Association between choroidal thickness and interstitial lung disease in patients with rheumatoid arthritis: A cross-sectional study.

Objectives: This study aimed to evaluate choroidal thickness (CT) in patients with rheumatoid arthritis (RA) and healthy controls and to determine its relationship with RA-associated interstitial lung disease (RA-ILD). Patients and methods: A total of 63 patients with RA and 36 age- and sex-matched healthy controls were recruited in the cross-sectional study. Serological findings, Disease Activity Score-28, disease duration, and medical treatment of patients were recorded. Patients with RA were subdivided into two groups: patients with RA-ILD (Group 1) and patients with RA but without ILD (RA-noILD; Group 2). CTs were measured using enhanced depth imaging optical coherence tomography. CT was measured at five points: the subfoveal region, 750 µm nasal and temporal to the fovea, 1500 µm nasal and temporal to the fovea. Patients with RA-ILD were evaluated with delta high-resolution computed tomography (ΔHRCT) and pulmonary function test to determine the severity of interstitial lung disease. Results: Four of 63 RA patients were excluded due to comorbidities. Thus, 59 RA patients, 20 in the RA-ILD group and 39 in the RA-noILD group, were included in the analyses. The RA groups were similar in terms of clinical characteristics and laboratory findings. There were statistically significant differences between Group 1, Group 2 and healthy controls (Group 3) compared to all CT values (p<0.05). The mean CT measured at 750 µm and 1500 µm nasal to the fovea was lowest in the RA-ILD group, followed by the RA-noILD and healthy groups (p<0.05). CT measurements did not correlate with the pulmonary function test and ΔHRCT. Conclusion: RA-ILD patients had a thinner CT measured at nasal points. However, there was no association between CT measurements and the severity of ILD.

Treatment of STING-associated vasculopathy with onset in infancy in patients carrying a novel mutation in the TMEM173 gene with the JAK3-inhibitor tofacitinib.

Objectives: This study aimed to reveal the genetic background of patients in the two-generation family suffering from rheumatoid arthritis, psoriatic arthropathy pain, scratches, and bruises. Patients and methods: A clinical exome sequencing analysis was performed in 10 individuals in the same family using the Sophia Genetics clinical exome solution kit. Results: A novel V194L mutation in the TMEM173 gene was identified in three members of the family. Two of the family members were treated with the JAK3 inhibitor tofacitinib and recovered completely one month after the treatment. Conclusion: The V194L mutation was reported for the first time in this study, and a positive response was achieved with tofacitinib.

The evaluation of tibial nerve using shear-wave elastography and ultrasound in patients with systemic sclerosis: A cross-sectional study.

Objectives: The study aimed to evaluate stiffness and the cross-sectional area (CSA) of the tibial nerve (TN) using shear wave elastography (SWE) and ultrasound (US) and investigate the relationship of these with disease activity, quality of life, and severity of neuropathic pain in patients with systemic sclerosis (SSc). Patients and methods: This cross-sectional study included 28 SSc patients (1 male, 27 females; mean age: 50±11 years; range, 28 to 67 years) and 22 age- and sex-matched healthy controls (4 males, 18 females; mean age: 48±6 years; range, 37 to 66 years) between March and April 2022. US and SWE were performed on the TN, and CSA and nerve stiffness were measured. The TN was examined by a radiologist, 4 cm proximal to the medial malleolus. A few days later, an evaluation was performed in the second session by a second observer to investigate inter-and intraobserver agreement. Interobserver agreement was evaluated using the intraclass correlation coefficient (ICC). The Scleroderma Health Assessment Questionnaire, European League Against Rheumatism European Scleroderma Trial and Research (EUSTAR) group activity index, and Douleur-Neuropathique 4 scores of the patients were evaluated. Correlations between the questionnaires and measurements of nerve stiffness and CSA were assessed. Results: Patients with SSc had significantly higher stiffness and CSA values of the right TN compared to healthy controls (p<0.001 and p=0.015, respectively). The nerve stiffness values of the right TN were positively correlated with the EUSTAR activity index (p=0.004, r=0.552). The CSA of the left TN was larger in patients with SSc (21.3±4.9 mm2 ) than in controls (12.8±3.4 mm2 ), and the nerve elasticity was positively correlated with the EUSTAR activity index (p=0.001, r=0.618). The interobserver agreement was moderate to good for measuring stiffness and CSA of the TN (ICC were 0.660 and 0.818, respectively). There was a good to excellent intraobserver agreement for measuring stiffness and CSA of TN (ICC were 0.843 and 0.940, respectively). Conclusion: The increased disease activity in patients with SSc is associated with TN involvement, which can be demonstrated by US and SWE.

