Ayşegül Özdoğan Bircan

To examine the relationship between oral handicap, clinical characteristics, psychosocial status, and quality of life in patients with systemic sclerosis (SSc). This cross-sectional study included 99 patients with SSc. Oral handicap was assessed using the Mouth Handicap in Systemic Sclerosis Scale (MHISS). Social appearance anxiety, anxiety/depression symptoms, resilience, and quality of life were evaluated using the Social Appearance Anxiety Scale, Hospital Anxiety and Depression Scale, Brief Resilience Scale, and World Health Organization Quality of Life–BREF (WHOQOL-BREF), respectively. Statistical and hierarchical multiple regression analyses were also performed. Oral handicap was associated with female sex (rho = 0.220, p = 0.029) and diffuse cutaneous SSc subtype (rho = − 0.482, p < 0.001). Oral handicap showed strong positive correlations with the facial and total modified Rodnan Skin Score (rho = 0.851 and rho = 0.737; both p < 0.001). Positive associations were also observed for gastrointestinal (GI) involvement, calcinosis, telangiectasia, Scl-70 positivity, and digital ulcers (p < 0.002 for all). MHISS scores were positively correlated with anxiety, depression, and social appearance anxiety, and negatively correlated with all WHOQOL-BREF domains (p < 0.001 for all). In the regression analyses, mRSS (β = 0.484, p < 0.001), GI involvement (β = 0.210, p = 0.006), and anxiety scores (β = 0.183, p = 0.036) remained independently associated with oral impairment. The clinical model explained an additional 54% of variance, with a further 5% contributed by psychosocial variables. Oral impairment in SSc reflects both clinical disease burden and psychosocial distress, underscoring its multifactorial nature.

Elastographic data regarding thyroid involvement in systemic sclerosis (SSc) are limited. This study aimed to evaluate thyroid parenchymal stiffness in patients with SSc using two-dimensional shear wave elastography (2D-SWE) and to investigate its relationship with clinical parameters. This single-center, cross-sectional case-control study included 36 SSc patients and 36 age- and gender-matched healthy controls. All participants underwent thyroid ultrasonography and 2D-SWE. Thyroid volume was calculated using the ellipsoid formula, and elasticity values were recorded in kilopascals (kPa). Clinical characteristics, laboratory parameters, and disease severity indices were recorded, and correlation analyses were performed. Thyroid volume and isthmus thickness were similar between groups (all p > 0.05; d = 0.10-0.35). Right, left, and total thyroid elasticity values were significantly higher in SSc patients than in controls before and after smoking adjustment (all unadjusted p ≤ 0.001; all adjusted p ≤ 0.007; d = 0.83, 0.79, and 0.90, respectively). Right lobe elasticity correlated weakly with erythrocyte sedimentation rate (r = 0.355; p = 0.034), while left and total thyroid elasticity correlated moderately with ejection fraction (r = 0.423; p = 0.010 and r = 0.390; p = 0.019, respectively). No significant associations were found with disease duration, modified Rodnan skin score, EUSTAR Activity Index, Medsger Disease Severity Score, autoantibody status, or major organ involvement. In SSc, thyroid parenchymal stiffness increases without volume change. This suggests that the fibrotic process may be reflected in the thyroid tissue at a subclinical level. Thyroid elastography may be a potential method for evaluating organ-specific fibrotic changes in SSc; further large-scale and prospective studies are needed to clarify its clinical significance.

Rheumatoid arthritis (RA) is an autoimmune disease characterised by systemic inflammation, with gastrointestinal symptoms being among the most common extra-articular manifestations. Functional gastrointestinal disorders (FGIDs), which occur in the absence of an organic cause, are reported more frequently in patients with autoimmune diseases. This study investigated the rate of FGIDs in RA patients, its relationship with RA disease activity, and its effect on the quality of life of RA patients. All RA patients completed the Rome IV questionnaire, the Short Form 12 (SF-12), and the Health Assessment Questionnaire (HAQ) to assess disease and general health. The Disease Activity Score (DAS 28), the number of tender and swollen joints, and acute-phase reactant levels were used to assess disease activity, with results recorded together with demographic data. Of the 115 RA patients, 54.8% had FGIDs, with the most common type being functional dyspepsia (FD) (39.1%). Other diagnoses included irritable bowel syndrome (16.5%), functional constipation (13.9%), and functional diarrhoea (7.8%). Patients with FGIDs had higher DAS28 scores compared to those without (median 3.77 [interquartile range: 2.68] vs. 2.96 [1.99]; p=0.017). After applying the Bonferroni correction for multiple tests (corrected significance level p<0.0042), we found that correlations between functional constipation and functional dyspepsia and quality of life outcomes were not statistically significant. FGIDs are common among RA patients and are associated with more severe symptoms and reduced quality of life. Their management may involve various strategies.

