Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune condition that primarily affects the joints and periarticular soft tissues. In the past two decades, the discovery of new biomarkers has contributed to advances in the understanding of the pathogenesis and natural history of RA. These biomarkers, including genetic, clinical, serological and imaging biomarkers, play a key role in the different stages and aspects of RA, from the so called ‘pre-clinical RA’, which is characterized by subclinical pathological events, such as autoimmunity and inflammation, to diagnosis (including differential diagnosis), treatment decision making and disease monitoring. This review will provide an overview on the current role of traditional and newer biomarkers in the main aspects of RA management, from the identification of individuals ‘at-risk’ of RA who are likely to progress to clinically evident disease, to ‘early’ diagnosis of RA, prognosis, precision medicine, and prediction of response to treatment.

Background/aim: Systemic sclerosis (SSc) is a chronic systemic disease characterized by vascular damage, autoimmunity, and fibrosis in the skin and internal organs. In this study, we tried to determine the causes of severe infection in patients with SSc and to reveal the factors associated with severe infection. Materials and methods: We retrospectively examined 214 SSc patients between January 2010 and August 2020. Forty-seven patients with at least one severe infection and 167 patients without severe infection were compared. Results: A total of 76 episodes of severe infections were detected in 47 (22%) patients. Common infections included pneumonia, infected digital ulcer, urinary tract infections, and osteomyelitis. Female patients had a higher frequency in the group without severe infection (91.6% vs. 80.9%, p = 0.035). Patients with severe infections had a higher frequency of digital ulcers (p < 0.001), cardiac (p = 0.002), and GIS involvement (p < 0.001). In multivariable analysis, digital ulcer presence (OR: 2.849 [1.356-5.898] (p = 0.006) and cardiac involvement (OR: 2.801 [1.248-6.285]) were associated with severe infection. Of the patients with severe infections, 34% had recurrent severe infections. There was no difference in demographic and clinical characteristics between patients with recurrent and nonrecurrent severe infections. Conclusion: The presence of digital ulcer and cardiac involvement seem to be associated with a severe infection in patients with systemic sclerosis. In patients with cardiac involvement and digital ulcers, more careful attention may be required for the development of severe infections.

Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare au-toimmune disease usually involving small vessels and progressing with necrotizing inflammation. Treatment requires long-term use of immunosuppressive agents to inhibit disease activity. Serious infections (SIs) are a common complication in AAV. Objective: The aim of this study was to identify the risk factors for serious in-fections which required hospitalization in patients with AAV. Methods: In this retrospective cohort study., we included 84 patients admitted to the Ankara University Faculty of Medicine in the last 10 years with a diagno-sis of AAV. Results: In 42 (50%) of 84 patients followed up with the diagnosis of AAV, an infection requiring hospitalization was identified. The patients' total corticosteroid dose, use of pulse steroids, induction regimen, levels of C-reactive protein (CRP) and the presence of pulmonary and renopulmonary involvement were found to be associated with the frequency of infection (p=0.015, p=0.016, p=0.010, p=0.03, p= 0.026 and p=0.029, respectively). In multivariable analysis, it was found that renopulmonary involvement (p=0.002, HR=4.95, 95% CI= 1.804-13.605), age of over 65 (p=0.049, HR=3.37, 95% CI=1.004-11.369) and high CRP levels (p=0.043, HR=1.006, 95% CI=1.000-1.011) constituted independent predictors of serious infection risk. Conclusion: The frequency of infection is known to be increased in ANCA-associated vasculitis. Our study showed that renopul-monary involvement, age and elevated CRP levels on admission are independent risk factors of infection.

To investigate the relationship of blood pH and bicarbonate levels with sleep disorders in patients with end-stage renal disease. The cross-sectional study was conducted at Kocaeli Derince Health Practice and Research Center, Kocaeli, Turkey, in July 2015, and comprised stable haemodialysis patients aged over 18 years who had undergone at least 3 months of treatment. The Pittsburgh sleep quality index was used to assess sleep quality, and the Epworth sleepiness scale was used to assess sleepiness. Blood urea nitrogen levels were measured to determine dialysis success. SPSS 17 was used for data analysis. Of the 62 patients, 22(35.4%) were good sleepers, while 40(65.6%) were bad sleepers, and 11(17.7%) had excessive daytime sleepiness. There was no significant difference between poor and good sleepers with respect to venous pH (p=0.197) and bicarbonate (p=0.305) levels. Also, the two levels did not differ significantly between patients with routine or excessive daytime sleepiness (p>0.05). Patients with excessive daytime sleepiness had significantly lower calcium (p=0.046) and higher creatinine (p-0.014) levels and were older (p=0.01). Age was the only independent predictor of both the index and the scale scores (p<0.05 each). Sleep disorders and sleepiness were found to be high in haemodialysis patients and there was a strong correlation between sleep disturbance and age. There was no correlation of either state with patients' bicarbonate or venous pH values.