A national, multicenter, retrospective study evaluating retention rate and efficacy of tocilizumab treatment in patients with active rheumatoid arthritis who had an inadequate response to csDMARDs and/or TNF inhibitors.

BACKGROUND: To describe the disease activity and retention rate in rheumatoid arthritis (RA) patients with inadequate response (IR) to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or tumor necrosis factor inhibitors (TNFis) who were prescribed tocilizumab (TCZ) as first-line or second-line biologic treatment in real-world setting. METHODS: Data gathered from patients' files was used in a multicenter and retrospective context. Retention rates and the Disease Activity Score in 28 joints with CRP (DAS28-CRP) were evaluated at time points. The relationship of drug efficacy with factors such as smoking, obesity, and previous use of TNFis was also examined. RESULTS: One hundred and twenty-four patients with a median (IQR) RA duration of 3.7 (7.4) years were included. Mean (SD) age was52.9 (12.9) and 75% of the patients were female. TCZ retention rates in the 6th and 12th months were 94.1% and 86.6%, respectively. In all patients, DAS28-CRP level decreased significantly from baseline to Months 3 and 6. There was an increase in patients with remission and/or low disease activity and a decrease in patients with high disease activity at Month 3 and Month 6 (p < 0.001 for both). Disease activity was similar between subgroups based on body mass index, smoking status, and previous use of TNFis at any time point. Regression analysis showed that absence of concomitant corticosteroid treatment independently was associated with remission/LDA achievement at Month 6 [OR = 0.31, 95% CI (0.14- 0.72), p = 0.006], and Month 12 [OR = 0.35, 95% CI (0.13-0.94), p = 0.037]. Overall, 25 mild adverse events were reported. DISCUSSION: TCZ was found to be effective and safe in RA patients with IR to csDMARDs and/or TNFis. The drug retention rate was considered satisfactory with more than half of the patients continuing TCZ treatment at Month 12.

Investigation of the relationship between interferon-gamma receptor 1-56C/T gene polymorphism and genetic susceptibility to lung sarcoidosis: A cross-sectional study.

Objectives: This study aims to investigate the relationship between the interferon-gamma receptor 1 (IFNGR1) polymorphism and susceptibility to lung sarcoidosis. Patients and methods: The study included a total of 55 patients (13 males, 42 females; mean age: 46.5±9.1 years; range, 22 to 66 years) with lung sarcoidosis and 28 healthy controls (6 males, 22 females; mean age: 43.9±5.9 years; range 22 to 60 years) selected from the Turkish population. The polymerase chain reaction was used for genotyping of participants to determine single-nucleotide polymorphisms. Hardy-Weinberg equilibrium, which is considered an important tool for detecting genotyping errors, was tested. Allele and genotype frequencies of patients and controls were compared using logistic regression analysis. Results: The analyses showed no correlation between the tested IFNGR1 single-nucleotide polymorphism (rs2234711) and lung sarcoidosis (p>0.05). The categorization analysis according to the clinical features, laboratory, and radiographic characteristics showed no correlation between the tested polymorphism of IFNGR1 (rs2234711) and these characteristics (p>0.05). Conclusion: The results of the study showed that the tested gene polymorphism (rs2234711) of IFNGR1 was not associated with lung sarcoidosis. More comprehensive studies are needed to verify our results.

Validation of the Turkish Version of the Sarcoidosis Health Questionnaire: A cross-sectional study.

