IntroductionThe aim of the study was to investigate whether there is a relationship between the European League Against Rheumatism (EULAR) outcome measures and quality of life (QoL), fatigue, anxiety and depression in patients with pSS and to define determinants which could affect quality of life.Material and methodsThe study included 105 pSS patients and 72 age/sex-matched healthy controls (HCs). Cross-sectional clinical data were collected, including the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Assessment of Fatigue (MAF) scale, the Short Form (SF-36), EULAR Sjögren’s syndrome disease activity index (ESSDAI) and EULAR Sjögren’s syndrome patient reported index (ESSPRI).ResultsThe SF-36 scores were significantly lower and anxiety, depression and fatigue scores were significantly higher in the pSS group than in the control group (all p-value < 0.05). ESSDAI was negatively correlated with SF-36 scores and positively with MAF. ESSPRI was negatively correlated with SF-36 scores except for the mental health subdimension, and a positive correlation was determined with MAF, HADS-A and HADS-D. Multiple linear regression analysis revealed that HADS-A, HADS-D, MAF, ESSPRI and ESSDAI were associated with most SF-36 subscales.ConclusionsThe results of this study provide further evidence supporting the use of ESSDAI and ESSPRI in daily practice. Quality of life was diminished in patients with pSS and was associated with different symptoms. This should be taken into account when managing patients with pSS.
Background: To investigate the link between carbamylated low-density lipoprotein (ca-LDL), atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk indices I and II (CRI I and II) and subclinic atherosclerosis in psoriatic arthritis (PsA). Methods: Thirty-ninepatients and 19 age, sex, body mass index matched healthy controls were included. Insulin resistance (IR) was assessed with homeostasis of model assessment-IR (HOMA-IR). Carotid intima-media thickness (CIMT) was measured at both common carotid arteries and mean CIMT was calculated. Results: The mean age was 49.50 ± 11.86 years and 64.1% were females in PsA group. In the PsA group, CIMT and HOMA-IR were significantly higher (p = 0.003, p = 0.043, respectively). AIP, AC, TG/HDL, CRI-1, CRI-2 and ca-LDL levels were similar between groups. In PsA group, CIMT was positively correlated with HOMA-IR, TG/HDL and AIP. Although ca-LDL was positively correlated with serum amyloid A (r = 0.744, p < 0.001), no correlation was detected between ca-LDL and CIMT (r = 0.215, p = 0.195). PsA patients with IR tended to have higher ca-LDL levels than patients without IR, but this difference lacked statistical significance (33.65 ± 26.94, 28.63 ± 28.06, respectively, p = 0.237). Conclusions: A significant increase in CIMT was seen in PsA patients without clinically evident cardiovascular disease or any traditional atherosclerosis risk factors. CIMT was correlated with HOMA-IR, TG/HDL and AIP.
The aim of the study was to investigate the effect of systemic sclerosis (SSc) on quality of life and sexual function in female patients. Materials and methods: The study included 30 sexually active female patients with SSc and 30 healthy control subjects. For all participants in both the patient and control groups, the female sexual index and SF-36 forms were completed and a detailed medical and sexual history was taken. Results: The mean age was 45.03 ± 9.22 years in the SSc group and 44.6 ± 11.52 years in the control group (P = 0.87). The SF-36 scores in the patient group were significantly lower than those in the control group. Sexual dysfunction was found in 26/30 (86.6%) of the SSc patients and in 6/30 (20%) of the control group (P = 0.0001). Significant differences were determined between the groups with respect to sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and pain. There was no significant relationship between the subgroups of SSc patients, duration of disease, lung involvement, and FSFI scores. Conclusion: Sexual dysfunction and lower health quality are common problems in female patients with systemic sclerosis.
In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.
Behçet's disease (BD) is a chronic inflammatory disease. The etiopathogenesis of BD is not well understood and several cytokines and genetic factors have been investigated. Interleukin (IL)-37, which a member of IL-1 family is an anti-inflammatory cytokine. The aim of the study was to analyze serum IL-37 level and IL-37 gene polymorphisms to assess its possible role in BD. Two hundred twenty-three patients with BD and 80 healthy controls (HC) were enrolled. Serum IL-37 level was measured using an enzyme-linked immunosorbent assay (ELISA). Deoksiribo Nucleic acids (DNA) were extracted using a genomic DNA isolation kit. Single nucleotide polymorphism (SNP) of IL-37 gene (rs3811047) was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) methods. Serum IL-37 level was not significantly different in BD and HC (p > 0.05). Serum IL-37 level was not associated with the disease activity (p > 0.05). However, its level was higher in mucocutaneous involvement compared with systemic involvement (p = 0.002) and HC (p = 0.005). IL-37 gene polymorphisms were similar in BD and HC (p > 0.05). IL-37 may play a role in the etiopathogenesis of BD by contributing to manifestation with more moderate clinical symptoms.
Background Positioning of the patient is a common strategy to increase oxygenation in the management of acute respiratory distress syndrome. The aim of this study is to demonstrate the effects of our positioning approach on disease outcomes in COVID‐19 patients with respiratory failure, by comparing patients compliant to positioning and not. Methods COVID‐19 patients who were admitted to our internal medicine inpatient clinic and developed hypoxaemia and underwent positioning during hospital stay were retrospectively investigated for compliance to positioning. Rates of mortality, intensive care unit admission, intubation, initiation of anti‐inflammatory treatment and length of hospital stay were compared between patients with and without compliance to positioning. Results A total of 144 patients were enrolled in this study (97 compliant with positioning, 47 incompliant with positioning). Rates of ICU admission (7.2% vs 25.5%, p < .001), anti‐inflammatory treatment initiation (68% vs 97.9%, p < .001) and length of hospital stay (5 (2‐16) days vs 12 (3‐20) days, p < .001) were significantly reduced in patients compliant with positioning. Conclusion Prone or other positioning should be considered in patients with noninvasive oxygen support for the potential to reduce rates of intensive care unit admissions, airway interventions, anti‐inflammatory treatment initiation and mortality.
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