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IntroductionThis study aimed to evaluate the diagnostic distribution, demographic characteristics, and medication adherence of elderly patients with rheumatic diseases (RD) and to contribute to improving adherence rates and patient outcomes in this demographic group by examining the factors affecting treatment adherence.MethodsThis cross-sectional observational study included 108 patients aged >65 years diagnosed with RD. Data on demographic characteristics, disease characteristics, comorbidities, and medication use were collected. Medication adherence was assessed using the Morisky Medication Adherence Scale-8 and the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression levels.ResultsThe median age of the participants was 70.5 years, with 69.4% female predominance. The most common diagnoses were rheumatoid arthritis (41.67%), gout (14.81%), and polymyalgia rheumatica (11.11%). Good adherence was associated with higher social support [odds ratio (OR): 4.99, 95% confidence interval (CI): 1.45-17.11], lower medication count (OR: 0.78, 95% CI: 0.63-0.95), and lower HADS scores (OR: 0.93, 95% CI: 0.87-0.98). Forgetfulness was the leading cause of non-adherence, as reported by 40.7% of patients.ConclusionThis study highlights that social support, polypharmacy, and mental health significantly affect medication adherence in elderly patients with RD. Medication adherence remains an important factor in the effective management of RD, and demographic factors, such as comorbidities and socioeconomic status, play influential roles.

Objectives: Spondyloarthritis (SpA) is a chronic inflammatory arthritis that mainly affects the sacroiliac joints and spine. Despite effective biological treatments, persistent pain is common in SpA patients, potentially due to central sensitization (CS), a condition of heightened central nervous system responsiveness. The purpose of this study was to investigate the link between disease activity and CS in SpA patients on biological therapy. Patients and Methods: One hundred and twenty SpA patients with at least six months of treatment with biological agents were included in this cross-sectional study. Patients’ demographic, clinical, and functional information were collected. The assessment of CS was conducted using the Central Sensitization Inventory (CSI), whereas disease activity and quality of life were evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP), and Ankylosing Spondylitis Quality of Life (ASQoL). Statistical analyses included correlation assessments and logistic regression to identify predictors of CS. Results: CS (CSI ≥ 40) was present in 40.8% of patients. Disease activity was significantly higher and quality of life was lower in patients with CS. BASDAI and ASQoL scores were strongly correlated with CS (r = 0.774 and r = 0.839, respectively). Logistic regression identified ASQoL and BASDAI scores as independent predictors of CS. ROC curve analysis demonstrated that ASQoL had the highest discriminative ability for predicting CS (AUC = 0.97). Conclusions: CS is significantly associated with higher disease activity and poorer quality of life in SpA patients receiving biological therapy. Incorporating CS assessment into routine clinical practice may enhance our understanding and management of persistent symptoms in SpA, improving patient outcomes.

There may be many confounding factors contributing to the QoL, when the whole body is evaluated with a non-specific HRQoL instrument.9 Additionally, treatment modalities and approach should be different among the body sites of involvement. [...]a site- and disease-specific QoL instrument can provide a more reliable approach. [...]there is a lack of an evaluation system concerning the social support dimension, which is a crucial component of HRQoL instruments.2 As a result, a comprehensive, disease-specific, and site-specific instrument may improve the ability to clinically characterize HRQoL in patients with knee and/or hip osteoarthritis. [...]the committee reached a consensus for the pre-final version: All items of the back-translated form were agreed with the original ones. [...]the Turkish version of Mini-OAKHQoL was prepared for the validation study.

