Archives of rheumatology最新文献

Background/Aims: Patients with autoimmune inflammatory rheumatic diseases (AIIRDs) are particularly vulnerable to infections as a result of their underlying autoimmune conditions. This vulnerability is further exacerbated by immunosuppressive treatments and associated comorbidities. This study aims to evaluate influenza vaccination rates, hesitancy, and awareness among this patient population. Materials and Methods: This descriptive study included patients with AIIRD receiving treatment at rheumatology and pulmonary medicine outpatient clinics. Between January and April 2024, a questionnaire was administered to assess influenza vaccination rates, knowledge, and attitudes. Results: Of the patients, 34.3% had received at least 1 influenza vaccination, while only 13% were vaccinated annually. Additionally, 62.2% recognized that they were at risk for influenza infection due to their current illnesses and medications and believed that they should be vaccinated. However, 59.2% had not received any professional information about the influenza vaccine. Only 38.2% were aware that vaccination was available free of charge for their condition. Older age, prolonged medication use, extended duration since diagnosis, presence of comorbidities, awareness of influenza risk, and receiving information about vaccination were all significantly associated with having received at least 1 influenza vaccination. No statistical relationship was observed between the type of rheumatic disease and vaccination (P= .7803). Patients relying on social media, TV, or internet sources demonstrated greater vaccine hesitancy (P < .0001). Awareness of vaccination recommendations was significantly associated with medication type (P < .0001). Hesitancy was reported by 38.7% of all patients and 48% of unvaccinated patients, influenced by negative experiences during the COVID-19 vaccination process. Conclusion: Influenza vaccination coverage among patients with AIIRD remains suboptimal. Physician reminders during routine visits could enhance vaccination rates. Health authorities might consider implementing pop-up alerts in clinical systems to prompt physicians to recommend vaccination when prescribing immunosuppressive medications.

Background/Aims: Kawasaki disease (KD) is often complicated by coronary artery lesions (CAL). Identifying reliable biomarkers may improve early diagnosis and risk stratification for CAL, facilitating timely intervention. This study aims to investigate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in KD complicated with CAL. Materials and Methods: PubMed, Scopus, Web of Science, Embase, and the Cochrane Library databases were searched from inception to November 30, 2024 for English-language studies comparing NT-proBNP levels in KD patients with and without CAL. Diagnostic accuracy metrics for NT-proBNP in detecting CAL were also analyzed. The analysis was performed using a random-effects model. I² statistics assessed the heterogeneity. NT-proBNP levels reported as medians were converted to means using established formulas. Results: Nineteen studies involving 9017 participants showed significantly higher NT-proBNP levels in KD patients with CAL (pooled standardized mean differences = 1.889, 95% CI: 1.274 to 2.504, P < .001), with substantial heterogeneity (I² = 98.5%). Eighteen studies assessed diagnostic accuracy, yielding pooled sensitivity and specificity of 0.78 (95% CI: 0.68-0.85) and 0.78 (95% CI: 0.70-0.84), respectively. The diagnostic odds ratio was 12 (95% CI: 7-21), with an area under the receiver operating characteristic curve (AUROC) of 0.85 (95% CI: 0.81-0.88), indicating good diagnostic performance. However, heterogeneity remained significant (I² = 99%). Conclusion: N-terminal pro-brain natriuretic peptide is a promising biomarker for detecting CAL in KD, with good diagnostic accuracy. While elevated NT-proBNP levels correlate with CAL, its role is best realized as part of a multimodal diagnostic approach. Future research should focus on standardization and validation across diverse populations.

Background/Aims: Interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α are the principal proinflammatory cytokines that contribute to inflammatory activity in patients with Behcet's disease (BD). The aim was to assess circulatory Sirtuin-1 (SIRT1) levels in BD and evaluate potential relationships with disease activity scores and several inflammatory markers in order to investigate its potential as a disease activity marker. Materials and Methods: Forty patients with BD and 40 healthy volunteers matched for age and sex were enrolled. Demographic and clinical data were recorded, including family history of BD, smoking and alcohol consumption, height, weight, and comorbidities. Patients with BD were classified with respect to disease activity, treatments, and organ involvement. Disease activity was determined and categorized using the Behcet Disease Current Activity Form (BDCAF). Inflammation markers and SIRT1 levels were studied in fasting blood samples. Results: C-reactive protein, IL-6, and TNF-α values were found to be significantly higher in patients with BD compared to controls, largely irrespective of disease activity. SIRT1 results were similar in patients and controls. SIRT1 measurements again showed no differences when compared across disease activity groups and patients with and without TNF-α blockade treatment. However, patients with concurrent vascular and ocular involvement appeared to have significantly lower SIRT1 levels when compared to patients with only ocular involvement. Conclusion: SIRT1 levels in the circulation of patients with BD appear to be similar to controls, regardless of disease activity or anti-TNF-α treatment; however, SIRT1 concentrations may be associated with vascular injury as demonstrated by significantly lower SIRT1 levels in patients with vascular + ocular involvement compared to those with only skin or ocular involvement.

