Atalay Doğru

Background/purpose: Interstitial lung disease (ILD) is an important factor determining the course of systemic sclerosis (SSc). Quantitative high-resolution computed tomography (HRCT) radiomics can aid in the detection of ILD, particularly when pulmonary function tests cannot be performed. The aim of this study is to develop machine learning (ML)-based models using only radiomic, only clinical, and radiomic + clinical combinations for the detection of ILD in SSc and to compare their performance. Materials and methods: This retrospective, single-center study included 67 SSc patients (38 ILD positive, 29 ILD negative). A total of 852 radiomic features were extracted from HRCT using whole-lung segmentation, and after feature selection, the performance of logistic regression (LR) models was evaluated using fivefold cross-validation and out-of-fold (OOF) probabilities to calculate AUC, accuracy, and F1-score (radiomic-only, clinical-only, radiomic+clinical); thresholds were determined using the Youden index. Calibration and decision curve analysis (DCA) were performed, and binary AUC differences were tested using the De Long method. Results: The radiomics-only model achieved an OOF AUC of 0.819, accuracy of 0.821, and F1-score of 0.838. The clinical-only model achieved an OOF AUC of 0.760, whereas the combined model achieved an OOF AUC of 0.825. The DeLong test showed no significant AUC differences between the models (all p  > 0.05). Decision curve analysis demonstrated positive net benefit for all strategies at low to moderate threshold probabilities, with largely overlapping curves. Conclusion: HRCT radiomic features demonstrated good discrimination for detecting ILD in SSc, achieving numerically higher performance compared with clinical variables alone; however, these differences were not statistically significant according to DeLong testing. Adding clinical variables to the radiomic model slightly increased sensitivity without a significant improvement in AUC. HRCT-based radiomics may serve as a useful imaging biomarker for ILD detection. Although pulmonary function data were unavailable in the present cohort, the observed results suggest that HRCT-derived radiomics may provide complementary diagnostic information.

Background: This study aimed to compare muscle quality between women with rheumatoid arthritis (RA) and age-matched healthy controls and to explore the associations with muscle strength and walking speed. Methods: Thirty women with RA and 30 healthy controls participated. Muscle thickness and echo intensity (EI) of the rectus femoris (RF), vastus medialis, tibialis anterior (TA), medial gastrocnemius (MG), and lateral gastrocnemius (LG) were assessed using B-mode ultrasonography. Disease activity was evaluated using the 28-joint Disease Activity Score. Isometric knee and ankle muscle strength were measured by handheld dynamometry and walking speed by the 20-meter Walk Test. Results: Women with RA exhibited significantly lower muscle thickness in the RF (1.08 vs. 1.51 cm; P = .032), TA (1.46 vs. 1.98 cm; P = .027), MG (1.09 vs. 1.53 cm; P = .040), and LG (0.86 vs. 1.13 cm; P = .013) compared with controls. Echo intensity values were significantly higher in the RA group across all muscles examined (all P < .05). Knee extensor strength (109.26 vs. 122.35 N; P = .004) and walking speed (1.09 vs. 1.98 m/s; P = .032) were also reduced in RA. Disease Activity Score correlated positively with EI (RF: rho = 0.425) and negatively with muscle thickness (RF: rho = −0.456). Conclusion: Women with RA show significant impairments in muscle quality, strength, and mobility, which worsen with increasing disease activity. Regular assessment of muscle morphology and functional performance may support early identification of functional decline and guide appropriate management strategies in this population. Cite this article as: Karapınar M, Ayyıldız VA, Alsa. A, Doğru A, Şahin M. Comparison of lower extremity muscle deterioration in women with rheumatoid arthritis and healthy controls: relationship with disease activity, muscle strength, and walking speed. Eurasian J Med. 2026, 58(3), 1144, doi: 10.5152/eurasianjmed.2026.251144.

Background: This study aimed to evaluate cardiac involvement during active inflammation in 2 pathophysi ologically different diseases, rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and the change in cardiac involvement with suppression of inflammation after effective treatment. Methods: The study involved 30 newly diagnosed, active RA and 31 active AS patients in need of biologi cal treatment. The patients were evaluated by the same cardiologist using pulse wave Doppler and tissue Doppler echocardiography at the beginning of the study and after 3 months of treatment. Myocardial per formance index (MPI) was obtained by dividing the sum of isovolumetric relaxation time and isovolumetric contraction time, calculated from the recorded Doppler tracing, by ejection time (ET) from the same tracing was calculated separately for both ventricles. Results: It was found that diastolic dysfunction was present at the time of diagnosis and did not improve after treatment, despite regression in inflammatory values and joint findings. In the pre-treatment period,MPI was found to be higher than the normal value range in both groups. The MPI was 0.5 ± 0.07 for RA patients and 0.51 ± 0.1 for AS patients. No significant difference was found between the 2 groups before treatment (P = .697). In the post-treatment evaluation, no significant difference was found in RA and AS patients compared to pretreatment. Conclusion: Inflammation-induced cardiac involvement may develop in both RA and AS patients, despite their different pathophysiologic pathways. Longer follow-up periods are necessary for the improvement of inflammation-induced diastolic dysfunction and MPI values compared to joint findings used in activation parameters. Cite this article as: Şahin A, Doğru A, Karabacak M. Evaluation of the cardiac effects of inflammation in patients with rheumatoid arthritis and spondyloarthritis. Eurasian J Med. 2025, 57(2), 0777, doi: 10.5152/eurasianjmed.2025.25777.

