Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA). The aim of this prospective study was to assess pulmonary involvement with high resolution computerized tomography (HRCT) in lifelong non-smoking patients with RA. Twenty-six female and eight male patients with a mean age of 45.26 +/- 11.6 years and without any evidence or symptoms of a respiratory disease were included in the study. Data were obtained regarding duration of disease, clinical symptoms and disease activity parameters. Standard chest roentgenographs, pulmonary function tests (PFT) and HRCT were performed. PFT was abnormal in eight (23.5%) and HRCT was abnormal in 23 patients (68%). The most frequent abnormalities obtained on HRCT were interstitial involvement including septal and peribronchial thickening and fibronodular infiltration, which were found in 23 patients, and bronchiectasis was found in nine patients. Using a highly sensitive technique such as HRCT the incidence of pulmonary abnormalities in asymptomatic rheumatoid patients may be much higher than previously reported.

We present the case of a young woman suffering from both ankylosing spondylitis and Behçet's disease, associated with a severe inflammatory arthritis. Although the HLA phenotype was positive for HLA-B27 and negative for HLA-B5, the clinical findings, especially the joint manifestations of Behçet's disease, seem to appear dominantly. The meaning of this rare combination was discussed with a review of the literature.

Objectives: This study investigates the demographic and clinical characteristics of patients with rheumatoid arthritis (RA) in Turkey, and attempts to identify strategies for the prevention, treatment, and support of RA. Patients and methods: A total of 2,359 patients (1,966 females, 393 males; mean age 51.6±12.5 years; range 18 to 75 years) with RA from 36 centers across Turkey, who were recorded in the Turkish League Against Rheumatism (TLAR) RA Registry between September 2007 and March 2011, were evaluated. Patients' demographic and clinical data were recorded. Disease activity, functional status, and radiographic damage were measured using the Disease Activity Score 28, the Health Assessment Questionnaire, and van der Heijde modified Sharp scoring method. Results: The mean duration of academic education received was 5.2±3.8 years, and 74.6% of the patients were homemakers. Non-biological diseasemodifying anti-rheumatic drugs were used by 91.0% of the patients, while 10.2% used biological disease-modifying anti-rheumatic drugs. The mean Disease Activity Score 28, Health Assessment Questionnaire, and Sharp scores were 4.0±1.4, 0.38±0.37, and 31.2±57.1, respectively. Of the patients, 17.8% were in remission and 14.1% had low disease activity rates, while 42.7% and 25.5% had moderate and high disease activity rates. Conclusion:The majority of patients with RA in Turkey are middle-aged homemakers. Despite the high rates of disease-modifying anti-rheumatic drugs use, the majority of patients had moderate and high disease activity. These findings indicate that treatment needs of RA patients are not met sufficiently.

A 14-year-old girl with familial Mediterranean fever (FMF) had had acute attacks of fever, abdominal pain, and arthritis for 4 years. Her last arthritis attack was protracted, leading to reflex sympathetic dystrophy (RSD) in her right lower extremity. Physical therapy along with sympathetic ganglion block and corticosteroid therapy was used for the treatment. To our knowledge, this is the first reported case of RSD arising in a patient with FMF. Early recognition of RSD in FMF patients is important, and physical therapy should be applied along with medical treatment.

Background:The number of geriatric patients and their mean age are increasing as life expectancy increases. Infections are one of the most important reasons for hospitalization, morbidity, and mortality among geriatric patients.Methods & Materials: The present study, retrospectively evaluated demographic characteristics, underlying diseases, and distribution of infections in patients aged 65 years who were hospitalized for treatment between January-1, 2010 and December-31, 2015, at the infectious diseases and clinical microbiology department.Results: Overall, 853 geriatric patients were included in this study, with 435 (51%) woman and 418 (49%) men, the mean age was 76.8 ± 7.3 years, and 86.2% of patients had at least one comorbid chronic disease. Hypertension, cardiovascular diseases and diabetes mellitus were most common comorbidities, and most common reasons for hospitalization included pneumonia (37.9%), urinary tract infection (22.9%) and cellulitis (7.7%). On evaluation of disease trends over years, rates of urosepsis, brucellosis, and Crimean Congo hemorrhagic fever were found decreased, tularemia cases were no longer observed, whereas fever of unknown etiology rates had increased. Moreover, beta-lactam antibiotics (88.2%), quinolones (21.1%) and macrolides (19.6%) were most frequent antibiotics used for treatment. The average length of hospital stay was 6.8 ± 5.1 days. Overall, 17 (2%) patients died during the study, 62 (7.3%) were transferred to other clinics, 53 patients (6.2%) were transferred to intensive care units, 51 (6%) were discharged with their current medical status, 670 (78.5%) were discharged with full recovery. Nursing home stay and being transferred from intensive care units were independent risk factors for mortality (p = 0.001).Conclusion: According to our results, age, presence of comorbidities, and mortality among patients transferred from intensive care units were high, and thus, this group of special patients should be more closely monitored. Taken together, it will be useful for healthcare facilities to calculate the proportion of their elderly patient population, and establish low-cost palliative care units for management of elderly patients with critical diseases. Concomitant chronic diseases further complicate geriatric cases, and thus, patient management becomes more challenging. Adequate knowledge regarding management of chronic diseases in such patients will ease follow-up of geriatric patients.