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This article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) ≥ of 30 kg/m2 were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients.

The rheumatoid arthritis impact of disease (RAID) score was developed as a patient-derived composite response index for the evaluation of the disease impact on cases with rheumatoid arthritis (RA). The aim of this study was to evaluate the psychometric properties and performance of RAID score in the real-life settings. Cases with RA from our multi-center, nationwide registry called Biologic and targeted Synthetic antirheumatic drugs Registry RA (BioStaR RA) were included in this cross-sectional observational study. Demographic data, disease duration, pain, patient’s global assessment (PGA) and physician’s global assessment (PhyGA) were recorded. DAS28-ESR, DAS28-CRP, the simplified disease activity index (SDAI) and the clinical disease activity index (CDAI) were assessed as disease activity evaluations. The health assessment questionnaire-disability index (HAQ-DI) and RAID were completed by all the participants. The construct validity was tested by the analysis of correlations between RAID score and scores of PGA, disease activity indexes and HAQ-DI. We also evaluated the discriminatory ability of RAID to distinguish patients with different levels of disease activity and disability and the cut-off values were calculated by ROC analysis. 585 cases with RA were included in this investigation. The RAID score was significantly positively correlated with PGA, all disease activity indexes and HAQ-DI (p < 0.001). The discriminatory ability of RAID score in different disease activity and disability groups was also demonstrated (p < 0.001). To estimate DAS28-ESR (remission/low + moderate + high), RAID score cut-off points were 2.88 (sensitivity 73%, specificity 62%), 3.23 (sensitivity 75%, specificity 60%) and 3.79 (sensitivity 74%, specificity 58%), respectively. Our study indicated that RAID was a reliable tool in daily clinical practice by presenting its correlations with disease activity and disability assessments and by showing its discriminatory ability in these parameters in the real-life experiences.

Multiple factors are believed to contribute to its development, including central sensitization, genetic predisposition, immunological factors, hormonal imbalances, and environmental influences.4 Among these factors, the dopaminergic pathway and iron deficiency are emphasized more frequently.5 Lipid peroxidation and oxidative stress may also play a vital role in the etiology of FS.6 Prooxidants cause increased superoxide activity in mitochondrial membrane potential and excessive synthesis of lipid peroxidation products.6 Cell mitophagy converts the balanced oxidant-antioxidant capacity in favor of oxidation.7 Increased levels of prooxidative factors, such as nitric oxide, lipid peroxidation, and mitophagy can cause pain sensitivity in fibromyalgia.8 FS symptoms appear in a wide range from pain to sleep disturbance. [...]research has focused on establishing the relationship between clinical and biochemical parameters.9 Preventing the specified oxidative stress, which has an important role in FS pathophysiology, is also important in treatment management. Effective treatment of FS is important to reduce pain and fatigue and improve quality of life.6 Proprotein convertase subtilisin/kexin type 9 (PCSK9) is one of nine members of the family of proprotein converters and is a serine protease in glycoprotein structure consisting of 692 amino acids.10 Although predominantly in the liver, it is also expressed in the kidneys, small intestine, and central nervous system.11 PCSK9 cleaves low-density lipoprotein (LDL) receptors (LDLRs), thus preventing the clearance of LDL from the blood.11 Increased LDL levels can lead to lipid peroxidation, converting LDL into toxic metabolites harmful to the organism.12 Additionally, PCSK9 promotes the release of proinflammatory cytokines and induces oxidative stress independently of LDL.13 Apelin is an endogenous peptide ligand for the apelin receptor (APJ), which is an extensively expressed G protein-coupled receptor.14 Apelin is expressed in various tissues, such as adipose tissue, liver, heart, lung, kidney, adrenal glands, gastrointestinal tract, and brain.15 Apelin serves multiple functions, such as blood pressure regulation, vascular angiogenesis, fluid and water intake, and effects on pituitary functions.16 Additionally, apelin is known for its antioxidant and anti-inflammatory effects.17 Although oxidative stress is known to play a role in the etiology of FS, to date, oxidative stress-related markers PCSK9 and apelin have not been investigated in patients with FS. PATIENTS AND METHODS This prospective case-control study included 58 female patients (mean age: 45.2±9.9 years; range, 25 to 66 years) who applied to the physical therapy and rehabilitation outpatient clinic of the Health Sciences University, Elazı¤ Fethi Sekin City Health Application and Research Center and were diagnosed with FS according to the 2010 American College of Rheumatology (ACR) criteria between May 2022 and February 2023.18 For the control group, 30 female volunteers (mean age: 43.1±9.9 years; range, 26 to 67 years) who applied to the clinic without a diagnosis of FS according to the 2010 ACR criteria and who were matched for age and body mass index were included.