Background/Aims: Axial spondyloarthritis (axSpA) is characterized by low back pain and sacroiliitis. It is important to exclude other causes of sacroiliitis before diagnosing axSpA. It was hypothesized that as one of the reasons for low back pain and sacroiliitis, the presence of lumbosacral transitional vertebra (LSTV) could lead to diagnostic confusion in axSpA. This study aimed to investigate the prevalence of LSTV in axSpA patients and whether LSTV caused any differences in disease characteristics compared to patients without LSTV. Materials and Methods: This was a retrospective study. Patients with axSpA who had available pelvic and lumbosacral spine radiographs and were over 18 years old were included. They were divided into 2 groups based on the presence of LSTV. These groups were compared in terms of age, sex, r-axSpA prevalence, biologic disease-modifying antirheumatic drugs (DMARDs) usage rates, and C-reactive protein (CRP)/erythrocyte sedimentation rate (ESR) levels. Likewise, patients with available diseasespecific clinical scores (Ankylosing Spondylitis Disease Activity Score with C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index [BASMI]) and those using biologic DMARDs were also divided into 2 groups based on the presence of LSTV and were analyzed accordingly. Results: A total of 130 patients (82 males, 48 females) were included. Ninety-five patients were using biologic DMARDs and 41 patients had available disease-specific clinical scores (only 19 had BASMI scores). The rate of presence of LSTV was 25.4% (n = 33). The most common type was Castellvi type 1b (39.4%). No significant differences were observed between axSpA patients with and without LSTV in terms of age, sex, r-axSpA prevalence, biologic DMARD usage, CRP/ESR levels, the number of different biologic DMARDs they had used, disease activity, physical function, and mobility. Conclusion: No diagnostic concerns were identified in axSpA patients with LSTV in this study. However, due to the high rate reported in this study, it is recommended that patients with LSTV undergo a more thorough evaluation prior to an axSpA diagnosis, with a diagnosis approach extending beyond simply meeting a set number of the Assessment in SpondyloArthritis international Society (ASAS) criteria.

Background/Aims: The aim was to investigate the effectiveness of exercise on muscle strength, lung capacity, spinal mobility, endurance, and quality of life (QoL) in postmenopausal osteoporosis patients without vertebral fractures. Materials and Methods: This study was conducted with 41 postmenopausal osteoporosis patients (aged 45-65 years) without osteoporotic fractures. Patients were randomized into 2 groups. The patients in the exercise group (EG) were given an exercise regimen (breathing, stretching, relaxation, balance, and strengthening exercises) 3 times a week for 8 weeks at the department. Patients in the control group were kept on their current medical treatment. A Cybex Isokinetic Dynamometer and a Saunders digital inclinometer were used to assess back extensor muscle strength and spinal mobility. Pulmonary function tests were performed with a Jaeger spirometer. "Timed loaded standing" method, Quality of Life Questionnaire of the European Foundation for Osteoporosis 41 (QUALEFFO-41) and Short Form Health Survey 36 (SF-36) were used to evaluate the impact of exercise on back endurance and QoL respectively. Results: Baseline demographic and clinical characteristics were similar between the 2 groups. At the end of the study, statistically significant improvements were noted in the EG's back extensor strength and endurance compared to baseline values (P < .05). Vital capacity, forced vital capacity, forced expiratory volume during the first second, maximal mid-expiratory flow rate, maximum inspiratory pressure measurements, and scores for QoL (physical function, mental function sub-scores, and total QUALEFFO-41 score, physical function, and vitality sub-scores of SF-36) were also significantly improved in the EG (P < .05). Spinal mobility of patients remained unchanged at the end of the study for both groups (P > .05). Conclusion: Muscle strength, trunk endurance, pulmonary functions, and QoL are known to be affected in postmenopausal osteoporosis patients. The findings supported that significant improvements can be achieved in these parameters even with appropriate short-term exercise in fracturefree periods.

Background/Aims: Rheumatoid arthritis (RA) is characterized by significant inflammation and joint damage. This study aims to investigate the frequency of abnormal ulnar variance (AUV) in RA patients and its associated factors. Materials and Methods: A total of 108 established RA patients meeting the 2010 ACR/EULAR RA criteria were included. After exclusions, the study proceeded with 98 patients. Demographic, laboratory, and clinical data were recorded. X-rays of the wrists were taken in accordance with the literature, with the forearm in a neutral rotation, the elbow flexed at 90°, the shoulder abducted at 90°, and ulnar variance was assessed with Hulten's method. A displacement of 1 mm or more of the ulna relative to the radius was defined as AUV. Results: The average age was 58.11 ± 12.05 years, with 82% being female. The mean disease duration was 175.16 ± 100.5 months, and the average diagnostic delay was 16.4 ± 11.18 months. Abnormal ulnar variance was present in 47.9% of patients. In patients with AUV, the average UV for the right hand was +2.24 mm, while the average for the left hand was +2.40 mm. When considering all RA cases, the average UV was +1.06 mm for the right hand and +1.09 mm for the left hand. In the multivariate analysis, RA-type joint involvement (RJI) and severe joint involvement (SJI) were identified as independent predictors of AUV. Conclusion: This study suggests that AUV may be an important finding in established RA. Future larger-scale and prospective studies are needed to elucidate the significance of AUV in RA cases.