OBJECTIVE AND AIM:  Sarcoidosis, a multisystemic granulomatous disease, generally results in a lower quality of life (QoL) because of its unexpected course and diverse clinical symptoms. The Sarcoidosis Health Questionnaire (SHQ) evaluates the QoL for people with sarcoidosis in terms of their health. This study set out to validate the SHQ in a group of Turkish sarcoidosis patients. METHODS:  The study included a total of 146 adult sarcoidosis patients (63 male and 83 female; mean age, 44±3.6 years; range, 27-63 years) between May 2019 and September 2021. Preparation, forward translation, reconciliation, back translation/back translation review, harmonization, finalization, and proofreading comprised the steps of the testing procedure for translation and cultural adaptation. The participants filled out three questionnaires, including the SHQ, 36-Item Short Form (SF-36) Health Survey, and King's Sarcoidosis Questionnaire (KSQ), and underwent pulmonary function tests (PFTs). RESULTS:  Of the patients, 95% had lung involvement, with a mean number of 1.3 organs involved. Each SHQ component displayed a moderate to high internal consistency, ranging from 0.806 to 0.844. The whole scale's Cronbach's alpha value was 0.781. The SHQ total score significantly correlated with physical component summary (p< 0.001, r=0.360) and mental component summary (p<0.001, r=0.352) scores of SF-36, and the general health status (p< 0.001, r=0.478), medication component (p<0.001, r=0.456), and eye component scores of KSQ (p<0.001, r=0.545). When patients were divided into groups based on organ involvement (p=0.01), oral steroid medication (p<0.001), and types of symptoms (P=0.021), there were significant differences in the total SHQ scores. CONCLUSION:  The Turkish version of SHQ can be a valid and accurate instrument for assessing the health of sarcoidosis patients in Turkey. When combined with normal physiological, radiological, and serological examinations, SHQ can assess the QoL of sarcoidosis patients and give useful new information.

Investigation of effectiveness of reformer pilates in individuals with fibromyalgia: A randomized controlled trial.

INTRODUCTION AND OBJECTIVES: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, sleep disorder, fatigue, other somatic symptoms. Clinical pilates method is therapeutic modality that can be used in improving the symptoms. The aim of this study was to investigate the effectiveness of reformer pilates exercises in individuals with FM and to compare with home mat pilates. MATERIAL AND METHODS: Twenty-eight women (age mean=45.61±10.31) diagnosed with FM were included in this study. Participants were randomly divided into two groups as reformer pilates group (n=14) and home mat pilates group (n=14). Reformer and home mat pilates exercises were given 2 times a week for 6 weeks. The number of painful regions with Pain Location Inventory (PLI), clinical status with Fibromyalgia Impact Questionnaire (FIQ), lower extremity muscle strength with Chair Stand Test, functional mobility with The Timed Up and Go Test (TUG), biopsychosocial status with Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) and quality of life with Short Form-36 (SF-36) were evaluated. All evaluations were assessed before and after treatment. RESULTS: There was a significant difference in FIQ and chair stand test in reformer pilates group, while in PLI, FIQ, BETY-BQ vs. SF-36 Physical Component in home group (p<0.05) compared with baseline. There were no statistical differences between the groups in terms of delta value (p>0.05). CONCLUSIONS: Reformer pilates exercises had positive effects on clinical status and muscle strength while home mat pilates exercises had positive effects on the number of painful regions, clinical status, biopsychosocial status and physical component quality of life. Clinical trial registration number NCT04218630.

