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Clinical Rheumatology

Cliffton Chan, Anne Krahe, Yim Tang Lee, Leslie L Nicholson
Some commonly reported systemic features of joint hypermobility syndrome (JHS)/Ehlers-Danlos syndrome hypermobility type (EDS-HT) are absent from nosologies due to insufficient validity. The primary aim was to examine the hypothesised high prevalence and frequency of orthostatic intolerance, easy bruising, and urinary incontinence in adults with JHS/EDS-HT and secondarily to determine the association between extent of generalised joint hypermobility (GJH) and these systemic features. A cross-sectional cohort study was conducted via online recruitment of medically diagnosed JHS/EDS-HT patients...
September 19, 2018: Clinical Rheumatology
Selcan Özgüçlü, Türker Duman, Funda Seher Özalp Ateş, Orhan Küçükşahin, Sevgi Çolak, Ümit Ölmez
Behçet's disease (BD) is a chronic inflammatory disease. The etiopathogenesis of BD is not well understood and several cytokines and genetic factors have been investigated. Interleukin (IL)-37, which a member of IL-1 family is an anti-inflammatory cytokine. The aim of the study was to analyze serum IL-37 level and IL-37 gene polymorphisms to assess its possible role in BD. Two hundred twenty-three patients with BD and 80 healthy controls (HC) were enrolled. Serum IL-37 level was measured using an enzyme-linked immunosorbent assay (ELISA)...
September 18, 2018: Clinical Rheumatology
Xue Li, Yu-Quan Qian, Na Liu, Rong Mu, Yu Zuo, Guo-Chun Wang, Yuan Jia, Zhan-Guo Li
To investigate the clinical pattern, survival rate, causes of death and risk factors in a large cohort of Chinese Han patients with systemic sclerosis (SSc). Inpatients treated from 2002 to 2014 were included in this study. Patients were classified into diffuse cutaneous SSc (dcSSc), limited cutaneous SSc (lcSSc), and SSc-overlap syndrome groups. Data were analyzed using Chi-squared tests, Kaplan-Meier curves, log-rank tests, and Cox proportional hazards modeling. Among a total of 201 patients, dcSSc (50.2%) was the major subtype, followed by lcSSc (30...
September 18, 2018: Clinical Rheumatology
Sung Soo Ahn, Juyoung Yoo, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
We investigated whether albumin to globulin ratio (AGR) at diagnosis may be associated with all-cause mortality in immunosuppressive drug-naïve patients with microscopic polyangiitis (MPA). We retrospectively reviewed the medical records of 88 MPA patients, who were first classified and in whom medications was first initiated in our tertiary Hospital. We collected clinical and laboratory data as well as the rate of all-cause mortality. AGR at diagnosis was calculated as a ratio of serum albumin over globulin fraction (protein-albumin)...
September 15, 2018: Clinical Rheumatology
Min Hui, Jiuliang Zhao, Zhuang Tian, Jieying Wang, Junyan Qian, Xiaoxi Yang, Qian Wang, Mengtao Li, Yan Zhao, Xiaofeng Zeng
Pulmonary arterial hypertension (PAH) is a severe complication and leading cause of mortality in patients with primary Sjogren's syndrome (pSS). This study was to investigate the overall survival rates and the utility of red blood cell distribution width (RDW) as a potential prognostic factor of pSS-PAH. This cohort study retrospectively enrolled 55 patients with pSS-PAH who were followed up at the Department of Rheumatology of Peking Union Medical College Hospital (PUMCH) between August 2007 and May 2017. The patients were stratified according to the level of RDW (≤ 15...
September 14, 2018: Clinical Rheumatology
Hironari Hanaoka, Harunobu Iida, Tomofumi Kiyokawa, Yukiko Takakuwa, Kimito Kawahata
To evaluate the efficacy and tolerability of mycophenolate mofetil (MMF) with or without calcineurin inhibitors (CNIs) in patients with inflammatory myopathy taking prednisolone, but refractory to conventional immunosuppressive therapy. The records of patients with inflammatory myopathy who had previously failed treatment with at least one immunosuppressant were retrospectively evaluated. We selected patients treated with MMF and divided them into two groups depending on whether or not there was concomitant use of CNIs...
September 14, 2018: Clinical Rheumatology
Lisanne Renskers, Ron J J C van Uden, Anita M P Huis, Sanne A A Rongen, Steven Teerenstra, Piet L C M van Riel
Patient-reported outcome measures (PROMs) are increasingly used in the assessment of patients with rheumatoid arthritis (RA). The aim of this study was to assess the construct validity and reproducibility of four types of PROMs (numerical rating scale (NRS), visual analogue scale (VAS), verbal rating scale (VRS), and Likert scale). In addition, patients' preference for one of these PROMs was measured. Patients with stable RA and no change in pain medication or steroid medication (n = 211) were asked to complete a questionnaire directly following, and 5 days after their outpatient visit...
