Demographic and clinical characteristics of patients with sustained and switching treatments using biological and targeted synthetic disease-modifying antirheumatic drugs: A multicenter, observational cross-sectional study for rheumatoid arthritis

Introduction Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results The study included a total of 565 patients. The mean age was 53.7 +/- 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment.Turkish Medicine and Medical Devices Agency ; Ankara Numune Egitim ve Arastirma Hastanes

Quality of life ın psoriatic arthritis patients-association with disease activity and diagnostic delay time

Karkucak, Murat/0000-0002-4348-8398;WOS: 000346628200010Objective: the purpose of this study was to determine the socio-demographic and clinical characteristics of 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 (DAS-28), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)] and laboratoly [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 I year (mnin-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

Fibromiyaljili hastalarda sosyodemografik özellikler, klinik bulgular ve yaşam kalitesi

Amaç: Fibromiyalji (FM) hastalarının sosyodemografik, klinik özellik- leri ve yaşam kalitesini değerlendirmeyi amaçladık. Gereç ve Yöntem: Fibromiyalji tanısı almış 37 kadın hasta ve 31 sağ- lıklı kadın çalışmaya alındı. Bireylerin demografik özellikleri sorgulan- dı. Hastaların ve kontrol grubunun fizik muayenesinde hassas nokta sayısı (HN), deri kıvrım hassasiyeti, kutanöz hiperemi ve retiküler cilt değişikliği değerlendirildi. Bireylerin ağrı şiddeti Görsel Ağrı Skalası (GAS), psikolojik durumları Beck Depresyon Ölçeği (BDÖ), yaşam ka- litesi Kısa Form-36 anketi (KF-36), fonksiyonel durumları Fibromiyalji Etki Sorgulama Formu (FES) ile değerlendirildi. Bulgular: Fibromiyaljili hastaların yaş ortalaması 39.2±6.5, kontrol grubunun 39.1±6.2 idi. FM’li hastalarda en sık yorgunluk (%94.6), uyku bozukluğu (%86.5), anksiyete (%86.5) semptomları tespit edildi. FM hastaları ile kontrol grubu arasında HN (p=0.001), GAS (p=0.001), FES (p=0.001), BDÖ (p=0.001) ve KF-36 (p=0.003) açısından anlamlı farklılık saptandı. İki grup arasında FES alt grupları açısından anlamlı farklılık mevcut idi ( p<0.001). KF-36 alt gruplarının karşılaştırmasın- da gruplar arasında fiziksel fonksiyon (p=0.001), ağrı (p=0.005), genel sağlık (p=0.017), zindelik (p=0.003), mental sağlık (p=0.008) açısın- dan anlamlı farklılık tespit edildi. Sonuç: Fibromiyalji farklı klinik özelliklere sahiptir. FM’li hastalarda fonksiyonel kapasite ve yaşam kalitesi düşük tespit edilmiştir. Bu yüzden hastaların sosyodemografik özellikleri ve yaşam kalitesinin değerlendirilmesi hastalığın tanı, tedavi ve takibinde önemli olabilir.Objective: We aimed to evaluate the sociodemographic and clinical characteristics as well as the quality of life of patients with fibromy- algia (FM). Materials and Methods: A total of 37 female patients diagnosed with FM and 31 healthy females were included into the study. In- dividuals were asked about their demographic characteristics. The number of sensitive points (NSP), skin fold sensitivity, cutaneous hy- peremia and reticular skin changes of patients and healthy controls were evaluated during physical examination. Individuals were evalu- ated for pain severity using the Visual Analogue Scale (VAS), for psy- chological 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 anxi- ety (86.5%). Differences between FM patients and controls were sta- tistically 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' sociodemo- graphic characteristics and the evaluation of their quality of life may be important in the diagnosis and monitoring of treatment progress

Trabzon'da Ayaktan Poliklinik Merkezimize Başvuran Hastalarda Kemik Mineral Yoğunluğu ile Osteoporoz Risk Faktörleri Arasındaki İlişki