Investigation of effectiveness of reformer pilates in individuals with fibromyalgia: A randomized controlled trial / Investigación de la eficacia de pilates con Reformer en personas con fibromialgia: un ensayo controlado aleatorio

Introduction and objectives: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, sleep disorder, fatigue, other somatic symptoms. Clinical pilates method is therapeutic modality that can be used in improving the symptoms. The aim of this study was to investigate the effectiveness of reformer pilates exercises in individuals with FM and to compare with home mat pilates. Material and methods: Twenty-eight women (age mean=45.61±10.31) diagnosed with FM were included in this study. Participants were randomly divided into two groups as reformer pilates group (n=14) and home mat pilates group (n=14). Reformer and home mat pilates exercises were given 2 times a week for 6 weeks. The number of painful regions with Pain Location Inventory (PLI), clinical status with Fibromyalgia Impact Questionnaire (FIQ), lower extremity muscle strength with Chair Stand Test, functional mobility with The Timed Up and Go Test (TUG), biopsychosocial status with Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) and quality of life with Short Form-36 (SF-36) were evaluated. All evaluations were assessed before and after treatment. Results: There was a significant difference in FIQ and chair stand test in reformer pilates group, while in PLI, FIQ, BETY-BQ vs. SF-36 Physical Component in home group (p<0.05) compared with baseline. There were no statistical differences between the groups in terms of delta value (p>0.05). Conclusions: Reformer pilates exercises had positive effects on clinical status and muscle strength while home mat pilates exercises had positive effects on the number of painful regions, clinical status, biopsychosocial status and physical component quality of life. Clinical trial registration number NCT04218630.(AU)

Introducción y objetivos: La fibromialgia (FM) es una condición crónica caracterizada por dolor generalizado, trastornos del sueño, fatiga y otros síntomas somáticos. El método de Pilates clínico es una modalidad terapéutica que se puede utilizar para mejorar los síntomas. El objetivo de este estudio fue investigar la efectividad de los ejercicios de Pilates con aparato (Reformer) y Pilates con colchoneta en casa, en personas con FM. Material y métodos: Se incluyeron 28 mujeres (edad media = 45,61 ± 10.31) diagnosticadas con FM. Las participantes se dividieron aleatoriamente en dos grupos: un grupo de Pilates con aparato (n = 14) y el otro grupo de Pilates con colchoneta casa (n = 14), 2 veces a la semana durante 6 semanas. Se evaluaron el número de regiones dolorosas con Pain Location Inventory (PLI), el estado clínico con Fibromyalgia Impact Questionnaire (FIQ), la fuerza muscular de las extremidades inferiores con la prueba de sentarse y levantarse de una silla, la movilidad funcional con The Timed Up and Go Test (TUG), el estado biopsicosocial con el Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) y la calidad de vida con el cuestionario Corto-36 (SF-36). Las evaluaciones se realizaron antes y después de la intervención. Resultados: Se observaron diferencias significativas en el FIQ y en la prueba de sentarse y levantarse de una silla en el grupo de Pilates con Reformer; a diferencia del grupo de Pilates con colchoneta en casa, las diferencias fueron en las mediciones del PLI, FIQ, BETY-BQ y el componente físico del SF-36 (p < 0,05) comparados con la evaluación basal. No hubo diferencias significativas en valor delta entre los grupos (p > 0,05). Conclusiones: Los ejercicios de Pilates con Reformer tuvieron efectos positivos en el estado clínico y la fuerza muscular, mientras que los ejercicios de Pilates con colchoneta en casa tuvieron efectos positivos en el número de regiones dolorosas, el estado clínico...(AU)

Validity and Reliability of the Turkish Version of the DASH-TR Questionnaire in Rheumatoid Arthritis Patients, Based on Rasch Analysis.

AIM: This study aimed to examine the validity and reliability of the Turkish version of the Disabilities of the Arm, Shoulder and Hand Problems (DASH-TR) questionnaire in rheumatoid arthritis (RA) using the Rasch analysis. METHOD: A total 97 individuals (13 men, 84 women; mean age:51.99 ± 11.12 years, range: 20-65 years) diagnosed as having RA according to the criteria of the American College of Rheumatology were included. The functional status of the upper extremities was evaluated with the DASH-TR questionnaire, patient global health with a visual analog scale (VAS), disease activity with Disease Activity Score 28-C-reactive protein (DAS28-CRP), and disability with Health Assessment Questionnaire (HAQ). DASH-TR was applied to the patients with RA who did not receive any treatment for test-retest at 1-week intervals. DASH-TR results were analyzed using the Rasch analysis. RESULTS: In the sample of patients with RA, it was determined that the DASH-TR scale did not provide a unidimensional structure and the items were collected in two dimensions. The first 20 items and the last nine items were differentiated in the two-dimensional structure, and the factor load of m21 was low. Person separation index was obtained as 0.948. Internal consistency reliability was quite high. A significant positive correlation was found between the DASH-TR and VAS, DAS28 and HAQ. There was excellent test-retest reliability according to the intra-class correlation coefficient (0.921, 95% CI 0.882-0.947; P < 0.001). CONCLUSION: The DASH-TR is a reliable and valid questionnaire and can be used for measurement of functional status of the upper extremities in RA.

