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To evaluate musculoskeletal system-related complaints; identify regions at risk in dentists by observing and inquiring the dentists at work; and find out the associations with age, sex, working years, academic position and departments, positions during work and daily working hours. Modified Nordic Questionnaire (m-nMQ) was used to evaluate pain, hospital admissions and absenteeism. Quick Exposure Check (QEC) form was utilized to assess risk exposure levels related with low-back, neck, hand-wrist and shoulder-arm. 163 dentists were included the most painful regions were found to be back (66.9%), neck (65%) and low back (64.4%). Musculoskeletal symptoms were more prevalent in women and research assistants. QEC scores were found to be lower in those who performed regular exercises. Dentists should be educated about ergonomics at the beginning of their professional life.

After baseline assessments, the patients were randomized into two groups: the supervised exercise group (SEG) and the home exercise group (HEG) as the control group. PATIENTS AND METHODS This single-blind, prospective, randomized-controlled study included a total of 48 female FMS patients (mean age: 43 years; range, 19 to 64 years) diagnosed according to the 2010 American College of Rheumatology (ACR) classification criteria who presented at the outpatient clinic of the Physical Medicine and Rehabilitation Department of Gazi University Faculty of Medicine between April 2018 and October 2018. Inclusion criteria were as follows: age between 18 and 65 years, with at least eight years of formal education, and chronic pain of an intensity of =4 cm on a 0-10 cm Visual Analog Scale (VAS) for pain within the past seven days. Clinical assessment Age, sex, height, weight, body mass index, time since diagnosis of the disease, marital status, level of education, occupational characteristics, medications used and any comorbid diseases of each participants were recorded.

The study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) in patients with familial Mediterranean fever (FMF) and to assess the relationships between FMF characteristics and severe COVID-19 outcomes such as hospitalization. The study was planned within a national network of 21 different centers. Demographics, FMF-related clinical and genetic characteristics, and COVID-19 outcomes were obtained. A total of 822 patients with FMF (mean age of 36 years) were included in the study. Fifty-nine of them (7%) had a COVID-19 diagnosis confirmed by real-time PCR test or chest CT findings. Most FMF patients with COVID-19 (58) had mild and moderate disease activity. All patients were on colchicine treatment. However, 8 of them (13.6%) were not compliant with colchicine use and 9 of them (15.3%) were colchicine resistant. Twelve FMF patients with COVID-19 were hospitalized. There were 4 patients requiring oxygen support. COVID-19 related complications were observed in 2 patients (1 thromboembolism, 1 acute respiratory distress syndrome). Hospitalized COVID-19 patients with FMF were older than non-hospitalized patients (median ages: 51 and 31 years, respectively; p: 0.002). Other FMF-related characteristics were similar between the groups. FMF-related characteristics were not found to be associated with poor outcomes in COVID-19. Thus, FMF may not be a risk factor for poor COVID-19 outcomes.

The aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine.

Aims: The aim of the this study is to evaluate beta-2-microglobulin (B2M) levels in patients with primary Sjogren's syndrome (pSS) and to investigate their correlation with serum biomarkers and disease activity indexes commonly used in daily clinical practice. Methods: Eighty-one patients with pSS were included in this retrospective and cross-sectional study. Demographic data, clinical characteristics, B2M, immunoglobulin (Ig) A, IgG, IgM, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum complement (C) 3 and C4 levels, anti-nuclear antibody, rheumatoid factor (RF), anti-SSA and anti-SSB antibodies were obtained from the medical records. Disease activity was evaluated by the European League Against Rheumatism (EULAR) SS Disease Activity Index (ESSDAI) and EULAR SS Patients Reported Index (ESSPRI). Results: Serum B2M level was significantly higher in patients with anti-SSA and anti-SSB antibody (median: 2.64 mg/dL, minimum: 2.02 mg/dL, maximum: 10.10 mg/dL) than in only anti-SSA positive patients (median: 2.31 mg/dL, minimum: 1.33 mg/dL, maximum: 4.26 mg/ dL, p=0.010) and both antibody negative patients (median: 1.80 mg/dL, minimum: 1.20 mg/ dL, maximum: 2.65 mg/dL, p<0.001). Also, patients with anti-SSA antibody have significantly higher serum B2M levels than anti-SSA and anti-SSB antibodies negative patients (p=0.009). Serum B2M level was significantly correlated with ESSDAI (r=0.482, p=0.001), serum IgG level (r=0.374, p=0.001), IgA level (r=0.341, p=0.002), RF levels (r=0.412, p=0.021) and ESR (r=0.239, p:0.031). There was no correlation between ESSPRI, IgM, CRP and serum B2M levels. ESSDAI was not correlated with C3 (r=0.044, p=0.697), C4 (r=-0.053, p=0.640), ESR (r=0.111, p=0.326), CRP (r=0.111, p=0.324) and IgG (r=0.154, p=0.169). Conclusions: Although serum B2M levels were higher in autoantibody positive patients, it has a weak correlation with clinical disease activity. Keywords: Primary Sjogren's syndrome, beta-2-microglobulin, ESSDAI, ESSPRI, biomarkers

