Academic publication activities and perspectives of rheumatology practitioners in the COVID-19 pandemic.

Objectives: This study aimed to analyze the research, publication activities, and perspectives on clinical practices of rheumatology practitioners during the coronavirus disease 2019 (COVID-19) pandemic. Materials and methods: The survey-based cross-sectional study was designed online and included 24 closed-ended questions. After performing a pilot test and validation of survey, it was conducted among clinicians between September 2021 and December 2021. Results: One-hundred fifteen clinicians (54 males, 61 females; 78.1% in rheumatology practice for at least five years) responded to the survey. The respondents indicated that they worked in coronavirus-related departments, comprising inpatient service (50.4%), consultancy (42.6%), and outpatient clinic (27.8%). Around 40% of clinicians stated they spent less time on scientific research (43.1%) and clinical learning activities (43.2%), while almost the same proportion of them spent more (41.1% and 45.0%, respectively). This study revealed that 53.5% published at least one paper covering mostly COVID-19 in the scientific citation index (SCI) or SCI-expanded (SCI-E) indexed journals. However, nearly half of them did not have any papers published in the SCI/SCI-E (46.5%) or non-SCI/SCI-E indexed (44.6%) journals. Regarding the perspectives of clinicians about clinical practices, they considered fewer biological (57.0%) and nonbiological (55.0%) drug usage, reported fewer outpatient clinic visits (88.2%), more newly diagnosed rheumatic diseases (62.5%), and more disease exacerbations (31.2%). Most of the clinicians (range, 76.2 to 86.3%) thought they accurately managed their patients during the COVID-19 pandemic. Conclusion: Clinicians published mostly coronavirus-related papers in the pandemic era, and in the self-assessment, clinicians thought that they correctly manage their patients. In addition, this study reflected the frequency of academic publications and clinicians' work routines during the pandemic.

The identification of association between ultrasonographic enthesitis and the ASAS Health Index in patients with axial spondyloarthritis.

This study aimed to evaluate association between the entheseal abnormalities in ultrasound and the Assessment of Spondyloarthritis International Society Health Index (ASAS HI) in patients with axial spondyloarthritis (axSpA). Seventy-four patients with axSpA were enrolled in this study. Ultrasonographic evaluation of entheses was performed by a blinded rheumatologist with the Madrid Sonographic Enthesitis Index (MASEI). The MASEI total score and the MASEI sub-scores (e.g., structural damage and activity scores) were calculated. The ASAS HI and the other SpA tools (e.g., Bath Ankylosing Spondylitis Disease Index, the Ankylosing Spondylitis Disease Activity Score) were used to evaluate patients' health and disease activity. Correlation and multivariate linear regression analyses were performed to assess the relationship between the MASEI and the ASAS HI. The mean score of the ASAS HI was 7.7 ± 4.6. The MASEI total score was calculated as 8.4 ± 6.8, while the mean MASEI-activity was 4.7 ± 3.6 and the mean MASEI-structural damage was 3.8 ± 4.5. There was no correlation between ASAS HI and MASEI total scores (r = 0.11, p = 0.34). However, the ASAS HI had a positive correlation with the MASEI-activity (r = 0.49, p < 0.001) and had a low negative correlation with the MASEI-structural damage (r = - 0.29, p < 0.05). In the linear regression model, the MASEI-activity and MASEI-structural damage were significantly related to the ASAS HI (ß = 0.72 and - 0.58, respectively; R2 = 0.53 p < 0.001). This study reported that the ASAS HI score was more negatively affected by active entheseal lesions rather than structural lesions. We suggest adding the entheses evaluation with ultrasonography to other tools for monitoring the health status of patients with axSpA.

The impact of the ongoing COVID-19 pandemic on the management of rheumatic disease: a national clinician-based survey.

This study aims to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the management of rheumatic diseases (RD). An online survey included 10 questions were designed to assess potential differences in rheumatology practice. The survey was conducted between March 2021 and June 2021. Marginal homogeneity test was used to compare frequencies of outpatient clinic patients between the pre-pandemic and pandemic. Other results were analyzed by descriptive statistics. One hundred three clinicians (75.7% in rheumatology practice for at least five years) responded to the survey. Almost 70% examined < 30 patients per day during the pandemic while nearly 70% examined ≥ 30 patients per day before the pandemic (p < 0.001). They indicated following reasons for decreasing outpatient clinic activity were concerns regarding COVID-19 transmission risk of the patients (95%) and the clinicians (53%), being able to supply chronic medications directly from the pharmacy (85%), lockdown (71%), limited outpatient appointments (64%) and using telemedicine (20%). The frequencies of rheumatology daily routine procedures were decreased as follows; patient hospitalization for diagnosing (80%) and treatment (78%), labial salivary gland biopsy (63%), Schirmer's test/salivary flow rate test (56%), nail bed video-capillaroscopy (52%), musculoskeletal ultrasonography (51%) and Pathergy test (50%). Clinicians hesitated to use rituximab (63%) mostly, followed by cyclophosphamide (53%), glucocorticoids (43%), tofacitinib (41%), mycophenolate mofetil (36%), and azathioprine (33%). In this first national survey, the prominent differences in the management of RD have decreased outpatient clinic activity, reduced rheumatology daily procedures, and hesitancy to use some rheumatic drugs.

Coexistence of fibromyalgia and metabolic syndrome in females: The effects on fatigue, clinical features, pain sensitivity, urinary cortisol and norepinephrine levels: A cross-sectional study.

OBJECTIVES: This study aims to evaluate the coexistence of metabolic syndrome (MetS) and fibromyalgia syndrome (FMS) and determine the effects of this coexistence on neuroendocrine levels and clinical features of FMS. PATIENTS AND METHODS: One-hundred female FMS patients (mean age 40.1±7.8 years; range, 24 to 58 years) and 38 healthy females (mean age 40.4±5.8 years; range, 30 to 55 years) were included in this cross-sectional study. MetS was identified by using the criteria from the Adult Treatment Panel III. Widespread pain index, symptom severity score and number of tender points were determined. Visual analog scale, Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Beck Depression Inventory, and pain pressure threshold were used as the outcome measures. The severity of FMS was assessed with total myalgic score (TMS) and control point score. RESULTS: Twenty-four (24%) of the 100 FMS patients and three (7.9%) of the 38 control patients fulfilled the MetS criteria (p=0.047). The coexistence of FMS and MetS was associated with higher symptom severity score (p=0.004), widespread pain index (p=0.001), number of tender points (p=0.039), and lower total myalgic score (p=0.029) values. There was a significant association between the occurrence of FMS and MetS (odds ratio=3.76; 95% confidence interval: 1.04-13.4; p=0.043). CONCLUSION: We found that patients with FMS had a nearly four times higher risk for MetS and the coexisting MetS may increase the severity of FMS. In clinical practice, when evaluating a patient with FMS, metabolic characteristics should also be evaluated.