Evaluation of the controlling nutritional status score and prognostic nutritional index in patients with familial Mediterranean fever.

OBJECTIVE: Familial Mediterranean fever (FMF) is the most common disease that leads to secondary amyloidosis in Turkish population. The prognostic nutritional index (PNI) and the controlling nutritional status (CONUT) score were recently investigated in many clinical conditions as predictors of disease activity and prognosis of underlying disease. We aimed to evaluate these indexes in FMF patients. METHODS: We included a total of 135 patients with FMF without amyloidosis at baseline. Demographic characteristics, particular attack features, treatment modalities, disease complications of patients, and a follow-up time for each patient were obtained. Disease complications were defined as amyloidosis or end stage renal disease. Baseline laboratory parameters in the attack-free period were used to assess the subclinical inflammation. Spearman's rho correlation analysis was used for numerical variables. Univariate and multivariate logistic regression analyses were used to determine factors that had an impact on the development of amyloidosis. Receiver operating characteristic (ROC) curve analysis was used to discover the appropriate cutoff points of CONUT score and PNI for predicting the development of amyloidosis. RESULTS: ROC analysis revealed that the optimal cutoff points for neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), CONUT score, and PNI were >1.9, >145, >2, and ≤54, respectively. The area under the curve values of CONUT score and PNI for predicting the development of amyloidosis were 0.830 (95% CI: 0.76-0.89, P < .001) and 0.940 (95% CI: 0.88-0.97, P < .001), respectively. Correlation analyses revealed significant positive correlations between CONUT score, NLR, and PLR. The high CONUT score was associated with the development of amyloidosis in FMF patients in addition to age and M694V homozygous mutation. CONCLUSION: Low PNI and high CONUT score at diagnosis may have a poor prognostic value for the development of amyloidosis in patients with FMF in addition to older age and M694V homozygous mutation. These indexes may be a useful and inexpensive screening biomarkers in clinical practice for predicting amyloidosis in patients with FMF.

Efficacy of local oxygen-ozone therapy for the treatment of digital ulcer refractory to medical therapy in systemic sclerosis: A randomized controlled study.

BACKGROUND: This study aimed to investigate the efficacy of local oxygen-ozone therapy in systemic sclerosis (SSc) patients with digital ulcers (DUs) who were resistant to medical therapy and had impairment in activities of daily living. METHODS: Participants' demographic data, and clinical parameters were recorded. Twenty-five SSc patients with DUs were randomized to the ozone group (I) (n = 13) to receive medical treatment plus local oxygen-ozone therapy and the control group (II) (n = 12) to receive medical treatment only. Hand functions were assessed using the Health Assessment Questionnaire (HAQ) and the Modified Hand Mobility in Scleroderma (HAMISm) test. Clinical parameters, HAQ, and mHAMIS scores were re-evaluated in participants 4 weeks after the initiation of treatment. RESULTS: Demographic and clinical characteristics of the two groups showed no significant differences. At 4 weeks after the initial treatment, the efficacy rate was significantly higher in the ozone group than that in the control group (92% versus 42% P = 0.010). Clinical parameters, HAQ, and HAMISm scores were significantly improved in the treatment group compared to those in the control group (P < 0.05). CONCLUSION: Local oxygen-ozone therapy was effective in the treatment of SSc patients with resistant DUs and improved clinical parameters and functional disability.