Data collection was provided from a national network database system, and 3,532 IRD patients (2,359 males, 1,173 females; mean age: 48.7±13.9 years; range; 18 to 90 years) were analyzed. Mortality rates have been reported to be about 2% in the general population.4 The patient's immune response has an essential role in the resolution of COVID-19, but it also plays a role in the development of cytokine storm syndrome with abnormal production of proinflammatory cytokines, mostly in more severe patients. Surveys about the relationship between IRD and COVID-19 throughout the pandemic have reached inconsistent outcomes.5,6 Management of the SARS-CoV-2 infection process in those with inflammatory diseases during the pandemic and continuation of DMARDs represented a difficult challenge for physicians in the field of rheumatic diseases. [...]this study aimed to assess the clinical outcomes and management of rheumatic therapies and risk factors for severe COVID-19 in patients with IRD of a national cohort. [...]infections can alter the course of autoimmune diseases and increase the risk of mortality. [...]it is important to establish a clear opinion of the interaction between viral infections and IRD.6 While IRD is predominantly characterized by musculoskeletal involvement, it is a wide spectrum of diseases that can affect many different tissue and organ systems.

The aims of this study were to investigate the main clinical and laboratory features, including pregnancy and genetic analysis, of Turkish Familial Mediterranean Fever (FMF) patients and to analyze the relationships between genotypic features, age of disease onset, clinical findings, and disease severity. A study was planned within a national network of 22 different centers. Demographics, clinical and laboratory findings, attack characteristics, drugs, pregnancy and birth history, disease severity, and gene mutation analyses were evaluated. Disease severity, assessed using a scoring system developed by Pras et al., was evaluated in relation to gene mutations and age of disease onset. A total of 979 patients (643 females and 336 males; mean age: 35.92 ± 11.97 years) with FMF were included in the study. Of a total of 585 pregnancies, 7% of them resulted in preterm birth and 18.1% resulted in abortions. During pregnancy, there was no FMF attack in 61.4% of patients. Of the MEditerranean FeVer (MEFV) mutations, 150 (24.3%) cases were homozygous, 292 (47.3%) cases were heterozygous, and 175 (28.4%) were compound heterozygous. Patients with homozygous gene mutations had more severe disease activity, earlier age of disease onset, higher rates of joint and skin involvement, sacroiliitis, and amyloidosis. Patients with compound heterozygous genotype displayed severe disease activity in close resemblance to patients with homozygous mutation. In addition, patients with compound heterozygous mutations had higher rates of protracted febrile myalgia and elevated fibrinogen levels. In 63.9% of compound heterozygous patients, age of onset was < 20 years, with greater disease severity, and high rates of attack frequency and colchicine resistance. Our results suggest that indicators for disease severity include early onset of disease and homozygous gene mutations. Furthermore, patients with compound heterozygous mutations displayed significant presentations of severe disease activity.

Objectives To evaluate quality of life (QoL) and related variables in patients with ankylosing spondylitis (AS), a chronic inflammatory disease of the spine. Methods Nine-hundred and sixty-two patients with AS from the Turkish League Against Rheumatism AS Registry, who fulfilled the modified New York criteria, were enrolled. The patients were evaluated using the Assessment of SpondyloArthritis International Society core outcome domains including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), fatigue (BASDAI-question 1), pain (last week/spine/due to AS), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and two QoL questionnaires (the disease-specific ASQoL and generic the Short Form-36 [SF-36]). Results The mean ASQoL score was 7.1 ± 5.7. SF-36 subscales of general health, physical role and bodily pain had the poorest scores. ASQoL was strongly correlated with disease duration, BASDAI, fatigue, BASFI, BASMI, BASRI, MASES, pain and SF-36 subscales (P < 0.001). SF-36 subscales were also strongly correlated with BASDAI and BASFI. Advanced educational status and regular exercise habits positively affected QoL, while smoking negatively affected QoL. Conclusions In patients with AS, the most significant variables associated with QoL were BASDAI, BASFI, fatigue and pain. ASQoL was noted to be a short, rapid and simple patient-reported outcome (PRO) instrument and strongly correlated with SF-36 subscales.