Amaç: Sekukinumab İnterlökin-17A’ ya bağlanan insan immünoglobulin G1 kappa monoklonal antikorudur. Bu çalışmada sekukinumab tedavisi kullanan psöriyatik artrit (PsA) hastalarının dermografik, klinik ve inflamatuvar paremetrelerini, tedaviye devam sürelerini ve yan etki profilini değerlendirmeyi amaçladık. Materyal-Metot: Çalışmaya 2006 CASPAR sınıflandırma kriterlerine göre PsA tanısı almış ve sekukinumab tedavisi kullanan hastalar dahil edildi. Tedavinin etkinliği ve güvenliği değerlendirildi. İlaç sağkalımı analiz edildi. Tedavi öncesi ve sonrası monosit/lenfosit oranı (MLO), nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO), sistemik immün inflamasyon indeksi(SII) (trombosit sayısı x nötrofil sayısı/ lenfosit sayısı), sistemik inflamatuvar cevap indeksi (SIRI) (nötrofil sayısı x monosit sayısı / lenfosit sayısı) inflamatuvar paremetreleri hesaplandı. Bulgular: Çalışmaya dahil edilen 41 PsA hastasının 45 ay süresince 29 (%70,7)’ unun sekukinumab tedavisine devam ettiği görüldü. Hastaların 12 (%29,3) tedaviyi bıraktı. Tedaviyi en sık bırakma nedeninin ilaç etkisizliği olduğu, yan etki olarak da dispeptik yakınmalar ve gastrointestinal yan etkiler olduğu tespit edildi. Tedavi öncesi ve sonrasında bakılan inflamatuvar paremetrelerde istatiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: Çalışmamızda hastaların büyük bir kısmında daha önce bir biyolojik ajan kullanmış olmasına rağmen sekukinumab tedavisinde kalım oranlarının oldukça yüksek olduğu saptanmıştır. Sekukinumab, PsA tedavisinde etkili bir tedavi seçeneği olarak klinik kullanımımızda yer almaktadır.

This retrospective study aimed to evaluate the comparison of functionality, mood, and biopsychosocial status in rheumatic patients with and without self-reported bowel problems and the evaluation of Bilişsel Egzersiz Terapi Yaklaşımı (BETY)- (Cognitive Exercise Therapy Approach in English)'s impact on these factors. The study included 718 patients with eight different diagnoses of rheumatism. The presence of self-reported bowel problems in rheumatic patients was assessed with item 10 of the BETY-Biopsychosocial Questionnaire (BETY-BQ), functionality with the Health Assessment Questionnaire (HAQ), emotional status with the Hospital Anxiety and Depression Scale (HADS), and biopsychosocial status (BPS) with the BETY-BQ. Sixty-five rheumatic patients were included in BETY group exercise sessions for three months, three days a week. The rate of self-reporting bowel problems in the total cohort was 61.6%. Among all BPS parameters examined, a significant difference was found in favor of rheumatic individuals who did not report bowel symptoms (p < 0.005). All patients included in the BETY sessions achieved improvement in all parameters, including bowel symptoms (p < 0.005). Many patients suffered from bowel problems, including study. Investigated parameters of rheumatic patients with bowel symptoms were negatively affected. BETY improved all parameters, including bowel symptoms. BPS features should be considered in disease management in rheumatic patients reporting bowel problems. BETY should be used as an exercise intervention based on the BPS model in these patients.

Aim:The present study was conducted to determine the relationship between oesophageal diameter and disease findings in patients with systemic sclerosis. Material and Methods:The study included 86 patients. A retrospective evaluation was performed on the demographic data, biochemical and serological tests, and chest high-resolution computed tomography (HRCT) images of the patients. The presence of dilatation was defined as a measurement of over 10 mm in width. The oesophageal area was calculated at the level of the widest measurement. The relationship between oesophageal dilatation and digital ulcer (DU), pulmonary involvement, and pulmonary hypertension was evaluated. Results:The number of patients with supra-aortic and infra-aortic esophageal lateral, anteroposterior, and widest esophageal dilatation measurements above 10 mm was 49 (56.9%). The largest oesophageal area was found to be 173.6±90.7 mm2. The prevalence of DUs did not differ significantly between the groups with and without oesophageal dilatation. Pulmonary hypertension was detected in 22 (44.9%) patients with oesophageal dilatation and was found to be significantly higher in those without oesophageal dilatation (p=0.04). The extent of pulmonary involvement was significantly higher in the group with oesophageal dilatation (p=0.003). Conclusion:The oesophageal diameter has been demonstrated to be associated with pulmonary involvement. HRCT offers a valuable opportunity to assess the oesophagus. Further research is required to ascertain whether oesophageal diameter can be utilised in HRCT evaluations as a means of patient monitoring.