Validity and reliability of the Turkish version of Psoriasis Epidemiology Screening Tool for the detection of psoriatic arthritis in patients with psoriasis.

Objectives: The Psoriasis Epidemiology Screening Tool (PEST) is a simple and useful questionnaire designed to screen arthritis in patients with psoriasis. This study aims to evaluate the validity and reliability of the PEST questionnaire in Turkish patients with psoriasis. Patients and methods: Between August 2019 and September 2019, a total of 158 adult patients with psoriasis (61 males, 68 females; mean age: 43.1±13.3 years; range, 29.8 to 56.4 years) who were not previously diagnosed with PsA were included. The testing procedure for translation and cultural adaptation was carried out according to the following steps: preparation, forward translation, reconciliation, back-translation/back-translation review, harmonization, finalization, and proofreading. Patients' demographic parameters, comorbidities, PEST, and Toronto Psoriatic Arthritis Screen (ToPAS 2) results were recorded. The patients were, then, assessed by a rheumatologist who was blinded to their PEST scores. The diagnosis of PsA was made according to the Classification criteria for Psoriatic Arthritis (CASPAR). The receiver operating characteristic (ROC) was assessed to obtain the sensitivity and specificity of the PEST questionnaire. Results: Of the patients, 42 had PsA, while 87 did not. Each parameter of PEST showed a low-high internal consistency ranging from 0.366 to 0.781. When the Question 3 was excluded, Cronbach alpha value increased to 0.866. The Cronbach alpha value of the whole scale was 0.829. The test-retest reliability of the Turkish version of PEST was determined as 0.86 for the total score (ICC=0.866 95% CI: 0.601-0.955; p<0.0001). There was a strong positive correlation between PEST and ToPAS 2 (r=0.763; p<0.001) and a moderate positive correlation between PEST and CASPAR (r=0.455; p<0.001). A cut-off value of ≥3 yielded a sensitivity of 93% and a specificity of 89% for the diagnosis of PsA with the highest Youden's index. The PEST scale was found to have a higher sensitivity, but lower specificity in the head-to-head comparison with ToPAS 2. Conclusion: The Turkish version of PEST is a reliable and valid tool for screening PsA in Turkish patients with psoriasis.

The First Effect of COVID-19 Pandemic on Starting Biological Disease Modifying Anti-Rheumatic Drugs: Outcomes from the TReasure Real-Life Database.

OBJECTIVE: The coronavirus disease 2019 pandemic has been resulting in increased hospital occupancy rates. Rheumatic patients cannot still reach to hospitals, or they hesitate about going to a hospital even they are able to reach. We aimed to show the effect of the first wave of coronavirus disease 2019 pandemic on the treatment of biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis or spondyloarthritis. METHODS: Patients were divided into three groups as follows: pre-pandemic (Pre-p: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within 6 months before March 11, 2020); post-pandemic A (Post-p A: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the first 6 months after March 11, 2020); post-pandemic B (Post-p B: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the second 6 months). RESULTS: The number of rheumatoid arthritis patients in the Post-p A and B groups decreased by 51% and 48%, respectively, as compared to the Pre-p group similar rates of reduction were also determined in the number of spondyloarthritis patients. The rates of tofacitinib and abatacept use increased in rheumatoid arthritis patients in Post-p period. CONCLUSION: The number of rheumatoid arthritis and spondyloarthritis patients starting on biological disease-modifying anti-rheumatic drugs for the first time decreased during the first year of the coronavirus disease 2019 pandemic.

Ultrasonographic measurement of the vascular wall thickness and intima-media thickness in patients with Behçet's disease with symptoms or signs of vascular involvement: A cross-sectional study.

