebra; L3 was thus chosen for additional analyses. The mean axial and sagittal L3 attenuations were 133.7 HU and 131.9 HU, respectively. The axial measurements were not significantly different from the sagittal measurements, with a mean difference of 1.8 HU (P > 0.05). The L3 axial CT attenuation threshold for 90% sensitivity was 170 HU and that for 90% specificity was 102 HU for distinguishing osteoporosis from osteopenia and normal bone mineral density (BMD). To distinguish the low BMD group from the normal group, the L3 axial CT attenuation threshold for approximately 90% sensitivity was 102 HU and for 90% specificity was 165 HU. Conclusion: The HUs derived from routine contrast-enhanced abdominal CT scans can be used for the evaluation of osteoporosis, without additional radiation exposure and cost. [ABSTRACT FROM AUTHOR]

A response from the authors of the article "Evaluation of Choroidal Thickness in Ankylosing Spondylitis Using Optical Coherence Tomography" in the 2014 issue is presented.