Psoriasis and family history of psoriasis may not affect disease severity of rheumatoid arthritis.

The incidence of psoriasis in patients with rheumatoid arthritis (RA) is higher than in the general population. In addition, psoriasis may negatively affect the severity of rheumatological diseases in patients with autoinflammatory or autoimmune diseases. In this study, we evaluated the effect of psoriasis or a family history of psoriasis on the characteristics of RA. This is a cross-sectional study. We included 737 RA patients who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) RA Classification Criteria, but did not meet the CASPAR psoriatic arthritis criteria. Subsequently, we compared disease activity, the need for biologic therapy, the number of conventional synthetic disease-modifying anti-rheumatic drugs taken, the frequency of erosive disease and extra-articular involvement, glucocorticoid doses and the Stanford Health Assessment Questionnaire scores between patients with and without a history of psoriasis, and patients with and without a family history of psoriasis. Thirteen (1.8%) patients had psoriasis, while 58 (7.9%) had a family history of psoriasis in first- or seconddegree relatives. All outcome parameters were found to be similar between the groups. We show that concomitant psoriasis has no effect on the evaluated disease characteristics of RA.

Effect of a bovine collagen matrix on tendon adhesions during the repair of rat Achilles tendon.

Adhesion after a tendon injury is one of the major problems following upper extremity surgery. In the present study, we evaluated a new material that is clinically usable as an adhesion barrier. Twenty-four male Wistar albino rats were used in the study. These rats (48 legs) were divided into three groups: sham, control, and experimental. No surgical intervention was performed in the sham group. After making a full-thickness cut through the right Achilles tendon, the tendon was repaired using the modified Kessler technique in the control group, while bovine collagen matrix was wrapped around the surgically repaired tendon using the modified Kessler technique in the experimental group. Two months after surgery, the operated and non-operated tendons were resected and analyzed through biomechanical, macroscopic, and histopathological examinations. The results of the biomechanical testing did not differ significantly between the control and experimental groups. Macroscopic examination of the adhesions revealed less adhesions in the experimental group but this difference was not statistically significant. Moreover, the results of the histopathological examination, which was performed based on five criteria, did not differ significantly between the two groups. Our study's results indicate that a bovine collagen matrix can be used to prevent tendon adhesion; however, larger studies are needed to verify these findings.

Baseline electrolyte abnormalities would be related to poor prognosis in hospitalized coronavirus disease 2019 patients.

Electrolyte abnormalities are not uncommon in coronavirus disease 2019 (COVID-19). Several studies have suggested that various electrolyte imbalances seem to have an impact on disease prognosis. However, no study has primarily focused on the effect of baseline electrolyte abnormalities on disease outcome. In this study, we assessed the validity of the hypothesis that baseline electrolyte imbalances may be related to unfavourable outcomes in hospitalized COVID-19 patients. Design of the study was retrospective and observational. We included 408 hospitalized individuals with COVID-19 over 18 years old. Baseline levels of sodium, potassium, calcium and chloride were assessed and the effects of abnormalities in these electrolytes on requirement for intensive care unit and mechanical ventilation, hospitalization duration and treatment outcome were evaluated. Patients were clustered based on electrolyte levels and clusters were compared according to outcome variables. Frequency of other severe disease indices was compared between the clusters. Lastly, we evaluated the independent factors related to COVID-19-associated deaths with multivariate analyses. In all, 228 (55.8%) of the patients had at least one electrolyte imbalance at baseline. Hyponatraemia was the most frequent electrolyte abnormality. Patients with hyponatraemia, hypochloraemia or hypocalcaemia had, respectively, more frequent requirement for intensive care unit and mechanical ventilation, higher mortality rate and longer hospitalization. The clusters associated with electrolyte abnormalities had unfavourable outcomes. Also, Clinical and laboratory features associated with severe disease were detected more often in those clusters. Hyponatraemia was an independent factor related to death from COVID-19 (OR 10.33; 95% CI 1.62-65.62; p 0.01). Furthermore, baseline electrolyte imbalances, primarily hyponatraemia, were related to poor prognosis in COVID-19 and baseline electrolyte assessment would be beneficial for evaluating the risk of severe COVID-19.