OBJECTIVES: This study aims to measure and compare bilateral carotid intima-media thickness (CIMT), bilateral jugular, common femoral, and main portal vein wall thicknesses (VWTs) in Behçet's disease (BD) patients with and without vascular involvement to obtain a cut-off value for vascular complications and determine their relationship with disease activity. PATIENTS AND METHODS: Sixty-three BD patients (41 males, 22 females; median age: 38.0 years; min 20 - max 71 years) and 30 healthy control subjects (14 males, 16 females; median age: 40.3 years; min 21 - max 60 years) were included in this cross-sectional study between February and March 2020. According to imaging findings, BD patients were divided into two groups as those with and without vascular complications. Disease duration, medical treatment and BD manifestations of patients were questioned. Disease activity was evaluated using the Behçet's Disease Current Activity Form (BDCAF) and the Behçet's Syndrome Activity Scale (BSAS). Two radiologists blinded to the diagnosis of BD used ultrasound to measure VWT and CIMT. Receiver operating characteristics were assessed to obtain sensitivity and specificity values for each VWT and CIMT. RESULTS: The groups were similar in terms of age, sex, and body mass index (p>0.05). There was a significant difference between the BD groups when the BDCAF and BSAS scores were compared, while there was no difference between them in terms of disease duration and medical treatment (p>0.05). All VWTs and CIMTs were significantly higher in patients with BD compared to healthy controls (p<0.05). There was no significant difference between the BD groups in terms of CIMT, jugular and common femoral VWTs (p>0.05). But portal VWT was significantly higher in patients with vascular involvement (p<0.05). A cut-off value of ≥1.35 mm yielded a sensitivity of 79.2% and a specificity of 82.4% for the diagnosis of vascular involvement with the highest Youden's index (area under the curve, 0.869; 95% confidence interval, 0.783 to 0.956). CONCLUSION: Portal VWT has high sensitivity and specificity for the screening of vascular involvement in patients with BD.

The relationship of ocular parameters with clinical parameters and disease-related quality of life in patients with systemic sclerosis: A cross-sectional study.

OBJECTIVE: To evaluate choroidal thickness (CT), corneal parameters, and scleral thickness (ST) in patients with systemic sclerosis (SSc) and to determine their relationship with disease-related quality of life (QoL). METHODS: The study included 38 patients with SSc and 40 healthy controls. A detailed ocular examination was performed on all participants. Corneal parameters such as K1, K2, Km, corneal volume (CV), central corneal thickness (CCT), and ST at a distance of 1000, 2000, and 3000 µm from the scleral spur were measured. CT was measured at five points, including the subfoveal area and the temporal and nasal points at radii of 750.0 and 1500.0 µm. The scleroderma health assessment questionnaire (SHAQ) was administered to SSc patients to investigate the disease-related QoL. RESULTS: Individuals with SSc had thicker ST at all distances from the scleral spur (P=0.008, P=0.001, P=0.002, respectively). All corneal parameters were significantly lower in the SSc group than in the control group (P < 0.05). Moreover, SSc patients had significantly lower median CT at N750.0, N1500.0, T750.0, and T1500.0 points and thinner subfoveal CT than healthy controls (P < 0.05). There was a weak-moderate negative correlation between ST and the components of the SHAQ scale and SHAQ-global. CONCLUSION: Despite not having ocular involvement, SSc patients had thicker ST but thinner CT and corneal parameters than healthy controls. This may indicate subclinical inflammation in patients with SSc. Only ST was affected by organ involvement and QoL among the ocular parameters.

Turkish version of modified Hand Mobility in Scleroderma test: A translation and validation study.

OBJECTIVE: Hand Mobility in Scleroderma (HAMIS) is a hand function test used to determine the degree of dysfunction of hand movements. The Modified Hand Mobility in Scleroderma (mHAMIS), on the other hand, was developed later and consists of 4 items. The aim of this study was to determine the reliability and validity of mHAMIS. METHODS: This study included a total of 39 patients with systemic sclerosis (SSc) who were assessed with mHAMIS. The Cronbach's α coefficient, Kappa concordance, and intraclass correlation were respectively used to assess the internal consistency, intra- and inter-observer agreement, and inter-observer reliability of the test. The correlation between the Health Assessment Questionnaire (HAQ), the Duruoz Hand Index (DHI), and the Turkish version of mHAMIS were evaluated. RESULTS: The internal consistency of the test items was between .912 and .939. The total internal consistency of the test was excellent, with a Cronbach's alpha value of .954. The intra- and inter-observer agreement were good, with Kappa values of 0.954 (95% CI 0.89-1.6) and 0.965 (95% CI 0.82-1.4), respectively. The inter-observer reliability was 0.966 (95% CI 0.936-0.982; P<.0001). There was a strong correlation between DHI, HAQ, and mHAMIS (r: .7-.8). CONCLUSION: The Turkish version of the mHAMIS test showed good intra- and inter-observer agreement, intra-observer reliability, and internal consistency. This test is a reliable and valid tool to assess hand functions in Turkish SSc patients.