Purpose This study was planned to test whether the Cognitive Exercise Therapy Approach- Biopsychosocial Questionnaire (BETY-BQ) is an appropriate questionnaire in assessing the biopsychosocial status in KOA. Methods Frequently used assessment tools, OA-specific scale The Western Ontario and McMaster Universities OA Index, the Hospital Anxiety and Depression Scale, and the Short Form-36 were utilized for the validity and responsiveness of BETY-BQ in individuals with KOA. The test–retest method, internal consistency analysis, and item analysis were used to test reliability. For the test–retest method, BETY-BQ was administered again to the same 30 individuals 1 week later. To assess the responsiveness of the BETY-BQ, individuals who underwent medical treatment were subjected to a second round of questionnaire administration after a 3-month interval. Results Moderate to weak correlations between BETY-BQ and the other questionnaires ensued the divergent validity. According to the confirmatory factor analysis, all goodness-of-fit indices of BETY-BQ were acceptable (CMIN/df = 2.212; RMSEA = 0.080; SRMR = 0.08). Both Cronbach’s α (0.900) and ICC value (0.941) showed that the BETY-BQ has excellent reliability in the KOA population. The Bland–Altman Plot showed high agreement as all differences between the first and second BETY-BQ were found between the 95% lower and upper limits. BETY-BQ demonstrated moderate responsiveness as the effect size and standardized mean response were 0.656 and 0.566, respectively. Conclusion A valid, reliable, responsive, multi-dimensional, and self-reported questionnaire for measuring biopsychosocial status in KOA was introduced to the use of healthcare professionals.

Background and Objectives: Autoimmune thyroid diseases are more prevalent in patients diagnosed with Sjögren disease (SD) than in the general population. SD and autoimmune thyroid diseases are two distinct yet interrelated autoimmune disorders. The objective of this study was to determine the frequency of autoimmune thyroiditis (AT), autoantibody relationships, and clinical features in patients with SD. Materials and Methods: The study included 525 patients. A retrospective evaluation was conducted on the demographic data, biochemical and serological tests, and pathological data of the patients. An anti-nuclear antibody (ANA) test was performed using the indirect immunofluorescence (IIF) method using HEp-2 (HEp-2000) cells as substrate. The Schirmer test and minor salivary gland biopsy were conducted on all patients. Results: AT was detected in 167 (31.8%) of 525 patients who participated in the study. The anti-nuclear antibody (ANA) test and anti-SS-A positivity rate were higher in the AT group (p value < 0.001 and 0.002 respectively). We found that the likelihood of developing AT increased as ANA titres increased. ANA positivity titres were found to be significant at 2+, 3+, and 4+ values (odd ratios 2.41, 3.40, and 4.21, respectively). Additionally, histological examination of salivary gland biopsies revealed a significantly higher prevalence of diffuse lymphocytic infiltration in the AT group. Conclusions: AT was present in 31% of patients with SD. The presence of ANA positivity, anti-SS-A positivity, and diffuse lymphocytic infiltration appears to exert an influence on the association between these two diseases.

Objective: Our study aimed to evaluate the results of hepatitis B and C serology screening before biological therapy and chemotherapeutic treatments in internal medicine clinics (rheumatology, medical oncology, and gastroenterology) by comparing between departments and investigating the virus reactivation status. Material and Method: The study included 1147 patients aged 18 and over who were admitted to the medical oncology, rheumatology, and gastroenterology departments between 2019 and 2021 and received cytotoxic chemotherapy and biological treatment. HBsAg, Anti-HBs, Anti-HBc, and Anti-HCV data were used to screen for hepatitis. The departments were compared and evaluated based on the frequency of screening and reactivation. Results: Before undergoing chemotherapy or biological therapy, 77% of patients in oncology, 40% in rheumatology, and 43% in gastroenterology were fully screened for hepatitis. The rates of incomplete screening were 16%, 48%, and 52%, respectively, while 3%, 10%, and 4% were never screened. In total, reactivation was observed in twelve patients (1.0%), while no reactivation was observed in 1135 patients (99.0%). A statistically significant correlation was found between the departments and the presence of reactivation (p