Metabolic syndrome is not uncommon in treatment-naïve rheumatoid arthritis patients.

OBJECTIVES: Rheumatoid arthritis (RA) is an independent risk factor for cardiovascular disease (CVD). Glucocorticoids are often used in the management of RA and might also contribute to the increased risk of metabolic syndrome (metS). Identifying metabolic alterations earlier and treating them together with disease-modifying therapy may be associated with better outcomes. Here, we aimed to investigate the frequency of metS and its components in treatment-naïve RA patients. METHODS: Fifty-three newly diagnosed treatment-naïve RA patients and 55 control subjects were enrolled. MetS was diagnosed using Adult Treatment Panel III report-defined criteria. We evaluated the metS-related metabolic and anthropometric alterations between the groups. RA patients were subdivided and those with and without metS were also compared with respect to disease-related parameters. RESULTS: MetS was more common in treatment-naïve newly diagnosed RA patients compared to controls (25 of 53 (47.1%) vs 9 of 55 (16.4%), respectively (p = 0.001; OR, 4.56; 95% CI 1.86-11.16). All evaluated anthropometric and metabolic parameters were similar in both groups. However, there was a trend to lower LDL and HDL cholesterol levels in RA patients. Furthermore, among those with metS, the number of fulfilled metS criteria items were higher in RA patients, compared to controls (p < 0.001). Interestingly, more RA patients fulfilled metS criteria with a glucose measurements item compared to controls (p < 0.001). CONCLUSION: MetS was more common in newly diagnosed and treatment-naïve RA patients compared to controls. MetS, along with tendency to present paradoxical and atherogenic lipid profiles in RA patients, may be among the underlying mechanisms of increased CVD.

Pulmonary multiple cystic lesions in a patient with Behçet's syndrome.

Pulmonary involvement, mainly originating from vasculitis, is one of the features of Behçet's syndrome (BS). We describe, for the first time in literature, computerised tomography images of a male BS patient with multiple pulmonary cystic lesions possibly originated from vasculitis or bronchiolar stenosis.

Pulmonary cavitary lesions may be one of the presenting features in Ig A nephropathy.

Immunoglobulin A (Ig A) nephropathy is the most frequent primary glomerulonephritis. Renal limited disease is the most widespread clinical form of the disease. Pulmonary involvement may also be seen concomitantly and capillaritis with pulmonary hemorrhage is the most frequent pulmonary involvement. In this paper, for the first time in literature, we describe an Ig A nephropathy patient with multiple pulmonary cavities as one of the presenting features of the disease. Also, no other etiology for the cavities was found other than Ig A nephropathy. Herein, possible pathogenesis might be capillaritis or deposition of immune complexes. As a result, it should be kept in mind that pulmonary cavity may be the presenting feature of Ig A nephropathy especially with other frequent signs of the disease.

Color Doppler analysis of female reproductive vasculature in Behçet's disease.

Behçet's disease (BD) may affect female reproductive vasculature. We aimed to evaluate Doppler sonographic characteristics of female reproductive vasculature and also ovarian volume, endometrial thickness (EMT) and antral follicle count of BD patients in comparison with a healthy control group. Seventeen premenopausal women aged between 18-45 years with BD, and a control group of 31 age- and body mass index-matched healthy women was included in the study. Uterine, spiral and intraovarian artery blood flow were examined by Doppler sonography in the late follicular phase. Resistance index, pulsatility index and systolic/diastolic ratio were recorded together with ovarian volume, EMT and antral follicle count. In particular this is a pilot study including the evaluation of the spiral and uterine arteries in BD. Doppler sonographic parameters, ovarian volume, EMT and antral follicle count of BD patients and healthy controls were not found to be statistically different. As a result of our analysis, we found similar Doppler sonographic features of both BD patients and the control group. Further studies conducted on a larger sample population with more aggressive BD symptoms may reveal the actual effect of BD on the female reproductive system.