A single center experience: physician related diagnostic delay and demographic and clinical differences between patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis.

Background. A large number of comparative studies have been conducted for ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA), including disease burden, treatment modalities and patient characteristics. The aim of this study was to compare physician related diagnostic delay time between patients with AS and nr-axSpA. Methods. In our retrospective study we included 266 patients with axSpA. Patients were classified into two subgroups, AS and nr-axSpA. The time from back pain onset until diagnosis of axSpA was defined as the diagnostic delay. The first specialist referred to and the first diagnosis for each patient was noted in detail. Patient characteristics, clinical manifestations and laboratory and imaging results at diagnosis were also compared between subgroups. Results. The diagnostic delay time was significantly longer for AS patients [6 ± 8.14 years vs 1.62 ± 2.54 years]. 40.9% of all patients were initially consulted by specialists in physical therapy and rehabilitation, followed by 29.7% consulted by a neurosurgeon and 19.9% by a rheumatologist. The most common initial diagnosis was fibromyalgia, 52.6% (140), followed by ankylosing spondylitis, 28.9% (77), and lumbar disc hernia, 12.7% (34). Conclusion. The vast majority of patients were initially evaluated by healthcare providers other than rheumatologists and mostly diagnosed with fibromyalgia. Efforts to increase awareness and to educate first healthcare providers may shorten the diagnostic delay time.

Effects of clinical Pilates exercises in individuals with fibromyalgia: A randomized controlled trial.

OBJECTIVE: This study aimed to investigate the effects of clinical Pilates exercises in patients with fibromyalgia (FM) and to compare the effects of one-to-one and group-based exercise methods. METHODS: A total of 42 women (mean age, 50.90±7.78 years) with FM were included. The participants were randomly divided into 2 groups (one-to-one exercise, n=16; group-based exercise, n=26). Disease impact was evaluated with the FM Impact Questionnaire, functional status with the Health Assessment Questionnaire, anxiety with the Beck Anxiety Inventory, quality of life with short form-36, and biopsychosocial status with the Bilissel Egzersiz Terapi Yaklasimi-biopsychosocial questionnaire. All the evaluations were performed pre- and post-treatment. Clinical Pilates exercises were carried out 2 days a week for 6 weeks. RESULTS: When the pre- and post-treatment data were compared, significant improvement was seen in all parameters in the group-based exercise group; in the one-to-one exercise group, improvement was noted in disease impact, quality of life, and biopsychosocial status. When post-treatment data were compared, only disease impact was significant for the one-to-one exercise group. Effect size results were found to be moderate and high for both methods. CONCLUSION: For clinical Pilates exercise in FM, one-to-one method was suggested to have high disease impact and low quality of life, whereas group-based exercise method showed high anxiety.

Levels of Carbohydrate Antigen 125 in Patients With Adult Onset Still Disease: A Case Report.

Adult onset Still disease (AoSD) is a rare systemic polygenic non-familial autoinflammatory disease. There is no specific biological parameter for diagnosis of AoSD today. This paper presents a case series of three patients with AoSD who had elevated baseline levels of carbohydrate antigen 125 (CA 125). The clinical course of patients was favorable with treatment modalities including steroids and non-steroidal anti-inflammatory drugs. After a comprehensive literature search, it appears that this is the first paper on the association between AoSD and CA 125.