• ÖZ

Objectives: This study aims to assess postural balance, fall risk, and the relationship of these parameters with disease-related factors in patients with systemic sclerosis (SSc). Patients and methods: Thirty patients with SSc (6 males, 24 females; mean age 51.1±10.6 years; range 35 to 65) and 30 healthy subjects (6 males, 24 females, mean age 52.4±8.7 years; range 35 to 65) matched for age, sex and body mass index were included in this cross-sectional study conducted between September 2018 and November 2019. Postural balance was measured with Biodex Balance System™ (Biodex-BS), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Individuals’ history of falls in the past year, functional capacity, lower limb muscles strength, pulmonary function, respiratory muscle strength, diffusion capacity, and dyspnea severity were evaluated. Results: The SSc group had postural balance impairment and a higher fall frequency than the control group. The SSc group had significantly higher sway index on postural stability (0.6±0.5), lower directional control score (42.1±8.0), and longer test duration (51.8±11.8) on limit of stability of Biodex-BS, lower BBS score (51.5±4.9), and longer test duration on TUG test (8.3±2.7) than control group (all p<0.05). Also, SSc group exhibited significantly lower functional capacity, limb muscles strength, pulmonary function, respiratory muscles strength, diffusion capacity, and higher dyspnea severity than control group (all p<0.05). The postural balance and fall frequency of SSc patients were significantly associated with functional capacity, lower limb muscles strength, pulmonary function, respiratory muscle strength, diffusion capacity, and dyspnea severity. Conclusion: Our results suggest that postural balance impairment and fall risk should be assessed as they appear to be important problems in patients with SSc. Furthermore, assessment of functional capacity, lower limb muscles strength, and lung involvement may highlight those with postural balance impairment and higher fall risk.

• ÖZ

Objectives: This study aims to investigate the relationship between estrogen receptors (ERs) and progesterone receptors (PRs) and histopathological findings in synovial tissue in rheumatoid arthritis (RA) and osteoarthritis (OA) patients. Patients and methods: Synovial tissue samples obtained from synovial surgery from 30 RA (10 males, 20 females) and 92 OA (27 males, 65 females) patients with median age of 59 (range, 50 to 67) years were analyzed retrospectively between January 2010 and January 2019. The relationship between histopathological features and hormone receptor presence was analyzed. Results: There was a meaningful relationship between histopathological parameters and RA and OA (p=0.01). The sex hormone receptor's presence was significantly higher in females with RA (p=0.01). Additionally, in the RA group, there was a remarkable relationship between ER and focal aggregates of lymphocytes (p=0.01), perivascular infiltrates of lymphocytes (p=0.03), and diffuse infiltrates of lymphocytes (p=0.01). In the OA group, a significant relationship was observed between PR and subchondral inflammation (p=0.01). In multivariate analysis, it was observed that ER was an independent risk factor for focal aggregates of lymphocytes in RA group (odds ratio [OR]=1.51 [1.02-2.25], p=0.04). Besides, PR was found to be an independent risk factor for subchondral inflammation in OA group (OR=3.90 [1.28-11.80], p=0.02). Conclusion: The presence of the sex hormone receptor in the synovium may change histopathological features and affect the clinical course.

• ÖZ

Objectives: This study aims to investigate whether single nucleotide polymorphisms (SNPs) at the +3179G/A insulin-like growth factor 1 receptor (IGF-1R) locus were associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) genetic susceptibility and also explore age and sex distribution of the rs2229765 in healthy adults. Patients and methods: This cross-sectional study was conducted between September 2012 and October 2014. Seventy patients with RA (7 males, 63 females; mean age: 54±1 years; range, 32 to 78 years) and 56 with AS (44 males, 12 females; mean age: 38±9 years; range, 22 to 57 years) were genotyped using polymerase chain reaction-restriction fragment length polymorphism method. The genotype and allele frequencies of the rs2229765 polymorphism in both patient groups were compared to those in 308 healthy donors (141 males, 167 females; mean age: 35±19 years; range, 18 to 75 years) who were further subjected to analysis of sex- and age-related genetic variation. Results: We identified the homozygous genotype AA (22.9% vs. 14.1%; odds ratio [OR]=2.33, p=0.034) and A-allele (47.9% vs. 37.5%; OR=1.53, p=0.032) associated with increased risk for RA, but not AS. The same genotype AA was non-significantly more common in healthy males than females, and the frequency of the A-allele was markedly higher in younger males (46% vs. 40%; p=0.039). The overall percentage of healthy carriers of the AA gene variant was 18%. Conclusion: We primarily present an inverse effect of the +3179G/A IGF-1R polymorphism on disease susceptibility to RA and AS, confirming the distinctly different immune pathways involved in the pathogenesis of both inflammatory arthritides. In addition, we could also show trends regarding age- and sex-specific patterns of the rs2229765 genotype distribution in the general population.