Familial Mediterranean fever (FMF) and spondyloarthritis (SpA) may show several common signs. This study aimed to evaluate the frequency of SpA and its manifestations in FMF, the impact of SpA on FMF, and the associations of non-episodic findings (heel enthesitis, protracted arthritis, and sacroiliitis) with the FMF features. Demographic, clinical, imaging, and genetic data were retrieved from medical records of the patients with adult FMF. To identify patients who met the classification criteria for SpA, data including rheumatologic inquiry were recorded. Patients with SpA and those who did not meet the criteria were compared in terms of FMF features. Regression analyses were performed to determine the factors that were most associated with sacroiliitis, enthesitis, and protracted arthritis. Of the 283 patients with FMF, 74 (26.1%) met the SpA criteria (64 axial, 10 peripheral); and 65 (22.9%) patients had sacroiliitis, 27 (9.5%) protracted arthritis, and 61 (21.6%) heel enthesitis. Patients with SpA were older and had more FMF severity, and heel pain rate than those without; however, genetic features, CRP, resistance to colchicine, and heel enthesitis did not differ. A meaningful number of patients without SpA had also displayed heel enthesitis, protracted arthritis, inflammatory back pain, heel pain, family history of SpA, and elevated CRP. Age was found to be the main predictor of heel enthesitis and protracted arthritis was linked with FMF severity. A significant number of patients with FMF meet the peripheral SpA classification criteria as well as axial SpA. SpA and its shared manifestations with FMF may have an impact on FMF.

Ongoing pain, paroxysmal and evoked pain and the pain intensity can be measured by VAS.6 The PDQ is a self-report scale that is used to distinguish the NP from other types of chronic pain without requiring a clinical examination.7 The PDQ displays good psychometric properties in RA, PsA and axial spondyloarthropathies.8 The NP can occur in rheumatic diseases due to compression syndromes, comorbidities, vasculitis or drugs used as treatment. [...]in this study, we aimed to examine the presence of NP in PsA and its relationship with functional parameters. [...]post hoc power analysis of this study was performed. The demographic data (age, sex, height, weight, body mass index [BMI]) and clinical parameters (disease duration, type of PsA, active/ latent psoriasis, presence of dactylitis, major organ involvement, erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) of the patients were noted.

Objective: The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. Methods: The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. Results: Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. Conclusion: The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.

ObjectivesRheumatoid arthritis (RA) is an autoimmune disease of unknown exact cause, characterized by chronic inflammation. The prognostic nutritional index (PNI), reflecting albumin concentration and lymphocyte count, is a newly established inflammation-based nutritional score. This study aimed to determine the relationship between PNI and disease activity in RA patients.Patients and methodsThis cross-sectional study included 138 RA patients who met the 2010 revised criteria of the American College of Rheumatology (ACR) for RA. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count in the peripheral blood (per mm3). The study population was divided into two groups: DAS28-ESR ≤ 3.2 (group 1 with remission and low disease activity) and DAS28-ESR > 3.2 (group 2 with moderate and high disease activity).ResultsA total of 138 patients with a mean age of 52.1 years were recruited. While the female gender was more prevalent in both groups, it was significantly higher in group 2 (p < 0.05). Group 2 exhibited a lower PNI compared to those in group 1 (42.17 ± 3.46 vs. 44.02 ± 2.92; p = 0.001). Multivariate logistic regression analyses revealed that PNI was an independent predictor of disease activity (OR, 0.850; 95% CI, 0.735–0.983; p = 0.029). ROC curve analysis determined that the optimal cutoff value of PNI for disease activity was 43.01, with a sensitivity of 69.1% and specificity of 57.7% (AUC, 0.66; 95% CI, 0.57–0.75, p = 0.001).ConclusionThis study demonstrates that the simple and readily available PNI could serve as an independent predictor of disease activity in rheumatoid arthritis patients. Key Points•The relationship between disease activity and the prognostic nutritional index, which is a nutritional indicator, in rheumatoid arthritis patients was investigated.•It has been shown that there is a connection between low PNI and high disease activity.•It has been shown that PNI can be used to evaluate disease severity with a simple calculation.

