Background: Rheumatoid arthritis (RA) is a chronic inflammatory disabling autoimmune disorder. Little is known regarding the association between the gut microbiome and etiopathogenesis of RA. We aimed to dissect the differences in gut microbiomes associated with RA in comparison to healthy individuals and, in addition, to identify the shifts in the bacterial community in association with disease activity; Methods: In order to identify compositional shifts in gut microbiomes of RA patients, V3-V4 hypervariable regions of 16S rRNA were sequenced using Illumina MiSeq. In total, sixty stool samples were collected from 45 patients with RA besides 15 matched healthy subjects; Results: Notably, RA microbiomes were significantly associated with diverse bacterial communities compared with healthy individuals. Likewise, a direct association between bacterial diversity and disease activity was detected in RA patients (Kruskal Wallis; p = 0.00047). In general, genus-level analysis revealed a positive coexistence between RA and Megasphaera, Adlercreutzia, Ruminococcus, Bacteroides, Collinsella, and Acidaminococcus. Furthermore, Spearman correlation analysis significantly stratified the most dominant genera into distinct clusters that were mainly based on disease activity (r ≥ 0.6; p ≤ 0.05). The predictive metabolic profile of bacterial communities associated with RA could support the potential impact of gut microbiomes in either the development or recovery of RA; Conclusions: The overall shifts in bacterial composition at different disease statuses could confirm the cross-linking of certain genera either to causation or progression of RA.

Background and Objective Sleep difficulties tend to be more prevalent in rheumatoid arthritis (RA) patients than in the general population. Patients’ mental, physiological, and life quality are all dependent on receiving good quality sleep. In practice, RA is managed not only by rheumatologists but also by a variety of other specialists. To assess subjective sleep quality in RA patients and its relationship to disease activity, pain intensity, and psychological state.Methods Three hundred RA patients participated in a cross-sectional study in which they were evaluated clinically and underwent the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, and Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28-ESR). Two groups of RA patients were created based on the PSQI score. Group 1 included RA patients with good sleep, and Group 2 included RA patients with poor sleep.Results The study included 276 females and 24 males, with a mean age of 38.5 ± 8.8 years and a disease duration of 4.3 ± 3.8 years. Sleep disturbances were found in 65.3% of our RA patients, with habitual sleep efficiency being the most commonly affected component (50%), and 91% of the patients studied did not take any sleep medication. Poor sleep was linked to increased DAS28, pain, and different degrees of depressive symptoms. All PSQI components and total PSQI scores showed a significant correlation with pain and depressive symptom severity scores. However, no correlation was found with disease duration or erosive joint changes.Conclusions Patients with RA frequently encounter sleep problems. Individuals with RA exhibiting poor sleep quality are more likely to encounter varying degrees of depressive symptoms, disease activity flares, and more intense pain. This issue, as well as its expected consequences for RA disease parameters, should be recognized.

Background: Rheumatoid arthritis (RA) is an autoimmune systemic condition that primarily affects all synovial joints, eventually leading to deformity and clinical disability. Much progress has been made in the evaluation of inflammation and disease activity in recent years; however, other factors that can influence these patients’ quality of life, including depression, stress, fatigue, sleep problems, fibromyalgia, sexual activity, and obesity, are often not evaluated by rheumatologists. Our purpose was to explore depressive symptoms in patients with RA and determine how they connected to other aspects of the disease, including pain severity, disease activity, and sleep quality. Results: A cross-sectional study including 1200 patients with RA was performed. Paints with RA were classified into two groups based on the presence or absence of depressive symptoms using the Beck Depression Inventory-II (BDI-II). Group 1 included patients with both RA and depressive symptoms of varying severity; group 2 included patients with RA but without depressive symptoms. The patients underwent clinical evaluation and application of the Pittsburgh Sleep Quality Index (PSQI), Health Assessment Questionnaire for pain (HAQ-pain), and the Multidimensional Assessment of Fatigue scale (MAF). RA disease activity was evaluated using the DAS28 score. Depressive symptoms of varying severity were prevalent in 96% of our patients with RA, of whom 43.3% had minimal depression, while 13.7% had severe depression. The RA group with depression had a longer duration of disease, prolonged morning stiffness, and high disease activity measured by the DAS28 score than patients with only RA. In RA patients with concomitant depression, pain, sleep, and fatigue scores were also worse. Conclusions: The presence of depression among patients with RA was associated with worse DAS28, HAQ, PASQI, and fatigue scores. Screening and recognition of such psychosocial disorders may help patients achieve optimal disease control and a good outcome.