• ÖZ

Objectives: This study aims to investigate the frequency of fibromyalgia syndrome (FMS) in rosacea patients and the relationship between disease disability score of FMS and quality of life score of rosacea. Patients and methods: This cross-sectional controlled clinical trial was performed between December 2017 and December 2018. One hundred female rosacea patients (mean age 43.2±10.1; range, 21 to 65 years) and 100 age- and sex-matched control subjects (mean age 41.2±11.1; range, 22 to 68 years) with no history of skin disease and systemic diseases including diabetes, cardiovascular, renal and hepatic diseases were recruited. Dermatology Life Quality Index (DLQI) scores were calculated using a 10-item self-administered questionnaire. The diagnosis of FMS was established according to 2010 American College of Rheumatology diagnostic criteria. Fibromyalgia Impact Questionnaire (FIQ) was used to determine the clinical severity and functional disability, while Visual Analog Scale (VAS) was used to determine pain severity in the patients with FMS. Results: The frequency of FMS in patient group was significantly higher than control group (p=0.019). The mean duration of FMS in patient group was significantly higher than control group (p=0.001). There was no significant difference in terms of the age of onset of FMS, FIQ and VAS scores between groups (p=0.53, p=0.54, p=0.07, respectively). DLQI scores were significantly correlated with FIQ scores in the patient group (r=0.43, p=0.008). Conclusion: The frequency of FMS in rosacea patients was significantly higher than control subjects without any skin disease and there was a correlation between disability score of FMS and quality of life score of rosacea. Investigating fibromyalgia symptoms in rosacea patients may be helpful for providing patient-based therapeutic approaches where neurologically based treatments may also be beneficial for rosacea.

• ÖZ

Objectives: This study aims to evaluate subclinical atherosclerosis using the Ankle-Brachial Index (ABI) in patients with psoriatic arthritis (PsA). Patients and methods: This case-control study included 51 PsA patients (24 males, 27 females; median age 47; range, 41 to 52 years) recruited at our hospital’s outpatient clinics between October 2016 and January 2017 and 50 healthy controls (24 males, 26 females; median age: 48.5; range, 40.7 to 56 years). Anthropomorphic measurements and laboratory results were recorded. In patients, the 66 swollen/68 tender joints count, dactylitis score, Leeds Enthesitis Index, Health-related Quality of Life, the Psoriasis Area and Severity Index, and Dermatology Life Quality Index were evaluated. Ankylosing Spondylitis Quality of Life and Bath Ankylosing Spondylitis Disease Activity Index were applied to patients with axial disease. Then, Composite Psoriatic Disease Activity Index was determined. A Doppler probe and a standard blood pressure cuff were used to calculate the ABI values for each participant. Results: Patients had lower right ABI (median, 1.05 vs. 1.1, p<0.01), lower left ABI (1.04 vs. 1.09, p<0.01) and lower overall ABI (1.03 vs. 1.09, p<0.01) compared with healthy subjects. Twelve (23.5%) patients had borderline ABI, but none of the controls (p<0.01). Patients with borderline ABI had a longer duration of psoriasis (25 vs. 15 years, p=0.03). The distribution of borderline ABI value was statistically significant between patients with axial disease and peripheral disease only (42.1% vs. 12.5%, p=0.02). Disease activity was found as an independent risk factor for borderline ABI in a binary logistic regression (odds ratio 6.306, 95% confidence interval 1.185 to 33.561, p=0.031). Conclusion: Lower ABI was found in PsA patients than healthy controls even in those matched with traditional cardiovascular risk factors. All participants with borderline ABI were in the patient group. Borderline ABI was associated with disease activity and disease duration.