Background/Aims: Primary Sjögren’s syndrome (pSS) is an autoimmune disease that can affect several systems. The purpose of this study was to examine the connection between primary Sjögren’s disease activity and the CRP-albumin-lymphocyte index (CALLY) and the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, 2 novel immunonutritional indicators that have not yet been applied to rheumatological disease activation. Materials and Methods: This cross-sectional study included 89 patients with pSS and 113 age- and sex-matched individuals. The relationship between haematological, inflammatory, immunonutritional biomarkers, and disease activation was investigated, as were the differences between the groups. Results: Eighty-nine patients (96.6% female, mean age 53.4 ± 15.0 years) and 113 control subjects (97.3% female, mean age 50.8 ± 14.9 years) were included in the study. The levels of C-reactive protein (CRP), erythrocyte sedimentation rate, red cell distribution width, neutrophil lymphocyte ratio, monocyte lymphocyte ratio, platelet lymphocyte ratio, and C-reactive protein albumin ratio were significantly higher in the group of patients with pSS compared to the control group (all; P < .001). Systemic immuneinflammation index and systemic inflammatory response index were significantly elevated in the patient cohort compared to the control group (P = .002 and P = .048, respectively). The CALLY index and HALP score were negatively correlated with EULAR Sjögren’s syndrome disease activity index (P < .001 for both). Conclusion: The CALLY index and HALP score represent a novel approach to assessing disease activity and prognosis in a number of conditions, including stroke, myocardial infarction, osteoarthritis, pulmonary thromboembolism, asthma, chronic obstructive pulmonary disease, and many types of cancer. They may also be useful as a guide to disease activity and monitoring in pSS.

The aim of this study was to explore the link between fear of falling and factors that may contribute to falls in patients with primary Sjögren’s syndrome (pSS). Our study included a total of 67 patients with pSS, aged between 18 and 65. The following tests were performed on each of them by the same researcher: (I) Pain Quality Assessment Scale (PQAS); (II) Berg Balance Scale (BBS); (III) Pittsburgh Sleep Quality Index (PSQI); (IV) Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); (V) Tampa Kinesiophobia Fatigue Scale Questionnaire (TSK-F); (VI) International Falls Efficiency Scale (FES-I); (VII) Timed Up And Go Test (TUG). Disease activities were recorded using the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) criteria. The following factors were associated with a fear of falling: (I) Deterioration in sleep quality (p = 0.031), (II) A decline in general health perception (p < 0.001), (III) Increased severity of pain (p < 0.001), (IV) Kinesiophobia (p < 0.001), (V) Difficulties with timely getting up and walking (p < 0.001), (VI) Increased disease activity (p < 0.001). There is no information available regarding the prevalence or contributing factors of fear of falling in individuals with pSS. This is the first study to examine fear of falling and contributing factors cross-sectionally in a sample of adults with pSS. These findings could aid in the development of a screening instrument to find modifiable risk factors for individuals with pSS who are susceptible to falling anxiety.

Objectives Microvascular damage is thought to play a role in the pathogenesis of sarcoidosis. We aimed to evaluate the nailfold capillaroscopy (NVC) pattern to detect microvascular changes in patients with sarcoidosis and the relationship of capillaroscopic parameters with clinical variables and disease-related measurements. Patients and methods Forty-two patients with sarcoidosis and 42 age- and sex-matched patients with systemic sclerosis (SSc) and healthy individuals were included in this cross-sectional case–control study. Patients aged 18–80 years who met the current American Thoracic Society criteria for sarcoidosis were included. NVC was performed by a digital microscope under a magnification of × 200. Capillary density, number of dilated, giant and neoangiogenic capillaries, capillary loop diameter, capillary shape, micro-hemorrhages, and number of avascular areas, were evaluated by an assessor who was blind to the groups allocation. Results Among the capillaroscopic parameters, neoangiogenesis and dilated capillaries, which can be seen in the pattern of scleroderma, were detected in patients with sarcoidosis but not significantly different from the control group (p = 0.055; p = 0.433, respectively). The rate of tortuosity and crossing capillaries of 50% and above was significantly higher in the sarcoidosis group than in SSc and healthy controls (p < 0.05). In patients with sarcoidosis, the only statistically significant finding was; forced expiratory volume (FEV1) in one second was lower in patients with a crossed capillary rate > 50% than in patients with a crossed capillary rate of less than 50% (FEV1; 87.21 ± 19.3, 102.5 ± 14.8, p = 0.04; respectively). Conclusion Patients with a diagnosis of sarcoidosis have different capillaroscopic patterns. The presence of these nonspecific abnormal patterns may reflect microvascular damage in the pathophysiology of sarcoidosis. Key Points • Microvascular damage may play a role in the pathogenesis of sarcoidosis. • There may be some nonspecific abnormal findings in capillaroscopy findings in sarcoidosis. • Capillaroscopy may be valuable in reflecting sarcoidosis lung injury.