Endothelial dysfunction in primary Sjögren syndrome.

OBJECTIVE: In this study, we aimed to investigate endothelial functions in primary Sjögren syndrome. METHODS: Thirty-five patients with primary Sjögren syndrome and 20 age and sex-matched healthy volunteers were recruited to the present study. Flow mediated dilatation of brachial artery and carotid intima-media thickness were measured in the study population. RESULTS: Carotid intima-media thickness values were similar between groups (0.50 +/- 0.10, 0.53 +/- 0.08, p > 0.05). Flow mediated dilatation of the brachial artery was disrupted in the primary Sjögren syndrome group (7% vs 12%, p = 0.002). CONCLUSION: There is endothelial dysfunction in patients with primary Sjögren syndrome, although they had comparable carotid intima-media thickness with the healthy control group.

Aortitis in a patient with psoriatic arthritis.

Aortitis, inflammation of the aortic tissue, is most commonly caused by vasculitic rheumatic conditions, and less frequently infectious organisms. Involvement of the aorta is well defined in HLA-B27-associated spondyloarthropathies such as long-standing ankylosing spondylitis and Reiter's syndrome. However, unlike other spondyloarthropathies, aortic involvement or true aortitis is not a feature of psoriatic arthritis and has been reported in only a few cases. Herein, we report the case of a 22 year-old woman with psoriatic arthritis who developed descending aortitis while using tumor necrosis factor inhibitors.

Correlation of thallium-201 uptake with proliferating cell nuclear antigen in brain tumours.

The aim of this study was to assess the correlation between thallium-201 (201Tl) uptake and proliferative activity measured using the proliferating cell nuclear antigen labelling index (PCNA-LI) in brain tumours. Twenty-nine patients with brain tumours were included in this study. Of these, seven were diagnosed with meningioma, 13 had high grade glioma (HGG) and nine had low grade glioma (LGG). A 210Tl single photon emission computed tomography study was performed on all patients before operation, and 201Tl uptake index (UI) and retention index (RI) values were calculated. Cell proliferation was determined by PCNA. While all of the HGGs and meningiomas showed intense 201Tl accumulation on visual interpretation, eight of the nine LGGs did not show accumulation of 210Tl at the tumour site. 201Tl UI values were 3.23+/-0.89 and 2.67+/-0.66 in HGG, 1.27+/-0.18 and 1.23+/-0.09 in LGG, and 4.35+/-1.60 and 2.52+/-0.78 in meningioma on early and delay images, respectively. There was a statistical difference between the 201Tl UI in HGG and LGG. PCNA-LI values were 16.72+/-6.15%, 1.63+/-0.81% and 2.00+/-1.88% in HGG, LGG and meningioma, respectively. The PCNA-LI in HGG was significantly higher than in LGG and meningioma. While the correlation coefficient between the 201Tl UI and the PCNA-LI was 0.94 in gliomas (n=22), there was no correlation in meningiomas. No statistically significant correlation was found between the RI and the PCNA-LI in gliomas. The presence of a strong positive correlation between 201Tl uptake and PCNA-LI indicates that 201Tl uptake can predict the proliferative activity of the glioma.

A new flap from the dorsum of the first intermetacarpal area: the first dorsal intermetacarpal flap.

Soft-tissue reconstruction of the hand still remains a challenge for plastic and reconstructive surgeons. Several flaps have been described to cover soft-tissue defects of the digits and the hand. In the first web region, there are some communications between the intermediate artery arising from the dorsal branch of the radial artery and the volar arteries of the thumb and the index finger. Depending on these communications, a new distally based flap is raised from the first dorsal intermetacarpal area. This flap has been used to cover various defects of the thumb in four patients and the distal radial side of the palmar area in one patient. Donor sites have been closed primarily except in one patient. There were no complications, and the results show that this flap is useful to cover soft-tissue defects of the thumb and proximal phalanx of the index finger as well as the radial side of the palmar and dorsal surfaces of the hand.