Background: Fibromyalgia syndrome (FMS) is a chronic condition causing widespread pain, fatigue, and sleep disturbances. Conventional treatments often provide limited relief, leading to growing interest in complementary therapies like ozone therapy. Objective: This study aims to retrospectively evaluate the short- and medium-term efficacy of ozone therapy in patients with FMS, focusing on changes in pain, functional status, sleep quality, fatigue, anxiety, and depression. Methods: Twenty-five FMS patients treated at the Physical Medicine and Rehabilitation outpatient clinic of University Hospital were included. Participants underwent a 10-session major ozone autohemotherapy protocol administered twice weekly. Key outcomes were measured using the Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS) at baseline, post-treatment, and six months post-treatment. Generalized Estimating Equations were used for data analysis. Results: VAS scores decreased from 6.4 to 3.68 post-treatment (p < 0.001) and partially increased to 4.12 at six months (p = 0.01). Similar trends were observed for FIQ, HADS, PSQI, and FSS. Tender points declined from 14.36 to 9.8 post-treatment (p < 0.001) and remained stable at 10.12 at six months (p = 0.289). FIQ scores improved from 59.2 to 39.08 post-treatment (p < 0.001) and stabilized at 40.12 at six months (p = 0.328). Conclusion: Ozone therapy demonstrates promising short- and medium-term efficacy in managing FMS symptoms, with significant improvements post-treatment. However, partial symptom recurrence at six months suggests the need for optimized protocols and further studies to ensure long-term sustainability.

OBJECTIVE: Patient-reported outcome measures assessing self-reported disability, pain, and function are primary endpoints for determination of optimal treatment strategies in hand-related conditions. In this study, we aimed to compare responsiveness

Pregnancy planning in patients with rheumatic diseases (RD) is a multifaceted public health issue that includes complex strategies targeting underlying disease activity and reproductive potential. Patients with autoimmune diseases, including those with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren syndrome, systemic sclerosis (SSc), and spondyloarthritis, present with heightened risks of adverse maternal and fetal outcomes, including miscarriage, fetal growth restriction, preeclampsia, preterm birth, and increased utilization of assisted reproductive technologies. Available evidence suggests that conception during sustained disease remission, alongside tailored drug therapies, enhances maternal-fetal outcomes. Critical determinants of obstetric prognosis include disease-specific activity indices, serologic markers, organ involvement, and prior gonadotoxic exposures which compromise ovarian reserve. Structured preconception counseling that integrates contraception strategies, fertility preservation, ovarian reserve assessment, and multidisciplinary follow-up is essential to mitigate these risks. Current management paradigms advocate the continuation of pregnancy-compatible disease-modifying antirheumatic drugs (DMARDs), while strictly avoiding teratogenic therapies. Despite these advances, substantial unmet needs exist in early risk stratification, patient education, and systematic integration of reproductive health counselling into routine RD management. This review synthesizes contemporary evidence, delineates existing gaps, and provides a strategic framework for optimizing pregnancy planning and reproductive outcomes in women with RDs. The review addresses the key domains, including preconception risk stratification, disease-specific considerations, fertility assessment, ovarian reserve evaluation, and optimization of drug therapies. A multidisciplinary, treat-to-target approach is essential to improve pregnancy outcomes and long-term maternal health in this high-risk population.

Introduction: Guidelines have great importance in revealing complex and chronic conditions such as axial spondyloarthropathy. The aim of this study is to compare the answers given by various large language models to open-ended questions created from ASAS–EULAR 2022 guidance. Materials and Methods: This was a cross-sectional and comparative study. A total of 15 recommendations in the ASAS–EULAR 2022 guideline were derived directly from their content into open-ended questions in a clinical context. Each question was asked to the ChatGPT-3.5, GPT-4o, and Gemini 2.0 Flash models, and the answers were evaluated with a seven-point Likert system in terms of usability, reliability, Flesch–Kincaid Reading Ease (FKRE) and Flesch–Kincaid Grade Level (FKGL) metrics for readability, Universal Sentence Encoder (USE) and ROUGE-L for semantic and surface-level similarity. The results of different large language models were statistically compared, and p < 0.05 was revealed as statistically significant. Results: Better FKRE and FKGL scores were obtained in the Google Gemini 2.0 program (p < 0.05). Reliability and usefulness scores were significantly higher for ChatGPT-4o and Gemini 2.0 (p < 0.05). ChatGPT-4o yielded significantly higher semantic similarity scores compared to ChatGPT-3.5 (p < 0.05). There was a negative correlation between FKRE and FKGL scores and a positive correlation between reliability and usefulness scores (p < 0.05). Conclusions: It was determined that ChatGPT-4o and Gemini 2.0 programs gave more reliable, useful, and readable answers to open-ended questions derived from the ASAS–EULAR 2022 guidelines. These programs may potentially assist in supporting treatment decision-making in rheumatology in the future.