September 12, 2018: Clinical Rheumatology
Jiunn-Horng Kang, Sudha Xirasagar, Herng-Ching Lin, Pai-Feng Kao, Li-Chin Sung
Specific data regarding the full range of stroke outcomes among patients with rheumatoid arthritis (RA) are lacking. This study aimed to investigate outcomes in RA patients hospitalized for a stroke. The study retrieved data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 26,336 patients who were hospitalized for stroke treatment. Of these patients, 736 patients with a prior diagnosis of RA before the index hospitalization were selected as the study group. We selected 2208 age-sex-matched patients without RA as the comparison group...
September 12, 2018: Clinical Rheumatology
Zheng Zhao, Gang Wang, Yanyan Wang, Jinshui Yang, Yiwen Wang, Jian Zhu, Feng Huang
In recent years, MRI has been regarded as a major diagnostic tool for spondyloarthritis (SpA), and anti-TNF therapy has been widely confirmed as an effective treatment strategy. This study was designed to investigate the correlation between the secreted protein dickkopf-1 (Dkk-1) and abnormal findings on magnetic resonance imaging (MRI) through a prospective study of 30 cases of SpA. Thirty patients with active SpA were included, all treated with recombinant human tumor necrosis factor (TNF) receptor-antibody fusion protein (YiSaiPu) injection at 50 mg/week for 6 months...
September 11, 2018: Clinical Rheumatology
H Lomzenski, R Thibodaux, M Guevara
RPGN can be subdivided into three categories on an immunopathologic basis: pauci-immune glomerulonephritis (PIGN), anti-glomerular basement membrane glomerulonephritis (anti-GBM disease), or immune complex-mediated glomerulonephritis (GN). PIGN is the most common cause of RPGN (80% of cases). The most common etiology of PIGN is anti-neutrophil cytoplasmic antibody (ANCA)-associated GN, which accounts for up to 90% of PIGN. PIGN is unique in that few to no immunoglobulin deposits are seen on glomerular immunofluorescence (IF) and electron microscopy (EM), but it is important to remember that dysregulation of the alternative pathway may result in the deposition of complements leading to inflammatory injury even in PIGN...
September 10, 2018: Clinical Rheumatology
K Lakota, T Švec, T Kveder, S Sodin-Šemrl, P Žigon, A Ambrožič, M Ogrič, S Markez, B Božič, M Tomšič, S Čučnik
Autoantibodies against dsDNA are utilized for the diagnosis and prognosis of SLE as they are highly specific and correlate with disease activity/renal involvement. However, different detection methods are used in routine diagnostic laboratories. Farr radioimmunoassay (Farr-RIA) has been designated as the preferred method, since it provides very specific and at the same time quantitative results, enabling follow-up of level variations over time. Using intercalating fluorescent dsDNA dye would enable all the benefits of Farr-RIA without the radioactive material and organic solvents...
September 10, 2018: Clinical Rheumatology
Minning Shen, Junyu Zhang, Kai Qian, Chunmei Li, Wenyu Xu, Bingjie Gu, Xiaoqin Wang, Qijie Ren, Leilei Yang, Hai Yuan, Dinglei Su, Xingguo Chen
To retrospectively analyze the efficacy and safety of febuxostat on gout patients with low serum uric acid level. A study was conducted in Nanjing First Hospital from October 2015 to September 2016. Thirty nine acute gouty arthritis patients from the emergency and outpatient department were included. Patients met the 2015 Gout Classification Criteria revised by American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and had urate deposition around the joints detected by dual-energy computerized tomography (DECT)...
September 9, 2018: Clinical Rheumatology
Serena Fasano, Domenico Paolo Emanuele Margiotta, Luciana Pierro, Luca Navarini, Antonella Riccardi, Antonella Afeltra, Gabriele Valentini
Prolonged remission (PR), defined as a 5-year consecutive period of no disease activity based on SLEDAI-2K, has been reported to be associated with a lower damage accrual over time in patients with systemic lupus erythematosus (SLE), as the consequence of a lower activity burden. Since disease activity is considered to play a role in the incidence of cardiovascular disease (CVD), we investigated the relationship, if any, between PR and the occurrence of a subsequent first CV event in patients with SLE. Out of 488 patients consecutively admitted to two tertiary Italian centers from November 1, 2000, to December 31, 2016, the 294 patients, who had been followed at least for 5 years, had not experienced any CV event at admission, and had been visited biannually during follow-up, were considered for the present study...
September 7, 2018: Clinical Rheumatology
J A Walsh, A B Gottlieb, B Hoepken, T Nurminen, P J Mease
To report long-term efficacy of certolizumab pegol (CZP) treatment with and without concomitant DMARDs in patients with psoriatic arthritis (PsA). RAPID-PsA (NCT01087788) was double-blind and placebo-controlled to week 24, dose-blind to week 48, and open-label to week 216. Patients had active PsA with ≥ 1 failed DMARD. At baseline, patients were randomized 1:1:1 to CZP 200 mg every 2 weeks: CZP 400 mg every 4 weeks: placebo. CZP-randomized patients continued their dose into open-label. Observed case efficacy data are reported to week 216 for week 0 CZP-randomized patients (dose combined) with and without baseline DMARD use (DMARD+/DMARD-)...