Clinical and demographic data, including, age, sex, disease duration, body mass index (BMI), pain, patient's global assessment, physician's global assessment, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and Maastricht Enthesitis Score, were recorded. Additionally, the presence of comorbid conditions with SpA may decrease the tolerability of medications and indeed may influence the decision to use biological drugs.3 The extraarticular manifestations and comorbidities of SpA patients were found to increase disability and healthcare expenditures.4 The association of SpA with comorbid situations were previously evaluated.5\"8 Some of the recommendations/guidelines underline the importance of considering comorbid situations during the management of SpA.910 The main objective of this study was to evaluate the comorbid conditions of Turkish patients with SpA. The questionnaire contains questions about hypertension (HT), diabetes mellitus (DM) (including any complication related to DM), renal disease, chronic lung diseases (asthma or chronic obstructive pulmonary disease), pulmonary circulation disorders, thyroid dysfunction (hypo-or hyperthyroidism, any thyroid surgery, and consuming thyroid hormone replacement or suppressing medicine), cardiovascular system disorders (coronary artery disease, myocardial infarction, congestive heart failure, peripheral vascular events, and cardiac valve disease) gastrointestinal (GI) system disorders (peptic ulcer and GI bleeding), hepatic disorders, history of cancer, neurologic disorders (stroke, dementia, atlantoaxial instability, and spinal cord injury/cauda equina syndrome), psychiatric disorders (depression/psychosis). Three or more groups were compared by the Kruskal-Wallis test or analysis of variance (ANOVA) depending on their distribution.

ABSTRACT Objectives: This study aims to investigate the prognosis of novel coronavirus disease-2019 (COVID-19) infection in patients with the chronic inflammatory-rheumatic disease and evaluate the effects of immunosuppressive drugs on the prognosis, clinical characteristics, laboratory findings and hospitalization periods of the rheumatic patients with COVID-19 infection. In general, immunosuppression and presence of comorbidities are associated with an increased risk of significant infections in patients with rheumatic diseases.4 Therefore, these individuals may be at a higher risk for a severe clinical course that can lead to hospitalization, complications, and death during COVID-19 disease.4 Immuno-mediated diseases and immunosuppressive treatments increase susceptibility to viral and bacterial infections and, therefore, it is predicted that understanding the effects of COVID-19 infection on the patients is an urgent need.5-7 Vabret et al.8 reported that it would be particularly interesting to examine how severe COVID-19 disease-associated with a hyperinflammatory process affects COVID-19 expression in patients with a pre-existing inflammatory disease or using immunosuppressive agents. Patients in the group with rheumatic diseases who we detected as positive for SARS-CoV-2 by means of polymerase chain reaction (PCR) performed in our center included all of the adult patients diagnosed with spondyloarthritis (SpA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), familial Mediterranean fever (FMF) and connective tissue diseases (systemic lupus erythematosus, Sjögren syndrome and systemic sclerosis, etc.) and others (polymyalgia rheumatic, gout, Behçet's disease, and reactive arthritis). Treatments administered before COVID-19 disease were grouped as follows: conventional synthetic disease-modifying antirheumatic drugs (csDMARD), (i.e., hydroxychloroquine, chloroquine, methotrexate, leflunomide, sulfasalazine cyclophosphamide, cyclosporine, and azathioprine) or targeted synthetic or biologic disease-modifying antirheumatic drugs (ts/bDMARD) (tumor necrosis factor-alpha [TNF-a], IL-1, IL-6 or IL-23/IL-17 inhibitors, abatacept, rituximab, Janus kinase inhibitors [JAK]) and others (glucocorticoids, non-steroidal anti-inflammatory drugs and those not administering treatment).

[...]we were unable to establish a relationship between PTX3 and disease activity, directly or indirectly. [...]the sample size was small. [...]the disease activity score was not balanced. [...]no correlation has been detected between PTX3 and disease activity in RA patients in previous studies.