Background/Aims: This study aimed to evaluate the reliability and validity of the Turkish edition of the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) among chronic cervical radicular pain (CRRP) cases caused by disc herniation. The secondary aim of the study was to evaluate the relationship between Turkish Short-Form McGill Pain Questionnaire-2 (TR-SFMPQ-2) and other pain and disability scales. Materials and Methods: The study was based on data from 103 cases of CRRP patients evaluated at the Algology outpatient clinic. In addition to TR-SF-MPQ-2, the Numerical Rating Scale, Neck Disability Index, Quick Disabilities of the Arm, Shoulder, and Hand, Cervical Radiculopathy Impact Scale, and a 4-question neuropathic pain questionnaire were completed. Cronbach's alpha (α) and intra-class correlation (ICC) tests were performed for reliability analyses. Confirmatory factor and Spearman correlation analysis were applied to assess structural and content validity, respectively. Results: Both the internal (α= 0.921) and test-retest reliability of the TR-SFMPQ-2 were high (all ICC values >0.9 and P < .001) for the total and 4 subgroups (continuous, intermittent, neuropathic, and emotional). The total and subscale scores of the TR-SF-MPQ-2 were in correlation with other scale results (r= 0.404-0.648, P < .001). Confirmatory factor analysis demonstrated that the scale exhibited 4 distinct factors. Conclusion: The TR-SF-MPQ-2 is a valid and reliable scale for Turkish patients suffering from CRRP.

Background/Aims: Currently, no validated method exists to assess possible pain catastrophizing in adolescents with FMF. Thus, the objective of this study was to determine the validity and reliability of the Turkish Pain Catastrophizing Scale-Child (PCS-C) in adolescents with FMF by investigating internal consistency, test-retest reliability, and convergent validity. Materials and Methods: Turkish PCS-C, Visual Analog Scale during rest (VAS-rest) and activity (VAS-activity), and Pediatric Quality of Life Inventory (PedsQL) Arthritis Module 3.0 were administered to 66 adolescents with FMF (age: 13-18 years). Cronbach's alpha value was calculated for internal consistency. Turkish PCS-C was re-administered 2 weeks later by phone to 24 participants to calculate intraclass correlation coefficients (ICCs) for determining test-retest reliability. Convergent validity was investigated by calculating Spearman's Rank Correlation Coefficients (rs) between Turkish PCS-C and other evaluated parameters. Results: Item 8 was excluded from the Turkish PCS-C due to its low contribution to internal consistency. Following this, the Cronbach's alpha was calculated as 0.934. The remaining items contributed to the total score (item-total correlations > 0.4), and Cronbach's alpha did not differ significantly with the exclusion of any items (change < 1%). The Turkish PCS-C demonstrated excellent test-retest reliability (ICC = 0.925). Fair to moderate positive correlations were detected between the Turkish PCS-C total score and VAS-rest (rs = 0.373), VAS-activity (rs = 0.536), and PedsQL scores (rs = 0.551). Conclusion: Turkish PCS-C may be used as a valid and reliable tool to assess pain catastrophizing in adolescents with FMF.· Unpredictable nature of the pain in FMF may cause pain catastrophizing. · The validity and reliability of Turkish Pain Catastrophizing Scale-Child (PCS-C) was shown for the first time in an adolescent age group. · Turkish PCS-C was introduced to clinical and research settings to evaluate the possible pain catastrophizing in FMF.

Background/Aims: Osteoarthritis typically features cartilage degeneration, synovial fibrosis, and bone remodeling. While clinical Western medicine therapies can restore joint functions, long-term use may exacerbate cartilage damage. This study was designed to investigate the impact of peroxiredoxin 3 (PRDX3) on ferroptosis and oxidative stress in osteoarthritis cartilage injury and its potential mechanism. Materials and Methods: In the osteoarthritis model, the expression of PRDX3 was downregulated. Single-cell analysis revealed that the PRDX3 gene was expressed in bone cells of osteoarthritis patients. Results: Sh-PRDX3 promoted osteoarthritis cartilage injury in the mouse model via the induction of oxidative stress. PRDX3 suppressed reactive oxygen species accumulation and mitochondria-dependent ferroptosis in the in vitro model or mice model of osteoarthritis. PRDX3 induced SIRT3 to reduce SIRT3 ubiquitin. Moreover, METTL3-mediated m6A modification decreases PRDX3 mRNA stability by YTHDF1 in the osteoarthritis cartilage injury model. Conclusion: These findings indicate that METTL3-mediated m6A modification decreases PRDX3 mRNA stability to relieve ferroptosis and oxidative stress in the model of osteoarthritis cartilage injury in a YTHDF1-dependent manner. Targeting METTL3 is thus a potentially effective therapeutic strategy for patients with osteoarthritis cartilage injury.