September 6, 2018: Clinical Rheumatology
Thurayya Arayssi, Manale Harfouche, Andrea Darzi, Samar Al Emadi, Khalid A Alnaqbi, Humeira Badsha, Farida Al Balushi, Carole Dib, Bassel Elzorkany, Hussein Halabi, Mohammed Hammoudeh, Wissam Hazer, Basel Masri, Mira Merashli, Mohammed Omair, Nelly Salloum, Imad Uthman, Sumeja Zahirovic, Nelly Ziade, Raveendhara R Bannuru, Timothy McAlindon, Mohamed A Nomier, Jasvinder A Singh, Robin Christensen, Peter Tugwell, Holger Schünemann, Elie A Akl
In the original version of this article the first name of the co-author was incorrectly spelled as "Khaled A. Alnaqbi". The correct spelling should have been "Khalid A. Alnaqbi". This is now presented correctly in this article.
September 6, 2018: Clinical Rheumatology
Wai Chung Yong, Anawin Sanguankeo, Sikarin Upala
In rheumatoid arthritis and systemic lupus erythematosus, cardiovascular disease is frequently one of the leading causes of mortality or morbidity. Studies have shown that acute systemic inflammation and chronic systemic vasculitis are associated with endothelial dysfunction and atherosclerotic plaque formation, subsequently leading to cardiovascular disease. This meta-analysis aimed to explore the association of subclinical atherosclerosis and arterial stiffness in primary Sjogren's syndrome. A comprehensive search of the MEDLINE and Embase databases was performed from date of inception through August 2017...
September 3, 2018: Clinical Rheumatology
Jonathan Gervais-Hupé, Jasmine Pollice, Jackie Sadi, Lisa C Carlesso
Our purpose was to determine the validity of the Central Sensitization Inventory (CSI) with psychophysical tests, psychological and physical factors in patients with Knee Osteoarthritis (KOA). Patients with KOA were recruited from three Montreal hospitals. Psychophysical tests (pressure pain threshold, conditioned pain modulation, temporal summation) were conducted and questionnaires administered to determine the presence of neuropathic pain, somatization, anxiodepressive symptoms, pain catastrophizing (PC), and widespread pain (WSP)...
September 3, 2018: Clinical Rheumatology
Qian Gao, Naqiang Lv, Aimin Dang, Zuozhi Li, Jue Ye, Deyu Zheng
Takayasu arteritis (TA) is a chronic inflammatory disease. Interleukin (IL)-6 and IL-10 are important cytokines involved in the immune response of TA in some ethnicities. We investigated whether the single-nucleotide polymorphism (SNP) of IL-6 and IL-10 genes and their expressions were associated with TA in a Chinese Han population. One hundred eighty-four TA patients and 235 healthy controls (HC) were recruited. DNA and RNA were extracted from peripheral blood cells. Genotyping of IL-6 and -10 was performed using polymerase chain reaction-ligase detection reaction (PCR-LDR)...
August 31, 2018: Clinical Rheumatology
Ferhat Demir, Alper Han Çebi, Mukaddes Kalyoncu
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood, yet its etiology is unknown. It is known that microribonucleic acids (miRNAs) play a role in immunoregulation. We aimed to evaluate the plasma expression of some candidate miRNAs that are associated with the pathogenesis of autoimmunity. Thirty-one patients diagnosed with JIA and age-sex-matched 31 healthy children were enrolled for the study. The plasma levels of four candidate miRNAs (miRNA-16, miRNA-155, miRNA-204, and miRNA-451), which are known to be associated with autoimmunity, were examined in all the subjects...
August 31, 2018: Clinical Rheumatology
Yusuke Suzuki, Hirotaka Iijima, Yuto Tashiro, Yuu Kajiwara, Hala Zeidan, Kanako Shimoura, Yuichi Nishida, Tsubasa Bito, Kengo Nakai, Masataka Tatsumi, Soyoka Yoshimi, Tadao Tsuboyama, Tomoki Aoyama
To compare the efficacy and adherence rates of two parallel home exercise therapy programs-multiple exercise (training and stretching the knee and hip muscles) and control (training the quadriceps muscles)-on knee pain, physical function, and knee extension strength in community-dwelling elderly individuals with pre-radiographic knee osteoarthritis (OA). One hundred patients with medial knee pain were randomly allocated to one of two 4-week home exercise programs. Individuals with a Kellgren/Lawrence (K/L) grade 0 or 1 OA (pre-radiographic knee OA) in the medial compartment were enrolled...
August 30, 2018: Clinical Rheumatology
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