Background: Rheumatoid arthritis (RA) is a form of inflammatory disease whose clinical pattern is largely dependent on the presence of both anti-citrullinated protein antibodies and rheumatoid factor (RF). Although this is still debatable, seronegative RA seems to be a somewhat less serious condition. The present study aimed to evaluate ankle joint ultrasound in relation to RF status and disease activity in RA patients. Methods: A cross-sectional study involving RA patients from a single center was conducted. Laboratory test evaluations and clinical activity assessments were carried out. The ankle joint was examined using musculoskeletal ultrasound (US). Results: The study included 100 patients with established RA in total. Eighty-two patients tested positive for RF with a mean age of 42.3, whereas only 18 tested negative with a mean age of 39.6. Patients who tested positive for RF had a longer duration of illness (9.39 ± 5.39 vs. 4.56 ± 3.24). There were no differences in clinical activity scores between the seropositive and seronegative groups. The pathological US findings of any ankle joint showed no differences between the seropositive and seronegative groups. Patients with US findings of tibialis posterior tenosynovitis in the left ankle and synovitis and erosion in the right ankle, particularly in the tibiotalar and talonavicular joints, had significantly high Disease Activity Score 28-Erythrocyte sedimentation rate-scores. The increased disease activity was accompanied by significant erosions on both ankles. Conclusion: In terms of disease activity, there is no clinically significant difference between seropositive and seronegative RA patients. Sonographic ankle joint abnormalities do not appear to be associated with the patients’ RF status. High RA disease activity, on the other hand, is associated with synovitis and erosions, particularly in the talonavicular and tibiotalar joints, as well as tibialis posterior tenosynovitis.

Background: Osteoarthritis (OA) is a frequently complex joint disease that involves all joint components, including cartilage degeneration and new bone development. Dickkopf-1 (Dkk-1) regulates bone growth and repair in OA. The purpose of this study is to determine Dkk-1 blood levels in individuals with primary knee joint OA, as well as their associations with disease progression and severity. Methods: This study included 45 individuals with primary OA of the knee and 45 healthy participants. Demographic data, body mass index, Visual Analog Scale, and Western Ontario and McMaster Universities Arthritis questionnaire scores were gathered. On radiography, the Kellgren and Lawrence score was acquired. The knee joint ultrasonography results were documented. The blood level of Dkk-1 was determined using the enzyme-linked immunosorbent assay method. Results: Dkk-1 levels in the blood were substantially higher in patients with OA than in healthy persons. Serum Dkk-1 levels appeared to have a significantly inverted relationship with radiological OA grades in knee OA (P < 0.001). Dkk-1 serum levels were significantly lower in individuals with ultrasonographic knee effusion (median = 3.2, interquartile range [IQR] = 3.1–4.16) than in those without effusion (median = 4.79, IQR = 4.04–5.09). Furthermore, there was a strong correlation between Dkk-1 levels and ultrasonographically measured femoral cartilage thickness. Conclusion: Dkk-1 is an interesting radiological indicator associated with degenerative articular joint disease. It may have a crucial function in slowing the process of degeneration in knee OA and reflecting the disease’s radiographic and clinical severity.

To study short-term impact of sleeve gastrectomy (SG) on bone outcomes such as bone metabolism, bone turnover, and bone mineral density (BMD). The study included 69 bariatric surgery-eligible patients (37 males and 32 females) ranging in age from 30 to 45 years. Dual-energy x-ray absorptiometry (DXA) scans were used to calculate areal BMD (g/cm2) and T scores in the total hip, femoral neck, and lumbar spine (L1-L4). Serum levels of C-terminal telopeptide (CTX), type 1 collagen propeptide (P1NP), parathyroid hormone (PTH), and 25-hydroxy vitamin D (25(OH)D) were measured. All patients received baseline and 12-month postoperative evaluations. The study included 69 individuals, 37 (53.62%) male and 32 (46.38%) female, aged 36.86 ± 6.31, with morbid obesity (mean BMI 46.32 ± 4.21 kg/m2) who underwent SG. The mean levels of circulating calcium, 25(OH)D, and PTH did not change significantly after surgery (p > 0.05) and remained within normal ranges twelve months later. Following surgery, bone turnover markers increased significantly (p < 0.05), with CTX showing a higher overall percentage increase than P1NP. The total hip and femoral neck BMD decreased significantly after surgery, but there was no significant difference in lumbar spinal BMD before and after surgery. This study demonstrates that BMD decreases drastically after SG, and bone loss is more pronounced at the hip and femoral neck sites 12 months after surgery than at the lumber spine. Regular follow-ups, including BMD measurements, are recommended after bariatric surgery, at least once a year.