Familial Mediterranean fever (FMF) is a chronic debilitating and inflammatory disease affecting primarily the populations of Mediterranean origin including Non-Ashkenazi Jews, Armenians, Turks, and Arabs.1,2 It is a lifelong disease with harmful effects on all aspects of quality of life (QoL) due to the presence of recurrent attacks and side effects of medical treatment.3 The concept of health-related QoL is known as the measurement of physical symptoms, functional status, and effects of the disease on psychological and social functioning.2 As in other chronic diseases, the problems in relation to QoL for FMF patients have become an important health topic particularly during the last decades.1,2,4 It has been thought that not only QoL itself, but its measurement is also regarded as the main controversial issue for ongoing publications.4 Besides, the issue of QoL has different perspectives including pain, fatigue, mood disorders such as anxiety and depression, and sleep quality that cause difficulty in evaluating their impacts on FMF patients.5,6 Patient-reported outcome measures have been used for the assessment of QoL in patients with chronic disabling diseases.7 These measurements help physicians and health policymakers to determine psychosocial problems in patients with chronic diseases and to perform a standardized assessment of these problems.1,8 For that purpose, some scales or indices have been used including Short Form 36 (SF-36), Hospital Anxiety Depression Scale (HADS), the World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF), the Health Assessment Questionnaire (HAQ), and the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale for the measurement of QoL in rheumatological diseases and FMF patients.1,5,8-11 In addition, Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale as a new, valid, and reliable scale has been also proposed.12 However, there is no consensus on the use and application of these scales or indices due to difficulties such as lack of quantitative measures and application in a busy clinical setting.10 In this study, we aimed to evaluate the effectivity of FMF-QoL Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients with lack of clinical data, a new acute FMF attack within the last seven days, pregnancy, known psychological and neurological disorders, sleep disorders, chronic fatigue syndrome, chronic pain syndrome, and fibromyalgia were excluded. [...]a total of 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years) were included. Sociodemographic characteristics of the patients including age, sex, educational status (illiteracy or primary education, secondary education, university or higher education), monthly income (US$<150, US$150 to 300, US$301 to 450 and US$>450), the status of employment, habits of smoking and alcohol, history of FMF in the first degree relatives, and disease-related variables including duration of FMF, age of onset (grouped as <5 years, five to 10 years, 11 to 20 years and >20 years), number of attacks per month (grouped as >2, one to two and <1), disease severity score developed by Pras et al.,14 (range, 2 to 19 points) and grading as mild (=5 points), moderate (6 to 10 points) and severe (=10 points), use of colchicine, and visual analog scale patient global assessments (PGA-VAS) were recorded using online data entry. In FACIT, a self-administered instrument, the total range for scores was 0 to 52 indicating the worst possible fatigue as 0 and no fatigue as 52.11 Statistical analysis Evaluation of demographic and clinical features on the FMF-QoL Scale score was regarded as the main outcome.

Fibromyalgia (FM) presents with persistent generalized discomfort, cognitive impairment, disruption of sleeping, mood changes, and fatigue.1 Although the pathophysiology of FM is not entirely clear, central sensitization is the most putative mechanism.2-4 Central sensitization is the breakdown in the central nervous system's pain regulation and disproportion between inhibitory and excitatory neurotransmitters.5 The prevalence of FM in patients with rheumatoid arthritis (RA) differs between 4.9 and 52.4%, depending on the methodology.6-16 The disruption of pain regulation in FM can affect composite disease activity scales, which leads to inaccurate treatment decisions in patients with RA.12,15-17 In addition, a high level of inflammation in a patient with RA may lead to the concomitant presence of FM.18 The inflammation in RA is evaluated by inflammatory markers and the disease activity scales.19 However, these do not precisely reflect subclinical synovial inflammation, which is an important parameter in RA management.19,20 Therefore, musculoskeletal ultrasonography (US) may help detect subclinical synovial inflammation.21-24 However, the role of musculoskeletal US in patients with RA accompanied by fibromyalgia has not been studied in detail. Participants' demographic data included age, sex, body mass index, educational status, medical history (comorbidity, drugs, disease duration), and laboratory data obtained from electronic records. A rheumatologist performed a clinical examination by tender joint count, swollen joint count, disease activity score 28 with erythrocyte sedimentation rate (DAS28-ESR), and functional status.28,29 Functional status was assessed with a validated Turkish version of the health assessment questionnaire (HAQ), which is a scale ranging from 0 to 3, with higher scores reflecting worse functional status.30,31 A physiatrist evaluated the patients for FM by the 1990 ACR FM classification criteria and 2016 ACR FM diagnostic criteria.1,26 The 1990 ACR FM classification criteria require the presence of widespread pain for more than three months and having tenderness in at least 11 of 18 specific tender points. Erosion and tenosynovitis/ paratenonitis were recorded by the binary scoring system as 0 = absent or 1 = present.22 The degree of power Doppler US activity for synovitis and tenosynovitis/paratenonitis were recorded according to the following semiquantitative scale: no intra-articular color signal = Grade 0; two single and one confluent signal or up to three color signals = Grade 1; color signal area covers between 1 and 50% of the intra-articular area = Grade 2; the color signal area covers more than 50% of the intra-articular area = Grade 3.32 The gray-scale US score was obtained by synovitis (0-27), tenosynovitis/paratenonitis (0-7), and erosion (0-14) scores.