The patients' demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and Short Form-36 scores were all recorded. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment. Disease activity of the patients was evaluated using the Disease Activity Score 28 (DAS28), Disease Activity Index for Psoriatic Arthritis (DAPSA), and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).12,13 Psoriasis severity was evaluated using the Psoriasis Area and Severity Index,14 and the functional status was evaluated using the Bath Ankylosing Spondylitis Functional Index,15 and the Bath Ankylosing Spondylitis Metrology Index.16 The risk of anxiety and depression was evaluated using the Hospital Anxiety and Depression Scale, and the QoL was evaluated using the Health Assessment Questionnaire (HAQ),17 Psoriatic Arthritis Quality of Life (PsAQoL),18 and the short form (SF)-36.19 Statistical analysis Statistical analyses were performed using the IBM SPSS for Windows version 22.0 software (IBM Corp., Armonk, NY, USA). Results of the numerical variables were presented as mean ± standard deviation (SD). Because the comparisons between the groups did not show a normal distribution, non-parametric tests were used.

Recent data support the theory that the fatty liver/fetuin-A pathway plays an important role in regulating insulin sensitivity and may influence atherosclerosis in humans.15,16 According to our hypothesis, we speculate that the sTWEAK pathway is important in the pathogenesis of RA, and the metabolic disorders may continue to rise because of this pathway even if the RA disease activity decreases. [...]in this study, we examined the relationship of serum sTWEAK levels with IL-6, TNF-a, fetuin-A, insulin, homeostatic model assessment (HOMA)-insulin resistance (IR), and disease activity in patients with RA who are in remission or have low disease activity. Physical inactivity, hypertension, diabetes, and obesity are associated with atherosclerosis in RA; however, the evidence for these risk factors is insufficient. [...]it is not possible to explain RA-associated atherosclerosis with only the known risk factors.2 Lower sTWEAK levels were observed in atherosclerosis patients and circulating sTWEAK levels were negatively correlated to the intima/media thickness in asymptomatic patients; therefore, it can be concluded that sTWEAK levels are low in many CVD indications.26-29 Consistent with these findings, low sTWEAK levels were also observed in the peripheral blood samples of obese individuals.29 sTWEAK levels were negatively correlated with glucose and glycosylated hemoglobin A1c levels as well as with HOMA-IR and abdominal obesity; this supports the hypothesis that low sTWEAK levels are associated with a poor CV profile. sTWEAK prevents TNF-a-induced insulin resistance by activating the protein phosphatase 2A pathway in human adipocytes.30 All these molecules are among the known CV risk factors.31-33 Moreover, the observed lower release of sTWEAK in carotid atheroma plaques compared to that in normal arteries supports an association between the lipotoxic effects of abnormal lipid accumulation and TWEAK synthesis.24 In our study, we found that the sTWEAK levels of the RA group that comprised patients who were in remission or had low disease activity were lower than those of the control group. sTWEAK had a weak positive correlation with BMI and a weak negative correlation with fetuin-A levels. [...]data were collected using a crosssectional research design. [...]the main purpose of this study was to investigate, using some current molecules, whether metabolic risk persists in RA patients with low disease activity who are undergoing treatment.

In our country, it is a subspecialty after completing the residency in either physical medicine and rehabilitation or internal medicine. Since the number of rheumatologists is inadequate in our country, physical medicine and rehabilitation specialists are intensely interested in the diagnosis, treatment, and rehabilitation of rheumatic diseases in addition to musculoskeletal and neurological diseases. [...]they do not reflect the entire disease picture including impairment, limitations, restrictions, and social participation. [...]the ASAS Health Index, a composite index, was developed for the assessment of SpA patients at the basis of International Classification of Functioning, Disability and Health. Moderate disease activity (1.3-2) may also be a target for treatment because low disease activity definition does not exist within the ASDAS. Since low disease activity may be misperceived that there is no disease activity, the term 'moderate disease activity' was preferred to reflect low-moderate disease activity.22 Expert panel discussed whether a 'window of opportunity' period as it is in RA existed for ax-SpA or not. The improvement in MRI scores at the end of the first year was 35.2% in SSZ, and 69.2% in ETA groups. [...]studies on efficacy of SSZ in early stage are required.11,32,43 Recommendation 9 Use of bDMARDs (the current practice is to start with a TNFi) should be considered for the patients with high disease activity despite standard treatments (LoA=9.75±0.58).