[...]there is a need for simple instruments that can be used to evaluate sleep disturbance in RA patients.10 The Jenkins Sleep Evaluation Scale (JSS) is a well-known instrument which can be used to evaluate sleep disturbances in patients relative to the disease and the intensity of the disturbance they may experience. [...]in this study, we aimed to assess the validity and reliability of the JSS when applied to a Turkish population with RA. [...]no further adaptations were needed.28 The JSS-TR is shown in the Appendix. According to these results, JSS-TR was found to have content validity.

Gastrointestinal (GI) involvement is highly prevalent in systemic sclerosis (SSc) and significantly affects patient quality of life and clinical outcomes. This study investigates the potential of undernutrition scores, namely the Control of Nutritional Status (CONUT) score and the Prognostic Nutrition Index (PNI), in predicting GI involvement in patients with SSc. A total of 82 patients diagnosed with SSc were enrolled in this cross-sectional study. Participants were evaluated using the UCLA Scleroderma Clinical Research Consortium Gastrointestinal Tract 2.0 (UCLA GIT 2.0) tool, which assesses the severity of GI symptoms and their impact on health-related quality of life. Malnutrition was assessed using CONUT and PNI scores derived from routine laboratory parameters. The correlation between these malnutrition indices and the UCLA GIT 2.0 scores was analyzed to determine the predictive value of malnutrition in GI involvement. The study found that patients with higher CONUT scores, indicating malnutrition, had significantly higher total UCLA GIT 2.0 scores. A moderate positive correlation was observed between CONUT scores and total UCLA GIT 2.0 scores ( r  =.539; p  <.01), while a negative correlation was found between CONUT scores and PNI ( r  = −.513; p  <.01). These findings suggest that malnutrition, as measured by CONUT and PNI, is associated with greater GI involvement in SSc. This study shows that malnutrition indices such as CONUT and PNI in SSc patients, together with the UCLA GIT 2.0 score, may serve as usefull predictors of GI involvment in routine clinical practice. Key-points (1) We investigated the relationship between the UCLA GIT 2.0 score, which assesses GI involvement in patients with systemic sclerosis (SSc), and the CONUT score and PNI, indicators of malnutrition. (2) In the study, a negative correlation was detected between UCLA GIT 2.0 scores and CONUT score and a positive correlation was found with PNI. (3) CONUT and PNI scores derived from routine laboratory parameters provide a simple and effective method to assess malnutrition and predict GI complications in SSc patients.

Psoriatic arthritis (PsA) is an inflammatory disease with a high prevalence of cardiovascular (CV) events due to traditional cardiovascular risk factors and increased systemic inflammation. In this review, our objectives were to (i) evaluate the cardiovascular events and risk factors and (ii) investigate the relationship between autonomic dysfunction and CV diseases in PsA. A systematic review of the literature was done on the Medline/PubMed, Scopus, and the Directory of Open Access Journals databases between January 2017 and July 2022. After screening and exclusions, 73 studies were included for the final review. Patients with PsA have a greater risk of CV diseases and increased traditional CV risk factors, including hypertension, diabetes mellitus, obesity, metabolic syndrome, and dyslipidemia. Although autonomic dysfunction is more common in PsA than in the general population, its relationship with increased CV diseases in these patients is still unclear. Limitations in explaining CV risk in these patient groups complicate patient assessment as cardiovascular risk factors are linked to the morbidity and mortality of PsA, and it is essential to improve an optimal screening and management strategy for CV disease. All CV risk scoring systems cannot fully assess the CV risk in these patients, so in addition to scoring systems, carotid ultrasound evaluation may be a part of the CV evaluation.Key Points• Psoriatic arthritis is associated with an increased risk of cardiovascular disease due to traditional cardiovascular risk factors, increased systemic inflammation, and autonomic system dysfunction, although not fully demonstrated.• The autonomic nervous system is crucial in regulating cardiovascular disease through its effect on the heart, blood vessels, and kidneys. Although the relationship between autonomic dysfunction and cardiovascular diseases has been shown, this relationship is still unclear in PsA.