Amaç: Bu çalışmada amacımız Trabzon ilinde ayakta tedavi kliniğine başvuran hastalarda osteoporoz (OP) risk faktörlerinin kemik mineral yoğunluğu (KMY) ile ilişkisini belirlemektir.Gereç ve Yöntem: Çalışmaya OP veya osteopeni tanılı 201 hasta dahil edildi. Hastaların sosyodemografik özellikleri kaydedildi ve standardize araştırma formu araştırmacı hekim tarafından dolduruldu. KMY ölçümleri dual enerji X-ray taraması ile lomber omurga ve femur boynundan yapıldı.Bulgular: Hastaların yaş ortalaması 61,47±10,57 yıl (182 kadın/19 erkek) idi. Yüz on beş hasta (%57,2) osteoporotik, 86 hasta (%42) osteopenikti. Yaş ile femoral T skorları arasında negatif yönde anlamlı korelasyon bulundu. Gebelik sayısı lomber T skorları ile negatif yönde anlamlı korelasyon gösterdi. Vücut kitle indeksi ve günlük çay tüketimi ile femoral T skorları arasında ihmal edilebilir pozitif yönde korelasyon tespit edildi. Menarş yaşı, menopoz yaşı, toplam laktasyon süresi, ve günlük kalsiyum tüketimi ile KMY arasında herhangi bir korelasyon bulunmadı.Sonuç: OP için yöresel risk faktörlerinin tanımlanması klinik uygulamalarda hastaların OP risk yönetimine faydalı olabilirObjective: 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 practic

Local steroid injection accompanied by ultrasonographic imaging in the treatment of

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. J Clin Exp Invest 2014; 5 (1): 126-12

The Relationship of Osteoporosis Risk Factors with Bone Mineral Density in Patients Admitted Our Outpatient Clinic in Trabzon

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

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey

WOS: 000367258400020PubMed ID: 25736952BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p < 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p < 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles

Relationship between pulse wave velocity and serum YKL-40 level in patients with early rheumatoid arthritis

Karkucak, Murat/0000-0002-4348-8398WOS: 000325962100007PubMed: 23797781Subclinical atherosclerosis has been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs of cardiovascular disease (CVD). the aim of this study was to investigate the relationship between serum YKL-40 level and arterial stiffness in patients with ERA. Forty two patients with ERA and 35 healthy controls with no history or current sign of CVD were included in the study. ERA patients with active disease, defined as DAS28 a parts per thousand yen3.2, and symptoms onset < 12 months were recruited. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (CF-PWV), and the intima-media thickness carotid (IMT-C) was measured by carotid ultrasonography. Serum YKL-40 levels were measured by an enzyme-linked immunoassay method. the mean age was 43.1 +/- A 5.8 years in ERA patients and 41.0 +/- A 5.9 years in control group. the CF-PWV and IMT-C of the ERA patients were determined significantly higher than the control group (P = .001, P < .001, respectively). YKL-40 levels were significantly elevated in ERA patients than controls (P = .008). the serum levels of YKL-40 in the ERA patients showed a strong correlation with CF-PWV (r = .711, P < .001) and IMT-C (r = .733, P < .001). Multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels (adjusted RA(2)A = .493, P < .001). We have shown that patients with ERA had increased CF-PWV and serum YKL-40 levels. in addition, there was an association between CF-PWV values and serum YKL-40 levels in patients with ERA. As a result, we believe that serum YKL-40 level and CF-PWV might reflect early atherosclerosis in patients with ERA

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey

WOS: 000367258400020PubMed ID: 25736952BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p < 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p < 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles

Effects of black soldier fly meal feeding on rainbow trout gut microbiota, immune-related gene expression, and Lactococcus petauri resistance

Providing a sustainable and affordable food supply is one of the most significant challenges facing the global aquaculture industry. Black soldier fly (BSF), Hermetia illucens, meal is a particularly promising alternative to animal-derived protein sources. Following a 90-day feeding experiment with four different diets containing BSF meal with increasing fish meal replacement levels of 25%, 50%, 75%, and 100%, designated as B25, B50, B75, and B100, and a control diet (B0) without BSF meal, the gut microbiota, immune-related gene expression, and Lactococcus petauri resistance of rainbow trout (Oncorhynchus mykiss) were studied. Regardless of diet, rainbow trout intestinal microbiota were different from those in water. In the intestinal mucosa, Fusobacteria, Firmicutes, and Proteobacteria were among the most prevalent taxa. Rainbow trout fed with a BSF-containing diet had a higher bacterial diversity in their gastrointestinal tract than fish fed with a control diet. The abundance of Firmicutes, Actinobacteria, and Proteobacteria increased in tandem with the replacement rate of fish meal with BSF meal. The B75-fed fish were found to be the most resistant group to L. petauri, followed by the groups fed with B100, B50, and B25. Compared to the control group, the expression of cytokines (Tgf, Il-10, Il-1β, Tnf − α, and Il-8) and immune-related genes (IgM, IgT, Mhc-II, and Tlr-5) increased significantly (P < 0.05) in all fish groups fed with a BSF-containing diet. Substituting fish meal with BSF meal beyond 50% enhanced the survival rates of fish infected with L. petauri. Furthermore, BSF-containing diets boosted the immune system and cytokine-related genes in fish. Due to improved survival and immunity, rainbow trout may be fed a 50% BSF meal substituted diet without removing chitin or pre-treating BSF meal